[Reprinted from Journal op Cutaneous and Venereal Diseases, Vol. III., No. 2.] 
CANITIES. 
BY 
GEORGE THOMAS JACKSON, M.D., 
Attending Physician to the Demilt Dispensary, Department of the Skin, etc 
SYNONYMS :—Trichonosis cana ; Trichonosis discolor ; Poliothrix 
Poliosis; Trichonosis poliosis; Trichosis poliosis; Spilosis poliosis; 
Poliotes; Gravness of the hair; Whiteness of the hair; Blanching 
of the hair; Atrophy of the hair pigment. 
Grayness or whiteness of the hair may be congenital or acquired; and 
of these, the latter is by far the most common. The whiteness is either 
partial or complete. 
Congenital canities usually occurs in the form of tufts, sometimes in 
round patches, the more or less pure white hair showing conspicuously 
amongst the normal-colored. mass. When the whiteness is general, we 
have albinism which is associated with a deficiency of pigment in the 
whole body. Cases of congenital canities are rare. 
Acquired canities may be premature or senile. Most often grayness 
does not begin before the thirty-fifth or fortieth year. If it occurs before 
this age, it may be considered as premature ; and when after this age, as 
senile. Premature canities is by no means uncommon, many persons be- 
coming gray between the twentieth and twenty-fifth year. The hair 
which, as a rule, first whitens is that of the temples ; then follows, with 
more or less rapidity, that of the vertex and whole head. Sometimes the 
beard first turns gray, but usually it changes color after the hair of the 
scalp. The last hair to become gray is that of the axilla and pubis. When 
the graying is due to some passing cause, as anxiety or some diseased state, 
the process may cease completely upon removal of the cause. Instances 
have been noted of normally-colored hair growing in after the fall of the 
white hair, but usually the whiteness is permanent. When graying of 
the hair is due to senile changes, it is progressive and permanent. As a 
rule, there is no change in the color of the scalp, though in some cases 
gray tufts are found upon pale-yellow patches of scalp. As in alopecia, 
so in canities, men are more frequently affected than women. 
The hair in canities is usually unchanged except in color, but it may 
be drier and stiller than normal. Canities may exist for years without 
alopecia. In the senile form alopecia is apt to come on-as another senile 
change; alopecia senilis, as is well known, is generally preceded by ca- 
nities. According to Landois, incipient baldness usually follows senile 
canities in from one to five years. Jackson, Canities. 
2 
The hair turns gray first at its root, and not at its point, as has boon 
maintained. The color at first is gray on account of the mixture of the 
normal color and the whiteness due to the absence of pigment. Gradu- 
ally, the white parts gain the ascendant, and the whole hair is blanched, 
becoming finally of a yellowish or snowy whiteness. The darker the hair 
is originally the more it is prone to turn gray. 
Sudden change of color of the hair from its normal hue to perfect white 
has been too well authenticated to allow of a doubt as to its occurrence, 
though it has been denied by good authorities, who have questioned the 
correctness of the observations reported. 
Leonard1 gives a long list of cases, including those *of Marie An- 
toinette, Mary, queen of Scots, and others. Landois2 reports fully a 
case of this sort observed by himself. It occurred in the person of a 
man, thirty-four years of age, who was admitted to the hospital suffering 
with delirium tremens. His delirium took the form of great terror 
whenever any one approached him. On admission, his hair was of 
blond hue, and was so up to the evening of the third day. On the morn- 
ing of the fourth day, the hair both of the beard and scalp was noticed 
to have become gray. Some of the hairs were white from root to point, 
some only at their roots, some only at their points, while some were 
white and blond at different points. A careful perusual of the reported 
cases will be sufficient to convince one of the reality of sudden blanching 
of the hair. 
Ringed hair is an anomalous variety of blanching of the hair in which 
the affected hairs are marked by alternate rings, one being that of the 
normal color, and the next white. The occurrence of this disease is very 
rare, and but few cases have been reported.3 In Wilson’s case, the dis- 
ease had been progressive for six years and affected only the scalp hair. 
The white portions occupied the entire diameter and were opaque by 
transmitted light. 
The hair has been known to lose its color under varying circum- 
stances. Thus Wallenberg4 reports a case in which, after an attack of 
scarlatina, the patient’s brown hair was entirely lost and replaced by a 
growth of white hair. Prolonged residence in a cold climate, with much 
exposure, will cause the hair to turn gray. Sometimes the hair will 
change its color with the season, becoming gray in winter and darker in 
summer.5 On the other hand, Cottle6 gives prolonged residence in hot 
1 “ The Hair, its Diseases, and Treatment.” Detroit, 1881. 
2 Virchow’s Archives, 1866, xxxv., 575. 
3 Wilson, E., Tr. Roy. Soc., 1867 ; also see “ Healthy Skin,” London, 1876, 
p. 109. - - 
4 Arch. f. Derm; und Syph., 1876, Heft 1. 
5 Wilson, Lect. on Dermat., 1878, p. 171. 
6 “ The Hair in Health and Disease,” London, 1877. Jackson, Canities. 
3 
climates, with much exposure, as a cause of canities. Albinoes, we know, 
are most frequent in the negro races, which inhabit the hot countries. 
Etiology ancl Pathology.—Senile canities and many cases of the pre- 
mature form are due to an obscure change in the nutrition of the hair 
papillae which interferes with the production of pigment. Whatever the 
nature of the change may be, only this function of the papillae seems to 
be interfered with, as the hair-forming function is in full activity, judg- 
ing from the fact that the hair in many cases is in full vigor. The hair 
depends, for its shade of color, upon the color of the hair cells, upon the 
color of the hair pigment, and upon the amount of air contained between 
the hair cells. It is from the outer layers of the hair that it chiefly takes' 
its color tone. Thus often under the microscope a large amount of 
pigment cells will be found in the medulla of a hair that appears white. 
In cases of sudden blanching of the hair, the change of color is de- 
pendent upon the formation of air bubbles between the hair cells of the 
cortical substance, the presence of the air rendering the cortical sub- 
stance opaque, so that the color of the pigment is obscured. If one of 
these hairs is placed in hot water, ether, or turpentine, the air bubbles 
will be driven out, and the hair will reassume its normal color. This 
same infiltration of the hair with air will be found also in some cases of 
ordinary premature canities, though most of such cases are due, as above 
stated, to interference with the production of pigment. According to 
Pincus,1 in the beginning of canities the pigment slowly leaves the middle 
layers of the papillae and remains alone in the external layers. With the 
increase of the canities, only a portion of the external layer of the papil- 
lae will produce pigment, which in straight hairs will run in streaks 
parallel to the long axis of the hair, and in curly hairs will run in a 
spiral. The blending of the colored and uncolored streaks will produce 
the gray color, which will gradually change to white as the pigment is 
less and less produced. There are various agents which act as active or 
exciting causes of canities. Age is one of the most prominent of these. 
Heredity exerts marked influence upon the blanching of the hair, most 
of the members of certain families turning gray at an early period of life. 
Neuralgia of the fifth nerve, dyspepsia of various forms, sudden fear or 
nervous shock (producing sudden blanching of the hair), abundant and 
frequent hemorrhage, excesses of all kinds, chronic debilitating diseases 
(as syphilis, malaria, and phthisis), local diseases or injuries to the scalp, 
as wounds, favus, repeated epilation, prolonged shaving, and the like, 
have been given by various writers as causes of canities. Schwimmer re- 
gards it as being principally a tropho-neurosis, and finds in the occurrence 
of grayness in the course of neuralgia a strong argument for his theory. 
1 Arch, fur Derm, und Sypli., 1872, ii., 1. 4 
Jackson, Canities. 
The cause of “ ringed hair” is ascribed by Wilson to the development 
of a gaseous fluid within the hair, and he thinks that either the white, 
opaque and smaller segments were developed during the night, and the 
larger and normal segments grew during the day ; or, the separate seg- 
ments were the product of alternate days. The gas may have been gen- 
erated at the time of the formation of the abnormal segment, or the cells 
which composed that segment may have been originally filled with an 
aqueous fluid which evaporated quickly, and was replaced by air pene- 
trating from without. Landois 1 does not think that the white places are 
the products of the growth by night, and the dark by day ; nor that the 
white places were due to drying of the hair elements. He believes that 
wo must assume an intermittent activity of the trophic or vaso-motor 
nerves of the papillae through whose influence a hair tissue is formed, in 
which a periodic development of gas takes place. The solution of the 
question is still in abeyance. 
Treatment.—We cannot restore the color to gray hairs. In some cases 
of canities occurring in the course of neuralgias, if we can cure the neur- 
algia, the color will gradually return to the hair. 
All that can be done for canities is to artificially restore the color by 
means of hair dyes ; and their use is to be deprecated. Happily the cus- 
tom of dyeing the hair is falling out of fashion. We append a few for- 
mulae for hair dyes, selected out of many. 
Hair Dyes.—Hebra and Kaposi give directions for the process of 
dyeing the hair black by “Henna.” This is made into a paste with 
water and spread upon the hair. In an hour the hair will be red. Then 
a paste is applied to the hair made from powdered indigo plant. Then 
damp heat is applied, and in a few hours, if experience and good judg- 
ment have regulated the process, the hair will have a fine, black color. 
Leonard gives the following preparations for dyeing the hair black : 
No. 1. 
3 Bismuthi citratis § i. =32. 
Aquae rosae, 
Aquae destillat aa ? ij.= 64. 
Alcoholis 3 v. = 20. 
Ammoniae q. s. =q.s. 
Sig. Apply in the morning. 
No. 2. 
3 Sodii hyposulphit 3 xij.= 48. (60.) 
Aquae destil . § iv. =128. (140.) 
Sig. Apply in the evening thoroughly to the hair. 
Nitrate of silver may be used in the strength of from five to ten grains 
to the ounce, saturating the hair with a solution, and allowing it to 
1 Virchow’s Archiv, 1869, xlv., 113. Jackson, Canities. 
5 
dry in the sun, or in the light in a warm room. If it is wished to hasten 
the process, an application of sulphuret of potash, of twenty grains to two 
drachms to the ounce of distilled water, will cause the dye to set instantly. 
Gloves should be worn when applying this dye, and a brush used to lay 
it on. 
Lead may be used in the form of the sugar of lead, ten to twenty 
grains to the ounce of water, applied to the hair, and when about to dry 
following it up with a solution of sulphide of ammonium about one- 
quarter the strength of that of the British Pharmacopoeia. 
Mercury may be used in the form of the bichloride three grains to the 
ounce of water brushed through the hair and followed when dry with a 
solution of hyphosulphite of soda, one ounce to two ounces of water. The 
last two dies are dangerous. For a brown dye, Pfaff recommends a 
pomade composed as follows : 
5 Ol. ovorum rec. press., 
Med. oss. bovis aa 50. 
Ferri lact 2.50. 
01. cassige ether *.... 1.50. 
The number of dyes is legion, and the above must suffice as examples. 
Before the application of any die, the hair should be thoroughly cleansed 
with soap and water.