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Society Transactions.

Society Transactions. THE JOURNAL OF CUTANEOUS DISEASES VOL. XXVI DECEMBER, 1908 NO. 12 THE PHILADELPHIA DERMATOLOGICAL SOCIETY. The regular monthly meeting of the Philadelphia Dermatological Society was held at the Polyclinic Hospital, on Tuesday evening, October 20, 1908, at 8:30 o’clock. Dr. M. B. Hartzell presiding. * * * Herpes Zoster of a Rare Distribution, A Case of. Presented by Dr. DAVIS. The patient, a male of fifty years, first came for treatment six days ago, complaining of severe pains in the head. The attack first commenced ten days previously with aching pains in the left temple, spreading over the left side of the face to the corner of the mouth, the patient being unable to sleep because of the pain. Three days after the beginning of the pain, groups of vesicles started to appear on the left cheek and chin, others developing on the lip, and the temporal region. The patient because of the severe pains, and a hectic temperature, was put to bed, the temperature reaching 103 degrees Fahrenheit. At present groups of typical, unbroken or drying up, vesicles are found on the left temporal region, the left cheek, the corner of the mouth, the left side of the lower lip, the left side of the tongue, and the inner side of the left cheek. Those present agreed that the case was unusual because of the distribution of the lesions and the severity of the symptoms. J Cutan Dis. 1908;26(12):582. What did the President know and when did he know it?—Senator Howard Baker, June 6, 1973 Reports that say that something hasn't happened are always interesting to me, because as we know, there are “known knowns”; there are things we know we know. We also know there are “known unknowns”; that is to say we know there are some things we do not know. But there are also “unknown unknowns”—the ones we don't know we don't know.—Secretary of Defense Donald Rumsfeld, February 12, 2002 Editor's Comment Unusual distribution? It's textbook mandibular branch of the trigeminal nerve! V3 from first-year anatomy! Back in the day when physicians were—if nothing else—master clinicians, how could these doctors not get it? I got it! Obviously, as of 8:00 PM October 20, 1908, the sensory distribution of the cranial nerves had not yet been mapped! Now all I had to do was find out when this feat was accomplished and I could write one of my You Are Here timelines. After exhausting my usual resources, I called the only neurologist I knew, Dr K—, a brilliant man, professor emeritus, and former head of his department; he had no clue. Hmm. Mr McF— recommended Dr R—. Dr R— suggested Dr Y—, who would know and, if not, would know who would. He didn’t. Even Professor H— was stumped, and he knows everything! This was great! If the answer was that obscure, boy would I have a heck of an article! I’d just have to find out the answer myself. So, off to the medical library I went. I started my search with the paper that first mapped the sensory dermatomes of the spinal nerves (incidentally, by correlating the cutaneous distribution of zoster lesions and the corresponding neuropathology).1 Oops! Case 18 in the study by Head and Campbell was a patient with zoster of the “inframaxillary division of the 5th nerve” accurately described and precisely illustrated.1(p501) A contemporary edition of Gray's Anatomy2 left no doubt: the inferior maxillary nerve is what we now call V3. Which takes me back to square 1: Since the distribution of the mandibular nerve was known at the time of the Philadelphia meeting, why didn't the attendees recognize it? All I know is it's now my head that hurts! References 1. Head HCampbell AW The pathology of herpes zoster and its bearing on sensory localization. Brain 1900;23353- 523Google ScholarCrossref 2. Gray H] Anatomy, Descriptive and Surgical. New York, NY: Bounty Books;190- 734 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Society Transactions.

Archives of Dermatology , Volume 144 (12) – Dec 15, 2008
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Society Transactions.

Abstract

THE JOURNAL OF CUTANEOUS DISEASES VOL. XXVI DECEMBER, 1908 NO. 12 THE PHILADELPHIA DERMATOLOGICAL SOCIETY. The regular monthly meeting of the Philadelphia Dermatological Society was held at the Polyclinic Hospital, on Tuesday evening, October 20, 1908, at 8:30 o’clock. Dr. M. B. Hartzell presiding. * * * Herpes Zoster of a Rare Distribution, A Case of. Presented by Dr. DAVIS. The patient, a male of fifty years, first came for treatment six days ago, complaining of severe pains in the...
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References (2)

Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.144.12.1555
Publisher site
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Abstract

THE JOURNAL OF CUTANEOUS DISEASES VOL. XXVI DECEMBER, 1908 NO. 12 THE PHILADELPHIA DERMATOLOGICAL SOCIETY. The regular monthly meeting of the Philadelphia Dermatological Society was held at the Polyclinic Hospital, on Tuesday evening, October 20, 1908, at 8:30 o’clock. Dr. M. B. Hartzell presiding. * * * Herpes Zoster of a Rare Distribution, A Case of. Presented by Dr. DAVIS. The patient, a male of fifty years, first came for treatment six days ago, complaining of severe pains in the head. The attack first commenced ten days previously with aching pains in the left temple, spreading over the left side of the face to the corner of the mouth, the patient being unable to sleep because of the pain. Three days after the beginning of the pain, groups of vesicles started to appear on the left cheek and chin, others developing on the lip, and the temporal region. The patient because of the severe pains, and a hectic temperature, was put to bed, the temperature reaching 103 degrees Fahrenheit. At present groups of typical, unbroken or drying up, vesicles are found on the left temporal region, the left cheek, the corner of the mouth, the left side of the lower lip, the left side of the tongue, and the inner side of the left cheek. Those present agreed that the case was unusual because of the distribution of the lesions and the severity of the symptoms. J Cutan Dis. 1908;26(12):582. What did the President know and when did he know it?—Senator Howard Baker, June 6, 1973 Reports that say that something hasn't happened are always interesting to me, because as we know, there are “known knowns”; there are things we know we know. We also know there are “known unknowns”; that is to say we know there are some things we do not know. But there are also “unknown unknowns”—the ones we don't know we don't know.—Secretary of Defense Donald Rumsfeld, February 12, 2002 Editor's Comment Unusual distribution? It's textbook mandibular branch of the trigeminal nerve! V3 from first-year anatomy! Back in the day when physicians were—if nothing else—master clinicians, how could these doctors not get it? I got it! Obviously, as of 8:00 PM October 20, 1908, the sensory distribution of the cranial nerves had not yet been mapped! Now all I had to do was find out when this feat was accomplished and I could write one of my You Are Here timelines. After exhausting my usual resources, I called the only neurologist I knew, Dr K—, a brilliant man, professor emeritus, and former head of his department; he had no clue. Hmm. Mr McF— recommended Dr R—. Dr R— suggested Dr Y—, who would know and, if not, would know who would. He didn’t. Even Professor H— was stumped, and he knows everything! This was great! If the answer was that obscure, boy would I have a heck of an article! I’d just have to find out the answer myself. So, off to the medical library I went. I started my search with the paper that first mapped the sensory dermatomes of the spinal nerves (incidentally, by correlating the cutaneous distribution of zoster lesions and the corresponding neuropathology).1 Oops! Case 18 in the study by Head and Campbell was a patient with zoster of the “inframaxillary division of the 5th nerve” accurately described and precisely illustrated.1(p501) A contemporary edition of Gray's Anatomy2 left no doubt: the inferior maxillary nerve is what we now call V3. Which takes me back to square 1: Since the distribution of the mandibular nerve was known at the time of the Philadelphia meeting, why didn't the attendees recognize it? All I know is it's now my head that hurts! References 1. Head HCampbell AW The pathology of herpes zoster and its bearing on sensory localization. Brain 1900;23353- 523Google ScholarCrossref 2. Gray H] Anatomy, Descriptive and Surgical. New York, NY: Bounty Books;190- 734

Journal

Archives of Dermatology – American Medical Association

Published: Dec 15, 2008

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