Archives of Dermatology and Syphilology

ABRAMOWITZ, E. WILLIAM

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240002001

Abstract Articles in which the harmlessness of phenolphthalein when used as a laxative has been questioned have appeared from time to time. They were concerned at first with various unexpected general symptoms and later also with the cutaneous eruptions which occur in certain persons after ingestion of the drug. I have been investigating the action of phenolphthalein and present in this paper the results of a survey of all the available literature dealing with reactions to phenolphthalein, not only the cutaneous reactions but those consisting of general ill effects as well. The results of biochemical investigations1 that have some bearing on the possible causes of the manifestations are also included. REPORTS OF GENERAL REACTIONS Incidence.— A study of the reports published in the literature since 1903 concerning cases of general disturbances attributed to the medicinal use of phenolphthalein2 has shown that prior to 1923 the patients presented various general symptoms unaccompanied by a cutaneous eruption, References 1. With the technical assistance of John A. Killian, Ph.D., and Edward F. Williams Jr., Ph.D. 2. (a) Schwartz, O.: Der heutige Arzneimittelverkehr und dessen Einfluss auf die Krankenbehandlung , München. med. Wchnschr. 50:24, 1903 3. Ueber den Gebrauch von Purgentabletten als Abführmittel bei Säuglingen und Erwachsenen , Schwartz München. med. Wchnschr. 50:1557, 1903. 4. (b) Holz, B.: Ueber Purgen-Vergiftung , Berl. klin. Wchnschr. 42:931, 1905. 5. (c) Blumenthal, F.: Diagnostische und therapeutische Vorschläge , Med. Klin. 1:841 ( (July 23) ) 1905. 6. d) Best: Ein Fall von Purgenvergiftung , Ztschr. f. Med.-Beamte 19:364, 1906 7. Näheres über Purgenvergiftung und Bemerkungen über den Arzneimittelverkehr , Best Ztschr. f. Med.-Beamte 19:722, 1906. 8. (e) Ortner, N.: Vorlesungen über spezielle Therapie innerer Krankheiten , ed. 4, Vienna, W. Braumüller, 1907, p. 531. 9. (f) Zabel, E.: Ein Fall von Purgen-Intoxikation , Deutsche med. Wchnschr. 37:743 ( (April 20) ) 1911.Crossref 10. (g) Fontagny: Urémie et phénolphtaléine , Burgoyne méd. 8:489, 1912. 11. (h) Erdös. J.: Beitrag zur Wirkung des Purgens , Therap. Monatsh. 27:332, 1913. 12. (j) Hydrick, J. L.: Albuminuria Following Ingestion of Phenolphthalein , J. Biol. Chem. 17:36, 1914. 13. (k) Fürbringer: Schwere Vergiftung durch Laxativ-Drops (Phenolphthalein) , Deutsche med. Wchnschr. 43:842, 1917.Crossref 14. l) Rosenstein, P.: Der Unfug mit Phenolphthalein , München. med. Wchnschr. 67:263, 1920. 15. (m) Schmilinsky, K.: Hämolyse durch Phenolphthalein , Deutsche med. Wchnschr. 48:1311 ( (Sept. 29) ) 1922.Crossref 16. (n) Lauze, G.: Les méfaits des purgatifs synthétiques; Deux cas de purpura consécutifs à l'absorption de laxatifs à base de phénolphtaléine; traitement et guérison des accidents purpuriques par l'homohématothérapie, (injection sous-cutanée de sang humain: méthode de Sicard) , Bull. Soc. d. sc. méd. et biol. de Montpellier 4:120 ( (Jan.) ) 1923 17. Les méfaits des purgatifs synthétiques; deux cas de purpura consécutifs à l'absorption de phénolphtaléine; guérison par l'hémohémathérapie , Montpellier méd. 45:260 ( (June 1) ) 1923. 18. (o) Martinson, H.: "Toxic Nephritis"; Persistent Hemorrhagic Nephritis Following Ingestion of Phenolphthalein Containing Laxative , Arch. Pediat. 41:578, 1924. 19. (p) Brockelmann, E.: Drug Eruption Due to Phenolphthalein Poisoning , Bull. St. Louis Baptist Hosp. 4:49 ( (Oct.) ) 1926. 20. (q) Talley, J. E., and Glenn, H. R.: Incipient Lipoid Nephrosis and Phenolphthalein Poisoning , M. Clin. North America 13:825 ( (Jan.) ) 1930. 21. (r) Ely, R. A.: Phenolphthalein Poisoning with Analax Tablets , J. A. M. A. 98:340 ( (Jan. 23) ) 1932. 22. (s) Cleeves, M.: Poisoning by "Ex-Lax" Tablets , J. A. M. A. 99:654 ( (Aug. 20) ) 1932.Crossref 23. (t) Nelson, W. E.: Possible Phenolphthalein Poisoning , J. A. M. A. 101:121 ( (July 8) ) 1933.Crossref 24. (u) Newman, B.: Phenolphthalein Intoxication , J. A. M. A. 101:761 ( (Sept. 2) ) 1933.Crossref 25. von Jaksch, R.: Die Vergiftungen , ed, 2, Vienna, Alfred Hölder, 1910, p. 345 26. Devrient: Ueber die Giftigkeit des Phenolphthaleins , Kazanski M. J. , (October) 1927 27. abstr., Schweiz. apoth. Ztg. 66:367, 1928. 28. (a) Bastedo, W. A.: Materia Medica, Pharmacology and Therapeutics , ed. 3, Philadelphia, W. B. Saunders Company, 1932, p. 184. 29. (b) Unterberg, E.: Beiträge zur abführenden Wirkung des Purgens , Therap. d. Gegenw. 4:203 ( (May) ) 1902. 30. Orvosi hetil. 78:792 [ (Aug. 25) ] 1934 31. (a) Berthoumeau, M., and Daguin, A.: Les propriétés purgatives de la phénolphtaléine , Presse méd. 16:378, 1908. 32. (b) Jarvis, G. O.: Phenolphthalein as a Purgative , Internat. M. Mag. 11:722, 1902. 33. (c) Magnus, R.: Allgemeines über Abführmittel , in Bock, J., et al.: Handbuch der experimentellen Pharmakologie , Berlin, Julius Springer, 1920, vol. 2, p. 1592. 34. (d) McWalter, J. C.: One Thousand Doses of Phenolphthalein , Lancet 2:1141 ( (Nov. 20) ) 1915.Crossref 35. (e) von Noorden, C.: Zur Behandlung der Stuhlträgheit , Med. Klin. 26:1429, 1930. 36. (h) Wood, H. C., Jr.: The Use of Phenolphthalein as a Cathartic , Philadelphia Gen. Hosp. Rep. 7:183, 1909. 37. According to the figures of the United States Tariff Commission, the sales of medicinal phenolphthalein in this country amounted to 451,418 pounds (204,710 Kg.) for 1933. On the basis of the U. S. P. dose of 1 grain (0.06 Gm.), it is estimated that in America last year several billion doses of phenolphthalein were consumed. 38. Vámossy, Z.: Ueber ein neues Abführmittel (Purgen) , Therap. d. Gegenw. 4:201 ( (May) ) 1902. 39. Rowntree, L. G.: Subcutaneous Purgatives: A Clinical Study of Phenoltetrachlorphthalein (see discussion) , J. A. M. A. 54:348 ( (Jan. 29) ) 1910. 40. Wood, H. C., Jr., in discussion on Rowntree.8 41. (a) Brasch, G.: Phenolphthalein als Abführmittel nebst Bemerkungen über die Art der Einführung neuer Arzneimittel , Ztschr. f. Med.-Beamte 19:450, 1906. 42. (b) Gillette, H. F.: Accidental Overdose of Phenolphthalein , J. A. M. A. 51:1782 ( (Nov. 21) ) 1908.Crossref 43. (c) Kaminsky: Etude sur le purgène , Méd. mod. 15:354, 1904. 44. (d) Orland, F.: Ein Fall von unbeabsichtigter hoher Phenolpththaleindosis bei einem Kinde , Med. Klin. 9:257, 1913. 45. Elmer, W. P.: The Action and Dosage of Phenolphthalein , M. Rec. 74: 838, 1908. 46. Sollmann, T.: A Manual of Pharmacology and Its Applications to Therapeutics and Toxicology , Philadelphia, W. B. Saunders Company, 1932, p. 237. 47. Footnotes 2 and 10d. 48. Lauze.2n Talley and Glenn.2q 49. Roux.2i Cleeves.2s 50. Fox, H.: Erythema Perstans Following Ingestion of Phenolphthalein , J. Cutan. Dis. 36:252 ( (April) ) 1918. 51. Abramowitz, E. W.: Erythema Multiforme Associated with Cutaneous Pigmentation (Melanin): Clinical and Pathologic Report of Five Cases , J. Cutan. Dis. 36:11 ( (Jan.) ) 1918. 52. Wise, F., and Abramowitz, E. W.: Phenolphthalein Eruptions , Arch. Dermat. & Syph. 5:297 ( (March) ) 1922. 53. Trimble, W. B.: Purpura , J. Cutan. Dis. 27:306, 1909. 54. Williams, E. F., Jr.; Abramowitz, E. W., and Killian, J. A.: The Value of the Monkey for the Study of the Laxative Activity of Phenolphthalein, Especially in Comparing Different Samples of the Drug , J. Lab. & Clin. Med. 19:1213 ( (Aug.) ) 1934. 55. Novy, F. G.: Phenolphthalein Eruption; Experimental Data on Its Causation , Arch. Dermat. & Syph. 26:125 ( (July) ) 1932. 56. Kastle, J. H.: The Conduct of Phenolphthalein in the Animal Organism , U. S. Pub. Health Serv., Hygienic Laboratory, bull. 26, 1906, p. 23. 57. Abel, J. J.. and Rowntree, L. G.: On the Pharmacological Action of Some Phthaleins and Their Derivatives, with Especial Reference to Their Behavior as Purgatives , J. Pharmacol. & Exper. Therap. 1:231 ( (June 8) ) 1909-1910. 58. Sulzberger, M. B.: Personal communication. 59. (a) Tonnel and Raviart: Erythèmes bulleux dus à l'ingestion d'antipyrine; leur pathogénie , Echo méd. du nord 1:18, 1897. 60. (b) Mibelli, V.: Ueber die fixen Antipyrinerytheme , Monatschr. f. prakt. Dermat. 26:533, 1898. 61. Loewe, S., and Lange, F.: Entgiftetes Phenolphthalein , Klin. Wchnschr. 9:207 ( (Feb. 2) ) 1930. 62. Kaufman, E.: Entgiftetes Phenolphthalein , Klin. Wchnschr. 10:1219, 1931. 63. Fox, H.: Phenolphthalein Eruption with Bullae , Arch. Dermat. & Syph. 26:741 ( (Oct.) ) 1932. 64. Corson, E. F., and Sidlick, D. M.: Urticaria from Habitual Use of Phenolphthalein , J. A. M. A. 78:882 ( (March 25) ) 1922. 65. Stancanelli, P.: Dermatitie eritemato-pemfigoide recidivante de origine medicamentosa (fenolftaleina) , Dermosifilografo 3:10 ( (Jan.) ) 1928. 66. Virga, E.: Erythèmes pigmentés fixes par phénolphtaléine , Dermosifilografo 3:675 ( (July) ) 1932. 67. Abramowitz, E. W.: Phenolphthalein Eruption Produced by the Eating of Iced Cup Cakes , M. J. & Rec. 136:31 ( (July 6) ) 1932. 68. Cannon, A. B.: Dermatitis Medicamentosa (Phenolphthalein) , Arch. Dermat. & Syph. 24:899 ( (Nov.) ) 1931. 69. One patient (footnote 18, case 4) had a recurrence ten years later after taking a sugar-coated gum laxative containing phenolphthalein. 70. Personal observation. 71. Wise, F., and Sulzberger, M. B.: Drug Eruptions , Arch. Dermat. & Syph. 27:549 ( (April) ) 1933. 72. Bernstein, F.: Ueberempfindlichkeit gegen Phenolphthalein , Dermat. Ztschr. 62:368 ( (Dec.) ) 1931. 73. Wise, F., and Sulzberger, M. B.: Personal communication. 74. Joltrain, in discussion on Milian and Mourrut: Erythème fixe récidivant dû aux laxatifs à base de phénolphtaléine , Bull. Soc. franç. de dermat. et syph. 39:1672 ( (Dec.) ) 1932. 75. Brockelmann.2p Cannon.35 76. Bloch, Bruno: The Rôle of Idiosyncrasy and Allergy in Dermatology , Arch. Dermat. & Syph. 19:192 ( (Feb.) ) 1929. 77. Kobayashi, Utaka: Ein Fall von Laxatol-Exanthem , Jap. J. Dermat. & Urol. 31:86, 1931. 78. (Kenedy, D.: Sulla ipersensibilita , Gior. ital. di dermat. e sif. 75:965 [ (April) ] 1934). 79. Naegeli, de Quervain and Stalder: Nachweis des zellulären Sitzes der Allergie beim fixen Antipyrinexanthem (Autotransplantationen, Versuch in Vitro) , Klin. Wchnschr. 9:924 ( (May 17) ) 1930.Crossref 80. Urbach, E., and Sidaravičius, B.: Zur Kritik der Methoden der passiven Uebertragung der Ueberempfindlichkeit , Klin. Wchnschr. 9:2095 ( (Nov. 8) ) 1930.Crossref 81. Loveman, A. B.: Experimental Aspect of Fixed Eruption Due to Alurate, a Compound of Allonal , J. A. M. A. 102:97 ( (Jan. 13) ) 1934.Crossref 82. Abramowitz.18 Mibelli.27b

OBERMAYER, M. E.;BECKER, S. W.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240021002

Abstract In dealing with the problem of tar one must first define what is meant by tar. To use the term "tar" as if it were a definite chemical compound, readily obtainable from the pharmacist, is erroneous. A brief résumé of the present, somewhat limited, knowledge of tars in general will illustrate this. Much of the information has been gathered from the writings of Porter1 and Perutz and Siebert.2 Since the latter authors have covered all the older literature on the subject we shall not cite it here. A few of the more recent publications have been cited by Nelson and Osterberg.3 Any product obtained by destructive distillation of organic substances is a tar. It is thus readily understood that the chemical composition of tars varies with the substances from which they were derived and with the temperatures to which they are subjected. There are four main groups References 1. Porter, H. C.: Coal Carbonization , New York, The Chemical Catalog Co., Inc., 1924. 2. Perutz, A., and Siebert, C.: Pharmakologie der Haut: Arzneimittel , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1930, vol. 5, pt. (1) . 3. Nelson, Marque O., and Osterberg, Arnold E.: A Purified Coal-Tar Ointment for the Treatment of Infantile Eczema , Arch. Dermat. & Syph. 15:669 ( (June) ) 1927. 4. Fleischhauer, L.: Sensitization of Skin to Light by Means of Liantral , Strahlentherapie 36:144, 1930. 5. Jaffrey, W. R.: A Report on the Therapeutically Active Principle Fraction of Crude Coal Tar , Canad. M. A. J. 18:680, 1928. 6. Rottman, H. G.: Coal Tar Therapy with Liquid Carbon (Bergin) , Dermat. Wchnschr. 84:534 ( (April 16) ) 1927. 7. Goeckerman, W. H.: Treatment of Psoriasis , Northwest Med. 24:229 ( (May) ) 1929 8. Treatment of Psoriasis: Continued Observations on Use of Crude Coal Tar and Ultraviolet Light , Arch. Dermat. & Syph. 24:446 ( (Sept.) ) 1931. 9. Herrick, J., and Sheard, C.: Effects of Irradiation of Crude Coal Tar by Quartz Mercury Vapor Lamps: I. Evidence of Chemical Changes as Shown by Changes in Absorption Spectra , Proc. Soc. Exper. Biol. & Med. 26:33 ( (Oct.) ) 1928. 10. Daubresse-Morelle, E.: L'actinothérapie générale associée aux applications de goudron dans le traitement du psoriasis , J. belge radiol. 18:336, 1929. 11. Allison, J. R.: Tar and Quartz Light Therapy , South. M. J. 22:592 ( (June) ) 1929. 12. Kuznitsky, E., and Jacoby, H.: Sensitivity of X-Ray Skin and Tar Skin to X-Rays, Ultraviolet Light Rays and Alpha Rays , Arch. f. Dermat. u. Syph. 156:136, 1928. 13. Urbach, E., and Konrad, J.: Ueber eine durch den langwelligen Anteil des Sonnenspektrums erzeugte Lichtdermatose vom Typus der Prurigo aestivalis Hutchinson: Die lichtschützende Wirkung des Resorcin , Strahlentherapie 32:193, 1929. 14. Bloch, Bruno, and Widmar, F. E.: Weitere Untersuchungen über die bei der künstlichen Krebserzeugung wirksamen Teerbestandteile , Arch. f. Dermat. u. Syph. 152:529, 1926. 15. Cook, J. W.: Hewett, C. L., and Hieger, I.: The Isolation of a Cancer-Producing Hydrocarbon from Coal Tar , J. Chem. Soc. 1:395, 1933. 16. Potonié, Robert: Neues zur Erdölentstehung , Naturwissenschaften 20:279 ( (April) ) 1932 17. Das Muttergestein des Ichthyols , Pharm. Ztg. 78:908 ( (Sept.) ) 1933 18. Scheibler, Helmuth: Ueber die chemischen Bestandteile der schwefelreichen, bituminösen Teeröle (Ichthyolöle) , Ber. d. deutsch. chem. Gesellsch. 48:1815, 1915 19. 49:2535, 1916 20. 52:1903, 1919. 21. Shibata, S.: Experimental Study of Tar: Action of Tar Obtained from Crude Petroleum by Distillation , Acta dermat. 14:94 ( (July) ) 1929. 22. Daubresse-Morelle.9 Allison.10 23. Dr. M. S. Kharasch, Professor of Chemistry at the University of Chicago, assisted in this work. 24. Dr. M. Adeline Bloodgood of the Department of Chemistry, University of Chicago, carried out part of the distillations. 25. White, Charles J.: Poisoning by Crude Coal Tar , J. Cutan. Dis. 34:497 ( (July) ) 1916 26. Crude Coal Tar in Dermatology , Arch. Dermat. & Syph. 4:796 ( (Dec.) ) 1921.

REUTER, MAURICE J.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240036003

Abstract Several decades ago arsenic was alleged to be a normal constituent of the body,1 but that claim has been much disputed. In recent times through the investigations of Throne and Myers2 and their co-workers and others3 renewed interest has been aroused in the occurrence of arsenic in the tissues and excretions of the body both in health and in disease. This work has emphasized the widespread use of arsenic and the countless possibilities for its absorption into the body. Water, dust, soil, food, drugs and articles of wearing apparel and of household use apparently are all potential sources of arsenic poisoning. Fordyce, Rosen and Myers2a showed that arsenic is found "normally" in a large number of persons, depending on the character of their food, drink, medication and environment. Later, as a result of tests made on a large series of normal persons, Myers and Cornwall2b References 1. Gautier, A.: Sur l'existence normale de l'arsenic chez les animaux et la localization dans certains organes , Compt. rend. Acad. d. sc. 129:929, 1899. 2. Fordyce, J. A.; Rosen, I., and Myers, C. N.: Quantitative Studies in Syphilis from a Clinical and Biologic Point of View; Normal Arsenic , Arch. Int. Med. 31:739 ( (May) ) 1923.Crossref 3. Myers, C. N., and Cornwall, L. H.: Normal Arsenic and Its Significance from the Point of View of Legal Medicine , Am. J. Syph. 9:647 ( (Oct.) ) 1925. 4. Throne, B., and Myers, C. N.: New York State J. Med. 26:843, 1926. 5. Myers, C. N.; Van Dyck, L., and Throne, B.: Arsenic as a Problem in Present Day Public Health Management , M. Times 57:134, 1929. 6. Throne, B.; Van Dyck, L. S.; Marples, E., and Myers, C. N.: Arsenic Findings in Dermatologic Conditions , New York State J. Med. 27:757, 1927. 7. Myers, C. N., and Throne, B.: The Relation of Arsenic to Public Health , New York State J. Med. 29:871, 1929. 8. Van Dyck, L.; Throne, B., and Myers, C. N.: Arsenic Findings in Eczema and Allied Conditions in Infants and Young Children , Arch. Pediat. 47:218 ( (April) ) 1930. 9. Myers, C. N.; Throne, B., and Kingsbury, J.J.: Toxic Action of Metals in Alopecia Areata , New York State J. Med. 33:991, 1933. 10. Vogel, K.: The Significance of Arsenic in the Excretions , Am. J. M. Sc. 176:215 ( (Aug.) ) 1928.Crossref 11. Kraetzer, A. F.: Raynaud's Disease Associated with Chronic Arsenical Retention , J. A. M. A. 94:1035 ( (April 5) ) 1930.Crossref 12. Shelden, N. D.; Doyle, J. B., and Osterberg, A. E.: Neuritis from Arsenic and Lead , Arch. Neurol. & Psychiat. 27:322 ( (Feb.) ) 1932. 13. O'Leary, P. A.; Snell, A. M., and Bannack, E. G.: Portal Cirrhosis Associated with Chronic Inorganic Arsenical Poisoning , J. A. M. A. 90:1856 ( (June 9) ) 1928. 14. Distribution of Arsenicals in the Body , editorial, O'Leary J. A. M. A. 91:805 ( (Sept. 15) ) 1928. 15. Oliver, T.: Elimination of Arsenic After Sheep-Dipping , Lancet 2:740 ( (Oct. 4) ) 1930. 16. Lowenburg, H., and Naide, M.: Arsenic Poisoning Caused by a Mouth Wash Containing a Solution of Potassium Arsenite , J. A. M. A. 100:737 ( (March 11) ) 1933. 17. Stoddart, W. O.; Riddell, A. R., and Bulmer, R. M. R.: Arsenic as a Potential Hazard for the Farmer , Canad. M. A. J. 27:264 ( (Sept.) ) 1932. 18. Halloran, C.: Dermatitis Exfoliative Due to Arsenic in Wall Paper , Arch. Dermat. & Syph. 20:303 ( (Sept.) ) 1929. 19. Thorel and Vinzent: A propros d'une intoxication collective par l'arsenic , Ann. de dermat. et de syph. 3:618, 1932. 20. Willcox, W. N.: Acute Arsenical Poisoning , Brit. M. J. 2:118 ( (July 22) ) 1922. 21. The Occurrence of Arsenic in the Body , editorial, J. A. M. A. 81:478 ( (Aug. 11) ) 1923.Crossref 22. Ayres, S., Jr., and Anderson, N. P.: Cutaneous Manifestations of Arsenic Poisoning , Arch. Dermat. & Syph. 30:35 ( (July) ) 1934. 23. Osborne, E. D.: Microchemical Studies of Arsenic in Arsenical Pigmentation and Keratoses , Arch. Dermat. & Syph. 12:773 ( (Dec.) ) 1925 24. Microchemical Studies of Arsenic in Arsenical Dermatitis , Osborne Arch. Dermat. & Syph. 18:37 ( (July) ) 1928. 25. Brooks, H. G., and Roberts, Leslie: The Action of Arsenic on the Skin as Observed in Recent Epidemic of Arsenical Beer Poisoning , Brit. J. Dermat. 13:121, 1901. 26. Evans, W. V.: Arsenic Poisoning from Sprayed Asparagus , J. A. M. A. 99:2202 ( (Dec. 24) ) 1932. 27. Food Poisoning Reported [Arsenic in Fresh Mustard Greens], Medical News , Evans J. A. M. A. 97:1971 ( (Dec. 26) ) 1931. 28. Howard, Tasker: Arsenic Poisoning , in Tice, F.: Practice of Medicine , Hagerstown, Md., W. F. Prior Company, Inc., 1924, vol. 8, p. 86. 29. Thorel and Vinzent. 3j Brooks and Roberts.30 30. Tolerance for Arsenic, Copper and Leads in Foods, report of the Committee on Foods , J. A. M. A. 101:1483 ( (Nov. 4) ) 1933. 31. Shelmire, B., in discussion on Shaffer, L. W.: Treatment of Postarsphenamine Dermatitis , Arch. Dermat. & Syph. 29:187 ( (Feb.) ) 1934. 32. Tannenholz, H., and Muir, K. B.: Methods for Microchemical Demonstration of Arsenic in Tissues , Arch. Path. 15:789 ( (June) ) 1933. 33. Schoch, A. G.: The Patch Test and the Element of Syringe Contamination in Arsphenamine Sensitization Dermatitis , J. A. M. A. 98:1367 ( (April 16) ) 1932.

GOODMAN, HERMAN;MARKS, IRVING

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240044004

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract REACTIONS TO SIMULTANEOUS INTRADERMAL INJECTIONS OF MEASURED AMOUNTS OF TRICHOPHYTIN AND VARIOUS VACCINES Intradermal injections of trichophytin and other bacterial products are in general use. It occurred to us to try simultaneous intradermal injections of more than one such product in the same person.In ordinary practice the amount of trichophytin or bacterial vaccine injected is measured in fluid bulk. The technician uses 0.1 cc. of a definite dilution. In this series of studies it was decided to use another method of measurement. The nitrogen content of trichophytin and various bacterial products has been measured, but as far as we know no one has previously used equivalent amounts of nitrogen in various products for intradermal diagnostic injection as a basis for the comparison of reactions. Equivalent Volume.— Table 1 gives the reactions of two patients to a series of intradermal injections of trichophytin and other bacterial products and the amount

GOODMAN, HERMAN

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240053005

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract For five or six years I have studied the results of chemical analyses of the blood of patients reporting to the outpatient department of the Stuyvesant Square Hospital. A relationship which is not generally stressed was disclosed by a tabulation of the sugar and the salt content of the blood. As the average sugar content decreases, the salt content increases. Although the relationship is not absolute, it is fairly constant. The converse can be supported: As the average salt content of the blood increases, the average sugar content decreases. In this report no explanation for this reciprocal relationship is offered. Sodium chloride is useful in therapy for many conditions. Baths of sodium chloride are recommended as a home remedy. Poultices of sodium chloride are prescribed. Surgeons have given infusions of solution of sodium chloride for shock. Recently, capsules of sodium chloride have been prescribed to prevent cramps on exertion. Physiologic

DeMONBREUN, W. A.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240056006

Abstract The clinical term blastomycosis has been used to designate any disease caused by a yeastlike fungus. At the present time, however, there is a growing tendency to limit this term to those diseases in which the causative fungi occur in the lesions, without associated mycelium, as large, round to oval cells possessing well defined membranes, well marked double contours and granular cytoplasm and multiplying in the tissues by budding, though capable of producing hyphae in more or less abundance in cultures. In line with this conception it is customary to designate those diseases caused by other yeastlike fungi by more specific terms, such as coccidioidal granuloma, sporotrichosis, torulosis and cytomycosis. It is now evident that the term blastomycosis is doubly a misnomer. It was applied under the mistaken impression (1) that the causative organism is a true yeast and (2) that Blastomyces instead of Saccharomyces is the correct scientific name References 1. Ota, M., and Kawatsure, S.: Zur Aetiologie der echten und falschen Blastomycosen, besonders der Gilchristschen Krankheit , Arch. f. Dermat. u. Syph. 169: 173, 1933.Crossref 2. Gilchrist, T. C.: A Case of Blastomycetic Dermatitis in Man , Johns Hopkins Hosp. Rep. 1:269, 1896. 3. Gilchrist, T. C., and Stokes, W. R.: A Case of Pseudo-Lupus Vulgaris Caused by a Blastomyces , J. Exper. Med. 3:53, 1898.Crossref 4. Castellani, A., and Jacono, I.: Observations on Fungi Isolated from Cases of Blastomycosis Cutis and Blastomycosis Pulmonalis in North America and Europe: Remarks on Blastomycetin , J. Trop. Med. 36:297 ( (Oct. 16) ) 1933. 5. Agostini, A.: Observations on Fungi Found in Cases of North American Blastomycosis of the Skin and Lungs , J. Trop. Med. 35:266 ( (Sept. 1) ) 1932. 6. Rewbridge, A. G.: Dodge, C. W., and Ayers, T. T.: A Case of Meningitis Due to Endomyces Capsulatus (New Species) , Am. J. Path. 5:349 ( (July) ) 1929. 7. MacBryde, C. M., and Thompson, E. J.: Meningitis and Dermatitis Caused by a New Variety of Blastomycete (Endomycete) , Arch. Dermat. & Syph. 27:49 ( (Jan.) ) 1933. 8. Moore, M.: Blastomycosis: Report of a Case, with a Study of an Etiologic Factor and a Classification of the Organism , Ann. Missouri Bot. Gard. 20:79 ( (Feb.) ) 1932. 9. Thaxter, R., quoted by Medlar, E. M.: A Cutaneous Infection Caused by a New Fungus, Phialophora Verrucosa, with a Study of the Fungus , J. M. Research 32:507, 1915. 10. Ricketts, H. T.: Oidiomycosis (Blastomycosis) of the Skin and Its Fungi , J. M. Research 1:373 ( (Dec.) ) 1901. 11. Hektoen, L.: Systemic Blastomycosis and Coccidioidal Granuloma , J. A. M. A. 49:1071 ( (Sept. 28) ) 1907. 12. Montgomery, F. H., and Ormsby, O. S.: Systemic Blastomycosis: Its Etiologic, Pathologic and Clinical Features as Established by a Critical Survey and Summary of Twenty-Two Cases, Seven Previously Unpublished. The Relation of Blastomycosis to Coccidioidal Granuloma , Arch. Int. Med. 2:1 ( (Aug.) ) 1908. 13. Wade, H. W., and Bel, G. S.: A Critical Consideration of Systemic Blastomycosis , Arch. Int. Med. 18:103 ( (July) ) 1916. 14. Benham, R. W.: The Fungi of Blastomycosis and Coccidioidal Granuloma , Arch. Dermat. & Syph. 30:385 [ (Sept.) ] 1934 15. DeMonbreun, W. A.: The Cultivation and Cultural Characteristics of Darling's Histoplasma Capsulatum , Am. J. Trop. Med. 14:93 ( (March) ) 1934. 16. Norton, J. F.; Thomas, J. G., and Broom, Norma H.: Laboratory Tests for Tubercle Bacilli by Culture Methods , Am. Rev. Tuberc. 25:378 ( (March) ) 1932. 17. The formula for Schaudinn's fluid is: Saturated mercuric chloride in physiologic solution of sodium chloride, 65 cc.; alcohol, 95 per cent, 33 cc., and glacial acetic acid, 2 cc. 18. Wade, H. W.: A Variation of Gemmation of Blastomyces Dermatitidis in the Tissue Lesion , J. Infect. Dis. 18:618, 1916.

SUTTON, RICHARD L.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240080007

Abstract Descriptions of a limited number of instances of congenital defect of the skin of the new-born are to be found in the literature. Most of these have appeared in publications devoted to pediatrics. It is of interest to note a case first recognized when the patient was in his thirty-eighth year. Congenital defect of the skin of the new-born is an extraordinary condition, characterized by absence at birth of circumscribed areas of integument. The defect is usually solitary, but lesions may be multiple, in which case they are usually either grouped or symmetrically located. The outline is sharply defined and circular or oval in most instances and from 1 to 5 or more cm. in diameter. The epidermis and dermis are absent, but the subcutaneous tissue is little affected, and there is no evidence of inflammation. The site of predilection is the vertex of the scalp, but cases have been References 1. Hahn, W. T.: Angeborner Defect eines grossen Theils der Haut des Rumpfes , J. d. Chir. u. Augenh. 30:156, 1841. 2. Abt, I. A.: Congenital Skin Defects , Am. J. Dis. Child. 14:113 ( (Aug.) ) 1917. 3. Huxley, J. S., and DeBeer, G. R.: The Elements of Experimental Embryology , London, Cambridge University Press, 1934, p. 25.

REIN, CHARLES ROBERT;FELDMAN, M. HILLEL

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240083008

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Recently, we observed a patient in whom an unusual form of nonulcerative tuberculosis developed in the soft tissues of the mouth following a regular dental procedure. REPORT OF CASE Mrs. A. J., an American, aged 27, a housemaid, visited her dentist on Aug. 12, 1933, because she had chipped the upper left cuspid. Owing to the severe pain when the drill was applied, the dentist devitalized the tooth under local anesthesia on September 6. A solution prepared by dissolving a tablet of procaine hydrochloride (E tablet) in Ringer's solution was injected infra-orbitally to produce local anesthesia. The root canal was treated and filled with gutta-percha dissolved in chloroform. Three weeks later the inlay was introduced. During this procedure the patient stated that she felt a burning pain over the area of the cuspid. Two hours later she first noticed a small hard mass in the soft tissues of the left

KARCHER, EDWARD W.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240086009

Abstract I wish to report on a type of dystrophy of the 6 year molars which I have observed in a number of cases of congenital syphilis. In cases of dystrophy of this sort the diameter of the crown is normal, and there is no deficiency of enamel or special tendency to early caries. The cusps, of normal size, are rolled inward without any shoulder at the crown and give the appearance of being clinched. The impression for figure 1 was taken from the tooth of an under-developed girl aged 9 years who also showed Hutchinson teeth and a suggestive facies. The Hinton test was positive. I have observed these changes only in cases of congenital syphilis, though it is probable, as is true of cases of the typical mulberry molar, that they may occasionally be found in cases of nonsyphilitic conditions due to some long illness occurring in the first References 1. Karnosh, L.: Histopathology of Syphilitic Hypoplasia of the Teeth , Arch. Dermat. & Syph. 13:24 ( (Jan.) ) 1926. 2. Schwisow, W.: Congenital Syphilis and the Teeth , Dermat. Wchnschr. 98:101 ( (Jan. 27) ) 1934. 3. Kreyenberg, G., and Schwisow, W.: Die Beziehungen des "Hutchinson-Zahnes" und des "Pflügerschen Knospenmolaren" zur kongenitalen Syphilis , Ztschr. f. d. ges. Neurol. u. Psychiat. 127:188, 1930.

Kelly, Richard J.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240089010

References 1. Sutton, R. L., Sr.: Granuloma Pyogenicum of the Lip , J. A. M. A. 66: 1613 ( (May 20) ) 1916.Crossref 2. Sutton, R. L., Jr.: A Fissured Granulomatous Lesion of the Upper Labio-Alveolar Fold , Arch. Dermat. & Syph. 26:425 ( (Sept.) ) 1932.

Pusey, William Allen;Rattner, Herbert

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240090011

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Grund, Jacob L.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240092012

Abstract In 1929, Lindsay1 described the favorable results which he obtained in a case of vitiligo by means of gold sodium thiosulphate injected intravenously. With the exception of a recent communication by Burgess,2 the relatively few subsequent reports dealing with the subject3 indicate that the treatment is without distinct value. The following case of vitiligo occurred in a Negro, a fact which facilitated observation of the degree of pigmentary change present as a result of gold therapy. REPORT OF A CASE W. R., a Negro, aged 28 years, applied for the treatment of depigmentation of the face, neck, upper part of the chest and lower part of the back, which had been present for three years. The onset dated back to a period when the patient was in the midst of intense musical study. Oil of bergamot had been applied without results. On Dec. 20, 1933, intravenous treatment References 1. Lindsay, H. C. L.: The Treatment of Vitiligo with Gold , Arch. Dermat. & Syph. 20:22 ( (July) ) 1929. 2. Burgess, N.: Successful Treatment of Vitiligo, with Report of a Case , Brit. J. Dermat. 46:331 ( (July) ) 1934. 3. Maloney, in discussion on Bechet, P. B.: Leukoderma Treated with Aurotherapy Followed by Dermatitis , Arch. Dermat. & Syph. 21:508 ( (March) ) 1930. 4. Pillsbury, D. M., and Kulchar, G. V.: Gold Dermatitis Limited to Depigmented Skin , Arch. Dermat. & Syph. 27:37 ( (Jan.) ) 1933. 5. Becker, S. W.: Vitiligo , Arch. Dermat. & Syph. 28:497 ( (Oct.) ) 1933. 6. Bloch, B.: Zur Pathogenese der Vitiligo , Arch. f. Dermat. u. Syph. 12: 207, 1917. 7. Bloch, B.: Das Pigment , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1927, vol. 1. 8. Becker, S. W.: Praver, L. L., and Thatcher, H.: An Improved (Paraffin Section) Method for the Dopa Reaction , Arch. Dermat. & Syph. 31:190 ( (Feb.) ) 1935.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240095013

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract The Committee of Organization of the Ninth International Dermatological Congress, to be held in Budapest, Sept. 13 to 21, 1935, under the leadership of Professor Nekam, has wisely issued a very full preliminary program. It shows several departures from the plans of previous congresses which will probably prove desirable. The greatest difference will be the time which is to be given to the consideration of the great dermatologic problems that are not purely scientific, i. e., technical, administrative and professional problems. Committees will be formed and conferences held on these nonscientific questions, and in order not to interfere with the scientific program the meetings of these committees and the conferences on general dermatologic problems will be held on September 13 and 14, preceding the opening of the scientific congress. The members of these committees are selected by the national dermatologic societies. The special committees will consist of: the permanent committee

Keil, H.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240097014

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor:— In the March issue of the Archives of Dermatology and Syphilology (31:371, 1935), Montgomery recorded a case in which there occurred simultaneously lesions of lupus erythematosus and an eruption resembling lichen scrofulosorum; on the basis of this association, it was adduced that the former dermatosis is a tuberculid. Naturally, I am interested in such instances since they would tend to negate the conclusions which I drew from a study of the postmortem data in over 125 cases of the disease. Further necropsy studies (about 50 personally observed cases) have corroborated and strengthened my belief that there is no direct relationship between lupus erythematosus and tuberculosis.In reviewing my paper for the 1934 "Year Book of Dermatology," Wise and Sulzberger, although not openly professing a belief in the relationship of the two conditions, did what all the adherents of this theory must now do to support the

Montgomery, D. W.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240098015

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor:— The coincidence of tuberculids and lupus erythematosus is interesting and important principally as tending to show that lupus erythematosus is also a tuberculid. In the case reported in my paper both lesions were present at the same time and in juxtaposition, and both lesions were typical.A considerable time has now elapsed since my article was submitted for publication, and the patient has greatly improved in general health with the administration of cod liver oil and iron and with attention to diet and to exercise. She could not tolerate gold preparations. Coincident with this constitutional improvement, the lesions of both types have improved, especially those of lichen scrofulosorum.The coincidence of the lesions, their juxtaposition and their simultaneous involution are all strong, though not absolutely conclusive, arguments that they arose from a common cause.Quite justly Dr. H. Keil requires that there should be no doubt regarding

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240099016

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Rattner, Herbert

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240100017

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Abramowitz, E. William;Rulison, R. H.

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240113018

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Dermatitis Medicamentosa (Chloral). Presented by Dr. Louis Tulipan. E. B., a woman aged 65, has a rash which appeared a few days after she had taken a mixture of bromides and chloral hydrate for insomnia. This occurred ten days ago. On the back and chest were confluent patches of bluish, erythematous macules. Around the periphery were discrete macules. The face, especially the part around the eyes, showed erythema and edema. The macules were somewhat edematous. With the exception of desquamation, the rash had practically disappeared by yesterday, when the patient took another teaspoonful of the mixture of bromides and chloral hydrate containing 5 grains (0.32 Gm.) of chloral hydrate. One hour later there developed severe itching, and shortly afterward an exacerbation of the rash appeared. The patient now presents a closely aggregated erythematous, macular eruption of scarlatiniform pinpoint lesions on the trunk and arms. There is edema of the face,

Silver, Henry;Chargin, Louis

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240143019

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Generalized Telangiectasia (Forme Fruste of Recklinghausen's Disease?). Presented by Dr. Adolph Rostenberg This girl, aged 15, had hemorrhagic measles in early childhood; the present cutaneous disorder is said to have developed after that illness. The family history is irrelevant.The patient presents on the face, arms, chest and back a large number of discrete vascular dilatations varying from the size of a pinpoint to several millimeters in diameter. They are flat and resemble "port wine stains." Besides these vascular lesions many moles and freckles are present in the same areas.The mental development of the patient is normal. Physically she is underdeveloped and looks like a child of 10. DISCUSSION Dr. Samuel M. Peck: The patchy vascular condition—it cannot be called an eruption—certainly resembles a naevus flammeus. The patient states that she suffered from frequent nasal hemorrhages. The father and sister had a similar history. I could not look into

Turnacliff, D. D.;Montgomery, Hamilton

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240150020

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract A Case for Diagnosis. Presented by Dr. John Butler, Minneapolis. This married woman, aged 28, says that five weeks ago she noticed a lesion resembling a pin scratch on the chin. The lesion was sharply marginated and became eroded; there was a peripheral spreading of about ½ inch (1.27 cm.) in diameter; there was no apparent infiltration and no pus, but considerable oozing serum which dried on the surface as a thin varnish-like crust was present.Three weeks later (about two weeks ago) she noticed an enlargement of the sublingual glands. The mass was about the size of a walnut and seemed to be soft and lobulated. It does not seem to have enlarged since it was first noticed. The first time I saw the patient, about a week ago, she said that she had been applying phenolized petrolatum to the sore. She discontinued the use of antiseptics, and several

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240160021

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract The appearance of this new edition attests the popularity that Stokes' work has attained. The features which gave the first edition individuality were especially the systematic way in which the subject was presented; the introduction of differential tables, particularly of diagnosis, which cleared and emphasized the points that were considered in each table; the minute attention given to technic and detail in the handling of the cases, and the intensive thoroughness of the whole work. The book has been thoroughly revised, but fortunately these characteristics have not been lost. The work remains, on the whole, perhaps the most intensive study of syphilis that has been made, at least in English. Fifteen of the original twenty-three chapters have been rewritten. A valuable chapter has been added on relapses and progression, which, in the way in which the subject has been brought together, is an addition to works of this sort. Other

1935 Archives of Dermatology and Syphilology

doi: 10.1001/archderm.1935.01460240161022