Excerpt from Dermatology, the Essentials of Cutaneous Medicine

The subject has been handled, so far as practicable, from the stand point of internal medicine. The etiology of skin diseases, as a whole, is not yet well understood. Nevertheless, it is obvious that the integument is not autonomous, and that it is greatly influenced by, and greatly influences, the rest of the body. Premature and tenta tive as must be beliefs connected with this interrelation, it is high time that they were stated, either to be sustained or overthrown in the future. They are set forth in this book, but our knowledge does not yet permit a classification of dermatoses solely on etiological grounds.

Nomenclature in dermatology is discouraging, involved and often unsound. Some terms, however fanciful, have become permanent. Lichen is an example of this. Since its ancient symbolism con notates something definite, there is no reason to assail it. Not so the word eczema! The disease thus styled is one with vesicular derma titis in aspect, causation, histology and course. Therefore, the sounder term should replace it. The word is nowhere independently employed in this book, but is used parenthetically after the expression dermatitis, wherever the latter appears. This compromise seemed expedient, for the undesirable term, not yet having been abandoned, must be continued until opinion becomes unanimous as to its further restriction. Scientifically, there is nothing to be said for the word eczema We Speak of occupational dermatitis and occupational eczema, of seborrhoeal dermatitis and seborrhoeal cc zema, of fungus dermatitis and fungus eczema, of dermatitis of unknown origin and eczema of unknown origin, etc., always meaning in each couple the identical thing. This is a handicap, particularly since dermatitis, being philologically and medically an accurate desig nation, is preferable; and such writers as Norman Walker, and Pusey have accepted the fact. Another complex subject is cutaneous tuber culosis. Here again there has been a plethora of verbiage. So far as possible an effort has been made at simplification. Congenital syphilis, too, is masked by a literary smoke screen, partly through the inaccurate interpretation of the term hereditary, partly through a series of superstitions that still sustain about a comparatively simple thing an artificial cloud of obscurity. With the utmost respect for venerable traditions, it has been attempted to divest a difficult field of medicine of unnecessary encumbrances.

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