Page:Archives of dermatology, vol 6.djvu/269

This page has been proofread, but needs to be validated.

CLINICAL REPORTS.


I. Remarkable Case of Feigned Eruption. By L. Duncan Bulkley, A.M., M.D., of New York.

Miss ———, a tall, overgrown girl, aged 16, with light hair and complexion, was sent to me from a neighboring city on account of an eruption which was thought to possess peculiar features. Her physician, a man of unusual ability, and also others acquainted with skin diseases, had been greatly puzzled, but had regarded the eruption as a neurosis. Dr. ———, her physician, wrote that she had had "a series of nervous troubles culminating in the eruption."

She was the second of three children, they being respectively three years older and three years younger; her older sister accompanied her, and appeared to be in perfect health, and was self-composed. Her mother was reported as exceedingly nervous, and her father, who was also with her, was likewise very nervous and excitable.

The patient was said to have been in good health up to six months previous to her visit, although she was always considered to be a "very nervous child," and had grown very rapidly. She was reported to have had spinal meningitis at six or seven years of age, and to have been in bed four months with it. Her menses had appeared at thirteen years of age, had recurred every four weeks, lasting four or five days, and occasionally gave some pain.

During the winter, in January, six months previous to her visit, she began to suffer unusually from cold hands and feet, and soon had facial neuralgia, and following this many nervous symptoms, which were indistinctly recalled and disconnectedly given, such as trembling of the hands and hysterical attacks, culminating in severe headaches. In February her physician found a small spot of insensibility over the spinal column, and a lack of feeling in the left leg, which were benefited by faradization. In March and April she had neuralgia in the right arm, also in the face. Two months before her visit she had some difficulty with a tooth or the gum, and a tooth was extracted very unexpectedly, which threw her into hysterics, with catching of the breath, etc.

The morning of her visit her father had discovered what he considered a great amount of one-sidedness of the spinal column. It was found on examination that a moderate amount of lateral curvature was present, both sitting and standing.

The eruption was first observed seven weeks previous to her visit, when a red patch appeared upon the right cheek. This was described