Clinical notes on psoriasis : with especial reference to its prognosis and treatment / by L. Duncan Bulkley.

  • Bulkley, Lucius Duncan, 1845-1928.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on psoriasis : with especial reference to its prognosis and treatment / by L. Duncan Bulkley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    This table fully bears out the chronic character of the disease, for there appear cases in it which had lasted thirty years or more at the time of first observation; in a very large number of instances (84, or ueai'ly one-quarter of the entire number) the eruption had existed from five to ten years previous to the first visit. The natural history of psoriasis is, therefore, to be reckoned by years rather than by days and months. Thus, of these 366 cases, no less than 221, or over 60 per cent., had lasted for five years or over. Comparatively few cases were observed at or soon after the first appearance of the eruption, only 12 cases during the first three months, and only 24 cases in all during the first six months of the existence of the eruption. It will be seen later that this is a fact of no little importance in connection with the proper treatment of the disease, and its prognosis. Something more can be learned in regard to the obstinacy of the complaint by a consideration of the periods of time during which these patients were under observation. These are shown in the following Table, IV.: Table IV.—Duration op Observation of 366 Patients with Psoriasis. Male. Female. Total. 1 month or less (74 seen but once) . . 95 45 140 15 21 16 30 28 60 12 30 8 15 3 4 ... . 3 11 4 5 4 9 5 10 13 29 10 15 . 7 13 15 20 2 6 20 30 . 1 2 Total 154 366 Here it will be seen that a large number of the cases were seen but for a short time; 191, or over one-half, for a period less than six months, and of these 74 were seen but once, and many others but two or three times. In looking over the notes of these cases we find that some of them yielded to treatment and were apparently cured even in a short time, while many were lost sight of before any conclusions could be reached as to the value of treatment. In