The cyclopaedia of practical medicine : comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc. / Edited by John Forbes, Alexander Tweedie, John Conolly.

Date:: 1848

Credit: The cyclopaedia of practical medicine : comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc. / Edited by John Forbes, Alexander Tweedie, John Conolly. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

73/828 (page 71)

$during travelling, have been well depicted by Dr. James Johnson. {Change of Air,- or the Philo- sophy of Travelling, &c. ; Amer. edit. : Nev? York, 1831.)] But change of air is not more valuable as a remedy in the cure of disease and its consequen- ces, than as a preventive of disease, more espe- cially in childhood and youth. At this tender and susceptible period of life, the rapid influence of the atmosphere in which we live, in deteriorat- ing or improving the health, is very remarkable ; a change of a few weeks from the country to a large town being often sufficient to change the ruddy, healthy child into a pale, sickly-looking creature, and vice versa. The comparative in- fluence of a town and country air on the health of children is seen in a striking manner in the families of the higher ranks of society, who spend a considerable part of every year in town. Chil- dren should never be reared in large towns, when this can be avoided ; and when unavoidable, they should be sent, during a part at least of every summer, into the country, which, indeed, is the proper place for children, until their system has acquired sufficient strength to resist the injurious eftccts of city life. When they cannot have this advantage, we consider it the duty of the medical attendants of families to urge a temporary annual residence in the country, as essential to the health of children, more particularly those who are deli- cate. How many neglect this invaluable means of improving the health of their oftspring, who have it in their power, and would willingly adopt it, were they aware of its importance ! So strong- ly, indeed, are we impressed with the value of this measure from ample observation, that we consider parents resident in towns, who have the means of giving their family the advantage of country air, and neglect it, deficient in one of their chief duties. To young females, who, by the habits of society, are much more confined to the house than boys, a temporary annual residence in the coun- try becomes a measure of still greater importance, and should be continued at least to the full period of their growth. We have reason to believe that the advantages of country air to the young and delicate are not yet sufficiently appreciated by the profession, and we are therefore anxious to call their attention to it, that they may use their in- fluence with the public, upon whose minds if they succeed in impressing the full value of pure air, they will be the means of contributing greatly to the health of the rising generation. James Clark. ALOPECIA—The falling off of the hairs, in an unusual degree, from any part of the body naturally covered with them, constitutes the essen- tial character of this disease. The name, which is derived from aXaJ7r»,f, vulpes, because the fox, when grown old and during summer, has been observed to be subject to this complaint, has, since the time of Sauvages, been used as the generic term of the disease; but, by the Greeks and Celsus, it was originally confined to one of its species.* * De Mpdicina, lib. vi. cap. 4. Melius, Tetrab. 2, Eermo 2, 55. Piso, rie cogn. et curand. niorhis, lib. i. cap. ]. Oribas. de loe. affect, cur. lib. iv. cap. 42. Paul. lib. iii. cap. 1. Serapion. hb. i. cap. 1. Mcrcurialis, Uh. i.cap. 4; lib. vi. cap. 4. Stn. Fluxus Capillorum, Ares (Celsus); Tyria (Arab.) ; Athrica, Dcpilatio, Defluvium Pilorum, Pelada, Pilarella (Auct. Var.) -, Pelade (Puree) ; Alopecia (^Sauvages) ; Calvities (Teu- tonice); der Kahlkopf, (Plenck) ; Trichosis Area (Good) ; Gangrena Alopecia (Young) ; Baldness. The diflTerent manner in which the hairs fall, the state of the skin from which they fall, and the healthy or unhealthy state of the hairs them- selves, lead to considerable variety of form in the disease. Sometimes the hairs are shed irregular- ly and indiscriminately, producing only a general thinness of the hair; to this Celsus applied the descriptive term, Jluxus capillorum.-\ Sometimes parts of the body are entirely deprived of their hairs, presenting smooth shining patches perfectly bald ; these are the areae of Celsus, (Lib. vi. cap. 4.) the alopecia areata of Sauvages, the porrigo decalvans of Willan. When the spots of bald- ness observed no particular form, although usual- ly they are nearly circular, they were denoted by Celsus, after the Greeks, aXiinrtKia; \. but when they presented a lengthened serpentine form, gen- erally commencing on each side of the occiput, and sometimes continued until they united in front, the term optaai; was applied to them.§ Sometimes this disease is universal, leaving not a single hair upon any part of the body ; (Welt''s Tr. Soc. Med. and Chi. Kn. ii. 264.) in which case it was called, by the French, la pelade,- although some will have it that, with the falling of the hair, a desquamation of the cuticle was also meant by this term. Sometimes the baldness is confined to one particular part, most commonly to the hairy scalp, when it formerly received the name of (pa'XdKpcocig or wu^a'pwcris; sometimes to the eye-brows, eye-lashes, or other parts of the body. The fall of the hairs may take place more or less rapidly ; sometimes in a few days, and even in a shorter period, the body has been known to lose all its hairs ; sometimes the change is slow and imperceptible. Sometimes the skin, from which the hairs fall, presents the ordinary appear- ance—smooth, shining, without redness or altera- tion ; sometimes it is pale, of a dead white colour, and furfuraceous ; sometimes it is covered with a scaly scurf like pityriasis, which, when removed, exposes an erythematic appearance ; sometimes the skin is natural in sensibihty, and sometimes it is affected with itching, or a sense of pricking or pungent acrid heat. Sometimes the hairs, before falling, as well as those which remain, pre- sent an unhealthy appearance ; at other times no alteration can be perceived in them, and those which surround the bald spots are as strong and healthy as natural. Nor are these distinctions trivial or of little help ; for they are all connected with particular causes and particular conditions of the body, and, therefore, lead to precision of treatment. The immediate cause of the falling of the hairs is unquestionably a diseased state of the follicles which nourish and support their bulbs, having the same relation to them as the capsule or membrane t Loc. Citat. lib. vi. cap. 1. Trallian. i. 2. Acinar M. M. ii. 5; iv. 9. Oribas. iv. 5. Fernel. Consul, i. I I Id. loc. citat. Galen, de Cur. Morb. sec. loc. lib. i cap. 2. § Celsus, loc. citat. Oribas. de Loc. Affect. Cur. i» 42 ; viii. 22, 24. Jlctuarius, M. M. v '■'$