SEBORRHOEA OLEOSA is generally lim ited to the face and is due to hypersecre tion from the sebaceous glands. As a result, the skin is covered with an oily coating, which gives the region a shiny appearance. Upon the application over the affected area of a piece of absorbent paper, a large number of fine grease-spots will appear, corresponding to the lar orifices. Dust may accumulate in the latter, constituting the so-called rhoea nigricans. The skin may preserve its usual color or appear congested and thickened. Seborrhoea oleosa is often observed in drunkards, and may occur as a complication of acne rosacea. (See also ECZEMA, volume ii.) Etiology and Pathology.—Sabourand has recently expressed the view that the causal organism of alopecia areata was also that of seborrhoea. He holds that when the microbe becomes implanted in the pilo-sebaceous follicle it sets up an epithelial overgrowth which encysts groups of the organism; these are ulti mately expelled as plugs. Four success ive stages may then result: a sebaceous hypersecretion of oily fluid, a gradual enlargement of the sebaceous gland, a progressive atrophy of the infected fol licle, and finally death of the hair. These stages correspond to the various forms of seborrhoea, to which pityriasis is often added through secondary infec tion. Brocq favors a plurality of pathog enic organisms, probably saprophytes, especially in the cases complicated with eczema, which organisms are capable of becoming pathogenic under certain con ditions and in appropriate soil.
Search for the germ of seborrhmic ec zema, or seborrhceitis, and in the scales of a series of cases. Seborrhma is caused by a specific germ or germs, in form dip lococci, whose life-history is most ac tive at the ordinary temperatures and with free access of the air, but which can develop at much higher and lower temperatures, and with a scarcity of oxygen. Merrill (N. Y. ?ed. Jour., Mar. 6, '97).
Treatment.—In many of these cases, if not in all, there is an underlying crasia which must be met by appropriate measures. The gouty and rheumatic diatheses prevail in many; neuroses are often traceable in the individual or per sonal history; a lymphatic temperament is usually observed in children; anwmia is a frequent accompaniment of the dis ease in young women. The salicylates are of value in the first; strychnine and arsenic in the second; the iodides and iron in the third, and iron and arsenic in the fourth class of cases. A carefully regulated, but nutritious, diet is neces sary, the avoidance of much meat being indicated in gouty individuals.
In dry seborrhoea Brocq recommends the following: 1 Betanaphthol, 4 grains. Camphor, Resorcin, of each, 3 grains. Precip. sulphur, 45 grains. Vaselin, 5 drachms.—M.
This ointment is applied carefully to the scalp by parting the hair in many places, removing any excess with a soft handkerchief. Next morning the head
is cleansed with a little ether. In oily seborrhoea Brocq applies the following lotion, three times a week, in the same manner as the naphthol mixture:— R Sulphur, drachms. Camphorated alCohol, 1 V, ounces. Glycerin, 1 ounces.
Distilled water, ounces.—M.
Lassar, in cases in which sulphur can not be conveniently used, applies the fol lowing salve three times a week, or less often if it proves irritating:— 4 Pilocarpine, 30 grains.
Vaselin, 20 grains.
Lanolin, 80 grains.
Essence of lavender, 25 drops.—M.
To cleanse the scalp a solution of bi carbonate of sodium, 5 drachms to the quart of water, may be employed. A borate-of-sodium solution, 1 drachms to the pint, is more effective when the scalp is very oily. This solution should be used once a week and the following wash used daily with a soft tooth-brush, parting the hair in many places:— 4 Tannin, 15 grains.
Alum, 1 drachm.
Rose-water, 6 ounces.—M.
Skinner recommends the following lotion, which serves as a tonic to the scalp and tends to encourage the growth of hair:— Tinct. of cantharides, 14 drachms.
Tinct. of cinchona, 2 ounces. Tinct. of benzoin, 6 drachms. Spirit of lavender, 1 ounces. Castor-oil, 2 drachms.
Alcohol, enough to make 10 ounces.—M.
The castor-oil should be dissolved in the alcohol, then mixed with the tinct ures and spirit, and filtered through kaolin.
When there are incrustations, which are often observed in children and aged people, the crusts should be poulticed off and their bases anointed with the follow ing salve: 1 Ichthyol, 45 grains.
Lanolin, Vaselin, of each, '/, ounce.—M.
The methods hitherto employed for the removal of the crusts of seborrhoea sicca have been either alkalies, by which the crust is more or less saponified, or, more usually, oils of one sort or another whereby they are liquefied. Neither of these methods is very satisfactory. As the crust is composed chiefly of fat, it was thought that a solvent might act better, and benzene suggested itself. The first patient it was tried on was a young man aged 25. He was getting very bald and had a thick crust of seborrhoea sicca. It was applied with a shaving-brush, and the whole thing disappeared in about two minutes.
The benzene leaves the hair and scalp very dry, and inunctions must fol low. For this hay-rum and castor-oil, of each, r3iss ; tr. eanth., f5ij ; aq. colonire, f3ss; may be used every morn ing, and the benzene be repeated about once in five days. For mild cases of the seborrhoea-oleosa type, the ben zene may be combined with an equal quantity of rectified spirits. No hairs are broken off in the removal of the crust. A considerable number of eases have been successfully treated in this way. E. W. Leftwich (Brit. Med. Jour., Jan. 5, 1001).