A Brief History of Plica Polonica
(Revised: 01-03-08)
DEFINITION: “Uncommonly, in patients who are heavily infested (with lice) and untreated, the hair becomes tangled with exudates, predisposing the area to fungal infection and results in a malodorous mass known as Plica Polonica. Numerous lice nits are found under the matted hair mass.” [Guenther et al., 2005] Plica Polonica can develop as a result of an immune response of the human body to head lice bites.[Gwadz, 2003]
6900-6300 BC In Israel, the Neolithic cave named ‘Nahal Hemar’, which is 14C dated to 6900-6300 BC, contained a mummy with matted hair and lice eggs. [Zias and Mumcuoglu, 1991]
c. 3000 BC “Medusa’s images in Old Europe began several thousand years prior to her reinvention in classical Greek myth.” [Le Van, 1995]
“The disease (plica polonica) is further stated to have been known to the ancients, and the heads of the Gorgons and Medusa are said to have been mere mythical representations of this form of disease.” [Kuchenmeister, 1857]
1600 BC “ … In the late bronze age of Minoan Crete, (1600 BC) … (Medusa) … is represented as the refined serpent-goddess-priestess.” [Le Van. 1996]
<113 BC “The Cimbrians were described by Roman writers as a people with similar medusa heads (that is, infected with plica polonica), …” [Kuchenmeister, 1857]
10th Century “Ibrahim ibn Jakub mentions in the 10th century that the majority of the Slavs suffered from skin rashes and swellings. Also al-Masudi notes that diseases of the skin and of the hair were of frequent occurrence among them.” [Grmek, 1959]
1000-1250 AD A male Chiribaya mummy [#802-1371] from southern Peru “exhibited hair that was matted in scab-like material and perhaps was badly affected by lice.”[Reinhard, 2003] In the Chiribaya culture, “Men had a higher infestation prevalence than women. This is because men more commonly had elaborate hair styles that covered the scalp in braids.”
5th – 15th Cent. “In the middle ages, Plica Polonica was known under a variety of local names: either ‘mahrenlocke’, ‘elfklatte’, ‘wichtelzopf’, ‘alpzopf’, ‘drutenzopf’, ‘drutenfuss’, ‘maerenvoet’, ‘sellentost’, or ‘selkensteert (selkin’s tail) in Lower Saxony; ‘marelok’ in Denmark; either ‘elflocks’ or ‘elvish knots’ in England; ‘saellocke’ in Thuringia; and ‘weichselzopf’ (Vistula-Plait) in Poland.” [Grimm, 1850] ‘Marenzopf’ was also used in Germany. [Croker, 1828] “Dreadlocks (convolution et contricatio capillorum firmissima) formed the diagnostic sign of a disease called trichoma, plica polonica (Latin), kottun (Polish), and Weichsel- or Hexenzopf (‘witchplait’; German)” [Forstl and Elliger, 1995]
c. 1285 “The greater numbers of writers fix the date of its [Plica Polonica] appearance in Poland at about the year 1285, under the reign of Lezekle-Noir.”[Gould & Pyle, 1910]
1287 Diderot’s Encyclopedie of 1765 states that Plica Polonica appeared in Poland in 1287, under the reign of Lescus the black. [Diderot, 1765] “Plica Polonica, the unsightly disease of matted hair, was introduced into Poland by the Mongol invasion (1287).” [Garrison, 1913] Other authorities claim that P. Polonica was not of Tartar origin, and that this was a misinterpretation of the old writers. [Brierre de Boismont, 1883]
1325 A Bohemian MS of 1325 lists various superstitious formulas for the cure of Plica Polonica:
“In Podlachia the ‘elftuft’ is solemnly cut off at Easter time and buried. In the Skwina district about Cracow, it is partially cropped with red hot shears, a piece of copper money tied up in it, and thrown into the ruins of an old castle in which evil spirits lodge; but whoever does this must not look around, but hasten home as fast as he can.” [Zakrzewski, 1830] [Grimm, 1850]
1554 Cromerius noted that plica polonica had been prevalent in Poland during the late Middle Ages and Renaissance. [Cromerius, 1554] [Forstl and Elliger, 1995]
c. 1594 William Shakespeare [1564-1616] wrote “Romeo and Juliet” in which Mercutio declaims in act 1, Scene IV:
“This is that very (Queen) Mab
that plats the manes of horses in the night,
And bakes [?cakes] the ‘elflocks’ in foul sluttish hairs,
Which once untangled, much misfortune bodes.”[Brewer, 1898]
In Shakespeare’s “King Lear,” Edgar declaims in Act II, Scene III:
“Blanket my loins: elf all my hair in knots” (mat together my hair in elf-locks)
1599 Thomas Lodge (c. 1558-1625) was an English dramatist and writer of the Elizabethan and Jacobean periods. [(Lodge) Wikipedia, 2007] “Lodge in his Wit’s Miserie, 1599, describing a devil whom he names Brawling-Contention, says ‘his haires are curled and full of elves locks, and nitty for want of kembing.’” [Furness, 1871]
1599 Staringelius, the rector of the University of Zamosc, was the first polish physician who wrote about plica polonica. [Staringelius, 1599] [Forstl and Elliger, 1995]
17th Cent. “In the early 17th century people started to associate the Polish plait (Plica Polonica) with disease, but believed it was only an external symptom of an internal illness. A growing plait was supposed to take the illness “out” of the body, and was therefore it was rarely cut off; in addition, the belief that a cut off plait could avenge itself and bring an even greater illness discouraged some from attacking it. It was also believed that casting a magic spell on someone could cause the person to develop a Polish plait.
These convictions were so widespread and strong that many people lived their whole lives with a Polish plait. A plait could sometimes grow very long – even up to 80 cm (over 30 inches). Polish plaits could take various forms, from a ball of hair to a long tail. Plaits were even characterized in a quite sophisticated way; there were plaits ‘male’ and ‘female’, ‘inner’ and ‘outer’, ‘proper’ and ‘parasitical’.”[Anon., 2005]
1600 Hercules Saxonia (Ercole Sassonia, 1551 – 1607) wrote a treatise on Plica Polonica. [Leibowitz and Ullmann, 1965]
<1610 “Hercules de Saxonia and Thomas Minadous, in 1610, speak of plica as a disease already long known.” [Gould and Pyle, 1910]
c. 1610 Plica Polonica mostly affected the peasantry, but it was not unusual among the higher social classes. For example: King Christian IV of Denmark (1577-1648) was afflicted with it. [Anon., 2005]
1615 Johan Agricola (1589-1643), a German doctor, wrote a short Latin essay titled: “De Helotide sive Plica Polonica.”[Agricola, 1615]
1616 William Browne (1590 – 1645), a British poet, published the second part of his Britannia’s Pastorals, in which he wrote:
“So broad her mouth was: as she stood and cride,
She tore her elvish knots of hayre, as blacke
And full of dust as any collyer’s sacke..” [Browne, 1616]
1623 “The Plica Polonica was supposed to be the operation of wicked elves; whence the clotted hair was called elf-locks and elf-knots. Thus Edgar (in The Tragedy of King Lear) talks of ‘elfing all his hair in knots.’” [Furness, 1871]
c. 1650 Parochial hospices, supported mainly by the Catholic Church, were maintained in the Grand Duchy of Lithuania during the second half of the 17th century. “Medical service was minimal, (and) most inhabitants had an illness called plica polonica (koltun).” [Kamuntaviviene, 1999]
1655 Ibn Sallum (Salih ibn Nasr Allah), a Syrian physician at the Ottoman court of Sultan Ahmed III, translated extracts of medical treatises written in Latin by contemporary European physicians. He described, for the first time in Arabic, the East European epidemic of plica polonica. [Sallum, 1655]
1660 William Davison, the physician to the Polish king John Casimir and the queen Marie Louise, wrote that plica polonica was due solely to uncleanliness and lack of care of hair. [Fronczak, 1898]
1665 Robert Hooke (who first published a micrograph of a louse) examined human hair under a microscope and noted:
“…. many have believed and asserted the Hairs of a man’s head to be hollow, like so many small pipes perforated from end to end. ….from the Polonian disease one may believe them such, yet I think we have not the least encouragement to either from the Microscope, much less positively to assert them such. And perhaps the very essence of the Plica Polonica may be the hairs growing hollow, and of unnatural constitution.” [Hooke, 1665]
1686 Sir Thomas Browne (1605-1682) wrote “Letter to a Friend,” which was included in a collected edition of his works published in 1686. A footnote states:
“Plica or gluey locks happen to both sexes, and being cut off
will come again. But they are wary of cutting off the same, for
fear of headache and other Diseases.”[Wilkin, 1862]
1699 Ambrose Stegmann wrote “Miscellanea curiosa sive Ephemeridum …” in which plica polonica is called “De plica Judaeorum”. [Stegmann, 1699]
18th Cent. “In the 18th Century it became commonplace to mention the illness that was regarded as the direct cause of death. At first the list of illnesses to choose from was not very long. First came phtisis, consumption; next was hidropis, dropsy; then paraliz, paralysis; pytocie, i.e., pustules (scarlet fever, smallpox, or the like); finally plica polonica, plica.” [Dworzaczek, 1959]
1707 Tobias Cohen (1652-1759), a Russian-Jewish physician, (Also known as: Toviah Kohn or Toviah Cohen or Toviah Katz, or Tobiasz Kohn), served as the physician-in-ordinary to five successive Sultans in Adrianople, Turkey. [Raisin, 1913] In 1707 Cohen published Ma’aseh tuviyyah (The work of Toviah). “This was one of the most influential textbooks in science and medicine published in Hebrew during the Early Modern period.” [Lepicard, 2003] This book provided the one of the first medical accounts of plica polonica. [Raisin, 1913] [Leibowitz and Ullmann, 1965]
“He (Toviah) indicated that the plica polonica is the result of a lack of cleanliness and inappropriate hygiene of the hair. Indeed, the individuals affected with the disease did not wash, clean and comb their hair even once a year. This practice resulted in infection of the root of the hair and thrombosis of the superficial veins. Toviah provided preventive measures as well as remedies for this condition.” [Massry et al., 1999]
1724 Macklus Stefan wrote a dissertation on plica polonica at Halae. [Estreicher, 1908] [Roy, 1830]
1724 Hieronymus Ludolf wrote a dissertation on plica polonica [Ludolf, 1724]
1728 The first two volumes of Chambers’s Cyclopaedia were published in 1728. The editor was Ephraim Chambers (1680 – 1740). He noted that:
“The Hairs, examined by the Microscope, appear to be fistulous Bodies like Horns. Their tubulous Structure is confirm’d from the Disease call’d ‘Plica Polonica’ wherein the Blood oozes out of their Extremities.” [Chambers, 1728a]
“PLICA, in Medicine, a Disease of the Hair, peculiar to Poland, and hence denominated Polonica, tho’ there are instances of it in Hungary, Alsatia, Switzerland, &c. See Hair.
The Plica is a severe, malignant, and dangerous Disease, wherein the Hair of the Head is matted and glu’d together beyond all Posibility of being extricated; attended with a grievous Disorder of all of the Limbs of the Body; and before the Hair become complicated, a violent Pain; a Sweat usually attending it.
An unseasonable cutting off of the Hair in this Case is dangerous; nor is there any proper and adequate Remedy for the Disease yet discovered.” [Chambers, 1728b]
1736 Mareincowski wrote: “Bemerkungen uber die Geschichte und Natur des Weichselzopfs,” [Mareincowski, 1736]
1739 Michael Scheiba wrote a dissertation on plicae pathologica (Juden-Zopff, Koltun) [Scheiba, 1739]
1765 The 12th volume of Encyclopedie, ou dictionnaire raisonne des sciences, des arts et des metiers (Encyclopedia, or a systematic dictionary of the sciences, arts, and crafts) was published in Paris in 1765. It noted that in Poland, Plica Polonica is called either gozdziec, gwozdziec or koltum.
1770 J. Seisser wrote a dissertation on Plica Polonica at Vienna [Roy, 1830]
1776 In 1776, Joseph Jacob Plenck (1738 – 1807) wrote De Morbis Cutaneis, an early book on dermatology in which Plica Polonica was discussed. [Panconesi, 1995]
1780 János Samuel Gabriel wrote a dissertation on plica polonica at Pestini (modern Budapest). [Gyory, 1900]
1786 Hester Lynch Thrale (1741 –1821) wrote Observations and reflections made in the course of a journey through France, Italy and Germany. She describes a Polish plait she saw in 1786 in the collection of the Elector of Saxony in Dresden. “The size and the weight of it was enormous, its length four yards and a half [about 4.1 m]; the person who was killed by its growth was a Polish lady of quality well known in king Augustus’s court.” [(Polish plait) Wikipedia, 2007]
1787 Dr. Vicat, a Swiss physician long resident in Poland, wrote Memoire fur la Plique Polonoise. An abstract of this treatise was published in English in 1787. [Vicat, 1787] “… the Plica Polonica is supposed to proceed from an acrid viscous humor penetrating into the hair, which is tublar; it then exudes either from its sides or extremities, and clots the whole together, either in separate folds, or in one undistinguished mass. (The dilation of the hair is sometimes so considerable as to admit small globules of blood; this circumstance, which however rarely happens, has probably given rise to the notion, that the patient, if his hair is cut off, bleeds to death.)” The symptoms of Plica, “…more or less violent, according to the constitution of the patient, or malignity of the disease, are itchings, swellings, eruptions, ulcers, intermitting fevers, pains in the head, languor, lowness of spirits, rheumatism, gout, and sometimes even convulsions, palsy, and madness. These symptoms gradually decrease as the hair becomes affected. If the patient is shaved in the head, he relapses into all of the dreadful complaints, which preceded the eruption of the Plica; and he continues to labour under them, until a fresh growth of hair absorbs the acrid humour. This disorder is thought to be hereditary; it is proved to be contagious when in a virulent state… Persons of higher rank are less subject to this disorder than those of inferior stations: the inhabitants of large towns than those of small villages; the free peasants than those in an absolute state of vassalage; the natives of Poland proper than those of Lithuania. … In a word, the Plica Polonica appears to be a contagious distemper; which, like the leprosy, still prevails among a people ignorant in medicine, and inattentive to check its progress; but is rarely known in those countries, where proper precautions are taken to prevent its spreading.”
1801 Erasmus Darwin (1731 – 1802) was an English physician, poet, natural philosopher, and the grandfather of Charles Darwin. [(Erasmus Darwin) Wikipedia, 2007] He wrote in “Zoonomia” that Plica Polonica was: “A contagious disease, in which the hair is said to become alive and bleed, forming inextricable knots or plaits of great length, like the fabled head of Medusa, with intolerable pain, so as to confine the sufferer on his bed for years.” [Darwin, 1801]
1801 Johann Christoph Adelung (1732 – 1806), a German grammarian and philologist, wrote in his German dictionary that the Weichsel-Zopf (Vistula-Plait) was also known as ‘Judenzopf’, ‘Alpzopf’. Alpklatte’, Mahrenklatte’, ‘Martofva’, ‘Nieders’, ‘Elfklatte’ and ‘Sellkensteert’ (in Hannover). He noted that it was epidemic in Poland, lesser Tartary, and Hungary. [Adelung, 1801] [(Johann Christoph Adelung) Wikipedia, 2007]
1806 “Schlegel (1806) reviewed the literature (on plica polonica) of the previous 200 years and listed 136 papers, dissertations and monographs from different authors… Schlegel wrote that trichoma had a lethality of 5%, leaving 45% of the affected crippled and with 50% making a full recovery. He felt that trichoma was the true cause of up to 32 000 of 55 000 deaths per year. The estimated prevalence was 1:10 to 1: 30 …” [Schlegel, 1806] [Forstl and Elliger, 1995]
1808 Hoffman reported that plica polonica was “… endemic in Poland and seldom, if ever, observed in any other part of Europe. … Besides the human species, other animals are subject to this complaint. It appears in some of the finest horses in Poland,” [Hoffman, 1808]
1808 F. L. de La Fontaine, Aulic Counsellor and Surgeon to the King, wrote: “… Plica Polonica, a disease endemic in Poland, and its neighboring countries, in which morbid matter is critically deposited upon the hair, and binds it together in such a manner, that to unravel it is impossible. Experience shows, that it is contagious, and very often congenital. There is no certainty where it first arose; the Arabians, Greeks and Romans, do not mention it; but some modern (19th Century) writers make the date of its origin, 1387, and add, that it came from Tartary.”
“… antimony is a specific in this disease. … The lycopodium is praised by old physicians as a specific; but unjustly. … Against the vermin, hair powder rubbed with mercury is the best remedy. If all these means be inadequate to produce the crisis, inoculations of the disease will often effect it. It is performed by putting on a cap which has just been worn by one who has had a recent plica. … After a complete crisis, the plica separates from the head, and remains attached only by sound hair. … if it has become dry, and all symptoms have ceased, it may be cut off. On the contrary, if recent, and the symptoms still continue, its removal is attended with great hazard, often inducing other violent diseases.” [De La Fontaine, 1808]
1815 Richard Bright [1789-1858], who later provided a classical clinical description of nephritis and the nephrotic syndrome [Bright’s disease], traveled in 1814-16 to Hungary and published his observations in 1818. He found that the hygiene of the peasants was very low. Many of them demonstrated Plica Polonica. Describing one peasant, Bright noted:
“To add, indeed, to the filthy appearance of this figure he was afflicted with that unseemly disease, known by the name of ‘Plica Polonica,’ in which the hair grows so matted that it is impossible to detangle it, and it becomes actually felted into balls, which from an unfounded apprehension of bad consequences, the peasants are very unwilling to have removed.” [Rooney, 1989]
150 years later, Plica Polonica was still prevalent in Hungary. [Mozer, 1995]
1817 Charles Gasc wrote an article on plica polonica which won a prize offered by the Medical Society of Paris. He noted that plica polonica was due to uncleanliness. [Gasc, 1817]
1822 Sir John Russell, an English traveler, wrote that: … “Cracow may be considered the centre of that singular and revolting disease, the Weichselzopf or Plica Polonica. It derives its name from its most prominent symptom, the entangling of the hair into a confused mass. It is generally preceded by violent headaches, and tingling in the ears ; it attacks the bones and joints, and even the nails of the toes and fingers, which split longitudinally; I saw such furrows on the nails of a person twelve years after his complete cure. If so obstinate as to defy treatment, it ends in blindness, deafness, or in the most melancholy distortions of the limbs, and sometimes in all these miseries together. The most extraordinary part of the disease, however, is its action on the hair. The individual hairs begin to swell at the root, and to exude a fat, slimy substance, frequently mixed with suppurated matter, which is the most noisome feature of the malady. Their growth is, at the same time, more rapid, and their sensibility greater, than in their healthy state; and, notwithstanding the incredulity with which it was long received, it is now no longer doubtful, that, where the disease has reached a high degree of malignity, not only whole masses of the hair, but even single hairs, will bleed if cut off, and that, too, throughout their whole length, as well as at the root. The hairs, growing rapidly amidst this corrupted moisture, twist themselves together inextricably, and at last are plaited into a confused, clotted, disgusting-looking- mass. Very frequently they twist themselves into a number of separate masses like ropes, and there is an instance of such a Zopf growing to the length of fourteen feet on a lady’s head, before it could be safely cut off. Sometimes they assume other forms, which medical writers have distinguished by specific names, such as, the Bird’s-Nest Plica, the Turban Plica, the Medusa-Head Plica, the Long-tailed Plica, the Club-shaped Plica, &c. The hair, however, while thus suffering itself, seems to do so merely from contributing to the cure of the disease, by being the channel through which the corrupted matter is carried off from the body. From the moment that the hair begins to entangle itself, the preceding symptoms always diminish, and frequently disappear entirely ; and the patient is comparatively well, except that he must submit to the inconvenience of bearing about with him this disgusting head-piece. Accordingly, where there is reason to suspect that a Weichselzopf is forming itself, medical means are commonly used to further its out-breaking on the head, as the natural progress, and only true cure of the disease. Among the peasants, the same object is pursued by increased filth and carelessness, and even by soaking the hair with oil or rancid butter. After the hair has continued to grow thus tangled and noisome for a period, which is in no case fixed, it gradually becomes dry; healthy hairs begin to grow up under the plica, and, at last, “push it from its stool.” In the process of separation, however, it unites itself so readily with the new hairs, that, if not cut off at this stage, it continues hanging for years, an entirely foreign appendage to the head. There are many instances of Poles who, suffering under poignant ailments, which were, in reality, the forerunners of an approaching Weicftselzopf, have in vain sought aid, in other countries, from foreign physicians, and, on their return, have found a speedy, though a very disagreeable cure, in the breaking out of the plica. But till the plica has run through all its stages, and has begun of itself to decay, any attempt to cut the hair is attended with the utmost danger to the patient; for it not only affects the body by bringing on convulsions, cramps, distortion of the limbs, and frequently death, but the imprudence has often had madness for its result; and, in furl., during the whole progress of the disease, the mind is, in general, affected no less than the body. Yet for a long time, to cut off the hair was the first step taken on the approach of the disease. People were naturally anxious to get rid of its most disgusting symptom, and they ascribed the melancholy effects that uniformly followed, not to the removal of the hair, but merely to the internal malady, on which this removal had no influence; and medical men bad not yet learned that this was the natural outlet of the disease. Even towards the end of the last century, some medical writers of Germany still maintained that the hair should instantly be cut; but the examples in which blindness, distortion, death, or insanity, has been the immediate consequence of the operation, are much too numerous to allow their theoretical opinion any weight. The only known cure is to allow the hair to grow till it begins to rise pure and healthy from the skin, an appearance which indicates that the malady is over. The hair is then shaved off, and the cure is generally complete,, although there are cases in which the disease has been known to return. The length of time during which the head continues in this state of corruption, depends entirely on the degree of malignity of the disease. … The Weichselzopf, at once a painful, a dangerous and a disgusting disease, is not confined to the human species ; it attacks horses, particularly in the hairs of the mane, dogs, oxen, and even wolves and foxes. Although more common among the poorer classes, it is not peculiar to them, for it spares neither rank, nor age, nor sex. Women, however, are said to be less exposed to it than men, and fair hair less than brown or black hair. It is contagious, and moreover, may become hereditary. In Cracow, there is a family, the father of which had the Weichselzopf, but seemed to be thoroughly cured; he married shortly afterwards, and his wife was speedily subjected to the same frightful visitation; and, of three children whom she bore to him, every one has inherited the disease. Among professional persons, great diversity of opinion prevails regarding its origin and nature. According to some, it is merely the result of filth and bad diet; but, although it certainly is more frequent among the classes who are exposed to these miseries, particularly among the Jews, whose beards it sometimes attacks as well as their locks, it is by no means confined to them; the most wealthy and cleanly are not exempt from its influence: of this I saw many instances in Cracow. Others, again, allowing that it is much aggravated by uncleanliness and insalubrious food, set it down as epidemic, and seek its origin in some particular qualities of the air or water of the country, just as some have sought the origin of goitres; but, though more common in Poland than elsewhere, it is likewise at home in Livonia, and some other parts of Russia, and, above all, in Tartary, from whence, in fact, it is supposed to have been first imported, during the Tartar invasion in the end of the thirteenth century. A third party has made it a modification of leprosy. The more ignorant classes of the people believe that it is a preservative against all other diseases, therefore adorne themselves with an inoculated Weichselzopf.” [Russell, 1828]
1827 Pierre Francois O. Rayer (1793 – 1867), was a member of the Acadmie Royal de Medicine and the founder of the first French journal on dermatology. He is known as the discoverer of Anthrax, Rayer’s disease, Rayer’s nodules, and that equine glanders can also be fatal to humans. [(Pierre Rayer) Wikipedia, 2007] In 1827 he published Traite Theorique et Pratique des Maladies de la Peau. He noted that Plica Polonica was also known as plicatio, plicatura, trachoma, and ï°ï¬ï¥ï£ï´ïµï®ï¨ï€®ï€ ï›Rayer, 1827]ï€ ï€
1828 Hufeland’s Journal reported a case in which for 10 weeks a woman had violent headaches which disappeared when a complete Plica Polonica was formed. [LMG, 1828]
1828 Dr. Samuel Hahnemann (1755 – 1843) wrote in The Chronic Diseases that: “ … the efficacy of the herb Lycopodium, (was) much praised in Poland for (curing) the plica polonia … (Koltun, Trichiasis) commonly found in Poland and Carinthia.” [Hahnemann, 1828] Ninety years later, Lycopodium, the spores of Lycopodium clavatum, was still listed in the 1918 Dispensary of the U.S., but had fallen into complete desuetude. [Moore, 2007]
1834 Dr. Marcinkowski wrote: “It is only in books that we find fantastical descriptions of hairs bleeding when cut, and being endued with extraordinary sensibility.” [Brierre de Boismont, 1883]
1834 Jozsef Oettinger wrote a dissertation on Plica Polonica at Pestini (modern Budapest). [Gyory, 1900].
1834 Jozsef Zanko wrote a dissertation on Plica Polonica at Pestini (modern Budapest). [Gyory, 1900].
1839 Rosenberg described 70 remedies recommended for the cure of Plica Polonica. [Rosenberg, 1839]
1839 Kajetan Kowakewski wrote an article, “Researches and Observations on Plica Polonica,” in the Dublin Journal of Medical Science. He claimed that one of the symptoms of plica is a desire for spirituous liquors. He noted that:
“The plica is almost entirely confined to certain countries. It occurs in Poland, Lithuania, Russia, Hungary, Silesia, Transylvania, and Prussia. It is most frequently met with among the lower classes of society, and often among the Jews, who have been established in these countries for centuries. It is nor improbable that the Slavonic races scattered through these countries are more liable to this affection. These races are by Schaffarik and other historians supposed to have proceeded from the center of Asia, where, as related by Roderic de Fonseca, the plica exists also. This author, when traveling in Asia, was informed that the individuals of certain tribes on the shores of the Ganges, were occasionally attacked with plica, which they attributed to the drinking of impure water.
In the countries of Europe just enumerated, plica attacks animals, most commonly horses, but has been known to affect dogs, oxen, sheep, wolves and foxes; it has never been known to occur in birds. From these facts alone, the endemic nature of the disease cannot be doubted. It is also occasionally met with in different parts of Germany; along the Rhine, Switzerland, in Holland and Paris.
The endemic influences predisposing to plica are unknown. It is a common belief in Poland, as in India, that it is caused by drinking impure water; and it is certain that it is most often met with on the shores of certain rivers, particularly the Vistula and Borysthenes, and in low and marshy situations.” [Kowakewski, 1839]
1841 Krause wrote Rudimenta plicae polonicae. [Krause, 1841]
1842 “… in the statistical return furnished by the Commissioners in Posen, in the year 1842, instances were met with in which individuals had been affected with plica for fifty or sixty years.” [Kaposi, 1874]
1843 “The number of publications (on Plica Polonica) increased steadily until in 1843 Beschorner, director of the first asylum in Poland, published a large (population based) study and could not substantiate the disease concept. [Beschorner, 1843] This led to an immediate cessation of publications on the matter.” [Forstl and Elliger, 1995] (This latter comment is not true, as a perusal of the documents on Plica Polonica from 1843 to the present will show.)
1847 Honore de Balzac (1799 – 1850) wrote The Brotherhood of Consolation in 1847 while residing in Wierschovnia, Poland, where he was attended by a celebrated Polish physician. In chapter XVII of the book, Halpersohn, the “Jewish doctor,” says:
“For the last seventeen years she has been a victim to the element in her system called plica polonica, which has produced all these ravages. I have seen more terrible cases than this. Now, I alone in the present day know how to bring this disease to a crisis, and force it outward so as to obtain a chance to cure it—for it cannot always be cured.” [Balzac, 1847]
NOTE: Balzac’s description of plica polonica, presumeably represents the local medical opinion in Wierschovnia, Poland where he lived in 1847. This 17th century opinion [Anon, 2005] was widely held, namely: that the appearance of the plica polonica meant that a disease was being resolved. As a result, many peasants were reluctant to have their plicas removed, since having a plica represented to them being in a state of good health. See: [Vicat, 1787]
1848 “The teacher Stieff, in Kaczkover-Rojewerdorf, … has within ten years, completely rooted out plica polonica from that locality, solely by inculcating cleanliness. In the Inowraclawer district, in the year 1837, there were 100 plica polonicas found amongst the recruits; in the year 1848, only eight.” [Kaposi, 1874]
1848 Wolf Derblich wrote a dissertation, De Plica Polonica, at Breslau in 1848. [Derblich, 1848] He noted that: “There had been a long tradition in Europe which held that the skin of a Jew is marked by disease, the ‘Judenkratze’ or ‘parech’ as a sign of devine displeasure. (Parech was a disease long attributed to Eastern Europeans including Jews under the designation ‘plica polonica’.)” [Gilman, 1991]
c. 1850 “In the second half of the 19th century some intellectuals waged a war against superstition and lack of hygiene among the peasantry. Many plaits, often to the horror of their owners, were cut off. In Western Galicia, it was Professor Jozef Dietl who made a particular effort to examine and treat Polish plaits. He organized an official census of people suffering from the disease, which spawned rumors that plaits would be taxed. Those rumors were said to have helped eradicate the Polish plait in the region. A huge preserved Polish plait can be seen in the History of Medicine Museum in Krakow. The Polish word for the Polish plait, koÅ‚tun, is now (in 2005) used figuratively in Poland to denote an uneducated person with an old-fashioned mindset.” [Anon., 2005]
1857 Erasmus Wilson, a Fellow of the Royal Society, wrote: ”Plica polonica, so far as I am able to infer from the description of the disease given by authors, is, in essential nature, analogous to the common ringworm of this country. There exists in it, as well as in ringworm, an enlargement of the diseased hairs, a condition probably depending on the larger size of the nucleated granules ; and the latter are the depositories of the morbid fluids which are found in such quantities in that affection. In other words, Plica is a state of granular degeneration of the hair, the granules being turgid with a viscous sanguineous fluid. The state of matting of the hair, which is thought to be peculiar to Plica, has also its analogue in ringworm ; and the conical bundles of which I have spoken, when describing the latter, are the representatives of the greater and more complete fasciculation of the Polish disease. “
“According to the best authors on plica polonica, the scalp is inflamed and excessively tender, the hairs are swollen and imperfectly formed; they are tinged with a viscous and reddish-coloured fluid. And the hair-follicles secrete an abundance of this fluid, which agglutinates the hairs, and then by desiccation unites them into a solid mass. The tenderness of the scalp in these cases is so excessive, that the bare touch of a single hair excites pain, and, when cut across, the reddish fluid with which the hairs are surcharged, oozes from the divided extremity. This appearance, together with their extreme sensibility, has given rise to the supposition of their being sarcofied, and pervaded with disgusting excoriations of considerable extent are frequently formed, and the matted hair becomes the resort of swarms of pediculi.”
“Plica is not confined to the scalp, but affects the hair on every region of the body, the nails of the fingers and toes are also changed, becoming rough, fibrous, and discoloured. Left to itself, the disease lasts ten or twelve months, the symptoms then subside gradually, the hair returns to its natural diameter ; and the filthy mass is pushed by degrees farther and father from the surface, until it falls off spontaneously, or is cut away by scissors.”
“the hair presents some modifications, in the manner of its matting, which bear relation to its length. Thus, in males, who wear the hair short, numerous locks are matted separately, constituting the variety known as plica multiformi, at other times, the matted hair forms a single coil, plica caudiformis; or, again, it may constitute a large and irregular mass without order in its matting, the usual character of the disease in women.”
““Several authors have asserted, that, in the majority of cases, the scalp is not affected in plica, and that the alteration in the hair occurs at a certain distance from the integument. This assertion is incredible, and it seems more reasonable to conclude, that in the cases adduced in support of this statement, the disease was advancing towards cure, and consequently that the morbid mass of hair
was removed by growth from the surface of the scalp.”
“A recent writer on this subject, Dr. Bidder, makes the following remarks : ” During the past summer, I remained for several weeks in a country where plica polonica is frequent. The disease occurred only in a mild form. In all the cases which I examined, about twenty in number, I found the hair, for a distance varying from half an inch to one inch from the scalp, perfectly natural; one would have believed that the disease had been removed from the head by the growth of the hair. The scalp was perfectly normal, being neither reddened, swollen, nor increased in sensibility, so that the disease of the hair would appear to be capable of existing independently of disorder of the scalp in which the matrix is embedded. “I had also an opportunity of observing the process of separation of the diseased from the sound hair. Two individuals presented themselves in whom the morbid mass had fallen by spontaneous separation, a rare occurrence. Once alive to the possibility of such a process, I soon discovered in two cases, a groove, as though made by a ligature, around the cylinder of the hair, and forming a perfect line of demarkation between the healthy and diseased portion. In some hairs, the groove resembled a mere crack ; in others, it had proceeded so far that the separation was nearly
effected. In other cases, I was unable to discover the line of demarcation.”
”CAUSES.—Supposing my opinion to be correct with regard to the nature of the disease, its causes will probably be found to be analogous to those of ringworm. The disorder is most prevalent on the banks of rivers and in the marshy districts of Poland, in which it appears to be endemic. It is met with, as is ringworm, among the noble* and the wealthy, as well as in the poor ; and, unlike ringworm, it occurs in adults as well as children.”
“TREATMENT—The treatment which is applicable to ringworm I should conceive to be suited also to plica. Change of air, improved diet, and altered hygienic conditions must be indubitably necessary,
and the same tonic alterative medicines. A prejudice seems to prevail in Poland against the removal of the mass by mechanical means, which I am inclined to think unreasonable. I should certainly suggest the trial of moderately strong stimulating local remedies.” [Wilson, 1857]
1861 Dr. T.M. Anderson, a Glasgow physician, cautioned “…that in those cases where the head has long been attacked by great numbers of pediculli, especially in the case of children, it is dangerous to eradicate them suddenly, for by doing so internal diseases have been developed and Divergie has seen two infants die from the sudden cutting short of the accustomed itching and secretion. It is, therefore, necessary, in such instances, to cure the disease more slowly, to attack only small portions of the head at a time, and especially to avoid cutting short the hair at once. It is only in rare instances, however, that such precautions are required.” [Anderson, 1861]
1862 Jan Dietl, a professor at the Jagellonian University in Cracow, wrote a voluminous report based on a study of 1,044 cases of plica polonica. The study was sponsored by the Austrian Minister of the Interior, and involved the participation of many prominent physicians.
“Plica is neither a disease of the hair, nor a plicomatous specific condition, nor a crisis of diseases; hence it has no physiological connection with the accompanying disease, nor can it be considered a pathological condition.”
“It is never hereditary, contagious, nor, of course, infective. The deep superstition of it being a cure and protective against any disease, together with negligence and uncleanliness. Is the chief cause of the existence of plica. Plica never occurs in people with short hair, but only where superstition, negligence, and uncleanliness hold sway, no matter what country, surroundings, climate, season, sex, age constitution, or nationality.” [Dietl, 1862]
1866 “A poor law physician at Insterburg in East Prussia described in 1866 notable cases of louse infestation: impetigo disfigured the skin with viscid and foul-smelling sores, matted scabs and crusts formed at the nape of the neck, a condition known as Plica Polonica and associated with poor Jews; lice congregated beneath the skin and caused swelling and abscesses, and a rough, black discolouring of the skin resulted from haemorrhaging due to louse bites.” [Hoeppli, 1959 cited by Weindling, 2000]
1866 Ferdinand von Hebra, a leading dermatologist in Vienna, wrote:
“Thus various diseases of the scalp (such as eczema and favus, even syphilitic ulcers) have been supposed to examples of the complaint: while in other instances the matted and tangled state of hair naturally long and abundant has been simply due to neglect, and braided false hair with it. Having myself had occasion to observe many cases of this kind, I am quite satisfied that there is no disease which deserves the name of plica Polonica. Indeed, the fact that this complaint does not exist has been fully established by careful investigations and observations, and it is to be hoped that the profession generally will adopt this conclusion, and no longer attribute to a special disease cases in which the hair happens to be matted together by the causes I have mentioned, and in which the persistence of this condition is due merely to prejudice, superstition and neglect of cleanliness.” [Hebra, 1866]
1866 T.W. Belcher, MD., discussed the state of knowledge of plica polonica in Dublin in 1866. [Belcher, 1866]
“The only alteration in the character of the hair which can be strictly regarded as a disease is that peculiar felting and matting of it together which constitutes the singular affection that has been named Plica Polonica. This disease, which is ” der weischelzopf ” of the Germans, is an affection of the hair endemic in Poland and the surrounding countries, where it is said to be produced by the bad living and unclean habits of the inhabitants. After inflammation of the scalp, which becomes swollen, red, and sore to the touch, a viscid exudation takes place from it, matting the hairs together, so that, as Dr. Fox observes—” Lice, pus, blood, and fungus elements are found mixed together in the plicose felting.” This disease affects the scalp, pubes, nails, and sometimes the chin and axillae; and after some months the diseased mass is said to be ” pushed off.” Dr. Fox, from whose description the above is for the most part condensed, considers it to be of the same nature as the Pellagra, or modified forms of elephantiasis, viz., a result of action of deteriorating influences upon the general nutrition at large. He also observes that a fungus—the trichophyton sporuloides of Giinsburg—has been found, and is supposed to be the real cause of the disease, the soil favouring the development of a parasitic fungus. On the other hand, Gustav Simon could not find any vegetation in the hairs themselves, and he regards the disease as consisting chiefly of an abnormal secretion from the surface of the skin, not especially implicating the hair follicles. Fuchs believed the sticky material to come from the hair follicles. Hillier thinks that the real nature of the disease is not fully proved, and Hebra suggests that it is not a distinct disease, but eczema or some other skin affection much neglected. Dr. Neligan never saw a case of it, nor has the Editor had that advantage. “
1868 Charles Darwin wrote: “The Plica Polonica …rarely affects Germans, who inhabit the neighbourhood of the Vistula, where so many Poles are grievously affected; and on the other hand, it does not affect Russians, who are said to belong to the same original stock with the Poles. [Darwin, 1868]
1872 Isidor Neumann wrote in his “Handbook of Skin Diseases” that plica polonica was really Eczema of the head (Eczema capitis), which only persists in people who do not pay attention to keeping their hair clean. [Neumann, 1872]
1874 Dr. Moriz Kaposi (1837 – 1902) (of Kaposi’s Sarcoma fame) wrote that:
“Those of our professional brethren who are intimately acquainted with the views of the Vienna dermatological school will be justly astonished that, in a place which should be devoted to the gravest scientific discussion, we treat of plica polonica, which long ago ceased to have any existence as a disease in the natural history of medicine, and, for decades, has been transferred from the pathological series to that of artificial, mechanical products.”
“Every year we have the opportunity of seeing some cases of plica polonica. Their aspect and cause are always the same. The individuals are mostly such who are affected with pediculi capitis, and have given rise to the plica polonica by neglect of the use of the comb, or such who endure it ‘in good faith,’ on account of some existing disease. We have invariably removed the plica polonica, and have never seen any ill result therefrom.”
“The removal of the plica polonica is most easily effected by means of the scissors. We have never seen the wonderful ‘bleeding’ of the plica hairs, which some authors mention, but which a medical man acquainted with anatomy cannot in the least credit. If there were bleeding this would come from the wounded scalp, cut by the scissors.”
“We can, however, also unravel the plica polonica and therefore need not necessarily cut it off. … Our nurses accomplish this in the course of twenty-four hours. The mass of the plica polonica is, first of all, saturated by pouring oil freely over it. If lice are present they are treated with petroleum, which immediately kills them. We must, however, be careful not to bring a light near on account of the very inflammatory nature of the petroleum. When the plica polonica is sufficiently saturated with oil, we then begin the manipulation of the unraveling by separating and loosening with the fingers the hairs glued together in small tufts, till the individual hairs appear separated to the utmost, and then only, we begin to smooth the hairs by means of a wide toothed comb. … Finally, the whole ball is unraveled by patient continuance of this manipulation – the plica polonica has vanished..” [Kaposi, 1874]
1870’s Gustave Flaubert (1821 – 1880), the famous French novelist, wrote Le Dictionnaire des Idees Recues (Dictionary of Received Ides) which was published posthumously in 1911-3. [(Dictionary of Received Ideas) Wikipedia, 2007] It defines Plica Polonica as: “If you cut your hair, it bleeds”. [Flaubert, 1870’s]
1882 “A report has been spread that the horrible disease known as the plica polonica has made its appearance in London, brought over by the traders in false hair from Poland. The disease is one of the most horrible kind, incurable, and rendering its victim an object as hideous to behold as the leper of the East. The hair, instead of dividing into fine and silky threads, conglomerates into thick matter, with only one thick root, which bleeds on being cut, so that no relief can be obtained save by cauterizing the whole mass.” [Anon, 1882]
1896 George. M. Gould and Walter. L. Pyle Wrote:
“Plica polonica, or, as it was known in Cracow–weichselzopf, is a disease peculiar to Poland, or to those of Polish antecedents, characterized by the agglutination, tangling, and anomalous development of the hair, or by an alteration of the nails, which become spongy and blackish. In older days the disease was well known and occupied a prominent place in books on skin-diseases. Hercules de Saxonia and Thomas Minadous, in 1610, speak of plica as a disease already long known. The greater number of writers fix the date of its appearance in Poland at about the year 1285, under the reign of Lezekle-Noir. Lafontaine stated that in the provinces of Cracow and Sandomir plica formerly attacked the peasantry, beggars, and Jews in the proportion of 1 1/2 in 20; and the nobility and burghers in the proportion of two in 30 or 40. In Warsaw and surrounding districts the disease attacked the first classes in the proportion of one to ten, and in the second classes one to 30. In Lithuania the same proportions were observed as in Warsaw; but the disease has gradually grown rarer and rarer to the present day, although occasional cases are seen even in the United States.
Plica has always been more frequent on the banks of the Vistula and Borysthenes, in damp and marshy situations, than in other parts of Poland. The custom formerly prevailing in Poland of shaving the heads of children, neglect of cleanliness, the heat of the head-dress, and the exposure of the skin to cold seem to favor the production of this disease.
Plica began after an attack of acute fever, with pains like those of acute rheumatism in the head and extremities, and possibly vertigo, tinnitus aurium, ophthalmia, or coryza. Sometimes a kind of redness was observed on the thighs, and there was an alteration of the nails, which became black and rough, and again, there was clammy sweat. When the scalp was affected the head was sore to the touch and excessively itchy. A clammy and agglutinating sweat then occurred over the cranium, the hair became unctuous, stuck together, and appeared distended with an adhesive matter of reddish-brown color, believed by many observers to be sanguineous. The hair was so acutely sensitive that the slightest touch occasioned severe pain at the roots. A viscid matter of a very offensive smell, like that of spoiled vinegar, or according to Rayer like that of mice or garlic, exuded from the whole surface of each affected hair. This matter glued the hairs together, at first from their exit at the skin, and then along the entire length; it appeared to be secreted from the whole surface of the scalp and afterward dried into an incrustation. If there was no exudation the disease was called plica sicca. The hair was matted and stuck together in a variety of ways, so as to resemble ropes (plica multiformis). Sometimes these masses united together and formed one single thick club like the tail of a horse (plica caudiformis). Again, and particularly in females, the hair would become matted and glued together into one uniform intricate mass of various magnitudes. The hair of the whole body was likely to be attacked with this disease. Kalschmidt of Jena possessed the pubes of a woman dead of plica, the hair of which was of such length that it must have easily gone around the body. There was formerly a superstition that it was dangerous to cut the hair until the discharge diminished. Lafontaine, Schlegel, and Hartman all assure us that the section of the affected masses before this time has been known to be followed by amaurosis, convulsions, apoplexy, epilepsy, and even death. Alarmed or taught by such occurrences, the common people often went about all their lives with the plica gradually dropping off. Formerly there was much theorizing and discussion regarding the etiology and pathology of plica, but since this mysterious affection has been proved to be nothing more than the product of neglect, and the matting due to the inflammatory exudation, excited by innumerable pediculi, agglutinating the hair together, the term is now scarcely mentioned in dermatologic works. Crocker speaks of a rare form which he entitles neuropathic plica, and cites two cases, one reported by Le Page whose specimen is in the Royal College of Surgeons Museum; and the other was in a Hindoo described by Pestonji. Both occurred in young women, and in both it came on after washing the hair in warm water, one in a few minutes, and the other in a few hours. The hair was drawn up into a hard tangled lump, impossible to unravel, limited to the right side in Le Page’s patient, who had very long hair, and in Pestonji’s case to the back of the head, where on each side was an elongated mass, very hard and firm, like a rope and about the size of the fist. There was no reason to believe that it was ascribable to imposture; the Hindoo woman cut the lumps off herself and threw them away. Le Page found the most contracted hairs flattened. Stellwagon reports a case of plica in a woman. It occupied a dollar-sized area above the nape of the neck, and in twelve years reached the length of 12 feet. There was no history of its manner of onset.” [Gould and Pyle, 1896]
1907 In the US, Rolla Thomas [Thomas, 1907] suggested that:
“Where the hair is matted or the nits abundant, it is better to have the hair cut short, though not absolutely necessary. The hair and the scalp is to be thoroughly saturated with petroleum, (coal oil) and allowed to remain for ten or twelve hours, when the parasites and ova are entirely destroyed. This will be followed by thoroughly washing the head with warm water and soap; any good toilet soap may be used ….The hair should be combed with a fine-tooth comb, in order to remove the ova, shells, and parasites.”
1908 “‘Plica Polonica’ infects the marshy regions of Lithuania and Russian Poland.” [Annon., 1908]
1910 “Plica has always been more frequent on the banks of the Vistula and Borysthenes, in damp and marshy situations, than in other parts of Poland.” [Gould and Pyle, 1910]
1911 The “1911 Encyclopedia Britannica” describes the marshy area near Minsk, Russia:
“The climate of the Polyesie [The Woods] is extremely unhealthy; malarias and an endemic disease of the hair (Plica Polonica) are the plagues of these tracts.” [Anon., 1911]
1913 Webster’s 1913 Dictionary defined Plica Polonica as a disease of the hair in which the hairs become twisted and matted together. Webster’s noted that the disease was of Polish origin, and hence was also called Polish Plait. [Webster, 1913]
1915 Two professors at Cornell University published a photograph of a case of ‘Pediculosis of the head’. “The illustration shows the characteristic indications of the presence of lice, viz: the occipital eczema gluing the hairs together, the swollen cervical glands, and the porrigo, or eruption of contagious pustules upon the neck.” [Riley and Johannsen, 1915]
1917 In “South Wind”, a well-known work by Norman Douglas (1868 – 1952), the water from the Fountain of Paradise on the fictional volcanic island of Nepenthe (Capri?) is described as having nitrous ingredients. The water was “efficacious for the distemper known as PLICA POLONICA….” [Douglas, 1917] [(Norman Douglas) Wikipedia, 2007]
1924 William Boericke (1849-1929) suggested in the 6th edition of his “Pocket Manual of Homeopathic Materia Medica,” that a dose of 1st to 3rd potency of Lesser Periwinkle (Vinca Minor) was an appropriate remedy for Plica Polonica. [Boericke, 1924]
1995 “No original publications can be found in the Hungarian medical literature about this topic [Plica Polonica]. However we can find people with this syndrome in Hungary also at the preset time. It can be connected with the increasing aging and growing poverty in our country.”[Mozer, 1995] However, “Bibliographia Medica Hungariae, 1472 – 1899” shows that three medical theses on plica polonica were written in Budapest between 1780 and 1834. [Gyory, 1900].
2000 In Switzerland, … “A young man presented with dreadlocks. There are remarkable similarities with the so-called plica polonica, that historically had been treated with long courses of mercury. Apparently very important in the 18th century, the interest for this hair-disorder appears to lost in specialized medical literature. In contrast dreadlocks, a recent hairstyle, are frequently encountered. Lack of other sources various websites provide dermatologists with answers to questions regarding complications. Fortunately a simple haircut is today treatment enough.” [Friedli et al., 2000]
2002 Robert Gwadz, assistant chief of NAID’s Laboratory of Parasitic Diseases, and a lecturer in parasitology at Columbia University, has noted that Plica Polonica can develop as a result of an immune response of the human body to head lice bites.[Gwadz, 2003]
2004 In the UK, the case of a 9 year old girl with pediculosis and matted hair, i.e. Plica Polonica, was reported. [Baron, 2004]
2005 A case of a child with head lice and matted hair [Plica Polonica] was reported at the Royal Aberdeen Hospital in Scotland. “The hair was entirely matted in a solid mass and gave off an offensive smell.” [Murray, 2006]
2007 A case of a one year old child with scabies, pediculosis capitis with secondary pyoderma, and plica polonica was diagnosed in Tamilnadu, India. “The patient was treated with antiscabetics and oral antibiotics. The entire family was treated for scabies and pediculosis capitis. The matted locks of hair were cut close to the scalp, after which the patient recovered dramatically.” [Gnanaraj et al., 2007]
©2007 by Harry A. Morewitz, PhD. All rights reserved.