Scholarly article on topic 'RINGWORM AND ALOPECIA AREATA'

RINGWORM AND ALOPECIA AREATA Academic research paper on "History and archaeology"

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Academic research paper on topic "RINGWORM AND ALOPECIA AREATA"

AX.DEH8JIITH: RINGWORM AND ALOPECIA AREATA. 197

Ringworm and Alopecia Areata : theib Pathology, Diagnosis, ajtp

Treatment. By H. Alders jiith, M.B. Lond., F.R.C.S. Fourth edition, enlarged and rewritten,. with new illustrations. London: H. K.

Lewis, 1897.

This is essentially a new book, and represents in clear, terse language our present knowledge of the cause, symptoms, and treatment of ringworm. The author adds the weight of his authority to the correctness, in the main, of the discoveries made by Sabouraud as to the plurality of the fungi causing this disease. It is now recognized that there are several fungi instead of one, as formerly believed, which are distinct botanically, morphologically, culturally, and clinically. These fungi— the author following Sabouraud—are divided into two classes—the small and the large spore-fungi; of the latter there are several varieties. The most common form of ringworm of the scalp is that due to the small spore-fungus—microsporon audouini. This does not produce ringworm of the bearded region or of the nails, but small f urfuraceous lesions are sometimes seen on the non-hairy parts. It is the most contagious type and, as a rule, the most rebellious to treatment. One variety of the large spore-fungus—the trichophyton megalosporon endothrix—is also met with on the scalp of children, and as a rare exception on the scalp of the adult; it does not invade the bearded parts or the nails, but sometimes produces transitory forms of body-ringworm, especially on the face and neck. The author cannot entirely agree with the general statement made by Sabouraud, that this type is not so rebellious. The other variety of the large spore-fungus—the trichophyton megalosporon ectothrix—is infrequent upon the scalp, but it is the fungus to which the common patches of body-ringworm, ringworm of the bearded region and of the nails are due. Sabouraud's statement is quoted that this variety is essentially an animal fungus, and is communicated to man from this source. It is the fungus usually found in pustular ringworm and in kerion.

Coming to the subject of treatment, it is learned that comparatively little progress has been made. The author's large field of observation in these cases has given full opportunity for the trial of the various vaunted new remedies, of which advantage bos been taken; but the regret is expressed that the chronic types of the disease remain about as rebellious as formerly. It is remarked, as those of wide experience know, that there are cases, especially those of limited area and of short duration, which will respond to prompt and active application of various remedies. There remain, however, many cases which prove obstinate and rebellious to almost all methods. The writer believes the best general plan in these obstinate cases is to treat the disease with the remedial applications commonly employed, which will usually prevent its spread, and which will also usually bring the area of disease down to one or to a few well-defined patches; this being reached, he has recourse to treatment with croton oil. The author has also used the crotou-oil method in single beginning areas, especially when for the educational interests of the child a rapid result was necessary. Particular directions ore given as to the manner of its application, as it is a remedy which requires care and skill to bring about the favorable result without permanent damage to the akin. Formalin—a 40 per cent solution of formaldehyde—the writer has also tried, and found it useful in some cases, but it is painful, and in his hands less certain and less successful than the croton-oil

198 BEVIEW8.

method; it is, however, c, safer remedy in the hands of the inexperienced.

Alopecia areata is discusscd at less length than ringworm, and very properly so. Alderemith is not a believer m its contagiousness, nor does he see any reason for considering it a parasitic disease. In the treatment, stimulation of the part is advisea, with such remedies as iodine, cantharides, and the like, together with tonics, if necessary. The local treatment is considered the more important, and general treatment alone useless.

In conclusion, the reviewer takes pleasure in recommending this most excellent and comprehensive book, especially to those whose misfortune it is to have much to do with ringworm cases. H. W. S.

A Text-book of Special Pathological Anatomy. By Ernst Ziegler, Professor of Pathology in the University of Freiburg. Translated and edited from the eighth German edition by Donald MacAlister, M.A., M.D., Linacre Lecturer of Physic and Tutor of St. John's College, Cambridge, and Henry AV. Cattell, M.A., M.D., Demonstrator of Morbid Anatomy in the University of Pennsylvania. Sections I.-VIII. New York: The MacMillan Company, 1896.

Since the publication, in 1884, of the first English edition of Ziegler's Special Pathological Anatomy, five German editions have appeared in rapid succession. The present is the third English edition of this popular text-book. The text has been entirely retranslated and the bibliography and other supplementary portions have been recast, references to only the more recent and important papers and monographs having been included. By omitting the references to the earlier literature, which are to be found in the previous English editions, much " valuable space has been gained." Presumably the editorial work of the translators referred to on the title-page has consisted in this recasting of the bibliography, which, it must be acknowledged, has been done carefully and judiciously, although one of the most valuable features of Ziegler's text-books of General and Special Pathological Anatomy have been their conveniently arranged lists of bibliography. It was, therefore, a matter of disappointment to many American teachers of pathology that the recent translation of the lost German edition of Ziegler's General Pathology, issued by another firm, omitted entirely all references to the literature. The second part of the Special Pathological Anatomy (Sections EX. to XV.) is already in press, and this is to be followed by a new version of the part on General Pathological Anatomy^ prepared from the latest German edition, so that soon all the systematic works by Ziegler will be accessible to the English reader in uniform style.

The volume at present under consideration contains, as already indicated, the first eight sections of the eighth German edition of the Special Pathological Anatomy, namely, those dealing with the morbid anatomy of the Blood and Lymph, the Vascular Mechanism, the Spleen ana the Lymph-glands, the Osseous System, the Muscles and Tendons, the Central Nervous System, the Peripheral Nervous System, and the Skin. At the end of the volume is a full index. The constantly