ANIMAL AND VEGETABLE PARASITES OF THE Human Skin and Hair. BY B. JOY JEFFRIES, A.M.,M.D. FELLOW OF THE MASSACHUSETTS MEHICAL SOCIETY; MEMI5ER OF THE AMEBICAN OPHTHALMOLOGICAL SOCIETY; OPHTHALMIC SURGEON TO THF, MASSACHU- SETTS CHARITABLE EYE AND EAR INFIRMAEY; OPHTHALMIC STTEGEON TO THE CAENEY HOSPITAL; LECTURER ON OPTICAL PHENOMENA, AND THE EYE, AT HARVARD UNIVERSITY; LATG LECTURER ON DISEASES OF THE SKIN AT BEBK8HIBE MEDICAL COLLEGE. BOSTON : ALEXANDER MOORE, 1872. Entered according to Act of Congress, in the year 1872, by Alexander Moore, la the Office of the Librarian of Congress, at "Washington. •TBBEOTTPED BY JOHN C. BKQAN & OO. 65 Congress Street CONTENTS. PAGE Animal Parasites of the Human Skin ... 7 Vegetable Parasites of the Human Skin . . 55 False Parasites of the Human Body . . .87 (V) H*^^> 70GU20 Eiometisal Library ANIMAL PARASITES OF THE HUMAN SKIN. CHAPTER I. Man's cutaneous envelope, like the integument of the lower animals, is subject to be temporarily visited bj parasites, or perhaps become a perma- nent abode for them. However unpleasant this idea may seem, only too many of the human family in the most civilized countries are annoyed or ren- dered miserable by the presence of the animal para- sites. Amongst the poor and dirty, the unfortunate children suffer a great deal from them, and we have seen serious trouble arise from their ravages. But all classes of the community are liable to be infested by them , — the wealthiest and the cleanest. Among the lower classes, prejudice, ignorance, and even superstition, help to favor the production and con- tinued existence of these parasites ; and in the upper (7) 8 ANIMAI. PARASITES classes a lack of knowledge of their nature, and the means to avoid or get rid of them. The mental agony of a young lady on finding her auburn tresses the home of the only too common insect, can only be appreciated by those who have realized it. We have known the most refined to sufier thus for months, merely from shame to apply to a physician, or ignorance of the very simple means necessary to be freed from what is naturally regarded as so loathsome. Where soap and water are attainable, man can keep his body clear of these animals. If every teacher in the public schools could be authorized to send a child so infested home, and at the same time knew enough to direct the mother or family what to do to relieve the child of its trouble, it would at least be a comfort to those physicians who, in at- tendance at the great charitable institutions, come necessarily in immediate contact with the thou- sands of poor people and their little ones, whom sickness and misery are constantly sending there. The animal parasites are the pest of the public schools. Neglect and ignorance alone foster their presence. By explaining the natural history, the habits, habitats, methods of propagating, and OF THE HUJMAN SKIN. 9 means of getting rid of these animals, we hope to be able to assist our readers in keeping a mens Sana in corjpore sano, — a sound mind in a healthy and cleanly body. The animal parasites of the human skin may be divided into two classes ; those which live on the skin, and those which live in the skin. We will commence our study with those of the first class, namely, the pediculi, of which there are three kinds, — the head-louse, the crah-louse, and the hody-louse. The first of these is met with only on the hair of the head ; it is entirely confined to the scalp, and never attacks the other hairy parts of the body. It is unfortunately too familiar an object to require any special delineation of it to be given here. The color varies, livid or pale gray, and is said to change according to the hair. The male insects are fewer in number than the females ; the latter are also much larger. They have three pairs of legs, and all the feet are sim- ilar. The last tarsal joint has a large claw on its outside, and on its inside two straight, thick, horny stumps, and a large bristle. A microscope of moderate magnifying power will show this structure of the animal. 10 ANIMAL PARASITES When the eggs are laid, they stick firmly to the human hair, and are called nits. This we will more particularly explain further on. In six days the young escape from the Q^g^, and are ready to lay eggs at the age of eighteen days. A female lays some fifty eggs in all. We thus see why such enormous quantities of the animals are often seen, and how they propagate with such astonishing rapidity. It is easy enough to tell when a person is in- fested with these vermin, because the animals creep about upon the head, and their eggs are large enough to betray themselves to thd" naked eye, especially on dark hair. As the insect can run about, the eggs will be found strung along the whole length of the hair. We said this kind inhabits only the scalp, where, by their creeping about, but more especially by their biting the skin, in pursuit of nourishment, they cause intense and constant itching, and hence intense and constant scratching on the part of the person infested. We all know how tender the scalp is made by hard brushing, combing, or vio- lent shampooing, and can therefore readily under- stand that the constant digging the finger-nails OF THE HUMAN SKIN. 11 into the skin of the head to allay the itching, will finally cause inflammation of the cutaneous surface. An artificial eczema, as dermatologists call it, is produced, and this all the more in those persons, children for instance, who are predisposed to eczematous eruptions. This inflammation causes a fluid to exude from the skin, which, with the blood coming from where the cuticle has been deeply torn by the nails, dries up and forms crusts and scales, mixed also with the natural fatty secre- tion of the scalp, from the sebaceous follicles. Hence the loathsome appearance which such a head presents. Moreover, the greater the amount of exuded fluid, the greater amount of food for these vermin, and the more rapid their growth and mul- tiplication. Thus we see that the irritation of the lice caused itching ; this led to the scratching, which, continued for a length of time, produced an artificial eczema, or inflammation of the skin. The exuded fluid of eczema is food for the pedicuU, under the crusts and scales the animals can hide ; the matted hair affords better opportunity for the eggs or 7iits to hatch, and so a person who has eczema of the head offers a much better field for the cultivation and propagation of these vermki. 12 ANIMAI. PARASITES Now dirt and poverty predispose to eczematous eruptions ; and those with such disease are, in these circumstances of life, more liable to come im contact with others infested with pedicuU, and thus the animals are transferred from one person to another. We all know how quickly one infested head in a school, or public institution, affects the other children, even when considerable care and cleanliness are exercised. But these insects never come except from contagion. The vermin crawl from one person to another. The eggs or nits are not transferred, for these adhere tena- ciously to the hairs where they are deposited by the female insect. All stories of the spontaneous generation of these or any other vermin are simply ridiculous, and arise from ignorance, and the lack of accurate and truthful observation. Care and cleanliness are necessary on the part of all who are forced to come in immediate contact with the dirty and squalid. Some sympathy, we hold, should be felt by the community for physicians who are obliged to do this, as it is quite as disagreeable for them as for others. Moreover, to say they are used to it is no argument, since the getting OF THE HUMAN SKIN. 13 used to it involves what others uever have to un- dergo. Probably the human race all over the world are infested more or less with pedicuU , It is even doubtfnl whether there are different species of this insect, or pecUculus capitis. One observer thought he found a particular species on African negroes. Lice are described as being rare among the Bra- zilian Indians, and among the Indians of Magda- lena, in Columbia ; but travellers have found them among the New Hollanders, and the Asiatic and American Indians. Their dried brood has been found in the hair of the Peruvian mummies. At one time, it was asserted that there was a partic- ular pedicidus tabescentium, or louse of the con- sumptive, and good people rather preferred to be supposed to have them than the common head- louse, which, however, they ivere. The next animal parasite of tlie human skin, whose natural history we will study, is thQ pedicu- lies pubis, or crab-louse, which resembles the pedicuhis capitis, but is shorter and broader. It does not run about on the surface, but grasps *the hair close down to the skin with its fore-legs, which are provided with strong crab-like claws. 14 ANIMAL PARASITES The animal holds on so tight, that it will be crushed before it relaxes the grasp of the hair ; it deposits its eggs, the nits, on the hair, just as the pediculus capitis does ; but as it cannot run about, these are always placed on the hair close to the skin, and hence often overlooked. To this wc shall recur again, when speaking of the treatment of these vermin. This animal lives on all the haired portions of the body except the scalp, which is the domain of the pediculus capitis. They never in- terfere with each other. When both are present on the same person, the head-louse will be found on the hair of the head, down, for instance, to the whisker, and never below ; whilst the crab-louse infests the whiskers up to the scalp, which he never occupies ; he does, however, take possession of the eyebroAVs and eyelashes. Why this is, is not yet known. The insect is transferred from one individual to another by contact, and by the agency of clothes, linen, and beds. It is said to be most abundant in southern climates. This pediculus lives on human blood, and, in obtaining it from the skin by biting deeply and firmly, it causes often considerable irritation, varying, of course, Avitli the cutaneous sensibility OF THE HUMAN SKIN. 15 of the person affected. . This itching calls for scratching, which finally produces a papular, or eczematous eruption, the seat of which, however, points towards the cause, and a careful examin- ation will detect the pediculi on the hair close to the skin, and the nits also near by. As these parasites do not cause so much irritation as the loediculi cajpitis, and infesting portions of the body covered by the clothing, they often remain unob- served, frequently living and thriving on an indi- vidual for an indefinite period, especially among those whose change of raiment or ablutions occur about as often as the equinoxes, but not with the same regularity. The ravages of the head-louse, and the ravages of the finger-nails and comb to allay the itching of the scalp, often produce, as we said, an artificial eczema, or inflammation of the skin, which, when long continued and excessive, may finally cause the glands in the neighborhood to swell up or break down into abscesses on the neck, for instance, or behind the ears. This rarely occurs with the pediculus pubis; yet in a person predisposed to glandular swellings, the glands in the groin may swell up from long-continued scratching, and consequent eczematous eruptions, 16 ANIMAL PARASITES from this insect. But pustules are not so readily caused on the other haired portion of the body as on the scalp ; moreover, the head being uncov- ered, is readily scratched when infested by ver- min, and the deep digging of the finger-nails is more irritating than the rubbing of the clothes. The third and last pediculus to be described is the jjediculus vestimenti, clothes-louse, or body- louse. It is similar to the pediculus capitis in external form, only larger, the principal distinc- tion being the size. It is whitish in color, and from one-twelfth to one-sixth of an inch in length. There are three legs on each side, having four joints, and terminating in claws. The habitat, or place of living of the insect, is the clothes, in the folds and seams of which the eggs are deposited, appearing as little yellowish-white shining dots. It feeds by biting the skin — principally those parts nearest its haunt : namely, where the clothes come in most immediate and constant contact withi I the cutaneous surface. Hence its ravages are seen) on the neck, l)ack, and shoulders, around the waist, I and wherever bands or straps give a resting-place for the insects, an opportunity for the eggs to hatch undisturbed, and hy lack of change of ap- I OF THE HUMAN SKIN. 17 pare], a constant field of food. But though the skin is mostly afiected at these parts, any portion of it which is covered may sIioav signs of the ver- min, since the patient will not only scratch where the insect bites, but any part of the cutaneous surface ; it being a well-known fact, that to allay the sensation of itching it is not necessary to scratch exactly where the source of irritation exists. Since the insect lives in the recesses of the clothes, and sallies forth from there to prey upon the skin for existence, a person so affected is quite free of vermin when naked, a few adhering to the skin, whilst the clothinsr removed mav be a livino; mass of them. It is the constant wearing of the same clothing, therefore, which affords a perma- nent home for these insects. According to the numbers present, and the cutaneous sensibility of the individual infested, will be the amount of irri- tation produced, and the consequent amount of scratching. At first the slight itching occasions only streaks of white or red from the marks of the finger-nails, but afterwards excoriations are seen from the further injury of the skin. These exco- riations, will have little drops of dried blood, the 18 ANIMAL PARASITES skin becomes quite red, aud, as with the other forms of pediculi, exhibits the scabs described — papules, vesicles, and pustules. When the insects have preyed upon the individual for a long time, the continued irritation causes continued conges- tion and infiltration, increasing the deposit of pig- ment in the skin, which finally becomes rougher, darker, and thicker than natural — sometimes ab- solutely as black as the negro's. The presence of these vermin, as with the other kiuds, cause, from the scratching, artificial ecze- matous eruptions, and in general call forth, on the cutaneous surface, any disease of this tissue to which the individual so afiected is liable, or pre- disposed to. The enormous numbers of these vermin which have at times been seen, and their apparently rapid production, has given rise to the idea that they were also generated spontaneously. But this, as we said above, is owing to incorrect observation and erroneous deduction. The jjed- iculi vestimenti^ like the other pediculi, thrive best when let alone, and where morbid cutaneous se- cretions attract them. They may be always detected on the clothing, if not on the body. The OF THE HUMAN SKIN. 19 general domain of their ravages tells the derma- tologist what insect he has to deal with. In the old days of superstition and credulity, the death of any person specially noted in history was very apt to be attributed by those succeeding them, or those who wrote their history, to the ravages of these several forms of lice, especially this last — the clothes-louse. For instance, Aris- totle relates that the poet Alcmanes, and the Syrian Pherecydes, died of ^^/^^Amas/s; i. e., of insects living on the body. Other more recent authors report the same of Herod, Sylla, even Plato, Philip the Second, and so on. However, nowada^^s, we understand that a person lying in bed sick, unable to move, uncleansed and neglected from superstition or otherwise, will soon attract, from those coming in contact with them, the par- asites that the want of bodily ablution, and igno- rance of a former age, allowed to accumulate till death might be readily attributed to them. In a civilized country, where soap and water, and med- icines which kill these vermin, can be obtained, there is no longer reason or excuse for their pres- ence, as we shall next see. 20 ANOIAL FARASITES CHAPTER II. We have given a sketch of the habits, habitats, and appearances of the three animal parasites of the human skin which live upon it, of the family of pediculi. AVe also spoke of the eftect upon the cutaneous surface of their seeking nourishment in the skin, the result of the intense itching caused thereby, and the consequences of the irritation from the person's endeavors to allay this. In this chapter we will endeavor to explain how and where these insects deposit their eggs, in w^hat w^ay they can be destroyed as well as the animals themselves, and thus enable those annoyed and chagrined by their presence to rid themselves of them and their effects. The head-louse and the crab-louse lay their eggs on the hairs, to which they are very firmly ftist- ened, so that endeavoring to remove them will sometimes even pull out the hair itself. They arc called nits, and are struno: alono- on the hairs like beads. The pediculus of the head, as it can run OF THE HUMAJ^ SKIN. 21 about, lays its eggs more scattered on the liair than the pediculiis pubis, which can only move by grasping the hair with its crab-like claws, and thus pull itself from one to another ; hence it lays its eggs close down to the skin on the hair, and where there are many these are strung close to each other, consequently often overlooked, even when somewhat carefully sought for. The eggs of these two insects are very much alike, and attached to the hair in the same method, so that a single de- scription will answer for both. A proper knowl- edge of them is so essential to understanding the methods of destroying them, that we shall give a somewhat minute description in explanation of the figures here given. The eggs, as seen, are pear- shaped. The posterior end is pointed, the ante- rior truncate, and furnished with a flattened round Fig. 1. 22 ANIIVIAL PARASITES cover. Fig. 1 represents the ordinary appearance of the egg when seen with a magnifying power of about eighty diameters. "\Ye here see how the Qgg is fastened to the hair, and why they stick so firmly, being cemented as it were with a strongly Fig. 2. glutinous substance. Fig. 2 shows the egg when rendered transparent in the glycerine, and exam- ined with a magnifying power of one hundred and thirty under the microscope. The broad end of the egg has a lip, to which is attached a conical lid, studded with little nodular processes. This lid fa}ls off when the animal is ready to come out of the shell. We see such a one at the side of the OF THE HUIHAN SKIN. 23 hair which has come off from the egg iu which the insect is curled up. In the other egg on the hair the pediculus is seen in the process of develop- ment. We now know what a nit is, and how the insect escapes from this egg. The shell is quite hard, even with difficulty broken between the fin- ger-nails. It entirely escapes long-continued and hard combing, and is not destroyed by ordinary washing with soap and water, or shampooing. This is a point people generally are quite ignorant of, but to be especially remembered. The other kind of pediculus which lives se- creted in the folds and seams of the clothes, lays its eggs there. They are seen as minute, round, yellowish-white dots, quite different from the eggs of the other pediculi, and never found sticking to the hairs. All these insects are regarded as loathsome, and yet every human being, from the highest to the lowest, is liable to become infested with them, for all classes of the community come in greater or less contact with each other ; and it is by contact, or by clothing, or utensils, that the animals are passed from one to another. We cannot easily avoid them, but we can always readily get rid of 24 ANIMAL PARASITES them and their effect on the skin, provided they have not continued their ravages too long, for their careful treatment by those experienced in cutaneous diseases is sometimes requisite to relieve the patient of their trouble. We mean that se- vere and persistent iuflammation of the skin is often caused by the presence, and consequent irri-, tation, of these animals we have described, call-' ing for the best efforts of those who have made diseases of the skin a special study, in order to subdue it. The treatment oiphthiriasis^ or the presence of lice, is quite simple, if three things are borne in mind, namely : that we must kill the live insects, destroy the eggs, and care for the condition of the skin left afterwards. Now there are a number of sub- stances of the mineral and vegetable world, which are quite deadly to these animals when brought iu contact with them, such as sulphur, mercury, seeds of stavesacre, of sabadilla; the root of pyrethrum or pellitory, many of the essential oils, and alco- hol. All the patent medicines and other adver-j-, tised nostrums warranted to destroy these vermim contain some of these substances ; but as many OF THE HUMAN SKIN. 25 of such medicines are irritating to the skin, their indiscriminate use is likely to do much harm. Sulphur can be used as vapor baths or fumiga- tions, but equally as well in the common sulphur ointment of the Pharmacopoeia. Its smell pre- vents its use by those who object to it, and other things do equally well. Mercury can be used as the common mercurial ointment, or two or three grains of the bichloride of mercury can be dis- solved in an ounce of water, and a few drops of alcohol added, to assist solution. When applied to the skin in this way the danger of salivation amounts to nothing. Seeds of stavesacre can be used as ointment, one part to four of lard, or an infusion of them in vinegar. Sabadilla seeds can be used as a powder when ground up, or as an ointment, one part to eight of lard. A few drops of the essential oils, as oil of cinnamon or rose- mary added to these ointments, disguise or im- prove the odor. The root of the pyre thrum or pellitory is generally used in powder. Some of the strong essential oils are also serviceable. We thus see that there are a variety of sub- stances we can employ, some one of which is always within every one's reach. To get rid of 26 ANIMAL PARASITES these insects on the head, we must remember that although the fine tooth-comb, steadily used, will, when the hairs are not matted and there is no se- cretion, remove all the live animals, yet it will not destroy the nits or eggs, or break them away from their attachment to the hairs. These eggs can only be broken down by repeated washing ivith alcohol or weah vinegar, or the strongest soft soap, such as the German Schmierseife, or smearing soap. The cure is not complete till the hairs are free from them. When there is no objection, as in children, it is better to cut the hair short, as thereby we get rid of large numbers of nits, and can bring whatever we use in more immediate contact with the animals we desire to destroy. When the hair is matted together b}' secretions, and the skin inflamed, it is absolutely necessary to cut the hair short, and use steady cleansing with soap and warm water, otherwise the animals con- tinue to propagate under the products of the inflammation, and multiply innumerably. It is not necessary to sacrifice the hair in women. Combing, Avashing, and the application of some of the above remedies are quite efi*ectual. When there is severe inflammation and much eruption on OF THE HUMAN SKIN. 27 the head, especially of children, it will be safer to consult some physician who pays especial attention to diseases of the skin ; remember, however, to avoid all who advertise in any form whatever, by newspapers, handbills, pamphlets or almanacs, and equally avoid patent medicines and quack nostrums. These, unfortunately, only too often succeed in fleecing the ignorant and credulous, because the general practitioner disregards or treats but lightly what in reality needs knowledge, thought and care. We have explained that the pediculus pubis, or crab-louse, lived on all the haired portions of the body except the scalp, which territory he always leaves intact for his cousin the pediculus capitis. This insect, it must again be remembered, cannot run about, but holds on to the hair close to the skin. Coml)in2: and rubbinof will not dislods^e it, but it is readily, like the pediculus capitis, killed by some of the substances mentioned. A powder called Capuchin powder is used in Europe, to de- stroy both these species of vermin. It is composed of equal parts of seeds of stavesacre, cocculus and sabadilla. To efiect a cure, all parts of the body infested, or likely to be, must be thoroughly 28 ANIMAL PARASITES \ rubbed. Some of the ointments, though not so cleanly to apply, are more effectual than the pow- ders in destroying this insect ; and washing them off with strong soap, and hard rubbing, breaks down the egg-shells, and prevents the young from hatching:. Thorousjhness and care are the secret of success. Any portion of the haired portion of the body neglected, may be the seat of continued contagion. The eyelashes even do not escape, and the figures we have given are drawn from the eggs of the pediculus pubis, found on the lashes. ^Ye can understand now how it is that some tribes of men whose habits are partic- ularly uncleanly, still manage to be comparatively free of these vermin. It is because they use strong-smelling fats and ointments for smearing the surftice of the body, and rubbing into the hair in their manner of dressing it. Perhaps the ne- cessity of some defence for the bod}', so much exposed in hot climates from the attacks of in- sects, originated the use of many ointments among savage tribes, especially those living in the tropics. In speaking of the pediculus vestimenti, or clothes-louse, we said, when the person infested had removed his clothes, he had removed the OF THE HUMAN SKIN. 29 insects, except any that might be then biting the skin: so that to get rid of these vermin, clean clothes and a thorough ablution is all that is nec- essary. After they have lived and multiplied on the individual indefinitely, as is often the case amongst the lowest classes in civilized countries, and among dirty semi-barbarous people who live in climates requiring constant clothing, then the products of the inflammation of the skin may con- ceal some of these insects and their eggs, render- ing an application to the skin of one of the remedies above mentioned necessarj^. Boiling clothes that can be washed, effectually destroys both eggs and insects. A heat of 150 degrees Fahrenheit applied to clothes that would be spoiled by boiling, will also destroy all the animals and their eggs concealed in the folds and seams. In some parts of the world the common people bury infested clothing in hay for several weeks ; in this way the insects are killed, and the eggs prevented hatching:. Strewinsr clothinof with some of the powders we have mentioned above, also suffices to disinfect it, without hurting the cloth in any way. But the treatment of the clothing, like the k 30 ANIMAL PARASITES treatment of the skin, must be thoroughly attended to. Of the million and a half of men who composed the Noi-thern and Southern armies during the re- bellion, we doubt if many score escaped being in- fested by these parasites. We should not like to say what proportion of the thousands of recruits who passed through our examination, had to be made clean before becoming soldiers. We have known of officers being furloughed from the field to return home, and once more get free of their travelling companions in the shape of vermin. Had every army surgeon, Xorth and South, been quite familiar with the habits and habitats of these insects, much suffering might have been saved. Those who did understand the proper and efficient methods of* prevention and treat- ment, often labored strenuously for the personal cleanliness of their command. Of course all ef- fort failed when the accidents or necessities of war prevented for weeks, or months, perhaps, change of clothing, requisite ablutions, and the wasning of under-garments. The horrors of the Southern prisons were rendered still worse by the loathsome presence of vermin, which the in- OF THE HIBIAN SKIN. 31 mates fruitlessly got rid of, as contagion soon caused them to become as infested as before. There was, however, great ignorance as well as great neglect. Even in times of peace, the sur- gical staff of our prisons, institutions of correc- tion, school-ships, asylums, children's homes, etc., kuow only too well how hard it is to enforce a personal cleanliness, which shall prevent the presence of contagious vermin. With great ar- mies in the field it is impossible ; but not neces- sary with these in times of peace. We do not propose to speak here of the vari- ous insects which attack man by stinging, or those which draw blood from the skin for food, as they cannot be strictly called parasites. We mean of the former class, scorpions, ants, spiders, etc., and of the latter class, bed-bugs, fleas, mos- quitoes, gnats, many species of flies, etc. We w^ill, therefore, now pass to the considera- tion of some of the animal parasites which live in the skin, or which may, under certain circum- stances, deposit their eggs there. The • great blue-bottle fly, miisca vomitoria, lays its eggs in the orifices of the human body, or in wounds and ulcers. The removal of their larvae is a matter ^2 ANIMAL PARASITES of care and importance. So also with the com- mon flesh-fly, musca carnaria. They thus add greatly to the misery of certain endemic diseases, as the aflections of the eye in Egypt. The house- fly may also deposit its eggs, and its larvae be found in wounds, and the orifices of the body. The eggs and larvae of the bot-flies may live on the skin, and there form boils. In South Amer- ica this parasite is reported as by no means rare upon man. Von Humboldt called it cestnis hu- maniis. It is not yet, however, settled whether this is difierent from the bot of the horse, sheep, ox, stag, and other bot-flies. Fluctuation will be sought for in vain in the tumors produced by them, but an orifice will be found in the swelling, from which a little moisture constantly oozes, and through which the hinder part of the cestrus is . kept in communication with the air. The prog- nosis is favorable, and immediate cure is only pos- sible by incision, and the removal of the cestrus. The Medina-worm, or Guinea hair-worm , /?/a- 7'ia onedinencis, is an inhabitant of another por- tion of the world, and need not, therefore, be dis- cussed here. On the other hand, we must take some notice of the sand-fiea, pulex penetrans, since OF THE HUMAN SKTNT. 33 it occurs in South America, and where our coun- trymen may more often come in contact with it. It is smaller than the common flea, and has a pro- boscis as long as the body. The male insect does not penetrate the skin. This is done by the fe- male, which swells up extraordinarily after it has burrowed under the skin of men and animals. Yon Humboldt thought it attacked only Euro- peans, and not the aborigines. It is described as an animal so small that it can only be seen by sharp eyes, with a good light, for which reason the seeking for the flea, after its immigration, is generally left to children. It perforates the skin down to the flesh, and, concealed in its little canal, swells up into a white, globular vesicle, which, in a few days, may become as large as a pea, the pain constantly increasing ; this is the abdomen of the female filled w4th eggs, or, more correctly, with larvse. Neglect of the disorder, or careless rupture of the vesicle, that is, the ab- domen, by which the young are scattered in the wound, where they then mine fresh passages, leads to bad sores, to inflammation of the glands of the groin, to mortification, and, in conse- quence, to amputation or mutilation of the limbs, 34 ANBLiL PARASITES or even to death. The toes are especially at- tacked by the flea, although other parts of the body are also visited. Persons who are staying in the places where the flea is common, must have their feet examined every two or three days. When the animal has once made an entrance, the orifice of the canal, which is marked by a red point, may be sought, the passage widened by a needle, and the flea drawn out, but without tear- ing it. With fresh punctures it is best to wait a day, until the occurrence of the white vesicle, that is to say, the swelling of the abdomen with the brood, allows the animal to be more readily detected. The cavity remaining after extraction, is treated like a simple wound. In Brazil they fill it with oil, snufi", or ashes. There are two animals remaining for us to de- scribe, inhabitants of the human' skin. One is the acarus scabiei, or sar copies hominis^ the itch insect, which causes no end of trouble in and on the skin. The other, and perfectly harmless para- site, of man's cutaneous envelope, is the acarus folliculorum, or pimple mite, of which J^ir/. 3 is a representation. This is a very enlarged view of the animal, since its true length is from one- OF THE HU3IAN SKIN. 35 hiuiclredth to one-fiftieth of an inch in length. Our figure here saves us any minute description of this parasitic animal. The true pimple mite was found by Henle and Gustav Sii|ion, in 1842, almost simultaneously, and independently of each Fig. 3. other. They are found generally and most abun- dantly in the glands of the skin which secrete the grease, either opening on the surface, or into a follicle, from which the hair springs. They are of very frequent occurrence, it even being as- serted that no one is free from them, and are dis- covered in the sebaceous glands of the face, chin, nose, and forehead, by pressing out the contents of the gland, and adding a drop of colored oil to it on the glass slide of the microscope. They 36 ANIMAL PARASITES sometimes occur singly ; sometimes several, ten to twenty, are found in the contents of one folli- cle. When in large numbers, their presence may possibly caus^ an acne-like eruption. We have often smiled at the success of the advertising quacks, who pretend to treat diseases of the skin, in duping their victims, and in fact the public in general, in reference to this harmless animal. When a sebaceous follicle becomes, on the face or nose for instance, distended by its natural con- '■ tents, the oriffce of the follicle is filled with a ' soft, cheese-like substance, to which dirt and dust '., adheres, presenting the appearance of a little ; black dot on the skin, over the centre of a whit- ! ish minute protuberance. Pressing with the nails each side of this, and we can force out a small cylinder of greasy substance, the black dot being one end of it. Now from this resembling a mag- got with a black head, it is generally sujDposed to be one ; and the quack tells his clients that it is a worm of the skin, supporting his assertion by the statement that worms live in the skin. What the true pimple mites are, and their comparative size, you, however, now know ; and, shall we say, should not be again duped . OF THE HUMAN SKIN, 37 CHAPTER III. Our chapter is headed by a magnified drawing of the little animal we are to describe. It is about one-sixtieth to one-seventieth of an inch in length, just visible to the naked eye. By living Fig. 4:. iTCH-iCiTE. — Male. in the skin of man it produces the disease known as itch. To understand how to treat this trouble- some afiection intelligibly, we must first study the natural history of the animal, its habits and hab- I 38 ANIMAL PARASITES itats. Before doing this, however, it will be in- teresting and instrnctive to glance at the general history of this little creature, called in English the itch-mite, and in Latin, sarco^tes hominis, or acarus scabiei. There is strong evidence in support of the idea that some of the diseases spoken of in the Bible as prevalent among the Jews were, in reality, due to the ravages of the itch-mite in the skin. Probably, when mankind began to people the world, these insects began to people them^ de- rived, by contagion, from the lower animals previously in existence. From a passage in Aris- totle's "History of Animals," it has been supposed that the insect was known to him as the cause of itch. The old Arabian physicians, in their writ- ings, mention it cjuite plainly, — Avenzoar, for instance ; but apparently we must come down to the twelfth century for indisputable reference to the itch-mite, in a work entitled ^^ Physica" written, curiously enough, by Saint Hildegard, the Lady Superior of the Convent on the Rupert>- Bcrg, near Bingcn. From that time downwards, the insect has been seen and spoken of by the medical writers of the times, as Guv de Chauliac, r OF THE HUMAN SKIN. 39 Gralap, Benedictus, Paracelsus, Ambrose Pare, Scaliger, Fallopius, Joubertus, Vidius, Schenck, HaffeurefFer, Riolanus, Mouffet, and many others. These names carry us down to the early part of the' seventeenth century, to Jansen's discovery of the microscope, in 1619. The knowledge of the use of the then primitive instrument soon spread, and the itch-mite was studied by it, the first rou2^h drawino: of the animal beino- o-iven l^y Hauptmann. During this (the sevententh) cen- tury, the various writers on medical topics show more or less knowledge of this mite. We will not, however, tire our readers by quoting their names. Some of them mention the custom, which has been a common practice from that day to this, of extracting the itch-mite from the skin b}^ means of a needle. Although, by this time, the mite had been depicted, and its association Vv'ith the itch disease recognized, jet it was not till 1687 that Dr. Bonomo, of Leghorn, and Ces- toni, an apothecary, studied our litt]^ friend in what we should now call a common-sense way, and thoroughly exploded the old ideas, handed down from one generation to another, that the itch-disease was due to thiclcened bile, drying of 40 ANniAL PAEASITES tJie blood, irritating salts, mdancliolic juices, and specitil fermentation, — the presence of the itch- mite, when admitted, being accounted for hy equivocal generation. These observers saw and described the iiisects quite perfectly, found their eggs, and discovered the females laying them, and came to the conclusion that the itch-disease, or scabies, arose solely from the presence of an ani- mal which is incessantly biting the skin, and thereby causing the patient to allay the itching hy scratching. They also explained the contagious character of the affection by the transference of the insects from one individual to another. Be- cause these discoveries were true, they were denied and combated by the medical writers of those days ; yet nearly one hundred and fifty years passed before any better natural history of the mite appeared. King George II. 's physician, Dr. Eichard Mead, of London, reported Bonomo and Cestoni's observations to the Royal Society, and published them in Xo. 283 of the "Philosoph- ical Transactions." We have given this little historical sketch to show how old the disease is, and how old a knowledge of its cause is also. Notwithstanding, OF THE HUJUAN SKIN. 41 from that time to this (1872) there has not failed to exist medical men or naturalists who deny the connection between the disease called itch and the itch-mite. It is with medicine a,s everything else in the world — denial of truth excites notoriety, so desired by the many. In view of what we have above said, it seems impossible to conceive that a correct knowledge of the itch-mite should be, since Bonomo's time, repeatedly lost in some of the great centres of medical teaching, to be again regained. In 1812, a prize was ofiered in Paris for the discovery of the little inject ; and a certain apothecary, named Gales, gained it, by exhibiting before a medical commission the cheese-mite. Consequently those v/ho searched patients with itch did not find this animal, and a prize was once more offered ; and Raspail showed the cheese-mite again, and, when the judges were satisfied, proved it was such, and exposed Gales* duplicity. The cause of the. itch- mite had henceforward its adherents and oppo- sers ; whilst, in various parts of the world, the lowest classes understood it, and the fiiethods of its destruction; for instance, the old women in Corsica, who picked them out with needles. 42 ANIMAL PARASITES Reuucci, a native of the island, probably familiar with these old ladies' occupation, finally, in 1834, taught the Parisian medical world how to find the itch-mite ; and, from that time to this, the insect and its ravages have been more thoroughly and scientifically studied, and the literature of the subject grown up into quite a dermatological library. In 1846, Dr. C. Eichstedt, of Greifs- wald, and Prof. Kramer, of Kiel, independently discovered the male mite. IVe who, nowadays, have treated the itch-disease, and studied the natural history of the itch-mite, naturally feel as if we knew pretty much all about it; yet, so late as 1844, Prof. Hebra, of Vienna, gave the Ger- man physicians a knowledge of a new and terrible phase of this insect's habits and habitats, in what is known as the Norwegian scabies, the first recorded case having occurred in that country. And so it probably will always be in the ever- advancing science of medicine, the present genera- tion smilino^ at the errors and i2:norance of the preceding one. But when a truth, like the one mentioned^ of Hebra's, is discovered, then others are rapidly and constantly being found to confirm OF THE HUMAN SKIN. 43 it. Other cases were soon reported by observers in Germany. We suppose, by this time, onr readers Avant to know a little more about the insect itself, anil per- haps have had hardly patience to read down so far as to learn about the stran<2:e-lookin5: animal headins^ our article. At present we include the itch-mite in the special class of acarina, and if our readers want to know more about the other members of this class, as the sugar-mite, the cheese-mite, etc., we would refer them to an article in the September number of the "American Naturalist," for 1869, by our friend A. S. Packard, Jr., Avho gives nu- merous and beautiful illustrations, accompanied by pleasantly told descriptions. What we here say will fill up this chapter for the acarics scabiei, or sar- cojptes liomini., or itch-mite. The animal is tortoise- shaped. The head distinct from the trunk, with four pair of jaws. Eight legs, four in front and four behind. The larva has but six legs. Beside the leo^s are lono: bristles. The male differs from the female in appearance, as to the bell-shaped suckers on the ends of the legs, and also is not so large. This insect has, besides man, been found in the skin of the horse, lion, llama, ape, Neapol- 44 ANIMAL PARASITES itan and Egyptian sheep, and the ferret. It has been thought, also, that the mites found in many other animals are the same as man's irritating com- panion, their growth being favored or retarded by their place of development, thus accounting for the apparent difierences in shape and size. The itch-mite lives in the skin, in little passages dug by itself, or, sometimes, just beneath the epidermis or scarf-skin. These burrows the animal makes extend into the deeper layers of the epidermi.^, down to and into the true skin, or rete mucosun}, as it is called. The acariis moults three times, not, how^ever, specially changing in form. The eggs are oval in shape, quite large for the size of the animal, and may be laid by the female to tlie number of fifty. AYe give here three drawings, to show how the animal gets into the skin to form the burrows, now called " acarian furrows" by dermatologists. In Fig, 5 the mite has got down beneath the epidermis. In Fig, 6 it has commenced digging the burrow longitudinally, and the place (/") where it was in Fig. 5 has, by the gradual growth of the cells, come up nearer to the surface of the skin. In Fig, 7, the point (/) has thus come u^ to the OF THE HUMAN SKIN. 45 surface, whilst the mite has gone along further with its burrow. An animal, when it gets on to the skin, crawls till it finds a suitable soft place, when it tips up on its fore-legs, and commences to work its way in. The female, as it progresses, lays its eggs behind her in the burrow, and when c \/^^/\yv\/VAA/\Ay\/\/\y< I'ir/. 5. Fig. 6. Fig. 7. exhausted, dies. These eggs will be seen, in a regular row behind the female, in the burrow, under the microscope with one himdred multiply- ing power. It is not settled how long it takes the eggs to hatch — from seventy hours to six or 46 ANIMAL PARASITES seven days. Probably one egg is laid every day. I Now, it must be remembered that the skin is con- stantly wearing off, and as constantly renewed by new growth from beneath ; hence, as will be seen by these illustrations, the eggs hatching in the furrow will come to the surface in time for the animal to escape from its shell when fully formed. These canals which the female acari burrow, have generally a serpentine form, and are from a twelfth to a quarter of an inch in length. They show on the surffice of the skin a whitish dotted appearance, the dots corresponding to the eggs — the female, as seen in the cuts, being at the bJuid end of the burrow. Ignorance or forgetfulness of this fact has been the cause of the itch-mite escap- ing detection. There v/ill l^e a little pimple or vesicle on the skin over where the mite went in ; and, as we see from these figures, the animal is not there, but off at some distance deeper in the skin ; hence, if we open the little vesicle, or cut it out, the insect escapes us. The old women in Corsica, and other parts of the world, knew bet- ter, and with a needle dug out the acarus from the end of the burrow. A surer way of obtaining it, and the whole burrow, is to clip this off with a OF THE HUMAN SKIN. 47 fine pair of curved scissors, commencing at the blind end, Avhere the mite lies buried. Of course a little experience is required to do this success- fully. Then, if we place this little lamina of epidermis on the microscope-slide, and a covering- glass over it, but without fluid, we shall most likely find the female acarus and the eggs she has laid behind her. A magnifying power of sixty to one hundred times is quite sufficient. After this animal had been proved to be the sole cause of the disease called itch, medical men thought it was always necessary to find the mite, to be sure that their patient had the itch. From the history above given, and explanations just made, we can see how natural it was that they should so often fail in this, and therefore conclude that their patient was not the victim of this ani- mal parasite ; consequently he w\as not properly treated, and did not get well — he continued to itch. Hence, to account for this, and cover up ignorance, was invented the "Jackson Itch," the "Seven- years' Itch," and, lately, the "Army Itch." We conclude the first did not derive its name from our former President, but was only popular dur- ing his reign. The second was ingenious ; for if a 48 AXIMAL PARASITES patieDt was told he had tho "' Seven-years' Itch," he naturally concluded that he could not get rid of it in less than that number of years, which gave time for treatment. As time goes on, soap and water, and personal cleanliness, become more popular, hence the itch-mite has become less and less common. In the old New England days it was the pest of the village-school, the town poor- house, and the city jail. During the rebellion, the great armies, on the march and in the field, of course had no opportunities for personal clean- liness, so as to prevent the contagion of the itch- disease, therefore it spread with great rapidity by contact, and the effects of the mite's presence in the skin would also be severe. The various arni}^ surgeons had not been accustomed to any such cases ; they searched in vain for the insect, and, repeatedly failing to discover it, finally concluded there must be an*itch-disease not due to the itch- mite, and called it the " Army Itch." These cases often were furloughed, and, in the cities at home, came under the care of those who, from special study of cutaneous diseases, were more familiar with the means of obtaining the parasite, as we OF THE HUMAN SKIN. 49 have above described, when search for it always revealed the true cause. This mite, in burrowing into the skin, produces intense itching, and sometimes a vesicular erup- tion on the surface; but this is all. The intense itching, however, causes those infested to scratch themselves incessantly, night and day ; and they consequently tear and lacerate the skin in every direction. The mite, as we have said, needs a delicate part of the skin to dig into — between the fingers, for instance — and here the peculiar look- ing burrows are first sought for. The portion of the skin of the whole body particularly ravaged by this unpleasant parasite are so definite, that those familiar with cutaneous diseases can, at a glance, say whether the patient has the itch. It must be remembered that several other diseases of the skin cause as bad itching as the itch-mite ; but the special portions of the general integument are, however, so marked to the practised eye, that we no longer feel any need of finding a mite in its burrow to establish our diagnosis and treat- ment. In fact, we might spend a long time in fruitless hunt, when the trouble has lasted some time, or treatment has been attempted. 4 50 ANIMAL PARASITES We seem, perhaps, very precise and prosy in all this ; but, during and since the war, so much scabies has been diffused through our country, that many family physicians are called upon to treat what they have never before seen, and their want of immediate success should not tell aofainst them. We only desire the community and phy- sicians to understand that the Jackson Itch, the Seven-years' Itch, and the Army Itch, all are due to the presence in the skin of one and the same animal, namely, the acarus scabiei, or sarcojptes hominis, the itch-mite depicted at the commence- ment of this article. How now, finally, can we get rid of our minute, insinuating, and irritating friends? They lie stored away beneath the hard layer of the scarf- skin ; this, therefore, must be removed, in order to expose them; then something fatal to them, but not hurtful to the skin, must be brought in contact with them, and finally the excoriations and eruptions caused by the constant scratching must be properly treated. The severity of these latter symptoms depend, of course, on the length of time the person has been affected ; that is to say, upon the number of itch-mites which are commit- OF THE HUMAN SKIN. 51 ting ravages upon him, and partly on the degree of the sensibility of the skin. As long as the person lives, the mite will flourish on him, till it is destroyed by proper methods. In the illustrations marked 1, 2, 3, the mite, as is seen, is quite deep in the scarf-skin ; our first effort towards treat- ment must therefore be to soften and break down or rub oft' this epidermis. Every one is familiar with the efiect of the long-continued application of warm water and soap to the skin, how" it swells up the scarf-skin, softens it, and renders it easily scraped or -I'ubbed oft". Therefore a person with this highlj^ unpleasant trouble, must first thor- oughly soak himself in hot water, and rub all parts of the body which are the abodes of the mites with the strongest soft soap. This will be half an hour's Avork. The more delicate the skin, the shorter time required. Next, the common sulphur ointment must be rubbed thoroughly over the body. This touches and is fatal to the itch-mite, already exposed in whole or part by the burrows being broken down by the soft soap and hot water. If it does not produce too much irritation, the ointment may be left on over-night, and removed by a hot bath in the morning. With delicate 52 ANIMAL PARASITES skin, sulphur soap can be used instead of sulphur ointment. If one such application as described does not suffice, it must be repeated. All the patent and popular medicines advertised latelv, on account of the itch being so widely spread through the country, are pretty sure to depend for their success on the presence of sulphur, the smell of which is hid, more or less, by other in- gredients. There are many other substances used by physicians to destroy this parasite. The above- described method will be sure to succeed if thor- ouglily carried out^ as of course a, few mites left will soon multiply and again annoy the patient. Those who are out of the reach of medicines and hot baths, may often succeed in getting rid of their minute friends, by bearing in mind the gen- eral laws of treatment; namely, that the hard scarf-skin must be softened and broken down, and afterwards, whatever kills the acari, and does not hurt the skin, be applied. Necessity Avill be the mother of invention. Nothing is more difficult, or, in fact, dangerous, than to ofive medical directions to be followed hw the community. We would most strongly advise any one suffering from the ravages of this little OF THE HUMAN SKIN. 53 pest to apply to a physician, and let him conduct the treatment. Those who make a specialty of cutaneous medicine, fortunately, nowadays, have a large choice of substances and methods of appli- cation, which can be adapted to the social condi- tion, the degree of cutaneous sensibility, and the age and sex of the patients applying to them. This is of more importance than would at first sight appear. It must be remembered that the skin is torn and lacerated by the victim's scratch- ing, from which we have an artificial inflammation of the surface, to be always taken into considera- tion in our method of treatment. A thick-skinned laborer needs very different applications from a delicate child, or feeble Avoman. We therefore again caution against self-treatment. A single word in regard to the clothing : All un- derclothes should be washed thoroughly. Outside garments, contrary to the generally-received idea, do not need anything done for them. In the great hospital at Vienna, fifteen hundred cases are treated yearly, and no attempt at -disinfecting the clothing is found necessary. The mite lives in the skin. It will therefore be seen that contagion comes from personal intercourse, particularly from 54 AI^IMAL PARASITES, ETC. hand to hand. The most high-bred, reiined, and cleanly, are not exempt. Although thus highly contagious, from the mite being passed from one to another, yet students of medicine in contact with it rarely get the itch ; and the writer has examined and handled hundreds of cases with impunity. VEGETABLE PARASITES OF THE HUMAN SKIN. CHAPTER I. We have given an account of some of the most common of the animal parasites which live on and in the hnman skin. We now propose to explain the vegetable jpar«527es which succeed •in growing on and in the skin and its appendages — the hairs and nails. They all belong to the class of cryptogams and order fungi, like the common moulds, seen to spring up and cover everything where warmth, moisture, and a quiet resting-place give opportunity for development. Whether they all are the same, or different species, and whether variety in soil and locality influences the form of their development, we leave for botanists hereafter to decide. It is enough for us to know that there are microscopic vegetable organisms which ger- (55) 56 VEGETABLE PAKASITES minate in the scarf-skin of the human body, in the nails, in the little follicles from which the hairs grow, and in the root and shaft of the hair itself; and that their presence produces partial destruc- tion or total loss of the hair or nails, and on the skin certain morbid appearances which have been classified among cutaneous diseases. We shall confine ourselves to those which thus give rise to diseases of the skin, for there are many more vegetable growths that infest the mucous membrane and internal portions of the body. A knowledge of the presence of these vegetable or- ganisms in certain cutaneous affections, and their being the cause of them, does not date back be- yond 1840, when the microscope had commenced to reach a degree of development which rendered its use constant not only in anatomy, but als© in clinical medicine. From that time to the present, scientific physicians and surgeons have steadily and constantly been sweeping the fields of their microscopes as the astronomers ' have swept the starry field with their telescopes, and thus from the efforts and studies of a large number of trained, in- telligent, and laborious observers, the atoms of light in the heavens, and the atoms of animal and veg- OF THE HUMAN SKIN. 57 etable life on and in our planet and its inhabitants, have revealed new worlds of existence to us. What, now, are these microscopic germs which plant themselves and grow on and in our skin and its appendages ? The elements of which they are composed may be divided into three morphological formations : 1. SjDores seen under the microscope as round or oblong cells with definite outline ; on these cells, in certain positions, is seen a brownish spot. 2. jSporidia, or strings of spores, looking like a rosary. 3. TJiaJIus fibres^ as they are called — that is, long, generally pretty straight, fibres, with double parallel outlines. Figure 8 represents these several elements and their mode of development, which is as follows : First, a long thallus fibre increases in length, then we see contractions at several difiTerent points, giv- ing it the appearance of a rosary, and finally by further contraction the separate spores are set free. Variety in the relative size and number of these separate elements constitutes, most probably, the various difierences in the appearances seen in the cutaneous diseases which are caused hj their pres- ence. These several afiections we shall describe in a future chapter, and confine ourselves in this 58 VECrETABLE PARASITES to explaining how and why vegetable organisms plant themselves, and grow on and in our skin and appendages. In the first place, w^here do these microscopic Fig. 8. Showing the mode of reproduction of the achoriou . — Bennett. spores or seeds of fungi come from? The* world is full of them. They are present in all vegetable mould, and are carried everywhere by the air and water. The dust from our window-panes will reveal them under the microscope. The air we It is with the greatest breathe contains them. OF THE HUMAN SKIN. 59 difficulty that fungous mould can he prevented from germinating: for instance, in or on vegetable and animal substances. Every one knows how soon dampness produces mould. Now the vegetable parasites of the skin are, as we said, one or sev- eral species of fungi. So constant is the presence of spores in nature, that it has really become more difficult to explain why more do not germinate on our bodies than why any do. A certain and steady degree of warmth and moisture are requisite for the development of vegetable life. Besides this is needed rest and quiet of the seed, that it may take in its nourishment from the surrounding me- dium. Your inkstand will have no mould on it if it is in daily use. The same with your jars of preserves and pickles. A well-raked garden-path has no weeds, as also a well-tilled field. The reason why the vegetable spores do not germinate more often on the living body is, that the body's growth and constant change of tissue^ throwing off of old to be replaced by new, interferes witli their opportunity. Warmth aud moisture are present, but the third element requisite to development is wanting; namely, a quiet resting-place. Hence we readily see that the more we use soap aud 60 VEGETABLE PARASITES water to macerate and wash off the effete scarf-skin from our bodies, the less liable will the skin and its appendages be to afford a suitable soil for the germination of the vegetable parasites. Medical experience shows this most perfectly. The cuta- neous diseases due to the presence of vegetable growths are more frequent amongst the lowest classes, where dirt and lack of cleanliness prevail. But dirty persons in the upper classes are equally liable to be infested ; immunity being in direct ratio to the use of soap and water. We have no need to pause here to discuss the point whether people at all ages offer a better field for the ger- mination of vegetable spores when their bodily health is reduced. It is at present enough for us to know that these parasites will flourish on the most healthy person, greatly assisted, of course, by lack of personal cleanliness, because then the seeds of the fungus have all the conditions requisite for their development. In disease, one condition is to be remembered as favoring the opportunity for growth of the vegetable parasites : it is, that then the healthy renewal of tissue is either much re- tarded, or perhaps wholly ceases. Hence spores have a better chance to develop. Bodily cleanli- OF THE HUMAN SKIN. 61 ness, also, during disease, is much less readily carried out, and we frequently have also the addi- tional needed element of moisture in the fluid natural and morbid products of the skin. How, now, do these microscopic spores get into the epithelium or scarf-skin, the nails, or into the hair-follicles, and the hair itself? The spores, from their extreme tenuity, penetrate themselves quite deeply into the cracks and fissures of the epidermis and hair, and more rapidly and still deeper when the filaments are formed. These push, sometimes merely mechanically, into readily formed cavities of the body, as in the follicles of the hair, or by elevation of the epithelium. Or- ganic action, however, soon taking place, the hard spore presses on the soft tissue and causes resorp- tion, thus enabling the spores, filaments, and mycelium to penetrate the tissues of the body. This is only the process of germinating we see exciting such great force everywhere in nature, enabling the vegetable seed to break through its hard husk, and the young plant to push its roots into the firm soil. The penetration, therefore, of these spores into the tissues of the body, as in the case of the skin and its appendages, the hair and 62 VEGETABLE PARASITES nails, is simply mechanical, and as readily ex- plained as the migration of any other foreign bodies from one place in the body to another. The vegetable growth pushes aside the animal tissue. Pressure always produces absorption in the animal organism ; hence the spores, in penetrat- ing and pushing deeper into the underlyiug tissue, cause atrophy of the fibres of the skin in those places. The cells containing the fat disappear, as a section of the skin will show, and a cavity is formed which is thinner at the spot where the growing parasite has fixed itself. We have, there- fore, now seen where these vegetable spores come from, they being on every substance the skin comes in contact with, even the air, in which they float; and we have also seen how they penetrate the special tissues we are considering. Let us study, now, the efiect of their presence and growth in these tissues. The mere presence of the vegetable parasite in the epidermis is not of itself an injury, since it produces only slight thickening and some discol- oration, with a branny condition of the surface. Unfortunately, however, itching is also caused, sometimes quite excessive, rendering the conse- OF THE HUMAN SKIN. 63 qiient scratching not only disagreeable, liiit pos- itively injurious. The effect of the parasites in the shaft of the hair and the hair-follicles is much more deleterious, so far as the life and growth of the hairs are concerned ; for these latter may in consequence either drop out entirely, or become brittle, dry, and easily broken and rubbed off, those remaininsr beins; lis^hter in color, and not so strons: and^ healthy. Absolute loss of hair from the whole surface of the cutaneous envelope may be caused by vegetable parasites, or the en- tire scalp rendered as smooth and free of them as a billiard-ball. Of course this must not be con- founded with baldness, the result of natural or premature loss of the hair. Further than this, the presence of vegetable growth in the epidermis or hair-follicle produces an eruption of a peculiar character, simulating some natural cutaneous dis- eases, and causing, also, itching and consequent scratching. The nails, when infested, become brittle, dry, thickened, and crumbling. More- over, masses of vegetable growth may lie half imbedded in the skin, which, producing loss of the hair, and being of a yellowish color, finally 'give the cutaneous surface a most revolting appear- 64 VEGETABLE PARASITES ance, as well as simulating the products of true disease of the skin. It will be seen, therefore, that it is not only extremely interesting, but abso- lutely necessary for the physician to be thoroughly acquainted with the natural history of these veget- able parasites, so that he may be able to detect them when on the skin, or its appendages, the hair and^ nails. He must also be acquainted with all their phases of development, and the appearances their presence produces, and thus be able to distinguish the effects they cause from similar ones, the result of, so to speak, true diseases. Fortunately the more extended use of the microscope by medical practitioners places this recognition more and more in their power. It is our object here, how- ever, to let the laiti/ know of their existence, and the consequences of their continued growth on the surface of our bodies. These vegetable spores are microscopic objects, varying in size, being some thousanths of an inch. As we said, their smallness enables them to pen- etrate every natural cavity, such as the folds in the skin ; and the}?- are carried everywhere by the wind where dust can get. Their form is generally oval or spherical. They are very firm, so as to be OF THE HUMAN SKIN. 65 scarcely crushed between the glass slides of the microscrope. Before they are thrown off they are not so firm, but more elastic and pliant. They do not lose their power of germinating by drying, except under a heat of 150*^ Fahrenheit. Being less dense than water, they float upon it, and are by that means also spread far and w^ide. They are nearly colorless — gray, brown, or yellowish when possessing any color. When in numbei*s, they give a gritty feel, and mouldy taste and smell. They are not much affected by chemical agents. Tincture of iodine gives them a dark, yellowish-brown look, like other purely nitrogen- ous substances. AYhen their cellulose walls are not colored blue by the action of the iodine, their nitrogenous contents become brown. On treating them with hydrochloric or nitric acid, or hot sul- phuric acid, before adding tincture of iodine, the nitrogenous part coagulates, contracts, separates from the sides of the spores, and remains, forming irregular masses in the centre. On applying, afterwards, tincture of iodine to these parts, they become brown, and the cellulose walls greenish — the complementary color of the blue of the cellulose and the brown of the tincture of iodine. 5 66 VEGETABLE PARASITES The structure of the spores is very simple. All present a cell without a nucleus, unless the brown or yellowish spot on them can be considered as such. The cellulose walls are thin, but firm and resisting. If, now, the reader has had the patience to come so far with us, he has learned that there are minute microscopic seeds of fungi scattered broad- cast in the earth, water, and air, and that they can insinuate themselves into the skin and its appen- dages, the nails and hair. When they have thus planted themselves and germinated, they prevent the hair's proper growth and condition, discolor the skin, gather in tubercular masses upon it, cause peculiar eruptions, and are accompanied by sometimes excessive itching. All this simulates other cutaneous ajffections of a non-parasitic origin. We will grant that except the loss of hair, and occasional loathsome appearances produced by the presence of these vegetable parasites, they are not to be feared or regarded with any special horror, certainlv not with the extreme dis£:ust the animal parasites involuntarily create. Why, then, is it so necessary for physicians to be familiar with the OF THE HUMAN SKIN. 67 parasitic cutaneous diseases, and why also should the community understand something about them and their cause, the fungus? Our answer is sim- ply that these cutaneous affections are liigldy con- tagious^ by the transportation of the spores from one person to another. Every one who has had any experience in boarding-schools, day-schools, children's hospitals, etc., knows how, like wildfire, "ringworm," or "scald head," will spread among the inmates and attendants, and how difficult it is to eradicate these when once started, even with the best attention and persevering labor. It is well known, also, how a barber's shop, whose soaps and brushes are invested with vegetable spores, will spread amongst the customers a parasitic dis- ease, which, together with some others not par- asitic, gets the popular name of " barber's-itch." Some of the vegetable parasitic diseases are more contagious than others. It would also seem as if these affections were at times almost epidemic, yet we know they arise from contagion, or individual contact. There is still another method by which the hu- man race becomes infested : namely, from the lower animals, and these pass the parasites from 68 VEGETABLE PARASITES one to another. Thus the following has been ob- served : a rat or mouse gets a vegetable fungus growing upon its skin and hair ; this is commu- nicated" to the cat, which catches and plays with the animal ; the child handling the cat becomes thereby affected, and finally the parents or nurse, from the infant. The peculiar contagious charac- ter of parasitic disease is, as we have said, best shown by children's schools, foundling hospitals, and the like institutions. Finally, we hear some one ask how do any of us escape the planting, germination, and ravages of these vegetable parasites, since, w^hen present, they are so contagious and so readily transplanted, and moreover are so innumerable in earth, air and water. It is in truth difficult to answer this, otherwise than as we have above : namely, that, like all other seeds, few find a suitable place to develop; ^. e., quiet, warmth, and moisture to- gether. Moreover, the continual throwing off of effete material from the surface of the skin must rid us of thousands of spores which are ready to germinate. The most potent means of preven- tion, however, is the continual brushing, combing, and shampooing the hair, and of scrubbing the OF THE HIBIAN SKIN. 69 body with plenty of soap and water. Dirt and uncleanliness are the inheritance of poverty ; hence it is that among the lowest classes most parasitic diseases are found ; that they are not, however, confined to them, our own experience, as that of other dermatologists, amply conjQrms, for we have seen enough even where cleanliness ought to be next to godliness. . 70 VEGETABLE PARASITES CHAPTER 11. We have explained what the vegetable parasites were, where they come from, ancl how they pen- etrate and develop in the human skin and its appendages, the hair and nails. Xow we will endeavor to explain more particularly the ap- pearances on the general cutaneous envelope of the body which are produced by the presence and growth of these fungi or moulds, and also to teach our readers how, if possible, to recognize their existence, and the safest and best means of pre- vention and cure. This is, however, by no means an easy task, and we cannot hope to succeed so well as we did in our books on the eye, and the methods of restoring or preserving sight. The reason is, the difficulty of describing a cutaneous affection so that even those familiar with it can recognize a given case. It is, however, quite necessary that the community — the laity, as the profession call them — should have some general OF THE HUMAN SKIN. 71 idea of the vegetable parasitic growths, and the morbid or unnatural appearances they produce on the surface of our bodies. Perhaps the best plan will be to take up in turn each disease, as there are not many, describe what it looks like, what it simulates, what its consequences are, and what can be done for cure by its unfortunate possessor, or that possessor's parents or attendants ; in other words, to give a medical history, as little techni- cal as possible, and as clearly and concisely ex- pressed as the subject will allow of. It must be remembered that these vegetable parasitic diseases we are about to describe, are not new affections recently appearing in the world, but are probably as old as man himself. Veg- etable* moulds existed before man's advent on our globe ; and when he appeared, they attacked and developed on his skin, as on that of other animals. As far back as any medical writings extend, we can trace the descriptions of diseases which we now readily place in the list of those due to the presence of a vegetable mould. It was not till about 1842, that the physician's inseparable com- panion, the microscope, brought to light the cause of these several cutaneous troubles, and showed 72 VEGETABLE PARASITES US the spores, and their method of germinating on our bodies. The various fungous diseases had been, by one dermatologist after another, classed with this or that set of idiopathic diseases, accord- ing to their general resemblance. When, as years went by, and in one after another of them the vegetable parasite was discovered by the new field of inquiry being more carefully studied by many busy observers, we naturally soon arrived at better methods of treatment, and having learned the cause, soon found means of removing it, in these before so intractable complaints. The suc- cess of treatment, and the novelty of discovery, brought the vegetable parasitic diseases very prominently forward, not only amongst the pro- fession, but also the laity, who soon learned where to apply for relief, induced by the success witnessed in other's cases. Thus some idea of these affections has spread abroad in the commu- nity, here in America, during the last ten years especially. This has given capital opportunity for travelling and advertising quacks to placard the streets, and their temporary offices, with startling and fearful pictures of these diseases, to impress the pocket and brain of their credulous OF THE HUMAN SKIN. 73 customers. It is very true that there are enough medical men who do not advertise, and yet are arrant quacks ; but it is still truer that all those who do, in any form, are sure to be impostors, who live and grow rich by fleecing the credulous. Scald-head, honeycomb ringworm, or, in tech- nical language, favus, is the first of the parasitic cutaneous diseases we will attempt to describe. It depends on the presence of a vegetable forma- tion, called achorion Schonleini, from Prof. Shon- lein, who discovered the fungus. This fungus consists of numerous little oval or rounded bodies, which are the spores or sporules we described in a previous number ; they are about one three-thou- sandth of an inch in diameter. Besides these, there are numerous tubes, varying in diameter ; their subdivision forming the spores, as seen in the figure accompanying the previous article on this subject. Favus attacks three separate structures of the skin: namely, the openings of the little follicles from which the hair grows, the epidermis or scarf- skin, and the nails. The hair follicles are the most frequent seat of the disease, and it is most com- mon on the scalp. When the fungus starts to grow, little yellow specks are seen scattered here 74 VEGETABLE PARASITES and there; which, under the magnify ing-glass, prove to be minute rounded, bright-yellow crusts, depressed in the centre, and having one or more hairs passing up through them. These minute yellow crusts gradually and steadily increase in size, till they are about one-fourth of an inch in diameter, and then the edge is elevated above the surface of the skin. It can now be raised from its bed, and, if done with care, a circular depres- sion is seen, corresponding to the convex lower surface of the crust; this soon fills up, the subcu- taneous tissue having been compressed. A new favus cup, however, shortly makes its appearance again, unless proper means are taken to prevent it. These masses of the fungus may be scattered separately, or if increasing greatly in number, they become thickly set together, touching and en- croaching on each other, thus forming irregular yellowish tubercular masses, rising considerably above the skin, in which the hairs are tangled. For other characteristic symptoms, we have itch- ing, a change in the appearance of the hairs, and a peculiar odor of the crusts . The itching generally attracts attention first, inducing the person to scratch the afiected part, and thereby produce OF THE HUMAN SKIN. 75 propagation of the affection from the scalp to other parts of the body. The hairs lose their gloss, be- come dull and dry, and assume a grayish or red- dish color. They break more readil}^ than natural, are often twisted or split longitudinally, and pull out more easily. When this vegetable mould has grown a long time on the scalp, the hair follicles are destroyed, and the hairs fall out, producing permanent and irremediable baldness. The sebaceous follicles, which secrete the natural and necessary oil or fat of the skin, are also de- stroyed, so that the parts affected become dry, and like parchment to the feel. The odor is quite characteristic, resembling that of mice; ^.e., a sort of mouldy smell. The presence of the parasite, and the consequent itching and scratching, produce a certain amount of eruption and rash over the parts affected ; the neighboring glands may also swell up, and form lumps under the skin. The dirt which predisposed to favus, of course predisposes to the presence of the animal j)arasite which inhabits the scalp, and which w^e have already described. This increases the itching, and complicates the whole course of the disease. They are, however, much more 76 VEGETyVBLE PARASITES 1 readily gotten rid of than the vegetal3le parasite. Favus may cover the whole scalp, and destroy all the hair. The person, by scratching, carries off some of the favus mould, and transplants it on other portions of the body. Hence, when of long standing, we are pretty sure to see patches of favus masses on different portions of the body. The vegetable matter also gets, by scratching, beneath the nail, where it takes root and germi- nates, as there it finds all the requisite elements for development ; namely, a steady degree of warmth, moisture, and a quiet resting-place. After the spores have remained for some time, and commenced to germinate beneath the nail, the latter becomes thickened over the affected part, while the color changes, becoming gradually more and more yellow, from the favus mould shining through. As the fungus grows and increases, it gradually presses on the nail, causing further changes, the longitudinal stride become very evi- dent, and fissures are formed. By degrees, as the pressure on the subjacent nail continues, it becomes thinner and thinner, until a perforation occurs, and then a favus cup makes its appearance exter- nally, more or less deformed, however, owing to OF THE HUIMAN SKIN. 77 the pressure previously exercised upon it from above. In an excessive case of favus of the scalp or body, the appearances are so marked, that any one who has ever seen a case, or a good portrait of one, would be in no doubt as to the nature of the affec- tion. But there are many other diseases of the skin, some of the appearances of which so simulate the various stages of favus, that we can hardly recom- mend any one, unless forced to by being away from medical advice, to attempt treatment except under the advice of a physician ; not, however, an advertising quilck dermatologist. The only treatment we can with safety recommend, is to soften the favus crusts in some oily substance, in order to remove them, keep up for weeks a steady daily epilation, or pulling out of the hairs, around and over the affected part, and rubbing in • a solution of two grains of corrosive sublimate to an ounce of water. That this latter medicine taken internally is a deadly poison, we believe every one now knows. It does no harm exter- nally, and serves to destroy the spores and pre- vent their germination. The epilation of the hairs is a difficult work, as they are very brittle 78 VEGETABLE PARASITES and readily broken off, instead of pulled out. There is, of course, considerable risk of conta- gion, especially of the nails, for the operator. Favus, fortunately, is not a common disease, and is found naturally amongst the lowest classes, where misery, and its accompaniment, dirt, give a large planting field to these spores, floating in the air and water, and on nearly every substance with which the skin comes in contact. During disease, this fungus, achorion Schdnletm, does not flourish well. Ringworm of the head and body is the next parasitic disease we will describe. Its technical name is herpes tonsurans^ and it is due to the presence of a fungus called trichophyton tonsurans^ showing under the microscope the spores and sporular tubes we have above described, in the root and shaft of the hair. The first symptoms of the growth of the parasite is itching, followed by a generally vesicular eruption, taking a circular form. The hairs, where the affection exists, be- come dry and dull, losing their lustre, and gray- ish or reddish, according to the color of the per- son's hair; i. e.^ light or dark. They are also twisted and very brittle, breaking off a little way OF THE HUMAN SKIN. 79 above the skin, and looking as if the hair had been cut short, like a tonsure. With the contin- uance of the itching, the skin swells somewhat, and looks of a darker color ; the fungus also appears on the hairs and surface of the skin. Finally, the hair follicles are inflamed, and the tissue around, and the matter then formed, tends to destroy the fungus itself. Thus more or less baldness is pro- duced on the scalp, and on the body where the hair is not so strong, and the integument diflfereut ; this disease forms reddish-looking scaly rings, fa- miliar to all as ringworm. Of course the symp- toms and appearances will vary according as the disease is on the scalp or body. All sorts of remedies are popular amongst the various classes of the community. Epilation, and the application of a parasiticide, as above described for favus, are the two quickest and best methods of treatment. The success of the popular remedies is entirely due to their irritating the skin, and thus making it throw off more quickly the diseased hairs and surrounding scarf-skin. Alopecia areata is our next disease to be noticed. It is due to the presence of a fungus called micro- sporon Audouini, mostly the spores above de- 80 VEGETABLE PARASITES scribed, infiltrated, so to speak, through the hair, rendering it so brittle as to break off close to the skin. The disease has no popular name. It pro- duces bald spots, when the hair is as cleanly re- moved as by the very closest shaving, the skin not showing any other signs of the disease. At first there is some slight itching, and the hairs soon commence to fall out. This may extend to every hair upon the body. Generally, however, it is confined to the head, and when occurring in a young person, gives their scalp, as smooth as a billiard-ball, a truly extraordinary appearance. When it has lasted some time, the skin becomes slightly puffy and parchment-like. It is not, ap- parently, so contagious as the affections previously spoken of. A patch of scalp quite destitute of hair is an important matter, especially when below where any head-gear will cover it, particularly for young ladies. When the whole scalp is clear, and the eyebrows gone, then it assumes still more im- portance ; for, no matter what the deceptions of fashion may be, we believe young ladies like to have some real hair of their own. The ravages of this parasite are hard to repair. Often the hair ceases to grow again, or only in spots ; treatment or THE HUMAN SKIN. 81 must be energetic, and properly conducted. Epi- lation of all the hairs surrounding a spot, steadily pursued, and the application of some remedy to kill the spores, are the means employed. Stimu- lation of the skin afterwards, even to repeated blistering, may induce the hair to grow again. Barber's itch is the name which has been given by the community to the next disease to be de- scribed : sycosis, or mentagra, is its technical name. It, however, must be remembered that this name of barber's itch would also naturally be applied to ringworm on the bearded face, or, in fact, to any itching eruption of the face. Eliny described the disease perfectly, just as it raged in old Rome under the Emperor Tiberius Claudius Csesar. It was passed from one to another of the male population by their practice of kissing when- ever they met. The fungus found is principally the spores of microsporon mentagrophytes, which infests the hairs and hair follicles. These latter swell up into hard lumps under the skin. The surface looks red, swollen, itches, and the hairs fall out or are readily removed by the slightest pull. Pustules are formed where the diseased fol- licles are, and the whole bearded part of the face 6 ' 82 VEGETABLE PARASITES presents a most loathsome appearance, such as to induce the unfortunate person to submit to almost any treatment — even that of cauterizing with hot iron, employed in old Rome. Nowadays the mi- croscope has shown us the cause of the trouble, and nature points to the cure by the dropping out of the diseased hairs. Epilation, the application of a parasiticide and cleanliness, will very rapidly get rid of the disease. Ignorance of this, or igno- rance of just how this should be done, the all- important point, allows many unfortunate men, not of the lower classes, to go about, a nuisance to themselves and their surroundings, from the really loathsome appearance of a part or the whole of the face. Proper treatment is very efficacious and successful. Chloasma, Liver Spots, are the popular names given to the last of the parasitic diseases of the skin we are to speak of, although in reality this cutaneous affection, as we shall see, has nothing whatever to do with true chloasma, or wdth the changed color of the skin accompanying organic or functional troubles of the liver. It is simply because this parasitic disease resembles the others in appearance, that the popular names have been OF THE HUMAN SKIN. 83 applied to it. It is sufficient to state here that chloasma, liver spots, and the j'-ellowish or brown- ish discoloration of the skin, are entirely due to irregularly distributed or increased amount of the jpigment of the skin, which, according as it is pres- ent in greater or less quantity, causes the differ- ence of color in the various races of mankind. The parasitic affection we are speaking of, also renders the surface of the skin of a more or less dark brown color ; hence the laity, and, we must add, only too many physicians, confound them. The technical name of the affection is jpityriasis versicolor, although it has nothing to do with ordi- nary pityriasis, the name having been given to it from its varying color, and long before its cause was discovered by Dr. Eichstadt in 1846. This cause is the presence in the scarf-skin of a fungus called microsporon furfur , a vegetable growth con- sisting of oval or rounded spores, of considerable size, and usually collected into large clusters like bunches of grapes. Besides these we have under the microscope the jointed and branching tubes. The spores and tubes are also found on and in the hairs, but not to such an extent as in ringworm of the head or body. 84 VEGETABLE PARASITES The affection is generally seen on the trunk of the body, more rarely in the extremities, although sometimes covering the whole surface of the skin, with perhaps the exception of the head. The portions of the body covered by the clothing are most often affected. We see spots no larger than the head of a pin, up to patches several inches in diameter, and of irregular outline. These are light brown or yellowish, hardly differing from the normal skin between, or darker brown up to almost black. The larger patches are made up by the gradually spreading and coalescing of the commencing fine spots. The affected surface will be found less smooth than healthy skin, and a fine disquamation going on. The scarf-skin can be more readily scratched up, and when placed under the microscope we see the vegetable parasite amongst the epithelial scales. The pres- ence of this mould causes itching, varying greatly in amount, hardly annoying to some persons, and to others positively unbearable. It naturally is most likely to be found amongst those classes in the community where a flannel shirt is only re- moved when a new one is purchased ; yet of all the parasitic affections of the skin, this is the one OF THE HUMAN SKIN. 85 which we have most often seen in the highest and wealthiest classes. It is contagious, though not so much so, apparently, as some of the other veg- etable parasites. We have seen that it does not especially affect the hairs, is principally confined to the scarf-skin, and is nothing more or less than a weed among the epithelial cells. The proper treatment is so simple and so effica- cious, that we sometimes lose our patience, when we find those applying to us have undergone all sorts of useless treatment internally, which is of no more service than dosing a river to kill the weeds in the meadows watered by it. We have only to macerate off the epidermis, and by the application of a parasiticide prevent the germina- tion of the spores until they are finally entirely gotten rid of. Soaking in hot water, and rubbing with strong soft soap, will remove the scarf-skin af- fected J and the application afterwards of a solution of two grains of corrosive sublimate in an ounce of water is all that is needed to, in a few days, cure an uncomfortable and often suspicious-looking affection, which, without proper treatment, will flourish on the skin for a lifetime. The confound- ing this parasitic disease with the pigment change 86 VEGETABLE PARASITES, ETC. of color of troubles of the liver or other organs, which the laity naturally enough do, but which physicians, at least, never should, gives plenty of opportunity for the ^ale of patent quack medicines, beauty washes, et cetera, and helps support the newspapers by the advertisements of travelling charlatans. "VYe trust now that our readers have, from these chapters on the vegetable parasites of the human skin, derived some idea of what the parasites themselves are, the appearances they produce on the cutaneous envelope and its appendages, the hair and nails, and the means to in some measure get rid of them, or at any rate avoid their plant- ing themselves and growing on the surface of the body. They cannot also but be struck with the excellent opportunity ignorance offers to quackery in reference to these affections. Eemember, an ounce of preventive is worth a pound of cure, and that preventive is simply plenty of soap, and lots of hot water. FALSE PARASITES OF THE HUMAN BODY. Omitting those articulated animals which only wound men when they are irritated, or do not live at all upon its juices, we here give Dr. Kucheu- meister's Report on the False Parasites of the Human Body. These are : — 1. The scorpions. The common European scor- pion has six eyes, and can only produce local phe- nomena, which are said to disappear by treatment with oils or ammonia, and in which, perhaps, col- lodion would prove useful. It is supposed that the effects increase with the age of the animal, and with more southern climates. The eight-eyed In- dian species is said to be much more dangerous. Only local phenomena can be laid to the charge of the twelve-eyed species in Algiers. 2. The true house spiders. Their bite scarcely (87) 88 FALSE PARASITES inflicts a worse Avouiid than that of a flea. How- ever, some of the larger southern spiders may be more dangerous. Treatment with cold applica- tions (cold earth or collodion) is sufficient. It may also be mentioned that a hysterical patient of Lopez pushed spiders under her eyelids, in order that the surgeon might remove these par- asites. 3. The hunting spiders. To this class belongs the celebrated Lycosa tarantula, first referred to by Ferrante. Many are inclined to regard the tarantula dance, which was said to occur after the bite, as a sort of chorea. It appears to me that in this case too little reference has been made to the following circumstance : it may probably happen that in particular cases the bite of the tarantula may produce violent local irritation, and that per- haps it was observed accidentally by the people that violent dancing, and keeping up the perspira- tion in bed, quickly healed these local symptoms. To excite a desire of dancinsr in those who were bitten, and thus to obtain a perspiration, it is well- known that two melodies were played — the Tar- antula and the Pastorale. Subsequently this cir- cumstance was confused or forgotten, and in course OF THE HUMAN BODY. GY) of years it came to pass that as soon as any one was bitten by a tarantula, they played to him, and he was obliged to dance. Hence it might easily happen that people were unable to imagine a tar- antula bite without its being followed by music, and, in consequence, by dancing. Thus the bite and the remedy came to be so mixed up together, that the people, and with them Ferrante, could no lono^er distinijuish between the two. The bite is a product of the animal, the dancing a product of the music, as we may every day see in the ball- rooms. 4. The bees, and humble-bees, wasps, and hornets. 5. The ants. Of course we need not here speak in detail of the caterpillars, toads, and snakes, which may accidentally wound and poison men with their bite ; nor of the lizards, if any of them are really venomous. They would not be men- tioned here at all, if the popular belief had not regarded some of the last-mentioned animals, as well as salamanders, frogs, and tadpoles, certain caterpillars, centipedes, beetles, etc., as actual parasites of man, and supposed that these animals, nay, even some species of fishes, such as the eels. yO FALSE TARASITES could carry on a parasitic existence in the interior of the human intestine. Unfortunately medi- cal men have given their assistance to this non- sense ; and I myself have seen one allowing himself to be fooled by a patient with an eel, and another with a frog. With such follies there are only two ways of dealing — jest and scientific ex- periment. The former has been done, and many, perhaps, are acquainted with the satirical tale in which a medical man in recent times has castigated a fool of this kind, who chattered about the pres- ence of living frogs in the body of a patient, in the same style as Dr. S. C. H. Windier (^swindler) once derided the infusorian theory of the process of fermentation. But such remedies are not thoroufT^h-ofoius:, and cannot effect a fundamental cure. For the cure of these follies we are in- debted to Berthold, of Littingen, and I here re- produce literally his conclusions : 1. All observations on living amphibia having remained loni? in the human bodv, and actini? as the cause of long illnesses in it, are false. 2. Eggs of amphibia, when swallowed, very soon lose their power of development in the stom- ach. (Dr. Kretschmar, of Stolpen, informed me OF THE HUMAN BODY. 91 as an analogous case, that trout often devour fer- tilized trouts' eggs at the spawning time, but that these eggs, when again taken out of the stomachs of the trout, and put uninjured into fresh water, do not become developed.) 3. It is, however, possible that amphibia may get into the human subject by intentional or acci- dental swallowing. 4. Such animals may be again evacuated either in a living or asphyxied state, when vomiting takes place soon after they are swallowed. 5. If this vomiting only takes place at a later period, the animals thrown up are dead; if no vomiting takes place, the animals are more or less digested, and we find either their epidermis or bones, or nothing at all of them, in the faeces. 6. The only and true reason why the amphibia cannot permanently live in the human body, is the moist heat of at least eighty degrees Fah., which no species of amphibia (frogs of all kinds, frogs' spawn, the tadpoles of frogs and toads, salaman- ders, tritons and their spawn, lizards, and slow- worms, were employed in the experiments) can resist from two to four hours. The method of experiment was as follows : 92 FALSE PAKASITES Berthold put the animals just mentioned in vessels with water and air, which were kept from two to four hours at the temperature of the stomach, eighty degrees Fah. The ordinary caterpillars also belong here ; they soon died, even at a low temperature, in water. They can get into the stomach with salad, or as far as concerns the smooth sixteen-footed cater- pillar of Aglossa pinguinalis, which lives in old fat or butter, and is therefore frequently found in the kitchen and cellar with fat articles of food. This caterpillar was found by Rolander and Linne in the faeces or vomitings, and regarded by the latter as very dangerous in the human intestine. If they are soon thrown up, they are either still alive, or retain their form ; but if this takes place later, they must bear more or less distinct traces of digestion about them. In the fseces they hardly can be found again, or only in cases of very im- perfect digestion, and with violent diarrhoea to drive them very rapidly through the intestines. The same applies to the Gordius aquatlcus^ which, however, from the hardness of its epidermis, may, perhaps, long resist, if not death, at least diges- OF THE HUMAN BODY. 93 tion. It might probably reach the stomach by the use of worm-eaten fruit. In southern countries, leeches {Hodmopis vorax) are readily swallowed with water, and these are said to be able to live some time in the human body, causing violent internal hemorrhages. This is mentioned by Larrey, and it was also expe- rienced at the siege of Mahon. Lastly, it may be stated, that hairs, fibres, and undigested flesh, passed with the fseces, have been described as parasites of man. The careful practi- tioner will be easily able to avoid mistakes. The hair of the processionary caterpillar (^Bom- hyx processioned) , which forms on oaks a bag-shaped cocoon often as large as a man's head , is very dan- gerous to man. Nicolai's observations and re- searches have proved that the caterpillar usually appears during the middle of May, at first to the number of from ten to twelve, on the bark of the oak, from whence it wanders to the first buds and twigs of the oak. Each single caterpillar is from the fourth to the third of an inch in length, and of the color of the bark of the oak. They have long, stiflf, black and white hairs or bristles, and a black stripe on the back. This 94 FALSE PARASITES little band of from ten to twelve caterpillars (prob- ably relatives) keep together on a twig, and eat during night and day" They grow rapidly, learn to move more quickly, upwards of one hundred and more uniting, and forming a wandering colony, in order to attack larger branches. They wander thus from twig to twig, casting their skin for the first time towards the end of May, by rubbing against the uneven bark of the oak. They are now of from one-third to one-fourth of an inch long, of a gray color, distinctly showing twelve segments, and on the top of each segment a black shield, with very short, velvet-like hair, of a pecu- liar lustre. The laro:e hairs are rans^ed in from two to three bunches on each segment, having lower down on their sides eight spiracles, and eight pairs of legs. During the time of the casting .oft* of the skin, the gray caterpillar becomes yellowish-brown, lustreless, stronger, but lazier. The caterpillars mostly gather where a branch w^ithers, and attach themselves so firmly by spinning a cocoon, that caterpillar and bark seem one. The cocoon is thin and transparent, and attached to its inner part is the cast skin. These caterpillars have quite OF THE ^UMAN BODY. 95 the appearance of the former, and begin their wan- derings afresh — a caterpillar leading each troop, having attached to ity tail other caterpillars, and so on. They grow now very large, and collect together, at the end of June or the beginning of July, in increasing numbers. The caterpillars, placing themselves side by side, or one above the other, cast their skin a second time, and wander again, leaving threads behind on the path of their emigration. They are now excessively voracious, and deposit largely the matter which is so obnox- ious to men and animals. Being now more than one inch in length, and very strong, they are seen to make long journeys, annexing all smaller troops which they meet on their way. They gather at last on the trunk of a thick tree, placing them- selves side by side to the extent of a man's hand, and then one above another, in three or four rows, after which some of the larger caterpillars are seen to creep from underneath, and spin all round the heap. The spinners are relieved by others at regular periods, and from six to eight caterpillars may be seen on the cocoon which is usually fast- ened to the sunny side of the trees, rarely to the stormy and northern side, at a considerable height, 96 FALSE PARASITES close to the twigs, and where a twig or branch is decaying. A hole is left in the cocoon for the passing in and out of the caterpillars, which is always guarded by several large caterpillars. These guards allow only larger caterpillars to pass, preventing all smaller ones which may happen to follow from entering, and appointing for their use a separate place close to the nest, from whence they are led by a larger caterpillar on new excur- sions, to young leaves, the leader returning to its nest. The larger caterpillars deposit faeces in the nest, which, fallinsr amonsf the threads of the cocoon, render the latter more opaque, and more capable of resisting external influences. This closing up happens usually at the end of July or beginning of August. Each caterpillar prepares for itself a separate case or cocoon inside the large cocoon, which is of a gray -yellow color, and silk- like appearance. The single cocoons of the cater- jDillars resemble, in the method of their spinning, that of Bombyx mori; they are, however, more oval, smaller, and very rich in the yellow, powdery substance, of which we shall have to speak. The cocoons are formed in one night. The butterfly escapes towards the end of August, by softening OF THE HUMAN BODY. 97 the threads of its cocoon with its saliva, and thus dissolves them. It copulates, lays eggs, and dies. Many of the chrysalides in the cocoons were de- stroyed by white, worm-like, hairless parasites. The inhabitants of Westphalia, in Germany, are well acquainted with the important and dangerous diseases and sufferings which are caused by these caterpillars, both in men and animals. It is very doubtful whether the noxious substance which acts like a poison, creating redness, itching, and burn- ing of the external and inflammation of the inter- nal parts, and causing even death, consists of the long hairs of the caterpillar. According to some writers, the nest or cocoon is to be looked upon as the cause of these disorders ; whilst others say that they are caused by an acrid noxious juice which the caterpillar is thought to secrete when it creeps over the surface of the skin. Nicolai con- vinced himself of the impossibility of the latter cause, for he observed itching pustules on his fore- arms, which were covered with clothing, though the caterpillar had never come near them. On one occasion, when attempting to attach to a board a large caterpillar by means of pins, and for this purpose piercing its black back shield, he saw on 98 FALSE PARASITES the edge of the shield a reddish-yellow, fine, dust- like, saffron-colored powder proceed from the shield, without the latter being altered in the least. The interior of this spot showed no especial organ nor opening. Later observations, however, are said to have discovered underneath these reddish spots two large warts, which almost touch one another, and which are especially noticed when the caterpillar casts its skin, and has become deprived of its hair. The same dust was found by Nicolai in the nests and cocoons in the parts which sur- round the chrysalis. The caterpillar also exuded this substance on being touched with a knife on the black shields. On coming into contact with the moist skin, it caused, after eight hours, red, itching pustules, but produced no effect when brought into contact with the dry or oiled skin. The dust loses its peculiar power by being pre- served in spirits of wine. Ratzeburg observed that feeding the caterpillars shut up in a glass, and the necessary repeated opening of the glass, were sufficient to cause inflammation. Lameil, Physician to the Lunatic Asylum at Charenton, observed, after the lapse of ten years even, on openmg aglass which contained a piece of a cocoon. OP THE HUMAN BODY. 99 similar effects. The microscope shows the dust to consist of very fine, straight, spiry, minute hairs, beset with barbs. They are exceedingly light, swim on water, and are sometimes carried away by the wind, flying about for some time in the forest. The dust is carried on to objects and into the air by the creeping of the caterpillar on a damp place, by touching it, by moving through the air, and by the falling of drops of rain on the bark. This dust seems , however, only to be formed after the second and last casting of the skin of the caterpillar. In places where the caterpillar is of frequent occurrence, the animals which come into the forests are attacked by various diseases : sheep, by inflammation of the eyes and violent coughing ; cows and goats, by the same symptoms, with in- ternal inflammations and ulcers all over the skin, the violent itching of which, makes the animals restless, and drives them almost to madness ; horses more especially suffer from it. The dis- eases of the eye caused by it are : Blenorrhoea of the conjunctiva, dimness of vision, and perforation of the eye. People become exposed to this poison by staying in a forest, by sleeping, working, or taking a ride, playing, cutting down wood even in 100 FALSE PARASITES winter- time, by gathering fruit, as strawberries, which grow under the oak-trees, by collecting grass, litter, or the fallen leaves of forests. The diseases which follow are violent inflammation of the eye, erythema of the e^^elids, blenorrhoea, coughing, inflammation of the throat and the lungs, violent itching and scalding eruptions of the skin (nettle-rash), and general fever. The question is, whether the above-described dust — which is found, according to Xicolai, more partic- ularly on the edges of the black shields of each segment lining the shields with a brownish-red and delicate border, and which is velvet-like, very fine, lustrous, and soft, and which can be loosened and shaken away at the caterpillars pleasure — be merely a mechanical, or also, at the saine time, a chemical irritant ; opinion difiers somewhat. Treatment and Projphylaxis. — The destruction of the caterpillars by burning and singeing them by means of wisps of straw, or by sweeping them off the trunks of the trees and crushing them on the ground, is always dangerous to the operator, since the dust is dispersed in the air. Obstacles to their migration, such as coal-tar, tarred paper, and digging trenches round the trees, are of no OF THE HUMAN BODY. 101 avail, as the caterpillar simply goes round them, and crosses even small brooks. I think it would be best to discover the nests, and wrap them up with rags soaked in oil, and then to cut away the branch, and to burn or bury it. It would be well, however, to destroy the insect in the chrys- alis state towards the end of July or middle of August, before the butterfly creeps out, in order to restrict its propagation, or to hunt up and annihilate the latest brood which exists before the second casting of the skin, without the dangerous dust. It would, therefore, be necessary to search from the beginning of May to the beginning of June, for the wandering troops. The collector of nests and caterpillars will do well to use a blunt hoe, to wear gloves, and to oil the skin. There are generally only one or two nests in each tree. The caterpillar has but few enemies in the animal kingdom, of which I may mention the ichneumon. Birds seem to be afraid of it. Precautions ought to be taken to prevent persons entering infected forests by means of notices, by the digging of ditches, etc. The pasturing of animals in such forests, and the gathering of fodder and litter, should be forbidden. The gathering of fruits of 102 FALSE PARASITES, ETC. any kind should be unconditionally interdicted ; and, in case nests are discovered when oaks or pines are cut down, they should be carefully re- moved, as mentioned above, without hewing them to pieces, and the Avood-c utter advised not to place himself towards the wind. Direct Treatment. — When the dust has been deposited on an individual, it is recommended by Ratzeburg to employ cold douche baths. Nicolai recommends milk poultices in the case of inflam- mations of the ej^e and the erysipelatous inflamma- tion of the eyelid ; rubbing in of oil on the more sensitive reddened parts, or appljdng fomentations or lotions with milk. When the throat or tonsils have become inflamed, oily emulsions, salad oil, and milk, are recommended ; but if the bronchi and lungs are inflamed, a more powerful antiphlo- gistic treatment is required : remedies which allay and restrict the irritation, especially emetics, when there is a tendency to sickness, and, on the whole, a quick and energetic treatment. 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