A PRACTICAL TREATISE
OK
HEALTHY SKIN:
WITH
RULES FOR THE MEDICAL AND DOMESTIC TREATMENT];
OF
CUTANEOUS DISEASES.
BY ERASMUS WILSON, E.R.S. *•* CONSULTING SUROEON TO THE ST. PANCRAS INFIRMARY, AND LECTURER ON ANATOMY AND PHYSIOLOGY IK MIDDLESEX HOSPITAL; AUTHOR OF “THE ANATOMIST’S VADE MECUM,” ETC.
Ellustrateti toftt Sfv Steel ISngrabfttfls.
WITH NOTES BY
T. S. LAMBERT, M. D.
PROF. OF ANATOMY AND PHYSIOLOGY IN PITTSFIELD INSTITUTE, BERK. COUNTY, MASS.; AUTHOR OP POPULAR TREATISE ON BATHING, ETC.
NEW-YORK: PRINTED BY LEAVITT, TROW & COMPANY, 33 ANN-STREET. 1847. Entered, according to Act of Congress, in the year 1847,by T. S. LAMBERT, In the Clerk’s Office of the District Court for the Southern District of New-York PREFACE.
If any work deserves to be universally read, it is the following Treatise. If I am at all capable of judging, there is not in the English language a single work which is so valuable as this. The subjects treated upon are of the greatest moment; and they are discussed with such eloquence and truthfulness, that the attention of the most hasty reader will be arrested, and he will see a beauty and an attractive usefulness in physiology which no other book could impress upon his mind. No excuse will be necessary for making an effort to bring the book within the means of every class. A book condensed in form will many times be read, from its more commodious look. In such a form, also, it can be easily carried in the valise or pocket even, and read on the way. Nor is there any doubt that a book at a low price sells more extensively than when higher in price. That any notes should be added to a work of such excellence, does not merit apology, in reality. Can it be expected that any work will be perfect ? Whether the notes were needed or not, will be seen by reading them. I hope they will render the treatise more useful. To see'this book widely scattered through the land,I doubt not will give pleasure to the phy- sician. The name of Erasmus Wilson is a sufficient guarantee that he will be interested and instructed by what has been written. But he will be surprised upon reading the book, to witness how much talent the author has exhibited in adapting his language to the popular reader, without any obscurity on one hand, or awkwardness of expression on the other. He will be ready to bestow an encomium upon the very polite manner with which he has endeavored to convince the reader that something 4 PREFACE. more than pretension is necessary to cope wilh disease successfully; and he will be glad to see that an advance step has been made toward en- lightening the public upon those topics, a true knowledge of which tends to free from disease, overthrow quackery, and give to merit its deserved reward.
THE EDITOR. A PRACTICAL TREATISE
HEALTHY SKIN.
CHAPTER I. divisions of the one great investing mem* brane of the body, is occasionally seen in ON THE SCARF-SKIN. domestic life, and is therefore alluded to in this place. It is dependent, obviously, In the following pages, I propose to on the analogy of structure subsisting make my reader acquainted with the between the two parts of the same mem- structure and uses of the skin, in the hope brane. To illustrate the transition of of awaking his attention to the necessity these membranes into each other, I may and manner of training it to the purposes refer to the eyelids, on the thin margin of health. I trust, moreover, by laying of which the skin becomes mucous mem- down correct and simple laws, to enable brane; the former covering the outside him to comprehend the principles upon of the lid, the latter the inside of the lid which a sound and effective domestic and front of the eyeball. The red sur- treatment of its diseases may be con- face of the lips is an illustration of a mu- ducted. cous membrane which has become dry 1. The skin is the soft and pliant mem- by exposure to the atmosphere, its junc- brane, which invests the whole of the ex- tion with the skin taking place at the ab- ternal surface of the body, following all rupt line where the red joins the lighter its prominences and curves. The inte- tinted covering of the face. The en- rior of the body, like the exterior, is cov- trance-tube of the ear is a cul-de-sac of ered by a skin, which, from the consiantly about an inch in length, and lined by moistened state of its surface, is denom- mucous membrane. This circumstance inated mucous membrane. At the various explains the discharges of matter from orifices of the body, the exterior skin is the ear which not unfrequently take place continuous with the internal skin, or mu- in children; for it is the ordinary charac- cous membrane, and in these situations, ter of mucous membrane, when in a state from the similarity of their structure, it ofinflammation, to send forth a discharge, is difficult to distinguish between them. but not so the external skin. The difficulty is increased by the cir- 2. An important medical law is found- cumstance, that when a portion of skin is ed on the continuity and similarity of made to occupy an internal position, it structure of the investing and lining assumes the humid character ofmucous membrane of the body. This law re- membrane; and when a portion of the solves itself into three expressions,— latter becomes external, it loses its mois- namely, that disease affecting a part ofa ture by evaporation, and then takes on membrane is liable to spread to the the ordinary appearance of skin. This whole; secondly, that disease of the mu- reciprocal of thetwo cous membrane may to the skin metamorphosis great spread , investing membranes, or rather, the two and vice versd; and thirdly, that dis- 6 ON THE STRUCTURE AND ease of a part of a mucous membrane an independent organism endowed with may become translated to a distant part life, and possessing within itself the pow- of the skin, and vice versd. As illustra- ers of growth and subdivision (plate 1, tions of a popular kind of these three po- fig. 8, a). As soon as they are fairly sitions, I may adduce, in evidence of the formed, the little granules collect to- first, the spreading nature of St. Antho- gether. by a kind of vital affinity, into ny’s fire, or erysipelas; of the second, the little masses ( b c), and the latter seem to itching of the nose and lips in children, acquire, by their concentration, an in- from irritation in the alimentary canal crease in the attributes of life; they im- caused by the presence of worms; or the bibe the fluid residuum of the transparent eruption around the lips which follows part of the blood, which continues to.be slight attacks of cold or feverishness. poured out through the cutaneous ves- The third position explains the coinci- sels for their nourishment, they increase dence of dyspepsia and other .internal in bulk in consequence of such imbibition disorders with cutaneous rashes and and its attendant assimilation, and they eruptions. become separated from neighbouring 3. It must have been observed by masses by the development around them every one, that the skin is composed of of a thin and transparent investing mem- two layers; for these we see separated brane ; they are, in fact, converted into from each other by the action of a com- cells (c). If' we examine the under sur- mon blister.* One of these layers, face of the scarf-skin when freshly sepa- namely, that which is raised by the fluid rated from the sensitive skin, the differ- of a blister, is the scarf-skin, or epider- ent kinds of particles here described, mis (plate 1), while that which retains namely, the elementary granules, the its connexion with the substance of the little aggregated masses, and the newly- body is the sensitive skin, or dermis (plate constructed cells, may all be seen forming 2). These layers perform very different a beautiful mosaic, the cells being the offices in the animal economy, and.are largest and taking the principal place, widely different from each other in struc- and the simple and composite granules ture. The scarf-skin is horny and in- occupying the intervening spaces. sensible, and is a sheath of protection to But the mosaic layer is no sooner com- the highly sensitive skin situated beneath plete, than the operations fora new layer it. The latter feels; but the former dulls of the same kind are already in progress, the impression which occasions feeling, and are gradually raising it from its bed and in some situations Is so dense and and pushing it upwards to the surface. thick as to exclude ordinary impressions The cells, at the same time, are increas- entirely. Of this we see an example at ing rapidly in size ( efg), extending their the ends of the fingers, where the hard borders so as to overlap each other on and dense nail is the scarf-skin modified all sides, and quickly attaining the di- for the purpose referred to. It is the mensions of the perfect cell—namely, the pier- an inch diameter scarf-skin which needlewoman f-{; 0 of in (/i). Now, ces in the operation of sewing on the fin- this rapid and remarkable growth is ef- ger ; it is the scarf-skin which the cutler fected by a series of changes within the shaves in order to test the sharpness of cell analogous to those by which the cell his blade. is originally formed; thus, new granules 4. Having established a distinction be- are produced, they collect together in tween the scarf-skin and the sensitive little masses, and, after a while, a cell- skin, I will now proceed to examine the membrane is developed around the structure of the former, and the mode of latter, so that when the original cell is its production and growth. fully formed, it is, in physiological lan- The scarf-skin is a transpa- a cell its originally guage, parent , containing in in- rent fluid exuded by The blood-vessels, terior secondary cells, granules and gra- and distributed as a thin layer on the nular masses. These changes, consti- surface of the sensitive skin. By a pro- tuting the growth of the cells, occur quite cess somewhat analogous to crystalliza- in the deepest strata of the scarf-skin tion, the solid elements of this fluid are (fig. 7), and as by degrees the deep lay- congregated into innumerable, minute, ers are gradually pushed upwards to- roundish granules; each granule being wards the surface, the cells lose by eva- poration their fluid contents, and are * [ It is usuallyunderstood, and I believecorrectly, that converted into dry, flattened scales (fig. the skin is composed of three “layers,”—the “ scarf- 7). The chief part of the thickness of skin,” the “sensitive skin,” and the rete mucosum, which is a middle layer, above the sensitive, and below the scarf-skin is composed of these flat- the scarf-skin,] tened scales, which are closely matted USES OF THE SCARF-SKIN. 7 together, and form a dense and laminated form of an emulsion, an
it is no uncommon thing to find the nail * [ Our author’s explanation of the cause of spots on spotted over with these white marks, the nails, does not seem to he very satisfactory. The cause which are moved onwards in its growth, is notknown. One cause for pinched toes, corns, &c., is to be found, not in a tight boot, or rather a boot too and are eventually carried to its free small, but in the bad fitting of it. If a boot allows the border. To obviate the appearance of foot to press forward, the boot not being tight enough hands must be care across the instep, the heel of the boot will wedge the toes such spots, the taken into the front part of the boot, very unpleasantly. Mr. of, and the nails as little disturbed as Bruce of Troy, a very excellent workman, pointed this The care of the nails should out to me very clearly. If this or any cause has made possible. the nails grow into the fiesh, they should not be cut very be strictly limited to the use of the knife closely, but a little wad of cotton should be very nicely or to their free and the pressed under the edge of the nail at the corner, so that scissors border, the nail shall be raised up, all the time, and in a while the ivory presser, to prevent the adhesion of nail w ill usually cease to cause any further trouble.] the free margin of the scarf-skin to the f [ I am told by intelligent tanners, that the scarf-skin of the lunula, and its growth for- is not removed in the process of making leather, and I surface suppose that the “grain” surface of leather is the outer ward with that part. This edge of scarf- surface of the scarf-skin.] USES OF THE SENSITIVE SKIN. 11 admirable is the living and breathing distribution ; some are yellow, highly skin ! elastic, hut brittle ; a third set are red- 17. The defensive portion of the skin, dish, and, possessing both strength and or corium (plate 2. fig. 3), is constructed elasticity, enjoy a contractile power above of excessively minute fibres, which are and apart from their other properties; collected into small bundles, or strands, while a fourth, without strength or elas- and these latter are interwoven with each ticity, possesses a faculty of independent other, so as to constitute a firm, strong, motion. It is these two latter that pro- and flexibly web. In the superficial part duce the motions occasionally manifested of the corium, the web is so close as to by the skin —namely, that state which is have the character of a porous felt; but denominated goose-skin, and the erection more deeply, the pores become progres- of the hairs under the influence of men- sively larger, and, upon the deep surface, tal emotion or physical sensation. have a diameter somewhat less than a 19. The defensive layer of the dermis line, or twelfth part of an inch. The naturally varies in thickness on different pores are round or oval in shape, parts of the body; for example, on the and are separated from each other back of the trunk and on the outside of by strands of fibres of double their own the limbs, where injuries are most likely diameter, which give to the under sur- to be received, the corium is thick; while face of the skin the appearance of a on the front of the trunk, and particular- coarse net. The strands are connected ly on the inner side of ihe limbs and in with the fibrous web in which the subcu- the flexures of joints, it is thin. This pe- taneous fat of the body is deposited, and j culiarity is associated with the occur- the open meshes are filled with little bags , rence of certain eruptions in particu- of fat (e e). The mechanical arrange- 1 lar situations; some are met with only ment which is here described is one on the inner sides of the limbs, while oth- which is calculated to excite our admi- ers are never seen but in the opposite lo- ration. A membrane of inconsiderable cality. Watery pimples and moist exco- thickness is so constructed as to offer dif riations are found in the former ; while ferent qualities, at different points of its dry pimples and the scaly forms of cuta- depth, upon one surface, being a porous neous disease prefer the latter felt fitted to give an even support to the 20. The sensitive layer of the skin delicately organized sensitive layer which (plate 2, fig. 3, b ) is thin, soft and une- is bedded upon it; and upon another, a ven, pinkish in hue, and composed of ves- coarse network, capable of adapting it- sels which confer its variotis tints ofred ; self to distention in every direction, and and nerves, which give it the faculty of of returning completely to its original sensation. Its unevenness has reference form That the distention and contrac- to an important law in animal organiza- tion of the membrane should meet with tion—namely, that ofmultiplying surface no check, the open meshes are filled, as for the increase of function; and the man- we have seen, each with a soft and com- ner of effecting this object is by the ex- pressible little cushion offat, and the en- tension of its substance into little, elonga- tire skin is preserved from the violence ted, conical prominences, technically ofcontusion by being pillowed on a soft termed papillae. These papillae are mi- and elastic medium, the subcutaneous fat croscopic in size, as may be inferred from of the body, which breaks the force of a their being imperceptible to the naked blow, by yielding before it. The crick- eye; and as they exist, in various de- eter, unknowingly, relies on this contri- grees of magnitude, on every part of the vance, when he receives the flying ball skin, their number is infinite. In struc- on his outstretched hand ; and we all test ture, every papilla is composed of a mi- its importance in the power which we nute vessel capillary from its (termed , possess ofsupporting, for hours together, hair-like size) and a minute nerve. In the whole weight of the body upon so smallerpapillae, the vessel and nerve form delicate a structure as that of the sensi- each a simple loop, and the four little cy- tive layer of the skin of the sole of the linders, with their enclosing membrane, foot. are a measure of the diameter of a single 18. Much more wonderful, however, is papilla. In other papillae, of larger size, the vital constitution of this membrane. and endowed with a power of more ex- The fibres of which the strands are com- alled sensation, the little vessel and nerve posed are of four kinds: the greater part are several times bent upon themselves are white and inelastic, the elasticity of previously to completing the loop. These the membrane which they contribute to little loops spring from a network (/) of form being derived from their manner of minute vessels (capillaries) and nerves. 12 ON THE STRUCTURE ANI> embedded m the porous stratum of the the blood/ having performed its circuitin' corium (§ 17) at the base of the papillae; the skin, runs onwards into vessels which* and they receive their supply of blood take a retrograde course through the in- and nervous influence through small ves- terstices of the corium, by the side of the sels and nerves,which take their meander- arteries, and return the blood to the heart; ingcourse through the fat-distended open- these are the veins'. The circulation of ings of the deeper strata of the corium. the blood through the skin, and its course We have seen already, that the openings from and to the heart, may perhaps be in the cerium are a provision for its elas- better explained by the annexed dia- ticity ; we have here a second purpose gram. which they fulfil, for in this, as in most of the operations of the animal organism, we meet with constant illustration of the beautiful lines of Pope r “ In human works, though labor’d on with pain, A thousand movements scarce one purpose gain ; In God’s, one single can its end produce. Yet serves to second, too, some other use.” 21. It is always interesting to observe the modification of a known principle of structure to suit a special purpose. An instance of this modification is seen in the palm of the hand and sole of the foot, and on the corresponding aspect of the fingers and toes. On the parts indicated, the sensitive layer of the dermis is raised in the form of small ridges (plate 2, fig. 1), which are curiously arranged, as may be seen by inspecting them on the hand in their epidermic dress {§ 11) ; some are traced in concentric ovals; others, run- ning more or less parallel, pursue a ser- pentine course ; some separate abruptly and suddenly diverge; and others are seen to part for a short distance, and again to reunite; a fitting maze for the mysterious reveries ofchiromancy. These In this diagram, the letters uiiK re little ridges, when examined with the mi- present the heart, composed of four cav- croscope, are found to be marked, at dis- ities, l l being the left, and s r the right, tances corresponding with the breadth of chambers ; a a, a channel representing the into small square allotments; the of arteries which conduct the ridge, system , and each allotment is made up of a tuft bright-red blood from the left chambers of papdlse, from ten to twenty in num- of the heart to every part of the body ; v ber. v, a channel representing the system of 22. In the sensitive layer of the dermis veins which return the blood of a dark- it is that the blood of the skin is chiefly red colour, and in an impure state, to s r. distributed, being conducted to this layer the right chambers of the heart; c c, ca- by small vessels, termed arteries, which pillary vessels of the surface of the body, find their way to the surface through the conducting the blood from the arteries to irregular interstices of the strands of fi- the veins, consequently intermediate ves- bres of which the corium is composed sels ; d, e,f g, h, intermediate vessels in (§ 17). Having reached the poious, felt- the interior of the body, supplying with like layer of the corium, the small arte- blood the various organs—the brain, liv- ries empty their blood into a very beau- er, stomach, kidneys. &c. The relation tiful and rich network of minute vessels of these vessels to the cutaneous inter- (plate 2, fig. 3./), remarkable for their mediate vessels shows, that if the blood frequent communications with each oth- were checked in its passage through c c, er, and for their uniformityof size ; these it would be driven, or repellted, or deter- the d upon , are capillaries, called also, because mined e. f, g, h. If the check they occupy an intermediate position be- were slight, d (which may represent the tween the arteries and veins, and are the kidneys) only would suffer ; if the check only communication between the two, were more severe, e, the stomach, f, the intermediate vessels. From these latter, liver, g, the spinal marrow, h, the brain. USES OF THE SENSITIVE SKIN. 13
or l r, the heart, would become over- culation, is a force-pump for propelling loaded with blood.* In like manner, an the contents of these cavities, the direc- ■overloaded state ofc c, whether the con- tion which the fluid is to take being regu- sequence of disease, or artificially produ- lated by apertures and valves, which ced, will lighten, or insome instances ex- permit its passage only in one direction. d h. So and won- from left chambers of the haust, , e.f g, fearfully Thus, the heart derfully are we madel This diagram (l l), the blood is propelled through a shows also how an eruptive disease may system of elastic tubes, called ar eries act the part of a safety valve to the eco- (a a), to every part of the body; the ar- nomy. On the opposite side of the heart, teries terminate every where in minute •a represents an artery conveying the im- vessels termed capillaries (c c); from the pure blood from the right chambers of capillaries, after a certain course, the the heart to the lungs ; v is the channel blood passes into veins (vv); and the by which, when purified, the blood is latter, being the returning channel of the brought back from the lungs to the left blopd. convey it to the right chambers of •chambers of the heart; c represents the the heart (rr). The circulation of the intermediate vessels, or capillaries of the blood, therefore, in its simplest expres- iungs, in which the purification of the sion, resolves itself into a transit from blood takes place. The circle r, a, c, v, the left (l) to the right chambers of the l, is the lesser circle, the course of the heart (r). Let us now inquire what pur- pulmonary circulation: l, a, c, v, r, is pose it fulfils during this transit. The the great, or systemic circle, the course arteries and veins are the mere carriers of the circulation through the rest of the of the blood; but the capillaries are system. But the truth is, there is but agents of high account in regard to its one circle or circulation, the channels of distribution. They exist so abundantly which are brought into proximity at the in all parts of the body, that some of its heart organs appear to be almost wholly made The blood which proceeds from the up of them ; and their abundance in the heart, and is conducted along the tubular skin may be inferred from the fact, that vessels, termed arteries, is of a bright the smallest needle-point cannot be in- vermilion colour, and pure; in the capil- serted into that structure without wound- laries, it yields up its nutrient principles ing some of these vessels. For the pur- to the tissues through which it meanders, pose of facilitating the passage of the and, at the same time, gathers the mate- biood, and preventing the possible oc- rials of decay cast off during the pro- currence of obstruction in the circula- cess of nutrition. Coincident with this tion, they communicate with each other ■change in the vital composition of the at minute distances, and thus constitute blood, is a change in its colour, tempera- a network of exquisite delicacy and beau- ture, and the form of its solid particles, ty ; and for the purpose of bringing every the blood-disks; it has lost nearly one portion of the blood into the most favour- degree of Fahrenheit, its little disks have able position for performing its office, become biconvex, instead of biconcave, their size corresponds with that of the which they were before ; and it returns solid particles of the blood (the blood- to the heart, through the veins, ofa dark- disks). and is pretty uniform throughout red hue, almost approaching to black, the entire body. In structure, the capil- and under the appellation of impure, or laries are porous, and permit the passage venous blood. outwards of oxygen and of the nutrient 23 That which is now stated with re- elements of the blood, and inwards (that gard to the skin, may equally serve as is, into the flowing stream) of the car- an explanation of the circulation of the bonic acid gas and the deb is of nutri- blood throughout the entire body. The tion. Coincident with these changes is heart, as I have represented in the dia- the gradual conversion of the blood, from gram, contains four chambers, two on its its previously bright scarlet hue. to a dark left, and two on its right side; and so far red. The purpose which the blood ful- as it is concerned in the process of cir- fils, therefore, is to convey oxygen and the elements of nutrition to the ever- changing tissues of the ; and in * body re- [Notwithstanding the admirable clearness and re- markable beauty of the description of the circulation, turn, to become charged with the ele- and which probably could not be surpassed, a slight error ments of decay, and thus is rendered un- might arise in the mind of the reader. The author does sustenance not probably intend to say, that a slight check would fit for the further of the ani- always first affect the kidneys, as this would not be the mal machine until subjected to some ease, even generally. In onr climate, a slight check will of purification. usually first affect the lungs, causing a cold, as it is popu- process larly called, though some other organ may suffer first ] 24. Having arrived in the chambersof 14 ON THE STRUCTURE AND the right side of the heart (r r), in the ter, in truth, may be styled the purifiers state of an impure and dark-coloured of the arterial b ood ; while the liver stream, the blood is now propelled through and lungs are the purifiers of the venous an artery (a) to the capillaries of the blood. lungs (c), and through the latter into four 26. All the phenomena ofcolour of the veins- (v), which convey it to the left skin, excepting that which is due to its chambers of the heart (l l). The blood, pigment(§ 8), are referrible to the quan- therefore, performs a second, but smaller, tity. velocity, or composition of the blood circuit, —namely, through the lungs, and flowing through its capillaries. When during this course, is affected in precisely mental emotion causes a sudden turges- the opposite manner to what occurred cence ol the capillaries, the natural red during its current through the body. hue of the skin is heightened, and the state From having been dark-coloured, it is is termed blushing. But an opposite ef- now bright scarlet; its carbonic acid and fect may be produced by the same cause, some of its water have been thrown off and particularly when the emotion is of into the lungs, and its little disks have a depressing kind, or when an inward resumed their biconcave shape, and have struggle ensues for mastery over the become again charged with oxygen. feelings, and then we have intense pallor The lungs, it need hardly be said, are —pallor dependent on the rush of blood the organs of inspiration—two cellulated from the skin upon some internal and per- bags filling the chest, constructed almost haps vital organ, may be the heart, may- wholly of capillary vessels, and distend- be the brain.* Inflammation is always ed with atmospheric air at every respi- accompanied by heightened circulation ration. The capillaries hold the same in the part inflamed ; and as most of the relation now to the atmosphere that they diseases of the skin are associated with did in the greater circle to the tissues of inflammation, so redness is a concomitant the body; and being endowed with the of cutaneous disease. This is remarka- same properties of permeability, they bly the case in St. Anthony’s fire, in scar- give passage, through their pores, to the let fever, and in measles. In the two carbonic acid of the impure blood, which latter diseases, another phenomenon also is discharged from the lungs with the ex- may be observed, which is, that the red- pired air, and they imbibe from the at- ness occurs in minute points, an appear- mosphere a portion of its oxygen. The ance which results from over-distention blood, therefore, on its return to the left with blood of the papillm of the skin chambers of the heart, is fitted again to (§ 20). Purpleness or blueness of the rssume its current through the system, skin always depends on some cause of and perform the functions of the greater retardation of the cutaneous circulation. circulation. Thus, on a winter’s day. the vigour of the 25. It may possibly be inferred, from nervous power is reduced by the cold ; this description of the circulation, that and in addition to the repulsion inwards the lungs are the sole purifiers of the of much of the blood contained within blood, and that carbonic acid gas and the vessels of the skin producing pallor, water are the sole impurities which are that which remains behind moves so lan- thrown off by that fluid. This would be guidly through the capillaries, that the incorrect, for about one-fourth of the ve- change from bright-red to deep black-red nous blood is distributed, by means of has time to be established before it com- capillaries, through the liver, and yields pletes its circuit and reaches the veins. up the elements of the bile before reach- The mottled appearance of the skin of ing the right side of the heart. Again, children in cold weather owes its darker many of the impurities introduced into shades to the same cause. As respects the blood with the elements of decay the colour resulting from altered cofnpo- pass undisturbed through the lungs, and sition of the blood, the yellow tints of are separated from the system by organs dyspepsia and jaundice are due to ad- specially destined to that office—namely, mixture of the colouring matter of bile the kidneys and skin.* These two lat- with the blood, and the varied hues of
* or to a similar [ Our author has here omitted the second stomach, chlorosis green sickness bowels or intestines. These, however, are very important colouring principle, assisted by an abso- organs for removing impurities from the system, and may lute the of blood be classed as purifiers of the arterial or red biood. A deficiency in quantity large part of what usually passes from the bowels, is not contained within the body. the refuse of the food passed on, but is waste substance, 27. The nerves of the skin, proceeding produced in all parts of the body by its action, and car- ried by the current of the blood to the bowels, where it is as they do from the great centre of the eliminated, excreted or cast out; hence, why so much nervous system—the brain and spinal can pass from the bowels when a person eats scarcely any thing, &c., &c.] * See description of wood engraving, page 12. USES OF THE SENSITIVE SKIN. 15 marrow—are the source of the sensibility serve more strongly to corroborate the of the skin. The degree of its sensi- diversity of sensibility existing among bility offers great and remarkable varie- individuals. ty, not only as respects individual cir- 29. I have hitherto referred only to cumstances, age, sex, temperament, and natural sensations—namely, to sensations state of health, but also in relation to the determined by the excitation ofthe nerves part of the skin under examination. of the skin, such excitation being direct- The differences of sensibility among in- ed either from without or within ; but dividuals are so great, that that which there are other sensations, and those of amounts to absolute torture in one is a a painful character, which are dependent matter of almost indifference to others, on an unnatural and unknown state of and this without any known signs by the nerves themselves, sometimes involv- which such variety of sensibility might ing a single nerve or part of a nerve, he predicted. The medical man is ac- and sometimes more or less of the whole quainted with this fact, and acts accord- nervous system, including even the brain. ingly, attributing to its right cause what Of this kind, is that distressing itching might, by the unobservant or the igno- of the skin which, without any external rant, be set down to diversity of moral cause, sometimes assails more or less of power. the surface of the body, destroying com- In reference to age, sex, temperament, fort and repose, rendering sleep impossi- and health, as modifiers of pain, there ble, and eventually injuring the health can be no question that the sensibilities by continued irritation. In the interval are more acute in the young than in the of the attacks, the sufferer is easy and at adult, and in the latter than in advanced rest, probably enjoying conversation, and life ; they are greater also in the female unconscious of his physical tormentor ; than in the male; in the sanguine and but the instant the thoughts recur to the nervous than in the phlegmatic and bil- seat of suffering, that instant the itching ious temperament; and in those who are is renewed. A lady, bearing the out- enfeebled by disease than in the sound ward appearance of perfect health, de- and robust. scribing to me the torture which she 28. However various the differences of experienced, remarked, “ the sensation sensibility may be in different individuals caused by the sponge dipped in scalding and under different circumstances, it water, and immediately applied to the would scarcely be supposed that any skin, is perfect bliss when compared with great amount of variety could exist in the pungent suffering caused by this itch- parts of the skin of the same person, and ing.” Instances are on record of kings yet such is the case. Dr. Weber, an being afflicted with this frightful malady. eminent physiologist of Leipsic, ascer- Plato, in his old age, suffered under it; tained by experiment, that, to be distin- as did the Abbe Morellet, in the eightieth guished as separate sensations, the points year ofhis age. Other varieties of pain- of a pair of compasses applied to the skin ful sensation experienced by the skin are of the middle of the arm or thigh must tingling, smarting, pricking, shooting, be separated from each other to a dis- creeping, tickling, burning, scalding, &c. tance of thirty lines, while on the tip of 30. An opposite state of sensation is the finger, tvVo sensations are obtained sometimes met with —namely, where the by a separation amounting only to one- sensibility of the skin is much dimin- third of a line. On the front of the fin- ished, and, in rare cases, even abrogated. ger, the distance necessary to give two This, like the preceding, is a state of the sensations was two lines; on the cheek, nerves, and sometimes of the brain, al- five lines ; forehead, ten lines; and on though the apparent seat of the disorder the middle of the breast, twenty lines. is the surface, and a part of the body The same gentleman has pointed out other distant from the real disease. curious phenomena in connexion with the sensation of the skin ; thus, he observed, that if the two hands were immersed in warm water of the same temperature, that in which the left was plunged would feel the warmest; and that, if the finger CHAPTER III. of one hand and the whole of the oppo site hand be held in hot water, the sen- ON THE PERSPIRATORY SYSTEM. sation communicated by the single finger would be trifling, while tothe entire hand 31. In the preceding chapters, the skin it would be unbearable. These facts has been described as a membrane of in- 16 ON THE STRUCTURE AND considerable thickness, constituting the and then prolonged for some length as a surface of the body, and composed of contracted tube (for whenever a blister three layers—namely, scarf skin, sensi- is formed, the lining of the perspiratory tive layer, and corium. I have now to duct is drawn out of the true skin), the point out the existence of numberless entrance of fluid into the tube must be as minute tubes, which traverse the three difficult to effect as its passage through layers of the skin more or less deeply, the scarf-skin itself. Again, the disten- and open on the surface of the scarf-skin tion of the scarf-skin acting with direct by as many minute apertures, which are pressure on the coils of the spire, must termed pores. These tubes, with their press them together and hermetically corresponding pores, belong to three sys- close the tube; and as the lining of the tems of cutaneous organs, now to be ex- first portion of the latter, after it has amined. namely, the perspiratory glands, passed the scarf-skin, is thick and rigid, oil-glands, and hairs. and projects like a cone from the under 32. The perspiratory apparatus con- part of the skin (plate 1, fig. 2, h d), the sists of very minute cylindrical tubes, fluid pressing on all sides will tend to which pass inward through the scarf- obliterate its passage, while the rest of skin, sensitive skin, and corium, and ter- the tube, in the act of being drawn out minate in the deeper meshes of the latter. and suddenly giving way with an elastic In their course through the scarf-skin, rebound, must be closed equally securely. each little tube forms a beautiful spiral On the palm of the hand and pulps of the coil (plate 2, fig. 3, a ); in its deeper fingers, the openings of the perspiratory course through ihe corium it is also pores (plate 1, fig. 1) are distinctly per- more or less spiral or flexuous; and on ceptible to the naked eye; they are arriving at its destination, coils upon situated at nearly equal distances* on the itself in such a way as to constitute a little ridges, and give to the latter the little oval-shaped or globular ball, the appearance of being crossed by little perspiratory gland (/i). The perspirato- transverse lines. On the sensitive l iver, ry gland, therefore, is a very small mass, they make a similar impression, dividing formed by the twisting of a minute tube; the ridges into little square allotments and the latter is constructed, and, indeed, (j 21), each allotment being separated is a prolongation, of the three layers of from that which precedes and follows it which the skin is composed—namely, by the shaft of a perspiratory tube (plate the scarf-skin, which lines the interior of 2, fig. 1). the tube (plate 3, fig. 17); the sensitive 34. Taken separately, the little per- layer, furnished with a rich net of capil- spiratory tube, with its appended gland, lary vessels; and the corium. which forms is calculated to awaken in the mind very a protective layer to the exterior for its little idea of the importance of the sys- strength and support. In the language tem to which it belongs; but when the of anatomical science, the tube and gland vast numbers of similar organs com- are an involution of the skin. The mouth posing this system are considered, we of the perspiratory tubule on the surface are led to form some notion, however of the scarf-skin, namely, the “pore” imperfect, of their probable influence on (plate 1, fig. 1), is also deserving of at- the health and comfort of the individual. tention. Its extremity is the section of a I use the words, “ imperfect notion,” ad- spirally-twisted tube, and in consequence visedly, for the reality surpasses imagi- of this peculiarity, the aperture is oblique nation and almost belief. To arrive at in direction, and possesses all the ad- something like an estimate of the value vantages of a valvular opening. of the perspiratory system in relation to 33. In this structure, and in the fact the rest of the organism, I counte i the of the scarf-skin being prolonged as a perspiratory pores on the palm of the tubular sheath into the perspiratory duct, hand, and found 3528 in a square inch. the reader will perceive the reason of a Now. each of these pores being the aper- phenomenon, which puzzled the earlier ture of a little tube of about a quarter of physiologists, and induced them to de- an inch long, it follows, that in a square clare, that there were no such things as inch of skin on the pahn of the hand “ pores ” in the skin. I allude to the there exists a length oi tube equal to 882 retentive powers of the scarf-skin in the inches, or 73| feet. Surely such an •case of a blister; it was thought, that if there were pores, the fluid of a blister * They are situated about one sixth of a line apart must those open- along the ridge, and a little less than a quarter of a line necessarily permeate and to that if from ridge to ridge. On the heel, there are four a ings ; but it is easy perceive, half pores in the compass of a line along the ridge, and each pore is, in the first instance, spiral, three and a half across the ridges. USES OF THE PERSPIRATORY SYSTEM. 17 amount of drainage as seventy-three feet the ordinarily insensible vapour becomes in every square inch of skin, assuming condensed in a sensible form. On the this to he the average for the whole body, other hand, when the atmosphere is dry, is someting wonderful, and the thought and the body or the air in motion, the naturally intrudes itself: What if this moisture is carried away so rapidly that drainage were obstructed?—Could we the sensible, under ordinary circum- need a stronger argument for enforcing stances. becomes an insensible perspira- the necessity of attention to the skin ? tion. The term “insensibleperspiration,” On the pulps of the fingers, where the therefore, properly applies to the imper- ridges of the sensitive layer of the true ceptible evaporation from the skin when skin are somewhat finer than in the palm the body is at rest, or in gentle motion. of the hand, the number of pores on a 36. To comprehend in what manner square inch a little exceeded that of the the perspiration is a means of limiting palm ; and on the heel, where the ridges the heat of the body, itwill be necessary are coarser, the number of pores on the to glance at the principal phenomena square inch was 2268, and the length of concerned in animal temperature. The tube 567 inches, or 47 feet. To obtain ordinary temperature of the body, as as- an estimate of the length of tube of the certained byplacing the bulb ofa thermo- perspiratory system of the whole surface meter under the tongue, is 100 degrees of the body, I think that 2800 might be of Fahrenheit. This maybe regarded taken as a fair average of the number of as the standard temperature of the hu- pores in the square inch, and 700, conse- man body in health, and it offers very quently, of the number ofinches in length. little variation, in summer or in winter, at Now, THE NUMBER OF SQUARE INCHES OF the equator* or the pole.f In disease, SURFACE IN A MAN OF ORDINARY HEIGHT even, the variation is less considerable AND BULK IS 2500; AND THE NUMBER OF than might be imagined, the lowest tem- PORES, THEREFORE, 7,000,000, AND THE perature on record, namely, that of NUMBER OF INCHES OF PERSPIRATORY Asiatic cholera, being 77°, and the high- TUBE, 1,750,000, THAT IS, 145,833 FEET, est 110|°.J The sources ofanimal tem- OR 48,600 YARDS, OR NEARLY TWENTY- perature are the chemical processes con- EIGHT MILES.* stantly taking place in the body during 35. The perspiratory system of the the action of the various phenomena skin is one of the usual channels by concerned in nutrition, and these, by de- which excess of water is removed from veloping heat, maintain a condition which the blood, and in effecting this purpose, is necessary to the continuance of life. the perspiratory function becomes a reg- The minimum of heat to be thus produced ulator of the temperature of the body. is, as we have just seen, 100 degrees of In health, perspiration is always taking Fahrenheit, and so long as this quantity place, even in a passive state of the is developed, the functions of the body body, and passes off in the form of an are properly performed, and a state of imperceptible vapour, which is therefore comfort is maintained; but the instant termed insensible perspiration. But when the temperature sinks below this point, the muscular system is in exercise, when the chemical processes have then to be chemical combination is active, and the aroused and stimulated by such means nervous system excited, the perspiration as are capable of augmenting the rap- is no longer insensible ; it becomes per- idity of respiration and circulation. ceptible, and more or less abundant, and These are the processes which, in the is then denominated sensible perspiration. winter season or at the poles, are engag- The existence of perspiration in its in- ed in keeping the temperature up to the sensible or sensible state bears relation, natural standard; and in this case, the however, not merely to the quantity of insensible perspiration, although it exists, perspired fluid, but also to the state of is at its minimum of activity, and every the atmosphere. Thus, in a close, damp collateral condition of external warmth day, when the atmosphere is warm, and already charged with moisture, it is in- * In Hindostan, the temperature is occasionally 120 of that the and degrees of Fahrenheit. capable receiving of skin, T In the polar voyages, the thermometer was noted as low as seventy degrees below zero. * To the medical reader, it maybe necessary toexplain, [ The standard temperature of different parts, varies that the sebaceous system is included with the system of at the same time. Our author has given the standard perspiratory glands and tubes in this calculation. I have temperature of one part only, and in this is not quite cor- ascertained, beyond question, that the sebaceous system is rect. The temperature under the tongue is 98° or the perspiratory apparatus of the greater part of the body, The temperatu'e of the stomach averages 100°, according the true perspiratory glands and tubes being found only in to Dr. Beaumont. The temperature of the lungs would certain parts. Therefore, the calculation which I have be a little above that, probably. See Meteal" on Caloric, made on those premises must be considered as falling Muller, 4tc.] within rather than beyond the truth. t A case of tetanus recorded by Dr. Edwards. 18 ON THE STRUCTURE AND and clothing is required to aid in the [ of about 120 yards in length, and 7 feet preservation of the proper amount of high, by about three in breadth. A little heat. But when the human body is within the mouth of the passage, the transferred to the equator, or when, as temperature was 104° in the upper strata has frequently happened, a man has sub- of the atmosphere, and 91° near the jected himself to a temperature * much ground; farther on, the air was filled greater than that of boiling water, at a with dense vapour, of a temperature of moment, too, when his own vital pro- 118° above, and 111° below; and over cesses were generating more heat than the bath it was 122°, the heat of the the natural standard required, it is then spring being 185°. After proceeding for that the influence of the perspiration, as about one-third the length of the passage, an agent in limiting the temperature of he began to feel a sense of oppression the body, is strikingly manifested. The and discomfort, his pulse rising from 70 thermometer, placed in the mouth of a to 90 beats in the minute. A short dis- man who had been exposed to a temper- tance farther, the oppression increased, ature of 120° for a quarter of an hour, his breathing became rapid and panting, stood at 105° ; and the temperature of and he was under the necessity of stoop- animals, when the heat has been raised ing his head frequently to the earth, in to a degree sufficient to cause death, has order to qbtain a chestful of air of a less never exceeded an elevation from nine to suffocating temperature. His skin, at fourteen degrees above the natural stand- this time, was bathed in a profuse per- ard.! The reduction of the heat of the spiration, his head throbbing, and his body at so elevated a temperature takes pulse beating 120 in the minute. Con- place at the expense of the water of the tinuing his progress, the sensations of blood and of the tissues. To be raised suffocation became insupportable; his in the form of vapour, water requires a head felt as though it would burst; his large amount of heat, and in this way pulse was so rapid as to defy calculation; the excess of heat is employed. Again, he was exhausted, and nearly uncon- as the water becomes dissipated by per- scious ; and it required all his remaining spiration, thirst is occasioned, and the power to enable him to hurryback to the fluids taken to alleviate the desire for open air. On reaching the mouth of the drink are immediately engaged in the passage, he staggered, and nearly fainted, evaporating process. From what has and was very uncomfortable until relieved been said in a previous paragraph (§ 35), by a bleeding from the nose. During it is evident that all the above high tem- the rest of the day, his pulse remained at peratures have reference to dry air, for 100; he had uneasy sensations over the when the air is moist, evaporation is surface of the body, and did not recover checked, and the removal of heat conse- until after a night’s repose. The same quently prevented. gentleman bore a temperature of 176° in 37. As an illustration of the influence dry air without inconvenience.* of a moist atmosphere, at an elevated 38. The regulation of the temperature temperature, on the human system, I may of the body is only one of the purposes adduce the effects occasioned to a gen- fulfilled by the perspiration; another, tleman who recently visited the baths of and an important one, is the removal from Nero, near Pozzuoli, the ancient Posi- the system of a number of compounds dianse. To reach the bath, he had to noxious to animal life. It was estimated pass along a narrow, winding passage, by Lavoisier and Seguin, that eight grains of perspiration were exhaled by * Tile furnace in which SirFrancis Chantrey was in the the skin in the course of a minute, a habit of drying his moulds was heated to a temperature of quantity which is equivalent to thirty- :150°, and into this his men occasionally entered without inconvenience. The oven used by Chabert during his three ounces in twenty-four hours. Of exhibitions in London was heated to between 400® and this quantity, a large proportion is, natu- (500°. but one f It is interesting to note, that in animals made the rally water; nearly per cent., subject of these experiments, the blood was found in the according to Anselmino, consists of solid opposite position to that which it would have occupied substance; of the one hundred after death from cold. Instead of being collected about latter, the heart and internal organs, as in death ensuing from parts contain about twenty-three parts of the latter cause, the heart was empty, and the vital fluid the remainder being organic matter. towards the of the body, in in- salts, dispersed periphery some one stances being actually forced out of its vessels into the sur- An analysis of hundred parts of the rounding tissues. The blood seemed to have been killed solid matter ofperspiration, according to by the heat, for it had lost its power of coagulating, and the its deep-black hue was notaltered by exposure to the at- Anselmino, gave following results—- mosphere, a change which takes place in living blood. namely: In a moist atmosphere, the animals died sooner than in dry air of a higher temperature, and without losing weight; in dry air they lost weight. * Gazette Medicale, April 27, 1844. USES OF THE PERSPIRATORY SYSTEM. 19
Osmazome,* combined with common hygrometric machine, and his tissues salt 48 parts have a natural tendency to an equaliza- Lactic acid salts, with osmazome . 29 parts tion of moisture with the medium in “ Animal matter, with vitriolic salts . 21 which he lives; but as this disposition, 2 “ Calcareous salts j in an active state, would be destructive of it is very 100 existence, properly controlled and regulated by the vital powers. An- To which may be added, carbonic acid other obstacle to absorption is the scarf- skin ; and so long as this retains its natural gas, ammonia, and iron, and in rare in- copper. peculiar odour of texture, and is bedewed with its ordinary stances, The oily secretion, absorption by perspiration is due to organic matters, the skin is and its acid qualities and acid impossible. Indeed, were it not so, our occasional lives scarcely be smell to the lactic acid, an organic sub- would secure for an in- stant ; for a moist stance not far removed in composition atmosphere, bearing infectious or mias- from vinegar. in suspension matter, distilled and without When the perspiration is checked, mata, traversing, impedi- 39. j the tissues of the would from disorder of the skin or cold, the ment, skin, introduce so much of the into whole of these matters fail of being re- poison the as would destruc- moved, and are circulated through the system be immediately i tive of life. We are exposed to system by the blood. Under favourable ! already circumstances, they are separated from great danger by the extent of breathing surface to the contact of the at- the latter by the kidneys, the liver, or offered the more would the lungs, but not without disturbing the mosphere by lungs; equilibrium of action those organs, indeed be a serious evil. When, how- of the condition the scarf-skin is and sometimes being the cause of disease. ever, of by contact The perspiration is a fluid, whose regu- changed the long of fluid, and of exhalation are particularly if the fluid be alkaline, or larity continuance and is thus not but absolutely warm, converted into a moist merely conducive, the of necessary to health; without, such regu- membrane, play absorbing powers becomes active, is larity, the animal temperature would run and then only limited the laws which the and substances of an injurious qua- by physical govern riot, transmission of fluids. It is lity would be allowed to premeate the in this way that we must the of thirst finest and most delicate of the tissues of explain relief to who been the body. Some experimentalists! in afforded persons have ship- wrecked and to France conceived by obstructing exposed the elements for that, without the perspiration of the skin, and thereby several days food by saturating their with sea-water. preventing the dispersion of animal tem- garments Instances are on in which in perature by evaporation, they would be record, bathing warm enabled to produce internal fever at will. milk has been successfully employed as a when To on this question, means of supporting life, the satisfy themselves communication they covered a rabbit with an imperme- between the mouth and coating of varnish; but the result the stomach was impervious; and nume- able to failed to satisfy their expectation. In- rous experiments tend show the possi- stead of an of temperature, the bility of absorption of substances in solu- increase tion heat of the body quickly diminished; through the skin, where the latter and in one hour and a half the animal has been for some time in contact with fluid. died ofasphyxia-! the 40. While speaking ofexhalation from 41. Whenever we wish to introduce medicines into the system by the skin, it be proper to consider the way of may the we find it to select another phenomenon allied with exhala- skin, necessary spots in tion, but having no directrelation to the those which the scarf-skin is system, I the trans- thinnest; and then'we are not satisfied perspiratory mean, with but rub mission of moisture the simple contact, the sub- through skin from stance “absorption,” as it is technically into the skin, in order that it may without, enter the pores, and attain as termed. Man, to a certain extent, is an close a vicinity as possible to the vessels of the sensitive of the dermis, which are * layer The peculiar animal principle which gives flavour to meats and part of the odour to perspiration, the agents for conveying the substances f Becquerel and Breschet. so introduced into the blood. By the J [I do not see that the experiment mentioned, and to is which I have seen reference made elsewhere, proved any friction which used in this process, thing, for the coat of varnish would, of course, cause the we also stimulate the cutaneous vessels fur of a rabbit to adhere and prevent the animal from and nerves, and obtain their co-operation. breathing freely, and We would expect the animal to die precisely as it did.] But even in this way, some few sub- 20 STRUCTURE AND USES OF THE stances only can be transmitted through the skin; and excepting in the instance of a single medicine, the practice is dis- carded.* Another plan, which is occa- CHAPTER IV. sionally pursued, will serve as a further illustration of the opposition afforded by ON THE OIL-GLANDS OF THE SKIN. the scarf-skin to the transmission of sub- stances from without. It is termed the 43. The apparatus for keeping the endermic method of administering medi- surface of the skin bedewed witli an cine. and is founded on the well-known oily fluid, resembles, in general particu- active absorbing power of the sensitive lars of structure and economy, that of layer of the skin. To succeed in this the perspiratory system. It consists of practice, the first step is to remove the minute tubes, which traverse the scarf scarf-skin, by means of a small blister, and sensitive skin, and enter the sub- and then to sprinkle the medicine on the stance of the corium, where they ter- exposed surface. Opium and other pow- minate in small glands (plate 3, figs. erful medicines have been administered 1—12.) These tubes are similar -in in this way, and have been found to act structure to the perspiratory ducts, be- as rapidly as when introduced into the ing composed of three layers, derived stomach. In some instances, the ender- respectively from the scarf-skin which mic method offers advantages, as when, lines their interior; the sensitive skin, for example, the medicines which it is which is the medium of distribution of desired to administer are known to disa- their vessels and nerves; and the cori- gree with the stomach, or when the power um, with its fibres, which gives them of swallowing is lost. The latter was strength and support. Like the perspir- the case in a patient suffering under hy- atory tubes, they are in some situations drophobia, in whom opium administered spiral; but this is not a constant feature; through the skin produced a soothing more frequently they pass directly to calm in the height of the most violent their destination, and they are also larg- struggles. er. The chief characters in ivhich they 42. The endermic absorption of the differ from the perspiratory apparatus skin is not always, however, the harbinger are, the straightness and greater diame- of good; deleterious substances are ter of their tubes, their absence in cer- sometimes accidentally introduced into tain situations, as on the palm and sole, the system in this manner. Violent at- and abundance in others where their tacks of strangury occasionally, though office is more needful, as on the face and rarely, follow the use of a blister, from nose, the head, the ears, &c.; and the the absorption of the juices of the Span- degree of complication in the structure ish fly into the blood, and its subsequent of their glands. This latter character is transmission to the kidneys for removal. sufficiently remarkable, since they offer A more distressing illustration of this every shade of complication, from the action is that inwhich arsenic is absorbed simple straight tube, to a tube divided into the system from the surface of a sore, into numberless ramifications, and con- a sore being at all times an actively ab- stituting a little rounded, arborescent sorbing surface. No medical man would mass, of about the size of a millet-seed. think ofapplying arsenic to an open sore; In a few situations, these little glands but unfortunately there are such things are worthy of particular notice, as in the in society as quacks,” quacks, too, pro- eyelids, where they possess great ele- tected by the legislature and the state; gance of distribution and form (fig. 12), and one of the favourite experiments of and open by minute pores along the these persons is that of treating cancer. edges of the lids. In the ear passages, Their universal remedy is arsenic; and where they produce that amber-coloured happy is the unfortunate sufferer who substance known as the wax of the ears; escapes destruction in their hands. With and in the scalp, where they resemble them, every trifling and temporary en- small clusters of grapes, and open in largement is a cancer, and their cure is pairs into the sheath of the hair, supply- death. ing it with a pomatum of nature’s own preparing (figs. 8, 9, 10.) * f Certainly it is not so in this country. Many sub- 44. The mode of formation of the stances are introduced into the system, very effectively, unctuous “ distilment ” of the skin, the by rubbing them upon the sound skin, and I think it is sebaceous as it is very frequently and judiciously done by our best phy- substance, called by sicians.] medical writers, is not the least curious of the phenomena of animal life. In a OIL-GLANDS OP THE SKIN. 21 previous chapter I have explained the coming impacted in that situation until manner of formation of the scarf-skin removed by art. While in this state the 4). namely, by a fluid which is suc- impacted matter reaches to the surface, cessively converted into granules, cells, and as it then comes in contact with the and scales; the same process takes place dust and smoke of the atmosphere, be- in the production of the scarf-skin of the comes dirty and black, and is recognized oil tubes and glands, the point of dis- as a small, round, dark spot. Such spots tinction between the processes being the as these are common on the nose, fore- difference in the nature of the fluid im- head, and other parts of the face of the bibed by the cells from the blood, and inhabitants of towns, and especially in its subsequent destination. In the case persons who have, constitutionally, a of the scarf-skin, the fluid is mainly torpid state of the skin. They are re- water, containing saline matters in solu- moved by squeezing the skin between tion. In the cells of the oil-tubes and the finger-nails, and then there issues glands, besides the water and salts, there forth an elongated, white cylinder of is also oil, partly in intimate mixture unctuous matter, modelled by the tube with albumen or white of egg, partly free in which it has been so long confined; and diffused. These substances are all in truth, a little candle, which, strange derived from the blood flowing through to say, from its form and size, and partic- the capillaries of the walls of the tubes ularly on account of its black extremity, and glands; and when the cells are is reputed to be a maggot or grub, and fully formed, that is. fully distended, they as such is popularly known. When the yield up their contents, and collapse into impacted matter produces inflammation scales, as in the case of the scarf-skin; of the tube, no uncommon occurrence, the fluid matters wT hieh they contain are it then has the appearance of a black consequently set free, and passing along spot in the centre of a small, red, conical the tubes to the surface, constitute the pimple, and is termed “punctuated or unctuous element of the economy of the spotted acne.”* skin. 47. Having now glanced at the nature 45. It will be perceived that, in the of the unctuous matter of the skin, and preceding description, I have only ac- pointed out its tendency to remain within counted for the fluid which is given off the tubes, and referred that tendency to by the cells during their collapse, and its cause, namely, torpor of the skin, I that the destination of the cells them- have, in the next place, to describe a selves still remains to be explained. contrivance of modern discovery that These latter are cast off' in the form of may be appropriately introduced with minute scales, like those of the scarf- the words of Hamlet:— and are from the in skin, expelled “ tubes, There are more things in heaven and earth, Horatio, company with their fluid product, to be Than are dreamt of in your philosophy.” dispersed upon the surface. Such are the phenomena which attend the forma- A few years ago, there were discovered tion and destiny of the unctuous matter by a German physician, Dr. Simon, in in a state of perfect health, in that state the unctuous matter which collects with- w Thich most nearly approaches one of in the oil-tubes, certain minute animals, simple nature. But in the inhabitants of which he published an account in the of cities and towns, in the midst of the June number of a German periodical, sedentary and irregular habits ofrefined Muller’s Archiv, for 1842. Having read society, and of the mental “wear and Dr. Simon’s account, I set myself to work tear” of practical life, such a state of to seek for the animals in question, and the unctuous system of the skin as I am before the end of June had seen some now describing rarely or never exists. hundreds of specimens, become so The actions, instead of being completed far interested in the subject, that I pur- according to the standard above estab- sued it with almost exclusive attention lished, are irregular and tdrpid, the con- for six months. In the course of this in- tents of the cells are unnaturally solid vestigation, I examined many thousands and dense, they are only parti/, or not of these animals, and arrived at some at all, emptied, and are thrown out in a novel conclusions with regard to them. mass upon the surface of the skin. I found that Dr. Simon’s description and 46. Sometimes, however,'the contents figures were imperfect; that he had over- of the cells are too dense and dry even * [ Tlie best way to remove the appearance referred to tor this mode of escape, and then they is, to rub the parts affected, several times per day, with collect in the tube of th,e gland, distend- the honey, lard and olive oil nnguent, before mentioned, then wash, thoroughly, with.fine soap, and rinse with ing it beyond its natural limits, and be- water.] 22 STRUCTURE AND USES OF THE OIL-GLANDS. looked several points of entomological In corroboration of this view is the fact, importance in the structure of the ani- that these little creatures increase in mal, as for example, the .head ; and numbers when the vital powers decline, that he had left one vein of the mine, so that, when the energies of the system namely, the progressive development of are reduced by disease, and when the the young from the growth and hatching skin, participating in that reduction, is of the egg to maturity, entirely uno- unable alone to fulfil its functions cor- pened. Under these circumstances, I rectly, these little beings are produced was enabled, in the month of December, to aid it in its work. 1842, to communicate to the Royal So- 49. The entozoon folliculorum (plate ciety a paper, since published in the 3, fig. 13) is extremely mi/iute, and quite Philosophical Transactions,* containing undistinguishable'by the naked eye, the many original observations, and upwards longest I have seen being but little more of forty figures of the animal. In this than a quarter of a line in length ; that paper, I found myself under the neces- is, forty-five, placed end to end, would sity of changing the name given to the measure in length only one inch. In animalcule by Dr. Simon, as being form and shape, in the perfect state, they founded on a wrong view of its structure are very like caterpillars, and have a and zoological position, and of assigning distinct head, with feelers, a chest, with to it the appellation entozoon fulliculo- \ four pairs of legs, and a long tail. The rum. f whole body is so transparent, that its 48. The animalcule of the skin is found ; interior may be easily seen, and the ani- in the oil-tubes whenever there exists mal always occupies the same position any disposition to the unnatural accumu- j in the oil-tube, the head being directed lation of their contents; it is found in inwards, and the tail towards the aper- numbers, varying from one or two to ture of the tube, as though it had crept twenty, in the interior of the little grub- into that situation from without. In like cylinder which is squeezed out by some persons, these singular creatures the pressure of the fingers (plate 3, fig. are larger than in others, and in some 5), and this in an apparently perfect than in other parts of the face. So state of health of the skin, or, more cor- much is this the case, that an eminent rectly, without any appearance of disor- naturalist to whom I showed figures of der, for the skin cannot be said to be in their varieties, considered the difference perfect health, when its functions are between the two, not merely in length, performed in a torpid manner. Now, as but also in shape, to amount, to a specific in the majority of mankind, and certainly character. If this be the fact, we may in all the inhabitants of cities and large look, I imagine, for the shorter variety towns, the skin is more or less torpid in on the alpine ridges of the nose or eye- its functions, so the presence of this ani- brow. and the longer kind in the glades mal in the skin is the rule, its absence, and valleys of the nose and cheek. But the exception. I have found it atall ages, the cause of the difference in length, I from youth to old age, more numerously believe to be a relative diversity in the it is true, at ttye latter than the former caliber of the oil tubes in different situ- period, and in great and remarkable ations. In the same group also, we find numbers during sickness. Under these eggs fig. 14) embryonic forms (fig. 15), circumstances, I see no other conclusion and young (fig. 16), all mingled together open than to assume that it performs in confusion. In pursuing this inquiry some beneficent purpose in the economy into the animal world. I have examined of the skin ; that purpose being, accord- them in the dog, and have found them ing to my belief, the disintegration of more recently in the horse. In both these the over-distended cells, the impression animals, the entozoa are relatively larger of a new condition on the contents of than in man, and, at the same time, more the cells, and the stimulation of the tubes tapering and slender. to perform their office more efficiently. 50. I now cbme to the uses of the unc- tuous product of the oil-glands: these * Researches into the structure and development of a are twofold, as in most of the operations newly-discovered parasitic animalcule of the human skin of nature; the first being mechanical, —the Entozoon folliculorum. Philosophical Transactions, of Part II., 1S44. namely, the protection and defence “ f The meaning of this term is simply, the living in- the skin ; th'e second, vital, the separa- habitant of the follicles (i. c., oil-tubes) of the skin.” the blood of matters noxious The word entozoon is applied by zoologists to an entire tion from class of animals, namely, the worms of the interior of the to life and health. In the exercise of body. I do not think this an objection to its use as a the former office, the unctuous substance generic appellation, and th§ specific name which follows, renders any mistake impossible. is diffused over those parts of the skin PURPOSES OP THE HAIRS. 23 which are naturally exposed to the vicis- special use. They are analogous to the situdes of temperature, as the nose, face, scarf-skin in mode of formation, and are ears, and head; to the injurious attrition so connected with it, that they come off of contiguous surfaces, as the flexures when the latter is separated from the sen- of the joints ; or to the contact of acrid sitive skin by the action of a blister, by fluids, as is instanced in the excoriations scalding, or decomposition. They resem- to which infants are liable. The oil of ble it, also, in the general features of its the unctuous substance is the main agent construction, but are somewhat more in effecting these purposes, as it pre- highly organized and complex. The vents, on the one hand, the evaporation hairs traverse the skin like the perspira- or congelation of the water of the scarf- tory and oil-tubes, and resemble both in skin, which would cause it to become the extent to which they are prolonged parched and peel off, and leave the sen- into it, the downy hairs, like the latter, sitve skin exposed ; affords, in the second being limited to the superficial strata; place, a soft medium to the contact of the long hairs, like the former, extending moving surfaces; and, in the third, re- more deeply, and even piercing it alto- pels moisture and fluids. In its vital ca- gether, so as to reach the subcutaneous pacity, as an agent for removing noxious fat. Within the skin, each hair is en- substances from the skin, the unctuous closed in a sheath or tube, closed at its matter is allied with the perspiratory extremity, where it supports the root of system, being a purifier of the blood. the hair, and constructed, like the per- The oleaginous part of the product sep- spiratory and oil-tubes, of three layers arates hydrogen and carbon ; its animal derived from the skin, namely, a lining constituents, a large proportion of nitro- of scarf-skin, a middle layer of sensitive gen ; and its salts, lime. skin, and an external and protective lay- 51. In considering the purpose of the er, the corium. These sheaths or hair- unctuous matter of the skin, there are tubes (plate 3, figs. 6, 7, 10-12), as they two situations in which it deserves es- resemble the perspiratory and oil-tubes pecial remark, namely, along the edges in structure, so, also, do they imitale the of the lids, where it is poured out in latter in function. The tubes of many considerable quantity, and in the canal of the downy hairs are, at the same time, of the ears. In the former place, it is oil-tubes, and hair-tubes, performing a the means of confining the tears and double function ; and even where this moisture of the eyes within the lids, of simplicity of structure does not exist, oil- defending the skin from the irritation of tubes are connected with the hair-tubes, that fluid, and of preventing the adhesion and open into them, sometimes one (figs. of the lids, which is liable to take place 8, 9, 10) to each tube, sometimes two upon slight inflammation. In the ears, (fig. 6), as in the case of the hairs of the the unctuous wax not only preserves the head. Indeed, the principle of forma- membrane of the drum and the passage of tion of these three kinds of tubes, name- the ear moist, but also, by its bitterness, ly, perspiratory tubes, oil-tubes, and hair- prevents the intrusion of small insects.* tubes, would appear to be the same. They all originate on the surface of the skin in the form of little pouches, and and grow inwards to the required depth. In the case of the hair-tubes with ap- pended oil tubes and glands, the former CHAPTER V. are first formed, and the latter are pro- ductions from their sides, growing as OF THE HAIRS. mere pouches, and increasing in length like the tubes from which they originate. 52. The hairs are appendages of the 53. Every part of the skin, with the skin contributing to its defence, like the exception of the palms of the hands and scarf-skin, of which, indeed, they may be soles of the feet, is organized for the pro- regarded as modifications, suited to a duction of hairs. On the major part of the body they are short and fine, and in * [ The want of activity in the oil glands, is the great many instances so small as scarcely to cause of chaps and several affections of the skin. The activity of the oil glands will be increased by briskly and rise above the level of the skin, while in frequently rubbing the skin, by vapour and shower bath- others, as the scalp, the eyebrows, and in ing; for these things will cause the blood to circulate and more freely through the skin. The skin must also be kept man, the whiskers the beard, they clean, that the'oil may flow out freely upon the surface. grow to a considerable length. The If this is not sufficient to keep the skin from chapping, it length and thickness of the hair, as these should be anointed freely with the honey, lard, and olive oil compound before spoken of.J instances illustrate, are regulated by a 24 STRUCTURE OF THE HAIRS. law of nature, the hair of the head being neither consistent with the known struct- always longer and finer than that of the ure of the hair, nor with observation. beard, and the latter longer than the When the hair is cut, it is liable to split, whiskers and eyebrows. When hairs are and become ragged at the ends. left to their natural growth, they attain 55. The author whom I have before a certain length, and are then thrown off quoted as having calculated the growth by a process analogous to the change of of the beard, has made some measure- the coat in animals, or the moult of birds, ments of the diameter of the hairs of the their place being supplied by young head, by which he ascertained that black hairs, which grow from the same tubes; hair was thicker than brown, and brown and this temporary decadence of the than blonde. Whether this is the fact hair occurs, also, where it is kept cut of or not, I am unable to say, and the point moderate length. When, on the other is not of much consequence. The aver- hand, hair is closely shaved, it appears age diameter of the hair of the head, ac- to become and at the same to own measurement, is ± persistent, cording my 3 0 time increases in strength and bulk. It of an inch. The same author likewise has been calculated by a curious investiga- instituted inquiries into the number of tor* that the hair of the beard grows at the hairs grown upon a square inch of the rate of one line and a half in the week ; skin of the head, and found, of black this will give a length of six inches and hairs, 147; chesnut, 162; and blonde,. a half in the course of a year, and for a 182. I have not, as yet, had leisure to man eighty years of age, twenty-seven repeat his observations. feet which have fallen before the edge of 56. At the bottom,of each hair-tube is the razor. a small conical prominence, analogous to 54. The shape of individual hairs is a papilla of the sensitive layer of the cylindrical for the smaller kinds, and dermis, with which latter it is connected more or less oval for those which grow by means of the walls of the tube. This to any length (plate 4, fig. 3). The hairs conical eminence (plate 4, fig. 4) is the of the head are never perfectly cylindri- producing organ of the hair, or hair pulp, cal, and those of the eyebrows and and is richly supplied with capillary ves- beard are more or less oval in contour. sels and nerves. The mode offormation When left to their natural growth, the of the hair by this pulp is precisely simi- end or tip is always conical and pointed, lar to the manner of production of the and in animals it is common to find that scarf-skin; a fluid separated fjpm the portion of the shaft which is nearest the blood is first poured out. on the surface of skin smaller than the more distant por- the pulp ; this is converted into granules, tion. These differences in the thickness then into cells, and the cells are subse- of the same hair, at different points of its quently modified to constitute the texture length, are easily explained. The pro- of the hair. Now, in describing the ducing organ is at first small; as the cells of the scarf-skin (§ 8), I pointed out formation of the hair advances, it be- that more or less of pigmentary matter comes larger, and growth havingreached formed an invariable constituent.of the a certaint, point, it shrinks, becomes again contents of the cells, the skin of the albino small, and eventually ceases to produce only excepted, and that in the negro the more; the fully formed hair then falls, cells were abundantly supplied with a and after a period the producing organ deep black colouring matter This same resumes it function, in the same order and circumstance is conspicuous in the hair- to the same end. To illustrate this phe- cells; they contain a large supply of nomenon, I have referred to animals, be- pigment when there is very little in the cause in them it is common, but the same scarf-cells, and upon it depends the col- thing is alse met with in man: look at a our of the hair. The hair of the negro hair pulled from the eyebrow: and the may be associated with the scarf-skin of same may sometimes be seen in the hairs the blonde, or the hair may partake so •of the head. A French anatomist, M. much of the character of the scarf-skin Mandl, has asserted that hairs become as to be flaxen. pointed at their extremity, by a process 57. The next consideration which ari- of deposition on their cut ends of certain ses relates to the structure of the hair, fluids containing horny matter in solu- and here we find the curious phenomenon tion, which makes their way from the of a threefold modification of the cells roots of the hairs through the centre of within so limited a circuit as that of the their shafts. 1 regard these views as er- hair pulp. At the point of the cone the roneous, and, in my opinion, they are cells undergo very little alteration from * Witliof, quoted by the celebrated Haller. their original spherical form; around PURPOSES OF THE HAIRS. 25 them, and comprising the chief thick- at the same time, the principal seat ofits ness of the hair, by a process of length- colour. In viewing a hair with the mi- ening and splitting common in the econ- croscope, it is evident that the pigment omy of cells, they are converted into is not diffused uniformly through the fibres ; and quite at the outer circumfer- fibrous texture, that there are some cells ence, a thin circle of cells are flattened which contain more than others, and ap- into the form of scales, like those of the pear as black spots amongst the rest, scarf-skin, or the contiguous layer of while, in all. that portion of the cell which cells which constitute the lining mem- is termed its nucleus is the most deeply brane of the hair-tube. So that a hair, tinted. It is upon this unequal mingling in its pigmy section, presents three dif- of the coloured with the uncoloured por- ferent textures, a loose cellular texture in tions that the tint of the hair depends. the centre, a strong texture of parallel Thus, the grey of the hair of the mouse fibres, and becoming more and more is produced by a succession of coloured dense towards the circumference exter- and uncoloured cells in alternate pairs nally to this, and a thin, varmsh-like (fig. 11), the blending of the colourless layer of flattened cells, constituting the and the black giving their compound polished surface of the hair (plate 4, fig. grey, just as alternate lines of blue and 3). We may compare this structure yellow produce upon the eye the impres- very aptly to the section of a twig, or sion of green : blue and red, purple ; and stem of a plant, with its cellular pith in red and yellow, orange. the centre, its dense wood encircling the 60. The exterior layer of the hair (plate pith, and its smooth and polished bark at 4. fig. 1), composed, as we have seen, of the surface. flattened cells or scales, of an oval form, 58. Although the central part of the exhibits a peculiar arrangement of these, hair of man is a loose pith in which the little pieces. They are so disposed, that original spherical form of the cells is epch newly formed circle overlaps the more or less completely lost, yet in many preceding, like tiles upon a house-top, so animals this form is retained with the that if the reader will imagine a convex most exact precision, and such hairs ap- surface coated with oval tiles, disposed, pear to contain in their axes a very beau- not in measured rows, as upon the roof tiful string of beads, rendered strikingly of a house, but irregularly, he will have obvious, in dried hairs, by the emptiness a perfect idea of the nppearance of the of the cells. Such is the appearance surface of the hair. The scales of a fish, of the very fine hairs of the hare or or of a serpent, would give just the re- mouse (plate 4, figs. 10, 11). In thicker semblance that I want, only, that in these hairs from the same animals, there are animals, the plates are arranged with the two or three or more rows of cells, and most perfect and beautiful regularity. the largest hairs from the number of With this structure in our recollection, these rows bear a resemblance in struc- we have a key to the well known pheno- ture to an ear ofmaize (fig. 10, b). This menon of a hair feeling rough when is the chief modification which the pith drawn between the fingers in one direc- of the hair undergoes in the animal king- tion, and smooth in the opposite, or to the dom, being more completely or less cel- movement of a hair from its root to its lulated, and holding a greater or less pro- point when rubbed longitudinally be- portion to the entire bulk of the hair; tween the fingers. These are natural sometimes, indeed, as in some hair inmy consequences of theprojection of the edg- possession from one of the deer tribe, the es of the scales. It also explains the cir- whole texture of the hair is cellular, the cumstance of hairs working their way other two portions being condensed into into wounds when the latter are not pro- a thin envelope (fig. 7). In the leather perly protected from their contact; the of a bird, which is a modification of hair irritation to the skin caused by woollen (fig. 8). the white pith with its dense ex- garments ; the adhesion of dust and dirt ternal covering is very evident in the to the hair, and the difficulty of separat- shaft, while the quill is an illustration of ing from it the particles of scurf which the outer parts alone, the transparent become entangled in its midst. puckered membrane, which is drawn out 61. A more important consequence of of the quill when first cut, being a single the projection of the edges of the scales row of dried up cells. In the growing which form its exterior surface is the fact feather, the contents of the quill would that the process offelling depends upon be found distinctly cellulated (fig. 6). this peculiarity. Without this, hair 59. The fibrous portion of hair (plate would be unfitted, from the smoothness 4, fig. 2) is the source ofits strength, and of its surface and shortness of its staple, STRUCTURE OF THE HAIRS. for combining with the strength neces- 63. That portion of the shaft of the sary for the production of felt. But in hair which is contained within the hair- this fitness for felting, there is great va- tube is steadied in its position by contact riety in hair, and an equal difference in with the lining scarf-skin of the tube, and the degree of prominence of its raised as the latter is continually undergoing edges. In human hair, they are very the process of formation and exfoliation slightly marked ; but nevertheless, felt- (§ 4), the superficial scales of the sheath ing is not uncommon when the hair is are moved towards its aperture with the neglected, and there are some diseases of growing hair, and are then scattered on the hair which turn wholly on this prop- the surface in the form of “scurf.” The erty offelting. When particles of dust scurf, therefore, is a natural and healthy collect on the edges of the scales and form formation, and though it may be kept projections, or the edges themselves be- from accumulating, it cannot be prevent- come loosened and raised, they give the ed (§ 5). It is produced on every part of idea of branches from the shaft of the the body where hair is found, although, hair, an appearance which misled Leeu- from the more active growth of the hair wenhoek into the belief, that hairs, like of the scalp, the facilities for collecting, feathers, were naturally furnished with and the contrast of colour, it strikes the branches. eye most disagreeably in that situation. 62. In the preceding description, I have Sometimes it happens, that instead of explained that the pulp is the producing obtaining a free eschpe at the outlet, of organ of the hair, and that’ in its earliest the tube, it becomes impacted, as I have state, the latter is composed of cells dis- previously noticed to be the frequentcon- tended with fluid like those of the scarf- dition of the unctuous substance of the skin. Pursuing this resemblance further, skin (§ 46). In this case, the hair also is the fluid, in the next place, is given up impeded in its onward movement; for, by the cells by evaporation, and these although from the position of its scales, latter are converted into fibres and scales. the hair is an agent in the prevention of Now, it follows from this process that the such an occurrence, and would naturally cellulated portion ofthe hair, namely, that carry the obstacles before it, yet the im- which is in contact with the pulp, must paction is sometimes too great for the be the bulkiest portion of the organ, and power which it is capable of exerting. for this reason it is called its bulb (plate When a condition of this kind occurs, the 4, fig. 4); while the evaporation, which hair makes pressure on the pulp at the occurs subsequently, explains the lesser bottom of the tube, and the impression, thickness of the shaft. Without some so produced on a vital tissue, transmitted explanation, it might be difficult to un- to the brain by the nerves of the pulp, is derstand how a hair could be thicker at felt as a sensation of itching, that is to its root than in its shaft, unless the root say, a sensation which, falling far short itselfwere stationary, and the producing ofpain, is nevertheless disagreeable. A organ of the part beyond it, which is not natural remedy for the unpleasant sen- the fact. When a hair is freshly plucked sation is at hand, the nail is conveyed to its root has a rounded, swollen appear- the seat of inconvenience, it disturbs the ance, well expressed by the term bulb, impacted matter at the aperture of the and presents certain varieties of aspect, tube, probably dislodges it, and the hair being sometimes obtuse, sometimes con- resumes its accustomed state. Those ical, sometimes perfectly straight, and who are subject to a dry scalp know the sometimes clubbed or bent. These ap- suffering which this trifling impaction pearances are the consequence of the vi- occasions, for where the unctuous sub- olence used in its removal, there being stance is deficient, it is most likely to oc- more or less of the membranous portion cur. In a natural state of the skin, the of the hair-tube torn away with it, which comb and brush are contrivances to pre- latter, being drawn across the root, or vent such a circumstance from arising ; rolling up on one or the other side, pro- hence comfort, as well as nicety, demands duces the irregularity inquestion. When, their regular use.* however, this membranous matter is 64. Having dwelt, I fear at too great washed away, the fibrous structure may length, on the economy of the long hairs be seen with the microscope to be the * [ The scurf of the head referred to in this section, does chief constituent of the root, and the not always seem to arise from the hair-tubes. So far as I have observed, it is usually the superficial part of the fibres being different in thickness, colour, scarf-skin, and is frequently too abundant for a healthy and length, the root has precisely the state of the scalp. To correct or prevent the evil, our of an old worn author has given the best directipns. For a wash I would appearance paint-brush, recommend the lotion men ioned in Sec. G5, except, take away to a rough, conical stump. half the quantity of potash.] PURPOSES OP 1 THE HAIRS. /
of the skin. I may now advert to those of repetitions of this process, the hairs are minor growth. On the general surface entirely liberated; and an occasional of the body, the hairs are less closely set return to its aid prevents the recurrence than upon the head, and in consequence of the same state. The lotion is as of this arrangement, the tubes enjoy a follows:— more independent position in the skin. It SOLVENT LOTION. would seem, also, that the corium which Fluid potash, half an ounce. con- Oil of sweet almonds, a quarter of an ounce. surrounds them is supplied with Rose water, two ounces. tractile fibres (§ 18) in greater number Common water, fourteen ounces. than in the parts between the tubes, and Shake well together, and rub upon theskin for five min that, moreover, these fibres have a circu- utes, then rinse with fresh water, and dry. lar arrangement around their cylinders. 66. The invisible, or downy hairs of When, therefore, the skin is stimulated the body, rarely appear above the level to contract by cold, these circular fibres, of the skin, for when they do, they ne- closing the tube around the hair, main- cessarily fall into the category of the tain it erect, and. at the same time, short hairs. I may best illustrate them, render the tube rigid and prominent. by referring to a position in which their The interspaces of the hair-tubes, on the presence is invariable, although seen in contrary, having no such fixed support, that situation as an exceptional occur- are drawn closer to the deep tissues, rence : I allude to the nose. The nose and form a level below that of the hair- is ordinarily bald; but if the unctuous tubes, which are thereby thrown into product of an oil-gland be squeezed out strong relief. It is this appearance which of its tube, and examined beneath the is commonly denominated “goose-skin,” microscope, one or more of these little and, as will be seen by observation, it is hairs will constantly be detected in the an appearance which is due to the pre- centre of the mass (plate 3, fig. 18). In- sence of the hairs. deed, when the unctuous matter has been 65. The short hairs of the skin are not detained in the oil-tube for any length of unfrequently disturbed, in their growth, time, the number of hairs may be con- by a cause previously referred to in con- siderable, as, for example, twenty, thirty, nexion with the hairs of the head (§ 63), or even forty. Now, the whole of these namely, deficient oleaginous qualities of hairs have, as far as we at present know, the product of the oil-tubes. When this been produced by a single pulp, and hav- happens, the dry scales and ceils of the ing attained maturity, have been shed, oil and hair-tubes collect at the aperture to be carried out of the oil-tube with the of the latter, and become a source of im- unctuous substance; but the latter being pediment of growth to the hair, which, retained, they have had time to collect, as a consequence, assumes a coiled and as we have seen, in astonishing numbers. twisted appearance. But sometimes, this I should be inclined to infer, from this closure of the orifice of the hair-pore circumstance, that these little hairs grow takes place after the fall of the old, and very quickly, and are shed at short in- previously to the growth of the young tervals of time. On no other hypothesis hair, in which case the latter is impris- can their nnmbers be satisfactorily ex- oned in the tube, and there grows, al- plained. though unable 1o escape. I have occa- 67. In their normal state and position, sionally seen nearly the whole of the hairs these little hairs are colourless and trans- of a limb thus imprisoned, and forming parent, having rounded blunt points, and little spiral circles, which are visible brush-like roots, but under the influence through the thin horny scale of desicca- of augmented action in the skin, theyare ted cells which covers them and keeps susceptible of growth to a Considerable them down (plate 6). The obstruction extent, both in length and bulk, in fact, occasions, as may be anticipated, a good of becoming equal in dimensions to the deal of itching and uneasy feelingin the short hairs of the body. Of this we have skin, and is more or less alleviated, by an example in the occasional growth of tearing up the filmy covering. For the visible hairs upon the nose. I may re- relief of this inconvenience. I am in the fer, also, to the disproportionate devel- habit of recommending a lotion which opement of hair in the male and the softens and partly dissolves the horny female, and may adduce, besides, some films. After its application, the skin curious illustrations of augmentation in requires to be thoroughly dried by a the growth of hair, recorded by various rough towel, and then brushed briskly writers. Schenkius and Ambrose Pare for a few minutes with a flesh-brush, or have left accounts of cases in which the horse-hair glove. With two or three entire body was covered with hair ; and 28 STRUCTURE OF THE HAIRS. Daniel Turner, quoting from Peter Mes- curves inwards to the middle line. The sias, on the authority of Damascenus, upper and inner rays from this centre relates, “ that upon the confines of Pisa, ascend to the line between the eyebrows, at a place called the Holy Rock, a girl where they meet those which are proceed- was born all over hairy, from the mother’s ing from the opposite centre, and those, unhappy ruminating and often beholding also, which are diverging from the ver- the picture of St. John the Baptist, tical central line of the forehead ; so that hanging by her bedside, drawn in his here a lozenge is formed, which is the hairy vesture.” A French physician, point of approximation of hairs from four Ollivier, writing recently, narrates the different quarters. It is this circumstance case of a young lady, remarkable for the that gives to the hairs of the inner end fairness of her skin and beauty of her of the eyebrows a direction towards the deep black hair, who was the subject of middle line; and occasionally we see fever, and whilerecovering, perceived the instances in which, from the unusual de- whole surface of her body to be in the velopment of these hairs, the eyebrows state termed “ goose-skin.” In a few meet at the base of the forehead, and days, the little elevations looked dark at form a little crest, for a short distance, the summit, and were surmounted each along the root of the nose. The lower by a short black hair, which grew very and inner rays from the angle of the eye rapidly, so that at the end of a month, diverge from the preceding, and are direc- every part of the body, with the excep- ted downwards and inwards upon the side tion of her face, the palms of the hands, of the nose ; when strongly developed, and the soles of the feet, was covered they meet those of the opposite side on the with a short hairy coat, ofabout an inch ridge of the nose, and at their point of in length. divergence from the ascending current 68. In the arrangement of the hairs necessarily form another lozenge. This on the surface of the body, it might be latter is a lozenge of divergence, that of inferred, that little existed to excite at- the forehead being one of convergence. tention; but this is not the fact, if we are The upper and outer rays from the angle to judge by the careful investigations to curve along the upper lid, forming, by which the subject has given rise. The their upper margin, the lower half of the hair-tubes are not placed perpendicular- eyebrow, and at the outer angle of the eye. ly, but obliquely, in the skin ; hence the being lost, in the converging currents of direction of the hairs, after their escape the whisker. The lower and outer rays from the tubes, is in the same sense to- from the centre at the angle of the eye, wards the surface; and the “ set ” of the together with those from the vertical line hair, from the root to the point, is govern- of the side of the nose, mouth, and chin, ed by a law as precise as that which make a gentle sweep over the cheek, side regulates any other of the secondary of the face, and jaw, to be lost, the upper vital functions. Thus, on the head, the ones in the front of the whisker, the hair radiates from a single point, the middle rays, after passing beneath the crown, to every part of the circumfer- ear, in the middle line of the back of the ence, making a gentle sweep, behind, neck, and the lowest rays in the angle towards the left, and in front, to theright. or bend of the jaw, in which latter situa- The direction of this sweep is naturally tion they come into coalition with an as- indicated on the heads of children, and cending current from the chest. The is that in which the hair is turned. On rays from the inner margin of the verti- the forehead, the downy hairs proceed cal line of the side of the nose, mouth, from the middle vertical line, with a and chin, are directed inwards upon those gentle curve to the right and left, curv- parts. On the upper lip, they are met ing downwards to the situation of the by a current directed from the apertures whisker, and forming, by their lower of the nose, outwards, and forming the border, the upper half of the eyebrow. sweep of the mustachio; a similar dis- Occasionally, the line of divergence of position is observed in the middle line of the forehead is oblique in its direction, the lower lip, near its free edge, while running from the left of the forehead to the* beard is formed by the convergence the root of the nose. At the inner angle of two side currents meeting at the mid- of each eye is situated another radiating dle line. The current from the side of centre, like that of the crown of the head ; the head divides at the ear, those which and a vertical line of divergence is con- pass in front of that part, and some, also, tinued downwards from this point, by from the skin before the ear, contributing the side of the nose, mouth, and chin, to to form the posterior border of the whis- the under part of the latter, where it ker, and then passing backwards beneath PURPOSES OF THE HAIRS. the ear. with the current from the face, of the trunk, proceeding around the in- to the middle line of the nape; while ner side of the thigh to the bend of the those which pa-ss down behind the ear knee; the other, an undulating line, be- converge with those from the back of the ginning at about the middle of the hip, head also to the middle line of the nape. running down the outer side of the thigh 69. On the trunk of the body, there is to the bend of the knee, then continuing a centre of radiation from each armpit, down the outer side of the leg, reaching and two lines of divergence, one of the the front of the ankle, and terminating latter proceeding from this point horizon- on the foot at the cleft between the great tally to the middle of the front of the and second toe. A short oblique line chest, the other from this horizontal line, connects the two vertical lines at the justin front of the armpit, vertically along bend of the knee. On the front of the the side of the trunk, across the front of thigh, the streams from the two lines the hip, and down the inner side of the converge, and descend towards the knee. thigh to the bend of the knee. From the On the back they converge also at the armpit centre, and from the opposite side middle line, but ascend towards the trunk of the horizontal line, a broad and curved of the body. On the leg, where there is current sweeps upwards and inwards but one line, the diverging currents over the upper part of the front of the sweep around the limb, and meet upon chest, and outwards, around the neck, to the shin, while on the foot they diverge the middle line of the nape, the outer- with a sweep, as upon the back of the most part of the current passing over the hand. shoulder to the middle line of the back. 72. Chemical analysis shows the hair From the lower side of the horizontal line, to be composed of a basis.of animal mat- and from the vertical line, the set of the ter, of a certain proportion of oily sub- current is downwards and inwards, with stance, of the salts of lime which enter a gentle undulation to the middle line in into the composition of bone, of flint, sul- front, and from the armpit centre, and phur, and two metals, namely, manga- vertical line downwards and backwards, nese and iron. The quantity of sulphur also with an easy undulation to the mid- is somewhat considerable, and it is this dle line of the back. The inner extre- substance which is the principal cause of mity of the horizontal line of the chest is the bad odour evolved by hair during its the seat of a lozenge of divergence, and combustion. The constituents ofhair of that of the line of the bend of the lower various colours also present some differ- jaw, at the front of the neck, of a second. ences, for example, red hair contains a 70. From the armpit centre just de- reddish-coloured oil, a large proportion of scribed there proceeds another line of sulphur, and a small quantity of iron; divergence, which encircles the arm like fair hair, a white oil, with phosphate of a bracelet, immediately below the shoul- magnesia; and the white hair of the aged, der. From the upper margin of this a considerable quantity of bone-earth or line the direction of the current is up- phosphate of lime. According to the wards over the shoulder, and then back- latest ultimate analysis, fair hair contains wards to the mid-line of the back. An- the least carbon and hydrogen, and most other line commences at this ring on the oxygen and sulphur ; black hair follows front part of the arm, and runs in a pretty next; while brown hair gives the largest straight course to the cleft between the proportion of carbon, with somewhat less index finger and thumb on the back of hydrogen than black hair, and the small- the hand: this is the line of divergence est quantity ofoxygen and sulphur. The of the arm ; from it and from the ring the hair of the beard was found to contain stream sets, at first, with a sweep for- more carbon and hydrogen than the hair wards, and then, with a sweep back- of the head, and less oxygen and sulphur. wards to the point of the elbow. In the The quantity of nitrogen is the same in fore arm. the diverging currents sweep all. downwards in front, and upwards be- 73. We come now to the question, hind, also tending to the point of the what purpose does hair perform in the elbow, which is thus a centre of conver- animal economy ? That it effects an im- gence; while on the back of the hand portant one, we have evidence in its al- and fingers the sweep outwards, with a most universal distribution among the curve having the concavity upwards, is mammiferous class of animals, and if we quite obvious. admit the analogy between the feather 71. On the lower limb there are two and the hair, among all warm-blooded vertical lines of divergence: the one animals additional evidence is obtained being the continuation of that of the side in the perfection of its structure, and 30 STRUCTURE OF THE HAIRS again, in its early appearance in the pro- around the mouth, and at a later period, gress of development of the young. As those of the head. The last which push a bad conductor of heat, it tends to pre- through are the hairs of-the fingers and serve the warmth of the body, and in those of the external ear and nose. At man it would have that effect upon the the period of adolescence, the hairs ac- head, and serve to equalize the tempera- quire a new impulse of growth in co-re- ture of the brain. It is also an a’gent of lation with the more active development defence against external irritants, as the of the frame; and when the powers of heat of the sun’s rays, and the bites of the system are on the wane, the hair is insects; and against injuries inflicted among the first of the organs of the body with violence, as we see illustrated in the to evince an associated infirmity. It use of the horse’s tail on the helmets of seems to be established that the hairs, at warriors. Of special purposes fulfilled their first formation, do not issue directly by the hairs, we have instances in the from the hair-tubes, but become bent up- eyebrows and eyelids, which are beauti- on themselves, so that they form a loop, fully adapted for the defence of the or- whereby the point of the hair is directed gans of vision; in the small hairs which toward the root, and the bend of the loop grow in the apertures of the nostrils, and towards the aperture of the hair-tube, or serve as guardians to the delicate mem- pore. The cause of this position of the brane of the nose ; and in similar hairs hair would appear to be some obstruc- in the ear-tubes, which defend those tion at the pore, from the accretion of the cavities from the intrusion of insects. unctuous substance of the oil glands, and Among the larger mammiferous animals, the cast cells of the hair-tube, for the the hair of the tail is used as a whisk to little scale formed by this accretion is remove flics that pierce the skin to suck gradually raised by the elasticity of the its blood or deposit eggs; and in those hair, and when the latter attains sufficient parts of the body which the tail cannot power is cast off’, and the hair bursts from reach, a flowing or bushy mane serves to its temporary imprisonment. supply its place. By a power of con- 75. In reflecting on the purposes of the duction of outward impressions common hair in the animal economy, we must to the hairs with all rigid bodies, these not pass over its chemical constitution. organs are calculated to perform the A large quantity of carbon and hydrogen office of an apparatus of touch. We feel are by its means separated from the sys- distinctly the disturbance of the hairs tem ; and although several other organs of the head by the movements of a fly, are concerned in the more abundant re- although the little animal is at some dis- moval of the same elements, yet it would tance from the skin; and, on a similar not be judicious to deny, that the compa- principle, the long and rigid hairs of the ratively trifling aid of the hair is, under upper lip of feline animals are an agent some circumstances, of importance in the of touch, transmitting whatever impres- exact counterpoise of the manifold ope- sion they receive to the sensitive pulp rations of the animal organism. A learn- upon which they are implanted. Indeed, ed French writer, Moreau, narrates the animals of the cat tribe have the power case of a young lady who was cured of of erecting these hairs, and rendering mania by the cutting of her hair. Ano- them fixed, so that the slightest impres- ther relates that a Capuchin friar was sion ofcontact is transferred to the nerves cured of a serious disease by shaving his of the sensitive pulp. beard, and several instances are recorded 74. Of the delicacy and beauty of struc- in which headache has subsided on the ture of the hair, 1 have endeavoured removal of the hair. Vauquelin and already to adduce evidence; and with Fourcroy have given it as their opinion, regard to its early development, I will that the hair, in conjunction with the now make a few observations. At the other products of the skin, is capable period of birth, the human infant, with- of supplying the office of the kidneys. out reference to sex, is covered with a Again, it has been observed that the thick down, and it is then that we have growth of the hair is unusually rapid in the best opportunity of observing the di- that disease in which the functions of the rection of the hairs (§ 68) ; for during the lungs are more or less completely abro- first year, the greater part of the tempo- gated, namely, pulmonary consumption; rary hairs have fallen, and are succeeded and we are but too well acquainted with by others which appear upon the surface the long silken eyelashes, and long and only in some situations. The first hairs streaming hair, of the suff erers from that that are developed are those of the eye- distressing malady. brow, then those of the upper lip and 76. It is a question whether the hair, PURPOSES OF THE HAIRS. 31 when once formed, receives any supply 1 to King Ferdinand, as a prodigy, who of fluids from the vital tissues of the pulp: thereupon pardoned him. saying, he had I am induced to think that this is the been sufficiently punished for his fault.” case, but only to a modified extent; my And again, this, from the same author: belief stops far within the range neces- a young nobleman “ was east in prison, sary to admit, with Mandl, a movement and on the morrow after ordered to lose of fluid to the tip of the hair capable of his head; he passed the night in such depositing its dissolved material in a fearful apprehensions of death, that, the regular manner on the cut extremity next day, Csesar sitting on the tribunal, (§ 54); or to acknowledge, with other he appeared so unlike himself, that he authors, the occasional commencementof was known to none that were present, no, whiteness at the tip. Much less can I not to Caesar himself, the comeliness and give credit to the bleaching of the hair beauty of his face being vanished’, his in a single night, or even in a single countenance like a dead man’s, his hair week ; the first step in the change may and beard turned grey, and in all respects have been made in a single night, and on so changed, that the emperor at first that night week the whole of the hairs of suspected that some counterfeit was the head may have become white at their substituted in his room. He caused him, roots; this is perfectly possible, and the therefore, to be examined if he were the only reasonable explanation of the cir- same, and trial to be made if his hair and cumstance. Thus we learn that Marie beard were not thus changed by art; Antoinette became grey in a short period but finding nothing counterfeit, astonish- from grief, as did the unfortunate Q,ueen ed at the countenance and strange visage of Scots. But the errorhas a foundation of the man, he was moved to pi y, and in poetry, as well as in fiction, and hence mercifully gave himpardon for the crime may not easily be dethroned. Lord he committed.” Dr. Cassan records the Byron gives it the weight ofhis authority case of a woman thirty years of age, who, in the u Prisoner of Chillon:” — on being summoned before the Chamber ofPeers to give evidence upon the trial “ My hair is grfcy, though not with years ; Lovel, underwent so powerful a re- Nor grew it white of In a single night, vulsion, that in the course of one night As men’s have grown from sudden fears.” the hair was completely blanched, and a furfuraceous eruption appeared all over Sir Thomas More, we are told, became her head, upon her chest, and upon her grey during the nightpreceding his exe- back. Henry of Navarre, on hearing cution. According to Borellus, two gen- that the edict ofNemours was conceded, tlemen, the one a native of Languedoc, was so exceedingly grieved, that in the the other a Spaniard, were so violently course of a few hours a part of one ofhis affected, the first by the announcement mustachios whitened. In one person, of his condemnation to death, the latter some of the eyelashes became blanched by the bare thought of having incurred a from mental agitation. And Moreau serious punishment, that both became narrates, that he once knew an aged blanched in the course of a single night. man for whom snow-white hair and a The gravity with which Daniel Turner countenance deeply marked by the fur- relates the following case, which he rows of care inspired the respect wThich attributes to Schenkius, is amusing:— we owe to age and misfortune. “ My “Don Diego Osorius, a Spaniard of a hair,” said he, “ was as thou seest it now, noble family, being in love with a young long before the latter season of my life. lady of the court, had prevailed with her More energetic in their effects than assi- for a private conference, under the shady duous toil and lingering years, grief and boughs of a tree within the garden of despair, at the loss of a wife most ten- the King of Spain, but by the unfortu- derly loved, whitened my locks in a single nate barking of a little dog, their privacy night. I was not thirty years of age. was betrayed, the young gentleman Judge, then, the force of my sufferings: seized by some of the king’s guard, and I still bear them in frightful remem- imprisoned; it was capital to be found in brance.” The catechist forgot, however, that place, and therefore he was con- to ask the old gentleman at what period demned to die. He was so terrified at after the sad night his feelings became the hearing of his sentence, that one and sufficiently calmed to permit him to ex- the same night saw the same person amine his hair; and in some of the other young and old, being turned grey as in cases, taking them as they stand, there those stricken in years. The jailer, is ground for suspicion that the colour of moved at the sight, related the accident the hair had unfortunately been washed 32 INFLUENCE OF DIET ON THE off. But to make the thing intelligible, times metwith in high places, and having a modern French author has advanced the sanction of high names. A more an hypothesis to explain the supposed celebrated name than that of Bich&t is phenomenon; and this I add, as a last, hardly to be met with among medical au- “ and I think a fatal counterblast” against thorities ; and yet Bichat has propagated the belief. 4i We must suppose a serious error, in declaring that he has the author in question, “ we must sup- found hairs growing from the mucous pose, to explain the sudden change of the membrane (§ 1). Similar statements hair, that at the critical moment when have been made by more recent writers, Nature is in revolution, and when, con- and amongst the places named as the sequently, the natural functions are sus- seat of hairs is the tongue. But the fic- pended or changed in nature, that an tions of the ancients on this subject far agent is developed in the animal economy, outweigh all that the moderns have ever and passing into the hair, decomposes written or imagined. Thus, in the “ Phi- the colouring matter. This agent must losophical Collections,” it is recorded, be an acid.” that “ Pliny and Valerius Maximus con- 77. It is by no means uncommon to cur in their testimonies, and that the find instances of a gradual change of heart of Aristomanes was hairy. Ccelius colour of the hair referrible to a particular Rhodiginus relates the same of Hermo- period of suffering, as was the case with genes. the rhetorician; and Plutarch of the greyness of Mary Q,ueen of Scots Leonidas, the Spartan.”* A prevalent and Marie Antoinette. Alibert records, belief, strengthened by the opinion of that after a severe illness, a head of brown several modern French writers on this hair was exchanged for one of bright red, subject, is. that the hairs growafter death. and in another person, from having been It is true that they lengthen, but their previously brown, the hair became deeply lengthening results from the contraction black. Several instances are narrated, of the skin towards their roots, and not in which brown hair became fair, and in I from the continuance of a vital process, an old person, the white hair fell off, and j after the death of the individual. But was replaced by brown. Dr. lsoard, • the olden writers outstrip the moderns “ detailing the constitutional peculiarities | again in invention ; for in the same Col- of a particular family, observes with re- lections,” Wulferus gives the “ account gard to one of its members, a young lady of a woman buried at Nuremberg, whose of seventeen, deaf, and dumb from birth, grave being opened, forty-threq years that each time she is attacked by a fever after her death, there was hair found is- peculiar to herself, she undergoes a suing forth plentifully through the clefts change in the colour of her hair, from a of the coffin, insomuch, that there was pleasing blonde to a dusky red, but that some reason to imagine the coffin had so soon as the febrile symptoms diminish, some time been covered all over with the natural colour returns. A more per- hair.” And Mr. Arnold gives • 1 the re- plexing case is the following, communi lation of a man hanged for theft, who in cated by Dr. Bruley, a physician of Fon- a little time, while he yet hung upon the tainebleau, to the Society of Medicine, gallows, had his body strangely covered in Paris, in 1798:—A woman, sixty-six over with hair.”f years of age, afflicted with consumption, had fair hair, transparent as glass; four days before her death, this hair became jet-black. On examining the roots of the hair, Dr. Bruley found the bulbs distend- ed to an unusual size, and gorged with a CHAPTER VI. black pigment, while the roots of those of the fair hairs which yet remained and ON THE INFLUENCE OF DIET ON THE were pale shrivelled. The case, HEALTH OF THE SKIN. however, is imperfect, from the circum- stance of the length of the hair being 79. In preceding chapters, 1 have en- unmentioned. deavoured to show, that whether we re- 78. The brief history of the hair which gard the skin as an independent organ, I have now given would be incomplete or consider its function in connection with were refer to the numerous fabu- I not to the entire system, we cannot fail of com- lous stories to which ignorance of the ing to the conclusion that it must be an economy of the hair has given birth ; and this is the more from the cir- necessary, * “ EncyclopaediaBritannica.” Article, Hair, cumstance of such fables being some- t “ Encyclopedia Britannica.” HEALTH OF THE SKIN. 33
important agent, for good or for evil, in staminal principles ; such at least must the animal economy. In addition to the be the diet of the higher classes of ani- power of sensibility which it confers on mals, and especially of man.” And the the system, it is the means of conveying i same author beautifully remarks —“ This to the mind a knowledge of the state of view of the nature of aliments is singu- temperature of the body ; it is, as it were, larly illustrated and maintained, by the the thermometer of vital heat, the de- familiar instance of the composition of grees upon its scale being computed by milk. All other matters, appropriated by the expressions agreeable and disagreea- animals as food, exist for themselves, or ble, in the place of the terms of the com- for the use of the vegetable or animal, of mon thermometer. The value of these which they form a constituent part. But expressions to health is not, however, suf- milk is designed and prepared by nature ficiently estimated, but it is.nevertheless expressly as food, and it is the only ma- certain that a disagreeable impression of terial throughout the range of organiza- temperature in the skin is a warning note tion that is so prepared. In milk, there- of something mischievous to health, act- fore, we should expect to find a model of ing either within or out of the economy. what an alimentary substance ought to If the temperature be elevated above be, a kind of prototype, as it were, of nu- the agreeable point, without an evident tritious matters in general. Now, every cause, there is fever; if it be lowered sort of milk that is known, is a mixture below the agreeable point, upon only a of the four staminal principles we have of the body, there is need of vigi- described, in other words, milk always fiartance. The temperature of health is a contains, besides water, a saccharine genial summer over the whole surface, principle, a caseous, or, strictly speaking, and when that exists, the system cannot an albuminous principle, and an oily be otherwise than well. This brings me principle. Though, in the milk of dif- to the rule of health which I wish to es- ferent animals, the three latter of these tablish, namely, by food, by raiment , by staminal principles exist in endlessly mo- exercise, and by ablution, to maintain dified forms, and in very differentpropor- and preserve an agreeable warmth of the tions, yet neither of them is at present skin.* Every thing above this is suspi- known to be entirely wanting in the milk cious ; every thing below, noxious and of any animal. dangerous. 81. To those who are unacquainted 80. Food is in a twofold manner a with the principles of chemistry, it will source of warmth: firstly, by supplying be a startling announcement, that all or- the material of nutrition requisite to bal- ganic matters, whether animal or vege- ance the continual waste taking place in table, are composed essentially* of the the body; and secondly, by conveying same elementary principles; and, more- into the system those elements which, by over, that these principles are only four their chemical combinations, elicit heat. in number, namely, oxygen, hydrogen, To insure these results, food must be nitrogen, and carbon. The two first of wholesome and sufficient, and must com- these gaseous elements are the constitu- bine all that variety of animal and vege- ents of water; nitrogen exists in the at- table, which a Divine Providence has be- mosphere, in conjunction with oxygen; stowed upon man. Dr. Prout has group- and carbon is the impurity of the air ex- ed all nutritive substances into four haled from the lungs during respiration. classes, which he terms aqueous, sac- Thus, in the air which we breathe, and charine, albuminous, and oleaginous. in the water which we apply to our com- The first of these needs no elucidation, monest uses, these four essential elements it is an abundant and necessary constitu- of every thing organic on the face of the ent of the body, and an universal com- globe, these four constituents of our- ponent of our food. The saccharine class selves and of our means of life, are pre- is derived from the vegetable kingdom ; sent, as almost sole components. The the albuminous chiefly from the animal saccharine staminal principles are com- realm: and the oleaginous from both. “ A posed of oxygen, hydrogen, and from diet,'” writes Dr. Prout, “ to be complete, forty to fifty per cent, of carbon; the al- must contain more or less of all the four buminous of oxygen, hydrogen, nitrogen,
* [One and perhaps two things have certainly been * [The word “essentially” is hardly used correctly. overlooked. This is very surprising, especially consider- Othersubstances besides oxygen, carbon, hydrogen, and ing their great effect upon the animal economy. There is nitrogen are essential parts of the system. Thirteen (Pe- scarcely any thing more essential for maintaining the tem- reira) different elements are always found as necessary perature of the skin, than pure air and a proper supply of components of the human body. Some are in very small nervous influence. Upon these subjects, we will in a quantity, yet they may be of immense importance. By proper place add a chapter.] “ essentially” I suppose was meant chiefly.) 34 INFLUENCE OF DIET ON THE and from fifty to seventy-five per cent, greatest amount of heat, being the che- of carbon; and the oleaginous of oxygen mical change which accompanies nutri- and hydrogen, with eighty per cent, of tion. Whenever an unusual proportion carbon. Now, as these three nutritive of carbon exists in the system, a larger principles embrace an extensive variety supply of oxygen than common is re- of substances, for example, the saccha- quired for its removal, an active chemi- rine includes sugar, acid juices, starch cal combination is consequently taking and gum ; the albuminous, all the varie- place in the tissues of the body, and an ties of flesh, jelly, curd, and gluten ; and energetic development of heat is the ne- the oleaginous, a great variety of oils, cessary result. Now we have seen that besides fat, suet, butter, and alcohol, it the alimentary principles differ from each follows that the whole of these substan- other in the proportion of carbon which ces, however dissimilar they may appear they contain, and if we are desirous of in character and properties, differ, in re- increasing the amount of heat, we should ality, only in the possession of a little have recourse to that kind of food more or little less of one or more of the which promises the maximum of carbon, primary gaseous principles ofwhich they and vice versA. Thus, the diet of inva- are all composed. lids suffering from feverishness should 82. When alimentary substances are be of the saccharine kind,* as containing taken into the stomach, they are submit- the least carbon; and the same remark ted to the chemical process termed di- applies to the summer season; while in gestion, which has for its object the sep- the winter, and cold climates, the olea- aration of the four above mentioned pri- ginous must necessarily be the prevailing mary principles from their state of union and favourite aliment. Of this principle, in the food, and their combination anew, we have a remarkable illustration in the in order to constitute an animal nutritive natives of countries near the pole, whose principle, capable of being received into food is almost entirely composed of fat the blood, and of undergoing successive and oil, and they are enabled, by its use, transmutations. For example; this to withstand the excessive cold of their newly-formed nutritive substance, having climate. How wonderful is the Provi- been mingled with the blood of the right dence that guides the seal and the whale, side of the heart, and propelled through whose blubber is the chief source of the the lungs, combines with the oxygen of oil they use as food, to the seats of these the atmosphere. It is then conveyed to desolate regions. the left side of the heart, and transmit- 84. The chemical process which has ted by the arteries to the capillary ves- now been described is identical with that sels in every part of the system (see dia- which takes place in a burning candle; gram, page 12). Here, another chemical the carbon of the fatty matter of which process, termed nutrition , is effected, the the candle is composed combines with newly-formed nutritive principle trans- the oxygen of the atmosphere, and car- udes through the coats of the capilla- bonic acid gas results; the process, in ries, and yielding up its oxygen, becomes man and animals, is therefore very cor- deposited as new matter in the living tis- rectly likened to combustion ; the same sues. The oxygen combines with the chemical change occurs, and heat is, in old material, just supplanted by the new, like manner, elicited. But the whole of and forms, among other effete substances, the carbon of the body is not got rid of which are separated from the body in by this process alone; some is deposited, various ways, carbonic acid gas. The as fat, in the tissues and bones; a large latter enters the blood-particles, commu- quantity is separated, as a fatty emulsion, nicates to them a different form and dif- by the liver; some is disposed of in the ferent refractive power, gives the deep formation of the hair and unctuous sub- colour which is characteristic of impure blood, and, finally, is cast off from the * [ The reader will observe that saccharine in the above the to section, is not used with its ordinary acceptation. Sugar, blood, in lungs, be removed from or that which contains it in large proportion, will not the body with the expired air. usually be proper lor invalids suffering with feverishness. - 83. Thus it will be seen that a On the other hand, sugar, or that which contains much of succes- it, is admirably adapted for food in winter. The amount sion ofchemical changes is taking place ; of carbon in food is not the only thing to be noticed, if firstly, in the then in the we are desirous of increasing the amount of heat. The stomach, blood, hydrogen, and articlescontaining it, may be productive of then in the tissues, and then in the lungs; great effects in the same manner. The best diet for inva- and the whole of these changes are at- lids is the following: Put a tablespoonful of tamarinds into a pint of milk, and warm till the milk curdles; tended with the development of heat; draw oft' the whey, and add to it a teaspoonful of loaf the most important, in reference to the sugar, (if the stomach will bear sugar,) a teaspoonful of as rise the gum-arabic dissolved, and half a pint of strong decoction present subject, giving to of slippery-elm bark.] HEALTH OF THE SKIN. 35 stance of the skin ; and some is eliminat- a dram of brandy, from its temporary ed by the skin as carbonic acid gas. stimulus, enables us to get rid of the The nitrogen of the food forms com- load sooner than we could do without it. pounds in the blood and in the tissues, But it seems to me, that a far wiser plan which are of a stimulant nature, and would be, to abstain from eating what hence are very proper to assist in the de- we know to be oppressive to the stomach, velopment of heat; but when these sub- and that by this means we shall attain stances are produced in excess, they act our end infinitely better than by first eat- as a cause of irritation, and, indeed, are ing a hearty meal, and then taking a so violent in their effects as sometimes stimulus, the efficacy of which is dimin- to cause death. The kidneys and the ished by every repetition of its use. If skin are the organs which separate these we were compelled to exceed the bounds irritating matters from the body, and of moderation in eating, there would be their detention in the skin I believe to be some apology for our conduct.”* the cause of some of the eruptions and diseases of that membrane. 85. In the preceding remarks, I have endeavoured to bring before the reader a view, as extensive as my limits will CHAPTER VII. allow, of the nature of food, and the chemical and vital which it processes by ON THE INFLUENCE OF CLOTHING ON THE is subjected to the purposes of nutrition. HEALTH OF THE SKIN. I need say little with regard to the good- ness of the food selected ; that is a mat- 86. Next in importance to a judicious ter to be left to the judgment and taste and rational diet, as a means of main- of the consumer ; but it may be as well taining the temperature of health, is the to remark, that all aliment, to be nutri- raiment selected for its preservation. It tious and beneficial to the system, must is a fact, which must be apparent to ev- be sound and fresh. When decomposi- ery one, that clothing, in itself, has no tion has taken place, combinations of a property of bestowing heat, but is chiefly dangerous kind are generated, which act useful in preventing the dispersion of the as poisons on the system. Of the arti- temperature of the body, and, in some cles of food which are thus to be eyed instances, of defendingitfrom that of the with suspicion are fish, potted meats, atmosphere. This power of preserving sausages, game, &c. There are, of heat is due to the same principle, what- course, individual peculiarities of consti- ever form the raiment may assume, tution, which cannot be taken into con- whether the natural covering of birds sideration here, in which the most whole- and animals, or whether the most beau- some food may prove noxious, as in the tiful and elegant tissues ofhuman manu- example mentioned by Dr. Prout, of a facture. In every case it is the power person who was unable to eat mutton which the coverings possess of detaining without being seriously ill. In this case, in their meshes atmospheric air that is the peculiarity was supposed to depend the cause of their warmth. We have an on caprice, and the meat was repeatedly exemplification of this principle in the disguised; but in every instance it pro- lightness of all articles of warm clothing duced the same injurious effects. As as compared with water ; the buoyancy, relates to the quantity of food taken, it is for example of a fleece of wool, or the best, at all times, to err on the side of lightness of a feather. In the eider-duck, moderation, and the appetite must be or the sea-bird, it is the accumulation of made the test of sufficiency. I have no warm air within their downy covering hesitation in condemning variety in a that defends them alike from the temper- single meal, however much variation of ature of the water, and from its contact. diet my be generally useful, for variety The furs from the piercing regions of the of dishes is simply an ingenious device north, which we prize so highly as arti- for heaping an unnatural load on the cles of dress, are, to the animals which stomach. Dr. Combe, in his work on they by nature invest, so many distinct digestion, and dietetics, has the following atmospheres of warm air, and the same excellent remark on this subject: “It principle is carried out in the clothing of may be alleged, that a glass of brandy man. Our garments retain a stratum of
a dinner facilitates * after heavy digestion, [ Not only is what Dr. Combe says true, but it will and therefore cannot do harm. I admit also be better, after the too large quantityof food has been at that when we eat too or taken, to avoid any alcoholic stimulus, as it will tend to once, much, produce disease, worse than the effects of surfeiting with fill the stomach with indigestible food, the food.] 36 INFLUENCE OF CLOTHING ON THE air, kept constantly warm by its contact from the organic world, some from the with the body, and as the external tem- vegetable, and some from the animal perature diminishes, we increase the kingdom; for example, hemp and flax number of layers by which the person is are the fibres of particular plants, while enveloped. Every one is practically cotton is a covering of the seed of a aware that a loose dress is much warmer plant. Silk, wool, hair, feathers, and than one which fits close ; and that a loose leather, are animal productions; silk be- glove is warmer than a tight one; and ing a kind of tenacious gum drawn that a loose boot or shoe, in the same man- through minute tubes, like those of the ner, bestows greater warmth than one of spinneret of the spider, in the body of smaller dimensions. The explanation is the silk-worm, and dried in the form of obvious: the loose dress encloses a thin excessively delicate threads. Wool is a stratum of air, which the tight dress is soft and elastic hair: while hair, feathers incapable of doing; and all that is requir- and leather have been already described ed is, that the dress should be closed at in preceding chapters of this work. Of its upper part, to prevent the dispersion these materials, the first five are chiefly of the warm air, and the ventilating cur- employed as articles of clothing, and in rent which wouldbe established from be- order to be fitted for that purpose, are low. The male summer dress inthis cli- spun into threads, and then woven into a mate consists of three layers, which ne- tissue of various degrees of fineness and cessarily include two strata of atmosphe- closeness. It is evident that this tissue ric air ; that of females contains more ; will have the effect of retaining a quan- and in the winter season we increase the tity of air proportioned to the size of its number to four, five, or six. As the pur- meshes: hence, besides the strata of at- pose of additional layers of dress is to mosphere imprisoned between the differ- maintain a series of strata of warm air ent articles of clothing, each article is in within our clothes, we should, in going itself the depository of an atmosphere of from a warm room into the cold, put on its own. Thick textures are warmerthan our defensive coverings some little time thin ones made of the same material, be- previously, in order that the strata of air cause the body of air retained in their which we carrywith us may be sufficient- meshes is great, as we see illustrated in ly warmed by the heat of the room, and blankets and woollen garments. Wool, may not be in need of borrowing from moreover, being in reality, hair, is cellu- our bodies. Otherwise, we must walk lated in its structure, and each of its lit- briskly, in order to supply heat, not only tle cells is the separate casket of a col- to keep up the warmth of the strata of lection of air (§ 58). Hair differs from atmosphere nearest ourselves, but also to wool Qnly in the greater solidity of its furnish those which we have artificially structure; but from its attendant hard- made by our additional coverings. When ness is little adapted to the purposes of we have been for some time in the air, weaving; it is employed chiefly in the we or if could examine the temperature production of manufactures termed felts; climate between the several layers of our for which, from the nature of its forma- dress, we should find the thermometer tion (§ 61), it is peculiarly fitted. Hats, gradually falling, as it was conveyed and sometimes bonnets, are made of felt, from the inner to the outer spaces. and so likewise is a particular kind of 87. These observations on dress have thick shawl recently introduced. Felts reference to the number of layers of are necessarily porous in their texture, which the covering is composed, but they besides being composed of a cellulated are equally applicable to the texture of fibre, and are proportionally warm. the garment itself. The materials em- Leather is a kind of natural felt, but of ployed by man in the manufacture ofhis much closer and firmer texture than an attire are all of them bad conductors of artificial manufacture. The thinner and heat; that is to they have little ten- softerkinds ofleather are sometimes used dency to conduct or remove the heat from as body-clothes, but its special and pro- the body; but, on the contrary, are di£- per purpose is the manufacture ofcover- posed to retain what they receive ; hence ings for the feet, to protect them from they are speedily warmed, and once cold and wet. To the inhabitants of cold- warm, preserve their temperature for a er climates, feathers are a source of pe- certain period, and convey the sensation culiar comfort, but, from their bulk, are of warmth to the hand. They are also not easily convertible into body garments. bad conductors of electricity, and on this From their lightness and warmth, they account become sources of safety in a are fitted to supply the wants of the most thunder storm. They are all derived refined and fastidious Sybarite, and they HEALTH OV THE SKIN. 37
serve to cover and protect us during the | ductor, water, for a bad conductor, dry ever-recurring winter of the twenty-four air. Hence cotton is. with good reason, hours, when, as I shall have presently to the favourite and proper body-linen of show, our power of generating heat is hot climates. Besides the absence of temporarily diminished. freshness in cotton, there is another ob- 88. Linen differs from other textures jection to its use; it is not, like linen, used as clothing in the roundness and composed of fibres which are perfectly pliability of its fibre (plate 4, fig. 13). rounded, but, on the contrary, its fibres These qualities give a smoothness and are flat and have sharp edges (plate 4, softness to its tissue which adapt it pecu- fig. 15), which latter are aph in delicate liarly, as a soft and agreeable covering, skins, to excite irritation. It is on this to be worn next the skin. Hence we find, account that we carefully avoid the ap- that in temperate climates, linen is an plication of cotton to a graze or wound, universal favourite. But linen has its and employ for such a purpose its objections; it is a good conductor, and 1 smoother and softer rival, linen, bad radiator, of heat, and therefore the j 90. Silk occupies the third place very opposite of a warm dress, which | above linen as a bad conductor and good should be a bad conductor and good ! radiator of heat, and comes next to cotton radiator. It is on this account that, de- ! as a means of bestowing warmth ; its spite its excellence in other particulars, | fibres (plate 4, fig. 14),like those oflinen, it feels cold when it touches the skin. ; are round, but softer and smaller; and But linen is open to a stronger objection 1 woven into a tissue, it has less disposition than that which I have just mentioned ; to absorb moisture than cotton. There- from the porosity of its fibre, it is very ; fore, so far as roundness of fibre, softness attractive of moisture, and when the j of texture, absence ofattraction for mois- body perspires, it absorbs the perspiration I ture, and power of communicating actively, and displaces the air which, in : warmth, are concerned, silk is greatly a dry state, it held within its meshes; so [ superior to both linen and cotton : more- that, in place of an atmosphere of dry air, j over, it gives the sensation of freshness it becomes the means of maintaining a | to the touch which is so agreeable in layer of moisture. Now, water is one of | linen. But with all these advantages, the best conductors of heat, and removes ; silk has its defects ; on the slightest fric- it so rapidly from the body as to cause a I tion.it disturbs the electricity of the skin, general chill. But this is not all; the and thus becomes a source of irritation. moisture in the tissue of the linen has so ; Sometimes, it is true, this irritation is great a capacity and attraction for heat, I advantageous, 'as causing a determina- that it continues to rob the body of more ; tion of blood to the surface ; but when this and more of that element until the whole action is not required, it is disagreeable, of the fluid is evaporated. These cir- and quite equal, in a sensitive constitu- cumstances have caused the entire aban- tion. to producing an eruption on the skin. donment of linen as a covering next the I have seen eruptions occasioned in this skin in hot climates, where the apparel manner, and when they have not occur- must be necessarily thin. But in tem- ! red, so much itching and irritation as to perate and cold climates, we get over the call for the abandonment of the garment. inconvenience by wearing a bad con- 91. Wool is open to several of the ductor and good radiator outside the i objections brought against the three linen, in the form ofa woollen or leather preceding tissues; thus, from the nature covering in the winter, and cotton or thin ! of its structure (plate 4, fig. 16), being woollen in the summer season. similar to hair in the formation of its 89. Cotton is a warmer covering than fibre, it is highly irritative to sensitive linen, from being a better radiator and skins, and, moreover, disturbs the elec- worse conductor of heat, and, in the pre- tricity of the cutaneous surface, on fric- sent excellence ofits manufacture, offers tion, even more than silk. On these most of the advantages of softness and accounts, there are persons who find it pliability of that texture. But it must be j quite impossible to wear woollen gar- admitted that it is wanting in the fresh- ments next the skin in any shape, whether ness of linen, a quality which, in this as flannel, worsted, or merino. Happily, climate, we could not easily dispense this is not absolutely necessary, for all with. But cotton has the advantage over the advantages of wool, and they are linen of not absorbing moisture to any- many, may be obtained by wearing the thing like the same amount, and conse- woollen garment outside one of linen; quently does not destroy its own radia- indeed, this is preferable inwarm weather, ting powers by substituting a good con- to wearing the wool next the skin, since 38 INFLUENCE OF CLOTHING ON THE the linen absorbs the perspiration, while This property is due to the porosity of the woollen garment preserves the the textures employed in the fabrication warmth of the body and prevents the of dress, and that it is an indispensable inconvenience resulting from its evapo- quality will be admitted at once, when ration. Wool, as may be inferred from we recollect that the skin is an import- these observations, is one of the worst ant agent in respiration, receiving oxy- conductors and best radiators of heat, gen through its tissues, and giving back and is, on this account, a valuable and carbonic acid in return, and an equally indispensable means of preserving the important agent in separating from the bodily heat in the winter ofcold climates blood those impurities that otherwise like our own ; and even in the summer would oppress the system and occasion it is a serviceable defence against colds death. In a previous chapter, I have and rheumatism. referred more particularly to these cir- 92. The influence which colour exerts cumstances, and, especially, in the in- over the apparel, as modifying its power stance of those remarkable cases where of preserving warmth, is very remark- death was occasioned by the application able. As a general rule, all the dark of an impermeable covering to the skin. colours absorb more light and more of This is a reason why any close dress, the sun’s rays than those of a brighter such as one impregnated with caoutchouc kind, and in proportion to this quality is (macintosh) would be objectionable next their power of absorbing heat. A good the skin; and it explains how a lady, toe absorber is also a good radiator; hence anxious for the protection of her person dark colours are good radiators of heat, against cold, may be suffocated in her and according to the nature of their ma- own dress. The apparel must be such terial, bad or good conductors. White, as shall permit free transpiration from on the contrary, reflects the rays oflight, the skin, and, moreover, convey the and with them, the heat, and thus is a transpired fluids from the surface ; other- bad absorber and bad radiator of heat. wise, cold, irritation to the skin, and Franklin, many years since, placed a other bad consequences must follow. number of small squares of various co- Those who have worn india-rubber socks loured cloths of the same material on the or shoes must have experienced the first snow, and found, after a time, that the of these discomforts, from the puddle of snow covered by the black piece was the transpired fluid in which their feet are most, and that beneath the white, the bathed in a few hours after putting the least melted. More recently, a similar coverings on ; and, as an instance of the experiment was made by Stark. He second, I shall adduce a quotation from enveloped the bulbs of a number of ther- my work on the diseases of the skin on mometers in pieces of cloth of the same the subject of a disorder termed Suda- material, but of different colours, and niina. or miliary eruption. “ Since the immersed the whole in boiling water. days of Sydenham, who advocated so* The thermometer around which the powerfully the adoption of a cool tem- black cloth was wound, was the first to perature and cooling regimen in fevers, indicate a given heat; then that which sudamina have become rare; but pre- was covered with green, then red, and viously to his time, they were exeeed- last of all, white ; the difference between ingly frequent, and, from their connex- the black and the white being twenty-five ion with fever, were regarded as a spe- per cent. This influence of colour is cific disorder, preceded and accompanied antagonized by the nature ofthe material, by a severe and dangerous fever. This and as it acts superficially, produces very fever was termed miliaria, and for many little change on thick, although consider- years was regarded as a dangerous and able on thin, textures, such as gauze. fatal disease, spreading like an epidemic, 93. We have now discussed the prin- and destroying multitudes of lives; but, ciples which render clothing a means, as I before remarked, since a more ra- firstly, of preventing loss of warmth by tional method of treatment has been em- the body ; secondly, of increasing its de- ployed in medicine, miliary fever has gree ; thirdly, of guarding it against ceased to exist.” On the same subject. “ alternations; and fourthly, of protecting Bateman remarks : Among the various it from intensity of heat, both of the at- circumstances under which the miliaria mosphere and sun; but there is one point was formerly excited, the puerperal state in connection with clothing that still appears to have been mostfrequently the remains to be observed, which is, that it source of it, insomuch, that it was de- permits the free transpiration of the skin scribed as an epidemic among puerperal so necessary to comfort, and even to life. women. This is sufficiently accounted HEALTH OP THE SKIN. 39 forby the treatment which was unhappily ture of a summer’s night strikes cold and pursued during the confinement after chill, while, a few months later, in the childbirth, of which an impressive des- winter season, that same temperature cription is given by Mr. White ; for not would feel oppressive, from its heat. I only was the mother immediately loaded may better illustrate this topic by relating with bedclothes, from which she was an experiment performed by Dr. Ed- not allowed to put out even her nose, and wards, of Paris. In the month of Feb- supplied with heating liquors from the ruary, this gentleman removed five spar- spout of a tea-pot; but to her room, rows from a warm room, and placed heated by a crowd of visitors and a fire, them in a cage surrounded by snow and all access of air was denied, even through ice. At the end of three hours they had a key-hole. From these causes, fever lost less than two degrees of temperature. was almost necessarily induced, with the In the month of July, four sparrows, un- most profuse sweats, oppression, anxiety, der the same circumstances and in the and fainting, and these again were ag- same lapse of time, lost upwards of twen- gravated by spicy caudles, spirits, opiates, ty-one degrees of temperature. They and ammoniacal medicines. That a were, in point of fact, nearly frozen by a number should perish under such man- degree of cold which, in the winter, they agement with every symptom of malig- could bear without discomfort. Man is nity, and that many who survived it in precisely the same position during the should escape with broken constitutions, two seasons ; in the winter, he possesses will surprise no person who is acquaint- the power of generating within himself ed with the baneful Influence of over- sufficient heat to resist the cold; in the excitement in febrile complaints.” summer, he loses this power, and is pro- 94. In the preceding remarks, I have portionally dependent for his heat on the endeavoured to establish as a law of temperature of the surrounding atmos- health the necessity of 'preserving an phere. agreeable temperance of the body , and I 95. It is this power ofendurance of cold have pointed out the means, so far as at one period, and the absence of its ne- food and raiment is concerned, of effect- cessity at another, that enables animals ing this object. I should wish it to be in their wild and unprotected state, to understood, also, that the feelings, if the vicissitudes of winter with so nervous system be sound, are the proper little preparation in clothing, and so little channel for arriving at a knowledge of real inconvenience. And, in like manner, the state of warmth of the system. I man, in our climate, anil in a state of will now proceed to describe certain phe- health, does not require an amount of nomena, in connection with the tempera- covering at all proportioned to the differ- ture of the body, necessary to be known ence of temperature between summer in order to derive the proper benefit and winter.* Indeed, we not uncom- from these observations. We have seen monly, from inattention or want of due that the temperature of man varies consideration, make no difference be- our summer our very little in the whole extent of range tween and winter dress ; between the tropic and the pole; that he and thepoor, fromnecessity,are compelled can support the intense heat of the former to know no distinction. But sickness has without much elevation of his inward the same effect on our system as the sum- heat; that he can live where mercury is mer constitution, and by reducing' our a solid mass, like lead, with the most power of generating heat, renders us trifling depression of his vital warmth. more than ordinarily susceptible of cold, But it must not be supposed that the con- even when the temperature is compara- stitution of the man is the same in these tively mild. Thus, when we suffer from two opposite conditions; it is, indeed, what is popularly termed i: a cold,” or a widely different; in the one he enjoys slight attack ofindigestion, we are acute- what may be termed a summer constitu- ly sensible of a low temperature; and tion ; in the other, a winter constitution ; and we all, being of it, * The inhabitants of Terra del Fuego, belonging to the without aware Petcheree or Yacanacu tribe of Indians, are naked, with have a summer constitution, to harmon- the exception of a small piece of seal-skin, which they ize with the warmth of summer, and a hang upon the shoulder next the wind. Their climate is much colder than that of North Britain, no season being winter constitution, to enable us to resist quite free from frost. In the month of March, when the effectually the inclemency of that season. thermometer stood at 40°, an infant about a week old lay in the bottom of one of their canoes quite naked ; and the other “ In words, we become inured or ac- little children were seen capering, quite naked, on the customed to the existing atmospherical beach, although the thermometer was at 40°. ” The state, so that, familiarized with the warm colour of the people is a light copper hue, the hair being “long, lank, and black.' 1—Abstract from Chambers’ breath of June, the moderate tempera- Edinburgh Journal for July5, 1845. 40 INFLUENCE OF CLOTHING ON THE it is then, as under other circumstances volumes for the results to health of the producing a like sensation, that we should ease and comfort of the rich, as con- protect ourselves by warmth and warmer trasted with the consequences of the de- clothing. Indeed, while we neglect this privations and contingencies of the poor. rule, we are augmenting the state of con- 97. In addition to the difference of gestion of the internal skin, or mucous power of preserving warmth dependent membrane, which is the essential cause on the differences of health, climate, and of the ailment under which we suffer, season, there are other modifications while by encouraging and promoting the which have reference to the activity of warmth of the skin, we tend to dissipate it. the vital energies at different periods of 96. The same remarks apply with equal life. The infant, for example, and the force to sedentary occupations in a warm aged person, are more susceptible of room, whether in the summer or the win- cold; that is, they have less power of ter season, or to employment conducted generating heat than the adult, and con- in a warm atmosphere in the winter time. sequently are more open to the injurious Such conditions are equivalent to the ef- influences originating in a low state of fect of a warm climate, and bring with the external temperature. The tempera- them the summer constitution, which is ture of a seven months’ child, well clad, unsuited to withstand the severity ofcold. and placed before the fire, was ninety de- To persons in this state, a greater amount grees of Farenheit.* In an infant of the of warm clothing is needful than to those full period, at birth the temperature va- whose constitution is hardened by out- cillates between 95° and 99°.f During door occupations and exercises in the air. the first week, the average temperature Thus from the influence of circumstan- of infants is 98° ; during the period rang- ces, the upper classes, and particularly ing between four months and fourteen the female sex, who are too frequently years, nearly 99°; in the adult, 100°; indisposed to take the exercise necessary and in eight old persons, between 87 and for health, are more in need of warm 95, the average was a little above 98°.£ clothing than the out-door labourer and In further illustration of the decreased the very poor, but not more so than a power of generating heat, Dr. Edwards class equally necessitous with the latter, ascertained the temperature of young namely, the needlewoman and ifMoor puppies and kittens lying near their labourer. This observation, it must be mother to be one or two degrees inferior recollected, applies to the article of cloth- to that of their parent, but when he re- ing only; for although in this the poor moved them, they rapidly cooled down, are no worse off as regards the mere ne- until within a degree of the level of the cessity, than the rich, yet, in another and atmosphere. Seeing this to be the case, a more important condition, their position we are not surprised to learn that many is very different, namely, in the posses- infants die from cold, and that the mor- sion of means for obtaining good and suf- tality ofinfants of the first month is near- ficient food. It may not be irrelevant to ly doubled during the winter season.§ the present subject to inquire whether According to M. Lombard, of Geneva, the difference in the condition of the poor one-sixth of these deaths result from in- and the rich exerts any influence on their flammationof the lungs! The mortality longevity: that it does upon their health of infants during the first year of their there can be no question. The answer life amounts, in Paris, to nearly nineteen to this inquiry is contained in the follow- per cent.; in the whole of France, to ing table, published by M. Benoiston. twenty-one and a half per cent.; in Phil- The first column contains the ages ex- adelphia, to twenty-two per cent.; in Ber- amined, and the three succeeding ones lin, to twenty-five per cent.; and in St. the mortality in one hundred persons; Petersburgh, to thirty-one per cent.|| the first being the common rate of mor- 98. What is now said of children must tality, according to M. Duvillard; the be repeated with regard to those who second, mortality in the rich; the third, have outlived the energies of adult life. the mortality in the poor. I have shown, above, that the natural Ages. Common rate of mortality. . Rich. Poor. temperature of old persons is inferior to 30 to 40 169 108 1-57 that of the adult; and if they feel the
40 — 50 215 1-17 2-13 cold less, it is that their sensibilities are
50 — 60 3 24 1 99 3-59 * 60 — 70 5-78 3-60 7-50 Edwards Roger, who makes his observations in the armpit, — 11-49 t 70 80 804 14-36 j Dr. Davy. 80 — 90 19-78 13-22 100 00 § Observations made in Belgium, Geneva, Russia and Paris. The inspection of this table speaks || Duvillard and Rau. OF THE SKIN. 41 blunted by age, that the same cause her independence and honour. The lit- which occasions their diminished power 'tle denizens of a warm nursery must not of generating heat makes them uncon- be subjected, without a carefully assorted scious of the want, but not the less liable covering, to the piercing and relentless to its effects. Indeed, the position of the east or north-east wind ; they must not aged, under these circumstances, is not a be permitted to imbibe the seeds of that little hazardous ; it is like that of a man dreadful scourge of this climate, con- handling heated iron with gloved hands, sumption, in their walks for exercise and who is unconscious of the warmth until health ; they must be tended, as the fu- he is burned to the quick ; or like the fish ture lords of the earth, with jealous care protected by a hard and massive shell, and judicious zeal. One-sixth of the that is unaware of danger until the knife deaths of young children, it must be re- is stuck into its heart. Dr. Davy found membered, result from cold (§97). that old persons, having a natural tem- 100. I come now to a subject teeming perature of 98° when their feelings of with interest, as of more general and uni- warmth were agreeable, had their tem- versal application than, perhaps, any that perature reduced 96° and 95° when sub- I have hitherto touched, I mean the sub- jected to cold. The winter season is al- ject comprehended under the popular ex- ways a period offatality among the aged; pression “ draughts,” and their conse- and in our establishments for the poor, quences. The principle on which the the number of deaths immediately fol- operation of this source of serious dis- lowing the temporary excitation of the ease depends is the partial cooling of the cheer of Christmas is quite remarkable. body through the medium of the skin, 99. The remedy for the modifications and is illustrated in the following exper- of vital temperature resulting from age iment by Edwmrds and Gentil. They is so obvious as to need but a passing re- immersed the hand, having a natural mark. Infants must be warmly fostered ; temperature of 98°, in cold water of 41°, young children must be warmly and ju- and kept it there for twenty minutes. diciously clad; and old persons must Five minutes after its removal, its tem- learn to apportion their clothing to their perature was ascertained to be nohigher age, and not to their desire of maintain- than 55°, and that at the end of one hour ing a perpetual and artificial youth. and a half, 69°. So that, as an effect of These propositions are so reasonable and the application of cold, for a short period, so obvious, that I may perhaps fall under to a part of the body, a depression of tem- the accusation of “adding perfume to the perature occurs to the amount of forty- violet;” but are they followed in practi- three degrees of Farenheit, and the part cal life ? Are the little highlanders whom recovers only fourteen degrees of its heat we meet during three out of the four quar- in one hour and a half; and if we sup- ters of the year, under the guardianship pose the heat to increase in this ratio, the of their nursery-maids, dawdling about system would require nearly five hours the streets, in our public walks or squares, to regain the temperature which in twen- properly protected from the cold ? Are ty minutes had been removed. Now, this the fantastically attired children whom is precisely the condition of a person who we see “ taking an airing ” in carriages exposes a part of the body, usually cov- in our parks, sufficiently and properly ered, to a cold but still atmosphere, or of clad? If this question can be truly an- a person preperly clothed, but seated in swered in the affirmative, then, and then a draught or current of cold air. The only, my remarks are needless. There warmth of the part so exposed, or of the can enter into the parent mind no more side of the person directed towards the baneful idea than that of rendering chil- draught—the uncovered parts first, and “ ” dren hardy by exposing them unne- then the covered —is reduced ; and, as an cessarily to cold, and by clothing them effect of the chill, the transpiration is inefficiently. I have known instances checked. But soon, another principle wherein parents acting on this principle comes into action, and one of greater im- have (ailed entirely in rearing their off- portance than even the preceding; it is spring. Does .Nature treat her progeny thus experimentally illustrated. When thus ? Does she not, first of all, ensure the hand is immersed for some time in the birth of her young only at a kindly cold water, and its heat consequently les- season, and then provide them with sened, the temperature of the opposite downy coverings, warm nests, and assid- hand is also reduced, and to a very re- uous protectors ? And we must imitate markable extent, so that the mischief of Nature, if we would give to Britain a partial cooling is not limited to the first race capable and worthy of maintaining effectproduced upon the exposedor chill- 42 INFLUENCE OF EXERCISE ON THE ed part of the body, but is gradually nor degree, it may be observed, that spread over the frame, until the person' whenever we are slightly chilled, as by feels completely chilled through. Have too light dress, by cold shoes, &c., any we not all, at some time or other, felt sensitive organ of the body immediately this ? Have we not felt, when a part of evinces discomfort or distress; thus, if the body is cold—as. for example, the we have suffered at any period from tic- feet—the chill strike through the entire douloureux or rheumatism, we immedi- frame ? Yes, it is too frequent an occur- ately feel a warning twinge, or if our rence not to have been experienced on lungs are delicate, we begin to cough; more than one occasion, by every one, while, on the other hand, the very instant and to his sorrow. It is in this way that we get warm, the twinge ceases, and the thin shoes, wet shoes, wet dress, or damp cough subsides.* sheets, do their work of mischief and dis- 102. In contradiction to what I have ease, and cannot, therefore, be too care- just advanced, it may be thought that fully avoided. Youth will resist much, when a person is warm, or in a state of strength much, health much, but it must perspiration, and is then exposed sudden- be recollected that we niE but once, and ly to the cold, that the checked perspira- although we escape ninety-nine times, tion is certainly the cause of the subse- yet the hundredth may be near, and the quent disorder. But that is not the case ; last. the perspiration is suppressed only as an 101. Now, the dangerous results which effect, and that with which the skin is sometimes flow from causes of the above moistened at the moment of exposure description, are popularly ascribed to merely increases the effect of the cold by “ checked perspirationbut the truth is, its-rapid conduction of heat (§88) and that the suppression of perspiration is evaporation. merely one of the effects of the shock re- ceived by the constitution, and by no means the cause. The first effect of the cold upon the part is a lowered tone of the cutaneous nerves, and a consentane- ous contraction in diameter of the capil- CHAPTER VIII. lary blood-vessels. As a consequence of these preliminary changes, the skin be- ON THE INFLUENCE OF EXERCISE ON THE comes contracted and shrunken ; less HEALTH OF THE SKIN. blood than natural is sent to the surface; nutrition and its chemical actions are sus- 103. It is quite true that the whole pended ; perspiration is suppressed; and body of known hygienic principles and the surface becomes pallid and bloodless laws are applicable to the health of the (see diagram, page 26). The blood, in skin, as conducive of that of the system fact, no longer able to enter the contract- in general. But there are parts of those ed capillaries, its cutaneous circulation laws which have reference to the skin being at an end, retreats upon the internal alone, and it is my present purpose to membrances and vital organs, affecting separate these as much as possible from one part or other of the mucous mem- the rest, that their importance may be brane, or one or other of the vital organs, more prominently seen. It is thus with according to the constitutional peculiari- the subject of exercise. Well-directed ty of the individual. In one, the blood exercise favours the preservation of the will be determined on the lungs, causing general health, by calling into direct ac- cough and inflammation ; in another up- tion the majority of the organs of the on the throat, producing sore throat; in body; and it also acts powerfully on the a third, upon the membranes lining the skin, by stimulating its functions, increas- nose, eyes, and ears, producing “ mi- ing its temperature, awakening its tone, graine,” or cold in the head ; in a fourth, and subjecting it to a current of atmos- upon the stomach, causing a bilious at- phere favourable for its respiratory of- tack ; in a fifth, upon the bowels, caus- fices. The conditions subservient to ing pain and inordinate action; in a sixth, health, which have been previously dis- on the kidneys, producing severe pain in cussed, namely, food and raiment, are in the loins ; in a seventh, on the joints, pro- * a ducing rheumatism ; in an eighth, on the [ The effects of vapourbath under such circumstances must be evident. It is precisely what is required. It nerves, producing neuralgia or tic-dou- quickly and genially warms the whole system. The surface, loureux ; in a ninth, on the brain, produ- blood will be immediately drawn back to the an equilibrium will be restored between the different parts of cing faintness, insensibility, convulsions, the circulation, and disease will be driven away in the and even apoplexy, and so on. In a mi- outset.] HEALTH OP THE SKIN. 43 one respect different in their nature from should arise when it is neglected, for days those which are to follow, namely, exer- consecutively, and'made to be secondary cise and ablution; the former are simple to occupations and pursuits of a trivial and easy in their application, appealing, nature. We are impelled by hunger to on the one hand, to a sense of appetite, the daily use of food, and by our sensa- on the other, to a sense of comfort for tions to the employment of dress. To their regulation, and making a demand those who know themselves, who have on the judgment only so far as selection a proper acqaintance with the animal and experience are concerned. The organization, there are also sensations latter are more complicated in their which indicate the want of exercise; they bearings, calling in the aid of judgment have the power of supplying that want, at the very outset of their application, or of rejecting its calls; but nature, in and frequently requiring to be employed the end, must triumph ; punishment will in opposition to the feelings and present assuredly follow the breach of her ap- enjoyment. In other words, they require pointed laws. We have seen that exercise the mind to direct and go with them; promotes the removal of the impurities and although the mind regulates by of the system. Suppose them to remain, reference to the inferior faculty of sen- the human frame immediately becomes a sation, yet, to ensure their benefits, the source of destruction to itself, and of evil soul must be present. to others; matters which should be cast 104. What is it that makes the differ- off, as useless and noxious, are mingled ence between the exercise of youth, and with the blood, and, fermented by its that of the felon on the treadwheel; heat, are developed on the skin in the between the pedestrian in the Isle of form of flushes and eruptions ; or they Wight or Switzerland, and the pedes- are exhaled as fetid emanations from the trian from Chelsea to the Bank; between lungs, or disposed of in some other way the light and quick footstep wending to equally disagreeable. The brain also Greenwich Park, and the dull tread of suffers in its turn; the mental faculties the nursery-maid at home ? Is it not are disturbed, the intellectual enfeebled, mind 7 Is it not the young and buoyant and the sentiments lowered. The inju- joy of the school-boy that inspirits his rious effects of neglected exercise cannot laugh and his leap? while, silent and be better illustrated than in the medical morose, humiliated, not convinced, the history of those who are compelled to felon suffers his monotonous existence, lead a sedentary life. In such persons, moving, it is true, but not in exercise. we find a pallid and discoloured skin, Is it not the novelty, or the beauty of the depressed spirits, incapacity for exertion, scene, the pleasant weather, or the im- headache, frequent palpitations of the munity from customary labour, that gives heart, fulness of the head, dyspepsia, spirit to the pedestrian’s tour, as com- tendency to biliousness, and general pared with the dull, desultory repetition imperfection and irregularity of the ali- of the same sights, same persons, same mentary functions. things, and same path from and to busi- 106. Another condition of “ beneficial ness? Is it not the prospect of enjoy- exercise ” is, that it should be moderate. ment, of gaiety, or pleasure, that makes A short walk, in agreeable society, either the difference between the elastic step of thoughts or friends, is infinitely pre- of the maiden enfranchised from present ferable to one of greater distance, and duties, and the same person in the pursuit taken as a task. But there is a feeling, of her necessity-impelled and ordinary too prevalent among the unthinking, that offices ? We need not ask which is most if a little be good, a great deal must calculated to be beneficial to health; necessarily be better, it is this princi- which to arouse the dormant functions ple, carried out to the utmost limits of of the skin; to promote the removal of extravagance and absurdity, that called irritating elements from the blood; to forth the re-action in medicine known increase the vigour of the frame, purify under the name of Homoeopathy. Peo- the complexion, and enrich the beaming ple, left to themselves, would have con- tints of beauty. In mind lies the great verted their insides into medicine chests; secret of beneficial exercise , and without the endless inquiry after something to do it, exercise is a misnomer, and a fraud this, and something to do that, was fast upon the constitution. amounting to a suicidal mania for drugs, 105. Exercise, in so far as practicable, when the opposite extreme rushed in, should be regular; a daily purpose is to and became the cause of a rational be answered by its use ; and therefore equilibrium. So, in exercise, we must it is unreasonable to expect that benefit neither have excessive nor infinitesimal 44 INFLUENCE OF EXERCISE ON THE
doses; we must endeavour to maintain exercise should be that when the tem- a proper medium between mischievous perature is most agreeable ; for example, extremes, and be guided by our sensa- midday in the winter; or the morning tions, not only present, but succeeding. and evening in the summer season. In Our first walk should be short, the next the morning of winter, the atmosphere a little further, and of somewhat longer is too cold for any but the soundest duration; succeeding walks a little in- lungs; and if the weather be not frosty, creasing on their predecessors, varied, there is more or less moisture in the air, as much as convenient, and the most which is insalubrious. The evening is agreeable in associations that can be much more objectionable, for the same selected. We thus put ourselves under reasons. In large cities, another objec- a kind of training; we discover our tion attaches to the morning and evening, powers of maintaining muscular exer- namely, the quantity of smoke retained tion, and we eventually arrive at a point near the earth by the cold air, which when we feel that our exercise is enough becomes dissipated by the middle of the and profitable. This is the point towards day. In the summer season, the middle which all our endeavours should tend; of the day is objectionable from its great our main object should be to use as heat, and the night air from the fogs much exercise as shall keep our bodies and mists which collect near the earth’s in health, and our minds cheerful and in surface. vigour. We should not be desirous of 108. Consideration must also be made exerting ourselves as much as possible, of the period of taking food; exercise any more than we should conform to the should not be taken either immediately same practice at the table; at a given before or soon after meals; and here I point our appetite, in health, whispers, must remind my reader, that the word “ enough;” the same expression will be exercise is not applied to a gentle walk, elicited by our feelings in relation to ex- or lounge, but to motion, performed to ercise, when we have made ourselves as the point of sufficiency with all the ener- well acquainted with* the practice and gies engaged. Such exercise requires influence of it, as of the more urgent the whole power of the nervous system necessity of taking food. In the recom- for the time, and a certain quantity of mendation of exercise to ladies, I am nervous power is necessarily expended. continually met by replies such as this: Now this loss must be regained before the li My household duties give me sufficient nervous system is directed upon another exercise; I am sure that I am tired effort, such as digestion; which, to be enough by bed-time;” or, “ I do take performed well, requires the whole of a exercise; there are my occupations at sound and fresh nervous apparatus. It home, and then my calls.” Now, it will is a law in the animal economy, that no be seen at once, that household occupa- two actions requiring a large expendi- tions are not exercise; for, in the first ture of nervous force, can be carried on place, they are duties, generally desul- at the same time. Now exercise, prop- tory, often irksome, and often anxious; erly effected, is such an action as I am calculated to engender fatigue both of now considering, and consequently, if it body and mind, but wholly wanting in be accomplished immediately before a the attributes pertaining to true exercise, meal, the latter must suffer. On the namely, change of thought, change of other hand, digestion absorbs the powers scene, and muscular action accomplished of the system so completely, that it is a in the open air. Again: it is well known, common thing to find it succeeded by that after being thoroughly fatigued by lassitude and drowsiness. It is evident, employments of this nature, a walk is therefore, that if exercise be taken the often refreshing and agreeable. Fash- instant the meal is swallowed, the latter ionable calls are open to the obvious must remain an undigested load on the objection of merely changing the air of stomach until the moment arrives for one house for that of another, and often rest, and then the function will be ex- without any mental satisfaction arising ceedingly imperfect, if performed at all. out of the accomplishment of the duty. 109. Another consideration, in the ob- Shopping is more animating; but here, servance of healthy exercise, is the also, more perhaps than in the call, the clothing employed during its use. It is objection of* an impure and confined at- evident that some arrangement should mosphere steps in, while the open, fresh, be made in this respect. It would be unbreathed air, should be the main object unwise to commence a long walk with of search. clothing adapted to a state of rest, and 107. The part of the day selected for equally so to relax from exertion without HEALTH OF THE SKIN. 45 having an additional covering to throw everybody breathes.” But after a sea- on. Indeed, without precautions on this son of London smoke, pure air has a head, exercise would become a cause of chance of being estimated. What a disease. Again: as all the energies of delicious beverage water would be re- the muscular system, and the chief of garded, if it were rare! can we conceive those of the nervous system, are to be any thing more grateful? It is perhaps thrown into exercise, the body should be true, that to be an epicure in water re- relieved of all incumbrances to its free quires a residence in London or a large motion. All ties about the person should city of some years’ duration, and the be easy, ladies should leave their stays same may be said of air. at home, and shoes and boots should be 111. In determining the kind of exer- ample and strong. cise suitable for the sexes and different 110. Of the kinds of exercise, it may periods of life, we must observe nature, be premised that all motion for this pur- and bear in mind the conditions of exer- pose should, if possible, be performed in cise previously considered. Childhood the open air, and in every departure from is a period of excessive mobility, and de- this principle, the nearest approximation mands excessive action. Games, wild, should be adopted. There is no condi- rude, and rapid, are the fitting exercise tion more necessary to the enjoyment of and enjoyment of boys. Nature com- health than pure air; and as we consume mands it. and the refinement of cruelty more air when the muscular system is in would be to restrain them. They are activity than at any other time, we must precisely in the condition of one who is endeavour to obtain it as pure as possible | inspiring laughing-gas; a necessity for at that period. In cities, the air is neces- muscular action exists, which*cannot be sarily impure, from the exhalations which restrained without danger to the indivi- arise on all sides, and the large quantity dual. Indulge the necessity, and in a of smoke diffused through the atmos- certain time the tumult ceases, and a phere. On this account, schools, where tranquil thrill of enjoyment, not fatigue, the physical as well as moral education remains. Such are the feelings of chil- of children is regarded, should be as far dren uncontrolled in their exercise. removed from the smoky atmosphere as Such has nature ordained. The games possible; and where this is not practica- of boys are so numerous, and in general ble, the purer air should be sought for, so well adapted for the purposes ofhealth, for the purposes of exercise, in the near- that I shall not stop to enumerate them. est outlet from town. Rooms in which Gymnastics also have advantages -when a number of persons are breathing, soon they are practised from inclination, or become contaminated, and we are fre- with a professional object, but are open quently made acquainted with this con- to objections when they incite toexertions dition of an apartment by the detection, beyond the powers of the body.* on entering it, of a peculiar faint odour, 112. For girls, the catalogue is hardly which is soon lost when we mingle with less than for boys, hoop played with each the crowd. I have previously remarked hand alternately, the skipping-rope, dan- on the necessity ofattending to the admo- cing and singing, being among the best. nitions of our senses, and in no case is this The whole of these games must be prac- more necessary than in that of the organ tised to sufficiency, and unrestrainedly, of smell. As disagreeable impressions to be of any use. Stays before woman- of temperature or appetite are bad, so hood are instruments of barbarity and also are those of smell. By a wise Prov- torture, and then they are needed only idence, odours dangerous to life are gen- to give beauty to the chest. It is the erally disagreeable, and cannot be too duty of every mother and every guar- carefully avoided. What is more disa- dian of children to inquire the purpose greeable, for example, than the smell of a for which stays were introduced into fe- smouldering wick of a tallow candle, and male attire. Was it for warmth? If so a case is rcorded of destruction to life from they certainly fulfil the intention very holding such a wick under the nose of a badly, and are much inferior to an elas- sleeping boy; or what more delicious tic woollen habit. Was it to force the than a chestful of pure air on some bluff ribs, while yet soft and pliable, into the hill in the country? It is true that our * senses become dulled by use, or the pur- [ It seems to me that by far the best exercise is bowl- ing. It calls into proper action the greatest number of suit of other objects; the man or woman muscles, and the most uniformly. It is taken in free air, of the world would despise the thought and is attended with a relaxation of mind and a sociality ofbeing of feeling which ishighly conducive to health. This kind indebted for any portion of their of exercise ought to be appropriated by the best classes in enjoyments to “ common air,” “ air that society.] 46 INFLUENCE OF EXERCISE ON THE place of the liver and stomach, and the by state. Next, the stays press upon the two latter into the space allotted for other muscles; how much young ladies could parts, to engender disease and deformity tell if they would ! but the muscles be- to the sufferer and her children for gene- come injuriously squeezed between the rations ? Truly, if this were the object, unyielding stay and the hard bones of the the device is most successful and the in- chest. As a consequence of this treat- tention most ingeniously fulfilled. But ment, the circulation of blood through few, I think, will believe that this really the muscles and the freedom of the ner- is the purpose which mothers and guar- vous fluid is interrupted. If it could be dians have in view in confining their seen when thus compressed, the muscle little victims in stays, whatever the result would be found pale and exsanguine, and may be. Yet these are not the days being deprived of the quantity of blood when ignorance can be pleaded as an ex- necessary for its nutrition, much less its cuse for such wrong-headed folly and action, it becomes wasted, or in technical wickedness; it is obvious that the stay is language, atrophied. The muscles, then, an appurtenance of woman only when by the use of stays are weakened and she has arrived at a state of full develop- rendered powerless, and the spine, at the ment; but then it should be divested of growing period oflife, is limited in its ex- all the apparatus of busks and bones that pansion and in its proper amount of mus- frequently encumber it, and its main cular support. The consequence is inevi- bearing should be limited to the upper table ; the spine sinks under the pressure half of the chest. The stay is, in reality, of the superincumbent weight, or the a support for the bust; such is its pur- child throws the pressure against one or pose, sucfr alone its intention. How very the other side of the stay, and curved ludicrous it would appear to put it on spine or spinal disease are established. boys; and yet boys have as much need Howr canitbe otherwise? If we wished of it as girls up to the period of woman- toproduce curved spine, could we adopt a hood, and I may say further, up to the more scientific or certainplan ? But stays period of marriage. But as stays form a are not the sole cause of curved spine, staple article of female dress in this spinal disease, and deformity in girls and country, it may be well to point out their young women. Another cause is, insuffi- physiological action on the frame. cient food; the stomach, forsooth, must 113. It is well known that the upper be schooled to a lady-like appetite,; Na- half of the trunk of the body, the chest, ture is turned off as a dunce. Another as it is properly termed, is constructed cause is, insufficient clothing, and an- of a framework of twelve pairs of narrow other, insufficient exercise. That horrid bones, the ribs, which bend round from word, lady-like,” haunts the poor girls the spine behind, to the breastbone in of the middle and higher classes through front. These bones constitute the de- yearswhich should be devoted to physical fence of the chief organs of the body, education, and leaves them at last the namely, the heart, the lungs, the liver, prey of deiormity and disease. It may be and the stomach, the two former being wholesome to reflect that spinal deformity above, the two latter below. Upon these is scarcely known in school-boys, and is bones are spread out certain muscles almost universal in school-girls. of respiration and the muscles which sup- 114. F ashion is the war-cryof tyranny, port the spine, and the muscles are cov- and some years ago, it was the fashion ered in by a layer of fat and by the skin. for women to appear Avith deformed bo- Muscles, it will be recollected, are the dies. Happily fashion has become more parts of the body termed flesh; they are rational at the present day, and it is most red in colour, moderately firm, receive sincerely to be hoped that British chil- a large quantity of blood and many dren will be educated, physically as well nerves, and are the agents by which as morally, to perform the duties of Brit- motion is effected. Moreover, they pos- ish mothers. I have described the man- sess the property of becoming large and ner in which small waists and deformed firm with exercise, and small and soft or spines may be made; I will now cite a flabby from disuse. Hence the expres- parallel from the work of my friend Mr. sion muscular is synonymous with “ pow- Tradesant Lay, entitled, “ On the Chi- erful.” Now, the first effect of stays is nese as they are.” “ At five,” writes Mr. to limit the bending and other movements Lay, ;t the rich man’s daughter has her of the trunk of the body; it moves, as it foot so firmly bound, that, in the native were, “ all of a piece and the obvious phrase, the whole is killed. The foot, consequence is, the degradation of the below the instep, is pressed into a line muscles from their firm to a soft and flab- with the leg, to add to the height of the HEALTH OF THE SKIN. 47 little sufferer, while two of the toes are cise are obtained with greater variety bent under the sole, that its breadth may and less fatigue. be only of the least dimensions. The agony of such a process, it would be hard to estimate ; but it is said to last about six weeks, when, I suppose, the wasting of all the parts, and the cessa- tion of many of their functions, have ren- CHAPTER IX. dered the whole insensible to pain. This insensibility to pain is perhaps confined ON THE INFLUENCE OF ABLUTION AND to the outer parts, for the chief person BATHING ON THE HEALTH OF THE SKIN. belonging to the temple on the island of Honam, stated that his sister suffered 116. The preceding chapters on the much anguish in the sole of the foot, or structure and purposes of the skin, and rather, in its lower and more central particularly those parts which treat of parts.”* the constant abrasion and reproduction 115. The exercise best adapted for the of the scarf-skin and the functions of the adult is walking and riding on horseback, oil-glands and perspiratory system, afford and for the elderly, walking, and the the groundwork upon which much of more gentle exercise of riding in a car- our reasoning on the necessity of ablu- riage. Walking, when practised with a tion must rest. The scarf-skin is being proper regard to the conditions mentioned constantly cast off in the form of minute in preceding paragraphs, bestows all the powdery scales; but these, instead of advantages which are to be derived from falling away from the skin, are retained exercise. It favours digestion and nutri- against the surface by the contact of tion, facilitates respiration, stimulates the clothing. Moreover, they become min- skin, and promotes its action, increases gled with the unctuous and saline pro- the temperature of the body, and invig- ducts of the skin, and the whole together orates the physical and mental powers. concrete into a thin crust, which, by its Equestrian exercise offers similar advan- adhesiveness, attracts particles of dust of tages to ihose whose strength is unequal all kinds, soot and dust from the atmos- to walking a sufficient distance, or a suf- phere, and particles of foreign matter ficiently long time, to derive benefit, and from our dress. So that in the course of is therefore peculiarly adapted for inva- a day, the whole body, the covered lids or persons of a weakly constitution. parts least and the uncovered most, be- The action of the skin is speedily excited comes covered by a pellicle of impuri- by riding on horseback; an agreeable ties of every description. If this pellicle warmth is diffused over the entire body, be allowed to remain, to become thick, and all the advantages of walking exer- and establish itself upon the skin, effects which I shall now proceed to detail will * [Another and greater evil of the present day, is pro- follow. In the first place, the pores will duced by the number and weight of the skirts worn. be obstructed, and, in consequence, Many spinal affections must arise from the combined effects of the weight and heat produced by present fash- transpiration impeded, and the influence ions. The disease of the spine must act upon the brain, of the skin, as a respiratory organ, en- and affect the intellect and disposition, ultimately, indeed, tirely prevented. In the second place, excite disease throughout the entire system. The skirts are usually so fastened that not only does a part of the the skin will be irritated both mechani- weight tend to enfeeblethe spinal region, but the remain- cally and chemically; it will be kept ing portion, and a greater or smaller share of the first, damp and cold from presses with most deadly influence upon the upper parts the attraction and of the abdomen. All the organs within are displaced detention of moisture by the saline par- downward, and then follows all the list of female com- and the once plaints which are so painful to bearand so tedious to cure. ticles, possibly, matters re- The effect of this mode of dressing is not less in jurious to moved from the system may be again personal appearance than it is to health. All free move- conveyed into it ment is restrained, a healthy circulation is retarded, de- by absorption. And, pression of spirits and of the animal functions is induced, thirdly, foreign matters in solution, such and beauty is lost. Allthis can be prevented by a little as poisonous gases, miasmata, and infec- ingenuity. Let a waist of the same form as the waist of the dress be made of linen, or jean, or the like. To this tious vapours, will find upon the skin a let the skirts be attached, so that the weight of the skirts medium favourable for their suspension may bear upon the shoulders. This is not an experiment and subsequent transmission into the to bo tried, but every lady exclaims in its favor who has tried it. In almost all the shop windows also may be seen body. These are the primary conse- skirts, light and beautiful, and adapted to make the dress quences of neglected ablution of the “set” in any desirable way. In cold weather, an agreeable warmth should be secured, not so much by in- skin; let us now inquire what are the creased thickness or number of skirts as by an addition to secondary or constitutional effects. the under garments. As health is valued, as long life is the and the desired, as the charm of beauty is wished for, let not these 117. If pores be obstructed things pass unheeded.] transpiration checked, the constituents of 48 INFLUENCE OF ABLUTION ON THE the transpired fluids will necessarily be undoubtedly, in some instances, obscured thrown upon the system, and as they are its principle, a remark applicable in the injurious, even poisonous, if retained, most modern times, in the most civilized they must be removed by other organs countries, and to most serious objects; than the skin. Those organs are, the but the principle evidently is, the utility lungs, the kidneys, the liver, and the of water to man. From the first hour of bowels. But it will be apparent to every existence to his latest breath, in health one, that if these organs, equally, or one and in sickness, on the throne or in the more than another, which is generally cellar, water is anuniversal good. Baths the case, be called upon to perform their were dedicated by the ancients to the di- own office plus that of another, the equi- vinities of Medicine, Strength, and Wis- librium of health must be disturbed, the dom. namely Hercules, and oppressed organ must suffer from ex- Minerva, to whom might properly be haustion and fatigue, and must become added, the goddess of health, Hygeia. the prey of disease. Thus, obviously The use of water has been enforced as a and plainly, habits of uncleanliness be- religious observance, and water has been come the cause of consumption and adopted as one of the symbols of Chris- other serious diseases of the vital organs. tianity. Again: if the pores be obstructed, res- 119. Let us now turn our attention to piration through the skin will be at an water in its several relations to cleanli- end, and, as a consequence, the blood, ness, health, and the relief of disease. deprived of one source of its oxygen, one In its former capacity, it enables us to outlet tor its carbon, the chemical j remove the pellicle of impurities previ- changes of nutrition wall be insufficient, ously spoken of from our bodies, and and the animal temperature lowered. also from the clothes "which we wear As a consequence of the second position, nearest our skin, and it effects this pur- cutaneous eruptions and diseases will be pose by its quality of dissolving saline engendered, the effects of cold manifest- matters, and holding in temporary sus- ed on the system, and the reabsorption of pension those which are insoluble. There matters once separated from the body are, however, certain substances for will be the exciting cause of other injuri- which water has a natural repulsion, and ous disorders. The third position offers over which it consequently exerts no in- results even more serious than those fluence until assisted by a chemical which precede. If a pellicle of foreign power. These substances are oily mat- substance be permitted to form on the ters of all kinds, and the skin, as we have skin, this will inevitably become the seat seen, is abundantly provided with an of detention of miasmata and infectious unctuous secretion. The chemical vapours. They will rest here previously power which is called into use for. the to being absorbed, and their absorption subjection of the oil is soap ; soap renders will engender the diseases of which they the unctuous product of the skin freely are the peculiar ferment. miscible with water, and hence is an in- 118. With such considerations as valuable agent for purifying the skin. I these before us, ablution becomes a ne- may affirm that it is an indispensable aid, cessity which needs no further argument for in no other wr ay can the unctuous to enforce strict attention to its observ- substance of the surface of the skin and ance. But I fear that water, the medium the dirt wdiich adheres to it be thoroughly of ablution, hardly receives a just appre- removed. I am aware that certain sub- ciation at our hands. Water is the most stances termed “ wash-powders,” are oc- grateful, the most necessary, and the casionally used as substitutes for soap; most universal, of the gifts of a wise they are rubbed on the skin with the Creator, and in an age when man drew hands, and act in the same manner that his luxuries more from nature and less crumbs of bread do upon a chalk draw- from works of his own production, ing. But draughtsmen well know that when water was his friend more than they cannot remove the chalk which has his servant, water was regarded as a entered the crevices of the paper, nor representative of the Deity, and was can they, indeed, restore the surface to raised to the dignity of a mythological its original whiteness and purity. Nei- god. Thus the rivers of Greece and ther can wash-powders follow the innu- Rome were represented allegorically by merable apertures of the skin, nor enter a tutelar god, with his attendant the mouths of the pores otherwise than nymphs, and to this day the Ganges is to obstruct them. A skin cleaned in adored by the votaries of Brahma. The this manner may always be detected by practice of the worship of rivers has a certain kind of shining, not to say HEALTH OP THE SKIN. 49 greasy, polish, and the whole complexion vote to our sensations, which will rarely looks mellowed into a kind of tone, as we deceive us. As regards the frequency of say of pictures, in which dirt and time ablution, the face and neck, from their ne- have softened and chastened the tints. cessary exposure to the atmosphere and But surely no one would care to put up the impurities which the latter contains, for the reputation of resembling an old cannot escape with less than two sapo- however rich its tints or admira- naceous ablutions the twenty-four picture, in ble the art developed in its painting. hours ; the feet, from the confined nature Soap is accused of being irritative to the of the coverings which are worn over skin, but this is an obvious injustice done them, require at least one; the armpits, to soap, for soap never irritates the deli- from their peculiar formation in refer- cate skin of infants. Depend upon it, ence to the detention of secretions, and that when soap does cause irritation, the also from the peculiar properties of the error is in the condition of the complain- latter, at least one; and the hands and ant, and betokens either an improper arms so many as nicety and a refined taste neglect of its use, or a state of suscepti- may dictate. No harm can arise from bility of the skin verging on disease of too frequent ablutions, much evil may that membrane. If we would have result from their neglect.* health, we must use soap. Ifsoap act as 121. Such is ablution when intended an irritant, we must train to its use by for the purpose of cleanliness,but it must beginning with a small quantity and in- be in the experience of every one, that creasing it gradually. I may be asked, other effects originate from its use ; that What is the best soap ? I reply, Good nothing is more refreshing than a white curd soap, without scent, or scent- thorough ablution; that, in point of fact, ed only by its contiguity to odorant sub- to those who conduct the operation pro- stances. The use of soap is certainly perly and with a due attention to temper- calculated to preserve the skin in health, ature, nothing can be more luxurious, to maintain its complexion, and tone, and nothing restore the energies more surely prevent it from falling into wrinkles; and agreeably, after hours of toil or exer- and if any. unpleasant sensations are tion ; and, as I am about to show, nothing felt after its use, they may be immediate- can be more healthy. The common ly removed by rinsing the surface with term which we hear applied to the effects water slightly acidulated wT ith lemon- of a thorough ablution is “ bracing;” in juice. professional language we speak of them 120. The unpleasant qualities usually as being “ tonic;” and in truth there ex- attributed to soap are frequently referri- ists no better means of restoring the ble to the temperature of the water used “ tone” of the system than the judicious in ablution. In this, as in most other of employment of water; and this leads me the rules of health, extremes should be' to the modes inwhich water may be used avoided. To a man whose duties call with the best prospect of benefit to the him to brave the cold of winter in all its health. intensity, water at its lowest temperature 122. It must not be supposed, that be- is appropriate and refreshing. But to cause water is a good and excellent tonic, woman or an invalid, such a degree of that our healthwould be better for being cold is not merely painful, but really in- thrown into a fever by it, or even drowned jurious to the skin. The temperature of in it, any more than that a parallel argu- the water should be raised to a point at ment would be tenable with regard to which it feels lukewarm, but no higher. food, clothing, or exercise. I know very For if cold water be hurtful to the skin, well that equilibrium is not suited to the that which is hot is infinitely more mis- times; that there exists among mankind, chievous, particularly in the winter sea- in medicine as in politics and religion, a son. The heat excites the circulation of certain thirsty “ go-ahead” or “ go the the part and stimulates its nerves; it is whole hog” principle which is absolutely then, perhaps, immediately exposed to a insatiable. I do not say that this char- cold atmosphere, sometimes a piercing acter is the peculiar attribute of the pre- wind. Can we be surprised that, with sent age, tor the history of nations proves such an extreme, the skin should be irri- it to have existed at all periods of the tated, roughened, and chapped, or that world. There is no philosopher’s stone the complexion should suffer % In alter- of cloth- * [ I must again say, that it seems to me, the popular nations of temperature, as food, prejudice against soap is correct. Lemon juice, I am ing, and exercise, moderation and judg- told by ladies who have tried it, is very bad for the skin. ment must if we are in I must also say that I think I have known cases where be used; and too frequent ablutions had produced bad effects. One doubt, we had better trust the casting thorough ablution per day is sufficient, as a general thing.] 50 INFLUENCE OF ABLUTION ON THE of health any more than for commuting Cooper, and to which he attributed much the grosser into the precious metals. of his unusually robust and excellent But every one who desires it has the health. elements of an equally valuable arca- 124. The second form of ablution by num” in conforming to a correct practice the sponge requires the aid of a large of diet, clothing, exercise, and ablution.* shallow tub, or sponging-bath, in which 123. The simplest mode of applying the bather stands or sits, while he re- water to the skin, and that by which the ceives the water from a sponge squeezed smallest extent of surface is exposed, over the shoulders and against his body. conditions of much importance to the The same precautions, with regard to weakly and delicate, is by means of the temperature, may be taken in this as in wetted sponge. In this mode, the water the preceding case, but the bather is may have any temperature that is agree- necessarily more exposed, and the form able to the sensations, a part only of the of bathing is suitable only to persons in body is exposed at a time, and as soon as moderate health ; excepting in the sum- that part has been briskly sponged, and mer season, when it may be borne by in- as briskly wiped dry, it may be again valids. In the early use of the sponging- covered by the dress. The whole body bath, the bather should content himself may in this way be speedily subjected to with a single affusion from the sponge, the influence of water, and to the no less and should then dry the body quickly. useful friction which succeeds it in the As there is more freedom for the limbs, operation of drying. An invalid rising there is more muscular action in this than from a bed of sickness would adopt this the former method, and the glow is pro- remedy by degrees, beginning first with portionally increased. Indeed, in the the arms, then proceeding to the chest, sponging-bath, exercise and ablution are and then, gradually, to the whole body. combined, and its employment by per- He would use warm water in the first sons ofsedentary habits is highly advan- instance, but if the season were summer, tageous. I know but one circumstance would be speedily able to proceed to that could render the sponging-bath ob- cold. A person of weakly habit begin- jectionable, and that is, the occurrence ning a system of daily ablution for the of palpitations. This, however, may be first time should commence in the sum- obviated, by relinquishing the drying of mer, and by the winter his powers of the body to an attendant, or adopting the endurance will have become so well “ wet sponge.” and after a short time, if trained, that he will bear cold water there be no tendency in the system to without inconvenience. It must be ad- disease of the heart, the palpitations will mitted. that the plan here laid down is cease. very simple; it requires no apparatus, 125. A third kind of ablution is that a sponge and a basin being the sole fur- with the shower bath, which provides a niture for its use; but it is no less a valu- greater amount of affusion than the able appliance to health. The cold chill former, combined with a greater shock of the sponge, which was at first disa- to the nervous system. But that which greeable, becomes pleasant, the quick more particularly distinguishes this from friction which ensues is agreeable, and the previous modes is the concussion of while it stimulates the skin, gives action the skin by the fall of the water, the de- to the whole muscular system; and the gree of concussion having reference to warm glow, the thrill of health which the height of the reservoir and the size of follows, Is positively delicious. I must, the openings through which the little however, call attention more strongly to columns issue. The usefulness and con- the “ glow of warmth” over the surface, venience of the shower-bath and its faci- as it is the test by which the benefit of lities of application render it a necessary the remedy is to be estimated in this and article of furniture in every house, the in all other forms of ablution and bathing. only question of importance with regard I can hardly conceive a case in which toit being the kind ofapartment assigned the application of water, according to to its use. I have known instances of this method, couldleave a chill behind it; the shower-bath being transferred to an but if such an occurrence take place, the area, an outhouse, or a cellar, so that the individual has need of medical aid, and bather had to make his way from a warm that should be promptly supplied. I may bed, if the bath were taken at rising, only mention that it was the present form of partly dressed, through cold passages, ablution which was used by Sir Aetley to his bathing place, and was generally chilled on his way. The bath, in such a * [ Here, should have been added, breathing pure air and cultivating the mind.] case, becomes an instrument of punish- HEALTH OF THE SKIN. 51 ment and disease, rather than of health. jar would occasion a severe and painful The shower-bath must be located in a shock. In using the cold shower-bath, dry room, a room in which a fire can be it will be found that the first impression lighted in the winter season—in an airy made upon the skin is much colder than dressing-room, for instance—and every that which follows; and after being pro- regard paid to comfort and convenience. longed for a few minutes, the sensation It is in this that the public bath is gener- is really one of warmth. This is an ally so much superior to that of home ; effect of the concussion of the skin by the in it, every suggestion that comfort and water, which I shall hereafter have more even luxury can invent is realized, and particularly to allude to. The old over such a bath only does Hygeia pre- “ tumbling-bath” is the parent of the side. The shower-bath admits of modi- present shower-bath, and much inferior fication, to render it suitable to the most in its value, for in it the whole body of delicate as well as to the most robust. water contained in the reservoir is thrown The extent of fall may be increased or at once upon the bather. diminished, the apertures may be regu- 126. Before quitting the subject of the lated, so as to produce the lightest shower shower-bath, I must refer to an objection or the heaviest rain; the temperature of that has been made to its use, namely, the water may be adjusted to any degree that it is liable to cause a determination of warmth ; and moreover, the quantity to the head, and is therefore improper delivered also determined. I cannot too for persons of full habit. This is an er- often repeat that the sensations of the ror originating in the abuse of the bath, bather must be tenderly regarded, if and is only so far related to truth as the good is to follow the practice of ablution; assertion, that an excessive meal will and this is in no case more necessary produce apoplexy. If a person whose than in delicate or convalescent health. vessels are oppressed with excess of By judicious training, the nervous sys- blood subject himself without training to tem, which would shudder under the the sudden shock of a shower bath, a application ofa tepid sponge to the skin, shock whose first effect is to impel the could be made to bear, without uneasi- blood inwards upon the vital organs, it ness, a smart charge of cold water from is impossible toasswerfor the result; the the shower-bath. It is evident that in result, in fact, must be ruled by the physi- this case a victory is gained over the cal strength of the tissues of those organs sensations of the utmost importance, and to resist the impulse. But the whole one which cannot be too highly valued ; tenour of the observations on food, rai- for by a parallel reasoning, the skin, ment, exercise, and ablution contained in which in this way is made to bear the this book is to guard against violent ex- shock of a shower-bath, could better and tremes, which are, in reality, a wilful risk for a longer period, resist the influence of life. If, in the case above supposed, of atmospheric cold and its consequent the individual be young, and the tissues morbid effects on the economy. In mak- elastic and strong, the vital organs will ing use of the word shock,” as expres- not only resist the strain, but will not in sive of the effect of a discharge of water any wise be injured. If, however, the by the shower-bath on the surface of the person have reached that time of life body, it must not be supposed that I refer when the tissues are brittle rather than to any unpleasant or painful effect; this yielding, something must give way. But is far from being the fact; the shock with I repeat that I cannot look upon this warm water, with which the bather otherwise than in the light of an excep- should always begin, is really agreeable, tional case, and such an one as could not and the feeling will be one of regret occur if the rules of bathing, here laid when the shower is at an end. A person down, were strictly followed. Indeed, unaccustomed to the shower-bath enter- the training necessary to arrive at the ing one with a strong charge of water at comfortable use ofsuch a bath as has been a low temperature, and pulling the valve- supposed, would itselfprevent the fulness, string, would certainly be shocked by the which in this case was the cause of mis- sudden and unusual sensation caused by chief. To prevent the dangerous con- the rush which immediately follows ; but sequences attributed to the shower-bath, this is abusing, not using the shower- it has been suggested that the feet should bath. In the like manner, a feeble stream be immersed in hot water during the of electricity may be passed through the operation. 1 can only say, that if this body without producing a disagreeable harmless expedient will in any way con- sensation, and with benefit to the part, duce to the confidence of the bather, let while half the quantity from a Leyden it be practised, by all means ; but philo- 52 INFLUENCE OF ABLUTION ON THE sophically it is useless ; the secret of safety that taken in an apartment; the temper- lies in the training ; not only in this, but ature of the atmosphere is probably also in all other matters in which the vi- agreeable, the sun may be warm, the tal organs are concerned. I should not fresh air breathes upon the limbs, and deserve the pardon of my lady readers the immersion is active, and accom- if I were to neglect another matter con- panied by diving, or the exercise of nected with this subject, namely, the swimming. The* saline bath, at rest, suggestion of some covering for the pro- differs from Ihe fresh-water bath in the tection of the hair. The best contrivance more stimulating properties of the saline for this purpose that I have seen, is a matters which it contains, and in the high, conical, extinguisher-shaped cap, greater weight of the water ; while the made of some light material, and cover- same bath in motion, that is, in the open ed with oiled silk. A cap of this shape has sea, produces a greater degree of con- the advantage of not interfering with the cussion than the river stream, particu- descending shower,while, by the breadth larly when accompanied by active motion of its base, it effectually protects the or swimming. The mineral baths, in like head, and offers the means of tying a manner, owe their special properties to border of the same silk beneath the hair. the mineral salts which they hold in so- 127. The douse, or douche-bath, is a lution. contrivance for applying water locally, 129. When the cold bath is disagree- and combining with affusion, more or less able to the sensations or to the constitu- concussion of the skin. As the remedy tion of the bather, it may be raised in for local disease, this form of bath has temperature to suit his purposes. It been in use from time immemorial; a jug then changes its designation, and, ac- of water poured from a height on a cording to its heat, is termed, temperate, part of the body is a douche-bath; and tepid, warm, or hot. A temperate bath and a more complete one is the stream ranges from 75° to 85°; a tepid bath, from a pump, the popular treatment of from 85° to 95°; a warm bath, from 95° a sprain. The douche-bath to the head to 98° ; and a hot bath, from 98° to 105°. is also applicable to some kinds of insan- In other words, the warm bath comes up ity. From these remarks, it will be ap- to the elevation of the warmest parts of parent that the douche-bath is less man- the exterior of the body, the hot bath to ageable than the forms previously de- that of the interior, and a little beyond; scribed, and that recourse must be had the temperature of the blood on the left to some bathing establishment when its side of the heart being 101°. use is required. In establishments of 130. The vapour-bath offers some this nature, the douche may be obtained points of difference from the preceding, of any size or temperature, and may be in the circumstance of extending its in- received in any direction, some being fluence to the interior as well as to the horizontal and some also ascending. exterior of the body. The bather is The concussion of the skin, caused by seated upon a chair, in a position agree- the blow of the water against the surface, able to himself, and the vapour is gradu- is a feature of importance in this form of ally turned on around him, until the re- bath; and when a sufficient height of quisite temperature (from 90° to 110°) column cannot be obtained, the blow is attained. The vapour is consequently may be supplied artificially by a little breathed, and thus brought into contact wooden hammer, with which the skin is with every part of the interior of the beaten as the water falls. lungs. The vapour-bath has undergone 128. The cold bath is of three kinds, much improvement within the last few fresh, saline, and mineral, and the pro- years, and its powers as an agent for the perties of each may be modified by being cure of disease have been increased by at rest or in motion. The still, fresh wa- the discovery of various vegetable sub- ter, or plunging-bath, offers few advan- stances, whose volatile elements are sus- tages over the shower-bath, and com- ceptible of being diffused through the bines the same principles. The allusion vapour, and, thus introduced into the is, perhaps, somewhat more complete; blood, are made to act upon the system.* the shock is dependent on the tempera- ture of the water, and the concussion on * I have lately had the opportunity of examining and the activity and energy of the bather, testing the merits of some admirably-conducted baths of this kind, kept by Mr. Sturgeon, of No. 3, New Basing who, by his active movements in the hall-street, and my opinion is stronglyin their favour. bath, supplies the want of motion in the [The vapor-bath, properly taken, is as beneficial, as cold-water bath on the banks injudiciously used, it is injurious. To take the bath pro- fluid. The perly, at all times observe the following rules. Except for of a stream is infinitely preferable to some especial purpose, the vapor should not be breathed HEALTH OF THE SKIN. 53 131. Bathing and exercise are very effected, the skin immediately shrinks, closely allied to each other—they both and the whole of its tissues contract. stimulate the actions of the skin, and As a result of this contraction, the capa- both, if carried too far, are productive of city of the cutaneous system of vessels fatigue. Bathing, again, is indebted to for blood is diminished, and a portion of exercise for some ofits useful properties. the blood circulating through them is In like manner, the rules of bathing and suddenly thrown upon the deeper parts those of exercise are very similar. Bath- and internal organs (see diagram, p. 12). ing, to be efficient in preserving health, The nervous system, among others, par- should be regular, should be commenced ticipates in it. and is stimulated by the by degrees, and increased by a process afflux, and communicating its impression of training, and should not be permitted of stimulus to the whole system, causes to intrude upon hours devoted to some a more energetic action of the heart and important function, such as digestion. It blood-vessels, and a consequent rush must not approach too near a meal, that back to the surface. This is the state is to say, if it be attended with the least termed “ reaction,” the first object and fatigue; nor must it follow a meal too purpose of every form of bathing whatso- closely,three or four hours being permit- ever, the test of its utility and security. ted to elapse. The time occupied in bath- Reaction is known by the redness of sur- ing in cold water by invalids should not face, the glow, the thrill of comfort and exceed a few minutes, ranging, perhaps, warmth, which follow the bath, and the from two to ten; but persons in health may bather shoufd direct all his care to ensur- carry it to the point of satiety, provided ing this effect. 1 By it. the internal or- always that they combine with it active gans are relieved, respiration is light- exercise. The period for the tepid, warm, ened, the heart is made to beat calm and or vapour-bath, is from a quarter to half free, the mind feels clear and strong, the an hour, unless special indications require tone of the muscular system is increased, to be fulfilled.* the appetite is sharpened, and the whole 132. I come now to the immediate phy- organism feels invigorated. This is the siological effects of bathing on the sys- end and aim of the bather, and to this all tem. When the body is moistened with his training tends. The error is> to ex- a sponge wetted in cold water, or when pect the result without the preparation. affusion by the sponge or shower-bath is After a proper training the most plethoric and apoplectic individual may derive or allowed to affect the head. On the other hand, the health and safety fioin systematic bath- head should be kept, cool; the inarm; a thick emer- feet ing ; but it will be seen, at a glance, by iti a should be used ; the hath should be taken Only till the perspiration begins to start from the face; tiie body the above explanation, that without the should be wiped till dry before it is exposed to the air. training the attempt would be madness. The object is, to draw out the blood from the internal organs to the surface. Hence why the vapor should not be Bu' the reader must not imagine, that inhaled. Many times it will be advisable to inhale cold because there is danger in bathing in a air, by putting one end of a tube in a bowl of ice, and drawing theair through ice in that way. Tire head should particular case, that the practice is dan- be kept, cool, as there is but a short course for the Wood gerous ; that would be an erroneous in- from the heart to the brain,—and the old proverb is good, “ I endeavoured to show almost without exception, keep the head cool.” Some- ference. have times the feet will not be warmed by vapor alone, though that food, raiment, and exercise, when it is allowed to pour directly upon them. The expansion used, are the source of many of the vapor is such, that heat is absorbed rather than judiciously given off, and it seems also as if the effect of the vapor enjoyments, and the means of our exist- sometimes enlarged the blood vessels throughout the sys- ence; and I think it will be granted,me tem to such a degree, that the blood is drawn away from excess in either the feet, (n these cases, the feet should be immersed iua without difficulty, that is vessel of warm water. A thick covering is required to replete with danger. Are we to give up cause the vapor to ho deposited quickly upon the skin. the use of food because an incautious One 'hickness of flannel, a blanket, or the like, is not sufficient, as the vapor condenses upon the covering when person eats himself into an apoplexy? it is thin. When the perspiration first starts, it will be up- Bathing is as little dangerous as food, on the head or face, invariably, so far as I have seen, two when the vapor-bath is taken. Nature seems to take par- the difference between the being, ticular pains, by this means, to keep the head cool; and that we prefer the one, and therefore by observing this, we may be sure in case of sick or well take it under mantle of our protec- people, that the bath has not been taken so long as to be the injurious. Pains should be taken to have the skin wiped tion, while we repudiate the other, be- very dry, that no evaporation may take place after the cause it is Jess agreeable to our appe- covering is removed. A salt vapor-bath should always be taken in preference to a simple vapor, as it stimulates the tites, or perhaps a little troublesome.* skin more powerfully, and there is not, the slightest danger that the most delicate person will take cold after its use.] * [ I do not think that many parsons who are in the * [The vapor-bath should not be taken, except for habit of bathing, would agree with our anther, in saying rome especial reason, as long as our author mentions. that it isless agreeable than our food, or at all troublesome. From five to ten minutes is long enough, if there is a pro- One of our most learned professors says, that if he must per arrangement; a longer while tends to exhaust the have one meat with hi3 ha h, or three meals without it, skin, and renders a person liable to take cold easily.] give him his bath. It will be found that a perfumedsalt 54 INFLUENCE OF ABLUTION ON THE HEALTH OF THE SKIN.
133. In order to increase and promote is effected. When there is any delicacy the reaction of the skin, various meas- of the respiratory organs, the horse-hair ures and manipulations are resorted to, and bristle brushes, by producing an in- some of them being practised in the creased degree of stimulation over the bath, others after quitting it. Of the chest and trunk of the body, are import- former kind is the operation of sham- ant additions to our means of cure. It pooing, which consists in pressing and is not intended, however, that the reme- kneading the flesh, stretching and relax- dy should be more unbearable than the ing the joints, and brushing and scrub- disease, which is likely to be the case if bing the skin. In the East, the practice the common horse-hair gloves* are em- is most singular. You are laid out at ployed : a better kind are those which full length, rubbed with a hair brush, have a brush surface; they are much scrubbed, buffetted, and kicked; but it softer and more efficacious. The elec- is all very refreshing.”* The ancients trical qualities which are spoken of in were in the habit of scraping the skin connexion with horse-hair gloves are an with an ivory knife. But practices so innocent fraud on the imagination of the agreeable to the bather have been little purchaser. The best form of flesh-brush followed in temperate and cold climates, is one in which the bristles are set on a partly from the prevailing neglect of the leather back. bath, and partly from the necessity of 134. The influence which the bath having the operation performed by a exerts over the nervous and circulating person skilled in the manoeuvre. Our system of the bather is not the least re- common means of stimulating the skin markable of its effects. The temperate are "confined to' the rough* towel, the and the tepid bath, for example, produce horse-glove or rubber, and the flesh- a gradual diminution in the number of brush, which are used after quitting the the heart’s pulsations, a calm in the ner- bath.f Indeed, this short catalogue em- vous system, and a tendency to sleep ; braces all the appliances requisite for the in other words, they are sedative in their purpose. For tender and delicate skins, action on the system. The hot-bath, on the rough towel answers every purpose, the contrary, causes an excitation of the and should be used by the bather him- nervous and vascular system, and in- self, unless the exertion be found too creased heat of the interior of the body, great, or cause palpitation of the heart. a quickened pulse, and profuse perspira- In the latter case, it must be resigned to tion. It is a siimulant to the system. an attendant, and the process completed The warm-bath, occupying a mid-posi- by the bather, in order that the reaction tion between the tepid and the hot-bath, may be increased by some degree of is also intermediate in its effects; but as muscular exercise. Some skins bear the power of maintaining and bearing the horse-hair and bristle brushes equal- heat is very different in differentpersons, ly well with the rough towel, in 'which it is impossible to fix upon the exact case these may be used after the drying point of neutrality for all. It appears to extend over a range of about ten degrees vapor-bath succeeded by a genial shower, is the greatest from 90° to physical luxury a man can enjoy ; giving more force to 100°, so that if we wish de- the mental powers, and elasticity to the spirits, than any signedly to produce a sedative or a sti- thing else in which he can indulge.] mulant effect on the we * economy, should, Sir Alexander Burnes’s Travels in Bokhara, t Since the above was written, l have had the oppor- having always regard to the feelings of tunity of examining a flesh-glove that comes recommended the bather, select a temperature above or to us by the experience of ages, and certainly offers ad- vantages superior to any other kind of rubber for the skin below the neutral range.f in existence. This is the Indian flesh-glove or kheesah, a 135. Another curious and important glove, or rather mitten, which has been used, from time immemorial, in Ilindoostan, Persia, and throughout the law is associated with the influence ex- East, and by a race of people, both from necessity and erted by the bath over the state of the luxury, more attentive to the skin than any other upon which a the face of the globe. The glove was introduced into pulse, is, power of absorption by England by Mr. J. Ranald Martin, of Grosvenor-street, the skin below the neutral range, and an and much labour and expense have been employed by augmented transpiration it. The Messrs. Savory and Moore in having a similar glove man- above ufactured in London. Their imitation, however, is per- absorbing power is modified by various fect, both in appearance and properties; and it is a sub- circumstances, such as the quantity of ject of much satisfaction to me to be enabled to recom- mend so admirable a contrivance forpromoting the health * In Hindoostan, the horse-hair glove is employed for of the body, through the agency of the skin. The glove rubbing down horses, a purpose for which they are certainly is made of goat-hair, the material used in the manufac- better fitted than for using to the human skin. ture of the Burruek or Persian glove-cloth, of which the t [ The effect upon the system of warm or cold baths, original kheesah is composed. will depend upon the length of time during which they [ The very best thing with which to rub the skin, are used. The cold bath, used for a moment or so, is either in health or sickness, is a pair of short hose more stimulating in its effect; used for a longer time, it will or less worn, according to what the skin will bear. Coarse prove sedative. The hot bath is at first stimulating, then woolen socks two-thirds worn are best as a general thing.] exhausting.] ON AIR. 55 fluids already contained within the tis- tissues, the loveliness of beauty, and the sues of the bather, the state of the body charm of wit or good sense, are alike de- in relation to food, activity of nutrition, pendent, in part, upon the oxygen of the &c. In this sense, medicated baths have air. We are immersed in a solution of the power of acting upon the system. it, and if our clothing is of that porous The process is, however, slow, and re- nature that it should be, the oxygen will quires long immersion when the water- act with life-giving energy upon the bath is used, but more active with the blood that is coursing through the skin. vapour-bath. A delicate and very extensive surface is 136. The opposite effect is produced presented in the lungs, to the action of when the temperature of the bath rises the oxygen, and the breathing apparatus, above the neutral range; in other words, a very large and important part of the above the temperature of the blood. In body, has been constructed for the pur- this case, transpiration is so active, that pose of bringing the air in close and the bather loses weight. If the bath be forcible contact with the lining of the prolonged, there is danger of its proving lungs, through which the blood is circu- fatal by the over excitation of the sys- lating with the greatest activity, seeking tem ; the pulse, as before mentioned, be- to spread itself out to the life-giving in- comes rapid, the beating of the heart fluences of the oxygen. Our author has tumultuous, the respiration quickened; shown that the food we eat is, in part, the bather experiences a sensation of for the purpose, either directly or indi- oppression amounting almost to suffoca- rectly, He hasdiken- tion ; he is faint and giddy, and falls into ed wfrat ace in system UdViie the insensibility of apoplexy. burning*ofim\a*dle. ••' \ 138. The comparison is a goorh one. The minutiae of the matter need nV. be discussed. It must be evident, upon a moment’s consideration, that breathing is for the purpose of causing the food we eat to burn. Certain parts of the food X.^ will unite with the oxygen we inhale, and heat will be produced. It will readily be ON AIR. seen that if certain parts of the blood unite with a part of the oxygen, there 137. The influence of air, both directly cannot be as much oxygen expelled from and indirectly, is so great, that it cannot the lungs as is received into them. Only certainly be amiss to devote a chapter 16 parts in a hundred of the 20 are ex- to a consideration of its effects. Three pelled, in the same form as they entered. substances constitute pure air; viz. nitro- Four parts have been lost, as the ex- gen, oxygen, and carbon: nitrogen pre- pression is, and may represent the amount dominates, by much—its proportion being of heat produced. Suppose the same air 80 parts in a hundred, oxygen 20 parts containing but its 16 parts in a hundred in a hundred, and carbon but one part in of oxygen, should be again inhaled. Not about two thousand: nitrogen produces containing the wholesome 20 parts in a no appreciable effect upon the system, hundred of oxygen, 4 parts will not be though its apparent negative character lost, but only 2 or 3, which may repre- may arise from our ignorance of its per- sent the heat produced. That a person haps important active use. Its chief utility may preserve a proper temperature, it is seems to be, to dilute the oxygen. Car- necessary then that he be supplied with bon is extremely obnoxious to the system pure air constantly. when present in any greater quantity 139. That a “ genial summer may be than in pure air. It is constantly gene- preserved in the skin,” it is necessary rated in all animals, and passes off from then that pure air be inhaled. The pro- the skin and out from the lungs, making per ventilation ofrooms may cause some it necessary to change the air of a room expense, but it is nothing compared with continually, that its poisonous influences the benefit derived therefrom. The cold- may not be exerted. Oxygen is justly est weather in winter, and the warmest called the vital air, as we can assure in summer, admit but one rule. Day and ourselves by a thousand trials and the night there should be free egress and experience of every day. that its pre- ingress for the air. Not so that a cur- sence is absolutely essential to the well rent shall blow upon a person, for this is being of all parts of the body. The pro- not necessary, but so that the air shall duction of heat, the reparation of the be perfectly pure. How shall the skin 56 MERITS OF HYDROPATHY. perform its duties without due regard is whole system, especially of the skin, he paid to one of the great producing causes must exercise the intellect, and cultivate of heat ? Close the draught of a furnace, an agreeable disposition. The eye the fires go out and the house grows cold. sparkles, when the spirits are lively, and Breathe impure air, or too little ofit, and looks mildness or anger, moroseness or the blood no longer flows out from the attractive sociability, according to the lungs, with its temperature sufficiently feelings that rule a person. As surely elevated or charged with the elements will the complexion exhibit the genial that shall produce heat—the skin grows influences that a happy temper will cause cool by radiation, its blood-vessels lessen to act upon it. in size, its sensibility is blunted, the oil- glands and perspiratory apparatus are no longer active, chaps occur, beauty of complexion is lost, and in its turn the skin begins to react upon the kidneys, the digestive organs, the lungs, the brain, CHAPTER XII. &c. &c. ON THE MERITS OF HYDROPATHY, OR THE TREATMENT OF DISEASE BY WATER.
142. The advantages to health of a judicious and sound system of diet, cloth- ing, exercise, and ablution, cannot be better illustrated than by reference to “ 7 rON THE NERVOUS SYSTEM. what has been termed the water-cure.’ The water practice has effected impor- The warmth of the skin is very tant results in the treatment of disease, much dependent upon the state of the and will, I trust, be instrumental in re- nervous system. In fever and ague, the storing to Medicine one of her most val- surface is chill, without any appreciable uable and important auxiliaries. Mgdical external cause. This state is said to meil may rw jealous thi?t these Imnefits depend upon the peculiar condition of the have' ,b.<*$ :Nmnjured the*vafety ” i nervous system. With the nervous sys- deep by other hands than those of the tem the mind holds, also, a very intimate high priests of Therapeia, but they Jiave connection, so that through the nervous no just reason of complaint; the treat- system the functions of the skin are very ment of disease by water had been im- readily affected. Mark the changes properly neglected; now, however, its that shame, fear, or anger, will produce merits may be tested, and the test aided in the colour of the cheek. Notice how by public encouragement; moreover, the the thick drops of perspiration will start remedy will revert to those who are upon the forehead, when various pas- alone qualified to employ it, and we sions are active ; it may be by the heat may fairly hope that a correct system of excitement, or by the chill of horror. for its use will be established by their Thus only can we account for the cold labours. Priessnitz. the peasant of Sile- feet and clammy sweats of those who sia, has done much, but he would have engross the mind so much with intel- done infinitely more had he received a lectual pursuits or business perplexities, medical education ; he would then have that the nervous system cannot exert a avoided many errors, and have entitled healthy influence upon the skin. That himself to the rank of a discoverer. At heat may be produced, there is evidently present, though armed with the experi- need of some cause that shall induce ence of twenty years, he is little more the various combinations, by means of than an experimentalist, and, in some which heat is exhibited. This is called | instances, a rash and incautious one. the nervous influence, and is dependent j A warm supporter* and eulogist of for its exhibition upon the nervous sys- Priessnitz remarks : “ The knowledge tem. Activity of mind, beyond a proper acquired by anatomy, physiology, and degree, exhausts the nervous influence. pathology, is indispensable to the full Proper cultivation of mind strengthens, understanding of the ‘ water-cure ’ and to so to speak, the nervous energies. its practice, without frequent error. It is 141. That the skin may be in a healthy true it has been discovered and brought state, relaxation of the mind is required, to extraordinary perfection without this on one hand, and on the other, if a per- son would realize perfect health of the * Dr. JamesWilson. |TREATMENT BY WATER. 57 knowledge, but Priessnitz did not bring | and what opinion to form as to the state it to its present state without twenty j of the constitution and nature of the long and patient years of practical study | disease. He goes no further, for the of the powers of water, of the vital phe- best of all possible reasons, because he nomena, and of those of disease, how- does not know or understand the means. ever imperfect his knowledge may be. He does not feel the pulse or look at the But Priessnitz is a genius; an extraor- tongue, both valuable, and almost indis- dinary case; one of those isolated in- pensable, when understood, and joined stances which occur so seldom in the with all other means; had "he done this, bistory of man; let not, therefore, other ; he would have acted somewhat differ- uneducated persons attempt to practise l ently in many cases which I have noted.” the ‘ water-cure,’ because Priessnitz has I think some of my readers will shudder practised it: the power of genius is no before such a picture of medical exam- rule for ordinary mortals.” ination. Priessnitz is evidently incom- 143. This I believe to be a plain state- petent to investigate disease, and his ment of the amount of merit due to examination embraces less than half of Priessnitz, and such as. I think, we cannot | the inquiry of every medical man. To refuse to accord him. To weigh truly the visit his want of knowledge charitably, advantagesof the system, we must, as the j we must admit that he sees with half an same author advises, allay the force of eye, a kind of inspection that I should habit, and the passion of prepossession.” think ill supplied by all the “ tact” which “ One ofPriessnitz’s great peculiarities,” I the uneducated peasant can bring to he observes, “ is his tact; this is a val- bear on his treatment. But this does uable attribute, and indispensable to a , not invalidate the benefits of water and great practitioner, though, when un- hydropathy; it only leads us to the con- aided by a knowledge of every mechan- ; clusion that we should not prefer to seek ical and rational means of ascertaining ! them at the hands of the redoubtable the precise state of all the organs, it Priessnitz, if we could obtain them at must frequently be followed by error.” home, administered by those in whom His patients, strange to say, look at this we feel confidence, and whom we know blundering upon the right at the risk of to have deserved that confidence by the hitting the wrong, as a special clairvoy- nature of their education and qualifica- ance., as a mode of £; peeping into the in- tions. The secret of Priessnitz’s success ternal recesses of the bosom, and into all seems to be explained in the following the windings of the abdominal cavity.” passage: “ He evidently tries to stick as The truth is, thatbeing incomprehensible close to nature as he can, and by this he to themselves, they regard it as super- has done wonders.” But this remark natural and wonderful, while the same immediately precedes a proof of his persons would consider the cautious failure, and shows him, with all his dis- process of induction and mature judg- I position to try, a blundering expounder ment, founded on carefully observed of Nature’s laws. For example, pursu- data and the collective experience of ing his perquisitions into himself, a Sile- ages of the medical man, as nothing at sian peasant, as the book of nature , he all out of the common. This is the : arrives at the conclusion, that whatever natural consequence oftraining a people j is suitable to him, must be good for his to believe that drugs are their cure; i patients. Now, listen, ye dyspeptics, to they at last value the filthy stuff alone, a few “first lines” of this Silesian- and despise the judgment which directs peasant-book. “ Priessnitz is himself so it. Truly, indeed, we deserve Napole- strong and hearty by his mode of life, 11 on’s contemptuous sneer, that England that he does not know he has a stomach, is a nation of shopkeepers,” so long as the truest sign of a healthy state; and, we tolerate the mental attributes of the not feeling with his patients, he forgets, medical man only for the sake of enjoy- or, from some mystification of reasoning, ing his drugs, and pay gladly for the overlooks the fact, that others are not in drugs, while we repudiate any reward this enviable position, or takes an un- as the harvest of a scientific education. physiological view of the influence of an 144. But toreturn to Priessnitz. When overloaded stomach on the whole body, a patient is brought to him to submit to on each of its organs, and on any disease the “ water-cure,” “ he looks at and feels with which it may be affected.” the skin, examines the make of, and 145. The consequences of self-inspec- marks on a man, with the greatest atten- tion, ignorance, and obstinacy,* on the tion and accuracy, and makes them val- uable guides as to what he ought to do, * “ The expression of hi3 countenance is intelligent 58 MERITS OF HYDROPATHY, part of Priessnitz, are attended with the out of the system. The proper treat- most mischievous and injurious results mentbeing, “ the general fomentation by to his patients. Dr. Wilson continues: ‘the wet sheet,’ and an additional hip- With all Priessnitz’s sagacity, it is a bath, and the warm compress to the matter of surprise that he has fallen bowels, foot-bath, &c. Another fatal into an abuse which interferes greatly error was in the diet, for he stuffed enor- with his excellent cure; this is, allowing mously the most indigestible matters, in vegetable and animal matters at his the hope of gaining strength. After a table, which are of an indigestible nature, dinner of pork and ‘ sauer kraut,’ salted such as pork baked to a cinder, sausages, cucumbers, and pastry for a ploughman, ‘ sauer kraut,’ salted cucumbers, and bad I always, the next morning, made a pastry, articles of diet which, even in point of conversing with him. I gene- health, should be avoided, when any rally found him sitting on a bench by food of a more salutary nature can be himself, looking on the ground, and obtained. What, then, must be the avoiding all intercourse.” While in effect when the majority of his patients this state, he had an objection to answer have, complicated with other complaints, any questions ; but after a little solicita- some disease or derangement of the di- tion, would acknowledge that he had gestive organs'? But a more flagrant passed a horrible night, sleepless and error still is the quantity which each sick. The tenor of the human mind, in person consumes. There is a kind of such a case as this, and the intolerance furor who shall devour most. It is true of good advice under such circumstances, that, with the ‘ water-cure ’ every person is well displayed in the next remark of can eat infinitely more than he could un- the author. “ If I had said a word about der any other circumstances. But this the pork, ‘ sauer kraut,’ and other indi- is not enough; indigestion may take gestible 1 combustibles,’ he would never place, and excess be committed in the have spoken to me again.” Dr. Wilson ‘ water-cure,’ as well as elsewhere. Wa- “ made it a rule to inquire, the morning ter only counteracts the evil effects. But after one of the indigestible dinners, how the point I am convinced of is, that it the dyspeptics and hypochondriacs found interferes with, and retards the final cure themselves. They were invariably in a of, the majority of the patients of Graef- suffering state.” enberg.” The following is a vivid pic- 146. Another of the peasant’s vagaries ture of the effects of this abuse. The is an objection to warm clothing. author is detailing a case of dyspeptic “ Priessnitz recommends people to clothe hypochondriasis; speaking of the pa- lightly, and to avoid flannel next the tient he observes: “ One day he came to skin.” “ His prejudice against flannel is my room, and I examined him. The so great, that he will not allow its use lungs and heart were perfectly sound. under any circumstances.” “ What On pressing deeply on different parts of makes Priessnitz so obstinate on this the stomach and bowels, great pain was point, I cannot exactly determine; but he caused, particularly about the region and has, with all his genius and sagacity, two pyloric orifice of the stomach; in the or three decided mystifications.” So, latter there appeared to be some hard- besides being poisoned with improper ness. I found that the process of press- food, taken in improper quantities, the ing, though made with great gentleness, invalid is to be deprived of his warm cov- made his hands and feet quite cold. The erings, and their future use prohibited. case was a clear one: he was ordered These are startling propositions ; and we to go through the sweating process twice can only come to the conclusion, that a day; a hip-bath and douche ; to eat as such a plan may be suitable for Graefen- much as he could, and without distinction. berg and Priessnitz, but most unsuitable At the end of seven months of this active for any place possessing inferior advan- treatment, he left Graefenberg very little tages of air and means of taking exer- better. The error in this treatment was cise. Priessnitz’s tact and sagacity are the douche, sweating, and diet.” Dr. then purely local, his plans applicable to Wilson goes on to say, that the misap- Graefenberg alone ; he is, in every sense plication of treatment arose from the of the word, a “ genius loci remove perversity of Priessnitz’s theory, which him from his native “ berg,” and the enforced the necessity of ejecting the fruits ofhis twenty years’ experience will Morrison’s pills, which were the cause of be well nigh lost, he will have all to the disease, and other morbid “ stuff,” learn over again. It must be recollected, that in drawing these inferences of the and inquiring; he has a general appearance of firmness, which he possesses, in fact, to the degree of obstinacy.” true character of Priessnitz as a minister TREATMENT BY WATER. 59 of disease, 1 have taken the statements tion, firstly, through the friction used by of a warm admirer as a groundwork; the attendants, and subsequently, move- and though in my own mind they do not ment in obedience to her own will. The detract from a certain kind of merit due patient was a lady nearly seventy years to the man, it is necessary that he should old; she was completely crippled with be brought down from the pinnacle of rheumatic gout, and had not been out of nonsensical flattery upon which his eulo- her bed for nearly twenty years. For gists have raised him, in order that he sixteen years she was unable to lie hori- may be rightly comprehended. The zontally ; and for seventeen had not used British nation are hearty detesters of a pen. Priessnitz at first refused to re- “ humbug;” and it is to be regretted ceive her, but yielding to solicitation, she —“ that so much of that material should have was treated as follows : Every morn- been interwoven, by indiscreet adulators, ing the upper part of her person was among the laurels of Priessnitz, both for gently rubbed all over for a few minutes his own sake and that of his system. with a towel moistened in cold water. The artificial throne upon which he has She was then well dried, and her dress been chaired, itself explains the remark replaced; the legs and feet were then of Dr. Wilson, that at Graefenberg, well rubbed in the same way, and the “nothing can exceed the prejudice same thing was repeated in the evening. against medical men.” To which may A bandage, well wrung out of cold wa- be added another little reason, which sa- ter, was placed round the waist, covered vours of negligence, but which is dilut- with a thick dry one, and the same ed, obviously with water, into the ex- dressing occasionally to the legs. A few pression “ reserve.” This reserve, then, tumblers of water were drunk during the “has its inconvenience, when carried to day, more or less, as she felt inclined.” excess, for he frequently omits to give Under this treatment, she got well. But the necessary instructions when the pa- this is no case in disproof of the value of tient forgets, or does not know how to air and exercise. A walk across the ask for them.” room to a feeble invalid is equal to a 147. Dr. Wilson deserves the warmest mile of brisk walking to a person in praise for his candid analysis of Priess- health. nitz and the “ water cure,” and still more, 148. The following remarks by Dr. for putting its principles into practice in I Wilson give a proper view of the treat- Britain. But his long residence at Gra- ment of disease by water. “ It is next efenberg, and his extreme anxiety to to impossible to do more than lay down establish the “universality of water,” general rules in the treatment of any render him a partial advocate of the given complaint. The treatment must merits of his remedy. Thus, after the be changed from day to day, according narration of a case, which I shall pre- to the state of the patient, the nature of sently quote, he obser ves, “ here there his disease, and the powers ofhis consti- was not air and exercise, and no partic- tution. One day, using cold water, ular diet. No doubt it will stagger a sweating, and douche; at another time, little those who think that diet, air, and substituting the wet sheet, chilled or exercise, constitute the principal parts of tepid water ; and even, sometimes, warm the water cure.” Now I think I may or hot water, which Priessnitz has re- answer formy readers as well as for my- course to in rare cases; at other times, self, that we are quite willing to give a doing nothing, or next to it. In fact, it fair share of honour to well directed ab- resolves itself to this: all depends upon lution ; and that, although we could the knowledge and tact of the practi- wish to see an equally well directed diet tioner ; and it requires the same study added, we are disposed to be satisfied in and same knowledge of all diseased this case with abstinence from alcoholic states, the powers, properties, and com- and other stimulants. But we cannot binations of the remedy, as in the prac- agree with him that air and exercise tice of medicine.” were omitted in the case referred to. 149. In admitting that disease has The patient was unable to walk out, but been cured, and that much benefit to she breathed the fresh air of Graefen- health has resulted from the treatment berg, to her a change of air, in her apart- adopted at Graefenberg, there are one ment: and exercise does not imply walk- or two considerations which must be ing many miles, but simply action of the taken into the argument. One of these muscles, to an extent commensurate with relates to the arbitrary medical rule the powers of the individual. Such mo- which reigns there, a rule of absolute tion was enjoyed by the patient in ques- necessity in the “ water cure,” and the 60 MERITS OF HYDROPATHY very basis of success in all medical ! law, that he has a fool for his client; po treatment. The place recognizes but ; liteness forbids me to say what kind of a one king, and dereliction is immediately patient a man has who physics himself. followed by banishment. This, there- 150. Those who have not read any fore, is a condition of importance, if we authentic detail of the “ water cure” will “ I wish to transfer the benefits of the wa- be astonished to hear of a writer saying ” I ter cure from Silesia to Britain. We j of himself, that in eight months he has must have Graefenbergs in the form of ; taken 500 cold baths, 400 hip-baths, has institutions, under strict laws and rigid ; reposed in a wet sheet for 480 hours, and discipline. The advantages of institu- ; drunk 3500 tumblers of cold water. “ I tions of this nature are thus referred to : once,” lie writes, “ by way ofexperiment, by Dr. Wilson:—“ Among the foremost, swallowed thirty tumblers of water from are the removal of the patient from all the spring before breakfast, each a large business, care, and temptation that can half pint, two of which I sometimes took interfere with the cure, and his return to at once. I was nearly three hours about a healthy state. The patient goes to bed it. At nine o’clock 1 was so hungry that early, and gets up early, and goes I could hold out no longer, otherwise 1 through the different parts of the cure would have tried another dozen. When with more ease and pleasure from the I went out at six, I had a wet bandage stimulus of association and example ; he on the stomach, tightly applied, and has the advantage of seeing similar covered by a thick dry one. When I cases to his own cured, of comparing went to breakfast, the abdomen was di- notes, and receiving consolation.” At minished in size, for my bandage no Graefenberg, therefore, existence and longer stuck so close. I never enjoyed a mind are dedicated to health; the pur- morning’s walk more, and during the day suit of health is the sole occupation of felt perfectly well. My usual quantity the day; the votaries of water will fol- was from five to ten tumblers before low out the rules of their director; they breakfast, two before dinner, one or two will be cured, and they are cured. at dinner, and two or three during the Now, it is only in an institution that we evening. This is about the general rule could hope to combine these advantages that ought not to be exceeded during the in Britain; and I trust that the day is cure.” not far distant when we shall see such 151. With our present knowledge of institutions, hygienic sanatoriums in fact, the importance of the application of the in the neighbourhood of all our large principles of hygiene to health, it will not cities and at our watering-places. My be without interest and instruction to readers will perceive an additional neces- pass in review the various modes of using sity for such institutions in the following water practised by Priessnitz. His man- glance at the instructions to a patient, ner of producing and keeping up profuse who inquires how far he may venture to perspiration is excellent; it is thus de- practise the “ water cure ” alone :—“You scribed by Dr. Wilson: “The bedding can apply cold water every morning, either is removed, and a blanket of the largest by the wet sheet, wet sheet-bath, cold- size is spread out on the mattress; the bath, or shower-bath, or simple ablution; patient, lying down at full length, is en- take a quiet walk, and drink three, four, or veloped in it as closely as possible, and five tumblers of water before breakfast; ; so as to fit well about the neck and feet. take a foot-bath at eleven or twelve | The best covering over this is a small o’clock, a tumbler or two of water, and feather-bed, which must be tucked in a good long walk. The fomentation may about the head and shoulders, and all the be applied during the day to the stomach way down to the feet; it is as well to as described. For a cold, you can lie in elevate the head as high as the patient the wet sheet, and be afterwards well finds it convenient or comfortable. In rubbed in the shallow, chilled bath for this state he is left until perspiration five minutes; or when heavy and indis- comes on ; it is then allowed to continue good sweating and a bath; but not for a longer or a shorter time. It gener- much more would I recommend to ordi- ally takes two or three hours before per- nary people to try themselves.” I think spiration begins; but it is a good plan, few persons would be so bold as to ven- Avhen it is slow, after the first hour, to ture upon these instructions, however begin rubbing the hands gently against simple they may appear to the suggester, each other, and up and down the sides, without the supervision of a medical di- doing the same with the feet, but not so rector. It has been said of a person as to fatigue or affect the breathing. As who conducts his own case in a court of the packing up takes place at four in the TREATMENT BY WATER. 61 morning, not to lose any part of the day, produces a momentary shock to the nerv- the patient has generally a good sleep ous system, causes the arrest of the per- for an hour or two. When perspiration spiration, and is followed by a general has fairly set in, the window is thrown re-action.* In describing the manner in open, and from time to time a wine-glass- which cold was produced by draughts of ful of cold water is given to drink. cold air, I had occasion to remark, that When it is considered that sufficient the checked perspiration was the elFect, perspiration has taken place, the bed and and not the cause, of the injury done to blanket are thrown off, and the patient the system, and that the real cause ol steps into a bath (if it be in his room) mischief was the chilling of the cutane- containing about a foot of cold water, ous nerves and the consequent depres- where he is well washed and rubbed, as- sion of the nervous powers. Cold never sisting himself as much as possible. Be- injures the body when acting as a stimu- fore sitting down in the bath, it is well, lant ; it is only when it. acts long upon as a general rule, to have a basin of cold the surface, and robs the latter of its water at the side, in which he just gives heat. The youth of Rome, to avoid cold, his hands, face, and breast a rub. When were wont, after their contests on the the large bath is used, the patient walks plain of Mars, to leap into the Tiber. By to it, still enveloped in the blanket, a this practice, they checked and removed cloak thrown over if necessary; here he the perspiration from the skin, prevented plunges in at once, if it is large enough. its slow evaporation and the cold engen- Sometimes it is necessary to have two dered by that process, and caused a baths, one with cold, the other having healthful reaction. If we hear of dis- water with the chill taken off. In this ease following this practice, it is in cases case, he enters first into the warmer bath, where the object is unknown or over- and after a good rubbing, transfers him- looked. The individual is labouring self quickly into the colder one, where under nervous exhaustion from fatigue, the same thing takes place for a minute or his nervous powers are lowered by the or two, returning again to the warmer long continuance of the ablution; or he one. Where the douche is in the house, is passive in the bath; there is always it is sometimes made use of instead of some such depressing cause. As a sti- the bath; I doubt its great utility. After mulant, I repeat, immersion cannot be all these processes, he dresses quickly, injurious. If the patient were to get up and goes out to walk for an hour or from the bed and dress, the probability longer, drinking, from time to time, a is, that he would take cold; he would tumbler of water.” It is not to be won- then necessarily chill; but the old action dered at that Priessnitz should have con- is stopped, and a new one induced, by sidered this as a process which no dis- the cold effusion. I may refer also to ease could elude, a thorough purgation the practice of Russia, as an illustration of the humors through the skin. But he of the harmlessness of exposure to a sti- found, in practice, that it was not gene- mulant cold while the skin is perspiring. rally applicable, that it was liable to pro- The Russian quits his hot vapour-bath duce emaciation and irritability, and that to be rubbed with snow 5 he then returns it was injurious in persons having a de- to the bath, and again to the snow, re- termination of blood to the brain or mu- peating the process several times, but cous membrane, or suffering from ner- always finishing with snow. The cold vous debility; that, in fact, he merely in his case has another effect; it subdues separated the diluent water from the the excitement of the circulation caused system by this means, and left the blood by his clumsy bath. But in the Priess- loaded with salts, and highly irritative, nitzian mode there is no such excitement. behind. A method of treatment introduced into 152. There is one part of this process, medicine many years ago, but rarely however, that calls for special remark, adopted at the present day, consisted in and that is, the sudden immersion of the pouring several pailfuls of cold water body in cold water while bathed with upon the patient, then drying him well, perspiration. This is easily explained; and returning him to bed. This remedy the skin is stimulated to excess, and were never gave cold.f not some means taken to check the ac- tion, it would be prolonged indefinitely, * It is but fair to mention, that at ail hydropathic es- and would be to tablishments, the temperature of the water is regulated by a cause of chill the sur- the state and power of the invalid. This rule is particu- face of the body, and give rise to cold larly enforced in the excellent establishment with which I and fever. The cold water, in am most familiar, namely, that of Miss Price, at Harrow, applied Middlesex. the manner described, is a stimulant; it t f By whatprecedes our authorhas very clearly shown MERITS OF HYDROPATHY.!
153. The cold bath of Priessnitz dif- and enveloping the trunk only; but in fers in nothing from the ordinary bath, the most delicate invalid, the shallow excepting in its application, being rarely bath, at an agreeable temperature, after taken but as an appendage to the sweat- the removal of the damp sheet, is indis- ing process, or wet sheet. The shallow pensable. “ Where there is great heat bath is a large tub, containing from six of the skin from fever or internal inflam- to twelves inches of water. The patient mation, the damp sheet is changed as remains in it from three to ten minutes, often as it becomes warm ; sometimes as rubbing his skin and dashing water over often as fifteen or twenty times before the the surface. It is also coupled with the patient is put into the bath ; but all this effusion, once or twice, of a basinful of course depends upon the symptoms. over the whole body; this bath is a de- It is a powerful prophylactic remedy, and, rivative in its action, and is employed by as I have said, possesses, at the same Priessnitz' in fevers and inflammations, time, a sedative, soothing, and soporific in which the period of ablution is pro- property, calming the pulse, removing fe- longed according to the judgment of the verish heat from the surface, and allaying prescriber. The hip-bath (sitzbad),* pain and irritation.” As regards domes- like the preceding, is derivative in its ac- tic qualities, Dr. Wilson observes, u after tion, and is used for chronic diseases, a long journey, or travelling day and more especially in those of the upper night, a damp sheet and cold bath remove and lower stomach. It also relieves de- every symptom of fatigue and any dis- terminations to the brain and chest, position to cold.” “ After a feverish “ flatulence, colic, spasms, and vomiting.” night, awaking with headache, malaise, The period ofprolonging it is from fifteen or what is called a state highly bilious, minutes to an hour, and during its con- let this process be gone through, using, tinuance, the surface of the stomach is at first, a shallow bath with ten inches to be quickly but gently rubbed with the of water at 80° of Fahrenheit, and a hand. In commencing either of the above good rubbing for five or ten minutes.” baths, the temperature of the water is to Such is the “ damp sheet,” and such are be slightly raised, and in succeeding days stated to be its effects. It is certainly gradually reduced to its natural standard. calculated to equalize the circulation, The skin, under the stimulation of the taking heat here, producing contraction water, becomes warm and vividly red. of vessels there, checking the vital chem- 154. The damp sheet (leintuch) is the istry ofmal-nutrition in this place, promo- chef-d’oeuvre of Priessnitz; it is simply ting perspiration in that, determining to a linen sheet wrung out of plain water the surface, and occasioning a general until no more drops fall. It is then placed and soothing calm to the nervous sys- on a blanket over a mattress, and the tem. And it is equally certain that, ad- sides of the sheet are brought over the ministered properly, it is not likely to patient and tucked in, so that he is well produce cold. If employed improperly, packed up from neck to foot. The blanket the cold bath which succeeds is the anti- is then arranged in the same manner aq dote to its bad effects. The test, how- the sheet, and a light down bed placed ever, of this, as of all other modes of over all. The head may be raised to application of water, is the subsequent any elevation that may be agreeable to reaction; where this occurs, the reme- the patient, and, when there is headache, dy, however monstrous to the eyes of a fold of linen dipped in water may be prejudice in its shape, is perfectly harm- laid upon the forehead. The process less. lasts for halfor three-quarters of an hour 155. The icet sheet bath (abreibung) is or an hour; the patient then rises, takes a sheet less completely emptied of its the cold or chilled bath, walks for an water by wringing than the damp sheet, hour, drinks some tumblers of water, and and thrown over the patient, who draws then is in high condition forbreakfast. In it about him, and rubs the upper part of different cases, the process may be modi- his body, while an attendant does the fied by reducing the size of the sheet, same by the back and lower limbs. This leaving out the legs or arms, or both, is continued for two or three minutes and then replaced by a dry sheet, with the advantages of following a vapor-bath by a shower. skin is dried. The In ease of a well person, it is a great luxury, as well as which the thoroughly preservative of health. In case of the sick, it would not author observes, “ this is an excellent generally be advisable,or must at least be managed with great discretion.] portable bath,” and very convenient for * I am enabled to give strong testimonyin favourof the daily ablution and travelling. It is tonic sitting-bath trom my knowledge of its successful use in in its medical effect. chronic disorders of the head, chest, and stomach, at the Harrow establishment. 156. The wet bandage , or compress CLASSIFICATION OF SKIN-DISEASES. 63 (umschlag), is a damp sheet in miniature, foot ba h , head bath , and 'partial baths for application to a part of the body. offer no peculiarities worthy of notice. When used for superficial inflammation, The cold foot-bath is used by him as a it acts by evaporation, and the thinner derivative in determination to the head the material employed the better. When and vital organs of the trunk. “ It is.” the inflammation is deep or chronic, it is says the author so frequently quoted, made to perform the purpose of a fomen- “ the best local remedy for habitual cold tation in the following way: a thin fo;d feet, keeping them in a glow for the rest of linen is wrung out of water until no of the day, and with repetition, perma- moisture runs from it, and is then spread nently restoring the warmth and circula- smoothly on the skin ; a second and thick- tion in them. To ensure a speedy re- er fold, but dry, and of larger dimensions, action, the feet must be warmed by rub- is placed over the preceding, and both bing or exercise before putting them in are retained in their place by a broad the cold water, and immediately after the bandage which completely envelopes bath exercise must be taken. A certain them. The wet compress is derivative way of warming the feet and keeping and sedative in its action, and keeps up them so is by drawing on a pair of cotton a gentle excitation of the skin and free socks well wrung out of cold water, over perspiration. Whenever it dries, which them another pair of thick dry ones, and does not take place for several hours, it a pair of large boots. A walk in this is again wrung out of water and ap- state warms the feet immediately, and plied; and its action is increased by they remain in a glow the whole day.* water, drunk during the period and ex- ercise. In this manner the wet compress may be worn for days together, or only during the night or day. Whenever it is laid aside, even for a few hours, it must be recollected that the surface is CHAPTER XIII. warm and perspiring, and the perspira- “ tion must be stopped by rubbing the skin ON THE RASHES” OF THE SKIN J NAMELY, briskly with cold water, and then drying st. Anthony’s fire, red rash, rose it well. In the latter case, water is used RASH. AND NETTLE RASH. as a stimulant. The above remedy is very useful in dyspeptic disorders. It is un- 15S. When the reader is informed that doubtedly based on the soundest physi- between ninety and one hundred varie- ological principles, and enjoys the ad- ties of disorder affecting the skin are vantage over some of the other modes of known, he will not be surprised to learn application of water of being perfectly that attempts should have been made, safe, and so manageable that the experi- at a very early period, to subject them to ment can be easily made. It isby no means some kind of classification. Hippocra- disagreeable; after a few minutes, the tes, the father of medicine, for example, wet is no longer felt, and the compress divided them, according to the supposed and not nature is then warm unpleasant. And of their cause, into two classes, this is the test of its utility; if it be dis- local and constitutional; the former he agreeable to the sensations and remain believed to originate in a morbid action so, it will do harm rather than good, and of the skin alone, and the latter in an at- should be abandoned. I have been fa- tempt on the part of nature, to eject from miliar with the wet compress in a dif- the system some morbid humour. But ferent shape for many years, and have the classification, ifit might be so called, seen the most beneficial and surprising of Hippocrates, afforded no means of dis- results follow its use ; it answers every tinguishing the various forms of disease purpose for which a poultice is generally from each other. Galen, perceiving this used, and is infinitely more agreeable as deficiency, endeavoured to supply it by a remedy. 157. The as used donche. The douches are sparingly used, and never at douche, by Priessnitz, treatment, in “ the beginning of except particular cases. is a column of water of from one to six * [ It is worthy of notice, that the free use of cold inches, or more,” in diameter, and de- water causes a craving appetite. This seems to show ten to that a considerable portion of our food is fuel. Cold scending from twenty feet.* His water taken into the system must be warmed to the tem- perature of the body. Water applied to the surface ab- stracts much heat, both by conduction and evaporation. * The douche baths employed at the Harrow establish- On these accounts, much heat must be produced in the ment are, 1, a waterfall douche of twenty feet descent; system. We thus clearly see why taking the cool air, 2, a vertical column douche, varying in diameterfrom half the sea breeze, the shower bath, &c., calls into action the an inch to two inches; 3, a horizontal column douche; digestive and circulating organs, proving very beneficial 4, A vertical shower douche ; and 5, a horizontal shower when these parts of the system are torpid.] 64 CLASSIFICATION OF SKIN-DISEASES. classifying diseases of the skin according other hand, the maligned mineral king- to their situation. He, also, established dom supplies us with such useful and two groups, namely, those affecting the harmless remedies as magnesia, soda, head and those affecting the other parts sulphur, and steel. of the body. An obvious objection raises 159. But to return. A more appropri- itself to Galen’s classification, in the fact, ate classification than either of the pre- that the same disease may at one time ceding took its origin in the early part attack the head ; at another, the body ; of the seventeenth century, in the labours and often, both at the same time. Never- of Riolanus; and this system, improved theless, Galen had followers; and within by modern investigations, is the famous the present century an eminent French artificial classification of Willan, a clas- divided the whole of the diseases sification now very generally followed ~f the skin into ringworms and tetters. both in this country and on the continent. nn these primitive forms of classification, But Willan’s system is incomplete; he the observer will perceive the reigning allowed himself to be diverted into un- popular theories of the present day. The necessary subdivisions by the terms people have still their ringworms and class, order, genus, and species, which their tetters, according to difference of he borrowed from Linnmus, and made situation of the eruption; and they have the subject intricate and complex. Ali- still their local remedies to “ kilt' 1' 1 the bert attempted to rival Willan by found- ringworm, or their inward medicines to ing a natural system in emulation of “ purify the blood.” But the Hippocra- Jussieu, but succeeded only in plunging tes and Galens of the present day take the subject into a still further perplex- no note of the rapid march of science; ity, and the system of Alibert scarcely their theories remain unchanged, and outlived the man. While cutaneous pa- their remedies the same. Barbarian re- thology was in this state, a new era was medies ofan early age are the panaceas in the act of dawning; one in which ana- of the uninformed at the present day, just tomy has received a new impulse from as the language which they employ may the use of the microscope, and physio- be referred at once to the Celtic or Sax- logy has been improved to a remarkable on roots from which it sprang. Thus, degree by that instrument and by or- ifwe would indulge an antiquarian taste ganic chemistry. A new basis was thus in tracing the roots of our language by afforded for classifying cutaneous dis- existing words, we must pursue our in- eases, and of this 1 availed myself in a quiry after obsolete expressions among classification published in 1842.* To the lower classes, particularly in the pro- this system I gave the name ‘ Natural vinces. And in like manner, if we aim Classification,” not from any likeness to discover ancient and forgotten medical which it bore to the natural system of remedies, we must seek them in the same Jussieu, or that suggested to Alibert’s quarter. The “toad’s heart” and the mind by a contemplation of the princi- “ viper’s fat” have still an existence as ples of the great botanist, but from its popular remedies; and at a recent exe- being actually founded on the structure cution in a provincial town, there were of the skin. Now, as I suppose my persons ignorant enough to request per- reader to have formed some idea of the mission to avail themselves of the touch structure of the skin by the perusal of of the dead man’s hand to dispel their the first four chapters of this work, wens and warts. It is the persistence of he is perfectly competent to form a these popular superstitions that is the judgment upon the natural system, and greatsource ofsad encouragement given to obtain an insight into the laws of dis- to empirical medicines. What ideas of ease illustrated by this classification. witches culling simples on the murderer’s In proceeding to a demonstration of this grave at the third hour of the morn, and system, I may remark, in the first place,, before the dew of the morrow sets, does that the agents of diseased action are the not the term “ vegetable pills” conjure nerves and the vessels. The scarf-skin, up ! What balmy influences are imag- it will be remembered, possesses neither ined in a pill formed of juice of primrose- of those organs, and therefore cannot be petals, and roses’-breath ! while the poor the seat of intrinsic disease. It may be, bolus, shorn of its name, is a vile com- and is, altered occasionally by the state pound of filthy and poisonous juices; of its producing organ, the true skin, but aloes, for example, gamboge, ipecacu- cannot be considered as itselfsusceptible anha, croton, castor, colocynth, scam- all vegetable * A Practicaland Theoretical treatise on the Diagnosis, mony, remedies, Flora’s Pathology, and Treatment of Diseases of the Skin, and Pomona’s gifts. While, on the Churchill, London. RASHES OF THE SKIIN'. 65
of the abnormal vital action termed state of the system, the cause, the nature “ disease.” of the part attacked, and that kind of 160. The constituents of the skin, ex- knowledge which the special study of clusive of the scarf-skin, are the true medicine confers, can decide. When skin, the perspiratory apparatus, the the redness is vivid, the heat great, and oil-producing apparatus, and the hairs the tumefaction considerable, we call the and hair-tubes. These four parts form state St. Anthony's Jive, or erysipelas. the groundwork of a primary classi- St. Anthony’s fire, moreover, is accom- fication into as many divisions of dis- panied by more or less constitutional fe- eases of the skin. Of the diseases of ver, namely, thirst, white tongue, quick the true skin, a secondary division com- pulse, pains in the head, &c. prises inflammation, under which a large When the redness is less vivid, the majority of the diseases of the skin may heat less, and the tumefaction but little be ranged: enlarged growth of the pa- perceptible, particularly if it be of long pillse of the sensitive layer; disorders duration, vary in its tints, and appear depending specially on the state of the settled on the spot, the case is one of vessels; disorders depending specially fiery spot, blotch , or red rash. The red upon the state of the nerves ; and disor- rash is generally slow in its progress, ders depending specially upon the state variable in point of extent, and not ne- of the colouring principle. The diseases cessarily accompanied by constitutional of the perspiratory apparatus are such fever, as is the case with St. Anthony’s as have reference to excess, diminution, fire. or alteration of the perspiratory fluid; the Sometimes, in place of one or several diseases of the oil-producing apparatus, moderate-sized or large spots, the latter to excess, diminution, and alteration of are numerous and distributed over the the oily product, detention of the product greater part of the body; they are small within the tubes and glands, and inflam- ■ and irregular in form, and have a crim- mation of the glands; and the diseases j son tint. This is the eruption known as of the hair and hair-tubes, to augmented ! the rose rash, so common in summer and diminished quantity of hair, altera- after over-exertion. tion in colour, disease of the hair-pulps, In another case, the redness may not disease of the hair-tubes, and altered di- at first be perceptible, but there is itch- rection of hair. A glance at the follow- ing and uneasiness in the part; and if ing table will render this arrangement it be scratched, the redness becomes vi- more clear: vid, and is marked by white wheals and 'Inflammation. small, white, rounded eminences; in fact, Enlarged t.he< papillre. the affected has the Diseases of Disordered stale part appearance of true skin. of vessels. Disordered state of nerves. the skin when stung with nettles, and is Disordered colour of the skin. thence called nettle rash, technically, ur- Diseases of the 'Excessive perspiration. from Latin “ perspiratory Diminished perspiration ticaria, the word urtica,” apparatus. _ Altered perspiration. signifying a nettle. These four inflam- 'Excess of product. mations of the skin are the so-called Diseases of the Diminished product. oil-producing- Altered product. “rashes.” apparatus. Detention of product. 162. To fully understand the nature Inflammation of the glands. of the family of the “ rashes,” it is fur- r Increase of hair. ther necessary to have some acquaint- the Diminution of hair. Diseases of of ance with their cause. The cause of hair and haii—- Alteration hair. tubes. Disease of hair-pulps. St. Anthony’s fire lies in the constitution, Disease of hair-tabes. and L Altered direction of hair. many persons have an hereditary or acquired disposition to. the production INFLAMMATION OF THE TRUE SKIN. of a rash of this sort, upon the existence of disturbance of the digestive or RASHES. any nervous system, or upon some wound of 161. We call that state of any part of the skin, even of a trifling nature; or the body where there exists redness, they take it by infection from another heat, pain, and swelling, “ inflammation.” labouring under that disease. In disor- Inflammation, therefore, may be trifling dered and weakened constitutions, it is or severe; it may be limited in extent or liable to attack the eyelids, and thence diffused over a large surface, or the signs extend to the head. It sometimes fol- by which it is known may be present in lows leech-bites or the scratch of a pin, unequal proportion; in other words, it and is always an indication of some ac- may be of little consequence or serious; tion or change in the system that re- and this nothing but a knowledge of the quires watching. A peculiarity of St. 66 RASHES OP THE SKIN. Anthony’s fire is its disposition to run knowledge of oneself, and may be avoid- from one part to another, from the hand, ed at another time. When external, for example, running up the arm to the they are within the reach of every one ; body in the course of a few hours; at and if they cannot be removed at once, another time, it suddenly quits the part may perhaps be mitigated, and the re- first affected without leaving a vestige of medy applied with greater certainty. its existence behind, and flies to a distant The treatment of disease is therefore one. These eccentricities, and the se- naturally entwined with its causes, and rious constitutional disturbance always the consideration of one is scarcely com- conjoined with it, render it an obnoxious plete without that of the other. Treat- companion. Very frequently, when the ment is suggested by the cause, it is de- redness and swelling are at their height, pendent on the cause, and it admits of the the scarf-skin is lifted up all over the same threefold division into moral, con- surface in blisters; and occasionally the stitutional, and local. Shakspeare has swelling is dropsical and alarming. shown himselffully aware of the neces- 163. The unprofessional person who sity of a moral treatment of disease, and has ever reflected on the cause of a given expresses his conviction in the well- disease will have felt the perplexity of known appeal of Macbeth to his physi- the subject, and the obscurity that envi- cian :— rons the term “ cause.” And yet no “ towmrds cure can be Canst thou not minister to a mind diseased ; progress effected Pluck from the memory a rooted sorrow ; until the cause is guessed or known, and Baze out the written troubles of the brain ; the treatment in with And with some sweet, oblivious antidote, directed accordance Cleanse the full bosom of that perilous stuff some proper principle. I have alluded Which weighs upon the heart V’ above to the cause of erysipelas being present in the constitution, and I may 164. In the domestic management of now observe, that the causes of disease St Anthony’s fire, every disturbing in general may be arranged into three cause, such as noise, conversation, bad classes, namely, moral, constitutional, news, heated temperature, cramming and local. The moral causes arc not the with nice broths and jellies, should be least powerful and energetic in the pro- avoided, and the injunctions of the medi- duction of disease, and as they are more cal man should be carefully followed. under the control of the patient or his The disease is always serious, and its friends than of the medical man, they consequences doubtful; it is often dan- should be most closely watched and care- gerous, often attended with delirium, and fully obviated. The constitutional causes. by no means a case to try Mrs. A.’s or depending upon some error in the phe- good Mrs. B.’s advice upon; in other nomena oflife, can be comprehended on- w'ords, it must not be tampered with. ly by the medical man, and to him they Officious kindness in the sick room is should be left. There are, however, highly dangerous; deeds are wanted constitutional remedies of great power, there, not words; the real wants of the but not sufficiently valued, in the hands patient should be anticipated, but no im- of every one, namely, diet, clothing, ex- aginary wants created. The inflamed ercise, and ablution.* The reduction of part should always be. raised into an inflammation may be effected entirely, easy position, and one which will facili- or much facilitated, by a diluent diet, tate the current of the blood to the that is, such an one as shall dilute and heart, and the prescription of the medical cool the blood; by a moist covering to man carefully followed. Sometimes he the part; by modified exercise or rest; may prescribe a cold lotion, in which and by local or general bathing, accord- case a layer of thinnest linen wetted in ing to the nature of the case. But such the lotion, but not so much as to drip and appliances require judgment; the cause make the bed wet and uncomfortable, may be one which demands other means, should be gently laid upon the part, and or the treatment may be carried too far. replaced by a second, as soon as the The local causes are either internal or first loses its moisture. Three of these external: when the former, they are out pieces of linen should be in use at the of the reach of domestic aid; but they same time—one on, one in the basin con- may be known causes, such as improper taining the lotion, and the third hanging articles, or excess, or even whntoffood; on a string to cool, previously to taking in which case, they contribute to the the place of the second. No other cov- ering should be placed upon this, as the * [Again our author has omitted to distinctly mention is to as the importance of breathing pure air and regulating the object encourage evaporation mind.] much as possible. ST. ANTHONY’S FIRE. 67 165. It may be said to be a law in of the linen must be regulated by the medicine, that whatever is disagreea- sensations of the patient, for a light cov- ble TO THE SENSATIONS OF A PATIENT ering will often give the sensation of a is injudicious; there are undoubtedly ponderous weight to a part in a state of many exceptions to this law in disease ; inflammation. The same precautions but even as a guide to those exceptions must be taken with regard to the drib- it is deserving of being borne in mind. bling of water, and the rvet compress I have endeavoured to show that this is must be covered by a dry fold of cotton the law oflife in every particular affect- or flannel, to prevent evaporation as ing health, and I shall have to make much as possible. Sometimes, every constant reference to this law in the thing in the shape of moisture is disa- management of the sick; therefore I greeable to the patient, and flour or cot- wish it remembered. I would make it ton, wool or lard, are used instead. the pass-word to the sick chamber; and These are considerations for the medical I would make every one repeat it before man to determine, but in his absence he or she entered the chamber. Nay, it either might be advantageously employ- should be written on the chamber door in ed, the sensations of the 'patient always large characters. How melancholy is respected. When there are blisters, they the death scene of the noblest of our should be gently snipped with a pair of poets, Byron, from neglect of this law. scissors (the scarf-skin being insensible), “ There was also in the scene,” writes and the fluid which they contain careful- his biographer, Moore, “ now passing ly absorbed by a clean sponge, squeezed around the dying Byron such a degree dry out of warm water, or by a piece of of confusion and uncomfort as renders it soft and dry linen. When flour is doubly dreary to contemplate. There employed as a covering for the surface, having been no person invested since his it generally soaks up this fluid. In illness with authority over the household, snipping the blisters, the only care re- neither order nor quiet was maintained quired is to avoid tearing off the scarf- in his apartment. Most of the comforts skin. When this is preserved, it falls necessary in such an illness were want- down upon the excoriated surface after ing; and those around him, either un- the escape of the fluid, and forms its prepared for the danger, were, like Bru- most natural and appropriate dressing. no, when he came, bewildered by it, or, 167. As regards internal remedies ofa like the kind-hearted Fletcher and domestic kind, the appetite of the patient Count Gamba, were by their feelings should again be consulted ; he will reject rendered no less helpless. every thing in the shape of solid food, “ ‘ In all his attendants,’ says Parry, but will take with pleasure cooling and 1 there was the officiousness of zeal, but unstimulating drinks, such as lemonade, owing to their ignorance of each other’s orangeade, sherbet, acidulated barley language, their zeal only added to the water, &c. These, therefore, are the confusion. This circumstance, and the most appropriate to his case. At a later want of common necessaries, made period, arrowroot, sago, and tea, come in Lord Byron’s apartment such a picture for their share of approval; and still of distress, and even anguish, during the later, light broths and soups, the yelk of two or three last days of his life, as I an egg beaten up with sugar in white never before beheld, and wish never wine, omelette, &c., form a transition to again to witness.’ ” a stronger diet. There is no greater 166. But to return: in fulfilment of mistake, no greater unkindness, than this law, the medical man will more fre- pressing niceties in the shape of food quently prescribe a warm fomentation upon sick persons when their inclination than a cold lotion, in St. Anthony’s fire; is opposed to them. Nature prohibits and this is a remedy which the friends food in illness; and to make her prohibi- and attendants of a patient may have tion indisputable, she removes the appe- recourse to, in such a case, without dan- tite and all disposition for eating. Shall ger, whenever the advice of a medical we disobey her mandates? Shall we man cannot immediately be procured. again partake of the forbidden apple, In the warm fomentation, the linen that we may be made wise to cruel con- should be thicker than in the former sequences ? Alas! so man was from case; it should be folded once or twice, the beginning, and is. These maxims dipped in warm water, or a decoction of are universal in medicine, and I cannot chamomile flowers and poppyheads, and too strongly impress them upon the applied in the same manner upon the in- reader; in so serious a disorder as St. flamed part. The thickness and folding Anthony’s fire they require additional at- 68 RASHES OF THE SKIN. tention. In this disease, the medical varieties of the red rash; I shall there- practitioner may think it right to depart fore conclude with two of a more familiar from the usual practice of keeping the kind, namely, gall and chap. Whenever patient low. and administer stimulants two surfaces, moistened by perspiration and wine. When he does this, the or other fluid, are in such contact with attendant should obey his instructions to each other that they rub together during the letter in the limitation of the quanti- the motions of the body, the part becomes ty. Wine and stimulants should on no red and inflamed, and is said to be account whatever be given to sick per- galled, or chafed. These circumstances sons, excepting under the direction of a are most frequent in young children, and medical man. are almost confined to persons having In convalescence, precaution must be tender and delicate skin. They occur had to the quantity and regularity of the between the large rolls of fat which exist food administered, for in returning health in young children and fat persons, in the after disease, a person is in a similar groins, behind the ears, &c., are exceed- state to one who has been starved. lie ingly painful, and if not remedied, give requires to have small quantities given rise to troublesome excoriations. The at a time, and repeated at intervals of chap, as it attacks the wrists in cold three or four hours. A moderate meal in weather and during the prevalence of health would be an excessive one to a piercing winds, is still more familiarly convalescent, and would probably be known. It is obviously an effect of cold. followed by injury to the stomach, and But there are chaps which depend on relapse into the disease from which he the contact of moisture associated with was just escaping. If a walk across the chafing, and which attack the covered room to the invalid is a mile to the same as well as the uncovered parts of the person in health, his diet must be regu- body, and these are sometimes very lated on the same principle as his exer- troublesome. A painful illustration of cise. the latter affection is chapped nipples; 168. The Red Rash or blotch , presents another is chapped lips. Red rash is great variety in form, situation, and se- neither infectious nor contagious. verity, and not less in duration. Very 169. The treatment ofred rash, when frequently it is referrible to a constitu- the functions of health are disturbed, re- tional cause, and is associated with dis- quires such hygienic and medical mea- ordered action of some of the vital organs. sures as will restore the disordered func- Of this kind are th efiery spots, or blotch- tions to their proper equilibrium. The es, that fix on the faces of women, the domestic treatment is chiefly of a local consequence of disordered health, dys- nature. For example: evaporating lo- pepsia, or tight lacing. Another kind of tions to relieve the heat of the inflamed red rash is that which affects one or both surface, and a nicely adjusted cotton web of the legs, and is accompanied by so elastic bandage, when the lower limbs much swelling as to resemble St. An- are affected, to give support to the ves- thony’s fire. This is a rash of elderly sels, and aid in the movement of the people, or younger persons of weakly blood towards the heart. The following health who have over-walked, or over- is anexcellent evaporating lotion for such exerted themselves. Sometimes the red a purpose: — circular or oval and patches are in form, EVAPORATING LOTION. to come out suddenly, disappear again in Spirit of wine, two ounces, the course of a few hours; or like St. Rose water, two ounces, Anthony’s fire, they vanish in one place Water, twelve ounces. and keep well corked, except when in use.* to appear in another. At other times, Mix, a small and they commence in blotch, kind of evaporating lotion is used by the they This spread circumference, while for all purposes in which such a remedy fade at the forming very distinct centre, is it is for example, blotch. have required; the one, rings—the ringworm I referred to the of St. body covered with rings, in treatment An- seen the whole thony’s fire, and the one I mean to imply entire and in cases “ partly partly broken, whenever the term evaporating lotion” of When they are thus rheumatic fever. is used in the course of this work. When acute and numerous in their eruption, a degree of calming effect is re- fades away; but when they greater the rash soon quired, the surface being unbroken, cam- appear and are slow, they are singly, phor water may be used in place of com- tedious in their cure. It would, however, mon water, or a drachm of sugar of lead, occupy too much space, and be ill-suited to a popular work, to follow out all the * [Cologne water is equally as good if not better.] ROSE RASH. 69 or Goulard’s extract, added. In this New honey, one drachm, White flowers of zinc, half a drachm ; latter it must be remembered, that case, and keep stirring till cold. the lotion is poisonous, and should be kept out of the reach of children. Opium After well washing and drying the is also added to the lotion, to produce skin, a little of this cerate should be calm; but this addition had better be gently but briskly rubbed into the part left to the medical practitioner. The with the palm of the opposite hand, so as mode of using an evaporating lotion is to reach the bottom of the cracks, and always that already described (§164); then wiped off with a dry towel, leaving and the chill may be taken off in cold no trace of grease on the skin. This pro- weather, by placing the bottle in warm cess should be repeated at bedtime, be- water. When the case is of long stand- fore sitting near the fire, and after each ing, and the redness does not disappear, washing, and the rubbing should be con- a stimulating application is then desira- tinued each time, providing it does not ble, and there is no better than warm cause bleeding, until the chapped skin is vinegar dabbed on the surface with a quite warm.* sponge, or used as a fomentation (§166). 170. Rose Rash. —The rose rash, or For blotches on the face, the best remedy the “rose,” is an eruption of small irre- is camphor spirit dabbed on the spot gular patches of a rose-red tint, which after washing, or twice or thrice in the spreads over the surface of the body, and day; or the following lotion used every is ushered in by a slight attack of febrile morning after washing : — symptoms. I have had occasion before, connexion with and red SUBLIMATE LOTION. in erysipelas “ Sublimate of mercury, two grains, rash, to speak of febrile symptoms,” Almond mixture, half a pint. and as they are common in all eruptive Mix. complaints, and indeed in every disease For chaps and galls, the treatment con- affecting the constitution, from common sists in keeping the surface as dry as cold upwards to small-pox, and only dif- possible, and dusting it frequently ivith fer in severity, I shall now proceed to starch-powder. Ifthese means fail, wash particularize them in the order in which the part with the followingstyptic lotion, they occur. They are chills, varying and after drying it off, dust the surface from a downright shiver to a sensation the with the white flowers ofzinc :— of water trickling down back ; heat, which maybe a mere flush, or succession LOTION. STYPTIC of or a burning glow; languor, Infusion of petals of roses,* one pint, flushes, Burnt alum, from ten to sixty grains.f often evinced by yawning] lassitude; pains in the back, loins, and When the does not yield to head, knees, excoriation limbs; restlessness; quickened circula- the lotion, a weak infusion of nut- styptic tion respiration; white or red, and might be or the tincture and galls fried, of frequently dry tongue; thirst; dry, catechu, or benjamin, gently dabbed on or parched skin ; absence of ap- the ttvo latter are shrunk, part. The tinctures and checked natural secre- possible domestic remedies for petite, nausea, the best tions. The whole of these symptoms, chapped lips, or nippies, or chapped collectively, with allowance when the are severe. A reasonable hands, latter variety, depending on constitution, good application for chapped hands or for severity constitute fever ; face is the following; and during its use, of attack, &c., and these symptoms, in a slight form, are the skin should be protected as much as in rose rash. Rose possible from cold water and cold winds present rash, how- is a slight complaint; it at- and cuffs, and also from the ever, only by gloves children under the name of parching heat of the fire. tacks young infantile rose , and adults of weakly con- CERATE FOR CHAPS. stitution, in the summer and autumn sea- Pure olive oil, one ounce, under the appellation ofsummer and Yellow beeswax, halfa drachm. son, autumn rose , and is sometimes associated Melt the beeswax in the oil, with a gentle heat, in a sand or water-bath, and when melted, stir in, with certain constitutional disorders, such as that ofinoculated small-pox, cow-pox, * This infusion is made by ponring a pint of boiling and gout. water upon two table-spoonfuls of the petals of the red rheumatism rose, letting it stand till it cools, then straining through linen. If the petals are home collected, they should be * [ From what hasbefore been said, it will be under- taken from the bud just before it opens, and dried quickly stood, that if a person’s hands chap, the action of the in the air, so as to preserve as much of theircolour as pos- oil-glands is to be increased as much as possible, and the sible. They should be kept in a dry place. artificial ointment prepared from honey, lard, and oil, t As the strength of thislotion must be regulated by the must be frequently used to subserve the same purpose. delicacy of the skin, it may be increased or diminished The use of soft water as a drinkis very important at all accordingly ; the weakest formula is best suited for infants. times, but especially so if the skin is diseased.] 70 RASHES OF THE SKIN. 171. Rose rash bears a close resem- ters of the rash is a sadden appearance blance to measles in the form of its little and disappearance ; occasionally the lat- patches of red, and is therefore styled ter is so conspicuous as to form the basis “false measles.” It is, doubtless, fre- of a variety, the evanescent nettle rash ; quently mistaken for measles; like them, while at another time it is as remarkable the efflorescence appears first upon for its permanent character, persistent the head and breast, and then passes nettle rash. The common cause of net- downwards to the feet; there is also red- tle rash is some error of digestion, either ness of the throat, but an absence of the from the nature of the food, or some watery eyes and symptoms of cold in the state of disorder of the nervous or other head wdiich accompany measles: there systems of the body. That which can is also much less constitutional disturb- best be appreciated by the non-medical ance; it lasts a shorter time, not more reader, and at the same time the most than three or four days, and is neither frequent cause, is food in an unwhole- contagious nor infectious. Another dif- some state. In other cases, the food, ference between them is the minor degree without being itself unwholesome, acts of intensity in the redness of the enip- like a poison on the individual; and in a tion. It is accompanied by itching and third class of cases, the peculiarity ap- tingling of the skin, and on this account pears to reside in the individual, rather is often very irritating to infants. Adults than in the food. Among the list of ali- bear the annoyance better, and in them mentary substances which have been the disorder is of so little importance as known to cause this troublesome affection scarcely to confine them to the house. are mussels, lobsters, crabs, shrimps, oys- The most common cause of rose rash in ters, dried fish, pork, goose, almonds, infants is the irritation occasioned by strawberries, raspberries, cucumbers, teething, and disorders of the mucous melons, mushrooms, rice-milk, and porter. membrane of the intestinal canal. In Now, it. is evident that the greater part adults, the more frequent causes are, of these substances are harmless to most heat of weather, fatigue, draughts, drink- persons; those which are most com- ing cold water when heated with exer- monly the cause of nettle rash, however, cise, and indigestible substances. are shell-fish, and particularly mussels. 172. The domestic treatment of rose A frequent cause in children is teething. rash is purely constitutional. The pa- 174. Whenever food is the cause of tient should remain at rest in a cool at- the disorder, the attack comes on sud- mosphere, and if in bed, lightly covered denly, a few hours after the meal; for with clothes, until the attack be passed example, in the middle of the night, after away, abstaining from solid food, and a hearty supper. The person suffers at taking cool and unstimulating drinks. first from a sensation of weight and ful- Drinks of this kind are technically termed ness in the chest accompanied with nau- diluents, from the influence they exert in sea, giddiness, and soon after, vomiting diluting and cooling the blood. Effer- and violent action of the bowels ; he feels vescing drinks are also useful; they, a pricking and tightness in his throat, however, require the direction of the which produce cough and difficulty of medical practitioner, as do cooling medi- breathing, amounting almost to a sense cines and baths. of suffocation. These symptoms arise 173. Nettle Rash.—The nettle rash from swelling of the membrane of the is so characteristically marked by its mouth and throat. Swelling of the tingling and pricking pain, its white ele- tongue succeeds, and shortly after, the vations and wheals on a red ground, and swelling extends to the face and head. the production of fresh elevations and The nose, lips, and ears, are burning hot, wheals wherever any part of the skin is and itch violently, and by degrees the rubbed or scratched, or even touched, as rash spreads over the whole body, affect- to he familiar to most persons ; it is, for ing chiefly the skin of the joints. Nettle the most part, attended with febrile symp- rash, from irritation caused by obnoxious toms ofmoderate severity, and generally alimentary substances, sometimes sub- with nausea and sense of fulness of sides in a few hours ; more frequently, it the stomach, only relieved by sickness. continues for a couple of days, and in When the febrile symptoms are severe, rare instances is so severe as to prove it constitutes the febrile nettle rash of fatal. medical authorities. When the eleva- 175. Nettle rash calls for medical aid tions are very numerous and closely to set the digestive system in order, and grouped together, the variety is termed if the cause be indigestible food, this clustered nettle rash. One of the charac- must first be removed from the stomach NETTLE RASH. 71 by the aid of an emetic, followed by a ning from the nose, sneezing, sore throat, gentle aperient. As regards domestic and more or less cough, followed by ex- treatment, vomiting, where it occurs, is to pectoration. Scarlet fever is known by be encouraged by drinking warm water; the absence of symptoms of cold in the and after this symptom has passed away, head, but the eyes are frequently red, acidulated diluent drinks will be found and there is sore throat and a peculiarly of service. A hot foot-bath will assistin red tongue, spotted all over with little determining from the head and upper scarlet points. Small-pox is distinguish- parts of the body, and a compress wrung ed by the negative of these signs, by out of cold water until it ceases to drip, sickness at stomach, severe pain in the and kept in contact with the stomach by loins, and especially by the known pre- means of a dry bandage, will relieve the vailing epidemic. When the rashes are irritation of the stomach and bowels. fully developed, measles and scarlet fever When the subject is a child, and the offer a striking difference in colour, the cause teething, the whole body should be former being compared to the hue of a immersed in a bath as warm as the child raspberry, and the latter to that of a will bear, and wrapped in flannel on be- boiled lobster-shell; in the former, also, ing transferred to bed. the patches are small and clustered; in All the rashes on their disappearance, the latter, large and irregular. The rash leave behind them a rough and peeling of small-pox is more decidedly punctu- state of the scarf-skin, which rubs off in ated than that of the two preceding, and powdery or branny scales, and makes the minute red points very speedily be- way for a new scarf-skin that is formed come prominent pimples. And the whole beneath. The speedy removal of the of these rashes are distinguished from old scarf-skin, and the restoration of pli- those of St. Anthony’s fire, red-rash, rose- ability of the new, may be promoted by rash. and nettle-rash, by the redness of gentle frictions with cold cream. the former being dotted, an appearance 176. It would be wrong to quit the which is due to the assemblage of num- subject of the rashes without adverting berless minute red points or dots (the pa- briefly to the characters of those three pillae of the sensitive skin distended with great scourges of childhood, measles, blood), and that of the latter being scarlet fever, and small-pox. These are blended and suffused. Small-pox, be- not diseases of the skin, although they sides its common type, presents a num- are generally manifested by a cutaneous ber of modified and aborted varieties, rash or eruption; they may, however, which I cannot do more than enumerate and do exist, without external indica- in this place; they are termed varicella, tions, and in essential nature are fevers hives, swine-pox, chicken-pox, horn-pox. of the blood. These fevers commence, 177. The period of time which inter- like all others, with chills, followed by venes between exposure of the body to the usual train of febrile symptoms de- the contagion of these essentially con- scribed in a preceding paragraph (§ 170), tagious and infectious diseases, and the and particularly by a drowsiness and premonitory symptoms of the fever, the languor. In measles the precursory period of “ incubation” as it is techni- symptoms, constituting the period of sick- cally called, is from two to ten days for ening. last for three days, before the ap- scarlet fever ; from seven to fourteen for pearance of the rash; in scarlet fever, measles; and from ten to sixteen for for two ; and in small-pox, for two, three, small-pox. Another estimate of time of or four. The rash, in all the three dis- equal importance in the history of these eases, follows the same course of devel- diseases is the period of seclusion of a opment, appearing first on the face and person who has suffered from the fever. neck, next on the trunk and arms, and This should not be less than a month in then on the lower limbs; declining in the either, and the utmost care should be same order. The appearance which it used in purifying and ventilating the presents, at this early period, is so simi- clothes, the furniture, and the apartment lar, that it wouldbe difficult, even for the which has been inhabited by the sick experienced eye, to distinguish between person. The floor of the chamber should them. It is necessary, therefore, that be washed every day with the solution some specific rule should be laid down, of chloride of lime, and the walls, also, if by which the precise disease may be dis- practicable; the windows should be kept covered. This is not difficult, for mea- open, the furniture transferred to an airy sles are always preceded by symptoms meadow before it is again used, and it usually indicative of a severe cold in the would be no excess of precaution to re- head ; such as red and watery eyes, run- paper the apartment. Clothes, linen, ERUPTIONS OF THE SKIN.
and bed-furniture, must be aired and various dimensions, and generally of a Avashed, and aired again; indeed, it is circular form, upon a red ground ; these scarcely possible to carry caution too far are the scaly eruptions. And in a fifth, after these diseases. the inflammation is due to an outward and living cause, namely, a minute animalcule which burrows in the scarf-skin, and is a cause of much irritation. This ani- malcular eruption is the disease termed “ itch.” CHAPTER XIV. DRY PIMPLES. ON THE ERUPTIONS OF THE SKIN ; NAME- LY, PIMPLY ERUPTIONS, SCALY ERUP- 179. Th e, papular* group of eruptions TIONS, AND THE ANIMALCULAR ERUP- or dry pimples are remarkable for the TION. high degree of cutaneousirritation which they create, and hence are very an- “ 178. The term rashes” may be pro- noying companions, and likely to be perly limited to that state of inflamma- torn into disagreeable and painful sores tion of the skin in which the inflamma- by attempts made to relieve the itching. tory action does not proceed beyond its They are common in infants and young more simple and primary signs, namely, children, and in themare known by thepo- redness, heat, swelling and pain. In- pular terms ted gum. red gown, and tooth- deed, it must be apparent, from the out- rash. In adults, they are technically term- line of them which precedes, that the ed lichen; and another and less distinct rashes are merely parts of a disturbance form, in which the eruption is only ap- of health seated more deeply in the con- preciable to the touch, though always stitution. There are other affections, distinguishable by the marks of the nails, however, in which the cutaneous disor- is denominated prurigo , on account of der is most conspicuous, and sometimes its excessive itching. the only sign of disease in the economy, In the red-gown and tooth-rash of in- and in which the inflammatory action fants, the pimples are sometimes paler seems to expend itself in the skin, and than the surrounding skin, and in one consequently gives rise in that tissue to variety are almost white. They are al- a more positive state of local disease. It ways accompanied by more or less of is to affections of this kind that the term feverishness, and indicate irritation in eruptions is properly applicable, and to the gums from the growth of the teeth, these I shall restrict it in the pages of or in the alimentary canal. In a few in- this work. We have seen that, in the stances, they are caused by flannel worn rashes which accompany measles and next the skin, or deficient ablution. scarlatina, the papilla? of the sensitive 180. Lichen exhibits great variety in skin are distended with blood, and as- its outward characters in different indi- sume the appearance of minute red viduals; in one, the pimples are brightly points, and that in small-pox these red red; in another, of debilitated constitu- points are subsequently developed into tion, they are bluish and livid; in a third, pimples, and constitute a real eruption. they are developed around the base of The same effect is seen in the less vio- hairs; in a fourth, they appear as circu- lent, but more prolonged inflammation of lar groups, and increase by their circum- the skin which accompanies the first or ference, while they fade in the centre, pimply group of eruptions; the papillae forming so many rings of various size; of the sensitive layer are raised into little in a fifth, a modification of the preceding, elevations, or pimples, which are some- they have the appearance of flexuous times distinctly apparent on the surface, bands; while, in a sixth, they are re- and at others are only appreciable by the markable lor producing intensity of suf- touch. In another group, the little ele- fering, or unusual disorganization of the vations are obviously filled with a small skin. They are all occasioned by con- drop of a transparent and colourless stitutional disturbance, sometimes refer- fluid; these form the group of u atery rible to the digestive, and sometimes to pimples. In another series, the little the nervous system. In some instances, elevations contain an opaque yellow however, they depend upon a local cause. fluid, or “matter;” these constitute the I have had a crop of lichenous pimples mattery pimples. In a fourth group, the on the backs of my hands, from rowing effect of the inflammation of the skin is the production of a well-marked scale of * Papula, a pimple. WATERY PIMPLES. 73 in hot weather; and in hot climates, that the maintenance of their health, we annoying disorder called prickly heat is should hear little of diseases of children. a lichen. Wearing woolen garments In children, as well as in the parent, the next the skin in the summer-time is also rules of health must be carried out, and an occasional cause of this eruption. the judicious use of the bath will often 181. Prurigo presents two degrees of sweep away any little ailment under severity, but even in its mildest form is a which they may be suffering. For itch- cruel and relentless disorder; all rest ing of the skin, both in the infant and the and repose are out of the question, and adult, there is no better remedy than the sleep impossible, until exhaustion con- juice of a lemon squeezed into a pint or quers suffering. But there is yet a se- half-pint of pure water, and used as a verer degree of this distressing malady, lotion. Distilled vinegar, and vinegar termed ant-bite prurigo, from the sensa- and water, may be used in the same tions being compared to having the flesh manner; but the remedy for an infant devoured by myriads of ants, or the skin must always be more diluted than that pierced with red-hot needles. And this for an adult.—When other means have occurs without any obvious reason in el- failed, I have frequently found the fol- derly persons, rendering their existence lowing lotion allay the most troublesome almost unbearable. It is this disease itching:— which is referred to in a preceding para- graph (§29) as the scourge of several ANTI-PRURITIC LOTION. distinguished persons, among whom Dilute pyroligneous acid, half an ounce. Camphorin powder, half a drachm. were Plato, and Charles the Fifth and Infusion of rose petals, one pint. Charles the Ninth of France. Mix. 182. The domestic treatment of in- fants and children is comprised in the Another useful anti-pruritic lotion is the application of the laws of health to the following:— mother as well as to the child. The po- sition of parent is one of serious respon- Chlorate of soda, one drachm. RoSe-water, two ounces. sibility, both morally and physically, and Common water, six ounces. “ the edict has gone forth, that the sins Mix. of the parent shall be visited on the chil- dren.” As the parents bestow their phy- For prurigo, when the preceding formu- sical likeness on the child, so also do they lae fail, a solution of two drachms of sul- their moral similitude, and in those phuret of potash or lime, to a pint of wa- whose moral attributes are essentially ter, might be tried; or the following, bad, it is sin to marry. Many diseases which I have found of great service:— are known to be hereditary, and the sin committed by the parents in marriage Sublimate of mercury, threegrains. under such circumstances is Dilute hydrocyanic acid, two drachms. fearfully Almond mixture, half a pint. avenged, when in old age their comfort Mix. and their prop, and often their support, is taken from them, as the natural con- The latter must not be used to children, sequence of their own want of reflection and, being poisonous, requires to be kept in due season. If we could insure good out of their way. Besides these reme- mothers, we could improve vastly the dies, which are directed to the relief of race of men. These observations may be a troublesome symptom, the diet must be thought out ofplace in a work of this kind, reduced and regulated, stimulants of all but they bear strongly upon the injunc- kinds, both food and drinks, must be tions I am now about to lay upon the avoided, and the tepid or temperate bath nursing mother of a sick infant. She frequently taken.* must, by following faithfully the rules of health in respect of the four great hygi- WATERY FIMI’LES. enic principles of food, clothing, exercise, and ablution, give health with her milk 183. The watery pimples or vesicles to her offspring; she must also pay close are the result of the same action as that attention to her mind, avoid all sources which gives rise to an ordinary blister; in- of irritation and anxiety, and remember flammation is excited in the sensitive skin that an mother sours her milk, angry * [ The of a frequent and continued application cold to and produces a fractious, and often the part affected, until a change is produced, is perhaps diseased infant. I am quite of opinion, the most, useful thing to do, especially in case of prurigo that ifmothers sound in ani, which is exceedingly troublesome. Cold can be ap- were constitution, plied by the use of cold water in case of children, or ice and bestowed the requisite care upon in case of an adult.] 74 ERUPTIONS OF THE SKIN. by an inward or an outward cause, and emits, and which, spreading upon the the inflamed vessels pour out the watery sound skin, causes irritation, and an ex- part of their blood, and so raise the scarf- tension of the disease. The discharge, skin from off the sensitive layer in the left to itself, dries up by evaporation, and form of a small dome, which in some forms a crust, which gets progressively situations, is conical, in others, a segment thicker. Around the lips and on the face of a sphere. As an example of the man- of children this crust forms a kind of ner in which these watery pimples may mask, and on the scalp it mats tlie hair be produced artificially, 1 may mention, together, and is peculiarly unpleasant. that in a case of this kind, of unusual ob- The discharge, however, still continues stinacy, occurring in a young woman in oozing out from the cracks in the crust, one of the French hospitals, a suspicion or from its edges, and distilling in small arose that the patient herself had some drops from the crimson surface of the ex- hand in the continuance of the disease, posed skin when the crusts are torn off; and upon watching her closely, it was and even after the fall of the crust, when found that she was in the habit, every the inflamed surface is covered by a thin day, after the medical visit, of dusting a scarf-skin, there is still some weeping blistering powder over her limbs. The from the oil and hair-tubes. watery pimples, as may be supposed, The presence of a copious watery dis- present great variety in point of number charge in this eruption conjoined with and size; some are so minute as scarcely the formation ofa thick crust, has gained to be discernible without close inspec- for it the appellation of humid tetter, a tion, while others increase to the magni- name which is properly applied. When tude of a hen’s egg. They are numer- it affects the scalp, and continues for a ous in the inverse ratio of their size, the long time, the deep tissues of the skin smaller ones being very abundant, and become implicated, and the pulp of the the larger ones scanty and few. These hairs may become injured, and the hair primary distinctions in the size of the pim- rail. In the latter case the disease be- ple form the basis of their division into comes a cause of partial baldness, and is four genera. The smallest vesicles, entitled to the designation humid, seal! , which are about the size of a pin’s head, or scalled head. A variety of humid and are often clustered together in vast scalled head, in which the humour from numbers, are known by the term ec- the excoriated surface runs down upon zema ; when they are of larger dimen- the hairs, and encloses them in little sil- sions, being equal in bulk to a small pea, very pellicles or sheaths, has received the they are termed herpes ; when of some- name of the asbestos scall. But the what larger size, they are designated term <£ scallis very objectionable, and rupia ; and when they assume the bulk a fertile source of error and mistake. In- of blisters, they are termed pemphigus. fants and young children are subject to 184. Eczema may be developed upon attacks of this eruption on the face, and any single part of the body, or may be the association derived from the nature of scattered over various parts at the same their food, at this period of their lives, has time. In the former instance, it assumes gained for the disease the name of milk the characters of a local disease, and is crust. There is, however, another milk not unfrequently met with on the scalp, crust, to which I shall have occasion to the face, or the ears. It exhibits also, refer when treating of the next group of three degrees of severity; one of these diseases, the mattery pimples. is the simple type; another is remarkable 185. Herpes, like eczema, may be for the vivid ground of red on which the scattered over divers parts of the body “ vesicles are developed ; while in a third, at the same time, thus assuming a gen- the fluid of the vesicles changes from its eral ” form, or it may be limited to a spot, original limpid and watery character to and be “ local ” in its nature. The latter a more or less opaque and yellow matter. is its more common character. It is ea- There is a fourth state, which most fre- sily distinguishable from other eruptions quently follows the decline of the active by its lir.tle dome-shaped, transparent, forms, namely, chronic eczema, and is and pearly bubbles, distended with fluid, characterized by a subdued degree of and surmounting a base of crimson red. inflammation, and long continuance. It is also known, practically, to most per- There is a peculiarity about eczema sons, as a familiar foe, in the shape of which at once distinguishes it from all an eruption, which breaks out upon and other eruptions, and renders it an unusu- around the lips on the dispersion of a ally disagreeable companion, and that is cold, or any slight ailment accompanied the copious watery discharge which it by feverishness. I need not call to mind WATERY PIMPLES. 75 the little bladders of water which form crusts which succeed the rupture of its in that case, nor the hard brown crust vesicles. As far as the latter are con- which succeeds, hut it may be satisfac- cerned, there is nothing to distinguish tory to know that thislittle scourge passes them from those of the two diseases be- under the dignified title of herpes lahialis. tween which rupia is placed ; they are Sometimes these little patches are seen generally larger than the vesicles of around the apertures of the nose, or upon herpes, and generally, but by no means the eyelids and ears, but their family always, smaller than those of pemphigus. likeness to that of the lips at once dis- But the main character of distinction be- tinguishes them. I have had occasion tween rupia and all other diseases of before (§ 168) to remark upon a peculiari- the skin is the formation of unhealthy, ty of disease affecting the skin, namely, foul, burrowing sores, which pour out a its frequent habit of beginning with a reddish and ill-conditioned matter in such small circular spot, which spreads by the quantity, that it collects and dries upon circumference, while it fades gradually the sore, and forms a crust of remarka- at the centre. This character is per- ble thickness. In one variety, called crust ceptible in the patches of herpes, when simple rupia, the is comparable in they attain any size, and the eruption is appearance and apparent construction, then designated vesicular ringworm. In and sometimes, also, in size, to an oyster- one very remarkable variety, the vesicles shell. In another, namely, prominent are arranged in concentric circles, which rupia , the crust is conical in shape, and acquire by age a difference of tint, and resembles a limpit shell. These are the constitute the rainbow ringworm. While two chief varieties of rupia; the third, another, besides being made up of a observed generally in starved and ne- number of patches, which assume more glected children, is distinguished by its or less of the annular character, has a corroding, ill-looking sores, and an ab- tendency to follow a circular direction in sence. or thin and imperfectly formed its course: this latter is the eruption so condition of the crusts. Rupia owes its well known under the name of zone, or origin to a weakly and debilitated con- shingles. The shingles usually embrace stitution, and the local disease, cannot be one-half of the trunk of the body in the removed without renovation of the entire situation of the waist, and very rarely system ; hence, it is always tedious, and the whole trunk. The rarity of the lat- often fatal. ter occurrence has given rise to an un- 187. Pemphigus.—The term pemphi- founded notion, that if the circle were gus, derived from the Greek, and signi- completed, the patient would die. In- fying “ a bubble,” is peculiarly applica- stances are occasionally met with in ble to this disease, which consists of an which shingles form a demi-zone upon eruption of bubbles of scarf-skin, enclos- the neck, face', or head, and they have ing a thin watery fluid. Another term been seen running, for a short distance, by which the disease is known is pom- and in a straight line, along the arm or phalyx, which means, literally, “a water thigh. Shingles are generally regarded bubble.” The French call it the £! bub- as a slight and trivial affection; this is ble fever,” and the Germans, u water- the case in young persons, and adults of bladders.” This is the kind of eruption good constitution. In these, the little which 1 have before referred to as having bladders shrink in five or six days, and been imitated by a girl in one of the are followed by a thin crust, which, in French hospitals, and it will be seen, due time, is rubbed off by the clothes, from its nature, that this can easily be and no trace of the eruption remains, done by any sufficiently stimulating ap- other than some degree ofredness of the plication. The bubbles raised under a skin. In old or weakly persons, however, common blister, are a local pemphigus, the disease is not so easily disposed of; only differing from the disease in ques- small sores are left behind when the tion in being produced by a known and crusts are removed, and the sores are local cause. The bubbles, in this dis- painful, and long in getting well. This ease, are raised upon a base of inflamed latter character establishes a transition skin scarcely larger than the bladder between herpes and rupia. which they support; they occur singly 186. Rupia.—The term rupia is deriv- or in patches, and they vary in size from ed from a Greek word, which signifies the dimensions of a split pea to the half “ dirt,” and it must be confessed that the of a walnut-shell, and from that to a disease in question is open to the impu- hen’s egg or orange. They rise up very tation conveyed by its name, from the rapidly, frequently in the course of a few unsightly appearance ofthe dirt-coloured hours, and break in two or three days. 76 ERUPTIONS OP THE SKIN. when they are followed by an excoriated quiring the highest qualifications of the surface, which becomes covered by a medical art. In domestic management, thin crust, and speedily heals. The va- we must be content to reduce the diet in rieties of pemphigus are acute and quantity and stimulating quality where chronic, the former being active and there is a tendency to fulness; to employ brief in its course, and accompanied by diluents where there is feverishness; a smart attack of feverishness ; the latter and to be cautious where there is doubt. slow, without fever, but with more in- The principle of local treatment is more trinsic constitutional disturbance. This obvious; the evaporating lotion (§ 169). disease has been known to spread as an the fomentation (§ 166), the tepid or epidemic, as was the case in Switzerland warm bath, these are our remedies. in 1752. When crusts collect so as to be unsight- 188. The treatment of the class of wa- ly, or a source of irritation, they may be tery pimples offers to our judgment the softened by a moderate quantity of the two indications which meet us in the following cerate at night, washing it off treatment ofmost other surgical diseases, in the morning with tepid water and namely, constitutional and local attention. soap. If the crust is not so much soft- Mr. Abernethy, many years ago, pointed ened as to come away with the first out the importance of constitutional re- washing, a second or third application medies in local disease; and, indeed, of the cerate will succeed, but no vio- without the force of so high an opinion, lence should be used in the removal. we must feel its necessity. The blood, the nerves and their functions, are more or ALKALINE CERATE. Sweet olive oil, one ounce. less implicated in every local affection; White wax, one drachm. and a shock, however trifling, cannot be Melt the wax in the oil, at a low heat, in a sand or water- given to any part of an instrument so bath, and then add— well attuned as the animal organism, Sub-carbonate of polish, one drachm. without producing a simultaneous vibra- Mix. tion through all its strings ; therefore it When the crust is removed, the inflamed is that so few local disorders exist in surfaces should be dressed with cold which constitutional treatment is not re- cream, or fomented if there be much quired. The main question is, what do heat or inflammation; but if the latter we mean by the term constitutional treat- has subsided, or the eruption is slow ment ? Are we to bleed, and purge, and and chronic in its nature, the following nauseate, and sweat ? Nay, rather than astringent lotion will be found of service. that, it were better to discard physic al- This lotion is very useful in milk crust together. Are we, then, to take the op- and scalled heads:— posite course of idealizing physic, and make a fool of our judgment by gulping ASTRINGENT LOTION. Distilled rose-water, one pint. at infinitessimals 7 Here the error would Sulphate of zinc, twenty to sixty grains. be, it may be admitted, on the safe side, Mix. but it is error. Are we such nevertheless, mode of using it on raw infants that we cannot trust ourselves The surfaces is to dab them with a of to the middle Must we gently piece shape course? fine wetted in For ever repeating the rash experiment of linen the lotion. be scalled the mode or the wilful felo-de-se of the head, proper of appli- Phaeton, cation is to rub it on the surface recognized monomaniac, who gently plunges with the ball of the after the re- into destruction in order to it? finger, escape moval the five or ten min- The answer, I fear, is, Such is the per- of crusts, for and repeat the twice or versity of human nature. The four utes, process three times a day. In cases of scalled great principles of health, food, raiment, where the lotion appears unsuita- exercise, and ablution, are all-powerful head, regula- ble to the skin, or circumstances do not constitutional remedies, and, by admit its the fol- tion and made to of proper application, modification, may be lowing cerate be found to be answer many purposes where health is will equally — deranged. Then there are certain sub- beneficial: stances in nature, known as medicinal, SCALLED-HEAD CERATE. that are also useful assistants. Olive oil, one ounce. Subcarbonate of soda, one drachm. In the constitutional treatment of the Shake well together, and then add — watery pimples, the system sometimes Sulphate of zinc, reduced to very finepowder, one drachm. requires to be lowered, sometimes to be Mix well. toned, sometimes to be altered, but the which is a question, though simple, re- Whenever the bladders are large, the MATTERY PIMPLES. 77 fluid may be soaked up by a sponge, or times yellowish, sometimes brownish, piece of dry linen, in order to prevent and sometimes almost black. The pro- the dispersion of an irritating fluid on duction of a crust, as one of the charac- the skin; and w7 hen of smaller size, ' ters of the mattery pimples, brings them they may be dusted with starch-powder j within the meaning of the term “(tetter with the same object; for herpes on the : and the nature of the crust, as compared lips, the styptic lotion (§ 169), of medi- | with the simple tetter, herpes, and the um strength, used every hour, and for | humid tetter, eczema, cannot be better several minutes at a time, is best suited; ' expressed than by the common popular for shingles, a cloth wrung out of the j name for this eruption, namely, crusted evaporating lotion (§ 169), and applied tetter. When crusted tetter attacks the in the manner described (§ 164). When head, it will probably destroy the hair, the shingles leave small sores behind | and become a scall, the crusted scall. them, the styptic lotion should be used, 190. Among the causes of obscurity and the surface then dusted with starch- which attend the study of the complaints powder ; the same lotion, or the astrin- of the skin, there is hardly a greater gent lotion, are the most suitable for the than the multitude of terms which are unhealthy sores of the rupia. For the applied to them ; and if the various dis- latter, in particular, the following lotion eases had been represented by a chess- is specific:— board, and the nafnes, well shaken to- LIME LOTION. gether in a bag. had then been emptied CHLORIDE OF board, Solutionof chloride of lime, one drachm to half an ounce. upon the so that several names Rose-water, two ounces. should fall indiscriminately on each Pure river water, fourteen ounces. square, there could not be a greater Mix. confusion than reigns over the nomen- clature of these disorders. Impetigo, MATTERY PIMPLES. for example, is one of the crusted tetters, the crusted tetter; its crust, in mattery nat- yellow. 189. The pimples form a some instances, having the aspect of a ural group distinguishable from other dab of honey dried upon the skin; and diseases of the skin by the nature of the this latter resemblance has been deemed fluid which they contain. This latter is sufficient to gain for it the surname of the no longer watery and transparent, or “ honey disease.” This honied expres- whitish and partially opaque, like that of sion is peculiarly to those in- but applicable the watery pimples, opaque and yel- crustations which not unfrequently form low from the first. It is poured out upon on the lips and ears of children. Some- the sensitive skin, and raises the scarf- times they constitute a mask for nearly skin in the same way with the watery the entire face, and the disease becomes pimples, and the resemblance is in- one of the varieties of the “milk crust” creased by the formation of crusts, on (§ 184). Pretty cognomens, it must be the drying up of the matter. But the for disorders, but mattery admitted, unsightly little bubbles of the pimples conveying, in their appearance, any rarely exceed the dimensions of a split thing rather than agreeable reveries of pea in size, and are never so minute as milk and honey, or pleasant associations those of eczema (§ 183.) They are de- of honied in one respect, of lips. Impetigo, veloped on a ground inflamed skin, resembles the humid tetter, namely, in and the degree of inflammation of the the oozing of fluid the excoriated division from skin is the basis of their into skin. It is this fluid, or humour, which two groups, termed, technically, impet- causes the great thickness of the crusts, igo and ecthyma.* The former presents and their reproduction when once re- the slighter degree of inflammation, and moved. A resemblance may be traced, sometimes there is scarcely any redness also, in the manner of evolut.on of the of the skin ; the latter is always accom- for sometimes the matkry pim- panied considerable inflammation and eruption, by ples break out in clusters ol regular form redness. The little bubbles attain their and various size upon a single part of full size in the course of two or three the body, and at other times they are days, and either dry up without breaking, scattered irregularly over the entire sur- or more frequently burst and then dry, face of the skin; the former is termed forming a hard crust, which offers con- figured, the latter scattered ; the former siderable variety of colour, being some- presents occasionally another peculiar- ity, namely. growth by the circumfer- * These terms signify a breaking out with impetuosity, and in centre, and simply breaking out, the former referring to impetigo, ence evanescence the the latter toecthyma. forming a crusted ringworm. Crusted 78 ERUPTIONS OF THE SKIN. tetter sometimes excites St. Anthony’s fomentation. These remedies will curb fire, and at other times is remarkable for the inflammatory excitement without tardiness, and obstinacy of course and interfering with the separation of any duration. When the latter character morbid humour from the system, and prevails, the eruption extends over an will facilitate the indications of nature. entire limb, or deposits an uniform in- When the crusts have formed, the as- crustation around it, so that the limb has tringent lotion (§ 188), used as a fomen- the appearance of a branch of a tree tation, is the proper remedy. Hard with a cracked and rugged bark. This crusts generally act as causes of irrita- kind of case necessarily interferes with tion ; the fomentationwill keep them soft, the motions of the limb, and wherever it and, making its way under the edges cracks, the humour rises up in the crev- and through the chinks of the crust, will ice, and spreads for a little distance excite the excoriated surface to healthy around the opening. Generally, these action. It is often desirable to get rid of oozing streams are tinged with blood, the crust altogether, for which purpose and the crusts which form are of a deep the alkaline cerate (§ 188), comes into brown colour, or black. use. On the head, this is peculiarly 191. I have remarked, that the crusted necessary, for nothing can be done in the tetter may invade the scalp, and when it treatment of these eruptions on the head does so, and remains on the head for any so long as the crusts remain. When the time, it causes fall of the hair, and be- crusts are gone, the astringent lotion comes, in consequence, a “scall.” The (§ 188) applied in the manner already varieties of character which it presents directed, will effectually cure them, not on the scalp have given rise to some of only on the scalp, but also on other parts the idle names assigned to these erup- of the body. In the “ milk crusts” of tions. For example, when the crust is children, it is also a valuable remedy; brittle and greyish in colour, and breaks but in these latter, as they arc necessa- up into little pieces, which are fixed on rily much exposed to the air, a cerate, the hairs like beads upon a string, or by affording a protective covering and scattered loosely among them, the dis- checking evaporation, must be the se- ease is called the granulated scall; and lected vehicle for the remedial applica- when the crust is harder, and, guided by tion. The scailed-head cerate (§ 188) is the hair, forms rigid prominences like most suitablefor domestic use; or in very stalactites in their shape, the disease be- young infants, the zinc ointment of the comes a stalactitic scall. The scalls shops diluted with oil. caused by the humid tetter have been 194. When the mattery bladders of already described (§ 184). ecthyma leave angry sores behind them, 192. Ecthyma.—The mattery pimple the latter must be treated with the as- called ecthyma is that which is developed tringent lotion (§ 188), used as a fomen- on a highly inflamed skin; the blad- tation, and should they continue, with ders are generally of the size of a split the chloride of lime lotion (§ 188). In- pea, and surrounded at their base by a deed. ecthyma and rupia are somewhat broad halo of redness. They are usually allied in their nature. But while the separate, not clustered like impetigo, minister ofcure is busily engaged on the scattered over various parts of the body, local treatment of these diseases, the mo- and followed either by a hard black crust, ral and the constitutional must not be for- or by a sore. Ecthyma occurs either as gotten. There is no medicine for moral an acute or chronic eruption; and in the causes of disease so important as gaiety latter shape attacks weakly children, and of spirits, change of thought, change of persons much reduced by sickness and occupation, and change of scene. Here- famine. In individuals of the latterclass, in lies, in fact, the secret of sea-bathing, the inflamed surface is more or less blue the bath being the excuse for the moral and livid, and the matter frequently co- physic. But there are persons who loured by admixture with blood. would be better suited by swinging on 193. As respects the treatment of the the branch of a certain oak, in a certain mattery pimples, the principle of man- forest, in a certain county, and for a cer- agement of all inflammations of the skin tain time. The patient may imagine will be correct in this. The redness, that it is the concatenation of swinging, swelling, and pain, which precede and ac- tree, and county, that is to do the good, company the evolution of the pimples, if he please, but the prescriber knows call for the use of the evaporating lotion, fullwell that the secret lies in the change either cold or tepid, as the sensations may of thought, occupation and scene. Mr. prefer, or if more grateful, the warm Abernethy’s story of his treatment of a SCALY ERUPTIONS 79 patient is a never-to-be-forgotten illus- times difficult to decide which. In im- tration of the importance of moral medi- petigo, it is generally the former; in cine in physical disease. A gentleman ecthyma, the latter. The doctor must he engaged in duties involving much re- consulted to solve the doubt. sponsibility and anxiety, consulted Mr. Abernethy for the cure of a string of ail- ments that rendered him incapable of SCALY ERUPTIONS. performing the obligations of his office ; 195. The scaly eruption, or dry tetter, he assured the surgeon, that to leave is a form of inflammation of the true skin, town for the sake ofhis health was utter- distinguished from the rashes and pim- ly out of the question, and that he could ples by the alteration of the scarf-skin, not be spared for a day from his engage- which immediately covers the inflamed ments. Mr. Abernethy pondered; he part. In the onset, the eruption makes knew the doctor who would certainly its appearance as a small, dull-red. spot, cure the gentleman ; but then he lived in slightly raised above the level of the one of the most remote towns of Scotland. surrounding skin, constituting, in point The and such gentleman reflected ; upon of fact, a broad and flat pimple, almost strong assurances of cure from Mr. Ab- as large at its summit as at its base, and ernethy, determined on the sacrifice of of about the diameter of a split pea. quitting his business, and seeking the Upon the surface of this pimple the Scottish iEsculapius. He started by scarf-skin becomes slightly roughened, mail, full of expectation and hope; busi- and after a little while, a very distinct ness was forgotten; anticipations of cure but thin circular scale is produced. The filled his mind, not unmingled with grati- little scale increases in thickness by the tude towards his adviser. The town addition of fresh layers to its under sur- was reached, but no physician found; no face, and has a bright, silvery lustre, such house, no such street, no such person which is due to the extreme thinness of known. Enraged at being made the dupe the layers of the scarf-skin. The per- ofan eccentric surgeon, he immediately sistence of the eruption in the form I am returned to London, thoughts of a very now describing, namely, as small pim- different nature to those which previously ples scattered over the skin, each pimple engaged him occupying his mind— being surmounted by a white, silvery, thoughts so tempestuous, that the loss of laminated scale, constitutes one variety a week in travelling and expectation of scaly disease termed lepra guttata,* were drowned, and with them, every from the Latin, gatta, ;t a drop,” the ap- consideration of his usual occupation. pearance of the eruption giving the idea Arrived in town, he drove with all speed of a number of drops of water hanging to a well-known door in Bedford-row, on the skin. The eruption does not, and was ushered into the presence ofMr. however, constantly retain its early pim- Abernethy, whom he at once overwhelm- ply character; more frequently, the pim- ed with a storm of indignant expostula- ples increase in dimensions, and spread tion. Mr. Abernethy smiled when a out into the form of circular patches, calm was at last restored, and asked having the size of a shilling, or half-a- after the gout; but the gout and all the crown, or crown piece. This enlarged other ailments had been forgotten in the growth naturally requires time; and in excitement of the journey; and the gen- proportion to the period occupied in tleman was bound to acknowledge the growth is the thickness of the laminated his wisdom of adviser. Railroads, unfor- scale ; the latter, however, never exceeds tunately, put this kind of practice out of in thickness a piece of moderately thick the range of possibility at the present paper, and always preserves its beautiful day; but they offer in return, advantages silvery aspect. There are no humours, which if properly used, are in reality no irregular, unsightly crusts, no excori- superior. An hour takes the invalid to a ated surfaces in this eruption; in fact, classic and delicious ramble, thirty miles there is nothing repulsive; but, on the from London, and the same conveyance contrary, if it were the general instead brings him back to lunch or dinner. We of being the exceptional, it would be do not lack the opportunities, but the thought very beautiful and highly fash- judgment to use them. But to return ionable. I have already more than once from this long episode, the moral and announced a principle of cutaneouspa- constitutional symptoms must be regard- thology in the changes which accom- ed in conjunction with local disease. The constitution be full and * The professional reader will perceive in the descrip- may inflammato- tion of the next group my reasons for considering this ry, or low and debilitated; it is some- form of eruption as a lepra. 80 ERUPTIONS OF THE SKIN pany the circular growth of all the erup- ceding paragraph, the pimples sometimes tions of the skin, namely, the decline of come oat in thick clusters, and so blend the disease in the centre, while ihe on- and interfere with each other, that the ward march takes place by the circum- disease can scarcely be distinguished as ference, until a distinct ring of greater or the same. Instead of distinct circular less dimensions is produced. Another forms, we have now irregular patches of illustration of this principle occurs in the every size; instead of one well-formed scaly eruptions; for as soon as the pim- and thick scale, there are numerous small ple attains the dimensions of a fourpenny and thin ones; and instead of a de- or sixpenny piece, and still more as it pressed centre and rising edge, the sur- becomes larger, a distinct depression is face is uniform : but the disease is essen- apparent in the centre of the little patch, tially the same, though unruly in its rise with a consequent rising towards the out- and obstinate in its progress, and though, ward edge. These are the characters moreover, it has received from medi- which distinguish the common dry tetter, cal authorities a different appellation, technically, lepra vulgaris. By the time namely, psoriasis , which may be Angli- the circular patches reach the size of a cised into irregular dry te'ter. The cir- shilling or half-a-crown, the scales usu- cular dry tetter, or lepra, exhibits a par- ally fall off, the last part to give way be- tiality in its eruption for the vicinity of ing the central point, which, as it is the joints,particularly the knees and elbows ; oldest, is also the most dense and gener- and this is remarkably the case in the ir- ally the thickest. When the scale falls, regular variety; so much so, that it is portions of scale continue to be formed common to find the latter about the on the prominent parts of the patch, but joints, and the former upon the limbs cf no new scale similar to the first; and the same person. The scaly eruptions very frequently the surface looks red have a taste also for symmetry, for and angry, and remains bare till the not only do they attack both elbows eruption declines altogether. Some- and both knees at the same time, but times the circles continue to enlarge un- very frequently the form of the patch is til they give way at one or two points, of similar shape on corresponding parts. and then previous observation and expe- Another frequent seat of the irregular rience can alone determine what the ug- scaly tetter is the scalp, limiting itself ly red patches which remain, in reality, rigidly to the boundary allotted to the are. Two other designations have been hair, but nevertheless, a very trouble- given to the scaly eruption termed lepra, some companion. Happily, the scaly as characteristic of varieties of appear- eruptions have no ambition to appear ance, namely, alphoides and nigricans. upon the face, their more common situa- The former of these, which simply means tion, with the exception of the scalp, be- “ white,” is applied to the eruption when ing the limbs. The variety of scaly the patches cease to enlarge, after attain- eruptions described in the preceding ing the size of a fourpenny or sixpenny paragraph as “ lepra guttata” is usually piece, the scales at this time being whiter ranked among the present family from than at any other. The other term re- the thinness and imperfection ofits scales, lates to a lividity in the hue of the patches and the absence of a size sufficient to give when they occur in persons of weakly it the decided character of the circular and debilitated constitution, the livor be- dry tetter, but its truesignification is that ing of the same nature with the blueness which I have assigned to it. By a French of the lips and fingers of a boy or girl author, it is called the isolated dry tetter, whose energies are not sufficient to keep the common form being the diffused dry them warm on a winter’s day. tetter; to these are added a third, but 196. The unprofessional person will rare variety, characterized by a disposi- perhaps, long ere this, have indulged a tion to creep along the skin in a curved smile at the gravity with which, in mag- and serpentine course; this is the gyrat- niloquent phrase, I have propounded the ing dry tetter; while a fourth is an ag- laws of cutaneous disease. And I am gravated state of the diffused kind, which quite ready to admit, that the subjects spreads over an entire limb, and main- for whom I am making such equitable tains its ground with the obstinacy pic- laws are, in many instances, very refrac- tured in its name, inveterate dry tetter. tory personages, and very apt to take Of these dry tetters, there are some an- the law into their own hands ; and so it noying and obstinate varieties which oc- is with the scaly eruptions, for instead of cur on separate parts of the body with- obediently breaking out secundum artem, out affecting others; one, for example, and according to the laws stated in the pre- locates itself upon the eyelids; another SCALY ERUPTIONS. 81 on the lips; a third beneath the finger- clears the hair for a time; they speedily nails; and though last, by no means collect in large quantities, and if not least, on the palms of the hands. In carefully and frequently removed, be- these situations, the disease is a cause come a source of still further discomfort, of great discomfort, from the unsightli- and one also of much unsightliness. ness which it occasions, and from the The annoyances which originate in this £; bad name” which attaches to all erup- vexatious complaint have given birth to tions upon the hands. Sometimes, the popular expression by which the curiously enough, it pitches on the disease is knowm, namely, dandruff, an tongue. appellation derived from two Saxon The preceding forms of dry tetter are words meaning “ itch” and‘ £ dirt.” Chil- sufficiently distinguished from other cu- dren and elderly persons are more liable taneous diseases by the swelling, or to dandruff than others. Those circular rather thickening and hardening of the red patches of about the size of a shil- skin which accompany them; by a dis- ling or half-crown which appear on the position, when extensive, to crack and face, and look as though they were dusted chap, the chaps being without humour over with little scales, are instances of and dry; and by the formation ofscales, the branny tetter. Sometimes they sur- sometimes of remarkable construction round the mouth to the edge of the lips, and of large size, but at all times of con- and sometimes also they affect the eye- siderable dimensions. lids. 197. I have now to describe a scaly 198. There is no class of diseases more eruption, in which there is more or less intractable than the scaly eruptions, and of a dry and reddened state of the skin none that more obstinately defy the best- occurring in patches of every variety of directed medical treatment. The dan- size, and accompanied by a copious pro- druff is, however, an exception to this duction ofminute bran-like scales. This general accusation. Domestic treatment disease has received a name derived should be principally directed to the regu- from a Greek word, meaning “ chaff,” or lation of the health by strict attention to “ bran,” namely, pityriasis, or the bran- its rules. The scales may be easily re- ny tetter. It may occur on any part of moved by the alkaline cerate (§ 188),and the body, but like its predecessors, ex- after these have fallen, the common hibits a predilection forcertain situations, sulphur ointment used, with long-con- and those, strange to say, generally the tinued friction. Under the influence of opposite to the ones selected by the other sulphur, used as a stimulant, this and dry tetters, from which one might infer other chronic affections of the skin will that, as all the scaly eruptions are essen- sometimes get wr ell. On the same prin- tially of the same nature, the difference ciple, vapour baths, medicated wdth sul- in the characters of the branny tetter is phur or iodine, are often of great service. probably referrible to a difference in the But the best of all external remedies for nature of the skin, or of the part on which lepra, and that which is almost wholly it is developed. The more common seats confided in at the French hospitals, is the of the branny tetter are the face, the tar ointment, of which creosote ointment scalp, the breast, the hands and feet, and is a refinement. When dandruff occurs the bendings of the different joints. These in young children, it is necessary to parts, with the exception of the palms and modify our remedies to suit their peculiar soles, are usually those in which the susceptibility of skin. The alkaline ce- scarf-skin is thin and the skin delicate, rate, diluted one-half, will remove any and the same qualities render persons crust or scales which may have collected who have naturally a thin and suscepti- on the skin, and the weakest formula of ble skin, most subject to this disease. the astringent lotion (§ 188), rubbed on Hence we find it more commonly in the part with the ball of the finger, will children, women, and elderly persons, remove any disposition in the skin to the than in robust men. All the dry tetters production of more. In the adult, the excite some degree of itching, particu- white precipitate ointment is an useful larly at the period of the fall of the scale, remedy both in dandruff and lepra, par- but none so much as the branny tetter, ticularly when the latter affects the hands; and the latter is particularly annoying but it requires to be used with precau- when it affects the hairy scalp. In this tion. Dry friction of the eruption, exer- latter situation, the itching is sometimes cise of the body to perspiration, and the unendurable, and the efforts to relieve it shower-bath, conjoined with an abstemi- bring down a shower of little shining ous diet, will often cure lepra after all scales. The most careful brushing only other means have failed. Brushing the 82 ERUPTIONS OF THE SKIN. patches with a flesh-brush, until they 200. The parasite of the human scarf- become tender, is also an useful remedy. skin is a species of mite, the “ acarus sca- ” biei (plate 5) ; the largest I have ex- ANIMALCUI.AR ERUPTION. amined measured the seventy-seventh part of an inch in length: that is about 199. The presence of animals in the the seventh of a and was of of such minute size part line, skin man, as the naked scarcely to be perceptible without the scarcely distinguishable by It is sub-globular form ; has a aid of is a eye. in microscopic power, phenome- brightly shining which reflects to excite the lively inter- coat, the non calculated light, and gives the animal theappearance est of and it is one to every zoologist, of a minute of a turned attention very bladder water, which I very early my comparison suggested its when pursuing the investigations traced by early ob- eight legs, four in front near out in this book. I soon had proof that servers; head, and four imperfect ones under- there existed a parasite within the scarf- the neath its body, and a strong, tortoise- skin peculiar to man ; and more extended ; indeed, it observation me to that the shaped head altogether, offers led believe much the character of a tortoise, with its was universal distribution among genus of arched and convex a under- animals. I have found it in the back, flat horse, and two legs, each almost and it in the Transactions of the surface, large figured the size of the head; on either side of the Veterinary Medical Association. I have latter, the resemblance, moreover, is in- seen in the mouse, and more re- it. also, creased manner which the the From these ob- by the in legs cently in pheasant. to from the front border of I am to that appear project servations, inclined think the But here the likeness ceases, man forms no to general body. exception the for hinder show them- and that a state of the the legs scarcely rule, in nature, selves beyond the outline of the body, little creature be found abundantly may and the creature runs with his the human scarf- considerable in peculiar habitat, rapidity, raising its body above the level skin ; but that artificial habits and man- of its head. The skin or shell of the an- ners have almost driven out of the him is white and ofpolite how- imal beautifully ribbed, and pale society. Occasionally, the head and are covered by a he makes incursions his an- fore-legs ever, upon of reddish like the horny case cient but is back with layer skin, haunts, driven of the The back presents whenever he is discovered. It insect tribe. wrath a number of and seem there are no protective projecting spines long would that porcupine hairs, set on round tubercules, game-laws for the unfortunate u curmud- “ ” and out in all are by no means similar hairs stand direc- geon,” yet battues tions from the segments of the under sunny skies different infrequent the of Italy, On the hinder the hairs and he is much indebted legs. legs, are with ourselves very long, and trail behind in to the perpetuation of the tax on soap. walking. we could divest our minds of a certain parasite has a peculiar objec- If The little we should, I think, accord to tion to soap, and cheap soap would go prejudice, him. The an animal such as I am now describing far towards exterminating the “ and for the lower which epithet beautiful,” perhaps baths orders, will “ The zoologist cannot do them clean skins and fresh linen, elegant.” give and there are its or- also against a otherwise, parts of are angry threatenings that evince a marvellous race, and should be as much ganization persecuted ; parts to discountenanced by a hu- beauty of structure the which as possible I now allude are the fore-feet, which are and discerning public. The ladies, mane composed of a delicately thin membrane, with their anger ; he again, pursue him divided into three and is known to possess an acute sense lobes, furnished of with three little which raise the and is sickened by the cruel com- tendons, smell, surface applied to the ground, and pro- pounds of the perfumer. To him the ” ducing a the footing of “ eau de millefleurs is a thousand dag- vacuum, secure ” little and make it difficult the “ eau de a perfidious the creature, gers, Cologne and almost to displace him the little oflavender impossible enemy, and bundles against his It is this circumstance spikes which the country maiden hoards will. which renders a foe, when in her absolute poison. I trust him steadfast drawers, he is permitted to set foot on the skin; that none my readers will take ad- of but his tenacity of hold acts against vantage of my candour in pointiug out “ ”* when to bring him out the points of the little brigand himself we seek weak from his burrow for examination. For to torment him any further. upon inserting the point of a needle into * The name by which he is popularly known in Gas- hold cony. his hiding-place, he foolishly lays ANIMALCULAR ERUPTION. 83 upon it with his tenacious feet, and so is ragged state of the scarf-skin which he easily drawn out. When placed upon invariably occasions. Indeed, this latter the skin, the acarus sets himself to work, character I look upon as the only essen- with his head and fore-feet, to make a tial mark of itch, the only proof of an ani- hole in the scarf-skin; into this he intro- malcular disorder, and in its absence the duces the front half of his body, and the suspected disorder is certainly not itch. rest speedily follows. The work of bur- I make this remark, because the itch is rowing is now easy, and he soon makes usually regarded as a revolting and un- a channel or burrow many times his own pronounceable disorder, but I have no length, and at the end of this, excavates hesitation in declaring that nineteen out a small chamber, in which he rests from of every twenty cases of so-called itch his labours, bores for his food, and turns are not the affection I am now describing; himself round when occasion needs. consequently, are not itch, and conse- When his supplies are exhausted in his quently are not communicable. little cave, he works onwards, and makes 202. The cure of itch is founded on another, and retraces his steps from time the distastes of the little animals; I have to time, to enjoy the fresh air, perchance, found camphor and musk, rubbed toge- or to select a more agreeable and com- ther with olive oil, constantly destroy modious site for his exertions. It is pro- them inyoung children inwhom delicacy bable, also, that he is actuated in seeking of skin forbids more stimulating re- for change by a necessity of giving up medies. In like manner, the following his old domicile to a young brood, which lotion, used five or six times a day, will require a convenient situation to wax in destroy them in children: — can assume strength before they the Sulphuret of potash, half an ounce. mining habits of their progenitors. Water, a pint. 201. It will occur to every one, that But the most efficient of all the poisons these evolutions, these marches and of the acarus scabiei is sulphur, inalmost sappings and counter-marches, these any form, provided that it be well rubbed minings, cannot take place in close prox- into the skin. This latter consideration imity as with so sensitive an organ the is highly important, for the little creature true skin without exciting some tickling, is ensconced at the end of a long some itching, in fact; and this circum- safely gallery, and unless the remedy be so ap- stance has given the popular name to plied as to enter the gallery, he is com- the But the annoyance, namely, itch. paratively safe. To obviate this possi- the itching is not the painful symptom I bility, the instructions in using sulphur to connex- have had occasion describe in ointment are, to rub it in for half an hour ion with the dry pimples (§ 179) ; on the together before the fire, w armth render- it is so far that a r contrary, bearable, it and diffluent and then said ing soft like oil, royal authority, James the First, is the patient is to betake himself to bed to have remarked, that the itch was fitted with a charge of ointment remaining on only for kings, the scratching being so the skin. Pour applications of this kind, exquisite an enjoyment. Indeed, nomen- one night and morning for its that namely, two clature is so eccentric in gambols, days, are sufficient to exterminate an en- we as often hear the thing, for I can tire colony, and destroy the eggs; and a hardly call it disease after such evidence, “ ” thorough wash afterwards, with plenty of spoken of as the scratch as by any a warm bath, completes the But effects caused soap, in other name. the by cure. For domestic purposes, the simple our little engineer are not limited to the ointment of the should be of an the sulphur shops production uneasy sensation, the remedy employed, half an ounce of skin in his vicinity looks more or less sub-carbonate of soda being added to red, little conical, watery pimples rise each pound of the ointment, and half-a- here and there upon the surface, and pound of the latter being used at each where the skin is peculiarly sensitive, or For children half this animals are active or application. the little unusually quantity will be sufficient. Another ex- numerous, mattery pimples even are de- cellent remedy, to be used in a bad similar veloped. To which, in very cases, manner, is the following:— when thepimples are scratched and torn, open sores. It must not Sublimed sulphur, quarter of a pound. may be added pound. be supposed, however, that all these Parings of white curd soap, half a signs are necessarily present in itch ; I Add boiling water to the mixture, and have seen cases in which there was no stir the whole together until it acquires other indication of the presence of the the consistence of cream. A fourth part marauder than his little burrows and the of this will be enough to rub in at one 84 ENLARGED PAPILLA OF SKIN.
the must time ; but question of quantity l always be determined by the extent of! the colonized skin. It is frequently lim- j ited to a small extent, in which case that CHAPTER XV. alone would require treatment. The principle should therefore be, to saturate i ON WARTS AND CORNS. the part completely. 203. Sulphur has obtained the credit 1 204. The next group of disorders of of being a specific for itch, and so it un- the skin carries us away from the gene- doubtedly is, when properly applied. ral affection of the true skin, termed in- What its precise mode of action may be, flammation, to an unnatural state of one I am not quite sure; but I believe it to of the constituents of the skin, namely, to depend upon the formation of sulphuret- the papillge (§ 20) ; the proper designa- ted hydrogen within the skin, this gas tion for the state of the skin which exists being highly destructive of animal life. in these disorders being, enlarged papil- It must not, however, be inferred that be- Ice. We have therefore to consider the cause sulphur cures the itch, everything causes which are capable of giving rise which sulphur cures is therefore the to enlarged papillae; and secondly, the itch. I have heard such an argument, effects which result from their enlarge- or rather abuse of argument, used. ment. With regard to the first inquiry, Nevertheless, as a stimulant is useful in it may be stated that the papillae obey all diseases of the skin that need stimu- the law of increase observable in all other lation, if the latter condition exist, it will structures of the body when subjected to cure them. But sulphur, besides being excitation, whether that excitation be a stimulant, is also an irritant to delicate natural, that is, dependent on actions skins, or if its use be prolonged, it may taking place within the system; or artifi- be the occasion of an eruption similar to cial, that is, resulting from irritation the eruption of itch. Now, if the erup- which reaches them from without. The tion, instead of the animalcule, should be papillae of the sensitive skin have been looked upon as the disease, why, sulphur described in a former chapter as being ointment will perpetuate the supposed uniform in length, and their length so disease, until either the skin gets accus- inconsiderable as to be undistinguishable tomed to the irritation, or the treatment to the eye, excepting in certain situations. is changed. ' This is the explanation of Now, it occasionally happens that a small cases of itch being months under cure, cluster of these papillae, amounting to when three days is the proper average. from five to twenty or more, in number, To apply the remedy effectually, it is take upon themselves to grow in length important to know the common seat of and bulk until they attain a gigantic the colony; this is the thin skin and pro- stature in comparison with their fellow tected parts between the fingers, the papillae (plate 6, fig. 2). They may, for bends of the wrists and elbows, the same example, reach a line in length. Again, parts on the legs, and the front of the it will be remembered that the papillae of trunk of the body, and here the ointment the sensitive skin are covered and pro- shouldbe most vigorously used, although tected by the scarf-skin, and that the it must not be spared on other parts. thickness of the scarf-skin bears an exact Another necessary and important pre- relation to the size of the papillae. It caution is the destruction or fumigation may therefore be inferred, that if the pa- of all the clothes worn by the affected pillae grow to this prodigious size, they, person, for one of these minute creatures intheir turn, will occasion the production remaining in the meshes of the cloth of a proportionate quantity ofscarf-skin, will be sufficient to reproduce an entire which will form a rounded prominence colony. The sulphur fumigation is of on the surface of the body. Such is the course the best tor the purpose, and reality, and the little prominence so pro- chlorine will be found a good auxiliary. duced is termed a wart (plate 6, fig. 1). The clothes should then be kept scented The size of the wart in height has refer- for some time. ence to the length to which the papillae have grown; its breadth depends on the number of the enlarged papillae; and it is quite possible that the growth of a single papilla might be the cause of a wart which would necessarily be of slender proportions. But the separate papillae in an enlarged cluster are always more WARTS AND CORNS 85 or less isolated, and each papilla acting or “ corn.” When the pressure, and for its own protection, throws out the consequently the thickening of the scarf- material for its own separate sheath of skin is distributed over an extensive sur- scarf-skin, so that, in reality, the wart of face, the state is properly a callosity. moderate size is a bundle of smaller Where it is limited, occupying, for ex- warts, the number of the latter being the ample, the prominence of a joint, and number of the papillae, and the whole where, in consequence of this limitation, being kept together by the ring of natu- the effects produced are more severe, ral scarf-skin which surrounds them. the case is one of corn (plate 6, fig. 4). This will serve to explain the well-known Callosities may occur on any part of the fact, that an old and worn wart always body where much pressure exists; on looks ragged at the end, as though it the shoulder, for instance, in persons who were composed of fibres, the fibres being are in the habit of carrying burdens ; on the above described sheaths; and more- the hands in certain crafts ; on the elbows over the wart has a tendency to split in a and knees, and on different parts of the longitudinal direction. Again, if we cut feet. Corns are usually limited to the off the top of a wart, the section gives feet, and are, in fact, a more severe de- the idea of the division of a bundle of gree of callosity. The papill® of the fibres ; if we cut a little further, we pro- central part of the corn are enlarged to bably divide a point from which the blood such an extent as to be equal in magni- oozes ; this is the extremity of the long- tude to those of a wart. In this state, est of the papillae, and a little nearer the the papillse take on the action of produc- base of the wart we should cut across ing separate sheaths of scarf-skin in the several. The common situation of warts samemanner as warts, and these sheaths, is the hands; sometimes they are pro- seen on the cut surface of a corn, give duced on the face, and less frequently on the idea of fibres, which popular igno- the other parts of the body. Their cause rance magnifies into roots. A corn ex- is unknown; but from their frequent tracted by its roots is therefore expected occurrence in schoolboys, dirt may be never to grow again, because trees, supposed to have some share in occa- which have roots, when torn up from the sioning them. It is a popular belief that ground never re-apgear. But the fact is, the blood which flows from warts, when that these so-called roots are, in reality, wounded, will cause them to grow on branches, and they may be cut off’, and whatever parts of the skin the blood torn off, and twisted off, as long as the touches; and schoolboys, who love ex- possessor lives, without curing the corn, periments, occasionally adopt this method unless the cause, namely, the 'pressure of transplanting them, but without suc- and friction , be removed. When the cess. Indeed, there is no truth in the cause is taken away, the papillse return supposition, and if a fresh crop should be by degrees to their pristine bulk, and the produced around a wart that has been corn disappears. teased by a schoolboy, the fact, when it 206. It will be apparent to every one, happens, admits of a more philosophical that if a shoe of a certain size be worn, explanation. and if this shoe, by its two small dimen- 205. The wart may be regarded as the sions, and consequent pressure, occasion effect of an excitation acting generally a corn, the corn, by increasing the size from within; but instances are not want- of the injured part of the foot, will neces- ing, in medicine, to prove that they may sarily increase the pressure on the al- also be dependent on an obvious external ready irritated skin. Pain and inflam- cause of irritation. mation follow this injury, and the least I now turn to a growth of the skin an- mischief that can happen is the enlarged alogous to the wart, but occasioned by growth of the papillse, more blood than an evident external cause, the cause in natural being now habitually sent to this particular case being either pressure them. But, on a particular day, when or friction, or both combined. Whenever vanity triumphs over comfort, and the a portion of the skin is subjected to long- “ light fantastic toe” has been more than continued and unequal pressure, the pa- usually wronged, blood bursts from the pillae of the sensitive skin are stimulated, pores of the sensitive skin, and the next and grow to anunusual size. Associated morning, when the corn is inspected, it with this increase of growth of the papil- has the character of a bruise. The doc- lae, is the increased thickness of the scarf- tor is sent for, a poultice is put on, rest skin, and this latter being the outward enjoined, and in a few days all is again and perceptible effect, is denominated, well; too well, in fact, to allow experi- according to its size, either “callosity” ence even a whisper. A gay party again 86 ENLARGED PAPILLAE OF SKIN. does slaughter on the unfortunate corn, professional chiropodist effects this object but similar means restore it as before. very adroitly; he generally works around Now I have had the opportunity of ex- the centre, and takes out the fibrous por- amining a corn which has been thus tion in a single piece. He digs, as he maltreated, and its section is precisely says, for the root. There is another way that of the geological section of a strati- of disposing of a corn which I have been fied mountain,stratum following stratum, in the habit of recommending to my of various hues, from a delicate yellow, friends; it is effectual, and obviates the to the deep black of dried blood, each necessity for the use of the knife. Have black line being the chronological memo- some common sticking-plaster spread on rial of a white day in the possessor’s ex- buff-leather ; cut a piece sufficiently large istence (fig. 4). to cover the corn and skin around, and 207. I must not dismiss the subject of have a hole punched in the middle of ex- corns without adverting to another tor- actly the size of the summit of the corn. ment, and one less easily guarded against Now take some common soda of the oil- than the preceding, namely, the soft shops, and make it into a paste, with about corn. The soft corn occurs between the half its bulk of soap ; fill the hole in the toes, and is produced in the same man- plaster with this paste, and cover it up ner as the common corn ; but in conse- with a piece ofsticking-plaster. Let this quence of the moisture existing in this be done at bed-time, and in the morning situation, the thickened scarf-skin be- remove the plaster, and wash the corn comes saturated, and remains permanent- with warm water. If this operation be ly soft. The soft corn, again, rarely repeated every second, third, or fourth becomes convex outwardly, but presses day for a short time, the corn will be re- severely on the deep textures, and gives moved. The only precaution requiring little indication, as regards size, of the to be used is to avoid causing pain ; and torment which it occasions. It is no un- so long as any tenderness occasioned by common thing to find a blister formed the remedy lasts, it must be repeated. under the soft corn, and its fluid oozing When the corn is reduced within reason- through a small round aperture in the able bounds by either of the above modes, centre of the latter. Sometimes, also, or when it is only threatening, and has the soft corn is followed by a deep and not yet risen to the height of being a sore painful sore, and inflammation of the foot; annoyance, the best of all remedies is a and on one occasion I examined a soft piece of soft buff leather, spread with corn which had eaten into the bones, and soap-plaster, and pierced in the centre produced inflammation of a joint. Dis- with a hole of exactly the size of the eased bone originating in soft corns is no summit of the corn. Ifit can be procured, infrequent occurrence. a better substance still for spreading the 208. The treatment of warts is to pare plaster upon is “ amadou,” or “ German the hard and dry skin from their tops, tinder,” commonly used for lighting ci- and then touch them with the smallest gars, and kept by the tobacconists. This drop of strong acetic acid, taking care substance is softer than leather, and does that the acid does not run off the wart not become hard and ruck up, as the lat- upon the neighbouring skin, for if it do, ter does, after it has been on for a short it will occasion inflammation and much time. The soft corn is best relieved by pain. If this practice be continued once cutting away the thick skin with a pair or twice daily, with regularity , paring of scissors, avoiding to wound the flesh ; the surface of the wart occasionally, then touching it with a drop of Friar’s when it gets hard and dry, the wart may balsam, and wearing habitually a piece be soon effectually cured. of cotton wool between the toes, changing The same treatment will keep corns the cotton daily. Caustic, as an appli- under, in spite of pressure; but there is cation for the cure of corns, is a remedy a knack in parting them which I will which should be used with great caution, now explain. The end to be gained in and would be better left altogether in the cutting a corn is to take off the pressure hands of the medical man. of the shoe from the tender papillae of the sensitive skin ; and to effect this ob- ject, the summit of the corn must be cut in such a manner as to excavate it, the edges being left to act as a bolster and still further protect the central part, where the longest, and consequently the most sensitive papillae are found. The NJEVI, OR MOTHERS’ MARKS. 87 sion of seeing a red dab on their child’s forehead, iftheir ladies choose to have an ungratified longing for a feast of peaches CHAPTER XVI. in mid winter.—Neither need mothers wrong themselves by idle reproaches, from supposing that any unchecked de- ON DISORDERS OF THE BLOOD-VESSELS sires on their part a cause of AND NERVES OF THE SKIN. became deformity to their offspring. They have to attend to the four cardi- MOTHER S’ MARKS. merely great nal rules of health, so often spoken of 209. Under the title of abnormal state in this book, and cultivate a calm mind ; of the cutaneous vessels are to be des- Nature will do the rest.* The subject cribed certain marks and patches on the of treatment I may dismiss summarily ; skin, known under the popular name of cases of this kind should be early sub- mothers ’ marks; technically navi. To mitted to the judgment of the medical explain the precise nature of these marks, man, for the marks are apt to enlarge, I must refer my reader to paragraph 20, and if they increase to any magnitude, in which the capillary vessels and the they get beyond medical relief, and are rich network which they form in the tis- sometimes fatal. They should on no ac- sue of the true skin, are described. The count be meddled with or teased by fre- so called mothers’ marks are nothing quent examination. They will sometimes more than an excessive dilation of these subside by the use of a gentle degree of capillary vessels on a spot of skin vary- pressure made with a piece of soap-plas- ing in size from a mere point to a patch ter, spread on leather, which has the ad- of several inches square. The simplest ditional advantage of keeping them out form of nrnvus is that which is called the of sight and observation. When hot and “ spider-markit is a small red point painful and attended with throbbing, the from which a number oflittle straggling evaporating lotion (§ 169). or the styptic vessels radiate on all sides. This mark lotion, will confer temporary relief. is usually developed on the face, and not unfrequently on the cheek; sometimes the mark resembles in size and colour a DISORDERED STATE OF THE NERVES. red currant; sometimes a cluster ofcur- 211. The nervous as respects rants ; sometimes a strawberry or rasp- system, its natural and ordinary functions, is en- berry ; and sometimes is uniform and of considerable extent, and is compared to veloped in mystery. We are acquainted a lobster. These marks are generally with its laws of action, with the results slightly raised above the level of the sur- of that action, and latterly have acquired rounding skin, and are subject to much some new information with regard to its variety in tint of colour, in accordance structure. But all the knowledge that with the quantity ofblood flowing through has hitherto been obtained tends only to them. when the circulation is prove to us how utterly insignificant are Thus, of naturally active, or the individual is ex- our powers investigation, and how cited by moral causes or exercise, the futile our attempts to comprehend the marks are bright red in colour; while, secret workings of the handicraft of an on the other hand, in cold weather, or Almighty Creator. It has been con- under a depressed state of the mental ceived that anatomy and physiology powers, they become claret-coloured, or have a tendency to bias the mind of the bluish, or livid. Again, there are some student of this branch of science in fa- which are permanently livid and dark- vour ofmaterialism. This is a reflection coloured, and they are styled black-cur- on the works of the Creator, on the part rants, blackberries, sloes, unboiled lob- of those who make the accusation; for sters, and other fantastic names. These to suppose them capable of giving birth blue marks are such as have a more di- 1o such a thought, is to imagine a lated state of the vessels, and a slower grossness of composition which the real current of blood, than the red kind, and student knows to be incorrect. How consequently afford time for the transition opposite is the truth! The material of the blood from its scarlet arterial tint, composition of the nervous system may to its venous and dark-coloured hue. be said to be thoroughly well known; 210. The notion of marks having its actions are also known. The brain, these the any connexion with the imagination of for example, is material abode of the the mother is ; perfectly fabulous so that * [Again it is necessary to suggest that there are six husbands need be under no apprehen- “ great cardinal rules.”] 88 ALTERED COLOUR OF SKIN.
soul, of thought, sensation, and will ; surface. This is obviously a morbid then there are nerves of sensation, sensation, depending on a present mor- nerves of motion, and nerves of special bid state of the nervous fluid. But what perception. The judge of his fellow- is the cause ? And how can we remedy man who has the hardihood to stigma- it? The former question can only be tize him in the eyes of the ignorant, by answered by generalities having refer- applying to him the appellation “ mate- ence to the health of the organization, rialist,” will probably infer, that science such as deranged digestion, disordered distinguishes a particular apparatus for functions of other kinds, &c. As re- thought, another for sensation, another spects the latter, we examine all the for will, and another for motion. How functions through, and if any be out of different is the fact! One simple, col- order, we endeavour, by general means, ourless fluid, hardly dissimilar to the to set them right. And with regard to colourless element of the blood, is the the local inconvenience, experience aids agent in the hands of the Almighty for us by recording certain substances which the development of these extraordinary have a decided effect, in calming such powers. The same material element irritation. Such are, for example, vine- developes the most opposite results. gar, diluted lemon-juice, the anti-pruritic Can an anatomist and physiologist, then, lotions (§ 182), the evaporating lotion knowing this fact, be a materialist ? (§ 169), the styptic lotion, &c. It is 212. Every thing whichrelates to sen- unnecessary to picture the torments to sation is dependent on the nervous sys- which persons labouring under this dis- tem, or more properly, on the nervous order are subject; those who suffer, know fluid; and in obedience to the laws of them too well; those who have never felt life, the nervous fluid must have a stand- them, cannot imagine their intensity.* ard of health to render it capable of executing its proper functions. If from neglect of the rules of health the hu- mours be foul, can we expect healthful sensation ? If the nervous fluid be poi- soned by alcohol, can we expect the CHAPTER XVII. sensations to be undisturbed ? If the nervous fluid enclosed in its protective ON DISORDERS AFFECTING THE COLOUR tubes is surrounded by tissues in an OF THE SKIN. active state of inflammation, can we ex- pect other sensations than those ofpain? 213. The human family exhibits two The answer is evident. Now, we know remarkable extremes in the degree of from observation, that if a part of the colour of the skin, these extremes, in body containing nerves, and consequent- their natural state, having reference to ly nervous fluid, be charged with caloric opposite conditions ofsolar light and cli- before the fire, the sensation is one of mate. Between the physical extremes heat; and that if ice be substituted, the on the surface of the globe, every degree sensation is said to be cold. But we ofvariety of tint is observed, and similar have reason to believe that the nervous states are reproduced under the influence fluid takes on a similar state to that of differences of constitution and health. caused by heat and cold, without the In the chapter on the scarf-skin, I have presence of either of those agents ; for in sickness we have sensations of chill, * [Onr author here speaks of nervous fluid, in very while the body is unnaturally hot, or the familiar terms. The existence ofit we are not at all sure is in a and vice of. How the nervous system exerts its influences no per- person high temperature, son can as yet safely even conjecture. To speak of ner- versa. From this we learn, that what vous influences is correct, as it leaves every thing in the we call sensation is a state of the nerves, very indefinite slate where it really is. These remarks seemed to be necessary, just at this time, as the quacks of or rather of the nervous fluid. But all the present day charge the human system with nervous our investigation fails in discovering and magnetic fluids, and withdraw them, and talk of the state can no laws of galvanic action, until a person would suppose that what that is. There be the principles or laws by which life is manifested had be- doubt that it is a disordered state, when come tangible; and the unfortunate patient, too unsus- is and pecting to believe that any man will trifle with so dear the sensation painful; the proba- a blessing as his own health or that ot the family lie bility is, that the state is healthful when loves so well, looks and hears until he perceives, as he the sensations are agreeable. thinks, all the laws of health and life condensed into a Now, single expression: “expel the humors;” “purify the from some unexplained cause, it too fre- blood “ galvanic action.” Alas ! the picture is all im- happens that a very distressing aginary. Too little do we yet know of this most perfect quently “ the manifestations.” state of itching takes possession of the of all works, beautiful of all God’s It is only the ignorant who understand the system per- skin, either on part, or on the whole fectly,and can administer specifics for every disease.] YELLOW AND BROWN SPOTS. 89 already pointed out the principal physi- equally vivid in the winter as in the sum- ological changes which result from aug- mer season, and are, in point of fact, of mentation and diminution of pigment; I constitutional origin. These are the cold may therefore confine myself in this place freckles; they offer some variety in colour, to those excessive alterations which, being sometimes brightly yellow, and from their unsightliness, are regarded in sometimes green, and are not confined, the light of disease. Under the head of like the summer freckles, to persons of a augmentation of pigment, we have the light complexion. Another discoloration, formation of patches of a dark colour occurring in the form ofpatches ofvarious and irregular shape on any part of the tints of hue, are “ saffron spots,” “sul- surface of the body, whether exposed to phur spots,” and “ liver spots.” In the stimulus of the sun, or covered by essential nature, these are the same as the dreSs. When these spots are more freckles, hut they are not always perma- or less raised above the surface of the nent. They often appear suddenly un- surrounding skin, they are called moles, der the influence of some general disturb- and they constitute in the popular mind ance of the system ; they are attended one of the kinds of “ mothers’ marks.” with some degree of itching, and they Moles exhibit every variety of size, form, fade away gradually when the cause and tint ofcolour, and they are generally which excited them is removed. covered by a pretty thick crop of dark- 215. The treatment of the family of coloured, bristly hairs. The reverse of discolorations involves surgical as well as this state, namely, diminution of pig- domestic means. The only safe and ment, gives origin to the state of skin certain mode of getting rid of moles is a which is met with in the Albino, and surgical operation. For the other forms which also occurs on parts of the . body of stain, the best local application is the in patches of various dimensions. In following cerate, which should be well Europeans, these white patches differ so rubbed into the affected skin at night:— of little from the tint the surrounding Elder-flower ointment, one ounce. skin as to excite little remark; but in Sulphate of zinc, twenty grains. tropical countries they are more striking, Mix well. and for that reason, probably, more fre- In the morning this is to be washed away quently observed. In Hindostan, where with abundance of soap, so as to secure these patches are not uncommon, and the entire removal of the grease, and the liable to spread over the where they are following lotion is then to be applied:— entire body, they commence with some degree of itching pain, and when Infusion of rose petals, half a pint. and Citric acid, thirty grains. fully formed, are attended with an in- Mix. sensible state of the skin, showing that The spots and liver spots will the cause lies deeply; very probably in yellow the nervous system. In a young quickly disappear under this treatment, lady and in most the freckles whom saw patches instances will I lately, these white not Should were the fever, and be ameliorated, if removed. sequel of scarlet the remedies rise to were so extensive as to be mistaken by give any unpleasant the her friends for the sound deeper irritation or roughness of the skin, skin, the lotion such tinted skin around being regarded as following will counteract ef- discoloured spots. fects :— colouring principle the Almond mixture, half a pint. 214. The of Goulard’s extract, half a drachm. skin occasionally offers varieties in its Mix. tint, dependent, probably, on a difference ofchemical composition, such difference If, associated with the discoloration of the being referrible to states skin, there is any constitutional disturb- of constitution of of the individual. Thus, when persons ance, that will call for the direction of a light complexion are exposed to the the medical man. influence of the sun and heat during the summer season, numerous round or oval-shaped yellow spots, similar in ap- pearance to stains, are developed in the CHAPTER XVIII. skin; these spots are popularly termed “freckles,” or summer freckles, and ge- nerally during the darker ON THE DISORDERS OF THE PERSPIRA- disappear and TORY SYSTEM. colder months of the year. There are, however, other freckles which have no 216. The disorders of the perspiratory- dependence on light or heat, which are system, though involving important re- 90 DISORDERS OF THE OIL-GLANDS
suits with regard to health, and, in some place, to quantity of the product; sec- instances, fatal diseases, offer so little to ondly, to quality; thirdly, to its export; interest the general reader, that I may and fourthly, to inflammation attacking dismiss them with a few passing remarks. the substance of the glands. The perspiratory apparatus is one of the We sometimes find the oily product of organs of the body by which unnecessary the skin so much increased in quantity andnoxiou3 materials are separated from as to become a source of great discom- the blood; therefore, any interference fort, particularly when the disorder is with its action is necessarily accompanied manifested on the face. In this case, the by disturbance of the circulating fluid, skin is always more or less bedewed with and also of the organs which co-operate a greasy fluid, which fills the hollows with the skin in its functions. The in- around the nose, attracts dirt from the fluence of checked perspiration is instan- atmosphere, and gives an unseemly pol- taneously perceived in the alteration of ish to the features. But this is not all; the product of the kidneys, while excess the action which gives rise to this in- of action of the skin is no less injurious creased quantity of product is one of ex- to the system, by causing exhaustion of citation in the skin itself, and unless it the nervous powers. Health lies in the be checked, will produce thickening and equilibrium, and the duty of the indivi- coarseness of the skin. On the other dual to himself is to pursue that state as hand, we occasionally meet with in- nearly as possible. Excess of perspira- stances wherein the function of the oil- tion is undoubtedly a state of disease ; glands is abrogated, where the oily pro- defectofperspiration is equally so ; while duct is deficient in quantity or entirely intermediate states may be indicative of absent, and where, in consequence, the intermediate conditions of health. The skin is dry, harsh, and rough. The habitually dry skin is not less a state skin, under these circumstances, requires which occasions excessive action of other to be stimulated, to perform its natural organs of the body than the habitually office, but the stimulant must be gentle, moist skin is a cause of other ailments otherwise inflammationwill be occasion- affecting the nervous system, and both ed, and a more serious disease establish- call for observation and a strict attention ed than that which the remedy was in- to the laws of health. Partial perspira- tended to remove. The remedy must tions are sometimes a cause of great in- also be of such a nature as to take the convenience and annoyance, and may place of the arrested fluid. affect any part of the skin ; for example, 218. When, in addition to increase in a case is related by a German author, in quantity, the oily product of the skin is which the disorder was limited to one so altered in its nature as no longer to half the body; and I am myself acquaint- spread upon the surface in the form of ed with one of a similar kind. Altera- oil, but acquires a disposition to adhere tions of a remarkable kind in the chemi- firmly to the skin, and dry up almost as cal nature and physical qualities of the fast as it is expelled from the glands, we perspiration are also occasionally met have then a curious, but, at the same with; such as changes in colour to green, time, an obvious result. The tendency blue, black, and yellow; changes in on the part of the substance, so altered odour, &c. One or two cases are on re- from its natural state, is to collect upon cord in which the odour of the perspira- the scarf-skin, and form a crust of equal tion resembled musk, and one in which thickness over the whole surface; but it was like the fumes of sulphur. this tendency is interrupted by the con- tinual movement of the skin. If we look at any part of the skin with atten- tion, we see at once in what manner this interruption is occasioned. From CHAPTER XIX. the nature of its connexion with the parts beneath, the skin is thrown into
ON THE DISORDERS OP THE OIL-GLANDS numberless folds, which, falling always in the same give a mark- AND TUBES. line, permanent ing to its surface. These markings are 217. The nature and purposes of the most conspicuous in the situation of oily product of the skin have been so joints, and offer some differences in fully pointed out in a preceding chapter, character upon its different sides, being that I may at once proceed to discuss always larger and coarser on the convex the disorders which affect this system in side, and smaller on the concave; in particular. These relate, in the first both, they are more or less elliptical FISH-SKIN DISEASE. 91 and diamond-shaped in their outline. and causes expansion of the aperture of These little diamond-shaped islets repre- the tube to an extent commensurate with sent the passive part of the skin when the bulk of the little cylinder (plate 3, the body is thrown into motion, while the fig. 3). Through this expanded aperture, movements that occur take place at the the dirt and smoke constantly existing in little grooves which surround the islets. the atmosphere enter, and the end of the Having now examined the bed on which little pile of oily matter becomes more or the crust forms, we at once perceive, that less blackened. In large towns, we can in consequence of the mobility of that scarcely examine a face without observ- bed, the crust, while in a soft state, will ing some of these round black spots, be cleft into little divisions resembling generally upon the nose and forehead; the diamond-shaped bases on which they and when they exist in any number, they are formed, and that any increase in the are a cause of much unsightliness. It is oily product will contribute to the thick- well known that these ugly spots may ness of these little divisions without alter- be removed by pressing the skin immedi- ing their diamond-shaped form. We have ately adjacent to them with the finger- therefore a number of little hard, and, nails, and then that there arises from the from discoloration by the atmosphere, aperture a little white cylinder, of mod- dark-coloured scales upon the surface of erate length, and having the appearance the skin, suggesting the idea of the scaly of a small white maggot with a black skin of a serpent or fish, and in compli- head, the black head being the part of ance with this idea, termed the jish-skin the collected matter which was discol- disease. This state of things sometimes oured by its approximation to the aper- occurs on the arm-pits, sometimes on ture of the oil-tube. From the resem- the breast or other parts of the body, blance referred to, these little black points and sometimes on the face. It is gene- are popularly termed grubs. They are, rally limited to a small extent of surface, as I have shown, merely the oily product but by no means always. I have seen of the skin impacted in the oil-tubes, in- instances where nearly the entire skin stead of being expelled as quickly as was in a similar condition. Again, in- formed. The longer these little piles are stead of remaining in a state of scales, permitted toremain in the skin, the more the little plates become occasionally so firmly they become fixed; and after a much increased in thickness as to assume time, when they lose their moisture, they the character of hard, polyhedral, and are converted into little horny spines, as rounded spines (plate 6, fig. 5), which dense as bristles, and having much that have been popularly magnified into a re- character. Sometimes they are a cause semblance with porcupine’s quills. This of inflammation of the gland, and of the comparison has suggested the name of adjacent skin, and then they constitute the 'porcupine disease , by which it is pop- the eruption known under the name of ularly known. Instances of porcupine spotted acne. men and porcupine boys are not uncom- mon at country fairs. TUMOURS OCCASIONED BY THE DETEN- 219. Detention of the oily product of TION OP THE OILY SUBSTANCE WITHIN the skin within the oil-tubes and glands THE OIL-TUBES, THE APERTURE OP takes place two in under circumstances; THE TUBE BEING OPEN. one of these, the aperture of the oil-tube remaining all the while open; in the 220. When the detention of the oily other, the aperture is closed, and is con- product is of long continuance, and when, sequently the cause of the detention. in consequence, the obstacle to the ex- When the aperture of the tube remains pulsion of the newly-formed matter is widely open, we may infer the existence progressively increasing, it is no uncom- of some torpidity in the gland, whether mon thing to find the oil-tube distended such torpor depend on the state of the to such an extent as to form a small skin, or of the system of the individual pouch within the substance of the skin. in whom the disorder occurs. Or, if not When this process isonce established, it torpidity of the gland, there is an unu- may go on to produce a cavity of remark- sual degree of dryness'of the oily pro- able size, the original aperture or outlet duct. Both of these states are, in reality, undergoing very little change, or being met with, and they give rise to some only slightly dilated in proportion to the difference in the morbid appearance of dimensions of the internal cavity. I have the skin. When the oily product of the a specimen in my collection, in which skin collects in the oil-tubes, it assumes such a cavity as I am now describing is the elongated form of those passages, as large as the hollow of a filbert-shell, 92 DISORDERS OF THE OIL-GLANDS. and I have seen others as broad as a assented; for the thing was an excessive crown piece. Now, these cavities, when annoyance to her, catching against her they occur, are filled with oily product clothes, very frequently meeting with which is more or less altered in its char- blows, and then giving her much pain. acters by detention, and by the changes The operation was speedily over, and she which the walls of the tube undergo in soon got well; but had I known as much being so unnaturally distended. Indeed, of the nature and origin of the growth as as the walls of the cavity become pro- I learnt from its examination after remo- gressively thinner, the cells of the new- val, the pain of an operation might have ly-formed matter contain less oil than been spared her. I trust, however, that formerly, and assume a perfect resem- my experience will serve others as well blance to the cells and scales of the as myself at a future time, and with that scarf-skin, having the beautiful silvery view 1 communicated the case to the polish, and also the laminated arrange- Royal Medical and Chirurgical Society, ment of the latter, the laminae corre- by whom it has been published in the sponding with the plane of the surface twenty-seventh volume of the Society’s ■which produces them. It sometimes Transactions. In this paper, I have happens that the aperture of these cavi- shown the analogy which subsists be- ties is so large as to admit the head of a tween the oily product of the skin, scarf- large pin, and then some of the matter skin, and horn, and have proved that the which they contain may be drawn out, growth in question was not merely horn- and sometimes a portion is pushed out by like, but was actually horn, both in inti- the formative force within, and forms a mate and in coarser structure. prominence on the surface similar in its 222. Having in the above case had my nature to the horny, bristle-like spines attention so forcibly drawn to the occur- mentioned in the preceding paragraph. rence of horn in the human being, I pro- Such collections as I am now describing secuted a search into the literature of the may be distinguished from other cuta- subject, and succeeded in collecting no neous disorders by the name of accumu- less than ninety recorded instances of lations of the oily product of the skin. horny growths. They appear to have 221. Accumulations of the oily pro- been more prevalent in the earlier than duct of the skin naturally give rise to an the present times, probably from a scar- enlargement or tumour of greater or less city of soap, and some curious specula- magnitude, and these tumours are dis- tions were excited in the minds of the tinguished from others by the presence older physicians by observation of them. of an aperture through which the con- Rhodius, for example, met with a Bene- tents of the swelling can be ascertained. dictine monk who had a pair of horns, But they do not always retain a passive and was addicted to rumination ; and Fa- character: in an instance before me, the bricius having seen a man with a horn substance collected to such an extent as growing from his forehead, whose son ru- to render the skin covering it as ihin as minated, is willing to give the fathercre- tissue paper; the skin then gave way, dit of transmitting this disposition tu . . and the substance protruded through the son by virtue of the ruminant character opening. I need hardly say that this was which he bore so obviously on the head. not accomplished without much pain and The most remarkable case ofhuman horn suffering to the poor woman in whom it on record is that of a Mexican porter occurred. The change which next en- named Paul Rodriguez. The horn was sued was, however, the most remarkable. situated upon the upper and lateral part As the matter was forced further and fur- of the head; it was fourteen inches in ther through the artificial aperture form- circumference around its shaft, and it di- ed in the skin, it dried by exposure to the vided above thispoint into three branches. air, and became as hard and dense as the Voigtel cites the case of an old woman finger-nail, or horn. It was in this state who had a horn with three branches when I first saw it; a decided horn, two growing from her forehead, and M. Du- inches and three-quarters in length, by bois had a woman under his care, in the one inch and a quarter in thickness, Hospice de Perfectionnement, with a growing from the front of the thigh, and horn that measured seven or eight inches firmly implanted in the skin. I had never in diameter at its base, and was six inches before seen so complete a human horn in length. The length of the horn in as this; and misled by the imperfect ac- some recorded instances is also remark- counts of the nature of horns contained able. Sir Everard Home saw two cases, in medical works, I proposed its removal in both of which the growth measured by the knife, to which she very willingly five inches by one inch in diameter. HUMAN HORNS. 93 They were curled, and had the appear- of this woman in Dr. Charles Leigh’s ance of isinglass. In one case, the horn Natural History ofLancashire, Cheshire, was fourteen years growing. Dr. Gre- and the peak of Derbyshire. Her por- gory mentions a horn which was removed trait and one of the horns is in the Ash- from the temple of a woman in Edin- molean Museum, and another ofthe horns burgh which measured seven inches. in the British Museum. Dr. Chariere, of Barnstaple, saw one 223. Grubs and accumulations are growing from the nape of a woman’s both of them due to the collection of the neck, which measured seven inches. A oily product of the skin within the oil- horn in the British Museum is said to tubes, attended, in the latter case, with a measure eleven inches in length by two remarkable state of expansion of the tube. and a half in circumference; and Bar- There is, however, another disorder be- tholin, Faget, and several other writers, longing to this group, in which, as in the have spoken of horns twelve inches long. preceding, the oil-tube is filled ; but in ad- A singular instance of horn is mentioned dition, the tubes of the little gland at its by Cruveilhier in his u Anatomies Patho- base are also distended, and the swollen logique,” as falling under the notice of gland rises up to the surface of the skin, Dr. Faget of Bordeaux. The subject and forms a small tumour, generally was a Mexican Indian, and the horn was about the size of a currant (plate 6, fig. situated in the lumbar region of the left 6). The resemblance to a currant is not side. After growing for three years, it confined to size alone, it is very like one had attained a length of four inches by in shape; there is the flattened and in- seven or eight inches in circumference dented summit, resembling the point of and was sawn off by the patient’s son ; attachment of the corolla of the currant, after another three years, it was submit- lines down its sides marking its division ted to another similar operation, and at into segments or lobes (fig. 7). and the the end of nine or ten years from its first smooth polish of the distended skin. Its appearance, was extirpated by M. Faget. colour is usually lighter than the sur- The proportion removed by M. Faget, rounding skin, from the whiteness of the with the two portions previously cut off, contained substance, which maybe some- amounted in length to about twelve times seen through its thinned walls, and inches. its base is more or less narrowed, so as to In a scarce tract in small quarto, pub- give it the character of being indepen- lished in 1676, there is “ a brief narrative dent of the skin. The contents of these of a strange and wonderful old woman little tumours, as may be inferred from that had a pair of horns growing upon their impaction in the tubes, is denser her head.” “ This strange and stupen- than natural, the cells are more distinct dous effect,” continues the pamphlet, “ be (fig. 8), and apparently filled with a dry gan firstfrom a soreness” of the back part granular substance, and retain their oval of the head where the horns grew. shape, instead ofbeing, as in the natural “ This soreness continued twenty years, state of the oily substance, collapsed and in which time it miserably afflicted this broken. If the little tumour be pressed good woman, and ripened gradually into between the fingers, it frequently hap- a wen near the bigness of a large hen pens that a small quantity of milky fluid egg, which continued for the space of five oozes out from its summit; but this is by years, more sadly tormenting her than no means a constant character, for in before, after which time it was, by a some the oily product is so dry as not to strange operation of nature, changed permit the filtration of this fluid through into horns, which are in show and sub- its mass. These small sebaceous tumours stance much like ram’s horn, solid and are generally met with on the neck or wrinkled, but sadly grieving the old face, particularly in the vicinity of the woman, especially upon the change of eyelids, and they are sometimes found weather.” The horns were shed four dispersed on other parts of the body. times, the first “ grew long, but as slen- They have been described by most au- der as an oaten straw;” the second was thors as being contagious, under the name thicker, and on the fall of the latter, two of molluscum contagiosum; but this is were produced, which were broken off not the fact, as I have been enabled, very by accident. One of these was present- satisfactorily to my own mind, aftercare- ed to the King of France; the other is ful observation, to determine. stated to have been nine inches long, and two inches in circumference. The peri- ods of shedding were three, four, and four years and a half. There is an engraving 94 DISORDERS OF THE OIL-GLANDS. reous salt, which, by their accumula- tion give hardness and density to the TUMOURS OCCASIONED BY THE DETENTION mass. Two such tubercles as these have OF THE OILY SUBSTANCE WITHIN THE lately been removed from the eyelid of OIL-TUBES, THE APERTURE OF THE TUBE Mr. Dalrymple. They have also been BEING CLOSED. seen in other situations. From their ob- 224. I now come to a disorder of the vious relationship to those described in oil-tubes of frequent occurrence, depend- the preceding paragraph, I have desig- ing upon closure of the aperture of the nated them calcareous miliary tubercles. tube, and consequent imprisonment of 226. Occasionally, I have seen the the product of the gland. In this case, place of the oily matter of these small Nature seems to accommodate herself to tumours occupied by a clear, watery fluid, the emergency, for the collected sub- which, collects to such an extent, as to stance loses the bulky character which render the skin thin and transparent, it ordinarily possesses, and rarely collects the tumour, under such circumstances, in any quantity; indeed, the size of the having the shape, and often the size little tumours occasioned by its accumu- and appearance, of a grape. I have lation is not greater than that of a mus- seen two such grapes hanging to the tard or millet-seed; and from this latter margin of the upper eyelid, and inter- circumstance they are denominated se- fering with the motions of the lids, and baceous miliary tubercles. These little even with the sight, besides being a tumours, or rather tubercles, are perfect- cause of deformity to the person who ly white and pearl-like in their appear- bore them. These are watery cysts of ance, and of a round form. They are the oil-tubes. frequently seen scattered about the eye- 227. There remains to be described, lids and sometimes on other parts of the among the tumours resulting from the accumulation of the oily product of the face ; they give rise to little or no incon- venience, other than that which arises skin, certain enlargements known by the “ from their unsightly appearance. I have name of wen,” or in technical phra- met with but one exception to this state- seology, encysted tumours. These are ment, namely, in the case of a gentleman most commonly met with on the scalp, who had one of these tubercles, oflarger but may also occur on other parts of the size than usual, at the inner angle of the body. They are usually globular inform, eye, which interfered with his comfort and sometimes so perfectly round as to in the closure of the lid, and threatened look like marbles projecting from the skin. to continne growing. I removed the con- When laid open, they are found to be tents in that case, and the tubercle has filled with the unctuous product of the not returned. skin, variously modified by its long de- 225. In the chapter which treats of tention, and sometimes so altered from the natural structure and functions of the its original character as to be scarcely oil-glands, I have stated the chemical distinguishable as the same substance. composition of the oily product, and in For example, the contents have some- general terms I have remarked that it times the aspect of bread-sauce, some- contains saline matters, namely, salts of times of more or less solid fat, occasional- soda, potass, and lime. Now, one of the ly they resemble melted wax, and at other commonest changes occurring in glands times, water of various tints of colour, is the alteration of the constituents of and holding in suspension floating sub- their peculiar product, and that this event stances of different kinds. Besides these is not infrequent in the oil-glands I have matters, it is no uncommon thing to find had occasion to show in preceding par- hair within these tumours, having an ori- agraphs, and shall have again to make gin similar to the tufts of hair mentioned known as I proceed. For example, we in paragraph 66. The pouch of the oil- occasionally meet with small, whitish tu- tube, which is so inordinately distended bercles, of the millet-seed kind, which, inthis form of tumour, is technically call- “ upon examination of their contents, turn ed its cyst,” and this is the meaning out to be composed of an excess of the of the name by which they are known to salts of lime, and are consequently hard medical men. This cyst is sometimes and stony in their nature, or like a piece curiously modified by the new conditions of mortar. When tested with the micro- which it is made to fulfill; for example, scope, the hard mass is seen to be made it sometimes becomes hard and rigid, like up of numberless small scales, like those a piece of parchment, and at other times previously described, and within these is calcareous and stony in its nature. scales are the minute particles of calca- The treatment of encysted tumours is SPOTTED AND ROSE ACNE. 95 purely surgical; the contents must be tirely. After the whole of the matter of let out, and the cysts, if possible, with- the horn is washed away, the astringent drawn. lotion (§ 188) will be of service in pre- 228. As respects the treatment of dis- venting its renewal. Small sebaceous tu- orders of the oil-producing apparatus of mours, millet-seed tumours, serous cysts, the skin, the various forms of affection and encysted tumours, all require surgi- call for the adoption of different means. cal aid, the treatment consisting in laying The excess of oily product spoken of in them open, and adopting some means paragraph 217, is best remedied by the which shall prevent their recurrence. application, with friction, of the following 230. Acne.—Inflammation of the oil- lotion to the face. This is to be used at tubes and glands, extending more or less night, and the following morning every to the neighbouring skin, gives rise to a trace of it washed away with abundance well known eruption on the forehead, of soap. If the skin should be at all ten- face, and back, called acne * (plate 6, der after this treatment, rinse it with the fig. 6). These pimples are so well known simple infusion of rose petals (§ 169). by most persons as scarcely to need de- The lotion is as follows: —- scription ; they are conical, red, and hard ; after a while, they become white LOTION FOR DISORDER OF THE OIL TUBES. and yellow at the point, then discharge Oil of sweet almonds, one ounce. a Fluid potass, one drachm. thick, yellow-coloured matter, mingled with a whitish and become Shake well together, and then add— substance, covered a Rose-water, one ounce. by hard, brown scab; and Pure water, six ounces. lastly, disappear very slowly, sometimes very and often leaving an This same used in the manner imperfectly, lotion, scar behind them. To these is the best for ugly symp- described, possible remedy toms are not consid- and accumulations unctuous sub- unfrequently added grubs of erable pain, and much unsightli- stance, and is so harmless in its nature always ness. When these little cones have the as to the skin of most persons. agree with blackhead of a at their it is not found to answer “grub” point, When, however, they constitute the variety termed spotted the required, the sublimate lotion purpose acne. These latter often remain station- containing more than two (§ 169) not ary for increasing or of the sublimate to half a pint of months, without grains becoming red; but when they inflame, milk be tried ; and ofalmonds, may sup- they are in no wise in their this also to unavailing, let lem- different posing be course from the common kind. diluted with one half be on-juice, water, 231. There a variety of tried, or the following:— is, however, acne which settles on the nose, and is a Hypo-chloride of sulphur, one drachm. subject of some facetiousness of nomen- Powder of gum acacia, one drachm. clature, though “ no joke ” to the pos- Rub together until the sulphur is well mixed, and then sessor. It is called, for example, “bac- add— its occasional bacchanal Water, half a pint. chia,” from origin, “ Mix. and rosacea,” from its rosy redness, 1 presume, not for its this lotion in a cool place and well corked. certainly Keep beauty. But if its history be pursued, 229. The treatment of the fish-skin it might, with very good reason, be called disease had better be left to the medical besieger , not only from the siege which man. Should, however, such aid be it lays to the nose and adjacent parts of difficult of attainment, the patient may the face, and the annoyance which it use the alkaline ointment (§ 188) without causes its victim, but from the manner any likelihood of inconvenience. He of its aggression and subsequent opera- will find this keep down the scales and tions. It begins, for example, by very prevent their increase. After an appli- slowly throwing up a mound of red cation at night, the ointment should be skin, and for months, perhaps, goes no completely washed away in the morning further; then we see a chain of low with soap. The occurrence of horns is barrows, extending to another mound in so rare, that few of my readers, proba- the act of rising, sometimes two chains bly, will require to put in practice any passing in different directions, or perhaps course of treatment for their removal; a mound in the distance which the chain but should the necessity offer, the alka- goes to meet. These operations are line ointment kept constantly applied, always remarkable for the slowness, but with the addition of a covering of oiled not less for their certainty of success, for silk, will be found effectual in softening them to a pulp, and removing them en- * Pronounced ac-nB. 96 DISORDERS OF THE OIL-GLANDS wherever the skin is hemmed inby these or the following, which is more particu- pimply ridges, it is as deeply red as the larly adapted to cases of this kind: — pimples themselves; and after a time, when the and a Sulphate or copper, twenty grains. whole nose, probably, Rose water, four ounces. considerable extent of the adjacent face, Water, twelve ounces. is covered by them, both the latter and Mix. the intermediate skin are marked by stronger when the are which out their A lotion, above large veins, spread found to be too is that streams a large mild, of the hypo- branches like tributary of chloride sulphur The mode river. small collections of of (§ 228). Occasionally, of using remedies is to rub matter form upon these pimples, these the yellow pimples for some minutes with a but this is no means their common rough by and them with the preserve a heightened towel, then dab lotion. character. They Sometimes an advantage is colour under all but un- gained by circumstances, having two one for evening dergo a change having relation to lotions, the the and one for the morning; the best for state of the blood flowing through them. application sublimate Thus, example, circulation morning being the for when the (§ 169.) When matter at is active, they are fully and lotion collects distended the top, and they are ripe, the pim- while in cold or fully brightly red; weather, to be and treated in under the causes which re- ples require opened, influence of the same manner. In the variety affect- tard circulation, are or even they bluish, the it is to the livid in hue. ing skin, desirable keep eruption in a moist state all the night 232. There is another form of acne the use of oiled silk over a which occurs the and is ex- through, by upon chin, piece of lint dipped in one of the above cessively and enduring. It obstinate and use either the hypo-chloride attacks women as well as but is lotions, men, of sulphur or sublimate lotion in the most common in the latter, and is much morning. the of aggravated by operation shaving. Acne rosacea requires a The of is similar to different appearance eruption it should be well that of a severe kind of acne, treatment: fomented namely, night with a decoction of marsh red with hard every large, conical, pimples, as hot as can the fo- bases, yellow heads in an mallow, be borne, advanced mentation being continued for full half stage; and later, hard, brown scabs. an hour. As soon as the parts are dry, The disease the oil-tube and affects dab them with the or neighbouring hair-tube, and therefore hypo-chloride, sublimate and over them a extends somewhat into the skin lotion, lay deeply ; piece of dipped in of from the sub- lint, either the moreover, relation which above covering the with sists the hair-tube and the dis- lotions, whole between silk. In the morning, wash them ease, each pimple rises at the a oiled base of with then dab them with the sub- and looks as it were transfixed soap, hair, if limate and leave them untouched shaft of the latter. From the lotion, by the chin, during the day. This is a general the disorder not to unfrequently spreads scheme treatment. were to at- the long of If I whiskers, and, by continuance, to down to meet every produces considerable thickening and tempt lay rules the task would be a tedious hardness of the skin over the emergency, whole one to my reader, and not less so to my- extent of those of the parts face. self. these not to 233. The of must be In pages, I propose treatment acne offer a substitute for medical advice, that constitutional as well as local. I am would be impossible ; but to give now course supposing the eruption of simply of my readers a rational view of disease, a crop of these pimples, and not a few combined with a rational of isolated which occur principle ones, may in any in order that one causes without treatment, they may beable from local any disor- to adopt a proper and der of health. The diet should be looked on an emergency the degree of judicious means of relief, appealing in to, exercise considered, and to the the abuse of mental labour. some- every difficulty higher authority Acne of the medical man. times requires reducing remedies, and at others, stimulating ones. With regard to local treatment, several of the lotions and ointments already mentioned in the course of these pages are calculated to be serviceable; such as, to begin with the mildest, the lotion for disorder of the oil- tubes(§ 228), the astringent lotion (§188), DISORDERS OF THE HAIR. 97 specific remedy for such a purpose. Sub- stances are sold by the perfumers called depilatories, which are represented as CHAPTER XX. having the power ofremoving hair. But the hair is not destroyed by these means, ON THE DISORDERS OP THE HAIR AND the root and that part of the shaft im- HAIR-TUBES. planted within the skin still remain, and are ready to shoot up with increased 234. In taking a survey of the disor- vigour as soon as the depilatory is with- ders of the hair, the divisions previously drawn. The effect of the depilatory is adopted for the morbid affections of the the same in this respect as that ofa razor, perspiratory and oil-producing apparalus and the latter is unquestionably the bet- will be applicable here. The unnatural ter remedy. It must not. however, be conditions in which the hair and hair- imagined that depilatories are negative tubes are involved being referrible to remedies, and that if they do no perma- augmentation and diminution in quan- nent good, they are at least harmless; tity, alterations in colour and direction, that is not the fact; they are violent ir- diseases of the hairs, and diseases of the ritants, and require to be used with the hair-tubes. utmost caution. This will be immediately 235. Augmentation ofhair in quantity seen when I inform my reader that depi- can only be regarded in the light of a latories are chiefly composed of quick- peculiarity, so long as it is confined to lime, soda, and sulphuret of arsenic, all those parts of the body which are pro- of w7 hich substances act by burning up perly organized for the production of and dissolving the hair. There could be long hair. It does, however, sometimes no objection to this process, if it were happen that hair is produced in places conducted with safety to the skin; but where such a growth is unnatural, and the depilatory requires to be laid on the that the unnatural growth is accompa- skin either in the form ofpowder or paste, nied by an altered state of the entire and necessarily destroys the scarf-skin skin. This is the case in those little at the same time that it acts on the hair, patches and spots which sometimes dis- for the scarf-skin and hair are. as I have figure the face, and are called “ moles.” shown in preceding chapters, identical Moles are of a dark colour, generally in composition. After all, the safest de- covered with hair of a longer or shorter pilatory is a pair of tweezers and pa- growth, and come under the popular de- tience. signation of “ mothers’ marks.” For ex- 237. Diminution of hair in quantity, ample : w 7hen sufficiently large and mo- from its decadence, involves much more derately tufted with hair, no matter what serious consideration than the opposite their form, they are the representatives condition. I do not now allude to the of the “ back of a mouse.” In moles, fall of the hair dependent on age; this the discoloration dependent on alteration is a natural consequence of man’s infir- of pigment (§ 213) is conjoined with un- mity, and cannot be regarded in the usual production of hair ; but they have light of a disorder; but sometimes the none of the dangerous properties of the fail of the hair takes place in young per- mothers’ marks, occasioned by disar- sons, and then it becomes a serious evil. rangement of the blood-vessels (§ 209), The degree of evil is necessarily much and are only sources of annoyance from modified by circumstances; if the subject their size, their colour, or their position. be a young lady, the inconvenience is There is no remedy for their removal, greater than if it be of the opposite sex. saving a surgical operation, and some- If the fall be limited to parts usually bald times the inconvenience from their pre- in the aged, again, the visitation may be sence is such that this is submitted to. bearable even in a young man. But when, The operation is trifling; and when ju- as I have frequently seen it, the entire diciously performed, no trace of such a scalp is laid bare, and with it the eye- proceeding is left behind. brows, eyelashes, whiskers, and beard, are 236. Under the circumstances above lost, the case is one of no common afflic- detailed, and in others to which I need tion. A wig but ill supplies the place of not more particularly refer, it comes to Nature’s foliage, and burnt cork for eye- be a question, How hairs in improper brows is only passable as a stage effect. situations are to be disposed of? I wish But the annoyance is greater than all, I could answer this question satisfacto- when, instead of a total fall, round white rily, for it is one that I have addressed patches of scalp become denuded, giving to me very frequently. I know of no the idea, most unjustly, of some disagree- 98 DISORDERS OF THE HAIR. able or degrading disease. This is one not particularly adverted to the loosen- of the numerous family of the ringworms ing of the hair, which frequently occurs of the public, but, like many other popu- in young persons, or in those of the mid- lar medical notions, wholly incorrect. dle period of life, and which, if neglected, The grounds of the misnomer are simply would become real baldness. Such a these: a disease recognized under the state as I am now describing is not un- name ofringworm produces a fall of the common in women, and generally termi- hair on the part alTected, then comes the nates in its mildest form, in excessive popular deduction, ergo, every fall of the loosening of the hair. The case, how- hair is occasioned by a ringworm. But ever, is far from being the hopeless one in the patches ofwhich I am now speak- which is generally imagined ; and if ing, there has been no previous percep- proper treatment be pursued, the hair tible disease; indeed, the case is one, not will grow afresh, and assume all its pris- of disorder of the skin, but of the nerves, tine strength. An useful practice in which supply the skin. I had a curious men, and those of the opposite sex whose case, in illustration of this opinion, about hair is short, is to immerse the head in twelve months back. A woman was cold water, morning and night, dry the sent to me from the eye infirmary, where hairthoroughly, and then brush the scalp, she was under treatment for disease of until a warm glow is produced. In wo- the eyes, in order that I might advise men with long hair this plan is objec- her with regard to a remarkable state of tionable ; and a better one is to brush baldness. She was a highly nervous the scalp until redness and a warm glow person, and subject to frequent and se- are produced, then dab among the roots vere pain in the course of four of the of the hair one or other of the following principal nerves of her scalp, and it sin- lotions. If the lotion produce smarting, gularly happened that the baldness was or tenderness, the brush may be laid limited to the lines of distributionof these aside, but if no sensation is occasioned, nerves. I prescribed for her a remedy the brushing should be resumed, and a to reinstate the hair, and requested to second application of the lotion made. see her again in a week. It was of This treatment should be practised once course too early to expect any appear- or twice a day, or at intervals of a few ance of hair, but the pains in the head days, according to the state of the scalp; were gone, and the eyes so much better, namely, if tender, less ; if insensible, that she had no occasion to return to the more frequently. When the baldness infirmary. If it were necessary, this is happens in patches, the skin should be not the only evidence I could adduce of well brushed with a soft tooth-brush, the direct nervous origin of baldness. dipped in distilled vinegar, morning and But to return: in partial baldness of the evening, or dipped in one of the following scalp occurring in round patches, the lotions: — skin is as white, smooth as if polished, LOTION FOR PROMOTING THE GROWTH OF THU HAIR and obviously thinner than the surround- skin. This of No. 1. ing thinness the scalp is Vinegar of cantharides, half an ounce. very remarkable in the baldness of age, Eau de Cologne, one ounce. the skin is almost transparent, the seams Rose water, one ounce. of the bones may be distinguished No. 2. through it, and it appears to Eau de Cologne, two ounces. have Tincture of cantharides, halfan ounce. scarcely any substance whatever. In- Oil of nutmegs, half a drachm. deed, I have in my collection a prepa- Oil oflavender, ten drops. ration of the skin of the scalp in which Mix. the latter is not thicker than paper. Par- No. 3. tial baldness of the scalp is entitled tothe Mezeron bark in small pieces, one ounce. “ Horseradish root in small pieces, one ounce. designation scallbut I think it better Boiling distilled vinegar, half a pint. to abstain from the use of this word, as Let this infusion stand for a week, and then strain through scalled head is the term usually employ- muslin for use. / ed to distinguish those cases ofbaldness If either of these lotions should be found of the scalp occurring in patches result- too irritating to the skin, use them in ing from watery or mattery pimples smaller quantity and less frequently. (§ 184, 189); or from another disease, No. 3 may be diluted with more distilled shortly to be described, the true ring- vinegar. If they have the effect of mak- worm. Partial baldness may occur in ing the hair harsh and dry, this incon- any one, and at any time, and more usu- venience may be removed by the use of ally attacks adults than children. oil or pomatum after each application of 238. In the preceding paragraph, I have the lotion. Pomatums for the growth of BLANCHING OF THE HAIR. 99 the hair are very inferior to the lotions, gree of mental reservation. We are and the celebrated pomatum of Dupuy- ready to admit, that all hair produced tren is both clumsy and inefficient. upon and after that night may be white, 239. In the chapter upon the structure but no further. And in this admission of the hair, I have narrated some instan- we can readily believe that blanching of ces of altered colour, and given an expla- the hair may be dated from a single nation of the nature of that change. Such night; all the growing hair may on that alterations are curious, rather than of night be formed white, but all above the any practical importance, and they occur level of the scalp retains its colour as so rarely as to call for nothing more than completely as if it formed a part of an a briefpassing notice. A more frequent artificial wig. These considerations lead change, however, is that in which the us to another kind of remedy for blanch- colouring pigment ceases to be produced, ed hair, one which acts only on the or in which a white calcareous salt is formed hair, and has no power either of substituted for the natural pigment. reaching that which is implanted below This state constitutes “ blanching of the the level of the skin or the root. I allude hair.” It must be a matter of common to “ dyingI have heard of persons who observation, that in those instances in have been led to adopt this artifice under which the pigment presents the deepest the supposition that the hair being once hue, blanching most frequently occurs, dyed will grow for ever after of that and greyness is most common ; while in colour. If they had reflected in time that persons of light hair and light complex- the dye acts only on the hair above the ion, blanching is comparatively rare. level of the surface, and that the hair There can be no doubt that the produc- continues to grow of the objectionable tion in this climate of a dark pigment is a colour, so as to require a weekly repeti- greater exertion to the economy than one tion of a disagreeable process, they of a lighter kind; and hence, when the would, I think, have hesitated before they power of the nervous system is reduced, had offered themselves as willing slaves the formation of pigment is one of the to a barbarous practice. first actions which suffers. It is -wisely 241. Altered direction of the hair may ordained that it should be so, for colour be discussed in a few words; the only of the hair is one of the conditions of ex- situation in which the hair is known to istence most easily spared, and it is one give rise to inconvenience by irregularity also that may well serve as a monitor of in the direction of its growth, is upon the human decay. When greyness shows margin of the eyelids, where the lashes itself in the hair, it is therefore an indi- sometimes grow inwards, and by press- cation of want oftone in the hair-produc- ing against the front of the eyeball, occa- ing organs; and if this tone can be re- sion irritation, and even inflammation. stored, the hair would cease to change, When such a state as this occurs, the and, at the same time, further change erring hair must be removed by means would be prevented. The lotions for of a pair of fine tweezers, and the inflam- promoting the growth of the hair are re- mation afterwards subdued by cooling medies of this kind, and I know no better and slightly astringent lotions. local means for checking greyness. 242. The only disorder coming strictly They must be used as recommended in under the designation of disease of the the preceding paragraph. substance of the hair is one which is 240. Seeing that cessation in the pro- known in this country only by reputation duction of pigment is a consequence of as an inhabitant ofPoland and Russia. I deficient tone in the scalp, resulting from mean plica polonica. In this affection, weakened energy in the nervous system, the hair is distended with a reddish we have an explanation at once of coloured fluid, and has the appearance blanching of the hair ensuing after fevers ofbeing converted into flesh. The scalp or constitutional disease, or of the same is much diseased, and bleeds on the state following intense anxiety or alarm. slightest touch, and so much pain is given From such a moment, pigment is no by the trifling movement which accompa- longer elaborated, and all the hair pro- nies the cutting of the hair, as to give rise duced subsequently to the shock is white. to the impression that the diseased hair But that already formed remains un- is really endowed with nerves. A large changed, because it is outof the reach of quantity of fluid weeps from the hair-tube, the living textures, and cannot undergo and agglutinates the hair into a repulsive alteration For this reason we must re- mass, which is left for nature to remove; ceive all statements of the hair becoming a process that requires from ten to twelve white in a single night with a proper de- months to accomplish. 100 DISORDERS OF THE HAIR. 243. The hair-tubes are liable to a pe- dotted with yellow points, as the invading culiar state of disorder, in which they column of its approach. This latter produce a yellow, paste-like substance character, and the destructive nature of which collects within them in such the disease, eating up, as it were, the quantity as to destroy the pulp of the roots of the hair, and causing the latter hair, and by its further increase, to give to fall, is the obvious origin of the popu- rise to a most serious form of disease of lar designation “ ringworm.” If ring- the scalp. The development of this dis- worm be not checked, it will destroy the order is attended with considerable irri- whole of the hair of the scalp, and give tation and itching, and when the skin of rise to deep-seated disease, with enlarge- the head is examined, a small patch of ment and disease of the glands of the redness will be detected as the seat of neck. the diseased action. Upon further in- 244. It is not the least curious part of spection, a number, and perhaps all the the history of ringworm, that its yellow hairs included within the area of this matter and crusts should, when examined patch will be found encircled at their with the microscope, be found to be com- base by a minute yellow spot. In a few posed of an organic formation, having days, this spot rises above the level of the character ot those vegetable growths the surface, and becomes a small pim- known under the name of “ mould,” that ple; and still later, the yellow matter of is, consisting oflittle plant-like stems and the hair-tube continuing to exude, forms branches, terminated at the extremity by a small cup around the hair, the concav- clusters of sporules or seeds. Of late ity of the cup being directed outwards, years, productions of this kind have been and its convexity being attached to the found in various parts of the body, but mouth of the hair-tube. It generally their vegetable nature is far from being happens that a number of these sulphur- established. Whatever their nature, yellow cups, produced upon a small cir- however, in a scientific point of view, cular patch of skin, form a cluster; this there is every reason to believe that the arrangement constitutes the clustered va- disease may be propagated by the dis- riety of the disease in question. At other persion of these seeds, and this, in a times they are distributed singly over practical sense, is the only important the scalp, and constitute the scattered consideration, as pointing to a means by variety. When they exist in the clus- which they may be destroyed, and their tered form, they somewhat the ap- reproduction arrested. The history of pearance of a piece of honeycomb em- this disease, its yellow points and pim- bedded in the hair, and from this resem- ples, loosened hairs and dry yellow cups, blance have received the name “ lavus,” will, I think, sufficiently distinguish it which literally means the honeycomb.” from every other affecting the scalp. I The disorder is, in reality, “ the true have before had occasion to mention dis- ringworm,” the most serious form of orders which had received the popular disease of the scalp, and highly conta- designation ringworm ; but the charac- gious. As the disease is deeply seated ters of these were all widely dilierent in the hair tubes, and continues to pro- from that under consideration. Some gress in them, the irritation and itching were of the nature of simple rashes, receive no relief from the escape of the lasting but a short time, and were found matter in the formation of the cups, but, on the body as well as on the head; on the contrary, seem to increase, and in some were watery pimples, and also at- attempts made to relieve the itching, the tended by a profuse watery discharge; hair comes away with the crusts. In- while another group was scaly and dry. deed, if the hairs be gently drawm by a Now, in the outset of the true ringworm, pair of tweezers, they will be found loose there is no discharge; but when, from and ready lo come out on the most mod- neglect, the crusts augment in great num- erate traction, and in this way we are bers, and the yellow matter collecting in often able to detect the extension of the the hair-tubes, causes inflammation of disease when no yellow matter is as yet the skin, discharges then arise, and fre- apparent at the surface. This disease quently deep and painful excoriations obeys the law of extension I have before and sores. had occasion to advert to as common in 245. In the treatment ofringworm, the cutaneous disease, namely, exhausting it- first point for attention is rigorous clean- self in the part first attacked, and extend- liness ; the head should be washed with ing by the circumference, carrying de- a profusion of soap, and the hair care- vastation as it goes, destroying the hair, fully combed, to remove all loosened and forming a well-marked red circle, hairs and every particle of crust. When TRUE RINGWORM 101 this has been done, the whole head, and which have been found useful in this dis- particularly the disordered parts, should ease ; their name is “ legion,” but their be well rubbed with the following lotion, principle is uniform. Some of these re- namely:— medies are in the possession of old wo- RINGWORM LOTION. men, and so long as ihe old women con- Sublimate of mercury, five grains. fine themselves to harmless substances, Spirits of wine, two ounces. they could not be ; Tincture of musk, one drachm. in better hands but Rose water, six ounces. old women fail to distinguish between Mix well. the nocuous and the innocuous, which It must be recollected that the yellow naturally plunges their treatment in matter is not confined to the surface doubt. I will give two instances of old alone, but extends into the hair- women’s remedies for ringworm; the deeply “ tubes, and the friction of the diseased first is writing ink.” Now, writing ink parts with the finger, when well wetted is a monstrously clumsy lotion, a combi- with the lotion, is necessary to introduce nation, in fact, of two highly astringent the latter into the hair-tubes. Unless and stimulating substances, namely, sul- attention be paid to this observation, the phate of iron and infusion of gall-nuts, lotion might be used without ever reach- either of which alone would be a passa- ing the seat of the disorder, and of course ble, but third-rate remedy, but together, without avail in respect to the cure of the a very nasty one. Then there is tobacco disease. Another point to be noticed is water, a rank poison, excluded from the necessity of carrying the principle of medicine for its dangerous properties, but still cleanliness to the sponges, combs, and occupying a place in the old wo- towels used by the patient. The sponge man’s pharmacopoeia. Old women, if and combs should be dipped in a weak they will insist on practising physic, solution of chloride of lime, and a clean should at least condescend to go lor a towel employed at each washing. Un- while to school, and learn the difference less these precautions be adopted, the between A and Z.* sponge, the comb, the brush, the towel, * [Our author has evidently been subject to the too may each convey the seeds of the vege- common officiousness of ignorant, self-willed nurses, and table growth, and the dis- has on that account made a rather harsh expression, espe- consequently cially tor a closing one. Some of our good mothers are ease, back to the scalp. most excellent nurses, and I think in a majority of cases are 246. I have said nothing about very desirous of following the advice of the doctor strictly, shaving ami place full confidence in him, or as much as he de- the head in ringworm, because in private serves. The experience of almost any sensible woman life I know it to be quite unnecessary. will convince her that the physician possesses knowledge care that may be made useful, and which is far superior to In public schools, even, ifproper be hers. On the other hand, they do not expect a doctor to taken, it is a needless measure ; but in know every thing, and decide immediately upon their workhouses it is advanta- complaints from the resources of his ignorance. It is undoubtedly only a few that make the number appear as legion A geous. Neither do I consider it as a few gossipping, tale bearing, slandering, mischief making, part of my duty to enter upon a detail of busy-bodies,—let them bear the blame. Yet they can hardly be said to be to blame ; the question is of their ca- the endless list of empirical remedies pacities.]
THE END.
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Fig. 2
Erasmus 'Wilson., del. H. Jordan,sc
PXutTE 6
Fig-1
Fig. 3 Fig. 2 tm.9
Fig. 10 Fig. 6 Fig. 5
Fig.7
Fig. 8
Fig. 4 a
Erasmus ’Wflgan., del. H. Jordan.: sc.