PEDIATRICS Vol. 48 No. 5 November 1971, pp. 744
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SCLEREMA NEONATORUM DESCRIBED FOR THE FIRST TIME IN 1784 BY DR. MICHAEL UNDERWOOD

T. E. C. Jr. M.D.

Michael Underwood (1737-1820), the most advanced writer on diseases of children in the eighteenth century, was the first physician to describe sclerema neonatorum. His description of this serious disease follows:

It may be proper in this place to take notice of a peculiar tightness and hardness of the skin over almost the whole body, that sometimes attends that kind of purging when the stools are of a waxey or clayey consistence, and usually takes place in the last stage of the disease, always affording a very unfavorable prognostic. It very rarely appears, I believe, but in disorders of the bowels on which account I have not assigned it a distinct head, though otherwise of sufficient importance. This symptom, or perhaps rather disease, somewhat similar to that called hide-bound in quadmpeds has not been mentioned in this view, by any writer on the diseases of infants. The ancients indeed described a somewhat similar affection under the name of Stegnosis and Cutis adstricto, but appear always to speak of it as a complaint of adults, often occasioned by cold. Dr. Denman first took notice of it in children, and has for some years paid great attention to it. It seems to be a spasm depending upon a certain morbid state of the first passages with which the skin is known to have a peculiar sympathy which instead of lying loose and pliable on the cellular membrane, is perfectly rigid as if it adhered to the bones. Some children indeed have been born with the complaint, none of whom have been known to live.