. Virginia medical semi-monthly. unds, but threeyears later married again. One year ago shewas separated from her second husband. Shehad no children by the second marriage. February 18th, of this year, the patient cameto my clinic at the George Washington Hos-pital for examination and treatment. Onphysical examination, her objective symptomsconsisted of a rather sharply defined, dry,slightly scaly, indurated, patchy lesion on the 282 THE VIRGINIA MED lower flexor surface of the right fore arm (thesame location and symptoms she had 13 vearsago). The surface of the patch on close ex-amination wa
. Virginia medical semi-monthly. unds, but threeyears later married again. One year ago shewas separated from her second husband. Shehad no children by the second marriage. February 18th, of this year, the patient cameto my clinic at the George Washington Hos-pital for examination and treatment. Onphysical examination, her objective symptomsconsisted of a rather sharply defined, dry,slightly scaly, indurated, patchy lesion on the 282 THE VIRGINIA MED lower flexor surface of the right fore arm (thesame location and symptoms she had 13 vearsago). The surface of the patch on close ex-amination was seen to be composed of numer-ous ill-defined, flat, angular, burnished papulesthat were more prominent on the edge of thelesion than in the center where the slight scal-ing was more noticeable. Besides this largelesion there were several smaller isolatedpapules and tubercles to be seen on the inter-nal surface of the wrist. In these places,which ranged in size from a pin-head to asplit pea, the angular, shiny papules were more. Anterior Surface Wrist. distinct. There were no signs of crusting, ul-ceration or exudation to mar the perfectly dry,indurated patch. There were no scars orother evidences of syphilis. The larger patchhad been formed by a confluence of smallerlesions, and there was nothing to suggest thatits border had been composed of slowlyspreading, scarring or ulcerating was little or no resemblance to a latesyphilitic lesion. Subjectively the patientcomplained of intense itching. The otherwrist was clear and there were no papules tobe seen on the neck or mucus membranes ofthe mouth. The patient insisted that she hadsyphilis and that the present lesion was theexact counterpart of what she had followingher first marriage. The Wassermann reactionwas negative, and I doubt very seriously ifthe patient ever had syphilis. Fowlers solution in moderate doses caused ?AL SEMI-MONTHLY. [September 8, the lesion to almost disappear in two picture was
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