"I am pleased, Doctor, by what you say," said Mr. Barnes, "because with such appreciation of the changes caused by death and exposure in the water, I must lay greater reliance upon your identification. In this case, as I understand it, there is something peculiar about the body, a mark of disease called lichen, I believe?"
"Yes. But what I have said about the changes caused by death must have weight here also," said the doctor. "You see I am giving you all the points that may militate against my identification, that you may the better judge of its correctness. We must not forget that we are dealing with a disease of very great rarity; so rare, in fact, that this very case is the only one that I have ever seen. Consequently I cannot claim to be perfectly familiar with the appearance of surfaces attacked by this disease, after they have suffered the possible alterations of death."
"Then you mean that, after all, this spot upon which the identification rests does not now look as it did in life?"
"I might answer both yes and no to that. Changes have occurred, but they do not, in my opinion, prevent me from recognizing both the disease and the corpse. To fully explain this I must tell you something of the disease itself, if you will not be bored?"
"Not at all. Indeed, I prefer to know all that you can make intelligible to a layman."
"I will use simple language. Formerly a great number of skin diseases were grouped under the general term 'lichen,' which included all growths which might be considered fungoid. At the present time we are fairly well able to separate the animal from the vegetable parasitic diseases, and under the term 'lichen' we include very few forms. The most common is lichen planus, which unfortunately is not infrequently met, and is therefore very well understood by the specialists. Lichen ruber, however, is quite distinct. It was first described by the German, Hebra, and has been sufficiently common in Europe to enable the students to thoroughly well describe it. In this country, however, it seems to be one of the rarest of diseases. White of Boston reported a case, and Fox records another, accompanied by a colored photograph, which, of course, aids greatly in enabling any one to recognize a case should it occur. There is one more fact to which I must allude as having an important bearing upon my identification. Lichen ruber, like other lichens, is not confined to any one part of the body; on the contrary, it would be remarkable, should the disease be uncontrolled for any length of time, not to see it in many places. This brings me to my point. The seat of the disease, in the case of Mr. Quadrant, was the left cheek, where a most disfiguring spot appeared. It happened that I was in constant attendance upon Mr. Quadrant for the trouble which finally caused his decease, and therefore I saw this lichen in its incipiency, and more fortunately I recognized its true nature. Now whether due to my treatment or not, it is a fact that the disease did not spread; that is to say, it did not appear elsewhere upon the body."
"I see! I see!" said Mr. Barnes, much pleased. "This is an important point. For if the body at the Morgue exhibits a spot in that exact locality and nowhere else, and if it is positively this same skin disease, it is past belief that it should be any other than the body of your patient."
"So I argue. That two such unique examples of so rare a disease should occur at the same time seems incredible, though remotely possible. Thus, as you have indicated, we have but to show that the mark on the body at the Morgue is truly caused by this disease, and not by some abrasion while in the water, in order to make our opinion fairly tenable. Both Dr. Elliot and myself have closely examined the spot, and we have agreed that it is not an abrasion. Had the face been thus marked in the water, we should find the cuticle rubbed off, which is not the case. Contrarily, in the disease under consideration, the cuticle, though involved in the disease, and even missing in minute spots, is practically present. No, I am convinced that the mark on the body at the Morgue existed in life as the result of this lichen, though the alteration of color since death gives us a much changed appearance."
"Then I may consider that you are confident that this mark on the body is of the same shape, in the same position, and caused by the same disease as that which you observed upon Mr. Quadrant?"
"Yes. I do not hesitate to assert that. To this you may add that I identify the body in a general way also."