McCall Anderson's Classification of Skin Diseases
Reproduced below are the contents of pages 8-12 of Thomas McCall Anderson's "Treatise on Diseases of the Skin, with Special Reference to their Diagnosis and Treatment" (London: Charles Griffin and Company, 1887). In addition to accounts of individual disorders, this textbook includes a tabulation by diagnosis of 11,000 consecutive cases of skin disease. This early "diagnostic index" reflects both the skin diseases prevalent and the social conditions in Glasgow at the time.
The Classification of Diseases of the Skin
It is not my intention to dwell at any length upon the classification which I have adopted, and which is but a modification of that followed for many years at the Glasgow Hospital for Skin Diseases, as explained by the late Dr. A. B. Buchanan in a very able article which he communicated to the Edinburgh Medical Journal, January, 1863. The object aimed at in this classification was to render it as useful as possible from a clinical point of view, and hence the most important point was to arrange the various diseases, as far as practicable, in accordance with their nature and cause. It is most desirable, no doubt, to have a classification in accordance with one principle; but in the present state of our knowledge it is impossible to fulfil the latter indication except at the expense of the former; and, accordingly two principles are involved in this clinical classification - namely, the pathological and the etiological.
We divide skin diseases, then, into two great classes - namely, (a) Functional and (b) Organic.
The Functional we subdivide into -
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The Organic we subdivide into-
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Before entering upon the consideration of the individual diseases of the skin, one or two preliminary observations may be made. The first of these is that it is always desirable, when possible, to examine our patients by daylight, especially in cases of doubt or difficulty, for artificial light alters the colouring, and changes the appearances of many eruptions to an extent that could hardly be credited. Again, it is of importance to make a rule of examining the whole surface of the body, or as much of it as possible, so as to enable us to secure a good general picture of the disease, and this is all the more necessary, seeing that the patient has a, tendency to exhibit the part most readily uncovered, or which he has least delicacy in exposing, or where the eruption appears to him to have assumed the most aggravated form. Now, it happens not infrequently that such a part is least characteristic of the disease, of which we have frequent illustrations in cases of scabies. Here, for example, the patient may exhibit his leg, which, as the result of scratching, is the seat of an acute eczematous affection, and, if we were to limit our view in such a case to this part, we would be apt to commit the error of calling the disease Eczema instead of Scabies. Finally, we must not at once accept as correct the statement of the patient as to the limitation of the eruption to the part exposed. Many say so in order to save themselves trouble, or from a. false feeling of delicacy, or because they are really ignorant, or forgetful, of the existence of any eruption elsewhere.
ANALYSIS OF 10,000 CONSECUTIVE CASES OF SKIN
DISEASE MET WITH IN HOSPITAL PRACTICE
Functional Affections |
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Pruritus |
39 |
Vitiligo |
4 |
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Organic Affections |
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I. Inflammations |
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Erythema * |
470 |
Erysipelas † |
10 |
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* Including strophulus, pityriasis and roseola |
# Including lichen urticatus |
II. New Formations |
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Varix |
41 9 |
Elephantiasis Graecorum |
1 6 |
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III. Haemorrhages |
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Purpura simplex |
6 |
IV. Disorders produced by uniform causes |
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a. Parasitic Affections |
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Vegetable |
Tinea favosa Tinea versicolor |
Circinata |
156 |
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Animal |
Scabies |
2527 |
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b. Syphilitic affections |
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Primary accidents |
24 |
c. Strumous [=tuberculous] affections |
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Lupus |
198 |
Strumous glands |
191 |
d. Eruptive fevers |
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Morbilli |
1 |
ANALYSIS OF 1,000 CONSECUTIVE CASES OF SKIN
DISEASE MET WITH IN PRIVATE PRACTICE
Functional Affections |
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Pruritus |
11 |
Alopecia |
18 |
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Organic Affections |
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I. Inflammations |
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Erythema * |
99 |
Rosacea |
21 |
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* Including strophulus, pityriasis and roseola |
§ Including Lepra |
II. New Formations |
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Varix |
4 2 |
Elephantiasis Arabum |
1 2 |
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III. Haemorrhages |
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Purpura rheumatica |
1 |
IV. Disorders produced by uniform causes |
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a. Parasitic Affections |
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Vegetable |
Tinea favosa Tinea versicolor |
Circinata * |
4 |
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* Including the so-called Eczema marginatum
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Animal |
Scabies |
44 |
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b. Syphilitic affections |
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Secondary and tertiary accidents |
51 |
c. Strumous [=tuberculous] affections |
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Lupus vulgaris |
22 |
Strumous glands |
9 |