HERPES TONDENS. 509 



SYMPTOMS AND COURSE. All the above-named diseases exhibit 

 great uniformity of appearance ; the differences between them are un- 

 important, and are based solely upon the difference of intensity in the 

 inflammation to which the growth of the fungi in the hair-follicles gives 

 rise. In mild kinds of the disease, papules form, and an exanthema 

 appears, having the character of lichen. In cases of greater intensity, 

 vesicles or pustules arise, accompanied by a herpetic or impetiginous 

 eruption. When there is no real inflammation of the hair-follicles, we 

 have pityriasis rubra, or porrigo asbestina. "When the disease is situ- 

 ated upon the scalp, round spots become observable as large as a six- 

 pence and sometimes as large as a dollar, which, unlike alopecia cir- 

 cumscripta, are not quite bald, but are covered with short, broken 

 hairs, and which so much resemble tonsures, that the affection is well 

 entitled to its name, herpes tondens seu tonsurans. Between the 

 short hairs, the scalp is covered with scales. Upon microscopic exam- 

 ination, the roots of the hair are found to be split up like a broom, and 

 between the twigs so formed there is an innumerable quantity of 

 spores and filaments, which spread into the shaft of the hair in wreaths. 

 The same elements are also found in the scales of the epidermis. 

 When the disease is situated upon a portion of skin which is merely 

 covered with a fine down, this is not so apparent, but it is still charac- 

 teristic enough to place the diagnosis beyond a doubt, without the 

 assistance of the microscope. If a herpes circinatus, a lichen circum- 

 scriptus, or an impetigo figurata, be of a well-marked circular form, 

 abruptly distinguishable from the parts about it, when its edge is of a 

 bright red, and studded with nodules, vesicles, and pustules, its centre 

 being paler, smoother, and covered with mealy dust ; when each point 

 of eruption is perforated by a hair ; and, finally, when it can be ascer- 

 tained that the patient has been in contact with a man or beast simi- 

 larly affected, the diagnosis is sufficiently insured. Herpes tondens 

 may recover without medical aid, the growth of the fungi finally ex- 

 hausting itself, the broken hairs falling out, and the diseased epidermis 

 becoming detached. Upon the hairy regions of the head, however, the 

 disease will exist for a long time before terminating in this way, while 

 upon surfaces void of hair it is usually of but short duration. 4 



TREATMENT. Depilation is indicated in the treatment of herpes 

 tonsurans, but, owing to the brittleness of the hairs, the process is by 

 no means easy of accomplishment ; moreover, it is often possible to 

 cure the disease with comparative ease without it, by dint of daily and 

 vigorous washing with soft soap, which is always to be followed by 

 an inunction of white-precipitate ointment. 



