Glass _ Book_ COPYRIGHT DEPOSIT HAIR AND ITS PRESERVATION * V Medullary or Marrow Canal Papilla 1 / / Cordical layer V • -i'i— -4 — Fatty layer , (Y Jd f*?*** Epidermal i^^.y\ layer >/:'". (™il — External wall T^^^^: ; %: ;-"-•( vj of follicle Bloodvessel ''/•*'. %* Fig. 1. — Hair, its Bulb and Shaft. HAIR Its Nature, Growth and Most Common Affections, WITH Hygienic Rules for Its Preservation. RICHARD W. MULLER, M.D. New York WILUAM R. JENKINS COMPANY PUBLISHERS Sixth Avenue and 48TH Street Copyright, 1913 By Richard W. Muller All Rights Reserved Printed by the Press of William R. Jenkins Company ©CI.A3 5154 7 / PREFACE Observing the almost universal ignorance of the nature of the hair, its characteristics, its development and its diseases, and the destruction of the hair of the young people of the present generation, I have come to the conclusion that some timely in- formation and advice with some hygienic rules for the preser- ation of the hair might not come amiss. It was my privilege to get the permission of the greatest specialist in hair diseases, Dr. Sabouraud, of Paris, to employ some of the fine plates he had made for his own great but still unfinished work on diseases of the hair, and thus to make my little contribution to the spread of knowledge in Hair diseases more profitable and intelligible to my readers. I do not think it would be possible to find an up-to-date book suitable to the general public, on the subject which I have chosen, i.e., The Nature, Growth, and most common Diseases of the Hair, and the proper Care thereof. The only work worth mentioning, written upon hair, is out of print and none has taken its place. After years of study at the clinics, universities and hospi- tals of Paris, London, Vienna and Berlin, and gathering all the newest scientific facts, I concluded to present them in this form to the public. Richard W. Muller, M.D. TABLE OF CONTENTS Page Chapter I. The Nature and Growth of Hair 1 Section 1. The Structure of the Scalp 1 2. The Relation of the Hair to the Scalp 3 " 3. The Nature and Structure of Hair 4 4. The Color of Hair 8 " 5. The Contour of the Hair and other Properties 10 " 6. The Growth of the Hair 11 Chapter II. Affections Causing Baldness 15 Section 1. The Different Forms of Baldness 16 " 2. Seborrhcea, Dandruff, Alopecia pityroides 17 " 3. Treatment of Seborrhoea for Ladies and Girls 22 " 4. Treatment of Seborrhea for Men and Boys 32 Chapter III. Other Forms of Baldness 35 Section 1. Alopecia, Pityroides Universalis — Universal Baldness — 35 " 2. Alopecia Praesenilis, Premature Baldness 40 " 3. Regeneration 46 4. Treatment of Premature Baldness 51 5. Cicatricial Baldness 54 Chapter IV. Alopecia Areata — Nervous Baldness 57 Section 1. Nature of the Disease 57 " 2. Treatment of Nervous Baldness 62 Chapter V. Superfluous Hair and its Removal — Knotted Hair— Split Hair.. 67 Section 1. Nature and Location of Superfluous Hair 67 2. The Removal of Superfluous Hair 70 3. Electrolysis and Kromayer's Method 73 4. Trichorrhexis nodosa, Knotted Hair 77 5. Trichoptilosis or Splitting Hair 79 CONTENTS. Page Chapter VI. Parasitical and Fungoid Diseases of the Hair 81 Section 1. The Origin of the Name 81 " 2. Trichophyton Tonsurans, Ringworm 81 " 3. Treatment of Ringworm 86 4. Favus 92 " 5. Treatment of Favus 94 " 6. Pediculosis capitis, Head Lice 98 7. Treatment of Pediculosis 100 Chapter VII. Hygiene of the Hair 103 Section 1. Cleanliness of the Scalp 103 2. Washing the Hair 105 " 3. Combs and Brushes 106 4. Style of Wearing Hair 108 5. Hats 110 6. Massage of the Scalp 112 Chapter VIII. Foreword on this Chapter 117 On Food in General and Especially for the Growth of Hair 119 Section 1. Food in General 119 2. Water 121 " 3. Animal Foods 123 4. Vegetable Foods 131 5. Fats and Oils 142 " 6. Crustaceans 144 " 7. Amount of Food Required 144 " 8. Value of Food in Common Use According to Calories 147 " 9. Special Food for Promoting the Growth of Hair 148 Literature 149 Prescriptions 151 Index 153 LIST OF ILLUSTRATIONS Page 1. Hair, its bulb and shaft Frontispiece 2. Marrow canal in the hair shaft 5 3. Hair on papilla 7 4. Showing change of papilla after hair has dropped off 7 5. Hair on papilla with muscle and gland 7 6. Hair pushing out old hair forward 9 7. Hair with follicle, glands and muscle 19 8. Hair with gland and invading microbes 21 9. Division of scalp for proper treatment 23 10. Hair with seborrhoic plug 25 11. Hair with follicle plugged up and colonies of microbes 27 12. Hair follicle with dead hair plugged in 29 13. Hair follicle in extreme case of seborrhoea 31 14. Case of seborrhoea, first stage 37 15. Case of premature baldness 39 16. Case of premature baldness 41 17. Case of receding temples 43 18. Other form of baldness 45 19. Other form of baldness 45 20. Extreme case of baldness due to seborrhoea 47 21. Premature baldness in young woman 49 22. Alopecia Areata, nervous baldness in man 59 23. Alopecia Areata, in a boy 61 24. Alopecia Areata, in a woman 63 25. Alopecia Areata of a malignant type 65 26. Young lady with hair on upper lip and chin 69 27. Young lady with hair on cheeks , 69 28. Young lady with well developed side whiskers 69 29. Same lady after treatment 69 30. A case of excessive hypertrichosis 69 LIST OF ILLUSTRATIONS Page 31. Prof. Kromayer's needles for epilation 76 32. Knotty hair 77 33. Split hair 79 34. Hair of child with ringworm 82 35. Hair infested with ringworm 83 36. Ringworm on boy's scalp 85 37. Ringworm on scalp and face 87 38. French poodle with ringworm 89 39. Typical appearance of hair attacked 91 40. Sections of hair with Favus 93 41. Favus spreading from scalp down over shoulder 95 42. Boy's body covered with Favus 97 INTRODUCTION Why is it that the hair, one of the most important assets of beauty, is so neglected by both men and women? We go to the manicure to improve our finger nails, and if our feet hurt us, we find our way to the chiropodist. But if our hair falls out, or is too dry or too oily, what do we do? Why, simply let it alone, or ask a friend's advice and follow or neglect it without a thought as to whether the advice is good, bad or indifferent. W T e see an advertisement of a hair tonic, with a picture of a woman with hair down to her feet, and without hesitation or doubt, we buy a bottle of it and apply it, often in a spasmodic manner, and find, if no visible bad results from its use, certainly no good ones ; and our hair does not grow down to the ankles after a few weeks' use of this infallible remedy. Is it any wonder then, that in the theatre, in church, or in any place of public meeting where men remove their hats, we see so many bald heads? And among women, do we not sometimes wonder how they carry all the false hair and rats which they find it necessary to use now-a-days to eke out their own scant supply. But the hair in childhood, to begin with, is neglected. Mothers who rush to the doctor for every little childish ailment, never give much thought to the care of the child's hair. They cut it short or let it grow, as suits their own views and theories, but INTRODUCTION without any real knowledge of the subject. Women wash their hair when convenient without any particular reason for so doing other than that they think it must need it; but they do it without knowing rightly how and when or what soap to use or whether any soap should be used. What would become of our teeth if they were treated as the hair is. A woman's hair is her crown- ing glory; therefore she should care for it as she does for her teeth and hands. And has not a bald head been a term of re- proach ever since the small boys made fun of Elijah's? Do we not daily hear remarks referring to the resemblance of some young man's cranium to a shining billiard ball? Oh, he has amused his hair away! or, he has lived too fast! or, less re- proachfully, his father or grandfather were bald, too, it must be hereditary! All of which conclusions are most often erroneous. The real reason generally is that no one took suffi- cient interest in the young man's scalp when he was a boy, until the stage of the disease which made him bald was too far advanced to save his hirsute adornment. Such being the case, I intend in the following chapters to explain in simple language what the nature of the hair is, how it develops, grows, becomes diseased and finally falls out, also how it may be preserved for its allotted time. CHAPTER I THE NATURE AND GROWTH OF THE HAIR As I firmly believe, that advice is more readily accepted and followed the better the subject is understood, I shall begin this article by explaining the manner in which the human hair de- velops and grows, also the anatomical relation between hair and scalp, and later show the difference between a healthy and un- healthy state of the scalp. Section 1 The Structure of the Scalp To understand correctly the nature and growth of hair we must know something of the condition of the skin in which it is imbedded. The skin is divided into three layers, the external or epider- mis, the middle or horny, and the lower or granular layer. The external and uppermost layer, called epidermis, consists of cells, which are packed closely together like the cells of a honeycomb. 2 THE HAIR To make them still firmer and more compact, there are spikes or thorns there, shooting forth from the walls of the cells into the neighboring cells, making a pretty solid web, holding as firmly together as possible. This is best illustrated by inserting the fingers of one hand between the fingers of the other hand and letting another person try to pull them asunder. Thus the epidermis is well able to withstand the injuries, to which it might be exposed. The middle or horny layer consists of connective tissue, long spindle-shaped cells, which run in all directions, their fibres binding together all parts above and below, side by side, like the steel trusses of a bridge. The third and lowest layer consists of numerous fat cells forming a soft bolster or cushion for the two upper layers, enabling the skin to stretch, yield to and follow all the different movements of the body and its organs without opening or ex- posing the unprotected parts underneath. By its formation the fatty layer is enabled, like a sponge, to take up, hold and release, as the case may be, large amounts of fluids, as happens in heart and kidney affections, which are so often followed by dropsical conditions. The fat, which is deposited there in large quantities, also serves to give the body the roundness and fulness so necessary to make the "human form divine." Such is the skin in which the hair is imbedded. NATURE AND GROWTH OF HAIR 3 Section 2 The Relation of the Hair to the Scalp Before describing the anatomical structure of the scalp let us see how the hair is imbedded in the scalp. If you keep in mind the structure of the skin, you will readily grasp the rela- tion of the hair to the skin. Imagine for a moment, that the scalp is a pillow and if you will thrust the point of your index finger deeply into the same, you will find that it is surrounded by the different covers of the pillow, viz : the outer washable cover, the inner one containing the feathers, and as a third envelope, the feathers themselves, which are contained in the pillow. Your finger represents the hair, the washable cover of the pillow is the upper layer of the skin, the cover holding the feathers will be the middle or horny layer of the skin and the feathers themselves represent the third or fatty layer. Imagine further, deep down in the depression your finger has made, a button fastened on the pillow, and you have a rep- resentation of the papilla or matrix of the hair from which it takes its origin, its nutriment and everything needed to fulfil its purpose in the life it is to live. The picture should now be clear to you. A depression lined by the three layers of the skin; at the deepest part of this depression a protuberance, called a papilla, out of which the hair develops; finally, the long hair shaft completely filling the depression, called the hair follicle. 4 THE HAIR The little swelling you have undoubtedly noticed at the lower end of your hair is commonly, but mistakenly, called the root; for it is not a root in the ordinary sense. It is simply an expansion, an attachment, which forms a comfortable connecting link between the hair and the papilla from which it grows and is called the hair bulb. Section 3 The Nature and Structure of Hair When we examine a hair by means of a microscope, we see that it consists of concentrically arranged layers of which, as in describing the anatomy of the skin, we will only mention the three most important ones, conforming to those of the skin, which surrounds the hair in the follicle. The upper or horny layer has smooth, firmly packed, flat- tened cells, placed like the tiles on a roof upon each other to protect the hair from outside injuries. The protection is all the more sure z& five cells overlap one another in the space of their own individual length, making a quintuple shield for every part of the hair shaft surface. The free ends of these overlapping tile-like cells are turned upwards toward the upper end of the hair. This arrangement facilitates the task of finding the point of the hair; when you hold it loosely between thumb and index finger, moving them ever so little up and down, the point soon appears between the fingers, as the projecting ends of the tiles help the movement. NATURE AND GROWTH OF HAIR fn&rrtnixc&ruit Fig. 2. — The Marrow Canal in the Hairshaft. 6 THE HAIR The middle layer of the hair, called the cortical portion (from cortex, i.e., rind) corresponds to the connective tissue layer of the skin, consisting as it does of long spindle-shaped cells drawn out and bound together lengthwise. If it were not for these cells binding the hair particles closely together, the hair would soon break and be ruined by being subjected to the exigencies of the fashions of hairdressing. When we use a lense magnifying 300 times or more, it is possible to discover that the cells of this layer do not bind them- selves absolutely everywhere, but in certain locations leave open- ings, which are filled with an oily secretion from the glands found within the hair for this purpose, thus giving it its lustre and beauty. It is well to explain right here in this connection the fact, that in case of serious illness and in some particular diseases of the scalp, this secretion dries up entirely, and soon after the lustre of the hair diminishes or disappears altogether, rendering it dry and lifeless and causing abundant scales to appear. The innermost layer of the hair consists of two rows of large, firm cells lying side by side along the hair shaft, forming what is called the medullary or marrow canal. Not every hair is thus provided, however; many have but two layers mentioned above, but a normal, healthy hair is by experienced observers found to have this marrow canal. The very finest hair may be deprived of it, hair growing late in life also may be without it, but the strongest and health- iest hair is regularly thus provided. NATURE AND GROWTH OF HAIR Fig. 3. Showing change of Papilla after Hair dropped off. Fig. 5. — Showing Hair ingrown on Papilla. Fig. 4. — Showing Hair on Papilla. 8 THE HAIR When severe illness occurs, we can find an intimate relation between it and the marrow canal. On looking at it under the microscope, we see the canal shrink to a diameter 1 / 4 — 1 / 10 the size it was before. It will continue in this attenuated form as long as the illness lasts, and gradually, slowly, reassume its former dimensions when the body has regained its pristine vigor. The knowledge of the measure of the hair growth and experience with the manner of estimating dimensions under the microscope, enable us to calculate with certainty the time which has elapsed since the patient suffered a severe illness, by examining one of the hair's medullary canal. Section 4 The Color of the Hair The color of the hair, blond, brown, red, etc., depends en- tirely upon that of the coloring matter or pigment deposited or dissolved in minute particles or corpuscles in the middle layer of the hair. The intensity of the color, however, is regulated by the lesser or greater quantity of this coloring matter present. Gray hair, so long regarded purely as a sign of approach- ing or premature age, is simply due to the absence or loss of pigment, or the presence of more or less air within the hair, caused either by sickness, worry, shock, severe mental strain long continued, or accidents to be mentioned later on. NATURE AND GROWTH OF HAIR papilla Fig. 6. — Showing young Hair pushing old Hair forward. 10 THE HAIR The change takes place at the growing end first and the natural color mixed with the colorless or white portion of the hair, caused by the presence of air in the marrow canal, ac- counts for the gray appearance. Section 5 The Contour of the Hair and Other Properties As the color, so the contour of the hair differs much, de- pending upon the degree of fineness. Flaxen hair is the finest of all varieties, being only 1/1500 — 1/500 inch in diameter, while black hair on the contrary with diameters of 1/450 — 1/140 is the coarsest. The contour may be round, oval or flattened. This regulates the curling quality of the hair; the more oval and flattened the hair may be, the prettier the curl; the rounder and the more circular, the less this quality. As hair absorbs moisture from the atmosphere, the curl will be better, the moister it gets ; the drier the straighter. Arti- ficially curled hair, however, will not stand moisture at all, but loses its curl in moist weather. I add here a few words about another peculiarity of the hair of which little is known. The hair is very elastic, and can be stretched to y$ its own length. It also is possessed of sufficient strength to sustain the weight of two to four ounces without breaking. NATURE AND GROWTH OF HAIR 11 Another interesting feature of the hair is its electric property. Passing a rubber comb through the long hair of a woman causes a crackling sound produced by electricity. In peculiarly susceptible people it will stand out straight from the scalp under the stimulus of electricity. Section 6 The Growth of the Hair The little swelling you may have frequently noticed at the lower end of your hair covered by some whitish, scaly matter, has been universally named the hair root. The hair practically has no root. It merely has an ex- panding part at the lower end of the shaft called the bulb, which fits closely over the rounded surface of the papilla or matrix, from which all nutriment needed for its growth comes. There all the cells, every part of the hair structure is developed unceas- ingly, to replace old, worn-out cells and eventually the hair which has been pushed aside or has fallen out. There, nerves, blood- vessels, lymph, and everything else needed for its development, is provided. The larger and better developed the papilla, the stronger and longer will be the hair growing from it. The bigger the expanded end of the fallen hair appears, the better is the chance of a strong hair following it; for in order to push and grow out of its follicle, the young hair has to move the old hair aside to 12 THE HAIR the wall of the follicle, or to push it forward in order to reach the daylight; a hair, loosened from its papilla, may still be lingering within the follicle and escape the fate of falling out for a long time, if it be not disturbed. The new hair may push it aside and keep on growing without removing the old hair from the follicle, both sharing it for some time till some rough agency, be it comb or brush or shampooing, massage or other strenuous work on the scalp, loosens the dead hair, which falls out in quantities, much to the surprise of their owner. Hundreds and hundreds of hairs thus fall out together. Every hair, however, must fall out some time to be replaced by a new one and to allow room for the following hair to grow. The growth of the hair depends too much upon general conditions to give any exact account of it, but it is safe to say that a normal hair will take 14 days to grow 3^ lines or ]/z inch. On different parts of the scalp, and in different individuals, the growth varies considerably, while on the crown and the back of the head, hair may grow 45-50 inches in length; at the side of the head, 18 inches is generally the limit. The longer the hair the quicker it grows. Therefore, the quickest growing hair is on the crown and back of the head. Of course, a man's hair does not grow as long as a woman's, it being rarely longer than eight inches. The custom of cutting does not improve hair, on the con- trary, latest observation proves that it retards the growth and makes it coarse. Nor does the hair always grow at the same rate, for after it has grown a certain length, say 12 inches, the NATURE AND GROWTH OF HAIR 13 rate decreases by one half, and later towards the end of its life, one can scarcely observe any change whatever. The finer the hairs the closer they will be on the scalp; the average, however, is 1,000 to the square inch and 120,000 on a normal scalp. In middle life the hair grows fastest and most vigorously, while after 35 it does not grow to its full length any more, except in rare cases; after 60 years only short hair will grow. These conditions obtain in healthy and normal persons. Ill health and abnormal conditions change matters considerably, as I shall demonstrate in later chapters. CHAPTER II * Affections Causing Alopecia (Baldness) Seborrhoea Anatomical Demonstrations of Seborrhoea In order to make my readers fully understand the meaning of seborrhoea (dandruff) and to show how this disease invades the human scalp and insidiously destroys hair, hair follicle and hair bulb, I have drawn a few pictures (after Sabouraud) and accompany the same with suitable explanations. Like all other diseases of the skin, seborrhoea is due at first to some minute lesion of the skin, which is called "primary lesion." In seborrhoea this lesion is the little thread, or, as Sabouraud calls it, filament, which can be squeezed out of the hair follicle by the pressure of the thumbnails or some suitable instruments the physician uses. This secretion of the glands within the hair follicle is con- stantly discharged in increased quantities, gradually covering the area surrounding this hair follicle and spreading beyond until ultimately, when no curative remedies are employed, the crown of the head, the temples and back are covered with a greasy mass, disgusting to see, hard to get rid of, and destructive to the hair. 15 16 THE HAIR Section 1 The Different Forms of Baldness Alopecia is 'from the Greek word Alopex (fox). The name is given to this affection from the resemblance of a bald head to that of a fox suffering from a disease, called mange. I shall mention but three varieties of baldness in this chap- ter. Other forms will be mentioned in later chapters. The first variety, Alopecia adnata (or congenital baldness), explains itself in the name. It may be total or partial. It is often hereditary, and is caused by arrested development of the hair-growing apparatus. The second form, Alopecia senilis (or senile baldness), comes with old age after 45 years and is due to diminished nutrition and lowering of the vitality. When recognized betimes much may be done to ward off the evil day of complete baldness by preventative and invigorating treatment. If once established, senile baldness is incurable. The third variety, Alopecia praesenilis (premature bald- ness), is of greater interest to us than all others, as we can hold out hopes of help and improvement, and even absolute cure, if called upon at an early stage of this disease. This premature baldness may be either idiopathic, that is, self-originating, or symptomatic, that is, caused by some local or general disease. When it is self-originating, appearing without cause, it does SEBORRHCEA 17 so before the 45th year, the hair gradually, almost imperceptibly, diminishing at both temples, at the top of the head, and thinning all over the scalp. Symmetrically on both sides and on the vertex towards front and rear, baldness spreads until the disease has reached its climax, when no further hair loss is noticed, a fringe of hair being left reaching from front to rear. Should any new hair appear, we find it thin and colorless, not much better than down found on other parts of the body. The other form of premature baldness which we have named the symptomatic, because due to general or local disease, requires a more lengthy discussion, as it is the form which most frequently comes under observation and destroys more hair than any other disease known to us. The diseases which most often cause this variety of bald- ness are Seborrhoea (dandruff), pityriasis and syphilis. All these are of the nature of scaly diseases and much con- fusion as to their names and origin exists in the text-books even to this day. For this reason I confine myself to the description of the most common of these diseases, Seborrhoea, or, as it is often called, dandruff. Section 2 Seborrhoea (Dandruff) Seborrhoea, of which two forms are known, the oily (oleosa) and the dry (sicca), comes on insidiously at the age of puberty. 18 THE HAIR Silvery scales are seen on the collar and coat of young people of both sexes, occasionally the scalp itches — and has to be scratched, bringing down more scales. On observing these young people closely, their faces seem oily, particularly the forehead, nasal fold and chin. An abnor- mal amount of secretion oozes out from the glands. On examination, the scalp is found to be covered with greasy, dirty scales, which being removed uncover a slightly reddened skin. If we press tissue paper firmly upon the scalp, a greasy stain appears. On pressing with thumb nails upon the surface, first a drop of oil is squeezed out and this is followed by a worm-like filament with a yellow head. This condition proves that the patient suffers from oily Seborrhoea. Should the patient in this condition go on for 4-6 years or more without the proper treatment, trusting himself to the prodigal use of hair tonics, hair washes, shampoos, bay rum and other alcoholic mixtures, a stage will be reached which admirably pictures the condition we find in dry Seborrhoea. The scalp instead of being oily, is now dried up, the hair has lost its lustre and gloss, scales, though not so many as in the former condition, cover the scalp and are found scattered through the hair. The hair has grown thinner and continues to diminish. The temples become more and more uncovered, the fore- head higher, a thinker's forehead develops, giving the sufferer the appearance of a wise and studious man. Finally the bald- SEBORRHCEA 19 Fig. 7. Showing Hair in Follicle with Glands and Muscle. 20 THE HAIR ness invades the top of the head and symmetrically spreads to front and rear, leaving an island, a tuft of hair over the forehead as a memento of pristine glory. \ Before proceeding to the discussion of the treatment of this disease, I wish to state the fact that the origin of Seborrhoea has been the object of the most diligent research for the last ten years by Dr. Sabouraud of the St. Louis Hospital of Paris as well as by the famous dermatologist, Dr. Unna of Hamburg. Both agree that a microbe, which Dr. S. calls "microbe a bouteille," and Dr. U. "flaschen bacillus," on account of its re- semblance to a bottle, is the cause of the condition called Seborrhoea. This microbe is believed to invade the follicles from which the hair issues forth. There it multiplies enormously and by its presence in large numbers obstructs the mouth of the glandular ducts, fills up the follicle, presses upon the tender new hair and its bulb, and finally destroys the follicle utterly. It was through the kindness of Dr. Sabouraud, whose clinic I visit annually for some weeks, that I was enabled to explain his theory of the origin of Seborrhoea by some sketches I made for this little book, which are found with elucidating descrip- tions on the first four pages of the chapter. SEBORRHOEA 21 ft*** /LcOAf Fig. 8. In Fig. 8 I have tried to demonstrate at a the in- vasion of the microbe, which is supposed to be the cause of the gland secreting abnormal amounts, irritated by its presence; b, b, b shows the sebaceous gland many times enlarged. At a, a are the microbes ; c is the exit of the duct of the gland, through which the Secretion is poured into the hair follicle ; d, d is the hair in unchanged form, as disease has not progressed far enough to injure the growth of the hair. 22 THE HAIR Section 3 Treatment of Seborrhoea for Ladies and Girls It is a great pity that this disease is so often discovered too late to be benefited by treatment. More often, through wr6ng and injurious treatment, valuable time is lost and great harm done to the scalp. In the case of ladies, greasy pomades and ointments must be avoided if possible, although some cases cannot be treated effectually without their use. Alcoholic solutions recommend themselves as the best remedies in oversecretions of the perspiratory glands of hands and feet; therefore we employ them and successfully in the over- secretion of the glands in the hair follicles, which is exactly the condition of affairs in Seborrhoea. The Alcoholic Solution of Salicylic Acid applied in the manner to be described, at the right time, and according to the severity of the disease, will do a great deal to improve the con- dition of the scalp and the hair. To apply this remedy correctly, a wad of absorbent cotton or a soft toothbrush must be used; a painter's brush or a child's hairbrush will also answer the purpose. To proceed methodically, part the hair once through the middle and then again twice at equal distances from side to side as shown in following sketch. SEBORRHCEA 23 Fig. 9. — Division of Scalp for proper Treatment. Now use the solution in this manner: Pour a sufficient quantity in a saucer after the hair of the patient has been parted in the middle and commence, say, for the sake of example, to treat the front section of the right side for the first day. Dip the cotton wad or brush into the fluid, raise a strand of hair and rub the fluid thoroughly into the exposed surface of the scalp for two or three minutes, then proceed to the next layer of hair, maybe ^2 inch further to the right, and do the same, layer by layer, down past the ear and as far as the scalp extends. If you have taken the forward row of hair, follow in the same manner on the second and third row until you reach the imaginary border line of the first section. It should take at least thirty to forty minutes to do this work with any degree of thoroughness and to expect good results. I 24 THE HAIR After thoroughly cleansing the scalp of the scales with which it is covered, we can test the work done by using a bit of cotton on a comb and going slowly through every part of the scalp, using a fresh piece of cotton each time. The cotton will show clearly whether the ridding the scalp of all the scales has been accomplished. For, should the cotton on the comb show greasy marks caused by the scales still left behind, the parts neglected must be done over again until every portion of the scalp has been freed from them. However, all efforts to do this unfortunately prove futile in some cases, and more severe measures are necessary and one must resort to the specialist. To free the head absolutely of its thickened layer of scales (dandruff), sulphur must sometimes be employed. The thick layers of scales consist, as I have explained be- fore, of decayed horn cells of the upper layer of the skin (and scalp). Sulphur attacks this mass energetically, and soon dries it up, and peeling off, leaves a new, regenerated, normal field for hair to grow and develop on. This sulphur lotion must be used with great caution, as must indeed every other remedy, since the scalp is in an abnormal condition and is easily inflamed by irritating applications. I can therefore only caution those who suffer from sebor- rhoea not to do anything without using great discrimination and care, and whenever in doubt to ask the specialist, in order to ac- complish their object without injury to their hair. SEBORRHCEA 25 fete tit *trf lands Fig. 10. Fig. 10 represents the seborrhoic plug b, nearly filling up the mouth of the hair follicles; at a can be seen the colonies of microbes incased in the plug; at / the epi- dermal or upper layer of the scalp is visible ; at e the sebaceous gland is seen. 26 THE HAIR Here follows a prescription for a sulphur lotion to be em- ployed in case other remedies used have not effected a cure. If. Florum sulfuris 10.0 Spiritus vini 100.0 Glycerinae gtt 10.0 Spir. Colon 10.0 (This mixture, containing alcohol, must not be used near flame.) This lotion is used in the following manner: The solution having been put into a deep dish or saucer the hair is again separated into six parts in the way previously de- scribed. In a few minutes the sulphur will have settled at the bottom of the dish and the yellow sediment may now be transferred by means of a brush over the affected portion of the scalp. To do this thoroughly should take two to three hours, and it is much better to take several days to do it properly. The physician is the proper person to apply this lotion, as he alone is able to judge what amount and what strength of the remedy it is proper to use in each individual case. Also the location to which it is to be applied can only be recognized by the experienced eye of the physician, while the in- experienced frequently overlook diseased patches of the scalp and thus the disease is perpetuated, reinfecting other and healthy parts of the scalp ad infinitum. After five to eight days the scalp must be reinspected, and more lotion applied, if the sulphur has disappeared. SEBORRHCEA 27 6eccUu Stlrrr&oUt. Sftactew AcUA, Fig. 11. Fig. 11 shows the entire plugging up of the hair fol- licle, making a complete stop-gap of the filament b, b, b. At a colonies of microbes are represented; enlarged sebaceous glands are seen at c, c, c, and d finally shows what is left of the hair itself. 28 THE HAIR Traces of sulphur will still be seen eight and ten days after the first application, but nevertheless fresh sulphur should be applied whenever needed or wherever it has disappeared. Another week may then be permitted to go by, when a further close scrutiny is necessary and so on until the skin peels off in flakes, and a new one begins to show. It takes three to four weeks before any improvement shows. Where the itching has been annoying, it will be found to have disappeared a few days after the commencement of this treatment. Hair will, however, continue to fall out for weeks before improvement will definitely set in. Sulphur being an irritant and not well borne by every one, other treatment has often to be employed. In such cases we prescribe as follows: 1, If. Acidi Salicylici 1.0 Spiritus vini 200.0 (Not to be used near open flame.) Fiat solutio. 2, I£ . Florum sulphuris 1.5 Vasilini flavi 30.0 M. fiat unguentum. These two remedies are to be used alternately, or, better yet, the salve should be rubbed in two days in succession, and the third SEBORRHCEA 29 tCoTTAorc'/tYa- sr*tt