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Sweat from 8 'rusters' and 8 control persons was examined for its sodium concentration. Sweating was induced by iontophoresis of pilocarpine on the distal forearm. In no case did the concentrations exceed the normal upper limit for this procedure, and no difference was found between the two groups. In this way the study failed to confirm earlier reports of elevated sodium chloride concentrations in sweat from 'rusters'. Proposals of a relationship between 'rusters' and patients with pancreatic cystic fibrosis were not substantiated. Hyperhidrosis of the palms and volar surfaces of the fingers was present in all 'rusters'. This seemed to be the main cause of the corrosive tendency, and patients referred for palmar hyperhidrosis were found to produce corrosion similar to the 'rusters'. Topical application of aluminium chloride hexahydrate in a 25% solution in absolute ethyl alcohol proved effective against both hyperhidrosis and the corrosive tendency.

When measuring sweating rates, close correspondence was found with the clinical estimation of hyperhidrosis. Corrosion was seen to increase with increasing sweat rates, reaching its maximum after an assumed rise in the actual sodium chloride concentration on the skin surface due to evaporation of water. The findings confirm that hyperhidrosis is of primary importance in the constitution of a 'ruster', and are also in good agreement with experimental reports. The small variations in palmar skin pH had no influence on the degree of corrosion; nor had the character of the metal surface. Of the two types of metal studied. corrosion was much more severe on the type having the lowest concentration of copper, thus confirming that increasing copper concentrations have a positive effect in reducing corrosion rates. At 50--60% relative humidity (RH) corrosion increased as time elapsed, whereas at 40% RH no corrosion developed on a sweat-contaminated plate. When exposed to 75% RH, metal samples became severely corroded in the course of a few days. Protective methods for the avoidance of rust are mentioned, with special emphasis on frequent handwashing.

Eleven women (group I) with axillary hyperhidrosis were treated ad modum Shelley & Hurley with local application of aluminium chloride hexahydrate 25% in absolute ethanol and plastic foil occlusion during two successive nights once a week. The patients were observed for 24 weeks. Another 12 women (group II) were treated for up to 12 weeks with aluminium chloride hexahydrate 25% in absolute ethanol but without using plastic foil occlusion. We have attempted to determine the effect of the treatment by sweat measurements, leaving the left axilla untreated during the initial 1--2 weeks as a control. An immediate reduction in sweat production of the treated axilla was found in both groups. The reduction increased during the first weeks and was maintained thereafter. The degree of sweat reduction was the same during standardized work and during rest (group II). At the final controls all patients in group I had discontinued the occlusion and had individualized the treatment, most of them using local application 1--2 times weekly. Two patients in group I had to stop the treatment because of unbearable itching. The other patients found the treatment completely satisfactory. All patients had experienced itching and smarting when starting the treatment. Often these discomforts were temporary but they seem to require active support by close medical control during the initital period of treatment. In contrast to previous investigations, effective treatment was achieved both with and without occlusion.