Affections of the Skin

the hygienic system orthopathy chapter 21 - continued


Definition: This is a symptomatic affection of the oil glands.

Symptoms: There is a diminution or total absence of the oil, resulting in a dry, harsh, and frequently scaling skin. It frequently accompanies psoriasis, scleroderma, prurigo, ichthyosis, and leprosy.

COMEDONES (Blackheads)
Definition: These are plugs of oil or sebum which form in the oil ducts of the skin. There is usually an overgrowth of the lining membrane of the ducts, and added to the plug may be scales from this membrane. It. is sometimes called a "flesh worm."

Symptoms: Blackheads are occasionally seen in children, even in babies, and in later life, but are most common in puberty and young adults. They may be either slightly elevated or slightly depressed, and are yellowish, bluish, brown or black in color. The nose, cheeks, and forehead are their most common locations. They are sometimes seen in the temples, ears, neck, back and chest, or wherever oil glands are present. They may be single, or with a "head" attached to two or more plugs; may be few or numerous; and upon pressure, exude a slender body, colored at its outer end, its body yellowish or white, its lower end white and soft.
Affections Of The Skin
COMEDONES (Blackheads)
Definition: These are plugs of oil or sebum which form in the oil ducts of the skin. There is usually an overgrowth of the lining membrane of the ducts, and added to the plug may be scales from this membrane. It. is sometimes called a "flesh worm."

Symptoms: Blackheads are occasionally seen in children, even in babies, and in later life, but are most common in puberty and young adults. They may be either slightly elevated or slightly depressed, and are yellowish, bluish, brown or black in color. The nose, cheeks, and forehead are their most common locations. They are sometimes seen in the temples, ears, neck, back and chest, or wherever oil glands are present. They may be single, or with a "head" attached to two or more plugs; may be few or numerous; and upon pressure, exude a slender body, colored at its outer end, its body yellowish or white, its lower end white and soft.

MILIUM (Grutum)
Definition: A functional affection of the oil glands.

Symptoms: It presents small, round, yellowish, or pearl-white, non-inflamed elevations in the skin. They appear chiefly on the face and their contents cannot be squeezed out until an opening is made. In this, they differ from blackheads with which they are frequently associated. They often develop under scars. The elevations are about the size of millet seed, hence the name. They feel gritty to the touch, hence the name grutum (grit).

Etiology: They result from the retention and hardening of the oil secretion in the ducts of the oil glands, the outlets of which have become closed.

Definition: An excessive scaling of the skin, particularly of the scalp, as a result of a decrease or absence of skin oil. The condition is seen largely in older people, but occasionally it is seen on the head and eyebrows of babies. In adults it may also develop on the hairless surfaces. The scales are yellowish or grayish. Often dandruff and falling hair are associated symptoms. When on the scalp it is frequently associated with falling hair, though there may be considerable dandruff with loss of hair.


Definition: This is a deficiency of sweat.
It is a symptom and is seen in fevers, diabetes, certain skin affections, and in cases of lowered nerve tone

Definition: A functional affection characterized by the secretion of colored sweat.

Symptoms: The sweat is most commonly red or yellow. The face and trunk are most frequently affected. It is often associated with excess sweating.

Definition: This is bloody sweating occurring usually in young hysterical women, upon the hands, feet, face, ears, and umbilicus, due to hemorrhage into the sweat pores.

Definition: Excessive sweating.

Symptoms: Excessive sweating is the primary symptom. Prickly heat, eczema or intertrigo often ensue in its wake. Local hyperidrosis is most frequently seen in the hands, feet and axillae. Unilateral sweating of the face is sometimes seen.

Etiology: Marked debility, tuberculosis, affections of the sympathetic nervous system and aneurysm are given as causes. These are effects — effects of enervation and toxemia. Overeating, too much fluid intake, the use of tea, coffee, fat and alcoholics lead to excessive sweating.

Definition: An affection of the skin characterized by the eruption of minute vesicles, resulting from the retention of sweat in the upper layers of the skin.

Symptoms: Minute, irregular, translucent vesicles appear on the skin. They are not surrounded by an area of inflammation and do not rupture, but dry up and are followed by slight desquamation.

Etiology: It is often seen in healthy persons who sweat profusely and is seen in febrile crises, like pneumonia and typhoid, that are associated with sweating.


ALOPECIA (Baldness)
Definition: This is partial or complete loss of hair and is also known as calvities. In rare cases all the hair on the body is lost.

Symptoms: Partial or complete baldness is the rule in the aged. The hair begins to thin at the brow or crown and progressing from these points, the head or much of it loses all of its hair. In congenital cases, baldness is usually only partial.

Etiology: No cause for congenital baldness is known. Baldness in "old age" is considered normal and is probably as normal as toothlessness in old age. It is considered to result from changes "due to senility" or some degree of atrophy of the scalp and hair follicles. Senility and atrophy are due to chronic toxemia. Hair is often lost in anemia, diabetes, chronic intoxications and various affections, as well as in seborrhea, psoriasis, folliculitis, and ringworm of the scalp. These things account for but few cases of baldness. Hair is often lost rapidly during or immediately after fever. The fact is that the cause of most cases of baldness is still unknown.

Care of the Patient: Once bald-headed, always baldheaded is the rule. I have seen one case of spontaneous regrowth of hair on the head of an aged man who had been baldheaded for, more than twenty years. Hair lost during or immediately after a serious acute affection like typhoid, usually (though not always) grows back immediately after normal health is restored. There is no way to restore lost hair and no known way to prevent its loss, once it begins to fall out. Better health and better nutrition should help.

CANITIES (Gray hair)
Definition: This is a skin atrophy resulting immediately from loss of pigment in the hair.

Symptoms: Though considered normal in advanced life (canities senilis), premature graying may occur even in adolescence. Albinism is a congenital form.
The hair may become gray in spots or patches, or it may involve all the hair of the head or body, and the loss of color may be partial or complete.

Etiology: The loss of hair pigment usually takes place slowly, though in some instances, its loss is comparatively rapid. Enervation and poisoning of the pigment secreting glands is the probable cause of graying.

Prognosis: Once developed it usually remains, though occasional cases are recorded. Where the hair returned to its original color or to some other dark color. The existence of such cases, though rare, points to the possibility that someday, a way may be found to restore normal color to gray hair.

Care of the Patient: There is nothing to do except adopt a wholesome mode of living and stick to it.
Atrophia unguis, as this is called, may be either congenital or acquired. In the congenital form the nail may be defective or distorted or absent from birth. In the acquired form, which is more common, the nails become thin, narrowed, furrowed, crumbly and distorted and lose their transparency. The condition is symptomatic of constitutional impairment and is seen in prolonged fevers, psoriasis, eczema and ringworm.

Definition: This is inflammation of the matrix (paronychia) and may be either acute or chronic. It may affect one or several nails.
Acute onychia follows contusion of the nail, where the matrix is bruised. It is very painful and if the matrix is seriously damaged, may result in shedding of the nail.
Chronic onychia is a low-grade inflammation developing in those who are forced to keep their bands more or less constantly in water. It may also be seen in certain types of malnutrition. One or several fingers may be involved. There is slight redness, swelling, little pain, no pus, and, if allowed to continue, deformity of the nails.

Definition: This is commonly called whitlow or felon and is applied to inflammation of the bone or bone covering, but is also correctly applied to inflammation of structures about the nail (paronychia) which is usually associated with inflammation of the matrix. It is common in washerwomen and scrubwomen, in diabetes, arsenic poisoning, glossy skin, leprosy, Reynaud's "disease," and other affections. Acute inflammation, redness, swelling and agonizing, throbbing pain are the symptoms. Pus forms and burrows around under the nail, which becomes thickened and discolored and is, finally, shed. The new nail may be normal but frequently is deformed.
Definition: A cracked and roughened skin.

Symptoms: The skin becomes dry, rough, broken and painful. Some of the cracks or fissures are quite deep and bleeding often occurs. Washing tends to aggravate the trouble.
Cracking of the lips is frequently a source of much annoyance, pain and bleeding. In many cases the crack lasts throughout the winter months. The crack may be in the middle, on one side, or at the corner of the lips. Often the fissure is deep and stretching the lips tends to tear it and prevent healing. There may be no scar but sometimes a well-marked scar develops.

Etiology: Exposure to cold air and wind, especially without careful drying of the skin after bathing, soap, and the overuse of hot water are the most common external causes. Vigorous skin health prevents chapping under all ordinary conditions. Soap and hot water rob the skin of its oil and leaves it dry. Some people are troubled as much by chapping in winter as others are by sunburn in summer. It is most common in those having delicate skins and is seen most often on the hands, cheeks and lips.

Care of the Patient: Cut out the use of soap. Use few hot baths, keep the affected parts out of water as much as possible. Thoroughly dry the body, face and hands after bathing and washing. Protect the chapped portions from wind. But, most of all, build up the general health with better diet and hygiene; in the case of the lips, avoid stretching the lips so that the crack may heal.

Definition: A local inflammation of the skin and deeper structures resulting from prolonged exposure to great cold.

Symptoms: There are three degrees of frost-bite as follow:

First degree: This is a mere redness or erythema.

Second degree: This presents much swelling and lividity with the formation of blisters and ulceration. Usually the surrounding tissues are considerably inflamed.

Third degree: This presents pallor of the parts, which lose their sense of feeling, though there may often be intense pain in the parts above the frostbite. The frozen parts becomes cold, swollen and puffy, then discolored and shriveled, with the formation of the typical line of separation between gangrenous and non-gangrenous tissue produced by a protective inflammatory wall.
The fingers, being small, and far from the circulatory centers, are the parts most often frostbitten, except the ears and nose. The feet are also frequent sites of frostbite.

Etiology: Poor circulation, with poor tone of the blood vessels predisposes the individual to frostbite. Alcoholism also renders one more liable to its development. Exposure to cold produces frostbite in a susceptible individual.

Care of the Patient: Sudden application of warmth causes much pain and severe inflammation. The parts are best rubbed with snow or cold water in a cold room. The temperature of the room should be slowly increased. When warmth has returned to the parts, they may be wrapped in flannel to keep them warm, but no heat should be applied. The blisters need not be evacuated, although evacuation probably produces no harm.

PERNIO (Chilblain)
Definition: A chronic skin inflammation and swelling resulting from frost-bite.

Symptoms: Chilblain is seen in various grades ranging from a mere transient redness to a deep destruction of tissues. The usual case presents redness, swelling, itching and intense burning, the parts being shiny and cold to the touch. Vesicles and deep ulceration may occur in the worst cases. The fingers and toes may develop a sausage-like appearance. Exposure to artificial heat causes intense stinging and burning or itching. The extremities — fingers and toes — and the ears and nose are the parts commonly affected.

Etiology: Chilblain is due to exposure to cold and damp. A sudden change from a low to a high temperature seems to be the chief cause. Anemic individuals and those with poor circulation are most likely to suffer.

Care of the Patient:
Prevention. Care for as instructed under frost-bite.
Remedy: Keep the feet dry and gradually innure them to cold. Vigorous use of the feet, as in walking and running, will build up the circulation in them and gradually overcome the tendency to frost-bite.
Definition: A rare skin affection caused by a vegetable fungus, the microsporon.

Symptoms: It appears as small, round or irregular, well-defined, slightly bran-like patches which are reddish brown in color. These develop usually in the arm pits and groins and between the hips and thighs in the rear. They are accompanied by intense itching, are slowly progressive, and may last for years.

Definition: This is infestation by lice, pediculi: it is also called phthiriasis. Three varieties are described.
Pediculosis capitis (head-lice) is the presence, on the scalp, of head lice, or their ova or "nits." They cause severe itching which leads to scratching, and this causes the formation of excoriations, with either serous, purulent or bloody discharge. The exudate dries into crusts and mats the hair together. A foul odor usually accompanies. Irritation often causes the glands in the back of the neck to enlarge and sometimes to suppurate. More often this occurs on the back part of the head. Frequently there are papules, pustules and excoriations scattered about the face and neck.

Pediculosis corporis (body lice) is lice on the body. These are larger than head lice. They hide in the seams of the underclothing and deposit their eggs where they hatch in about 6 days. The louse gets out upon the skin only when searching for food. Crawling upon the skin, it causes intense itching which results in scratching, making lines or marks (excoriations), blood crusts, and, in chronic cases, pigmentation and thickening of the skin. The shoulders, chest, waist and thighs are most affected.

Pediculosis pubis (crab lice or pubic lice) is lice in the hairs of the genital region. These are the smallest of the lice. These lice fasten themselves to the hair of the pubic region, where they cling tenaciously while burying their heads deeply in the orifices of their follicles. The pubes and perineum are usually involved. Occasionally the armpits and the hairy region of the chest, and even the eyebrows, eyelashes, and beard are involved. Itching is intense and is accompanied by hemorrhagic punctures, papules, and scratches about the affected parts.

Definition: This is a common skin affection caused by the presence in the skin of a vegetable parasite called tinea trichophytina. There are six varieties.

Tinea circinata is ringworm of the body. It begins as one or more rounded or irregular pea-sized hyperemic scaly patches. These form into a circle in a few days with very small papules or vesicles around the outside. The patches heal in the center as they spread from their outer borders. Adjacent patches may coalesce, producing ring-shaped patches of skin that overlap or fold over each other. They are pink or red in color, with slightly elevated borders and, upon scaling, give off bran-like flakes. Itching is usually slight.

Tinea circinata cruris is ringworm of the thighs. This begins and develops as does tinea circinata.

Tinea Cruris (eczematoid ringworm) is so-called washerwoman's itch. It is very common and resembles intertrigo. There are macular, vesicular, papular, scaling, macerated (soft from cooking) and callous (like keratosis) types. It is common for several forms to develop in the same individual. The thigh, pubes, (around but not in the hairy region), the penis, labia, scrotum, perineum, arms, and the cleft between the buttocks as far up as the sacrum are common locations for the vesicular type. Extreme itching may be present around the labia, anus, and buttocks. The macular form is especially likely to develop under hanging breasts, between the toes, between the penis and scrotum, and between the buttocks. The feet is the location of the callous type.

Tinea trichophytina unguium is ringworm of the nails. Ring-worms form under the nails.

Tinea tonsuraus is ringworm of the scalp. This begins as does tinea circinata and may occur anywhere upon the hairy scalp, often producing partial baldness.

Tinea sycosis is ringworm of the beard or barber's itch and was discussed elsewhere.

TINEA VERSICOLOR (Chromophytosis)
Definition: This is "Liver spots" and is closely allied with ringworm but is not a true ringworm. It is due to a vegetable parasite.

Symptoms: Though usually found on the trunk, in rare cases it may develop on the neck, arm, armpit and face. It begins as yellowish, pin-head to pea-sized macules which are scattered over the affected sections. Within a few weeks or months these increase in size and run together forming large, irregularly shaped patches, with sharply defined edges. Usually fawn-hued they vary in color from pale yellow to brown, or may present a distinctly pink tint. A fine mealy scale covers the involved area, which, if not apparent, becomes noticeable upon scratching the surface. Itching is mild but usually persistent. It is seen chiefly in adults.

Etiology: Parasitic skin affections are due to animal and vegetable parasites that come in contact with the skin, most often in filthy surroundings. Most of these parasites are powerless against normal skins of full resistance. A healthy skin and cleanliness constitute the best protection against them.
A lowering of the powers of life, with abnormal nutrition and consequent slow and imperfect renewal of the tissues are essential before parasites can gain a foothold in the skin and thrive therein. When the skin is weakened and debilitated and ready to undergo de-generation, physiological scaling of the skin occurs prematurely and the skin fails to renew itself promptly and perfectly. This affords opportunity for parasitic invasion.
The resulting inflammation, eruption, suppuration, etc., are efforts to dislodge them.