THE CARE OF THE SKIN: 
A LECTURE BEFORE THE Y. M. C. A. LYCEUM, i 
BY 
J. CLARK McGUIRK, M. I). 
Dermatologist to the Louisville City Hospital and the 
Masonic Orphans and Widows' Home. 
Reprint : American Practitioner and Xews. 
Printed by John P. Morton & Company . 
1887 THE CARE OF THE SKIN 
A LECTURE BEFORE THE Y. M. C. A. LYCEUM. 
BY 
J. CLARK McGTJIRE, M.D. 
Dermatologist to the Ixmisville City Hospital and the Masonic 
Orphans and Widows’ Home. 
Reprint: American Practitioner and \e%v4. 
LOUISVILLE: 
Printed by John P. Morton *nd Company. 
1887 THE CARE OE THE SKIN. 
That we may better appreciate the impor- 
tance of the proper care of the skin, it is well 
to know something of the anatomy and physi- 
ology of this, one of the most important and 
complex organs of the body. 
It is practically divided into two parts, the 
outer cuticle, scarfskin or epidermis, and the 
deeper true skin or corium. The epidermis is 
subdivided into the corneous layer, composed 
of flat, lifeless, colorless cells, and the mal- 
pighian layer (so named from the anatomist 
Malpighi), of irregular shaped cells, developing 
to replace those of the outer layer that have 
been cast off. The true skin or corium 
(from the Latin corium, leather), is divided 
into the outer papillary layer, made up of 
little elevations called papillae, intended to 
give a greater amount of surface to the skin. 
It has been computed that there are about one 
hundred and fifty millions of these over the 4 
The Care of the Skin. 
whole body; below this is the reticulated layer 
(from the Latin reticulatus, net-like or lat- 
ticed), made up of elastic interlacing fibers, 
the meshes of which become larger and larger 
until we reach the subcutaneous tissue which 
connects the skin with the parts beneath. 
The corium is well supplied with blood-vessels, 
lymphatics, nerves, glands, and hairs. The 
arteries from below send off' little capillary 
loops, which ascend in the papillae, then de- 
scend to become veins; they are called capil- 
lary from the Latin word capillarw, like a hair, 
they are so small and slender. Some of the 
nerves send off prolongations that become lost 
in the deeper cells of the epidermis; others 
enter the papillae to wind around and pene- 
trate little bodies called tactile corpuscles. 
There are two varieties of glands, the su- 
doriparous, and sebaceous glands; the sudori- 
parous derives its name from two Latin words, 
sudor (sweat), and pario (I produce)—they are 
made up of tubes twisted in the form of a coil 
in the lower part of the corium, with a duct 
ascending through the entire thickness of the 
skin to open upon its surface; they are most 
numerous on the palms of the hands, where 
there are about two thousand seven hundred The Care of the Skin. 
5 
to the square inch, or about two million three 
hundred and eight thousand over the whole 
body, an entire length of secreting tubes of 
two and one third miles. The sebaceous 
glands are made up of a mass of lobules, with 
a tube that usually enters a hair follicle. 
The hairs are regarded as modified epidermis. 
Almost the entire skin is provided with these 
appendages, except the palms, soles, and some 
other parts. They receive their nourishment 
and grow from the hair papillae which they 
surround in the corium. The total number on 
an average head of hair is said to be one 
hundred and twenty thousand. They are elastic, 
stretching about one third their length, and 
will support a weight of about two and a half 
ounces. In some cases they may grow to great 
length and in unusual quantity. As to blanch- 
ing of the hair in the course of a few hours, 
there are but few well-authenticated cases; in 
one mentioned in Flint’s Physiology, the hairs 
turned white in the course of the night, in a 
patient under observation at a hospital; he 
was suffering with delirium tremens. The 
blanching is caused by the accumulation of 
air in the medulla and cortex of the hair, 
there is no diminution in the amount of pig- 6 
The Care of the Skin, 
ment. Sir Erasmus Wilson has reported the 
case of a young woman in whom the hairs 
covered almost the entire surface of the body, 
and were thick enough to conceal the skin. 
Cases are reported in which the beard grew to 
the length of seven or eight feet. 
So much for the anatomy of the skin. It is 
usually regarded simply ns a covering for the 
parts beneath, and to give shape to the form, 
but, as has been seen, it has functions peculiar 
to itself. It is an organ of sensation, especially 
of touch. This sense can be cultivated to a 
wonderful degree. We may see this exempli- 
fied at the blind asylum, where the inmates are 
taught not only to read, but to study geogra- 
phy, botany, and anatomy by means of models, 
through this sense alone. It has been related of 
a blind sculptor, that he could model the most 
perfect likeness simply by touching the face, 
and of others who could even tell the color of 
objects in the same way. 
It is an organ of absorption; gases as well as 
liquids are taken up by the skin. This is 
shown in the case of animals whose bodies 
were subjected to carbonic-acid gas, their heads 
remaining free, Death from the poison soon 
resulted. The power the skin has of absorb- The Care of the Shin. 
7 
ing fats and oils is taken advantage of in the 
treatment of many diseases. Shipwrecked sail- 
ors have relieved their intense thirst to a cer- 
tain extent by saturating their clothes with 
the salt water. 
The skin is an organ of secretion. Sweat is 
constantly poured out in the form of insensi- 
ble perspiration, in amount about two pints or 
pounds in twenty-four hours. It has a saline 
taste, and is alkaline in reaction ; composed al- 
most entirely of water, it regulates the tempera- 
ture to a great extent by the amount that is se- 
creted. In the functional disorder of the sweat 
glands, known as bromidrosis, it has an offen- 
sive, disgusting odor, that will render a patient 
not only a burden to himself, but repugnant 
to every one with whom he comes in contact. 
It is said of Henry IV, of England, who suf- 
fered from this affection, that the ladies of his 
court would faint from the offensive odor when 
in his presence. Professor Hammond relates 
the case of a woman who exhaled the odor of 
violets during an attack of hysteria. In an- 
other functional disorder of the glands, known 
as chromidrosis, it may be colored black, blue, 
or red, or it may become phosphorescent; the 
body then becomes luminous in the dark. The 8 
The Care of the Skin. 
secretion from the sebaceous glands, known as 
sebum, is a semi-fluid substance containing 
fifty per cent of fatty matter, and is intended 
to give softness to the skin. The so-called 
“ flesh-worms,” or “ grubs,” are really masses 
of sebum which clog up the follicles; the little 
black-heads are caused by an accumulation of 
dirt and pigment. 
It is an interesting fact, that if animals are 
covered with an impermeable substance, death 
w ill soon ensue. It is related that a child’s death 
was caused at the coronation of Pope Leo X, 
by being covered with gold-leaf to represent 
an angel. 
Considering the important functions the skin 
has to perform, and the harm that will result 
from the non-performance of these functions, 
the importance of its proper care can hardly 
be overestimated. It is true that “ beauty usu- 
ally produces love, but cleanliness will preserve 
it.” Cleanliness is absolutely essential to the 
correct performance of the functions of the 
skin and the preservation of the general health. 
The dust, secretions, and the cast-off epithelial 
scales must be removed by frequent washing. 
This brings us to the subject of baths and 
soaps. The ancients indulged more freely in The Care of the Skin. 
9 
the bath than is the custom with us. The Ho- 
mans especially fully appreciated the pleasures 
and necessity of the bath, and indulged in it to 
excess. They erected magnificent buildings, 
supplied with all the requisites for hot, cold, 
and vapor-baths. From the ruins, as we now 
see them, we can form but an inadequate idea 
of their splendor. Buildings, including libra- 
ries, gymnasiums, and baths, were free to the 
public. Women have endeavored to beautify 
their skin by bathing in milk and scented wa- 
ters. To such an extent was this carried in 
Paris at one time, that there was great scarcity 
of milk for the table. I know of a well-known 
prima- donna who uses a quart of cologne in 
each bath. Turkish baths I do not believe are 
necessary for a healthy skin. Any of you gen- 
tlemen who propose to indulge in this luxury 
should postpone reading Mark Twain’s expe- 
rience till you have tried it for yourselves. I 
am sure you can then better appreciate his 
advice to the attendant to use a jack-plane as 
a much simpler method of getting rid of the 
skin, which seemed to be the object of the 
bath. 
Time will not allow me to say any thing 
further as to the use of the bath than to ad- 10 
The Care of the Skin. 
vise you, after a cold bath, to use brisk fric- 
tion with a towel, not only to further cleanse 
the skin, but to excite the cutaneous circula- 
tion, and so draw the oversupply of blood from 
the internal organs. Those suffering from heart 
troubles should abstain from the use of the hot 
bath, as the heat will cause a determination of 
blood to the surface, and so deprive the heart 
of its normal supply. Soaps, as you know, are 
made of fats or oils and soda or potash caustics, 
according as they are hard or soft. Their effi- 
cacy depends upon their power of rendering 
grease and debris soluble in water. Only the 
best soaps should be used for the toilet, as the 
cheaper ones are often found to contain dele- 
terious ingredients. Tn specimens I have ex- 
amined, by means of the microscope, I have 
found little particles of bone and other foreign 
matter. Of course these will render a soap 
highly irritating to the skin. 
There is a popular error that soap should 
not be used upon the face. There is no good 
reason for this belief; in fact, it is more impor- 
tant on the face than elsewhere. Not only is 
the face the most exposed portion of the body, 
but there is a greater amount of secretion here 
than elsewhere on the body to catch the dust. The Care of the Skin. 
11 
It has been said that country girls wash their 
faces and do not have acne. City girls ab- 
stain from the use of soap, and do. Though 
this is exaggerated, I have met with cases that 
have been aggravated by neglect of this part 
of the toilet. 
There is an old saying, “Women who paint 
their faces to seem beautiful, do early deface 
the image of their Creator and yet they will 
frequently resort to any means that hold out 
the least hope of improving their complexions, 
such as plastering their faces with paste, en- 
ameling, binding it in raw beef, and even wear- 
ing medicated masks. The purpose of most of 
these applications is simply to conceal repul- 
sive blemishes, which, in the majority of cases, 
could be readily removed by appropriate treat- 
ment. Such methods can only do harm; for 
if they do not directly injure the skin, they 
make it tender, and much more apt to be af- 
fected by external agencies. To make their 
hands white and bloodless, women have been 
known to spend the night with them sus- 
pended by means of pulleys. 
I am frequently asked, are dusting powders 
harmful ? Most of them are, for they are liable 
to contain lead, bismuth, or other deleterious in- 12 
The Care of the Skin. 
gradients. Plain starch or magnesia are the 
least harmful. I advise against the use of any 
of them, as they will clog up the openings of 
the glands, and so are apt to prevent the per- 
formance of their proper functions. If the face 
is abnormally greasy, a little sulphate zinc in 
water and alcohol, as a lotion, will be found of 
benefit. “ Lotions for the toilet,â€~ as found in 
the shops, are liable to contain mercury. This 
may be absorbed and produce symptoms of con- 
stitutional poisoning. What is known as “flake 
whiteâ€~ is made by mixing carbonate of lead 
with rose-water. Cases are not infrequently 
reported of women who have been poisoned, 
showing symptoms of the constitutional effects 
of the lead. Some of the symptoms are delirium, 
abdominal pain, a peculiar drop of the wrist, 
and a characteristic blue line along the edge of 
the gum. The study of skin diseases is sadly 
neglected, though its importance is recognized 
and exemplified in the vast number of cases 
reported by even a few specialists. Members 
of the American Dermatological Association, in 
1886, reported sixteen thousand eight hundred 
and sixty-three cases. Twenty thousand new 
cases are said to occur in one year among the 
poor of New York City. Prof. Bulkley, of The Care of the Skin. 
13 
New York, has published a book of two hun- 
dred and fifty pages upon one disease alone, 
known as “Acne.” 
I will now give you a few hints upon the 
treatment of several minor affections of the skin. 
The little “ black-heads,” papules, and pustules 
that frequently appear on the face in young 
people are best treated in the following manner: 
The papules and pustules should be opened; the 
face is then to be bathed in hot water, as hot as 
can be borne. The black-heads are to be re- 
moved by means of a watch key, or squeezed 
out between the fingers. A powder composed 
of sulphur, one dram to the ounce of starch, 
dusted on the face at night will be found of 
benefit in some cases. The annoying complaint 
known as rosacea, popularly known as “rum 
blossom,” so called, perhaps, because the ma- 
jority of cases are not caused by stimulants, is 
characterized by redness of the nose and cheeks, 
with dilatation of the blood-vessels. The disease 
may last indefinitely and cause hypertrophy of 
the nose, till in rare cases it may grow as large 
as the fist. Its causes are numerous, as diges- 
tive disturbances, nervous troubles. Alcohol 
is only one of many causes. It is more or less 
common in those subject to sudden changes in 14 
The Care of the Skin. 
temperature, as hack-drivers; it may he ag- 
gravated by certain articles of food, as fried 
articles, tea, coffee, etc; it is apt to continue 
indefinitely unless properly treated. Hot water 
applications will do good in many cases, and a 
lotion composed of sulphur, fifteen grains, 
glycerine, one dram, rose-water, one ounce, 
used several times a day. Operative pro- 
cedures may be necessary. 
Bromidrom may at times be relieved by means 
of a dusting powder composed of half a dram 
of salicylic acid to the ounce of starch, or by 
means of a lotion of permanganate of potash, a 
grain or two to the ounce of water. The socks 
must be soaked in this solution, then dried be- 
fore being worn. 
Discolorations, such as freckles, and so-called 
“liver spots,” should be let alone, for even if 
they are removed by strong stimulating reme- 
dies, the chances are decidedly in favor of their 
return. 
* Dandruff is best removed by paying strict 
attention to cleanliness, removing the scales by 
means of soap and water, and then by using a 
stimulating application, such as half an ounce 
of tincture cantharides to the ounce of bay rum. 
This is an excellent application for premature 
baldness. The Care of the Skin. 
15 
Itching of the skin, or pruritus, may accompany 
many different diseases, but it may occur as the 
sole disorder. Very little can be done in the 
way of home management for this disease. A 
weak solution of carbolic acid, a few grains to 
the ounce, or alkaline baths, composed of a 
dram of bicarbonate soda to the pint of water, 
may be tried. 
Many of you are familiar with the annoying 
affection known as urticaria, nettle rash, or hives. 
It is characterized by the sudden appearance of 
white or red elevations of the skin, accompanied 
by the most intense itching. It is caused by 
gastric disturbances, by the ingestion of certain 
articles of food in some individuals, such as 
fish, berries, shell fish, nervous disturbances, 
etc. As to treatment, if caused by indigestion, 
emetics and aperients should be given ; locally, 
vinegar and water, whisky, alkaline baths, and 
carbolic acid lotions, a few grains to the ounce, 
may relieve the itching. 
It is well known that many dye stuffs may 
cause inflammations of the skin and even con- 
stitutional poisoning. Colored stockings have 
been found to contain poisonous quantities of 
arsenic and antimony. I have seen many cases 
of eczema produced in this way in those who 16 
Ihe Care of the Shin. 
are predisposed to the disease, not only from 
colored stockings, but from the red lining of 
gloves, hats, and shoes, and colored undercloth- 
ing. In the latter case they were worn before 
being washed. The condition of the skin is 
very similar to that produced by poison oak. 
The treatment consists in removal of the cause 
and the application of soothing remedies. 
Hair-dyes, as a rule, are harmful. They may 
not only cause baldness from the lime, lead, or 
silver which they contain, but the lead may be 
absorbed and act injuriously on the system. 
The confidence with which a bald-headed man 
will use a hair restorer, recommended by a 
bald-headed barber, has been referred to as a 
sublime example of faith-cure. Read the ex- 
perience of Tittlebat Titmouse in “Ten Thou- 
sand a Year,” and I am sure you will hesitate 
before using hair-dyes. 
The Massachusetts State Board of health has 
had a large number of so-called hair restorers, 
now on the market, analyzed. It was found that 
all that wTere examined contained lead in varying 
quantities. Ladies suffering from hirsuties, or 
an abnormal amount of hair, will resort to any 
means to get rid of this blemish. They usually 
shave or extract the hairs, but this only acts as The Care of the Skin. 
17 
a stimulant to renewed growth. So-called 
depillatories are worse than useless. They 
contain ingredients that have the power of 
dissolving the hair; but, if we remember the 
anatomy of the skin, it is evident that it is 
impossible for them to reach the papillae, from 
which the hair receives its nourishment, with- 
out destroying the whole thickness of the skin. 
The only means by which the hairs can be per- 
manently removed is the method now resorted 
to by dermatologists, known as electrolysis. A 
fine needle is inserted into the hair follicle down 
to the papilla, which is destoyed by the passage 
of an electric current from the negative pole of 
a galvanic battery. Five thousand hairs have 
been removed from a lady’s face by this means, 
resulting in permanent relief of the trouble. 
The habit of cutting the hair and wearing a 
wig is not to be advised, for the advantage de- 
rived from the cutting is often more than counter- 
balanced by depriving the hairs of light and air 
which are necessary to their healthy growth. 
I would sum up this whole question by the ad- 
vice : keep as clean as possible ; remember the 
aphorism, cleanliness is next to godliness; ab- 
stain from the use of any local application, un- 
less it is absolutely necessary, but on the other 18 
The Care of the Skin. 
hand the injurious use of the hath for the pur- 
pose of cleansing the skin may he followed 
by an irritable and abnormal condition of the 
cuticle. 
In closing my lecture I desire to make a few 
remarks upon some popular errors in regard to 
skin disease. The majority are regarded as 
contagious, and the fear is expressed that those 
who come in contact with the afflicted are liable 
to become affected; but this is far from the truth, 
for out of the hundred or more diseases that may 
affect this organ only two or three are really 
contagious. The laity believe that as a rule 
cutaneous diseases result from “bad blood,” the 
impurities of which find exit through the skin, 
and in so doing take the form of an eruption. 
Consequently it is harmful to remove them. I 
have had patients express themselves as very 
solicitous about the sudden cure of a disease of 
theskin; the consequence, in theiropinion, might 
be disastrous by the “ driving in ” of a disease 
that might attack some internal organ. Nothing 
could be more absurd, for it is absolutely im- 
possible in this sense to either “ drive in ” or 
“drive out” a skin disease. The blood has 
little to do with skin diseases. There are dis- 
eases as peculiar to this organ as to any other, The Care of the Skin. 
19 
entirely localized, depending upon changes in the 
tissues themselves. Others are caused by para- 
sites ; still others by nervous disturbances. It is 
evident that the much lauded “ blood purifiers â€~ 
for cutaneous diseases are, to say the least, use- 
less. A patient may get well while taking these 
quack nostums ; the fact is then extensively ad- 
vertised. This is about on a par with the 
announcement of lottery companies of the for- 
tunate individuals who have obtained prizes; 
the tens of thousands who are not so fortunate 
are never heard from.