120 INANITION AND MALNUTRITION 



loss in weight, reaching its normal proportionate weight within two weeks. 

 In albino rats underfed from birth to 3 weeks (with retarded body weight of 

 10 g.) or to 10 weeks (15 g.), and then fully refed to body weight of 25, 50 and 

 75 g., Jackson and Stewart ('19) obtained nearly normal weight (or above) for 

 the integument in all except one group refed to 25 g., which was sub- 

 normal (Table 7). In rats similarly underfed for longer periods (from 3 

 weeks to nearly a year of age), and then refed until permanent dwarfed size was 

 reached, although the body weight was markedly below normal adult, the 

 weight of the skin was but slightly below that normal for corresponding body 

 weight (Table 8). 



General Appearance.— The integument varies in appearance during inani- 

 tion. Tiedemann ('36) and Falck ('81) noted that in starvation the human skin 

 is atrophic, lax, dry, shrunken and pale. A somewhat similar description for 

 atrophic infants is given by Bourgeois ('55), Vincent ('04), Birk ('n), Lesage 

 Cn), Nobecourt ('16), Nicolaeff ('23) and others. According to Thiercelin 

 ('04) and Rosenstern ('11) the skin of such infants may be at first eczematous, 

 later pale or cyanotic. In the adult man studied by Meyer ('17) the skin was 

 dry, rough, and discolored for several days before death. In this case there 

 were no folds, excepting the volar and plantar regions. As a result of war 

 famine, there is a notable increase in the occurrence of skin infections (Rubner 

 '19, Richet and Mignard '19, Vandervelde and Cantineau '19, Ivanovsky, '23), 

 probably due to lessened immunity. The frequent occurrence of edema during 

 famine has already been mentioned, and this, of course, may alter greatly the 

 appearance of the skin. 



The hairs in dogs during starvation remain firmly attached, according to 

 Falck C75), or become easily detached, according to Bich ('95). An increased 

 growth in thickness of the hair coat in underfed cattle was observed by Weiske 

 ('75) and Van Ewing and Wells ('14). Thickening and roughening of the hair 

 coat were also found in underfed mice by Judson ('16) and Thompson and 

 Mendel ('18); and in underfed horses by Moehl ('22). Trowbridge, Moulton 

 and Haigh ('18) observed that poorly nourished steers shed their hair very 

 late in the season. Irregularities in the hair coat also occur during various 

 forms of partial inanition, to be mentioned later. Porter ('89) noted that absence 

 of pigment is characteristic of the famine-stricken, and that in women the black 

 hair may become yellowish, devoid of pigment. In the emaciated victims of the 

 Russian famine, Ivanovsky ('23) stated that " the hair grew more slowly, fell out 

 prematurely and tended to rapidly become gray. Growth of the nails on hands 

 and feet was retarded, and the teeth readily decayed. The eyes became limpid 

 as with aged people; the skin lost its elasticity and became wrinkled." 



Epidermis. — Cunningham ('80) found fatty degeneration of the deeper epi- 

 dermal cells, and also atrophic changes in the dermis, in starved larvae of B-nfo 

 melanosticus and Rana tigrina. Among the victims of the Indian famine, Por- 

 ter ('89) observed that fatty degeneration of the cuticle may give rise to the 

 "famine skin," a harsh, dry, patchy scurf also described by Donovan in the 

 Irish famine of 1847. The vitality of the skin appears too low to throw off 

 the dead epithelium. 



