68 An Introduction to Medical Mycology 



should be kept constantly over the treated area. We have found that this 

 not only prevents spread of the infection but tends to set up follicular irri- 

 tation valuable in furthering cure. If the reaction to the adhesive plaster is 

 too severe, it may be applied only part of the time. When the adhesive is 

 left off the scalp, some fungicidal ointment should be used and a linen cap 

 applied. The rest of the scalp should be treated with ointment containing 



10 per cent ammoniated mercury applied morning and night. Shampoos 

 are allowed, but the ointment is reapplied immediately after them. If 

 the area of infection is large or if there are many different patches, manual 

 epilation is not practicable. 



Schwartz reported successful treatment of tinea capitis due to M. audouini 

 using the following formulas: 



1. Salicylanilide 5 

 Hyamine 1622 (25 per cent) 5 

 Carbowax 1500 100 



2. S. S. copper undecylenate in carbowax 1500 



3. Pentaehlorphenol 1 

 Carbowax 1500 100 



One of these remedies is applied daily for at least 40 days before improve- 

 ment should be expected. Cure may not be obtained before 100 or more 

 applications. A better effect was obtained in some instances by alternating 

 the prescriptions. 



(2) Roentgen epilation.— The use of roentgen rays by those competently 

 trained has proved of infinite worth in the treatment of the resistant forms 

 of tinea capitis. The incidence of infection in France, England and other 

 countries has been materially reduced, and this treatment has been of marked 

 economic importance in controlling the disease. A word of caution, however, 

 is in order. The epilation of hair by means of roentgen rays is a most delicate 

 operation, requiring considerable patience, special training and skill. The ma- 

 chine must be accurately standardized, and the technic of the operation 

 should be learned thoroughly under the personal supervision of an authority. 

 The reader is referred to Chapter XXVII in MacKee and Cipollaro's X-Rai/s 

 and Radium in the Treatment of Diseases of the Skin for further details 

 of technic. It may be emphasized that after the epilating dose of roentgen 

 rays, the patient should be given an ointment containing 3 per cent am- 

 moniated mercury. When the hair begins to loosen (after 18 to 21 days), 

 daily shampoos are in order, and the hairs which cannot be epilated readily 

 (as noted under the filtered ultraviolet rays) should be removed manually. 

 The removal of adhesive tape applied to the scalp assists depilation at 



1 1 lis time. The patient should not be discharged before two examinations 

 under the filtered ultraviolet rays, made one week apart, have indicated 

 normal conditions. A final inspection one month later is advisable. In pa- 



