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Neelam A. Vashi Editor

The Dermatology
Handbook
A Clinician’s Guide

123
The Dermatology Handbook
Neelam A. Vashi
Editor

The Dermatology
Handbook
A Clinician’s Guide
Editor
Neelam A. Vashi, MD
Department of Dermatology
Boston University School of Medicine
and Boston Medical Center
Boston, MA
USA

ISBN 978-3-030-15156-0    ISBN 978-3-030-15157-7 (eBook)

https://doi.org/10.1007/978-3-030-15157-7

© Springer Nature Switzerland AG 2019

This work is subject to copyright. All rights are reserved by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of transla-
tion, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage
and retrieval, electronic adaptation, computer software, or by similar or dissimi-
lar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service
marks, etc. in this publication does not imply, even in the absence of a specific
statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and
information in this book are believed to be true and accurate at the date of pub-
lication. Neither the publisher nor the authors or the editors give a warranty,
expressed or implied, with respect to the material contained herein or for any
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with regard to jurisdictional claims in published maps and institutional
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This Springer imprint is published by the registered company Springer

Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Contents

1 The Basics: Skin Types, Definitions,

and Differentials�������������������������������������������������������������   1
Elizabeth R. Rae, Mayra B. C. Maymone,
and Neelam A. Vashi

2 Dermoscopy Basics �����������������������������������������������������   35

Sarah Kam and Neelam A. Vashi

3 Diagnosing Bedside: Common Laboratory

Techniques���������������������������������������������������������������������   43
Catherine Higham and Neelam A. Vashi

4 An approach to Dermatopathology:

Immunohistochemical and special stains��������������������� 51
Mary M. Barrett, Neelam A. Vashi,
and Hye Jin Chung

5 Dermatologic Emergencies������������������������������������������� 65
Caroline LaRosa, Andrew Chen,
and Amy Y.-Y. Chen

6 Common Skin Diseases: Quick Reference ���������������   77

Ming H. Lee and Neelam A. Vashi

7 Guidelines from the Academy ����������������������������������� 103

Jacqueline Watchmaker and Neelam A. Vashi

v
vi Contents

8 Commonly Used Drugs and Medication

Guidelines����������������������������������������������������������������������� 149
Julia M. Mhlaba, Supriya Immaneni,
Neelam A. Vashi, and Roopal V. Kundu

9 Pediatric Dermatology Practical Approaches

and Prescribing Tips������������������������������������������������������� 191
Margaret S. Lee and Neelam A. Vashi

10 Dermatologic Surgery��������������������������������������������������� 219

Daniel J. Callaghan and Neelam A. Vashi

11 Cosmetic Pearls��������������������������������������������������������������� 243

Dana Saade, Emmy Graber,
Mayra B. C. Maymone, and Neelam A. Vashi

Index��������������������������������������������������������������������������������������� 273
Contributors

Mary M. Barrett, MD Department of Dermatology, Boston

University School of Medicine, Boston, MA, USA
Daniel J. Callaghan, MD Boston University Medical Center,
Boston, MA, USA
Amy Y.-Y. Chen, MD, FAAD Central Connecticut
Dermatology, Cromwell, CT, USA
Andrew Chen, MD, FACS Division of Plastic Surgery,
Department of Surgery, University of Connecticut School of
Medicine, Farmington, CT, USA
Hye Jin Chung, MD, MMS Department of Dermatology and
Pathology and Laboratory Medicine, Boston University
School of Medicine, Boston, MA, USA
Emmy Graber, MD The Dermatology Institute of Boston,
Boston, MA, USA
Catherine Higham, MD Department of Dermatology,
Boston University Medical Center, Boston, MA, USA
Supriya Immaneni Department of Dermatology,
Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
Sarah Kam, MD Department of Dermatology, Boston
University Medical Center, Boston, MA, USA
Roopal V. Kundu Department of Dermatology and Medical
Education, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA

vii
viii Contributors

Caroline LaRosa, MD Dermatology Associates of Western

Connecticut, Southbury, CT, USA
Margaret S. Lee, MD, PhD Departments of Dermatology
and Pediatrics, Boston University School of Medicine, Boston,
MA, USA
Ming H. Lee, MD Department of Dermatology, Boston
University School of Medicine, Boston, MA, USA
Mayra B. C. Maymone, MD, DSc Department of
Dermatology, Boston University School of Medicine, Boston,
MA, USA
Julia M. Mhlaba Department of Dermatology, Northwestern
University Feinberg School of Medicine, Chicago, IL, USA
Elizabeth R. Rae Department of Dermatology, Boston
University School of Medicine, Boston, MA, USA
Dana Saade, MD Department of Dermatology, American
University of Beirut Medical Center, Beirut, Lebanon
Neelam A. Vashi, MD Department of Dermatology, Boston
University School of Medicine and Boston Medical Center,
Boston, MA, USA
US Department of Veterans Affairs, Boston Health Care
System, Boston, MA, USA
Jacqueline Watchmaker, MD Department of Dermatology,
Boston University Medical Center, Boston, MA, USA
Chapter 1
The Basics: Skin Types,
Definitions, and Differentials
Elizabeth R. Rae, Mayra B. C. Maymone,
and Neelam A. Vashi

Table 1.1 Skin types

Skin type History/physical examination
I Always burn, never tan
II Always burn, but sometimes tan
III Sometimes burn, but always tan
IV Never burn, always tan
V* Moderately pigmented
VI* Deeply pigmented dark brown to darkest
brown/black
*
Patients with natural pigmentation of these types may be classified
into a lower skin-type category if the sunburning history so indicates.
Adapted from Fitzpatrick TB. Soleil et peau. Journal de Medecine
Esthetique. 1975;2(33)

E. R. Rae · M. B. C. Maymone
Department of Dermatology, Boston University School of Medicine,
Boston, MA, USA
e-mail: [email protected]
N. A. Vashi (*)
Department of Dermatology, Boston University School of Medicine
and Boston Medical Center, Boston, MA, USA
US Department of Veterans Affairs, Boston Health Care System,
Boston, MA, USA
e-mail: [email protected]

© Springer Nature Switzerland AG 2019 1

N. A. Vashi (ed.), The Dermatology Handbook,
https://doi.org/10.1007/978-3-030-15157-7_1
2 E. R. Rae et al.

Skin Lesion Description

Describing skin lesions and findings is an important skill in
order to effectively communicate with colleagues. The
description should include primary lesion terminology with
information in regards to color, distribution, color, configura-
tion, borders, and shape along with any secondary lesions if
present. The tables below define terms that are used to
describe lesions.

Table 1.2 Primary Lesions

Term Size Description
Macule <1 cm Flat spot that can only be noticed visually;
without elevation
Papule <1 cm Dome-shaped, flat-topped, may be umbilicated
or with a dell
Vesicle <1 cm Raised bump filled with air or clear liquida
Pustule <1 cm Raised bump filled with pus
Nodule <1 cm Elevated bump on the skin that can occur in all
layers of the skina
Cyst Varies Nodule filled with liquid or semi-liquid
Plaque >1 cm Flat-topped but raised lesion; with elevation
Patch >1 cm Large flat spot (macule)
Bulla >1 cm Fluid-filled sacs that occur when fluid becomes
under the skina
- Flaccid (more likely epidermal) vs tense
(more likely dermal)
- Epidermal bullae can appear tense on acral
sites because the overlying stratum corneum
is thicker
- Although tense blisters can evolve to flaccid,
flaccid blisters will not become tense
Tumor >1 cm Firm, solid mass on the skin or subcutaneous
tissuea
a
Primary Skin Lesions. SkinVision. https://www.skinvision.com/
library/primary-skin-lesions. Published July 10, 2017
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 Chapter 1. The Basics: Skin Types, Definitions... 3

Table 1.3 Terminology of other descriptive lesions

Term Description
Wheal Red, swollen plaque, often itchy and
changes shape, aka hives or welts
Telangiectasia Dilated blood vessels near the skin
surface that cause threadlike lines
Petechiae Non-blanching red spot that is
typically <1 cm
Purpura Non-blanching red spot that is
typically >1 cm
Comedones Dilated hair follicles filled with
keratin, bacteria, and sebum
Closed comedones (whiteheads) have
an obstructed opening to the skin
Open comedones (blackheads) have
an opening to the skin filled with dark
appearing (oxidized) skin debris
Milium or Milia (plural) Small, superficial epidermoid cysts,
appear as small, white bumps
Burrow Tunnels formed in the skin, appear
as linear lines (from parasitic
infestation)
Boil (furuncle) Pus-filled bump that forms under the
skin when bacteria infect or inflame
one or more hair follicles; begin as
red, tender bumps; painful
Carbuncles are clusters of boils that
form connections under the skin
4 E. R. Rae et al.

Table 1.4 Terminology for describing color, shape, texture, and pat-
tern of lesions
Color
Although describing color can be somewhat subjective, the
description should be made with the specific color. It is important
to also distinguish certain features of colors with specific terms as
described in the below table.
Term Description
Depigmented No color/white; Wood’s lamp
will fluoresce
Hypopigmented Decrease of skin pigment or
color
Hyperpigmented Increase in skin pigment or
color
Erythematous Red and blanches on
palpation (or diascopy)
Violaceous Purple
Purpuric Red/purple that does not
blanch
Dusky Dark purple/gray; can
be difficult to distinguish
purpura vs early necrosis
Shape
The outline of an area, or shape, tells important information
about the underlying lesion and helpful when communicating
through medical records.
Term Description
Annular Round with central clearing
Round/nummular/discoid Round without central
clearing
Ovoid Oval-like
Serpiginous Having a wavy margin
(snake-like)
 Chapter 1. The Basics: Skin Types, Definitions... 5

Table 1.4 (continued)

Targetoid Like a target, with three
zones: dusky (or blistered)
center, surrounded by white
ring, and then erythema;
often refers specifically to
erythema multiforme lesions
Polycyclic Multiple overlapping annular
lesions
Arcuate Incomplete annular arc
Polymorphous Many different shapes
Texture
Texture refers to the feel and/or consistency of a surface or
substance.
Term Description
Soft Easily compressible, like fat
Firm Not easily compressible
or movable, hard; such as
when feeling calcium filled
lesions that are very hard on
palpation
Indurated Firm and bound-down
Boggy Edematous, suggesting fluid
between collagen in the
dermis
Fleshy Implies exophytic or
pedunculated with a soft,
squishy texture
Horny Has thick pointy
hyperkeratotic elements, an
example is a cutaneous horn
Vegetative Layered extension of a
plaque/tumor, appears to be
growing upon itself
(continued)
6 E. R. Rae et al.

Table 1.4 (continued)

Juicy An edematous/fluid-filled
appearance
Patterns
Patterns can be thought of as the configuration, groupings,
distribution of lesions and also provide diagnostic information.
Term Description
Follicular/folliculocentric Arising from and associated
with hair follicles
Morbilliform Multiple macules and
papules 2 mm to 1 cm
Reticular/reticulated Net-like
Retiform Branching and/or angulated
Guttate Small spots or “drops”
Monomorphic/monomorphous All lesions appearing
identical and in the same
stage

Table 1.5 Secondary lesions

Term Description
Erosions Epidermal breaks in skin (superficial, do not
appear deeper than top layer of skin)
Ulcers Deeper breaks in skin involving the dermis; may
appear “punched out” or with “undermined
borders”
Crust Dried exudates or plasma from vesicle, pustule,
trauma (aka scab)

Scale Compacted stratum corneum appearing as

flakes
“Branny” scale is exfoliating scale (bran-flake
like)
 Chapter 1. The Basics: Skin Types, Definitions... 7

Table 1.5 (continued)

Term Description
Eschars Thick black/necrotic crusts (can be associated
with infections such as rickettsialpox,
anthrax, brown recluse spider bites, ecthyma
gangrenosum)
Dermal Wrinkled
Atrophy
Epidermal Shiny
Atrophy
Poikiloderma Appearance with 3 components: atrophy, hypo/
hyperpigmentation, and telangiectasia
Collarette of Small circle of scaling (from ruptured/evolved
Scale vesicle or pustule)
Trailing Scale Scale at inner edge of erythema; occurs
in pityriasis rosea and erythema annulare
centrifugum
Leading Scale Scale at edge of erythema (such as in tinea
corporis)
Exfoliation Peeling of topmost skin layer (stratum corneum)
Desquamation Scaling and loss of topmost skin layer (stratum
corneum)
Denudation Loss of entire epidermis including basement
membrane
Epidermal Scale, pigmentation alteration, vesiculation,
Change fissures, lichenification/thickening, epidermal
atrophy, verrucous/papillomatous change
Dermal Dermal atrophy, loss of elastic tissue (termed
Change anetoderma), erythema, papules, plaques,
nodules, cysts, sclerosis/scar/keloid, peau
d’orange (dimpled appearance)
8 E. R. Rae et al.

 ifferential Diagnoses Based on Primary

D
Lesions
Primary Lesions

Macules and Patches

White/Hypopigmented Macules

Alezzandrini’s syndrome (vitiligo)

Amelanotic melanoma or melanoma with regression
Amino acid disorders (e.g. Phenylketonuria)
Atrophic lichen planus
Chediak-Higashi syndrome
Chemical leukoderma (i.e. phenols)
Halo nevus without nevus
Hypomelanosis of Ito
Hypopigmented mycosis fungoides
Idiopathic guttate hypomelanosis
Incontinentia pigmenti – fourth stage
Lichen sclerosis et atrophicus
Morphea
Nevus anaemicus
Nevus depigmentosus
Oculocutaneous albinism
Partial albinism (piebaldism)
Pityriasis alba
Pityriasis Lichenoides chronica
Progressive macular hypomelanosis
Post inflammatory hypopigmentation
Radiation dermatitis
Scarring discoid lupus erythematosus
Syphilis, yaws, pinta
Thyroid disease
Tinea versicolor
Tuberculoid leprosy
 Chapter 1. The Basics: Skin Types, Definitions... 9

Tuberous sclerosis
Vitiligo
Vogt-Koyanagi syndrome (vitiligo)
Waardenburg’s syndrome (piebaldism)

Brown Macules

Acanthosis nigricans
Adrenocorticotropic hormone (ACTH) administration
Addison’s disease
Agminated Nevus
Albright’s syndrome
Ataxia-telangiectasia
Becker’s nevus
Berloque dermatitis
Bloom’s syndrome
Cafe au lait spots
Congenital nevus
Drug (i.e. arsenic, psoralen, chlorpromazine, minocycline)
Dyskeratosis congenita
Ephelides
Erythema dyschromicum perstans (initial lesions)
Erythromelanosis follicularis faciei et colli
Exogenous Ochronosis
Fanconi’s syndrome
Fixed drug eruption
Galli-Galli disease
Hemochromatosis
Junctional nevus
Lentigo maligna
Lentigo
Lichen amyloidosis
lncontinentia pigmenti - third stage
Macular amyloidosis
Melasma
Mongolian spot
Moynahan’s syndrome (LEOPARD)
10 E. R. Rae et al.

Nevus of Ota/Ito
Nevus spilus
Peutz-Jeghers syndrome
Pigmented contact dermatitis (Riehl’s melanosis)
Phytophotodermatitis (i.e. limes, celery, fig)
Postinflammatory hyperpigmentation
Seborrheic keratosis (early)
Speckled lentiginous nevus
Traumatic tattoo
Tuberous sclerosis
Urticaria Pigmentosa
Von Recklinghausen’s Neurofibromatosis

Erythema/Red Macules

Acral erythema (palms and soles – due to chemotherapy)

Carcinoid
Drug hypersensitivity syndrome (sulfa, anticonvulsants, allo-
purinol, minocycline)
Erysipelas
Figurate erythemas –
• Erythema multiforme
• Erythema annulare centrifugum
• Erythema marginatum
• Erythema chronica migrans
• Erythema gyratum repens
• Erythema dyschromicum perstans
Fixed drug eruption
Necrolytic migratory erythema (glucagonoma)
Physical agents –
• Heat (erythema ab igne, first degree burn)
• Cold
• Trauma
 Chapter 1. The Basics: Skin Types, Definitions... 11

Postinflammatory erythema
Scarlet fever
Staph/strep toxic shock syndrome
Toxic erythema (drug, infection, systemic disease)
Ultraviolet exposure
Urticaria
Urticaria pigmentosa
Vascular nevi
Viral exanthems (i.e. nterovirus, hepatitis, mononucleosis,

measles, roseola, erythema infectiosum)

Atrophic Patches

Acrodermatitis chronica atrophicans

Anetoderma
Aplasia cutis congenita
Atrophic lichen planus
Atrophie blanche
Atrophoderma of Pasini and Pierini
Chronic graft vs. host reaction
Extramammary Paget’s
Focal dermal hypoplasia
Follicular atrophoderma
Leprosy
Lichen sclerosus et atrophicus
Lupus erythematosus
Macular atrophy
Malignant atrophic papulosis (Degos disease)
Meischer’s granuloma (giant cell elastophagocytosis)
Morphea
Necrobiosis lipoidica diabeticorum
Nevus lipomatosus
Sarcoidosis
Steroid application or injection
Striae
Syphilis, tertiary
12 E. R. Rae et al.

Papules and Plaques

Red Papules

Arthropod reaction
Bacteremia (i.e. meningococcal, gonococcal)
Disseminated candidiasis
Eruptive xanthomas
Folliculitis (i.e. bacterial, candidal, eosinophilic, fungal,

viral)
Gianotti-Crosti syndrome (children-acral only; hepatitis B,
EBV)
Guttate Psoriasis
Hot tub folliculitis (Pseudomonas)
Lymphomatoid papulosis
Miliaria rubra/profunda
Papular drug eruption
Pityriasis lichenoides et varioliformis acuta
Scabies
Secondary Syphilis
Viral exanthem

Annular Papules

Alopecia mucinosa
Arthropod reaction
Basal cell carcinoma
Contact dermatitis
Dermatophyte infections
Elastosis perforans serpiginosa
Erythema elevatum diutinum
Granuloma annulare
Leiomyoma
Lichen planus
Lymphocytic infiltrate of Jessner
Lymphocytoma cutis
Lymphoma/leukemia cutis
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 Chapter 1. The Basics: Skin Types, Definitions... 13

Leishmaniasis
Mastocytoma
Meischer’s granuloma (giant cell elastophagocytosis)
Necrobiosis lipoidica diabeticorum
Nummular eczema
Sarcoidosis
Syphilis, secondary or tertiary

Hyperkeratotic Papules

Acquired perforating dermatosis (Kyrle’s disease)

Acrokeratosis verruciformis of Hopf
Actinic keratosis
Arsenic ingestion
Confluent reticulate papillomatosis (Gougerot-Carteaud)
Cutaneous horn
Darier’s disease
Elastosis perforans serpiginosa (elastic fibers)
Epidermal nevi (Inflammatory Linear Verrucous Epidermal
Nevus – ILVEN)
Follicular lichen planus
Incontinentia pigmenti (verrucous stage)
Keratoacanthoma
Keratosis pilaris
Keratosis punctata
Lichen spinulosus
Lichen striatus
Lithium ingestion
Localized epidermolytic hyperkeratosis
Perforating folliculitis
Phrynoderma
Pityriasis rubra pilaris
Porokeratosis
Psoriasis
Reactive perforating collagenosis (collagen fibers)
Seborrheic keratosis
Verruca vulgaris/plana
14 E. R. Rae et al.

Lichenoid Papules

Bowenoid papulosis (genitals)

Cowden’s disease (lichenoid papules on the face)
Gianotti-Crosti (acral lichenoid papules)
Lichen amyloidosis
Lichen myxedematosus
Lichen nitidus
Lichen planus
Lichen sclerosus et atrophicus
Lichen simplex chronicus
Lichen spinulosus
Lichen striatus
Lichenoid actinic keratosis
Lichenoid drug eruption
Lichenoid seborrheic keratosis
Papular granuloma annulare
Sarcoidosis
Secondary syphilis
Tuberculosis cutis lichenoides (lichen scrofulosorum)
Verruca plana

Linear Papules

Contact dermatitis
Granuloma annulare
Herpes zoster (usually vesicular)
Ichthyosis hystrix
Insect bites
Jellyfish stings (usually vesicular)
Koebnerization (i.e. lichen planus, psoriasis, verruca vulgaris)
Linear epidermal nevus
Lichen planus
Linear porokeratosis
Lichen nitidus
Lichen striatus
 Chapter 1. The Basics: Skin Types, Definitions... 15

Linear verruca vulgaris/plana

Nevus unius lateris
Nevus verrucosus
Sporotrichosis

Red Plaques

Actinic keratosis
Acute hemorrhagic edema of infancy
Alopecia mucinosa
Amelanotic melanoma
Bowen’s disease
Discoid lupus
Eosinophilic granuloma
Erysipelas
Erythema elevatum diutinum
Fixed drug eruption
Granuloma annulare
Granuloma faciale
Kaposi’s sarcoma
Langerhan’s cell histiocytosis (intertriginous areas)
Leishmaniasis
Leprosy
Leukemia/lymphoma cutis
Lupus vulgaris
Lymphocytic infiltrate of Jessner
Malignant angioendotheliomatosis
Mycosis fungoides
Polymorphous light eruption
Pseudolymphoma of Spiegler-Fendt
Psoriasis
Rosacea
Sarcoidosis
Seborrheic dermatitis
Superficial basal cell carcinoma
Sweet’s syndrome
16 E. R. Rae et al.

Annular Plaques

Actinic granuloma (annular elastolytic giant Cell Granuloma)

Alopecia mucinosa
Basal cell carcinoma
Bowen’s disease
Cutaneous larva migrans
Deep fungal infection
Discoid lupus erythematosus
Eosinophilic annular erythema
Erysipeloid
Erythema annulare centrifugum
Erythema chronicum migrans (Lyme disease)
Erythema multiforme
Factitial dermatitis
Fixed drug eruption
Granuloma annulare
Granuloma faciale
Leprosy
Leukemia/lymphoma cutis
Lichen planus
Lichen sclerosus et atrophicus
Lichen simplex chronicus
Lupus vulgaris
Lymphocytic infiltrate of Jessner
Lymphocytoma cutis
Morphea
Mycosis fungoides
Necrobiosis lipoidica diabeticorum
Necrolytic migratory erythema
Nummular eczema
Papular mucinosis
Parapsoriasis
Polymorphous light eruption
Porokeratosis of Mibelli
Psoriasis
Sarcoidosis
Seborrheic dermatitis
 Chapter 1. The Basics: Skin Types, Definitions... 17

Syphilis, secondary
Tinea
Urticaria

Nodules and Tumors

Table 1.6 Dermal tumors and nodules
Dermal tumor/nodule Diseases
Appendageal Adenoma sebaceum
Chondroid syringoma
Clear cell acanthoma
Clear cell hidradenoma
Cylindroma
Eccrine acrospiroma
Eccrine poroma
Eccrine spiradenoma
Eruptive vellus hair cyst
Hydrocystoma
Nevus sebaceous
Pilomatrixoma
Sebaceous adenoma (consider
Muir-Torre syndrome)
Sebaceous epithelioma (consider
Muir-Torre syndrome)
Sweet’s syndrome
Syringoma
Trichoepithelioma
Trichofolliculoma
Tricholemmoma
Malignancy Cutaneous metastases
Kaposi’s sarcoma
Keratoacanthoma
Keratoacanthoma/squamous cell
carcinoma
Leukemia/lymphoma cutis
Mycosis fungoides
Nodular basal/squamous cell
carcinoma
Nodular melanoma
Various soft tissue sarcomas
(continued)
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 CHAPTER VI
MAGNETS AND MAGNETISM

In many parts of the world there is to be found a kind of iron ore,

some specimens of which have the peculiar power of attracting iron,
and of turning to the north if suspended freely. This is called the
lodestone, and it has been known from very remote times. The name
Magnetism has been given to this strange property of the lodestone,
but the origin of the name is not definitely known. There is an old
story about a shepherd named Magnes, who lived in Phrygia in Asia
Minor. One day, while tending his sheep on Mount Ida, he happened
to touch a dark coloured rock with the iron end of his crook, and he
was astonished and alarmed to find that the rock was apparently
alive, for it gripped his crook so firmly that he could not pull it away.
This rock is said to have been a mass of lodestone, and some
people believe that the name magnet comes from the shepherd
Magnes. Others think that the name is derived from Magnesia, in
Asia Minor, where the lodestone was found in large quantities; while
a third theory finds the origin in the Latin word magnus, heavy, on
account of the heavy nature of the lodestone. The word lodestone
itself comes from the Saxon laeden, meaning to lead.
It is fairly certain that the Chinese knew of the lodestone long
before Greek and Roman times, and according to ancient Chinese
records this knowledge extends as far back as 2600 b.c. Humboldt,
in his Cosmos, states that a miniature figure of a man which always
turned to the south was used by the Chinese to guide their caravans
across the plains of Tartary as early as 1000 b.c. The ancient Greek
and Roman writers frequently refer to the lodestone. Thales, of
whom we spoke in Chapter I., believed that its mysterious power
was due to the possession of a soul, and the Roman poet Claudian
imagined that iron was a food for which the lodestone was hungry.
Our limited space will not allow of an account of the many curious
speculations to which the lodestone has given rise, but the following
suggestion of one Famianus Strada, quoted from Houston’s
Electricity in Every-Day Life, is really too good to be omitted.
“Let there be two needles provided of an equal Length and
Bigness, being both of them touched by the same lodestone; let the
Letters of the Alphabet be placed on the Circles on which they are
moved, as the Points of the Compass under the needle of the
Mariner’s Chart. Let the Friend that is to travel take one of these with
him, first agreeing upon the Days and Hours wherein they should
confer together; at which times, if one of them move the Needle, the
other Needle, by Sympathy, will move unto the same letter in the
other instantly, though they are never so far distant; and thus, by
several Motions of the Needle to the Letters, they may easily make
up any Words or Sense which they have a mind to express.” This is
wireless telegraphy in good earnest!
The lodestone is a natural magnet. If we rub a piece of steel with
a lodestone we find that it acquires the same properties as the latter,
and in this way we are able to make any number of magnets, for the
lodestone does not lose any of its own magnetism in the process.
Such magnets are called artificial magnets. Iron is easier to
magnetize than steel, but it soon loses its magnetism, whereas steel
retains it; and the harder the steel the better it keeps its magnetism.
Artificial magnets, therefore, are made of specially hardened steel. In
this chapter we shall refer only to steel magnets, as they are much
more convenient to use than the lodestone, but it should be
remembered that both act in exactly the same way. We will suppose
that we have a pair of bar magnets, and a horse-shoe magnet, as
shown in Fig. 13.
If we roll a bar magnet amongst iron filings we find that the filings
remain clinging to it in two tufts, one at each end, and that few or
none adhere to the middle. These two points towards which the
filings are attracted are called the poles of the magnet. Each pole
attracts filings or ordinary needles, and one or two experiments will
show that the attraction becomes evident while the magnet is still
 some little distance away. If,
however, we test our magnet
with other substances, such
as wood, glass, paper, brass,
etc., we see that there is no
attraction whatever.
If one of our bar magnets
is suspended in a sort of
stirrup of copper wire attached
to a thread, it comes to rest in
a north and south direction,
and it will be noticed that the
end which points to the north
Fig. 13.—Horse-shoe and Bar Magnets, is marked, either with a letter
with Keepers. N or in some other way. This
is the north pole of the
magnet, and of course the other is the south pole. If now we take our
other magnet and bring its north pole near each pole of the
suspended magnet in turn, we find that it repels the other north pole,
but attracts the south pole. Similarly, if we present the south pole, it
repels the other south pole, but attracts the north pole. From these
experiments we learn that both poles of a magnet attract filings or
needles, and that in the case of two magnets unlike poles attract, but
similar poles repel one another. It will be noticed that this
corresponds closely with the results of our experiments in Chapter I.,
which showed that an electrified body attracts unelectrified bodies,
such as bits of paper or pith balls, and that unlike charges attract,
and similar charges repel each other. So far as we have seen,
however, a magnet attracts only iron or steel, whereas an electrified
body attracts any light substance. As a matter of fact, certain other
substances, such as nickel and cobalt, are attracted by a magnet,
but not so readily as iron and steel; while bismuth, antimony,
phosphorus, and a few other substances are feebly repelled.
The simplest method of magnetizing a piece of steel by means
of one of our bar magnets is the following: Lay the steel on the table,
and draw one pole of the magnet along it from end to end; lift the
magnet clear of the steel, and repeat the process several times,
always starting at the same end and treating each surface of the
steel in turn. A thin, flat bar of steel is the best for the purpose, but
steel knitting needles may be made in this way into useful
experimental magnets.
We have seen that a magnet has two poles or points where the
magnetism is strongest. It might be thought that by breaking a bar
magnet in the middle we should get two small bars each with a
single pole, but this is not the case, for the two poles are
inseparable. However many pieces we break a magnet into, each
piece is a perfect magnet having a north and south pole. Thus while
we can isolate a positive or a negative charge of electricity, we
cannot isolate north or south magnetism.
If we place the north pole of a bar magnet near to, but not
touching, a bar of soft iron, as in Plate II.a, we find that the latter
becomes a magnet, as shown by its ability to support filings; and that
as soon as the magnet is removed the filings drop off, showing that
the iron has lost its magnetism. If the iron is tested while the magnet
is in position it is found to have a south pole at the end nearer the
magnet, and a north pole at the end farther away; and if the magnet
is reversed, so as to bring its south pole nearer the iron, the poles of
the latter are found to reverse also. The iron has gained its new
properties by magnetic induction, and we cannot fail to notice the
similarity between this experiment and that in Fig. 2, Chapter II.,
which showed electro-static induction. A positively or a negatively
electrified body induces an opposite charge at the nearer end, and a
similar charge at the further end of a conductor, and a north or a
south pole of a magnet induces opposite polarity at the nearer end,
and a similar polarity at the further end of a bar of iron. In Chapter II.
we showed that the attraction of a pith ball by an electrified body was
due to induction, and from what we have just learnt about magnetic
induction the reader will have no difficulty in understanding why a
magnet attracts filings or needles.
 PLATE II.

(a) EXPERIMENT TO SHOW MAGNETIC INDUCTION.

(b) EXPERIMENT TO SHOW THE PRODUCTION OF MAGNETISM

BY AN ELECTRIC CURRENT.

Any one who experiments with magnets must be struck with the
distance at which one magnet can influence filings or another
magnet. If a layer of iron filings is spread on a sheet of paper, and a
magnet brought gradually nearer from above, the filings soon begin
to move about restlessly, and when the magnet comes close enough
they fly up to it as if pulled by invisible strings. A still more striking
experiment consists in spreading filings thinly over a sheet of
cardboard and moving a magnet to and fro underneath the sheet.
The result is most amusing. The filings seem to stand up on their
hind legs, and they march about like regiments of soldiers. Here
again invisible strings are suggested, and we might wonder whether
there really is anything of the kind. Yes, there is. To put the matter in
the simplest way, the magnet acts by means of strings or lines of
force, which emerge from it in definite directions, and in a most
interesting way we can see some of these lines of force actually at
work.
Place a magnet, or any arrangement of magnets, underneath a
sheet of glass, and sprinkle iron filings from a muslin bag thinly and
evenly all over the glass. Then tap the glass gently with a pencil, and
the filings at once arrange themselves in a most remarkable manner.
All the filings become magnetized by induction, and when the tap
sets them free for an instant from the friction of the glass they take
up definite positions under the influence of the force acting upon
them. In this way we get a map of the general direction of the
magnetic lines of force, which are our invisible strings.
Many different maps may be made in this way, but we have
space for only two. Plate III.a shows the lines of two opposite poles.
Notice how they appear to stream across from one pole to the other.
It is believed that there is a tension along the lines of force not unlike
that in stretched elastic bands, and if this is so it is easy to see from
the figure why opposite poles attract each other.
Plate III.b shows the lines of force of two similar poles. In this
case they do not stream from pole to pole, but turn aside as if
repelling one another, and from this figure we see why there is
repulsion between two similar poles. It can be shown, although in a
much less simple manner, that lines of electric force proceed from
electrified bodies, and in electric attraction and repulsion between
two charged bodies the lines of force take paths which closely
resemble those in our two figures. A space filled with lines of
magnetic force is called a magnetic field, and one filled with lines of
electric force is called an electric field.
A horse-shoe magnet, which is simply a bar of steel bent into the
shape of a horse-shoe before being magnetized, gradually loses its
magnetism if left with its poles unprotected, but this loss is prevented
if the poles are connected by a piece of soft iron. The same loss
occurs with a bar magnet, but as the two poles cannot be connected
in this way it is customary to keep two bar magnets side by side,
separated by a strip of wood; with opposite poles together and a
piece of soft iron across the ends. Such pieces of iron are called
keepers, and Fig. 13 shows a horse-shoe magnet and a pair of bar
magnets with their keepers. It may be remarked that a magnet never
should be knocked or allowed to fall, as rough usage of this kind
causes it to lose a considerable amount of its magnetism. A magnet
is injured also by allowing the keeper to slam on to it; but pulling the
keeper off vigorously does good instead of harm.
If a magnetized needle is suspended so that it is free to swing
either horizontally or vertically, it not only comes to rest in a north
and south direction, but also it tilts with its north-pointing end
downwards. If the needle were taken to a place south of the equator
it would still tilt, but the south-pointing end would be downwards. In
both cases the angle the needle makes with the horizontal is called
the magnetic dip.
 PLATE III.
(a) LINES OF MAGNETIC FORCE OF TWO OPPOSITE POLES.
 (b) LINES OF MAGNETIC FORCE OF TWO SIMILAR POLES.

It is evident that a suspended magnetized needle would not

invariably come to rest pointing north and south unless it were
compelled to do so, and a little consideration shows that the needle
acts as if it were under the influence of a magnet. Dr. Gilbert of
Colchester, of whom we spoke in Chapter I., gave a great deal of
time to the study of magnetic phenomena, and in 1600 he
announced what may be regarded as his greatest discovery: The
terrestrial globe itself is a great magnet. Here, then, is the
explanation of the behaviour of the magnetized needle. The Earth
itself is a great magnet, having its poles near to the geographical
north and south poles. But a question at once suggests itself: “Since
similar poles repel one another, how is it that the north pole of a
magnet turns towards the north magnetic pole of the earth?” This
apparent difficulty is caused by a confusion in terms. If the Earth’s
north magnetic pole really has north magnetism, then the north-
pointing end of a magnet must be a south pole; and on the other
hand, if the north-pointing end of a magnet has north magnetism,
then the Earth’s north magnetic pole must be really a south pole. It is
a troublesome matter to settle, but it is now customary to regard the
Earth’s north magnetic pole as possessing south magnetism, and
the south magnetic pole as possessing north magnetism. In this way
the north-pointing pole of a magnet may be looked upon as a true
north pole, and the south-pointing pole as a true south pole.
Magnetic dip also is seen to be a natural result of the Earth’s
magnetic influence. Here in England, for instance, the north
magnetic pole is much nearer than the south magnetic pole, and
consequently its influence is the stronger. Therefore a magnetized
needle, if free to do so, dips downwards towards the north. At any
place where the south magnetic pole is the nearer the direction of
the dip of course is reversed. If placed immediately over either
magnetic pole the needle would take up a vertical position, and at
the magnetic equator it would not dip at all, for the influence of the
two magnetic poles would be equal. A little study of Fig. 14, which
represents a dipping needle at different parts of the earth, will make
this matter clearer. N and S represent the Earth’s north and south
magnetic poles, and the arrow heads are the north poles of the
needles.
Since the Earth is a
magnet, we should expect it to
be able to induce magnetism
in a bar of iron, just as our
artificial magnets do, and we
can show that this is actually
the case. If a steel poker is
held pointing to and dipping
down towards the north, and
struck sharply with a piece of
wood while in this position, it
Fig. 14.—Diagram to illustrate Magnetic acquires magnetic properties
Dip. which can be tested by means
of a small compass needle. It
is an interesting fact that iron pillars and railings which have been
standing for a long time in one position are found to be magnetized.
In the northern hemisphere the bases of upright iron pillars are north
poles, and their upper ends south poles, and in the southern
hemisphere the polarity is reversed.
The most valuable application of the magnetic needle is in the
compass. An ordinary pocket compass for inland use consists simply
of a single magnetized needle pivoted so as to swing freely over a
card on which are marked the thirty-two points of the compass.
Ships’ compasses are much more elaborate. As a rule a compound
needle is used, consisting of eight slender strips of steel, magnetized
separately, and suspended side by side. A compound needle of this
kind is very much more reliable than a single needle. The material of
which the card is made depends upon whether the illumination for
night work is to come from above or below. If the latter, the card must
be transparent, and it is often made of thin sheet mica; but if the light
comes from above, the card is made of some opaque material, such
as very stout paper. The needle and card are contained in a sort of
bowl made of copper. In order to keep this bowl in a horizontal
position, however the ship may be pitching and rolling, it is supported
on gimbals, which are two concentric rings attached to horizontal
pivots, and moving in axes at right angles to one another. Further
stability may be obtained by weighting the bottom of the bowl with
lead. There are also liquid compasses, in which the card is floated
on the surface of dilute alcohol, and many modern ships’ compasses
have their movements regulated by a gyrostat.
The large amount of iron and steel used in the construction of
modern vessels has a considerable effect upon the compass needle,
and unless the compass is protected from this influence its readings
are liable to serious errors. The most satisfactory way of giving this
protection is by placing on each side of the compass a large globe of
soft iron, twelve or more inches in diameter.
On account of the fact that the magnetic poles of the Earth do
not coincide with the geographical north and south poles, a compass
needle seldom points exactly north and south, and the angle
between the magnetic meridian and the geographical meridian is
called the declination. The discovery that the declination varies in
different parts of the world was made by Columbus in 1492. For
purposes of navigation it is obviously very important that the
declination at all points of the Earth’s surface should be known, and
special magnetic maps are prepared in which all places having the
same declination are joined by a line.
It is an interesting fact that the Earth’s magnetism is subject to
variation. The declination and the dip slowly change through long
periods of years, and there are also slight annual and even daily
variations.
At one time magnets were credited with extraordinary effects
upon the human body. Small doses of lodestone, ground to powder
and mixed with water, were supposed to prolong life, and
Paracelsus, a famous alchemist and physician, born in Switzerland
in 1493, believed in the potency of lodestone ointment for wounds
made with steel weapons. Baron Reichenbach, 1788–1860, believed
that he had discovered the existence of a peculiar physical force
closely connected with magnetism, and he gave this force the name
Od. It was supposed to exist everywhere, and, like magnetism, to
have two poles, positive and negative; the left side of the body being
od-positive, and the right side od-negative. Certain individuals,
known as “sensitives,” were said to be specially open to its influence.
These people stated that they saw strange flickering lights at the
poles of magnets, and that they experienced peculiar sensations
when a magnet was passed over them. Some of them indeed were
unable to sleep on the left side, because the north pole of the Earth,
being od-negative, had a bad effect on the od-negative left side. The
pretended revelations of these “sensitives” created a great stir at the
time, but now nobody believes in the existence of Od.
Professor Tyndall was once invited to a seance, with the object
of convincing him of the genuineness of spiritualism. He sat beside a
young lady who claimed to have spiritualistic powers, and his record
of his conversation with her is amusing. The Reichenbach craze was
in full swing at the time, and Tyndall asked if the lady could see any
of the weird lights supposed to be visible to “sensitives.”

“Medium.—Oh yes; but I see the light around all bodies.

I.—Even in perfect darkness?
Medium.—Yes; I see luminous atmospheres round all
people. The atmosphere which surrounds Mr. R. C. would fill this
room with light.
I.—You are aware of the effects ascribed by Baron
Reichenbach to magnets?
Medium.—Yes; but a magnet makes me terribly ill.
I.—Am I to understand that, if this room were perfectly dark,
you could tell whether it contained a magnet, without being
informed of the fact?
Medium.—I should know of its presence on entering the
room.
I.—How?
Medium.—I should be rendered instantly ill.
 I.—How do you feel to-day?
Medium.—Particularly well; I have not been so well for
months.
I.—Then, may I ask you whether there is, at the present
moment, a magnet in my possession?
The young lady looked at me, blushed, and stammered, ‘No;
I am not en rapport with you.’
I sat at her right hand, and a left-hand pocket, within six
inches of her person, contained a magnet.”

Tyndall adds, “Our host here deprecated discussion as it

‘exhausted the medium.’”
 CHAPTER VII
THE PRODUCTION OF MAGNETISM BY
ELECTRICITY

Fig. 15.—Diagram to illustrate Magnetic effect of

an Electric Current.

In the previous chapter attention was drawn to the fact that there are
many close parallels between electric and magnetic phenomena,
and in this chapter it will be shown that magnetism can be produced
by electricity. In the year 1819 Professor Oersted, of the University of
Copenhagen, discovered that a freely swinging magnetized needle,
such as a compass needle, was deflected by a current of electricity
flowing through a wire. In Fig. 15, A, a magnetic needle is shown at
rest in its usual north and south direction, and over it is held a copper
wire, also pointing north and south. A current of electricity is now
sent through the wire, and the needle is at once deflected, Fig. 15, B.
The direction of the current is indicated by an arrow, and the
direction in which the needle has moved is shown by the two small
arrows. If the direction of the current is reversed, the needle will be
deflected in the opposite direction. From this experiment we see that
the current has brought magnetic influences into play, or in other
words has produced magnetism. If iron filings are brought near the
wire while the current is flowing, they are at once attracted and cling
to the wire, but as soon as the current is stopped they drop off. This
shows us that the wire itself becomes a magnet during the passage
of the current, and that it loses its magnetism when the current
ceases to flow.
Further, it can be shown that
two freely moving parallel wires
conveying currents attract or
repel one another according to
the direction of the currents. If
both currents are flowing in the
same direction the wires attract
one another, but if the currents
flow in opposite directions the
wires repel each other. Fig. 16
shows the direction of the lines
of force of a wire conveying a
current and passed through a
horizontal piece of cardboard
covered with a thin layer of iron Fig. 16.—Magnetic Field round wire
conveying a Current.
filings; and from this figure it is
evident that the passage of the
current produces what we may call magnetic whirls round the wire.
A spiral of insulated wire through which a current is flowing
shows all the properties of a magnet, and if free to move it comes to
rest pointing north and south. It is attracted or repelled by an
ordinary magnet according to the pole presented to it and the
direction of the current, and two such spirals show mutual attraction
and repulsion. A spiral of this kind is called a solenoid, and in
addition to the properties already mentioned it has the peculiar
power of drawing or sucking into its interior a rod of iron. Solenoids
have various practical applications, and in later chapters we shall
refer to them again.
If several turns of cotton-covered wire are wound round an iron
rod, the passing of a current through the wire makes the rod into a
magnet (Plate II.b), but the magnetism disappears as soon as the
current ceases to flow. A magnet made by the passage of an electric
current is called an electro-magnet, and it has all the properties of
the magnets mentioned in the previous chapter. A bar of steel may
be magnetized in the same way, but unlike the iron rod it retains its
magnetism after the current is interrupted. This provides us with a
means of magnetizing a piece of steel much more strongly than is
possible by rubbing with another magnet. Steel magnets, which
retain their magnetism, are called permanent magnets, as
distinguished from electro-magnets in which soft iron is used, so that
their magnetism lasts only as long as the current flows.
Electro-magnets play an extremely important part in the
harnessing of electricity; in fact they are used in one form or another
in almost every kind of electrical mechanism. In later chapters many
of these uses will be described, and here we will mention only the
use of electro-magnets for lifting purposes. In large engineering
works powerful electro-magnets, suspended from some sort of
travelling crane, are most useful for picking up and carrying about
heavy masses of metal, such as large castings. No time is lost in
attaching the casting to the crane; the magnet picks it up directly the
current is switched on, and lets it go the instant the current is
stopped. In any large steel works the amount of scrap material
produced is astonishingly great, hundreds of tons of turnings and
similar scrap accumulating in a very short time. A huge mound of
turnings is awkward to deal with by ordinary manual labour, but a
combination of electro-magnet and crane solves the difficulty
completely, lifting and loading the scrap into carts or trucks at
considerable speed, and without requiring much attention.
Some time ago a disastrous fire occurred at an engineering
works in the Midlands, the place being almost entirely burnt out.
Amongst the débris was, of course, a large amount of metal, and as
this was too valuable to be wasted, an electro-magnet was set to
work on the wreckage. The larger pieces of metal were picked up in
the ordinary way, and then the remaining rubbish was shovelled
against the face of the magnet, which held on to the metal but
dropped everything else, and in this way some tons of metal were
recovered.
The effect produced upon a magnetized needle by a current of
electricity affords a simple means of detecting the existence of such
a current. An ordinary pocket compass can be made to show the
presence of a moderate current, but for the detection of extremely
small currents a much more sensitive apparatus is employed. This is
called a galvanometer, and in its simplest form it consists essentially
of a delicately poised magnetic needle placed in the middle of a coil
of several turns of wire. The current thus passes many times round
the needle, and this has the effect of greatly increasing the deflection
of the needle, and hence the sensitiveness of the instrument.
Although such an arrangement is generally called a galvanometer, it
is really a galvanoscope, for it does not measure the current but only
shows its presence.
We have seen that electro-motive force is measured in volts, and
that the definition of a volt is that electro-motive force which will
cause a current of one ampere to flow through a conductor having a
resistance of one ohm. If we make a galvanometer with a long coil of
very thin wire having a high resistance, the amount of current that
will flow through it will be proportionate to the electro-motive force.
Such a galvanometer, fitted with a carefully graduated scale, in this
way will indicate the number of volts, and it is called a voltmeter. If
we have a galvanometer with a short coil of very thick wire, the
resistance put in the way of the current is so small that it may be left
out of account, and by means of a graduated scale the number of
amperes may be shown; such an instrument being called an
amperemeter, or ammeter.
For making exact measurements of electric currents the
instruments just described are not suitable, as they are not
sufficiently accurate; but their working shows the principle upon
which currents are measured. The actual instruments used in
electrical engineering and in scientific work are unfortunately too
complicated to be described here.
 CHAPTER VIII
THE INDUCTION COIL

The voltaic cell and the accumulator provide us with currents of

electricity of considerable volume, but at low pressure or voltage. For
many purposes, however, we require a comparatively small amount
of current at very high pressure, and in such cases we use an
apparatus called the induction coil. Just as an electrified body and a
magnet will induce electrification and magnetism respectively, so a
current of electricity will induce another current; and an induction coil
is simply an arrangement by which a current in one coil of wire is
made to induce a current in another coil.
Suppose we have two coils of wire placed close together, one
connected to a battery of voltaic cells, with some arrangement for
starting and stopping the current suddenly, and the other to a
galvanometer. As soon as we send the current through the first coil,
the needle of the galvanometer moves, showing that there is a
current flowing through the second coil; but the needle quickly
comes back to its original position, showing that this current was only
momentary. So long as we keep the current flowing through the first
coil the galvanometer shows no further movement, but as soon as
we stop the current the needle again shows by its movements that
another momentary current has been produced in the second coil.
This experiment shows us that a current induces another current
only at the instant it is started or stopped, or, as we say, at the
instant of making or breaking the circuit.
The coil through which we send the battery current is called the
“primary coil,” and the one in which a current is induced is called the
“secondary coil.” The two momentary currents in the secondary coil
do not both flow in the same direction. The current induced on
making the circuit flows in a direction opposite to that of the current
in the primary coil; and the current induced on breaking the circuit
flows in the same direction as that in the primary coil. If the two coils
are exactly alike, the induced current will have the same voltage as
the primary current; but if the secondary coil has twice as many turns
of wire as the primary coil, the induced current will have twice the
voltage of the primary current. In this way, by multiplying the turns of
wire in the secondary coil, we can go on increasing the voltage of the
induced current, and this is the principle upon which the induction
coil works.
We may now describe the construction of such a coil. The
primary coil is made of a few turns of thick copper wire carefully
insulated, and inside it is placed a core consisting of a bundle of
separate wires of soft iron. Upon this coil, but carefully insulated from
it, is wound the secondary coil, consisting of a great number of turns
of very fine wire. In large induction coils the secondary coil has
thousands of times as many turns as the primary, and the wire
forming it may be more than a hundred miles in length. The ends of
the secondary coil are brought to terminals so that they can be
connected up to any apparatus as desired.
In order that the induced currents
shall follow each other in quick
succession, some means of rapidly
making and breaking the circuit is
required, and this is provided by an
automatic contact breaker. It consists
of a small piece of soft iron, A, Fig.
17, fixed to a spring, B, having a
platinum tip at C. The adjustable
screw, D, also has a platinum tip, E.
Normally the two platinum tips are
just touching one another, and Fig. 17.—Diagram showing
matters are arranged so that their working of Contact-Breaker for
contact completes the circuit. When Induction Coil.
the apparatus is connected to a
suitable battery a current flows through the primary coil, and the iron