538 PHYSIOLOGICAL CARE OF THE SKIN. 



An observation of Adamkiewicz and Senator tends to support this view. 

 They noted that in a human being with an abscess in the motor area of the cerebral 

 cortex for the arm, convulsions and sweating occurred in this member. 



According to Adamkiewicz, all of the four paws of the cat sweat on 

 irritation of the medulla oblongata, in which the dominating center for 

 the secretion of sweat appears to be situated, even three-quarters of an 

 hour after death. 



Nerve-fibers that pass to the unstriated muscular fibers of the sudorif- 

 erous glands, and are wanting in the smaller glands, must have an influ- 

 ence upon the discharge of the secretion. 



Pilocarpin and other diaphoretics, when injected subcutaneously, even after 

 division of the nerves, cause sweating first at the site of injection. Atropin, in 

 the same way, causes first local suppression of sweat-secretion. If the sweat- 

 nerves are divided, in the cat, the irritability of the fibers (sciatic) to electrical 

 stimulation is lost in the course of four days. In cats operated on, delayed 

 sweating after injection of pilocarpin occurs during the course of three days, and 

 this may be prolonged, after the lapse of six days, even to a delay of ten min- 

 utes. At a later period, the sweating may remain entirely in abeyance. The 

 familiar phenomenon of the dry skin of paralyzed members is in accord with this 

 observation. 



If in man, a motor nerve, such as the tibial, median, or facial, be irritated, 

 sweat appears in the distribution of the active musculature and in the corre- 

 sponding distribution on the unirritated half of the body ; and both when the cir- 

 culation is free, as well as when it is arrested. On sensory and thermic irritation 

 of the skin, there likewise occurs reflex sweating always upon both sides, inde- 

 pendently of the circulation. The seat of the sweating is independent of the 

 site of cutaneous irritation. In the case of the author himself, cold sweat appeared 

 immediately upon the forehead as soon as the mucous membrane of the mouth was 

 irritated by strong vinegar. 



PHYSIOLOGICAL CARE OF THE SKIN. 



PATHOLOGICAL ABNORMALITIES IN THE SECRETION OF SWEAT AND 



SEBUM. 



In order to maintain the normal secretion of the skin, the care of this organ 

 by means of frequent ablution and baths, soap being used to remove the fatty 

 accumulation upon the skin, is of the greatest significance, as in this way the 

 pores are kept open. By friction of the epidermis, baths aid metabolism, by an 

 action upon the cutaneous vessels influence the circulation and the heat-economy 

 of the body, and have a stimulating effect upon the nervous system. The estab- 

 lishment of public bath-houses must be considered among the most beneficent 

 measures for the preservation of the public health. 



Diminution in the secretion of sweat, anidrosis, occurs in cases of diabetes and 

 carcinomatous cachexia; further, together with other nutritive disorders of the 

 skin, in connection with certain nervous diseases, as, for instance, paralytic de- 

 mentia. It has been observed in circumscribed areas of the skin as one of the 

 phenomena of certain trophoneuroses ; as, for instance, unilateral atrophy of the 

 face, and in paralyzed parts. In some of these cases there may be paralysis of 

 the nerves in question, or of their spinal centers. 



Increase in the secretion of sweat, hyperidrosis, occurs in part in readily excit- 

 able persons, in consequence of irritation of the nerves in question. In this cate- 

 gory belongs the sweating that attends debilitated states, and that occurs also in 

 hysterical persons, principally upon the head and the hands; and the so-called epilep- 

 toid sweats that occur paroxysmally. Unilateral sweating, principally of the head, 

 long known to earlier physicians, is especially noteworthy. This has been ob- 

 served in conjunction with other nervous disorders, in part among the symptoms 

 of irritation of the cervical sympathetic dilatation of the pupils, exophthalmos. 

 Landois has, however, observed unilateral sweating without other evidence of 

 sympathetic disorder, probably as a manifestation of irritation of the true sweat- 

 fibers. 



Qualitative alterations in the secretion of sweat, paridrosis. In this cate- 



