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A generalized similarity formulation extending the work of Terrill (1967) for Couette–Poiseuille flow in the annulus between concentric cylinders of infinite extent is given. Boundary conditions compatible with the formulation allow a study of the effects of inner and outer cylinder transpiration, rotation, translation, stretching and twisting, in addition to that of an externally imposed constant axial pressure gradient. The problem is governed by η, the ratio of inner to outer radii, a Poiseuille number, and nine Reynolds numbers. Single-cylinder and planar problems can be recovered in the limits η→0 and η→1, respectively. Two coupled primary nonlinear equations govern the meridional motion generated by uniform mass flux through the porous walls and the azimuthal motion generated by torsional movement of the cylinders; subsidiary equations linearly slaved to the primary flow govern the effects of cylinder translation, cylinder rotation, and an external pressure gradient. Steady solutions of the primary equations for uniform source/sink flow of strength F through the inner cylinder are reported for 0η1. Asymptotic results corroborating the numerical solutions are found in different limiting cases. For F<0 fluid emitted through the inner cylinder fills the gap and flows uniaxially down the annulus; an asymptotic analysis leads to a scaling that removes the effect of η in the pressure parameter β, namely β=π2R*2, where R*=F(1−η)/(1+η). The case of sink flow for F>0 is more complex in that unique solutions are found at low Reynolds numbers, a region of triple solutions exists at moderate Reynolds numbers, and a two-cell solution prevails at large Reynolds numbers. The subsidiary linear equations are solved at η=0.5 to exhibit the effects of cylinder translation, rotation, and an axial pressure gradient on the source/sink flows.

The rôle of the liver, particularly when it is characterized by hypertrophic cirrhosis, in the development of cutaneous xanthoma has been so thoroughly established that it needs little discussion in this paper. It is the study of other, associated features which should add to the knowledge of the nature of xanthomatous changes. As to the precise classification of the condition in our case of xanthoma, one's first thoughts turn to Christian-Schüller's disease or related xanthomatous states. However, it will be indicated in succeeding pages that such essential symptoms of Christian-Schüller's syndrome as lesions of the bones and exophthalmos were absent. Likewise, the comparatively common juvenile xanthoma, which often occasions so much diagnostic difficulty for the dermatologist in connection with urticaria pigmentosa, was promptly eliminated from consideration by the profound general systemic accompaniments. It seemed wiser, therefore, to refer to and classify the condition as xanthoma tuberosum as it occurs in

Every physician is aware of the extent to which ivy poisoning may at times proceed; in the severer cases the affliction may amount to more than a nuisance and interfere not only with the comfort of persons who enjoy the great outdoors, but also with the function of military bodies, boys' summer camps, and other institutions that are so closely related to it.Local treatment is unsatisfactory, as indicated by the seven-page list of vaunted remedies in McNair's 1 recent monograph on "Ivy Dermatitis"; and this has led, conformable to the present-day immunity trend, to the development of preventive and curative systems involving both the intramuscular injection of an extract of the plant and the administration of its tincture by mouth.Introduced by Schamberg 2 in 1919, and developed by Strickler3 in 1921 and 1923, such favorable reports have subsequently been published by Alderson,4 Bivings,5 Williams,6

As to the several phases indicated in the title, there is no surprise at the development of xanthomatous characteristics in a zoster lesion since zoster is only one member of the list of diseases the sequelae of which may be fibrous; almost a dozen cases of "scar xanthomas" have already been described in the literature. Nevertheless, this additional illustration of the notorious propensity for xanthomatous infiltration to involve granulation tissue amplifies the knowledge of the conditions under which the infiltration can take place. It is thoroughly established that hypercholesterosis of itself will not guarantee xanthomatous infiltration even in the presence of pathologic fibrous tissue. There are an additional x and perhaps also y and z factors in the pathogenesis that remain to be sought out. Before one can generalize, one needs more and more data covering both the local and the general conditions under which xanthomas develop in scars, and

It is scarcely necessary to elaborate on the scope and limitations of the disease long known as ringworm. Every physician can envisage how the term may have come into vogue, and how it was at first applied to a variety of more or less circumscribed lesions, annular and otherwise, which had a tendency toward peripheral spreading and perhaps central clearing. I have no doubt that some cases of psoriasis and syphilis were included in that category in the olden days. After that, with the discovery that in most of such cases fungus could be found, the term ringworm became confined to a more contracted group of lesions, not only circumscribed but even diffuse, which were caused by fungus, or at least in which fungus was found. As it stands today, then, any disease of the skin (with the exception of favus) which is caused by fungus may be admitted into

It is the main purpose of this paper to publicize the rapid expansion of the geographic distribution of chromoblastomycosis and to indicate the enlarging scope of the morbid anatomic changes. For a long time the known tissue changes remained almost entirely those of verrucous dermatitis of the legs, but during the last seven years data have been accumulated from a number of cases which have shown different pictures frequently enough to demonstrate that the dermatologic features of the disease are not uniform and simple. Asthere is promise that the range in gross tissue reaction will eventually compare with that of tuberculosis, syphilis and other members of the group of specific infectious granulomas, dermatologists should consider the possibilities of this disease when encountering atypical granulomatous conditions the cause of which is doubtful clinically. The case that we report from Philadelphia was one of this kind; the histologic picture was a surprise.

When the foregoing communication by Schaffer and me1 was submitted for publication in 1933, Urbach's publications of 1932 and 1933 had not come to our attention. Since these publications are destined to play a large part in future considerations of the cutaneous lipoidoses, it is desirable to indicate what position the condition which we described as pseudodiabetic xanthoma occupies in relation to his classification.It should be emphasized at the outset that the term pseudodiabetic xanthoma was submitted by us as an essentially clinical designation. Urbach's nomenclature, while based partly on the clinical features, stressed the pathologic changes (extracellular cholesterosis and lipoid proteinosis).2 Nevertheless, our case can still be fitted into Urbach's system, although our report admittedly had shortcomings in respect to some of the chemical determinations of the various lipoids concerned. On the basis of his classification, a special niche will have to be made, I

CONTENTSReport of a Case Non-neoplastic Nature of Xanthoma in the Case Reported Clinical Data Clinical Summary Macroscopic Observations at Necropsy Histopathologic Data Pathologic Diagnosis Pathologic Summary Clinicopathologic AnalysisGeneral Considerations The Regressive Stage of Xanthoma Intermissions in Hypercholesteremia Xanthomatosis of Mucous Membranes Association of Cancer and Xanthomatosis Fatty Changes of Epithelium, Including Cancer Cytology of Xanthomatosis Associated with Cancer and Other Malignant Conditions Rôle of Cholesterol in the Development of Cancer Nondiabetic Intolerance for Dextrose Pseudodiabetic Xanthoma Rôle of Nerve Tissue (Neurilemma, Endoneurium) in Xanthomatosis Relationship Between the General Pathologic Process and the Original DermatosisSummary and ConclusionsAbstract of DiscussionREPORT OF A CASENON-NEOPLASTIC NATURE OF XANTHOMA IN THE CASE REPORTEDIt is by now the consensus, although knowledge of the fact has not yet become sufficiently disseminated among members of the medical

NecrobiosisLipoidicaDiabeticorum. Presented by Dr. Arthur M. Greenwood, Boston, and Dr. Ethel M. Rockwood, Boston.Case 1.—M. R., a female, has had the disease for five years; the approximate duration of the diabetes, which is poorly controlled, is five years.The total cholesterol content of the blood was from 156 to 179 mg. (normal content, 230 mg.) ; the sugar content varied from 240 to 360 mg., and the nonprotein nitrogen content was 33 mg., per hundred cubic centimeters.Case 2.—Mrs. M. C. has had the disease for eight years; the approximate duration of the diabetes is nine years.The sugar content of the blood varied from 180 to 620 mg. per hundred cubic centimeters.This patient states that she sustained an injury, and she has received some roentgen therapy.Case 3.—Mrs. M. V. has had the disease for nine years; the approximate duration of the diabetes, which is

HYPERPIGMENTATION FOLLOWING CHEMICAL DERMATITIS. PRESENTED BY DR. E. F. CORSON. J. B., a white man, aged 33, presents a dermatitis of the exposed parts following two and one half hours' exposure to ethyl gasoline, which caused an illness of one week. The dermatitis appeared the morning after the accident. Two months later there developed on the face and hands a freckle-like eruption which has persisted. The blood count is normal. There is no blue line on the gums. The patient feels well. DISCUSSION Dr. E. F. Corson: Dr. Beerman suggested that ultraviolet therapy be tried on the parts which have not been affected by gasoline dermatitis in order to see what effect is produced and whether other agencies can bring about the same kind of pigmentary change. MACULAR ATROPHY OF THE SKIN (ANETODERMIA OF SCHWENINGER AND BUZZI). PRESENTED BY DR. T. BUTTERWORTH. D. H., a white girl, aged 11 years,

SCLERODERMA. PRESENTED BY DR. D. M. PILLSBURY. An American girl, aged 5 years, presents a large patch of scleroderma involving the right flank, with extension over the anterior abdominal wall, the right buttock and the right side of the right foot and little toe. The lesions on the trunk and buttock are of the circumscribed type, and the lesion on the foot is linear. There is marked pigmentation at the periphery of the lesions on the body. The process has been extending for three years.On examination, the blood count, urine and blood calcium were normal. DISCUSSION Dr. F. D. Weidman: I thought that the condition was hemiatrophy. The skin is softer over the affected areas and is more pliable than normal skin. The fat is atrophic underneath, the skin is not bound to the underlying parts, and whereas it may be that there is fibrous tissue in the deeper

We have classified the congenital abnormality of the elastic tissue reported here as juvenile elastoma. The rarity of the condition (we have been unable to find in the literature any description of a condition identical with it) prompts this report. REPORT OF CASE HISTORY.— M. W., aged 5½ years, white, first seen on Dec. 10, 1930, was referred by Dr. Henry Dietrich for a cutaneous condition which had been present for two or three years. There were no symptoms, and the past history was unimportant except that the child had suffered from repeated attacks of tonsillitis up to two years before, and during this same period (i.e., from 6 months to 3 years of age) she also suffered from recurrent pyelitis. The parents and one brother, aged 16, have entirely normal skins. EXAMINATION.— The trunk, buttocks and lateral and anterior aspects of the thighs presented numerous discrete, pea-sized, flesh-colored to

Every dermatologist is familiar with the group of multiple benign epithelioma-like tumors that occur on the face and chest, and that are notorious for a diversified nomenclature. Benign cystic epithelioma, epithelioma adenoides cysticum, syringoma and other tumors are sufficient to conjure up a long series of dermatologic investigations, ranging from the time of Kaposi1 in 1891, to that of Paul and Inglis2 in 1927. By this time it would appear that the subject had crystallized, or nearly crystallized, at least to the extent of establishing two categories of lesions as seen histologically, and two others which might, but less certainly, be distinguished clinically. The effort has been made to correlate these two, and today there seems to be a general belief that the disease with a predilection for the chest, among other symptoms, is likely to show the histology, more or less, of the sweat apparatus (syringoma), whereas

It is not our purpose in this communication to revamp the history of erythema elevatum diutinum, brief though it is, for Trimble1 dealt with it in the Archives barely three years ago. His report stimulated a recrudescence of case reports2 before various regional dermatologic societies, but nothing essentially new was added. There has not been a sufficient accumulation of cases as yet to yield data for establishing a well rounded, representative symptom complex and for analyzing the significance of the Bury and Hutchinson forms. From the original description of the condition by Crocker and Williams3 in 1894, it appears that the English are best acquainted with the disease, and that except for Trimble's formal report just mentioned, none has been made elsewhere, either in American or in Continental literature, although Trimble, in his discussion, expressed the belief that two other cases had been reported in the United

By this time the dermatologic profession has become accustomed to think at once of hypercholesterolemia when xanthoma is mentioned; moreover, thanks to Darier,1 Pollitzer and other disciples of the French school, it has learned to go still further and to look at diabetes, rheumatism and nephrosis as among the morbid states that might underlie the hypercholesterolemia. But here any further current knowledge of the relationship of the xanthomas to the hemic state stops, as far as the specialty in general is concerned. Yet back of the more outstanding facts there is a large store of information, concerning not only xanthoma but also xanthosis in general, which is more or less denied to many dermatologists because it is so widely scattered in the literature. As an intimate knowledge of this is necessary to an understanding of several different yellowish dermatoses already well known to dermatologists, to the interpretation of yellowing

The subject will be arranged under the following headings.Nomenclature and Classification: Bringing out the attitude of the taxonomist and the bearing it has on the selection of an appropriate name for these intertriginous (primarily and essentially) ringworms.Etiology: The flora of normal skins. The rôle of bacteria, blastomycetes and hyphomycetes—are the last mentioned solely responsible for everything charged against them in epidermophytosis? A catalog and distribution (anatomic and geographic) of the various species reported. The status of the dermatophytids.Laboratory Diagnosis.Hygiene: The viability of ringworm material "extra corpore."Histopathology.Rational Therapeutics: What can the laboratory offer in this direction?Before proceeding to the body of this paper, I wish to say that I have attempted to present the case in such a way that the reader will maintain a point of view in which he can judge the situation for himself; I

The occurrence of calcium deposits in the skin, while not frequent, is such a spectacular phenomenon that it has received a full measure of attention in the literature, and its mention does not arouse special curiosity. In the face of all this, and in extenuation of this paper, we submit that our case was, as far as we could find, unique in that the epiderm and other epithelial structures were heavily calcified and that it was unusual in the following respects: 1. Many of the appendages, particularly neural ones, were affected. 2. It occurred apart from any recognizable retrogressive changes, preceding or otherwise, and therefore may probably be classed among the extremely rare examples of metastic calcification—the "kalkmetastase" of the Germans. If this is true, the skin would constitute another and new approach to the diagnosis of morbid internal states, for the histologic examination of the skin gave the first

Those who undertake to study cutaneous mycology read but a short distance into the subject before they become acquainted with the property of pleomorphism (or better, polymorphism) which is expressed to a unique degree by the ringworm fungi. If they embark on culture studies the importance of this property will at once be borne home, because it immediately complicates the problem of determination of species, which is the very foundation for advance in this as in other parasitologic fields. Probably every dermatologist is aware that variations in cultural characteristics result from trivial alterations in the composition of the mediums, and those who have done practical work will add that even the moistness (freshly prepared or not) of the medium, the thickness o.f the layer which it constitutes and the extent to which the strain has been subcultured have more or less effect on these capricious organisms. Indeed, variations in form

When a condition like hypercholesterolemia bears an important relation to different human diseases, its experimental production in animals must appeal as one of the first implements to acquire when experimentally investigating such disease states. To do this qualitatively is not difficult—cholesterol cramming suffices. But such data as the amounts necessary to be fed, and, once induced, the quantitative variations in different animal species, the speed of development, duration, intensity, i. e., refinements of hypercholesterolemia, do not appear to have been collected. Probably this would have been done long ago had the quantitative chemical technic been more satisfactory. The situation may be gathered from our preceding communication.1The last disconcerting blow was a personal communication from Luden to the effect that the anticlotting substances, sodium citrate and calcium oxalate, produce fluctuations of the cholesterol figures "in a wholly irregular way." If Luden's point is well taken, the whole fabric of

During attempts to induce xanthic lesions in the skin of animals it became necessary for us to review the literature pertaining to normal figures for animals and to check up on our own technic. Contemporary workers on blood cholesterol tell us that there is no one place where such data are brought together, and after a tedious search through a wide range of subjects in which the cholesterol phase played a greater or lesser part, we have come to the same conclusion. It is to obviate possible repetition of this work by subsequent workers that we report what we found. The values are recorded under the heading of the various technics which have been proposed. We trust that we have not overlooked many. Of the technic itself, only enough will be sketched in to indicate the principles concerned, or variations from other technics. Unless specially expressed in percentages, the values

The survey of the literature which our cases caused us to make led us to believe that multiple hemorrhagic sarcoma of Kaposi has received attention far beyond what might be expected. Thus, being rare and withal so benign as regards life and death (usually), it cannot be considered as one of the dermatoses of outstanding clinical importance; and yet we find that those contributing to the literature include a large proportion of our most distinguished dermatologists, and that they have given their best thought to the comparatively small number of cases which comes under the care of any one of them.Whatever the explantation may be, the result is that the disease has been sufficiently described and discussed, and a comprehensive review of the literature by us would be superfluous. Accordingly, what we shall have to say in the way of summaries and reviews will be limited to the visceral

This communication is offered for two reasons: In the first place, it is desired to place on record certain blastomycetoid bodies in order both to obtain information concerning possibly previous reported cases and to supplement cases which may be reported in the future. In the second place, attention is called to the phagocytosis of both normally and abnormally staining elastic fibers both in this case and in proved cases of blastomycosis. For the further study of the latter feature the writer would be grateful for blastomycetic material either in the paraffin block or in the wet. REPORT OF A CASE HISTORY.— A white woman, aged 23 years, developed a "mole" on the upper portion of the calf four years ago. Stationary for six months, it grew rapidly for the next nine months, attaining the size of a small lemon, when it was removed under local anesthesia. It was not painful,

In 1910 Brumpt and Langeron1 recorded two cases of ringworm of the toe-nails from which they obtained the species of coco-brown fungus above indicated. Last year (1919) Wile and Gaudin2 made a very brief report of thirteen cases of onychomycosis, seven of which furnished P. brevicaule. These are the only cases I have been able to locate in the literature in which this organism is concerned, and I believe therefore that it is the first time it has been reported in an American. BRUMPT AND LANGERON'S CASES The disease had been present for ten years on the right great toe of a man, aged 32 years. It had also existed on the right second toe of his mother, aged 68, for fifteen or twenty years. In extemporaneous potash preparations Brumpt and Langeron found mycelia, chlamydospores and conidia; they stated that the filaments recalled those of Madurella and Indiella.

Today there are two diseases which the dermatologist thinks of as producing a hardening of the skin in very young infants or in the new-born; these, edema neonatorum and sclerema neonatorum, are so uniformly and routinely described in all the text-books that they at once come to the mind of every dermatologist when any abnormal cutaneous firmness appears at birth or in early infancy. This is true in spite of their rarity, particularly in the case of sclerema neonatorum, which the case herewith presented most closely resembles, and which is so uncommon that the occurrence even of clinical cases is still held to afford sufficient ground for report in the literature. In reviewing the literature of the last five years, I have found only fourteen such case reports.The unusual title given it and the usefulness of this case depend almost entirely on the fact that a necropsy was performed,

That the histologic picture at the margins of chronic or subacute cutaneous ulcers often simulates or actually reproduces that of carcinoma cutis is common knowledge to the pathologist. This would especially apply to the more highly differentiated type of epithelioma, approximately grade 1 of Broders.1 It is well known that there are many irritative factors which may lead to mimicry of malignant hyperplasia of the epidermis, such as cutaneous blastomycosis, bilharziasis of the rectum, Paget's eczematoid dermatitis, and around pellagrous dermatitis.2 In all these, the histologic picture may at times be quite good for a malignant growth, but we learned long ago that a malignant condition microscopically was not necessarily a malignant condition clinically; i.e. not a matter of life and death to the patient. In some classes of cases it has thus developed that we have had to require in addition some of such clinical changes as

For several years I have had more or less to do with the mounting and maintenance of gross morbid museum specimens, a large number of which were especially prepared for student-instruction purposes in large medical schools.Suspended in the usual way by ligatures on glass frames, and after handling several times in the course of a year by instructors and students, these specimens have suffered, entailing much loss in time and some of material in repair. If of soft texture (liver), the threads have torn out, if necrotic the detritus has fallen out, and the glass frames are sometimes broken by shaking when the specimen is handled by students. If the mounting medium has become turbid, a more or less thick layer of nontransparent material intervenes between the eye and the specimen. Or, where the specimen is small (parasitic worms) and fastened to a glass slide by gelatin, the latter

Acrosclerosis and Scleroderma. Presented by Dr. Carroll S. Wright, Dr. Reuben Friedman, and Dr. Jack Weiner.H. H., a white man aged 51 years, stated that he became ill in 1949. About 18 months ago his fingers and toes became puffy and later the skin became tight, so that by August, 1950, he was unable to close his hands. Later his knees and hips became stiff. He developed pains in the chest and complained that in winter his fingers turned pale and ached on exposure to cold.On Jan. 23, 1950, he was treated with cortisone and later with sex hormone and corticotropin (ACTH), without improvement. He subsequently complained of "stomach trouble" in the form of substernal burning, difficulty in swallowing, and the spitting up of "dark, jelly-like material." Roentgenographic studies of the gastrointestinal tract and the chest were reported negative.The patient was a middle-aged white man not appearing

Kaposi's Sarcoma. Presented by Dr. Henry G. Decker and Dr. Herbert Luscombe.W. W., a white man aged 72, presents over the face, neck, and trunk many purplish-red nodules and firm plaques varying in size up to about 5 cm. in diameter. The face has a leonine appearance. There is enlargement of the axillary, cervical, inguinal, and epitrochlear lymph nodes.The patient noted the eruption in April, 1952. There was no itching or pain. In the last three weeks he has had a weak feeling in the stomach with shortness of breath.Blood tests revealed 57.4% hemoglobin, 2,800,000 erythrocytes, 3,100 leucocytes, 24% polymorphonuclear leucocytes, 74% lymphocytes, and 2 young lymphocytes. The hematologist reported severe pancytopenia and hypocellular marrow with a few primitive cells, possibly representing early leukemic changes.The report on the biopsy specimen was as follows: Epidermis was somewhat atrophic. Beneath this was a band of relatively normal

TORULOSIS is a fatal disease caused by the yeastlike fungus, Cryptococcus neoformans (Torulopsis histolytica, Lodder). The number of reported cases is increasing, and it has become evident that the disease is not as rare as was once thought. More than 120 cases are on record,1 and the 3 unreported cases that are known to us indicate that there are many more.The clinical and pathologic features are primarily those of meningoencephalitis.2 The disease may simulate other disorders of the central nervous system, particularly tuberculous meningitis and tumor of the brain.The disease is worldwide. The factors predisposing to infection and the portal of entry are unknown. The histopathology has been excellently described.2bTreatment has been eminently unsuccessful, the patients usually dying within four to six months after the appearance of symptoms. The spontaneous remissions which may occur are usually brief. This fact obviously complicates the evaluation

BOTH in civil life and in the armed forces, the control of those conditions of the feet which are commonly diagnosed as "dermatophytosis" has long been a problem. Even when "cured" they are likely to recur. They sometimes incapacitate. The incidence in college students is 50 to 70 per cent. Youth, hot climates and sweaty feet are predisposing factors. Today, in the army and navy, 8 per cent of hospital admissions in the United States are for dermatoses in general, and dermatophytosis ranks in incidence second only to contact dermatitis. In the foreign field the figure would doubtless be larger, and reports from the South Pacific area indicate that these dermatoses are outstandingly severe there. In short, there is acute need for a satisfactory means for keeping the feet of fighting men in good condition, in which connection intertriginous dermatitis poses a large problem.At this point

LINGUA NIGRA. PRESENTED BY DR. J. F. BURGESS, MONTREAL, CANADA. F. M., a white woman aged 33, was first seen May 2, 1939, on account of a marked black "hairy tongue," first noticed by her in February. She was given daily doses of 100 mg. of nicotinic acid by mouth, beginning on May 12. There was gradual improvement, so that at the time of her presentation, after six weeks' therapy, little trace of the condition remains. DISCUSSION Dr. Arthur M. Greenwood, Boston: At the Huntington Clinic in Boston, many cases of carcinoma cf the tongue are observed, and black hairy tongues frequently follow irradiation in these cases. The papillae become hypertrophic and secondarily infected. It may be that the patients have a deficient diet, because of the difficulty in eating. SYPHILIS WITH NEGATIVE SEROLOGIC CHANGES: EXFOLIATIVE DERMATITIS. PRESENTED BY DR. DONALD S. MITCHELL, MONTREAL, CANADA (BY INVITATION). B. B., a

EPIDERMOLYSIS BULLOSA. PRESENTED BY DR. MERLIN TREVOR-ROPER MAYNARD, SAN JOSE, CALIF. B. D., a white girl aged 2½ years, is presented because of vesiculobullous lesions which rupture and leave superficial crusted erosions. They have occurred since birth, mainly about points subject to friction and trauma, such as the tips of the fingers, the elbows and the heels.She was presented before the San Francisco Dermatological Society on Sept. 27, 1935 (Arch. Dermat. & Syph. 34:140 [July] 1936). She was treated with local soothing and antiseptic ointments and protective bandages up to Aug. 18, 1936. At this time many severe ulcerative lesions were present on the feet, backs of the legs, abdomen and hands. She then was given enteric-coated tablets of anterior pituitary. On Sept. 1, 1936, she was considerably better. This therapy was continued until September 29, at which time she was relapsing somewhat. She was not seen again

The cutaneous conditions best known to be associated with polycythaemia vera are two: the purplish red color of the skin in general and ecchymosis. The former is readily understandable, with the erythrocytes numbering up to 13,000,000 or more. Hemorrhage in the form of ecchymosis is also readily explainable, since polycythaemia vera is one of the "anemias" referable to essential disease of blood-forming tissue, of which hemorrhage is a notorious feature.In addition, Kaposi's1 (1894) acne urticata has been reported as associated with this disease in no fewer than 8 cases. We are calling special attention to this association and contributing an additional case. It is the more interesting because it connotes a reactive process beyond the simple regressive ones concerned in ecchymosis. Incidentally, for the sake of completeness, scattered examples of other changes will also receive mention.Acne urticata is emphasized in this communication not only because in our

The glomus tumor has already been described in the American literature of surgery (Adair1) and of pathology (Popoff2). It has received more general attention in The Journal of the American Medical Association.3 Recently Stout4 has described it thoroughly for the oncologists. It is therefore superfluous to repeat the details of the subject, however desirable they might be for the fullest understanding of the circumstances attending our case.In brief, the neuromyo-arterial glomus is a normal vascular anastomosis which is distinctive in two respects: (1) it is arteriovenous, i. e., there are not any intervening capillaries, the structure having a special and peculiar architecture, and (2) it includes special arrangements of muscle and nerve tissue. It occurs almost exclusively, as known at present, on the extremities, both upper and lower. It is supposed to play an important part in heat regulation. It assumes dermatologic

To the great majority of American dermatologists the term cutaneous lymphoblastoma conveys a certain definite clinical picture. It consists usually of a preliminary diffuse dermatitis (generalized scaly erythroderma) succeeded by a tumor-like stage (granuloma fungoides sensu stricto). It is the clinical phase which commands the scene. Promptly after the appearance of the clinical manifestations, however, the picture becomes associated with disease of the lymphoid apparatus. Therefore, considerations of this subject must be arranged into, and must revolve around, two fields: (1) the essentially dermatologic and (2) the hematopoietic.It is not urgent to discuss the former field because dermatologists are so familiar with it, but at present there is real need for better understanding of the precise scope of the lymphoblastoma. The rôle of the lymphocyte in particular is implied, for if the suffix is removed from ``lymphoblastoma'' only ``lymphoblast'' remains. Indeed it was the original intention

Scopulariopsis is a genus of fungi closely related botanically to Penicillium. It differs therefrom mainly in the fact that the fruit head is less complex. Thus, whereas in Penicillium large numbers of branching conidiophores, each surmounted by a chain of conidia, extend from the main stem, in Scopulariopsis the number of such conidiophores is limited to four or five, or a conidiophore may be solitary. The end-result is thus only a partial approach to the formation of the classic brushlike aggregation of conidial chains which is so characteristic of Penicillium. However, in other respects Scopulariopsis closely resembles Penicillium, with its shorter or longer chains of conidia extending singly or in groups from the tips of conidiophores. Indeed, future studies may confirm a suspicion that Scopulariopsis is but a degraded form of Penicillium, as the synonymous designation, Penicillium brevicaule, indicates.Species of Scopulariopsis are widely distributed in

In the etiology of coccidioidal granuloma, Coccidioides immitis is commonly regarded by North American physicians as the one and only agent. It is well known that the disease occurs also in South America, but it is not common knowledge that Almeida1 recently called attention to notable discrepancies between the South American strains of coccidioides which indicate that the situation has become complicated by the entrance of another new species of fungus on the scene, namely, Paracoccidioides brasiliensis (Splendore, 1912, emended by F. de Almeida, 1929-1930). In short, when P. brasiliensis was originally observed it was not critically compared with the original, true C. immitis and was erroneously regarded as being identical with it; ergo, the disease that was being studied was called coccidioidal granuloma. Surprising as it may seem, it now appears that in South America C. immitis is rare; in 257 reports of cases of coccidioidal granuloma in

Poikiloderma Vasculare Atrophicans. Presented by Dr. S. S. Greenbaum.M. S., a white man, aged 58, was admitted to the Mount Sinai Hospital on Oct. 12, 1932, with a chief complaint of redness and slight itching of the skin. The condition had existed intermittently for twenty-five years, starting on the chest as a macular lesion, 6 cm. in diameter, containing red spots and whitish areas. This lesion disappeared and recurred several times, and then similar areas appeared in other parts of the body, avoiding the face, forearms, buttocks and perineum. There were no mucosal lesions. These lesions remained quite constant, occasionally showing an inflammatory areola. The history was otherwise negative except for hay fever in 1912 and a "nervous breakdown" in 1923.The patient had a blood pressure of 180 systolic and 110 diastolic, diseased teeth, apical fibrosis, enlargement of the heart to the left, with a systolic apical murmur

The blastomycosis with which North Americans are familiar is that due to a yeastlike fungus originally described by Gilchrist1 which, long unnamed in formal botanic style, has been recently designated ``Blastomycoides dermatitidis'' by Castellani.2 This organism produces a granulomatous, suppurative, chronic lesion which may effect both the skin and the internal organs. On the skin the condition is commonly verrucous and often resembles tuberculosis verrucosa cutis. Chromoblastomycosis, however, is essentially a South American disease. While it resembles North American blastomycosis in some ways, it differs from that condition in certain important respects. Thus, whereas both diseases are chronic and the cutaneous lesions may be most extensive, verrucous, crusted and malodorous, the internal organs do not appear to be affected in chromoblastomycosis; that is, metastasis has not been reported. The granulomas appear to be more superficial in chromoblastomycosis than in Gilchrist's disease, and in general

To group a number of otherwise dissimilar dermatoses under a solitary character such as color and at the same time to discuss them from the standpoint of pathology properly require explanation. Ordinarily, to occupy the sacred precincts of pathology and revolve around a single item, such as color, might well be criticized as being, if not sacrilegious, in bad form, or at least of a low order of appreciation of the premises. The particular color in this case, yellow, is an outstanding and comparatively distinctive one when present in a dermatosis— there is little question in a given lesion whether it is or is not present. Furthermore, it is present in but a limited number of dermatoses, and hence from the standpoint of differential diagnosis confines considerations to but a limited list of dermatoses. That is, the situation is different from that of redness, whiteness or brownness

The patient, an unmarried white man, aged 40, was admitted to the University Hospital, Nov. 24, 1914. He had joined a ship's crew only four days previously and earlier history than this, therefore, could not be expected. On the day of admission he had been ashore, returning in perfect health, for he was afterwards observed reading in his bunk. At 8:30 p. m. he was seized with chills and sweats, receiving 5 grains of quinin therefor. Half an hour later he was unconscious. His companions said he had fainted. On recovery he complained of headache and pain in the back of the neck. He walked unsteadily to the ambulance and was received in the hospital in a state of forgetfulness, constantly asking where he was, but remembering only a few minutes. In a few minutes he became restless, surly, and so violent as to require mechanical restraint. In four hours

The diffuse form of blastomycosis of the central nervous system appears as plastic meningitis which may be combined with cystic infiltration of the gray matter. The central nervous system is involved chiefly, and sometimes apparently primarily, and the causative organisms are found in the meninges and in the cysts. REPORT OF A CASE HISTORY. —H. P., a man, aged 39, was under the care of Drs. Charles H. Frazier and William G. Spiller, at the University Hospital from May to July, 1921. On admission he complained of severe paroxysmal headache of one months' duration. The headaches were progressive and were not localized. Projectile vomiting had occurred daily during the week preceding admission. The eyesight had become poor during the preceding two weeks. He was aware of no loss of memory, aphasia, weakness or difficulty in walking, and had had no convulsions. A short time previously he had had temporary difficulty

While xanthosarcomas are rare, there are weightier reasons for making this report. The occurrence of two widely separated tumors was responsible for a consideration of (1) the problem of metastasis (involving the question of genuine malignancy) versus pluricentric tumors and (2) complex problems of internal medicine ranging from the embryologic, developmental aspects of tumors of the acoustic nerve to the diversified changes that may occur in tumors incidental to hypercholesteremia.Thus, with xanthomatous tumor-like masses occurring (1) in granulation tissue (Garrett1), (2) in diabetic and pseudodiabetic conditions (Weidman and Schaffer2), (3) with adenocarcinoma of the stomach, (4) with adenocarcinoma of the duodenal papillae, (5) with strictures of the bile ducts, (6) with acute pancreatitis and (7) with hydatid cysts, the attention of the surgeon must be drawn to the field of disturbed general lipid metabolism, which most of the lesions just mentioned can connote.In short, it is

Owing to the example and interest of Dr. Milton B. Hartzeil, I have been more or less actively engaged in the study of the higher fungi for nearly twelve years. During this time, I have passed through the three stages of the development of any specialist. I refer here to the classification of my former professor of anatomy, Dr. George A. Piersol, who told his students that there were three stages in the development of the anatomist: (1) that of the primitive student who felt that he could never know anything about anatomy; (2) that of the young graduate, or even instructor, who felt that he knew everything about the subject, and finally, (3) the inevitable and true realization, born of bitter experience, that one can never hope to know much about anatomy. I feel that I have arrived at the third stage of mycology, in view of having passed through the first two stages, and that I am now in the final one of discouragement, indeed pessimism, about knowing all that should be known on the subject.Recently I have been wondering what attitude the practicing dermatologist, too, or even the average and not necessarily mycologically inclined laboratory man must have toward the subject. I can envisage the general practitioner poring over the .toes of his patient, making