The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![which sun jnds the roots of the teeth, (for the ]irocess of the formation of the teeth and the hair is perfectly the same) ; but the precise nature of the diseased state has not been determined. It would seem to depend sometimes upon inflamma- tion of the follicles, sometimes upon their ulcera- tion, sometimes upon a temporary deficient action, and sometimes upon atrophy or death of the folli- cles. In the body of a man who had become almost entirely hald in consequence of a putrid fever, of which he died, Bichat observed all the pilous follicles in their natural state, and small hairs shooting forwards from their bottom ; but he remarks that, before the fall of the hair in aged people, the cavity of the bulbs of the hairs gradu- ally diminishes, and the follicles, which contain the bulbs, at last disappear. The destruction of the pilous follicles may, however, be caused by pressure, by friction, and by other causes. Thus it has been observed to be produced by the pres- sure of certain subcutaneous tumours. Alopecia may be a purely local and idiopathic disease ; the affection originating in the follicles themselves. This happens when it arises from external causes, as from the application of quick lime or other depilatories; from the fumes of quicksilver, as was observed by Forestus in gold- smiths ; from exposure of the head to the rays of the sun ; from frequent pressure of weights upon the head ; and from friction of any hairy surface by the garments or otherwise. Or it may be local and consecutive, as when the follicles are injured by becoming involved in the inflammation, ulcera- tion, or other morbid process of any adjacent cutaneous disease, as happens in porrigo, im- petigo, variola, eczema, elephantiasis, and several others. Alopecia may also be secondary and symptom- atic, a consequence of general debility and con- stitutional exhaustion ; and hence it attends the convalescence of febrile diseases, and the puer- peral state ; hence, also, it is a common symptom of the advanced stage of phthisis, of diabetes, and of most cachectic diseases ; thus justifying the prudence of the Komans, who estimated slaves affected with alopecia at the lowest price. Hence it is also observed in the nervous debility which follows excessive venereal indulgences or seminal emissions, and has been known to be produced by- painful and distressing headachs ; by long con- tinued and intense study ; by the depressing pas- sions, as fear; by cares, disappointments, and anxiety. Of this kind was evidently that singular case related by Ravator, of a person, who, after a violent commotion, was attacked with amaurosis of the right eye, and all the hairs of the same side of whose body lost their colour, and fell from the eye-brows and eye-lashes as well as from the head. Of the same nature, also, was, in all probability, the remarkable case of M. le Chevalier d'Epemny, (Gazette Francois, Feb. 23, 1763.) who, after an assiduous application for the space of four months, without any previous symptom of disease, lost his beard, his eye-lashes, his eye-brows, and, in short, all the hair of his head and body. Alopecia may be a sympathetic affection, not a symptom of a constitutional disease, but caused by a disease or disordered state of some other organ or system of organs. The most common t>nn of this description which has come under our observation, is that which proceeds from chronic inflammation of the mucous membrane of the stomach, giving rise to a particular form of dyspepsia, which has, for this reason, been called inflammatory. Of this nature, probably, was that mentioned by Galen, (De Cur. Morb. Sec. Loc. lib. i. cap. 2.) arising from eating poisonous mushrooms; and that other noticed by Hippo- crates, (De Internis Affectibus, sect. 4.) in which the reader will readily recognize a well-marked case of the above-named form of dyspepsia (gas- trite chronique), and to which case there is, in an excellent record of modern medicine, (Journal des Progres, 1830. torn. ii. p. 43.) a parallel in form as well as in cause, and which, it is deserving of attention, was afterwards succeeded by an attack of diabetes mellitus. Of the e-ime nature also was in all probability that species of alopecia termed by the Arabians (Avenzoar, Avicenna,) bilious, in contradistinction to the other species which they called phlegmatic,- which last, in all appearance, corresponded with that form described by Celsus as most difficult of cure, pejus est quod densam cutem et subpinguem ex toto gla- brum facit, coinciding with the observation of some modern writers, that if the skin is pale or insensible, and it is difficult by friction to produce redness, the case is irremediable. Of the same nature is the case given by Lemery, of a man, who, some months after excessive catharsis, lost successively all the hairs from his body; and also another strikingly singular case, which, both in its causes and its cure, justifies the opinion which we have ventured to give of the nature of this species of alopecia. It is so illustrative that no apology is required for relating it. Lodovico Gnemmi, a Piedmontese, fifty-seven years of age, a person of great vivacity of temper, of a plethoric habit, but spare form of body, having the skin of a dull white colour, began, in the winter of 1825 and 1826, to feel severe pains in the head, with a sensation of burning heat over all the body, but most particularly in the skin : it was to such a degree, that, during the coldest night of winter, he was obliged to throw off his bedclothes. After having passed fifteen days in this painful state, he began by degrees to lose all the hairs of his head, then those of the beard, eye-brows, eye-lashes; and in the course of a month, there was not to be found a hair upon the surface of his body, neither in the arm-pits, on the breast, on the genital organs surrounding the anus, nor upon any of his extre- mities. All his skin was as smooth as polished marble, and the slightest trace of hairs could not be felt by the hand. He remained for two years in this state, so deformed by the loss of his hair that he hardly ventured to show himself in public, but always feeling on the surface of his body a sense of pungent acrid heat, more especially on the surface of the scalp, which was always mor- bidly sensible and painful to the touch.' In the beginning of March, 1828, he was attacked with a severe peripneumony, which was treated and cured by the most active antiphlogistic remedies, viz.: low diet, general and local blood-letting, cupping, purgation, blisters, &c, and, strange to say, under the influence of this treatment, on the decline of so severe an inflammatory disease and in a state of the greatest weakness of the circula- tion, the hairs which had disappeared for the](https://iiif.wellcomecollection.org/image/b21116805_0070.jp2/full/800%2C/0/default.jpg)
