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May 1991

Malleus Humidus

Arch Dermatol. 1991;127(5):646. doi:10.1001/archderm.1991.01680040054004

Dr. Lukaschewitsch reports two cases at a meeting of the Society of Physicians of Kiew. (Monatsh. f. prak. Dermat., Bd. XII., No. 2.)

  1. A Jew, 16 years old, in whom the disease had existed for five months under the form of tubercular lesions in the skin, the muscles, and mucous membranes, developed a large ulcer on the hard palate, with muco-purulent discharge from the nose. The case was interesting owing to the favorable influence exerted on the disease by warm salt baths. It led to the absorption of many infiltrations.

  2. A Cossack, aged 25, was infected from a horse two and a half months before he was seen in May, 1890. Two large infiltrated masses of the size of a goose-egg were present, one on the right and one on the left thigh. The inguinal glands were also enlarged. Inunctions of mercury and iodide of potash internally produced no effect. Injections hypodermically of hydrarg. bichlor. (1:2,000) caused the newer infiltration to disappear altogether and the older one to diminish one-half in size. In August he was given tinct. iodine 2-7 drops. New lesions, however, developed; loss of strength set in accompanied by severe diarrhea. When the case was reported the patient was a little better, but there was little hope of recovery.

In both cases, the diagnosis was confirmed by the microscope, by cultures and inoculations on cats and guinea pigs.

Dr. L. also briefly refers to the cases of malleus reported in Russia during the last ten or eleven years. They are 46 in number (45 men, 1 woman), and of these only five ran a chronic course. Inoculation occurred three times from man to man and twice from the corpse. The infection took place through the various mucous membranes or by accidental wounds, or through the air, the bacilli in a dry state retaining their vitality for three months. When the disease was inoculated the period of incubation was from three to six days, but it was unknown when infection occurred in other ways. The diagnosis was rendered very difficult before the appearance of cutaneous lesions or implication of the mucous membranes, for the reason that examination of the blood in acute cases is frequently, in chronic ones constantly, negative in demonstrating the presence of the bacilli. Of the 46 cases, only 3 acute and 2 chronic ones remained alive. Therapy, warm baths, and iodide of potash in large doses.

George T. Elliot.

J Cutan Genito-Urin Dis.

May 1891;9:196-197.

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