132 INANITION AND MALNUTRITION 



vibrissae appear constant, however. Bessesen ('23) found the integument 

 usually subnormal in weight (Table 12). 



The extensive literature on human scurvy has recently been reviewed by 

 Hess ('20) who notes that the skin is usually pale or livid and dotted with 

 numerous petechiae. These are variable in size and most frequently located on 

 the lower extremities. There may also be larger superficial hemorrhages, with 

 color varying from reddish in the more recent to blue, green or brown in the 

 older lesions. Emaciation and edema may occur, the latter most frequently 

 localized in the regions of the ankles or eyes. According to Sato and Nambu 

 ('08) and Comrie ('20), cutaneous hemorrhages, often associated with sclerosis 

 and marked edema, occur especially in the lower extremities. 



That the regions of the sweat glands and especially of the hair follicles are 

 particularly susceptible to the petechial hemorrhages was observed by Lasegue 

 and Legroux ('71), and confirmed by Aschoff and Koch ('19), Bierich ('19) and 

 Wiltshire ('19). Wiltshire also described a peculiar "hyperkeratosis" of the 

 affected follicles, each presenting a hard swelling, of pin-head size, due to the 

 accumulation of epithelial debris at the mouth of the follicle. The hairs become 

 atrophic, and may be broken off and regenerated. A similar hyperkeratosis is 

 said to occur in other malnutritional states. 



Water Deficiency. — Tiedemann ('36) stated that in man during extreme 

 thirst the skin becomes dry and hot. Schuchardt ('47) found no apparent loss 

 in the skin of pigeons with loss of 44 per cent in body weight on a dry barley diet. 

 Scheffer ('52) and Falck and Scheffer ('54) in a dog which lost 20.7 per cent in 

 body weight during 28 days on dry biscuit, noted an apparent loss of 28 per cent 

 in the weight of the skin. Bowin ('80) observed that in dogs on a dry diet the 

 skin becomes roughened and the hairs are easily detached. Pernice and Scag- 

 liosi ('95a), in chicks fed dry maize only, noted that the comb, at first red, 

 becomes pale and later cyanotic. At autopsy the skin is dark reddish or nearly 

 black (from passive congestion), and the fat has almost disappeared. As shown 

 in Table 9, Kudo ('21) found that in adult albino rats on dry diets (acute or 

 chronic thirst), the relative loss in the weight of the integument is slightly less 

 than that of the whole body, as found in total inanition. As shown in Table 10, 

 Kudo ('21a) noted that in young albino rats (about 4 weeks old) which were 

 held at nearly constant body weight by a dry diet for various periods (1-13 

 weeks), the integument usually loses slightly in weight (7.5-14) per cent. This 

 slight loss appears early and is not progressive in the longer experiments. The 

 skin becomes somewhat roughened, but the hair is not easily detached (as it is 

 in adult rats). Dryness and desquamation were observed on the plantar sur- 

 faces. The claws become much elongated, especially in the longer test periods. 



According to Tobler and Bessau ('14) the loss of turgor in the skin of mal- 

 nourished infants with diarrhea is due to the withdrawal of water from the skin. 

 Marriott ('23) states that during anhydremia the skin becomes gray, wrinkled 

 and dry, and loses its elasticity. There is marked stagnation in the peripheral 

 circulation. 



