File:Clinical essays (1862) (14761292206).jpg

Identifier: clinicalessays00rich (find matches)
Title: Clinical essays
Year: 1862 (1860s)
Authors: Richardson, Benjamin Ward, Sir, 1828-1896
Subjects: Clinical medicine Clinical Medicine
Publisher: London : J. Churchill
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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om-menced about the head: there was also some fallingoff of the hair. I made the most rigid inquiries asto the nature of this eruption and its cause, and noinformation was withheld me, as I believe; but Icould not see reason even for a suspicion of pre-existing syphilitic malady. The lepra continuedalone until August 1859, when she first perceived apeculiar sensation beneath the nails. The surfacebeneath the nails felt benumbed; and at times, espe-cially in the evening, it was the seat of a tinglingsensation, described in common parlance as pin& andneedles. The immersion of the hands in water mode-rately warm would bring out this sensation at anyhour of the day; but it always occurred, sponta-neously, about bed time. After a few weeks, thenails commenced to look glazed. They seemed,said the patient, as if they had been smeared overwith varnish of a yellow tinge. They then beganto show little indentations all over the surface, as ifthey had been pricked with the point of a pin, and
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tibee .i. J)aiiue3iield,Lith. .„R»dicird str*rf;Covent Ooim. DISEASED CONDITION OF THE NAILS. 33 had afterwards been rubbed with a black substance.Beneath the nails thickening now began, so thatsome were raised an eighth of an inch. The edgesalso crumbled, but not with the same degree of irre-gularity as was noticed in the first named case. At the time when the patient came under myobservation, every nail on the hands was affected,except that of the left forefinger; the nails of thegreat toes were also diseased in a similar way. Thenails were firmly fixed, to my sensation, when trying tomove them ; but the patient said that they felt looseto her sensation, and that after soaking them in waterthey really were loose. Some of them were deeplycupped in the centre. I sent this patient to Mr.Orrin Smith for illustration. He has sketched fourof the fingers with great care, together with a patchof the scaly eruption from the arm. The differentdrawings, given in the accompanying plate, show

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