DISEASE FROM PARAFFINE.
We are indebted to Dr. Alexander Ogston for the first obser vations that have been made on disease from paraffine. The work men engaged in the manufacture of crude paraffine have the skin of their hands, of their feet and legs, and of other portions of their bodies, brought daily, for many hours at a time, into con tact with the paraffine shale and with the oily matters mixed np with it.
Two distinct classes of symptoms characterize this disease, one acute, the other chronic. In the acute form the parts of the skin exposed to the crude paraffine are covered with a rash of bright red nodules which lie close together, and are largest and most numerous on the wrists and where the dress fits tightly. The palms of the hands and soles of the feet are not affected, but the back of the hands and upper surface of the feet suffer severely.
Similar nodules arise, though to a lesser extent, on the face, neck, and other parts of the body to which the oily matters find access. In the acute form of the disease the size of each bright red nodule is about equal to a grain of barley; it is hard to the touch, tender on pressure, and rounded in shape. Dr. Ogston discovers that each nodule consists of a single hair follicle with the parts immediately surrounding it; the whole in a state of active inflammation. The hair emerges from the very summit of the nodule, and the orifice of the hair follicle, much enlarged, is easily visible to the naked eye as an aperture of a magnitude simi lar to that of a pin-hole in a card. The dilatation extends to the deeper part of the follicle, which forms the kernel of the inflamed knot. The redness and hardness of the nodule after a time dis appear, leaving the hair follicle enlarged and its mouth gaping so as to show retained masses of epithelial scales.
" In all paraffine workers," Dr. Ogston remarks, " openness and enlargement of the hair follicles continue to some extent, and the black dots on the skin of their hands and face strike the eye of the observer at once. Men with dark complexions and strong hair are specially deformed in this way, while those of fair complexions and of light or reddish hair escape comparatively unaffected. The chronic form of time disease exhibits the following characteristics. The backs of the feet and toes, the backs of the hands and the backs of the fingers, between but not over the joints, present a honey-combed appearance of the skin. The skin is elevated, thick ened, and inelastic, so as to prevent and render difficult and pain ful the flexion of the fingers and hand. The raised honey-combed patches are of natural color, and are not inflamed, but consist of deeply-grouped arrays of hair follicles with.a hard deep skin between and around them; the follicles packed with dry, brittle accumulations of epithelial scales, so extensive as to be easily visi ble through the follicle, the latter being large enough to admit the extremity of an ordinary probe. The hairs themselves have disappeared from these patches, having probably become atrophic from the pressure of the epidermic masses, while cracks and bleed ing fissures traverse the indurated parts, and in rare instances a follicular abscess gives variety to the picture." When the malady becomes confirmed the general health of the sufferer is greatly affected; the complexion becomes pale, the skin becomes loaded, the body wastes, and the constant irritation and pain of the skin produce sleepless nights. Dr. Ogston accounts for the production of the disease in a very clear and satisfactory way.
" The oily matters in the shale called blae oil, when separated, are both penetrating and irritating to the skin; coming continu ally in contact with the epidermis, they soak into the hair follicles, where they create an irritation soon leading to hardening and in creased shedding of epithelial scales. This shedding of the scales is not counterbalanced by increased expulsion, owing doubtless to the large quantities cast off, and to the natural fatty and lubricat ing substances being dissolved out and removed by the blae oil. Thus the brittle epidermic masses or scales plug the follicles and increase the irritation. Parts of the kind supplied with sweat glands and no hair follicles, palms of the hands, soles of the feet, and knuckles of the fingers and toes, escape the irritation. After a time the hairs and the most exposed parts waste and fall out, but the retention of the epithelial masses keeps up the process in the follicles and the hardening of the surrounding skin."