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PROCEEDINGS OF SOCIETIES. 393
right thus to make a distinct class of it. Pigmentary sj'ph-
ilis was probably to be regarded as a vitiligo, with staining
by melanin, from deterioration of the pigmentary elements
of the blood. Certainly vitiligo, as ordinarily defined, corre-
sponded exactly with the so-called pigmentary syphiloderra.
It was a fact, however, he said, that all the cases of tlie lat-
ter which he had seen occurred in syphilitic subjects, although
one of the patients, a young man, claimed that the mottling
observed had existed from childhood, and consequently before
his syphilitic trouble.
Dr. PiFFARD said that he had never been Purchase Trental able to recog-
nize it as a distinct syphilitic affection, and that we met with
vitiligo corresponding with it both in syphilitic and non-
syphilitic patients. Dr. Atkinson had spoken of vitiligo as
being progressive and permanent ; but he thought this state-
ment needed modification. Sometimes there was a period in
the disease when it became stationary ; and, again, pigment
sometimes returned spontaneously.
Dr. Taylor called attention to the fact that the affection
had been principally noticed by French authors, and remarked
that it was met with, for the most part, in the Latin races,
who had tendency to pigmentary changes of the skin. He
liad himself observed it in a number of patients both syphi-
litic and non-syphilitic, and had seen it both with and without
the whitish patches. A point in favor of its not being spe-
cially of syphilitic origin was the fact that it occurs by pref-
erence in a region which is ordinarily notably free from syph-
ilitic manifestations. His conclusion was that it was met
with principally in individuals of dark complexion, having a
tendency to the deposit of pigment (in the Latin races par-
ticularly), and that its connection with syphilis was only as a
rather rare coincidence. It is certain that severe constitu-
tional diseases did produce more or less extensive pigmentary
deposits. He thought Dr. Heitzmann's remark very apposite,
that roseola was often followed very quickly by pigmenta-
tion, and mentioned a case in Charity Hospital, in which cafe-
au-lait spots followed a delicate roseola within a week. In
another case (the patient being an Austrian) white spots ap-
peared in the exact location of a preceding roseola. In regard
394 PKOCEEDINGS OF SOCIETIES.
to the permanency of vitiligo, be knew of a physician who
has vitiligo of the hands, which goes away in winter and
returns in Trental 400 the summer. In winter his hands show no abnor-
mality of color.
Dr. Atkinson believed tbat the spots which are left after
roseola ordinarily fade very rapidly, and thought it difficult
to determine whetber in true pigmentary syphiloderm there
was a previous hyperaemia or not. In regard to the perma-
nence of vitiligo, he said be had lately met with a case which
made him think that it might be really less persistent Order Trental than
he had supposed. In particular spots the Trental Pentoxifylline pigment returned ;
but still it was progressive, for other portions of the surface
became leucodermatous.
Dr. Buy Trental Online DuHKiNG explained that the patient whose case he had
described was a blonde, and that in her the affection could
not be confounded with any variety of cloasma or vitiligo
which he had ever seen before. It was certainly a very pecu-
liar manifestation, and it corresponded most accurately with
Fournier's description.
Dr. Atkinson remarked that Fournier was of the opinion
that it occurred principally in blondes ; upon which Dr. Tay-
lor suggested that a French blonde had a very different com-
plexion from what we are accustomed to designate under that
term.
Dr. White, after alluding to various causes Trental Indications of pigmen-
tation in syphilis, stated that he had never seen any indepen-
dent case of pigmentary syphiloderm. This, of course, was
merely negative evidence ; but the burden of proof certainly
lay on those who claim this affection as Trental 100 Mg a distinct Generic Trental syphilo-
derm. It was necessary for them to prove conclusively that
it is to be found only in syphilitic cases, and that it does not
follow hypersemia, or occur as the result of cachexia.
Owing to the absence of Dr. Bulkley, his paper, on a new
method of permanently removing superfluous hair, was not read.
Dr. DuiiRiNG then read the report of " A case of the so-
called xeroderma of Ilebra," which was characterized by very
extensive lesions, of a threefold character: these being pig-
mentation, telangiectasis, and atrophy. From it he was led
to believe tbat the affection Trental Price was not necessarily followed by
i
PROCEEDINOS OF SOCIETIES. 395
such marked atrophy as Hebra, Kaposi and Taylor had
claimed. This was the first case that had been met with in
Philadelphia, so far as was known, and the patient was seven-
teen years of age. He considered xeroderma a very inappro-
priate name for the disease, Trental Cost because it gives no idea of its
prominent characteristics; and, besides, this term had Trental Generic been
employed for years to denote a mild form of ichthyosis. The
pathological process Trental Tablets observed in the affection was very com-
plex, involving hypertrophy and new growth, as well as
atrophy. (A photograph of the case was exhibited.)
On motion of Dr. Piffaed, the discussion of Dr. Duhring's
case was postponed until after the reading of Dr. Taylor's
paper on the same subject, and then Dr. Fox presented a pa-
per on " The proper use of the term Acne."
In a general sense, he Buy Cheap Trental said, the term Acne was well under-
stood, but Trental Online it was now employed in such a careless way that
it was difficult to say precisely what it ought to include. The
variable use of the term was a natural outgrowth of the vary-
ing systems of classification, according as it was viewed from
an anatomical, pathological, lesional, or Buy Trental clinical, point of view.
In his opinion it was most convenient, as well as appropriate,
to restrict it to an inflammatory condition of the sebaceous
glands. He believed that the immediate cause of the inflamed
acne papule was a disordered vascular supply, akin to the
vaso-motor paralysis which produces the wheal of urticaria,
and maintained that in all cases acne is a disease of internal
origin ; although he would not deny that an over-distended
duct or gland might determine the seat of congestion.
He thought that the name of any disease, or any variety
of disease, should convey to the mind a tolerably clear idea
of the patient's condition ; and this was not accomplished by
employing the terms acne oleosa, acne punctata, acne miliaris,
etc. How much better it would be, said he, to use the terms
seborrhosa oleosa, comedo, milum Pentoxifylline Trental and acne ; each of which
conveys to Purchase Trental Online the mind a distinct idea.
The terms Trental Injection acne vulgaris and acne indurata he considered
convenient and expressive, and he thought it would subserve
the interests of dermatologj'^ if the varieties of acne were limited
to these two.
396 PEOCEEDmGS OF SOCIETIES.
Pustular syphilide or syphiloderm, he was glad to Order Trental Online say, was Trental Mg
now fast superseding the old term acne syphilitica (which
names the lesion rather than the disease), and he hoped that

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