Friday, July 24, 2009

Modern Medicine At Its Finest, or, Good Thing Dad Does Not Wear Hats

I recently came across this article, from the Journal of the American Medical Association. I found it interesting. I think you will too.


If anyone had insisted 25 years ago that tuberculosis was only slightly hereditary, but distinctly communicable, they would have been laughed at. The germ theory has now become a doctrine of ever-widening scope, and we realize that many affections are directly communicable and only a few hereditary. At the present moment it seems that even for so old-fashioned an affection as baldness a complete change of opinion as regards etiology is taking place. As with tuberculosis, so it has long been noted that baldness is likely to run in families. The sons of bald fathers are all the more likely to become bald young, and it is not the rule to find a single bald brother where there are a number in a family. On the other hand, daughters seldom become bald, but then the women folk rarely use the combs and brushes of the male members of the family, while boys not only use such articles in common, but often exchange hats, have their hair cut frequently at barbers, and in general are not rarely in circumstances in which they are likely to contract the disease, if it is communicable.

It is nearly ten years now since Sabouraud at the Pasteur Institute pointed out that premature baldness is practically always associated with the presence of certain bacteria. The seborrheic condition causing what is known as dandruff, on which early baldness probably often depends, he demonstrated to be a very probable result of the presence of these micro-organisms. Bacteriologic investigations made since have tended to confirm this opinion, and while they have failed to show the existence of any specific germs, they have made it appear probable that microbes play an important roˆ le in causing the increased desquamation of the epithelium which chokes up hair bulbs and finally leads to their obliteration. Undoubtedly the ordinary conditions of scalp hygiene among men are favorable to the development of these germs. The circulation to the scalp all comes from the vessels of the neck and finds its way over the bony skull to be distributed to the hair bulbs. It is especially likely to be interfered with by the pressure of the hat band, and that this is an important factor in the etiology of alopecia can be seen from the fact that baldness always begins just above the occipital prominence at the back or above the frontal bosses anteriorly, that is, just where the pressure of the hat band on the blood vessels is most likely to be occlusive. This interference with the circulation lowers the resistive vitality of these parts of the scalp and consequently provides opportunities for the growth of micro-organisms. It must not be forgotten, moreover, that these three points mentioned are especially liable to infection. The comb and brush are used particularly in arranging the whorl of hair in the occipital region and in parting the hair and brushing it back over the frontal bosses anteriorly. If infection plays an important role, then, in the production of baldness, these are just the parts that, theoretically, should be first affected, and from which infection should spread to the other parts of the head. As a matter of fact this is what occurs in practice.

Greater care should be taken with regard to brushes and combs, especially in families in which early baldness is the rule. The hair brush should be dipped in an antiseptic solution several times a week. Combs should be boiled regularly and frequently, and under no circumstances should
members of precociously bald families use other combs or brushes than their own, or allow them to be used on them, in barber shops, unless they are assured of their sterilization beforehand. These precautions may seem a high price to pay for the prophylaxis of premature baldness, and many will prefer to take the chance of becoming bald, but some have such a horror of the affliction that they will willingly put themselves to much trouble to prevent it.

JANUARY 14, 1903
JAMA. 1903;40:249 as quoted in JAMA. 2003;289(4):494 (doi:10.1001/jama.289.4.494)

This all just begs the question, why were bald men using combs 100 years ago?

Skip to 1:17 in the clip. Worth it.


Michelle! said...

To style their comb-overs? I can see now how medical school breeds germphobes.

peetie said...

Very good point, Michelle. Did I ever tell you about my professor that used his sideburn for his combover? I bet he needed two combs.