Vol. 71, 1915 - The University of North Carolina at Chapel Hill

32 THB CHARLOTTE MEDICAL JOURNAI,.
method has also been employed in the
treatment of syphilis, apparently with
good results.—Revista Clinica de Madrid.
The Nervous System and Cutaneous Pigmentation.
More than ten years ago it was discovered
that one of the important sources
of the coloring matter of the skin is an
end-product of protein disintegration in
the intestine, namely tyrrosine. In fact,
it was shown that all the colors of the
butterfly's wing are similarly derived
from decomposition products in the
This wizardry of biological chem-
bowel.
istry has its counterpart in the production
of aniline dyes from coal tar. The
pigment cells of the skin are subject to
many influences, not only chemical, but
also thermic, actinic and mechanical;
and are developed to a higher degree of
complexity in the lower orders of life,
such as the fishes and amphibia. The
fact that the later can in many instances
adapt their cutaneous coloration to that
of the environment indicates a close relationship
between the nervous system
and the pigmentary apparatus of the integument.
That such a relationship,
though less pronounced, exists in human
beings is indicated in the instances of
changes in skin coloring arising in the
course of nervous diseases, and in the
conspicuous examples of graying of the
hair resulting from fright or intense mental
strain.
This subject forms the basis of an interesting
study by Fritz Nehl (Zeitschrift
fur klinische Medizin, Vol. 81, Nos. 1
and 2.) He points out that the instances
of so-called sudden graying of the hair
as the result of anxiety must be regarded
critically. In these cases, according to
Landais, there seems to occur, not a disappearance
of pigment, but an accumulation
of innumerable minute bubbles of air
in the hair. The premature garying of
the hair associated with prolonged grief
and worry is perhaps to be explained on
the basis of a disturbance in the general
physicial condition of the individual. In
this instance there are associated with the
graying of the hair a general emaciation,
a reduction in the hemoglobin-content in
the blood, and a loss of tonus in the skin
and in the body musculature. There are
however instances of the direct effect of
changes in the nervous system upon the
cutaneous pigmentation. Thus, canities
is frequently observed in the territory
supplied by a particular nerve. The neural
causation is especially manifest if
local neuralgic pains are present, as in
idiopathic vitilgo, and in the case of the
pigmentary atrophic spots of leprosy in
which there is a reduction in sensibility
in the afi^ected cutaneous areas.
The pigmentary anomalies of segmental
pigmented nevi and of congenital
segmental albinism are attributed to disturbances
in the development of the cutaneous
cells rather than to any neurologicol
factor. The question whether the
pigmentation of Addison's disease has
anything to do with the nervous system
has not yet been solved. Undoubtedly,
however, the suprarenals with their innervation
by the vegetative nervous
system have some influence upon the
cutaneous pigmentation. That the
potent factor is the vegetative nervous
system is also indicated in the instances
of pigmentation occurring in exophthalmic
goiterdiseases of the ovaries, and
pellagra, in all of which the atonomic
nervous system is involved.
The pigmentation observed in scleroderma
and facial hemiatrophy, and frequently
confined to the areas of distribution
of particular nerves, suggests that
the sympathetic fibers in the peripheral
nerves are the ones responsible for the
pigmentary changes. At any rate, in
these conditions there are neither motor
nor sensory disturbances. Moreover, it
has been shown. that sections of sympathetic
nerve fibers may give rise to a disappearance
of pigment from the skin, as
in the cases of unilateral graying of the
hair following lesions of the cervical
sympathetic, and of heterochromia of the
iris occurring after resection of the upper
cervical ganglion. It is quite probable,
therefore, that prolonged grief and worry
may through the agency of the autonomic
nervous system give rise to premature
graying of the hair.—New York
Medical Record.
Chronic Catarrhal Bronchitis.
This Condition, so frequently encountered
and especially so in the changeable
climate of the middle and western
states, is a clear indication for the continued
administration of cod liver oil.
These patients, if unable to seek a more
suitable climate, should be instructed
carefully as to dress and bodily functions.
Thus, every efl^ort should be made to
guard against exacerbations. With close
attention to dress and the systematic use
of cod liver oil, such as Cord. Ext. 01.
Morrhuae Comp. (Hagee) which is the
preferable cod liver oil preparation by
reason of its palatability and therapeutic
effectiveness, the patient is employing the
best means for use in this form of bronchitis.