DERANGEMENTS OF SECRETION IN THE SKIN. 515 



soft soap is contraindicated. It used formerly to be thought neces- 

 sary to expose the clothing to a temperature at which albumen will 

 coagulate, in order to kill the insects and eggs lodged in them. The 

 linen was boiled ; and the cloth garments were baked in the so-called 

 " itch-oven," or sent to the " kettles " at the establishments for clean- 

 ing feather beds, which exist in all large cities. We have already 

 mentioned that Hebra declares this to be superfluous. According to 

 the undisputed testimony of this authority, the treatment of the itch 

 in private houses is much less difficult, and promises far more success 

 than was formerly supposed ; and the danger of catching the disease 

 anew from clothing, bedding, furniture, or other utensils that have not 

 been disinfected, is purely imaginary. 6 



VIII. DERANGEMENTS OF SECRETION IN THE SKIN. 



WE are aware that gaseous, watery, and oleaginous secretions are 

 given off from the surface of the skin. There is no doubt that, under 

 certain conditions, the quantity and quality of these secretions vary 

 from the normal ; but we are imperfectly acquainted with the nature 

 of these variations, and with the sources whence they arise. 



The secretion of gases, especially of hydrogen gas, is increased in 

 febrile disease apparently from causes purely physical whenever 

 there is much elevation of the temperature of the skin. If we weigh 

 a patient who has had a fever, we shall find him much lighter than he 

 was prior to his illness. If we take account of every thing eaten and 

 drunk by him, and if we deduct from this the loss of weight, and the 

 weight of the fasces, sputa, urine, etc., which have been evacuated 

 during the sickness, it will be found that the excretion through 

 the skin (and lungs) greatly exceeds the normal amount. It is 

 well known that an increase of the insensible perspiration is not 

 always accompanied by an augmentation of the secretion of sweat ; 

 and indeed, that the skin usually is dry while the former is going on 

 most rapidly. A copious supply of watery liquid greatly increases the 

 amount of gaseous perspiration. An athletic medical student, for the 

 sake of experiment, dieted himself for a long period of time upon ex- 

 actly the same quantities of food and drink as were given to two patients 

 with diabetes mellitus. The quantity of urine which he secreted was 

 much increased, but upon calculating the daily amount supplied to the 

 system, and upon deducting the weight of the daily excretions of urine 

 and faeces, as well as the gain hi weight of the body, from the weight 

 of the food and drink which he consumed, it was found that the insen- 

 sible evaporation from the skin and lungs had been very considerably 



