[Footnote 1: Abstract of a paper read before the Pennsylvania State
Medical Society, at Norristown, May 10, 1883.--_N.Y. Med. Jour._]
By JOHN V. SHOEMAKER, A.M., M.D., Physician to the Philadelphia
Hospital for Skin Diseases.
The object of this paper is to briefly describe the hair and its
important functions, and to suggest the proper manner of preserving it
in a healthy state.
I know full well that much has been written upon this useful part of
the human economy, but the constant increase of bald heads and
beardless faces, notwithstanding all our modern advancement in the
application of remedies to the cure of disease, prompts me to point
out to you the many ways of retaining, without medication, the hair,
which is a defense, ornamentation, and adornment to the human body.
[Dr. Shoemaker here gave an interesting history of the growth and
development of the hair and its uses, which we are compelled to omit.
Then, proceeding, he said:] Now, the hair, which fulfills such an
important function in the adornment and health of the body, requires
both constitutional and local care to keep it in its normal, healthy
state. When I say constitutional care, I mean that the various organs
of the body that assist in nourishing and sustaining the hair-forming
apparatus should, by judicious diet, exercise, and attention to the
nervous system, be kept healthy and sound, in order that they in turn
may assist in preserving the hairs in a vigorous condition.
In the first place, that essential material, food, which is necessary
to supply the waste and repair of all animal life, should be selected,
given, or used according to good judgment and experience.
Thus, mothers should feed their infants at regular intervals according
to their age, and not permit them to constantly pull at the breast or
the bottle until the little stomach becomes gorged with food, and some
alimentary disorder supervenes, often setting up a rash and
interfering with the growth and development of the hair. It is
likewise important, in case the baby must be artificially fed, to
select good nutritious food as near as possible like the
mother's--cow's milk, properly prepared, being the only recognized
substitute. Care and discretion should likewise be taken by parents
and nurses, after the infant has developed into childhood, to give
simple, substantial, and varied food at regular periods of the day,
and not in such quantities as to overload the stomach. Children need
active nutrition to develop them into robust and healthy men and
women; and it is from neglect of these important laws of health, and
in allowing improper food, that very often bring their results in
scald head, ring-worm, and scrofula, that leave their stamp in the
poor development of the hair. With the advent of youth and the advance
of years, food should be selected and partaken of according to the
judgment and experience of its acceptable and wholesome action on the
consumer.
The meals should also be taken at regular intervals. At least four
hours should be left between them for the act of digestion and the
proper rest of the stomach.
It is, on the contrary, when the voice of nature has been stifled,
when judgment and experience have been set aside, that mischief
follows; when the stomach is teased and fretted with overloading, and
the food gulped down without being masticated, gastric and intestinal
derangement supervenes, which is one of the most prolific sources of
the early decay and fall of the hair.
The nervous system, which is one of the most important portions of the
human structure, and which controls circulation, secretion, and
nutrition, often by being impaired, plays a prominent part in the
production of baldness. Thus, it has been demonstrated by modern
investigation that the nerves of nutrition, by their defective action,
are often the cause of thinning and loss of hair. The nutritive action
of a part is known to suddenly fail, the hair-forming apparatus ceases
to act, the skin changes from a peculiar healthy hue to a white and
shining appearance, and often loses at the same time its sensibility;
the hairs drop out until very few remain, or the part becomes entirely
bald. It is the overtaxing of the physical powers, excessive brain
work, the exacting demands made by parents and teachers upon
children's mental faculties, the loss of sleep, incessant cares,
anxiety, grief, excitement, the sudden depression and exaltation of
spirits, irregular and hastily bolted meals, the lack of rest and
recreation, the abuse of tobacco, spirits, tea, coffee, and drugs of
all forms, that are fruitful sources of this defective action of the
nerves of nutrition, and consequent general thinning and loss of hair.
The hair, particularly of the head, should also receive marked local
attention. In reference to the use of coverings for it, I know of no
better rules than those which I laid down in my chapter on clothing in
"Household Practice of Medicine" (vol. i., p. 218, William Wood & Co.,
New York), in which I state that the head is the only part of the body
so protected by nature as to need no artificial covering.
The stiff hats so extensively worn by men produce more or less injury.
Premature baldness most frequently first attacks that part of the head
where pressure is made by the hat. It is, indeed, a pity that custom
has so rigidly decreed that men and women must not appear out of doors
with heads uncovered. It would be far better for the hair if to be
bare-headed were the rule, and to wear a hat the exception.
Since we can not change our social regulations in this respect, we
should endeavor to render them as harmless as possible.
The forms of hats that are least injurious are: for Winter, soft hats
of light weight, having an open structure, or pierced with numerous
holes; for Summer, light straws, also of open structure.
As regards the head-covering of women, the fashions have been for
several years favorable to proper form. The bonnet and hat have become
quite small, and cover but little of the head. This beneficial
condition, however, is in part counterbalanced by the weight of false
curls, switches, puffs, etc., by the aid of which women dress the
head. These, by interfering with evaporation of the secretions,
prevent proper regulations of the temperature of the scalp, and
likewise lead to the retention of a certain amount of excrementitious
matter, both of which are prolific sources of rapid thinning and loss
of hair in women.
False hair has likewise sometimes been the means of introducing
parasites, which give rise to obstinate affections of the scalp.
Cleanliness of the entire surface of the skin should next demand
attention, and that should be done by using water as the medium of
ablution. It is a well-known physiological law that it is necessary,
in order to enable the skin to carry on its healthful action, to have
washed off with water the constant cast of scales which become mingled
with the unctuous and saline products, together with particles of dirt
which coat over the pores, and thus interfere with the development of
the hairs. Water for ablution can be of any temperature that may be
acceptable and agreeable, according to the custom and condition of the
bather's health. Many chemical substances can be combined with water
to cleanse these effete productions from the skin. Soap is the most
efficacious of all for cleanliness, health, and the avoidance of
disease. Soap combines better with water to render these unctuous
products miscible, and readily removes them thoroughly from the skin.
The best variety of soap to use is the pure white soap, which cannot
be so easily adulterated by coloring material, or disguised by some
perfume or medicinal substance. Ablution with soap and water should be
performed once or twice a week at least, particularly to the head and
beard, in order to keep open the hair tubes so that they may take in
oxygen, give out carbon, carry on their nutrition, and maintain the
hairs in a fine, polished, and healthy condition. In using water to
the scalp and beard, care should be taken not to use soap-water too
frequently, as it often causes irritation of the glands, and leads to
the formation of scurf. It is equally important to avoid using on the
head, the daily shower-bath, which, by its sudden, rapid, and heavy
fall, excites local irritation, and, as a result, loss of hair quickly
follows. In case the health demands the shower-bath, the hair should
be protected by a bathing cap. The most acceptable time to wash the
hair, to those not accustomed to doing it with their morning bath, is
just before retiring, in order to avoid going into the open air or
getting into a draught and taking cold. After washing, the hair should
be briskly rubbed with rough towels, the Turkish towel heated being
particularly serviceable. Those who are delicate or sick, and fear
taking cold or being chilled from the wet or damp hairs, should rub
into the scalp a little bay rum, alcohol, or oil, a short time after
the parts have been well chafed with towels. The oil is particularly
serviceable at this period, as it is better absorbed, and at the same
time overcomes any dryness of the skin which often follows washing.
It might be well to add in this connection that I have frequently been
consulted, by those taking salt-water baths, as to the care of the
hair during and after the bath. If the bather is in good health, and
the hair is normal, the bather can go into the surf and remain at
least fifteen minutes, and on coming out should rub the hair
thoroughly dry with towels.
Ladies should permit it remain loose while doing so, after which it
can be advantageously dressed.
It is, however, often injurious to both men and women having some
wasting of the hair to go into the surf without properly protecting
the head; the sea water has not, as is often thought, a tonic action
on the scalp; on the contrary, it often excites irritation and general
thinning. Again, it is most decidedly injurious to the hair for
persons to remain in the surf one or two hours, the hair wet, and the
head unprotected from the rays of the sun. This latter class of
bathers, and those who hurriedly dress the hair wet, which soon
becomes mouldy and emits a disagreeable odor, are frequent sufferers
from general loss and thinning of the hair.
An agreeable and efficient adjunct after ablution, which I have
already referred to, is oil. Oil has not only a cleansing action upon
the scalp, but it also overcomes any rough or uneven state of the
hair, and gives it a soft and glossy appearance.
The oil of ergot is particularly serviceable in fulfilling these
indications, and, at the same time, by its soothing and slight
astringent action upon the glands, will arrest the formation of scurf.
In using oil, the animal and vegetable oils should always be
preferred, as mineral oils, especially the petroleum products, have a
very poor affinity for animal tissues.
Pomatum is largely used by many in place of oil, as it remains on the
surface and gives a full appearance to the hairs, thus hiding,
sometimes, the thinness of the hair.
It will do no harm or no special good if it contains pure grease, wax,
harmless perfume, and coloring matter, but it is often highly
adulterated, or, the fat in it decomposing, sets up irritation on the
part to which it is applied. I therefore always advise against its
use.
The comb and brush are also agents of the toilet by which the hair is
kept clean, vigorous, and healthy. The comb should be of flexible gum,
with large, broad, blunt, round, and coarse teeth, having plenty of
elasticity. It should be used to remove from the hairs any scurf or
dirt that may have become entangled in them, to separate the hairs and
prevent them from becoming matted and twisted together.
The fine-tooth comb, made with the teeth much closer together, can be
used in place of the regular toilet comb just named when the hair is
filled with very fine particles of scurf, dirt, or when parasites and
their eggs infest the hairs. It should, however, always be borne in
mind that combs are only for the hair, and not for the scalp or the
skin, which is too often torn and dug up by carelessly and roughly
pulling these valuable and important articles of toilet through the
skin as well as the hair.
The brush with moderately stiff whalebone bristles may be passed
gently over the hair several times during the day, to brush out the
dust and the dandruff, and to keep the hair smooth, soft, and clean;
rough and hard brushing the hair with brushes having very stiff
bristles in them, especially the metal or wire bristles, is of no
service, but often irritates the parts and causes the hair to fall
out. [Dr. Shoemaker then denounced the use of the so-called electric
brush, saying its use was injurious, as also was the effort to remove
dandruff by the aid of the comb and brush. Continuing, he remarked:]
And now the question arises, Should the hair be periodically cut? It
may be that cutting and shaving may for the time increase the action
of the growth, but it has no permanent effect either upon the
hair-bulb or the hair sac, and will not in any way add to the life of
the hair.
On the contrary, cutting and shaving will cause the hair to grow
longer for the time being, but in the end will inevitably shorten its
term of life by exhausting the nutritive action of the hair-forming
apparatus. When the hairs are frequently cut, they will usually become
coarser, often losing the beautiful gloss of the fine and delicate
hairs. The pigment will likewise change--brown, for instance, becoming
chestnut, and black changing to a dark brown. In addition, the ends of
very many will be split and ragged, presenting a brush like
appearance. If the hairs appear stunted in their growth upon portions
of the scalp or beard, or gray hairs crop up here and there, the
method of clipping off the ends of the short hairs, of plucking out
the ragged, withered, and gray hairs, will allow them to grow
stronger, longer, and thicker.
Mothers, in rearing their children, should not cut their hair at
certain periods of the year (during the superstitious time of full
moon), in order to increase its length and luxuriance as they bloom
into womanhood, and manhood. This habit of cutting the hair of
children brings evil in place of good, and is also condemned by the
distinguished worker in this department, Professor Kaposi, of Vienna,
who states that it is well known that the hair of women who possess
luxuriant locks from the time of girlhood never again attains its
original length after having once been cut.
Pincus has made the same observation by frequent experiment, and he
adds that there is a general opinion that frequent cutting of the hair
increases its length; but the effect is different from that generally
supposed. Thus, upon one occasion he states that he cut off circles of
hair an inch in diameter on the heads of healthy men, and from week to
week compared the intensity of growth of the shorn place with the rest
of the hair. The result was surprising to this close and careful
observer, as he found in some cases the numbers were equal, but
generally the growth became slower after cutting, and he has never
observed an increase in rapidity.
I might also add that I believe many beardless faces and bald heads in
middle and advancing age are often due to constant cutting and shaving
in early life. The young girls and boys seen daily upon our streets
with their closely cropped heads, and the young men with their
clean-shaven faces, are, year by year, by this fashion, having their
hair-forming apparatus overstrained.
I also must condemn the modern practice of curling and crimping, the
use of bandoline, powders, and all varieties of gum solutions, sharp
hair-pins, long-pointed metal ornaments and hair combs, the wearing of
chignons, false plaits, curls, and frizzes, as the latter are liable
to cause headaches and tend to congestion. Likewise I protest against
the use of castor-oil and the various mixtures extolled as the best
hair-tonics, restoratives, vegetable hair-dyes, or depilatories, as
they are highly injurious instead of beneficial, the majority of
hair-dyes being largely composed of lead salts. But, should your
patients wish to hide their gray hairs, probably the best hair-dye
that can be used safely is pyrogallic acid or walnut juice, the hairs
being first washed with an alkaline solution to get rid of the grease.
Nitrate of silver is also a good and safe hair-dye, but its
application should be done by one experienced in its use. The
judicious use of these hair-dyes will give the hair above the surface
of the skin a brownish-black appearance, the intensity of the color of
which depends upon the strength of the solution. But hair-dyeing for
premature grayness should be avoided, as the diseased condition may be
averted by the proper remedies. Never permit the hair to be bleached
for the purpose of obtaining the fashionable golden hue, as the
arsenical solution generally used is highly dangerous; but, if your
patients must have their hair of a golden color, insist upon their
hairdresser using the peroxide of hydrogen, which is less dangerous
than the preparation first mentioned.
Perhaps one of the most pernicious compounds used for the hair at the
present day is that which is sold in the shops as a depilatory. It is
usually a mixture of quicklime and arsenic, and is wrongly used and
recommended at this time by many physicians to remove hairy moles and
an excessive growth of hair upon ladies' faces. Its application
excites inflammation of the skin; and, while it removes the hair from
the surface for a time, it often leaves a scar, or makes the part
rough, congested, and deformed.
In the meantime, the hair will grow after a short period stronger,
coarser, and changed in color, which will even more disfigure the
person's countenance. With the present scientific knowledge of the
application of electrolysis, hairs can be removed from the face of
ladies or children, or in any improper situation, in the most harmless
manner without using such obnoxious and injurious compounds as
depilatories.
In conclusion, let me add that, if the hair becomes altered in
texture, or falls out gradually or suddenly, or changes in color, a
disease of the hair, either locally or generally, has set in, and the
hair, and perhaps the constitution, now needs, as in any other
disease, the constant care of the physician.
A general remedy for this or that hair disease that may develop will
not answer, as hair diseases, like other affections, have no one
remedy which will overcome wasting, thinning, or loss of color.
Patients reasoning upon this belief, frequently apply to me for a
remedy to restore their hair to its full vigor or give them back its
color. I always reply that I have no such remedy.
The general health, as well as the scalp and hairs, must be examined
carefully, particularly the latter, with the lens and microscope. All
changes must be watched, and the treatment varied from time to time
according to the indications.
No one remedy can, therefore, under any circumstances, suit, as the
remedy used to-day may be changed at the next or succeeding visit. No
remedy for the hair will be necessary if the foregoing advice be
followed which I have just narrated, and which is the result of some
seven years of labor and experience.
The proper consideration and putting into practice of these
suggestions will most certainly secure to the rising generation fewer
bald heads and more luxuriant hair than is possessed at the present
day.
* * * * *
[Concluded from SUPPLEMENT No. 387, page 6179.]
THE INFLUENCE OF EFFECTIVE BREATHING IN DELAYING THE PHYSICAL
CHANGES INCIDENT TO THE DECLINE OF LIFE, AND IN THE PREVENTION OF
PNEUMONIA, CONSUMPTION, AND DISEASES OF WOMEN.
By DAVID WARK, M.D., 9 East 12th Street, New York.