Dandruff

“ This type of the disease forms one type of dandruff. When it is of long standing the hair becomes dry and falls out.
[84 MOTHERS' REMEDIES] Mixed type.—This type is common upon the scalp. The surface is covered, more or less, with scales and crusts. If the disease continues long the hair becomes dry, lusterless and falls out. Permanent baldness may result.
Causes.—These may be constitutional and local. "Green sickness" (chlorosis) , disorders of the stomach and bowels are often the cause. ”

“ The hair has a great tendency to accumulate dirt. It catches the dust flying in the air, and also retains the secretion of fat and the desquamated epithelium of the scalp and the products of perspiration.
The two chief causes of the premature thinness of the hair are a deficient circulation of blood in the scalp and dandruff, and it is said that dandruff causes the loss of hair in 70 per cent. ”

“ Schurig recommends the use of mouse-dung, both internally and externally, for various disorders, for constipation in children, for scald head, and dandruff, in which cases it was applied as an ointment, for the elimination of calculi in kidneys and bladder, for all swellings in the fundament, piles, warts, tumors in ano, hemorrhages of the lungs, for the suppression of the menses, and even to excite the growth of the beard. ”

“ A few months ago I saw the patient again, and I feel sure that the disease is eradicated.
Miss W., 42 years old, passed her childhood in the West Indies, and brought from there a peculiar skin disease. When I saw her for the first time her features looked old for her age, skin gray and sallow, hair gray, rough, full of dandruff, and moisture oozing from the ears and forehead. The scalp feels hard and thickened. The cervical glands are indurated all around the neck. On the left chest an herpetic eruption of the size of a dollar, and on the mamma a hard tumor of the size of a fist. ”

“ First, the human hair is made by the body, and it is made, like everything else in the body, out of the blood-stream. It is perfectly true that the dandruff germ gets into the roots, and makes trouble, and that the process of killing this germ can be helped by chemicals; but it does not take a ten-dollar prescription, it only takes ten cents' worth of borax and salt from the corner grocery. (Put a little into a saucer, moisten it, rub it into the scalp, and wash it out again.) ”

“ None of these dressings is needed by the healthy scalp, and proper care will preserve the hair in better condition than they will. The nearer the body can be kept to the standard of perfect health by means of bathing, exercise, and good diet, the less likely is dandruff to develop. ”

“ If you watch a groom brushing and currying the coat of a thoroughbred horse, you will get a fair idea of hew you ought to treat your own scalp at least twice a day, night and morning.
If this currying of the hair be thoroughly done, and the head washed with soap and hot water about once a week for short hair and twice a month for long hair, most of the dangers of dandruff and of other infections of the scalp will be avoided. One thing to be remembered is, don't brush too hard or too deep. There is an old saying and a good one, "You can't brush the scalp too little, or the hair too much." ”

“ Her- picidc killing the dandruff germ, leaves the hair free to grow as healthy Nature in- tended. Destroy the cause, you remove the effect. Kill the dandruff germ with Herpi- cide.
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“ The hairy portion of the neck may also be invaded. The disease may begin by the formation of papules and pustules about the hair-follicles on previously healthy skin, or chronic hyperæmia, or even eczema, may have preceded. The lesions generally occur in numbers, in close proximity, and, together with the accompanying inflammation, make up a patch of disease involving a greater or less area. The pustules are discrete, flat or acuminated, small in size, yellowish in color, perforated by hairs, show no disposition to rupture, and are, as a rule, apt to appear in crops. ”

“ Caries was a pustular disease, in which bristle-like hairs formed a prominent feature. Rima was a name applied by the physicians of Salernum to a superfluity of hair. In addition to these diseases of the scalp, we find also descriptions of gutta rosacea, morphoea and scabies, a fairly extensive dermatology for this early day. In favus, Gilbert tells us that, after the removal of the pustules, there remain foramina, from which exudes a poisonous substance, resembling honey. Of course his system of treatment is rich in variety and comprehensiveness. ”

“ In certain diseases of nervous origin, notably in herpes zoster, the eruption follows the course of a certain nerve. In the face we get erythema, lupus erythematosus, rosacea, eczema, actinomycosis, &c, and syphilitic and malignant ulcers. Rodent ulcer usually selects the face, and generally the nose or orbit. The face too is usually the selective site of lupus vulgaris. The scalp is the chief site oi two varieties of lesion — the pustular, as in pustular eczema and impetigo contagiosa, or the dry and scaly eruptions, as psoriasis, ringworm and squamous syphilides. ”

“ Usually chronic, continuing as the same type, or passing into eczema rubrum.
Describe the symptoms of squamous eczema.
Squamous eczema (eczema squamosum) may be defined as a clinical variety, the chief symptoms of which are a variable degree of scaliness, more or less thickening, infiltration, and redness, with [Pg 105] commonly a tendency to cracking or fissuring of the skin, especially when the disease is seated about the joints. It is developed, as a rule, from the erythematous or papular type. Itching is slight or intense.
The disease is not uncommon upon the scalp. ”

“ In vertical section of the small nodules the round-cell mass will be found to be wedge-shaped, the base of the wedge being towards the skin; the deep-lying apex is usually pierced by a hair or two. The growth is found around sebaceous follicles, blood-vessels, lymphatics, and sudoriparous glands; but it is especially abundant, and most deeply situated, around the hair-follicles.
Diagnosis.— Malignant and syphilitic ulcerations of the groin are common enough; the disease under notice, however, differs widely from these— clinically, histologically, and therapeutically. ”

“ The following conditions may be regarded as contributory to eczema:
Exposure to winds; cold, dry air; heat; the use of hard water or strong soaps; lack of cleanliness, and the irritation of clothing. It frequently accompanies chronic constipation, indigestion, and other conditions of the [563] intestinal canal; overfeeding; too early or too excessive use of starchy foods.
Eczema of the Face:—Eczema Rubrum.—This is the most frequent form. It affects the cheeks, scalp, forehead, and sometimes the ears and the neck. It begins on the cheeks as small red papules. ”

“ The protection is less perfect about the hairs and the sweat glands. Infection by the route of the sweat glands is, however, uncommon, for the sweat is a fluid unfavorable for bacterial growth and the flow acts mechanically in washing away organisms which may have entered the ducts. Infection by the route of the hair follicles is common. There is no mechanical cleansing as by the sweat, the space around the hair is large and the accumulated secretion of the hair glands and the desquamated cells furnish a material in which bacteria may grow. ”

“ Very different, however, are the scales on the skin of the head, which, at times, form a loose dandriff, filling the hair with a most unsightly scurf. This is a serious evil, and requires patient and careful treatment to get rid of thoroughly; and nothing can be less likely to effect a remedy than the use of very hard brushes, which, by irritating the scalp, tend to aggravate the symptoms. Anything which unnaturally irritates the skin of the head will originate dandriff ”

“ Describe the symptoms and course of prurigo.
The disease first appears upon the tibial regions, and its earliest manifestation may be urticarial, but there soon develop the characteristic small, millet-seed-sized, or larger, firm elevations, which may be of the natural color of the skin or of a pinkish tinge. The lesions, whilst discrete, are in great numbers, and closely crowded. The overlying skin is dry, rough and harsh; itching is intense, and, as a result of the scratching, excoriations and blood crusts are commonly present. ”

“ The face and scalp are never invaded, except in infants. Itching is a marked symptom, usually worse at night. In well-advanced cases the secondary symptoms, such as papular elevations, vesicles, impetiginous and ecthymatous pustules, which are often torn by the scratching invoked, the crusts and excoriations of various characters, and a variable amount of cutaneous inflammation, with infiltration and pigmentation, taken together with the presence of burrows, constitute a clinical picture of the disease. ”

“ Symptoms of Seborrheic Eczema.—In the dry form of the disease, in which there is a scaling of the scalp, the hair is dry and unmanageable, the head itches, especially when the patient sits under a light or becomes overheated. There is a more or less constant falling of the scales upon the clothes. The scalp looks pale, and will be found covered with fine grayish or yellowish, readily detachable scales. Sometimes there is more or less redness of the scalp. ”

“ Symptoms: skin thickens with papules, vesicles or pustules, scurf, crusts, depilation, surface glossy, abraded, scratched, raw, rough, fœtid, itching, emaciation, exhaustion. Chronic eczema of the back. Fat, old, gluttons. Symptoms: circumscribed patches on back, loins, quarters, tail, intense itching, skin thickened, cracked, raw, encrusted, black, folded, rigid, fœtid, hair broken, erect, shedding. Very inveterate. Chronic eczema of elbow and hock. Causes: friction on summits of prominent bones, filth, infection, predisposition. ”

“ Diseases of the skin tend to manifest themselves in certain parts of the body; i.e. certain diseases exert a selective influence on the sites of their eruption. Symmetry is characteristic of eczema, psoriasis, drug rashes and the eruptions of specific fevers, while others, such as herpes zoster, ring-worm, tertiary syphilis and new growths, tend to be asymmetrical. Eczema selects the flexor aspect of the limbs and the neighbourhood of folds of skin and opposed surfaces, while psoriasis favours the extensor surfaces and the outer side of the elbows and knees. ”

“ Eczematous symptoms may be superadded. In severe cases the entire extensor surfaces of the legs and arms, and in some instances the trunk also, are invaded. It is worse in the winter season. [Pg 119]
What is known in regard to etiology and pathology?
It is a disease of the ill-fed and neglected, usually developing in early childhood, and persisting throughout life. It is extremely rare, even in its milder types, in this country. Clinically and pathologically it bears some resemblance to papular eczema.
Give the prognosis and treatment of prurigo. ”

“ Pruritus is a functional disease of the skin, the sole symptom of which is itching, there being no structural change. [Pg 245]
Describe the symptoms of pruritus.
The sole and essential symptom is itchiness, usually more or less paroxysmal, and worse at night. There are no primary structural lesions, but in severe and persistent cases the parts become so irritated by continued scratching that secondary lesions, such as papules and slight thickening and infiltration, may result. It is much more common in advanced life—pruritus senilis. ”

“ A sudden disappearance of the rash, or of the inflammation of the throat, is a bad omen. With such symptoms as these, there is usually little or no rash, and the little there is, of a pale, livid color, and the skin, in general, inactive. ”

“ I found the Down begin to make my hand itch, and in some places to smart again, much like the stinging of a Flea or Gnat, and this continued a pretty while, so that by degrees I found my skin to be swell'd with little red pustules, and to look as if it had been itchie. But suffering it without rubbing or scratching, the itching tickling pain quickly grew languid, and within an hour I felt nothing at all, and the little protuberancies were vanish'd. ”

“ Lichen ruber, or pityriasis rubra pilaris as it is called by many writers, is a rare disease, but one which is liable to affect children as well as adults. It is a chronic and obstinate disease, in which the lesions are small, reddish, acuminate papules,
Fig. 43.—Papular form of lichen ruber.
usually seated at the orifice of hair follicles. These do not increase in size, but by multiplying and coalescing produce patches covered by fine, whitish scales and characterized by an exaggeration of the natural furrows of the skin.
The eruption often undergoes a spontaneous improvement,
Fig. ”

“ In different stages of the fever, after a few days, a cutaneous efflorescence is perceivable, from which the disease takes its name, preceded by and accompanied with itching and pricking heat of the skin, and eruption of diminutive{97} pustules, the size of millet seed, and, by the fingers, may be felt prominent: they are rarely seen on the face; commonly on the neck, back, breast, and extremities ”