Page:The Journal of Nervous and Mental Disease, 1876.djvu/569

Tucker — Case of Herpes Zoster Frontalis. 561

{{smaller|{Read before the Chicago Society of Physicians and Surgeons, Sept. 11, 1876.)}}

RECENT advances in neurological science are compelling us to pluck diseases, so to speak, one by one, from the positions they formerly occupied in this or that classification, and, on account of a more intimate acquaintance with their real character, to transplant them to a new and more appropri- ate field. In this new field, they have doubtless always be- longed, and here they have been placed heretofore by shrewd, practical conjecture, though it has hitherto been impossible to determine their true position and relations, till the broader sig- nificance of neurotic influence was fully and truly recognized and understood. This is particularly true of many forms of cutaneous eruptions, especially the phlyctenoides, the most prominent of which is herpes zoster, whose peripheral mani- festation has led it to be classified, until quite recently, as purely a disease of the skin. Neuro-pathologically considered, this disease is, however, as remote from a purely peripheral affection as epilepsy or tetanus, etc., the trophic changes which it presents being no less symptoms of internal disease than an epileptic or tetanic convulsion — the phenomena peculiar to the diseases named being determined by the nervous centre, which is the seat of the lesion, or irritation. To look upon this dis- ease from an eccentric standpoint alone, and ignore or under- estimate the fact that there is an irritation, or lesion, back of the external phenomena which produces the trophic changes of zoster, is to lose sight of the only rational guide to its therapeutics. It is of comparatively little importance to make a colored map of this disease, though it may furnish a very correct representation of its superficial appearances, presenting the character of its vesicles, with their gradual transformation