Notes on psoriasis / by R.W. Taylor.

  • Taylor, Robert W. (Robert William), 1842-1908.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on psoriasis / by R.W. Taylor. Source: Wellcome Collection.

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    we can place psoriasis in the category of diseases incidental to the develop¬ ment period of the human subject. With the data at our command, it would be folly to attempt to draw conclusions. I think that the facts here stated are food for thought and should be incentives to observa¬ tion by my worthy colleagues. Then at some future day we can pretty correctly determine the moot point as to whether syphilis has a more or less remote relation to psoriasis. I think I may mention the fact that in certain exceptional cases the papular syphilide presents appearances so closely resembling psoriasis as to be at least perplexing. Then again the indolent subacute course of the non-specific disease is very similar to that of the same syphilide. So much for etiology; now as regards prog¬ nosis. I think that our views as to the curability of psoriasis are suscep¬ tible of modification. We are taught that relapses are inevitable, and that Hebra’s classical case of the psoriatic man who suffered also from hemoptysis, being the only person he ever knew of not suffering a relapse of his skin affection, has had too much influence upon us. It has cer¬ tainly been the cause of a gloomy prognosis in hundreds of cases. With¬ out burdening my hearers with dry details of illustrative cases, I will state concrete facts, vouching for their truth. I have almost convinced myself that, if psoriasis is treated early and persistently in the young subject, it maybe cured. In several instances, the early eruption has been promptly cured by me; in none of them has there been a relapse in a period of six and eight years. I think that frequent attacks of the disease engraft on the skin a morbid tendency, or rather, expressed in a homely way, that the skin takes on a bad tendency, which may be even permanently engrafted on it. I should suggest this modification of our opinion as to prognosis of psoriasis—namely, that relapses are not inevitable, but that they are most severe and frequent in those cases which have been neg¬ lected or inefficiently treated in early life. From careful and prolonged observation I think I am able to affirm that a combination of arsenic and mercury (as in Donovan’s solution) will yield better results in young psoriatic subjects than will arsenic alone. In old and inveterate cases, I think that the latter alone is our best internal remedy. My belief is strong that, if psoriasis is attacked in its early stages by efficient internal and external treatment, before it engrafts itself deeply upon the nutrition of the skin, it can be thoroughly cured. I may here mention the fact (as analogical evidence) of the persistence of the so-called syphilitic palmar and plantar psoriasis, when for any reason it has become chronic, and of its amenability to treatment if attacked early. DISCUSSION. Dr. Wm. A. Hardaway said that he was fully aware of the peculiar view taken by Wilson that psoriasis was a remote result of syphilis, but,