The Tenth International Congress of Dermatology

and the only other occasion when London had the honour of entertaining the world's dermatologists was in 1896. Forty-five coun;tries, including the U.S.S.R., were represented, and the attendance was well over one thousand. The three main topics for discussion were: "The Pathogenesis of Eczema," "A.C.T.H. and Cortisone," and "The Treatment of Tuberculosis of the Skin." Dr. Pillsbury (U.S.A.) indicated the magnitude of the problem of eczema by stating that the majority of World War II troops suffering from skin disease in the tropics were suffering from some form of eczema, and more troops were invalided from the Pacific war theatre because of skin disease than because of war wounds. The prevalence of eczema in civil life is comparable. Professor Miescher (Zurich) expressed doubt as to how far we were justified in regarding eczema as an allergic disease. Dr. Brain (London) discussed the problem of infantile eczema, and stressed the value of sedatives and careful nursing care. Some dermatologists were showing increasing doubt about the part played by food sensitisation in'the production of infantile eczema. The discussion on A.C.T.H. and Cortisone was opened by Dr. Brunsting (U.S.A.), who stressed the fact that these drugs do not eradicate the cause of disease nor do they repair damaged tissue. Rather they act as buffers to reactions of tissue to injury. With prolonged dosage, undesirable side-effects include disturbances of electrolyte metabolism, alterations in the psyche, and signs of hyperadrenalism. There is ever present the liability to develop severe pyogenic infection, which may often be difficult to detect while the patient is having the drug. Dr. Ereaux (Canada) discussed the use of cortisone in the management of pemphigus vulgaris and its variants. He thought that this disease is the only dermatological condition which consistently merits the employment of the drug. He had maintained patients up to two and a half years on cortisone. Dr. Ereaux doubted the wisdom of using cortisone in the treat. ment of psoriasis, erythrodermias, sarcoidosis and eczematous dermatitis. In the latter condition great care and experience are required to prevent the development of severe erythrodermia when cortisone medication is discontinued. He concluded that in dermatology A.C.T.H. and cortisone can shorten the course of a self-limited condition, control many of the serious illnesses and cure but few of the dermatoses. Dr. Sulzberger (U.S.A.) thought that the effects of the drugs might be designated as "morbidistatic"-in analogy to "bacteriostatic," "fungistatic," etc. He noted …