CHAPTER VI 



EFFECTS ON THE INTEGUMENT, ADIPOSE TISSUE AND MAMMARY 



GLAND 



The present chapter includes the effects of inanition upon the skin and appen- 

 dages, including the mammary gland. In connection with the tela subcutanea, 

 the effects upon adipose tissue in general are also noted. 



The effects of inanition on the skin and appendages are of interest in der- 

 matology, and especially in relation to the diagnosis of the various deficiency 

 diseases (pellagra, malnutritional edema, scurvy, etc.). Atrophy of the skin is 

 likewise characteristic in many other disorders involving general malnutrition. 

 The effects on the mammary gland are of obvious importance in pediatrics. 

 After a summary of the more important effects the changes will be considered in 

 detail under {A) total inanition, or on water alone, and (B) partial inanition. 



Summary of Effects on the Skin and Appendages 



These effects will be summarized for both total inanition and partial inanition 

 including the deficiency disorders. 



Changes in Weight. — In adults, aside from the tela subcutanea, the loss in 

 weight of the integument during inanition is usually relatively less than in the 

 body as a whole, although nearly equal in the rat and frog. In the newborn rat, 

 the skin may increase in weight while the body is held stationary; but the growth 

 impulse soon decreases to a minimum, later increasing in experiments begun 

 toward the adult stage. The loss in weight of the skin is promptly regained 

 upon refeeding. 



The general appearance of the skin during total inanition is variable, thicken- 

 ing and roughening of the hair coat being frequent. The epidermis becomes 

 somewhat atrophic, but mitoses persist in reduced number in the deeper epi- 

 thelial cells. In the corium, the pigment is generally reduced in amount. The 

 healing of skin-wounds is slow and imperfect during inanition and hibernation. 

 The tela subcutanea during inanition loses heavily in weight (up to 90 per 

 cent or more), chiefly through atrophy of the adipose tissue. The rate of loss 

 varies in. different regions, however, and in some cases fat may persist in con- 

 siderable quantities, even at death from starvation. Flemming established 

 three histological types of adipose atrophy; simple, serous and proliferative; 

 to which may be added gelatinous or mucoid atrophy, occurring chiefly in adi- 

 pose bone marrow. Hibernating animals subsist chiefly upon fat stored in the 

 so-called hibernating gland. In general, the ordinary neutral fats of the body 

 appear to be easily mobilized, while the lipoidal fats contain phospholipid 

 which are relatively resistant to starvation. The atrophic adipose tissue is 

 easily restored to normal upon adequate refeeding. 



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