FRAGILITAS CRDNIUM

As the name signifies, this is a condition of the hair characterized by
extreme fragility, which may manifest itself in several ways: the hair
may split up into a few or many filaments, either at or toward their free
end, or near and sometimes extending into the root, or it may be simply
brittle and break off from brushing, combing, or handling. It may be
extremely slight or quite pronounced. The scalp hair of women and
long beard in men are its usual sites. Duhring² described a peculiar case
involving the beard, characterized by marked atrophy of the hair-bulb
and splitting of the hair substance, the fission taking place within the
follicle and producing irritation of the skin and follicular papules. Parker³
and Hyde⁴ each refer to a somewhat similar instance. The most common
part, however, for the fission to take place is at the hair-ends, and it may
extend some distance up the shaft. In other cases, exceptionally, how­
ever, it occurs near the middle of the shaft. The condition may confine
itself to scattered hairs, or chiefly to the hairs of a limited region; on the

¹1 am indebted to Jackson’s book on Diseases of the Hair and Scalp, 1890,
for suggestions, etc., in the preparation of the articles on the various atrophic
diseases of the hair; and also to his (Jackson and McMurtry) later work, Dis­
eases of the Hair, 1912. The small book by Beigel, The Human Hair, also contains
much interesting matter; also G. Behrend’s paper (“Ueber Knotenbildung am Haar-
schaft,” Virchow’s Archiv, 1885, vol. ciii, p. 437, reviews several atrophic affections
and gives numerous references and some illustrations).

² Duhring, “Undescribed Form of Atrophy of the Hair of the Beard,” Amer.
Jour. Med. Sci., July, 1878 (with illustration).

³ Rushton Parker, Brit. Med. Jour., 1888, ii, p. 1335 (with illustration).

⁴ Hyde and Montgomery, Diseases of the Skin.

974

DISEASES OF THE APPENDAGES

other hand, almost all the hairs may show more or less involvement.
The hair is usually noted to be dry and sometimes is of slightly irregular
contour.

Exclusive of the cases (symptomatic fragilitas crinium) due to ring­
worm and favus, in which the short and broken-off hairs are affected,
nothing is really known as to the cause of the affection. The patients
seem in good health. Kaposi’s idea that it is owing to the distance the
end is from the source of nutrition scarcely holds when we know that
sometimes the process is not limited to the longer hairs, and, moreover,
occasionally the same condition takes place in the middle of the shaft,
and indeed at the root-end—at the very point of nutritive supply.
Gamberini thinks it due to lack of care and excessive length, but these are
not always factors. Examinations of the bulb show some to be normal
and some atrophied—the latter was especially noted in Duhring’s case,
and the medulla was nowhere normal, and the cortical substance in the
narrowed portion brittle and dry.

Treatment.—As in all diseases of the skin, the general health should
receive attention if there are any indications pointing toward the neces­
sity for such. When involving the shaft or ends the hairs should be
clipped off just below the cleft part. Singeing, so often resorted to, is
damaging. The scalp and hair should be kept clean; if shampooing is
frequently necessary, a little vaselin should be rubbed into the scalp
afterward. If there is a marked disposition to dryness and splitting
up, a little oiliness, imparted by a trifling amount of liquid vaselin to
the hair, by oiling the comb, and then wiping off the excess, will some­
times lessen the tendency. If occurring on the bearded part at the hair-
ends, these should be kept well clipped; and if on the root-ends, con­
stant shaving should be practised for a time.

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