from I'll K riIII.AIIKI.PIIIA I‘OI.VCI.INIC. Vol. V. Sc|>l. J. Adslsliuit Demonltriltor of OliHtctrici in the University of Pennsylvania; Instructor in Gynecology. l*fiilacle)|>l>ia Polyclinic, etc. The curious and exceedingly rare dermic condition of the new-born which has lieen designated by the name of Ritter, who first scientifically described the disease, and is also known as dermatitis exfoliativa infantum vel neonatorum, or, as Ballantyne terms it, keratolysis neonatorum, isan acute cutaneous disease characterized by a primary hyperc mia, followed by an excessive exfoliation of the epidermis, and accompanied at times by of age, her two previous pregnancies having been normal in every resjiect. When seven months of the present pregnancy had elajised her youngest child, 3 years of age, developed a mild attack of scarlatina, which ran an un- eventful course, and was followed by the usual amount of desquamation. No untoward symptoms were manifested by the mother, nor did she notice any unusual fetal mani- festations. 'The gestation proceeded in a normal manner to term, and the patient was delivered on the evening of May 7, 1896, of a female child, after a labor of but two hours’ duration. This was followed, how- ever, by a smart attack of postpartum hemor- rhage, which left the jiatient in quite an ex- hausted condition. The child was large and well-formed, and to all intents alisolutely healthy. On the seventh day, however, the mother called attention to a curious flush- ing of the surface of the liody, including the face, which was unattended by fever, vomit- ing, or other systemic manifestations. This increased in intensity until the ninth day, when there occurred an epidermic desquama- tion, large flakes of skin rolling up over the Inxly and eventually falling off. There was no febrile reaction, nor during the jieriod of desquamation did the temperature fall at any time below the normal, while the child, except for its peculiar appearance, seemed alisolutely well, and look the nipple in the usual manner. By the end of the second week the disease had run its course. During the heat of the following July and August the infant passed through a severe attack of summer complaint, from which it rallied, al- though in a greatly emaciated and debilitated condition. It has suffered more or less from selwrrhea of the scalp, and the mother states that its skin is unusually sensitive, rescind- ing promptly to the slightest source of irrita- tion. a vesicular or bullous formation, and by a high mortality. It is more common in male than in female children, and the disease gener- ally appears in the second week, and is very rare after the fourth or fifth week. At first apparently healthy, the infant suddenly de- velops an erythematous flush upon the fare or buttocks, which soon heroines general; there is no fever, nor is there any gastric dis- turbance to be noted. An exioliation of the epidermis quickly follows, the cutii le falling off in large Hakes. In a very short time a new epidermis is formed, and the entire pro cess, occupying a week or two, may l>c unac- companied by systemic manifestations. In many cases, however, there will develop complications, as diarrhea, pneumonia, or marasmus, and the child ultimately perishes from exhaustion or from loss of body-heat due to the removal of so much of the epidermis. Eczema and subcutaneous lioils are occa- sionally to be noted as sequelae. The case about to l>e rejKirtcd is a typical instance of this interesting aflet tion. The mother, Mrs. G., was a tertipara of 37 years This case is esjiccially interesting as substan- tiating the theory that the disease in question is a sequence of some form of intrauterine exan- them. It is lielicvcd that the fetus has been the subject of one of the exanthemata in a mild form, the cutaneous lesion of the dis- ease only manifesting itself some days after birth. The fact that another child in the family had suffered from scarlatina during the later months of the gestation, and the well-recognized predisposition of the fetus in utero to acquire the zymotic diseases, are at least strong reasons for believing that there was in this instance an association between the two diseases. When we rememlier that the prognosis of Ritter’s disease is grave, fully fifty per cent, of the infants perishing from the causes already mentioned, the mild course of the disease in the present instance adds another source of interest to the case. Contrary to the usual rule the child was a fe- male ; otherwise the course and history of the disease was typical of the milder form. The treatment of the dermatitis should con- sist in the application of some emollient oint- ment, as of ichthyol, resorcin, or boric acid; protection of the denuded surface with cotton; and the administration of good milk and tonics, with proper atten- tion to hygiene.