[Reprinted from The Medical News, June 22, 1895.] 
A CASE OF HEM AT IDR OS/S COMBINED WITH 
CHROMIDROSIS. 
By ISADORE DYER, M.D 
DERMATOLOGIST TO CHARITY HOSPITAL ' PROFESSOR OF DERMATOLOGY, 
NEW ORLEANS POLYCLINIC LECTURER AND CLINICAL INSTRUC- 
TOR IN DERMATOLOGY, TULANE UNIVERSITY, ETC., NEW 
ORLEANS, LA. 
The case herewith reported is interesting on account 
of the recurrent attacks of the disease and for the variety 
of the location of the separate eruptions. 
The patient was a professional rubber in a local Turk- 
ish bath. He is twenty-six years old, an American, five 
feet eleven inches in height, and weighs 147.5 pounds. 
The patient called after his first eruption, but there was 
no evidence of the condition, and his healthy appear- 
ance and otherwise normal state made me somewhat 
skeptical of his statement. Two of the attendants em- 
ployed at the same bath, however, fully confirmed his 
description of his first attack, and the details were in- 
teresting. Just after rubbing a patron of the bath one 
of the other attendants remarked that the patient was 
" sweating blood " between his shoulders, and wiped off 
the sweat with a towel. The towel was stained with the 
secretion. The sweating persisted for fully half an hour, 
leaving the skin reddened for quite an hour after that. 
The patient was advised to send for me as soon as 
another attack occurred, and also to note any untoward 
experience or sensation on his own part. Meantime it 
was ascertained that the father was subject to similar 
attacks in his youth. Neither father nor son, however,. 2 
was a hemophile. The man himself was normal in 
every way. Although of a slender frame he was well 
made physically, and, on examination of his chest and 
heart, I found him perfectly normal. The urine showed 
no unusual evidence. Fully two weeks after the first 
attack I was called to the Turkish bath to see the patient 
in an acute attack. He had been exposed in the hot 
room of the bath, but had done no rubbing. 
He was in no way distressed, except by his desire to 
hold the eruption for me to see. There was a marked 
scarlet eruption, involving the knee and the upper third 
of the right leg, arranged in a triangular manner with 
the base of the figure at the knee. The eruption was 
almost dense in its character, but here and there it was 
mottled. The appearance presented was that of an 
abraded skin, which on closer examination appeared to 
be, what it most likely was, a diffuse hemorrhage into 
the skin. There were absolutely no subjective symp- 
toms, and there were no signs of swelling or of inflamma- 
tion, simply the startling scarlet redness of the eruption. 
A sketch was rapidly made of the patch, which faded 
while this was being done. There had been no sweat- 
ing with this eruption, but the patient assured me that 
the former attacks had been preceded and followed by 
just such an eruption. At the time I was called the 
eruption had been present for an hour. It was fully an 
hour under observation, and the patient assured me sub- 
sequently that it lasted fully an hour after his leaving me. 
In fading, the patches became broken, fading first in 
the center, until finally only the margins were apparent. 
Between the first attack and the one here described the 
patient informed me that he had had one on the chest. 
Just nine days subsequent to the attack described the 
patient reported, with a two-ounce bottle filled with a 
fluid the color of ordinary carmine ink. This he stated 
had been collected from his back during an attack the 
night before, which had lasted longer than any of the 3 
preceding attacks, and which, for the first time, had left 
him weak and with pains in the joints. The fluid was 
examined by Dr. Pothier, the pathologist of Charity 
Hospital, and found to contain a mass of broken-down 
epithelial cells and fibers of cotton, stained red. There 
were no blood-corpuscles. Acids produced no reaction, 
and alkalies rendered the liquid colorless. Chemic 
agents, iron, etc., gave no reaction for blood. The 
staining of the fibers and the absence of blood-cor- 
puscles or coloring-matter of the blood argued for a 
true chromidrosis. There was no suspicion of fraud 
on the part of the patient, and no occasion for it. Be- 
sides, the testimony of three other individuals who had 
witnessed the previous three attacks, and of one of these 
who twice had wiped off the sweat and had finally col- 
lected the fluid, must be considered reliable. Moreover, 
the patient did not wear colored underwear, but gray 
worsted and flannel mixed. The patient had been an 
attendant in the same bath for nearly a year, and seemed 
to have been affected in no other way by this new occu- 
pation. He had taken no drugs for an indefinitely long 
period preceding the eruptions. The change of occu- 
pation and the physical exertion incident to the rubbing 
at the bath seem alone to determine the cause of the 
eruption. The hereditary tendency might be remarked, 
but, of course, is to be qualified accordingly. The case 
is of some clinical interest from the sex and age of the 
patient, and from the concurrence of the two generally 
accepted reflex disturbances of the sweat-glands. 
Under my advice the patient left the Turkish bath, 
and since changing his occupation to one of out-door 
life he has had no recurrence of the affection, although 
over two months have elapsed. 
124 Baronne Street.