RINGWORM IN GENERAL SURVEY IN LITERATURE
In daily life we find ringworm a difficult disorder to cure: a few cases yield to almost any sensible treatment, but the bulk of them offer a stubborn resistance. And yet we often find the therapeutics of ringworm in the text-books confined to a very few lines. One author of no mean standing tells us that the soft- soap treatment generally suffices! However, some authors do not hesitate to speak out plainly on the subject. And I notice that the more the authors know of ringworm, the more they have studied it, the less therapeutically positive do they become. Willan (1817) confessed that it is “hard to cure.”
Gruby (1844) made the discovery that a fungus was present in the broken-off hairs and in their root sheaths. This parasite was fully described by Malmsten, in Stockholm, in 1845, and it was named by him the Trichophyton tonsurans. Cazenave’s name, Herpes tonsurans, is most commonly met with in many works. Its other names are legion.
Alder Smith, M.B. Lond., F.R.C.S. (“Ringworm: Its Diagnosis and Treatment,” London 1885), has very usefully spent many years in studying ringworm, and in the work just named shows himself a thorough master of the subject, has position as Resident Medical Officer at Christ’s Hospital, London, affording him incomparable opportunities for such studies. I shall take this author as the representative of the latest views of science on the subject of ringworm.
Alder Smith thus defines ringworm:-
“Ringworm is a disease of the skin caused by a microscopic vegetable parasite; and the characteristic lesions are due to this minute fungus invading the epithelial layers of the skin, the hair follicles, and the hairs. The growth which causes this very troublesome affection belongs to the lowest order of plant life, the fungi or moulds; the same fungus is found both in ringworm of the head and the body, and the two affections are essentially one. This disease, which is a very common one, is liable to attack all classes-the rich as well as the poor-and is highly contagious, but it is almost entirely confined to children.” And then says:-
“The history of ringworm is complicated, as certain varieties of form of the disease have received a number of designations from the older authors.” *”Viz.- Porrigo scutullata, Willan; herpes tonsurans, herpes squamosus, Cazenave; herpes circinatus, Bateman; porrigo ton soria, dartre furfuracee arrondie, Alibert; tinea tondens, squarus tondens, Mahon; phyto- alopecia, Malmstem; rhizophyto-alopecia, trichophytie, Gruby; dermatomycosis tonsurans, Kobner; tinea trichophytina, tinea circinata, Anderson; trichonosis furfuracea; porrigo furfurans; lichen herpetiformis, Devergie; lichen circumscriptus, figuratus, gyratus, impetigo figerata, etc.; Germ., scherende flechte; Fr., herpes tonsurant; teigne tondante; teigne tonsurante.”
As to the life-history of the fungus I will refer my readers to Alder Smith’s work, which is beyond compare the best epitome of the subject with which I am acquainted, almost all the other works on ringworm are antiquated and only of historic value. But I must quote what Alder Smith says of the host of the Trichophyton tonsurans.
“All children are not equally susceptible to ringworm. A certain unknown condition of the skin is necessary for the growth of the fungus, as some children never take ringworm though constantly liable to become infected For it is evident that when one child in a family has ringworm, and is not under any treatment, the others must be exposed to the action of the fungus; yet, at times, the disease does not spread.