Until the latter part of the nineteenth century, scleroderma was considered solely a cutaneous disease. The recognition that proliferation of connective tissue in the viscera was analogous to the skin lesions prompted the name, "pry gressive systemic sclerosis." Recent evidence indicates that Raynauds phenomenon, which is frequently associated with scleroderma, is also expressed in the viscera as vasconstriction, particularly in renal and pulmonary arterioles.Ante le termino del dece-none seculo, scleroderma esseva considerate como solmente un morbo cutanee. Le recognition que proliferation de tissu conjunctive in le visceres esseva analoge a1 lesiones cutanee inspirava le designation "sclerosis systemic progressive." Recente observationes indica que le phenomeno de Raynaud, que es frequentemente presente in association con scleroderma, se exprime etiam in le visceres como vasoconstriction, specialmente in arteriolas renal e pulmonar.H E TERM SCLERODERMA was first used to d3scribe a disease charac-T terized by hard tight skin with a hidebound appearance. Later it became apparent that there was systemic involvement manifested by connective tissue and/or vascular alterations. Nevertheless, the name persisted, because ,kin changes were nearly always present and the nature of the disease process affecting the body as a whole remained ill defined.Early cases. The first patient with scleroderma might have been described by Hippocrates.'" "A man at Athens" had generalized pruritus and thick skin over his entire body which could not be lifted an account of its thickness. The skin condition failed to respcnd to medications but was cured by hot baths. The patient subsequently died of dropsy. Though the dropsy might lime been due to sclerodermatous involvement of the heart and lungs, the vague description makes the diagnosis uncertain. The older writers also creciited Galen"' with recognizing scleroderma. He believed that the diagnosis was made from the white pallor, hardness and thickness of the skin. He noted a difficulty in warming up during exercise because of abnormally low perspiration. The impairment of water loss in sclerodermatoiis skin has been confirmed by modern investigations.""The first well documented case was described in a monograph by Curdo8 in 1753 ( fig. 1 ) . A fifteen year old girl had the typical cutaneous maniiestations of scleroderma. The skin improved with emmolients, milk and vapor baths but exposure to cold reversed the beneficial changes. Nevertheless, stiffness of the hands persisted because of "increased muscular tension." The name,
