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skin, paralysis, colour and blood

NOSE, RED.A harmless, hut often very disfiguring, affection of the skin of the face, caused by paralysis of the facial capillaries. It is charac terised by a bright-red to bluish-red discoloration, which may extend over smaller or larger areas of the face. Sometimes only the tip of the nose is affected ; in other cases also the sides of the nose are discoloured ; and in some instances the affection may extend to the middle of the cheeks, or even to the chin and to the lobes of the ears. The colour disappears under pressure with a finger. In many cases the discoloured areas show a smaller or larger number of delicate streaks, which do not blanch under pressure. These streaks are the dilated capillaries of the upper layers of the skin. The colour usually becomes darker and more distinct during rapid changes in temperature, after drinking hot or alcoholic beverages, after eating, and under emotional disturbances. In some rare instances, however, the colour fades slightly during summer.

The immediate cause of the redness is, as already stated, a paralysis of the capillaries of the skin, which are thereby dilated and rendered unable to contract to their normal width. This paralysis of the blood-vessels may be due to various causes. It may be the result of a chronic inflammation

of the lower layers of the skin owing to an abnormal increase of secretion from the cutaneous oil-glands (stearrhea), which causes the skin to become thicker and to become covered with pimples and nodes ; or it may be due to an impairment of the blood (chlorosis) ; or to wasting diseases (consumption ) ; or to deficient nutrition. Slight grades of freezing also give rise to a similar paralysis of the capillary vessels, causing insignificant reddening of the skin, similar to slight chilblains on fingers or toes. This redness usually appears where some part of the dress (the veil, for instance) adheres closely to projecting parts of the skin (as the nose, chin, and lobes of the cars). In these places the circulation of blood is naturally slow and diminished.

Although red noses are frequently seen in persons addicted to alcoholic beverages, they cannot always be ascribed to chronic alcohol-poisoning, but possibly to impaired nutrition and deficient circulation of the blood. There are, furthermore, a good many drunkards without red noses.