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CONTROL OF TINEA CAPITIS
1268 "Pallot’s tetrad" nearly two hundred years before Fallot was born. The new Danish edition of his dissertation on the brain contains not only a facsimile of the original treatise, as it was delivered to the French Assembly in M. Thevenot’s house in 1665, but also the English translation, made by Dr. G. Douglas in 1733, which was incorporated in James Winslow’s " Anatomical Exposition of the Structure of the Human Body." It is a beautifully scientific work, confessing ignorance, refuting unfounded assertions, pro-
infection is not readily determined without culture ; but Beare and Cheeseman describe six points of differentiation which have enabled them to make a correct forecast of the culture findings in 97% of cases. These six points are : (1) the tendency of M. audouini to affect specific areas of a city, and of if. canis infection to arise sporadically ; (2) the tendency of M. canis to cause more severe reactions than M. audouini (though sometimes there may be little or no reaction); (3) M. canis infections when examined under Wood’s light lose their brilliance and after a few weeks appear posing investigations, suggesting experiments. Especially he pressed the need for careful dissection : dull green, whereas M. audouini fluorescence remains brilliant for some months ; (4) visible changes in the As the Brain is a Machine, we must not flatter our lesions are more rapid with M. canis than with M. selves that we can discover the contrivance of it by any other means than are made use of for knowing other Machines ; 6[Md!oMMM ;(5) a history of skin disease in a kitten in the and we have no way left but to take it to pieces, and to house is far more common with M. canis than with consider what every part is capable of in a separated and 31. audouini infections ; and (6) associated tinea corporis an united state." is much more common with M. canis scalp infections And again : " This method of Dissection makes indeed than with M. audouini infections. Early identification but a very small Shaw, and a Man cannot well display his of the fungus is important because M. audouini infections Learning at the same time thaf he acknowledges his call for X-ray epilation, whereas M. canis can usually for own I much rather choose but as my part Ignorance ; often be dealt with successfully by local applications. I not to to own what do know, than impose upon my Hearers, ancient Opinions, which will some time or other X-ray expilation by the Kienbock-Adamson technique be demonstrated to be false." is still the best method of dealing with M. audouini, Steensen’s achievements in geology were hardly less persisting if. canis, and Trichyphyton sulphureum infections ; for children between 1 and 3 years of age remarkable than his contributions to anatomy ; and this may have to be carried out under general anabs. indeed geologists regard him as the founder of their thesia. In infants under 1 year of age spontaneous cure science. His remarkable mind, however, had still another is common, no matter what the organism, so that local field to explore. In 1667 he was converted from the Lutheran faith, in which he had grown up, to Roman application of fungicides may suffice. Local epilation is because of the risk of subsequent infection inadvisable he all and in 1675 his scientific Catholicism ; gave up of non-epilated areas, and because the resulting studies and entered the priesthood. He quickly rose to a bishopric, and became apostolic legate for Northern appearance is no better than when total epilation is Germany and Scandinavia ; but his natural austerity carried out. Beare and Cheeseman found that salicylanilide in carbowax was ineffective, failure resulting in led him to forsake these honours, and he died a plain 7 out of 13 patients treated, and contact dermatitis ill He in is buried at Florence in great poverty. priest, 3 ; in 1 patient severe folliculitis developed and led to San Lorenzo, the church of the Medici. gross scarring. Among 23 patients treated with salicylanilide in pentaglycol there were 14 failures. Manual CONTROL OF TINEA CAPITIS is a necessary accompaniment of local fungicidal epilation THE rational treatment of ringworm of the scalp depends applications, and the whole process is not only tedious on identifying the responsible fungus ; its dissemination but depends for success largely on the intelligent coöperacan be prevented only if the local human and animal tion of parents. Nevertheless, Barlow and his associates3 nidi of infection are found and eliminated. 111icrosporon reported eventual cure in 64.8% of 261 cases of audouini is the commonest infecting organism, accounting if. audouini infection treated with local applications, for most school and institutional epidemics. if. canis, in an average time of 10 weeks. In their hands eupram. in which the kitten and not the puppy is usually the host, monium in carbowax hydroxide gave the best results is a less common cause ; it gives rise to sporadic cases cures and 3 failures). (39 in which infection becomes attenuated by child-toWhen local fungicidal applications fail it is because of child transmission and eventually dies out, unless their inability to penetrate into the hair shafts, their enhanced by infection of an animal host, after 4-6 influence being confined to the epidermis and the human transfers in series. In some country comfollicles. In these circumstances their only virtue is munities trichophyton infections, usually acquired from in lessening the spread of infection on the scalp and to calves and occasionally from horses, are a further cause other children, until folliculitis and scarring, or natural of tinea capitis. Of 1004 cases examined in Northern spontaneous shedding of affected hairs, takes place ; Ireland by Beare and Cheeseman1 957 were small spore meanwhile absence from school is prolonged and the in M. 806 the was infections; audouini, organism sense of uncertainty maintained. Fungicides are much and in 85 if. canis, while in 66 the organism was undetermore likely to succeed in M. canis than in M. audouini mined. There were 43 trichophyton infections, 1 of favus, and 3 kerions. M. audouini is essentially the infections, probably because in the former they set up a more easily and it is this inflammatory reaction fungus of epidemic ringworm, so these figures from a folliculitis and subsequent shedding of the affected hairs that leads limited district may be misleading. Walker,2 in a to disinfection. For trichophyton infections other than three-year survey of the dermatophytes in Great Britain, T. sulphureum Beare and Cheeseman recommend boric examined material from 2015 cases of tinea capitis and starch poultices, manual epilation, and Whitfield’s isolated M. audouini in 1427, M. canis in 505, M. gypseum ointment ; and they emphasise the importance of in 2, and various trichophyta in81. efforts to eliminate or at least reduce the cattle strenuous In identifying infections with small spores Wood’s at present prevalent in some parts of the ringworm in some cases of is tinea light capitis, indispensable ; in particularly of long standing, naked-eye examination country, an attempt to prevent these human infections. may show little or no abnormality, whereas examination Sir THOMAS WATTS, M.D., a former M.p. for the Withingwith Wood’s light reveals extensive areas of infection. ton division of Manchester, died at Southport on June 3, When spontaneous cure is taking place the fluorescence at the age of 82. For many years he was in practice at becomes less brilliant. The nature of a miscrosporon Hyde, Cheshire. "
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1. Beare, J. M, Cheeseman. E. A. 2. Walker, J. Ibid, 1950, 62, 239.
Brit. J. Derm. 1951, 63, 165. 3. Barlow, A. J. E., Chattaway, F.
W., Whewell, C. S.
Ibid, p. 251.
infection is not readily determined without culture ; but Beare and Cheeseman describe six points of differentiation which have enabled them to make a correct forecast of the culture findings in 97% of cases. These six points are : (1) the tendency of M. audouini to affect specific areas of a city, and of if. canis infection to arise sporadically ; (2) the tendency of M. canis to cause more severe reactions than M. audouini (though sometimes there may be little or no reaction); (3) M. canis infections when examined under Wood’s light lose their brilliance and after a few weeks appear posing investigations, suggesting experiments. Especially he pressed the need for careful dissection : dull green, whereas M. audouini fluorescence remains brilliant for some months ; (4) visible changes in the As the Brain is a Machine, we must not flatter our lesions are more rapid with M. canis than with M. selves that we can discover the contrivance of it by any other means than are made use of for knowing other Machines ; 6[Md!oMMM ;(5) a history of skin disease in a kitten in the and we have no way left but to take it to pieces, and to house is far more common with M. canis than with consider what every part is capable of in a separated and 31. audouini infections ; and (6) associated tinea corporis an united state." is much more common with M. canis scalp infections And again : " This method of Dissection makes indeed than with M. audouini infections. Early identification but a very small Shaw, and a Man cannot well display his of the fungus is important because M. audouini infections Learning at the same time thaf he acknowledges his call for X-ray epilation, whereas M. canis can usually for own I much rather choose but as my part Ignorance ; often be dealt with successfully by local applications. I not to to own what do know, than impose upon my Hearers, ancient Opinions, which will some time or other X-ray expilation by the Kienbock-Adamson technique be demonstrated to be false." is still the best method of dealing with M. audouini, Steensen’s achievements in geology were hardly less persisting if. canis, and Trichyphyton sulphureum infections ; for children between 1 and 3 years of age remarkable than his contributions to anatomy ; and this may have to be carried out under general anabs. indeed geologists regard him as the founder of their thesia. In infants under 1 year of age spontaneous cure science. His remarkable mind, however, had still another is common, no matter what the organism, so that local field to explore. In 1667 he was converted from the Lutheran faith, in which he had grown up, to Roman application of fungicides may suffice. Local epilation is because of the risk of subsequent infection inadvisable he all and in 1675 his scientific Catholicism ; gave up of non-epilated areas, and because the resulting studies and entered the priesthood. He quickly rose to a bishopric, and became apostolic legate for Northern appearance is no better than when total epilation is Germany and Scandinavia ; but his natural austerity carried out. Beare and Cheeseman found that salicylanilide in carbowax was ineffective, failure resulting in led him to forsake these honours, and he died a plain 7 out of 13 patients treated, and contact dermatitis ill He in is buried at Florence in great poverty. priest, 3 ; in 1 patient severe folliculitis developed and led to San Lorenzo, the church of the Medici. gross scarring. Among 23 patients treated with salicylanilide in pentaglycol there were 14 failures. Manual CONTROL OF TINEA CAPITIS is a necessary accompaniment of local fungicidal epilation THE rational treatment of ringworm of the scalp depends applications, and the whole process is not only tedious on identifying the responsible fungus ; its dissemination but depends for success largely on the intelligent coöperacan be prevented only if the local human and animal tion of parents. Nevertheless, Barlow and his associates3 nidi of infection are found and eliminated. 111icrosporon reported eventual cure in 64.8% of 261 cases of audouini is the commonest infecting organism, accounting if. audouini infection treated with local applications, for most school and institutional epidemics. if. canis, in an average time of 10 weeks. In their hands eupram. in which the kitten and not the puppy is usually the host, monium in carbowax hydroxide gave the best results is a less common cause ; it gives rise to sporadic cases cures and 3 failures). (39 in which infection becomes attenuated by child-toWhen local fungicidal applications fail it is because of child transmission and eventually dies out, unless their inability to penetrate into the hair shafts, their enhanced by infection of an animal host, after 4-6 influence being confined to the epidermis and the human transfers in series. In some country comfollicles. In these circumstances their only virtue is munities trichophyton infections, usually acquired from in lessening the spread of infection on the scalp and to calves and occasionally from horses, are a further cause other children, until folliculitis and scarring, or natural of tinea capitis. Of 1004 cases examined in Northern spontaneous shedding of affected hairs, takes place ; Ireland by Beare and Cheeseman1 957 were small spore meanwhile absence from school is prolonged and the in M. 806 the was infections; audouini, organism sense of uncertainty maintained. Fungicides are much and in 85 if. canis, while in 66 the organism was undetermore likely to succeed in M. canis than in M. audouini mined. There were 43 trichophyton infections, 1 of favus, and 3 kerions. M. audouini is essentially the infections, probably because in the former they set up a more easily and it is this inflammatory reaction fungus of epidemic ringworm, so these figures from a folliculitis and subsequent shedding of the affected hairs that leads limited district may be misleading. Walker,2 in a to disinfection. For trichophyton infections other than three-year survey of the dermatophytes in Great Britain, T. sulphureum Beare and Cheeseman recommend boric examined material from 2015 cases of tinea capitis and starch poultices, manual epilation, and Whitfield’s isolated M. audouini in 1427, M. canis in 505, M. gypseum ointment ; and they emphasise the importance of in 2, and various trichophyta in81. efforts to eliminate or at least reduce the cattle strenuous In identifying infections with small spores Wood’s at present prevalent in some parts of the ringworm in some cases of is tinea light capitis, indispensable ; in particularly of long standing, naked-eye examination country, an attempt to prevent these human infections. may show little or no abnormality, whereas examination Sir THOMAS WATTS, M.D., a former M.p. for the Withingwith Wood’s light reveals extensive areas of infection. ton division of Manchester, died at Southport on June 3, When spontaneous cure is taking place the fluorescence at the age of 82. For many years he was in practice at becomes less brilliant. The nature of a miscrosporon Hyde, Cheshire. "
-
1. Beare, J. M, Cheeseman. E. A. 2. Walker, J. Ibid, 1950, 62, 239.
Brit. J. Derm. 1951, 63, 165. 3. Barlow, A. J. E., Chattaway, F.
W., Whewell, C. S.
Ibid, p. 251.