195. Erythema-Inflammatory Redness of the Skin.
DEFINITION.- Hyperaemia of the cutis, manifesting itself by superficial redness or blush of the skin without swelling or breach of continuity.
Erythema, especially if chronic, is sometimes due to stomachic derangement; flushing of the face after meals is a common erythematous symptom.
There is no marked itching; no heat, tension, burning, or exudation, as in erysipelas, for which it is sometimes mistaken.
EPITOME OF TREATMENT.-
Belladonna (simple redness); Aconite (febrile disturbance, and flushing of the face from excitement), Apis, Rhus, K.-Bich., Nux V. (flushing after food), Bryonia, Mang., Ferrum, Arsenicum, Ranunculus- Bulb.
ACCESSORY MEASURES.- Regular open-air exercise; sufficient time for, and freedom of the mind during meals; simple food; a nd the free use of water internally and externally. Where there is pain, a compress moistened with Goulard-water relieves.
ERYTHEMA NODOSUM.- There is a form of Erythema known by this name, and associated with Rheumatism. The spots are sometimes as large as a walnut, and raise above the surface. They occur generally on the shins, rarely above the knee, and are accompanied often by pain. Apis., Rhus., K.-Bich, are most likely to be useful, but the general condition must be treated.
196.- Intertrigo-Chafing-Soreness of Infants.
DEFINITION.- Redness and chafing produced by the friction of two folds of skin, especially in fat children and adults; it is seen in the groin, axilla, and neck; sometimes a fluid is exuded, the acridity of which increases the local mischief, and presently an offensive raw surface is produced.
EPITOME OF TREATMENT.-
Chamomilla (in infants); Calcarea carb. (tubercular children); Lycopodium (obstinate cases); Mercurius (rawness and great soreness); Sulph. The parts should be well washed with cold or tepid water, and carefully dried, two or three time a day; a piece of linen, saturated with Calendula lotion, may be laid between the opposed surfaces; or, in bad cases, a lotion composed of one part of tincture of Hydrastis of ten of Glycerine may be applied in the same manner.
Dusting the chafed parts with a fine powder consisting of equal parts of powdered Lycopodium seeds and Oxide of Zinc, or of Fuller’s earth, is very useful.
197.- Urticaria-Nettle-Rash.
DEFINITION.- A transient, non-contagious affection, characterized by an eruption of prominent patches or wheals, either redder or whiter than the natural skin, of regular or irregular shape, with heat, tingling, and itching, more or less sever. In patient subject to this disease there is often a condition of lowered blood coagulability and the administration of lime salts in such cases will relieve.
VARIETIES.- Urticaria may be acute or chronic. The acute form may be accompanied by fever and sometimes will alternate with attacks of asthma.
SYMPTOMS.- Similar to or more intense than those produced by nettle-stings. The eruption consists of elevations, occurring in streaks or wheals of an irregular shape, on a red ground; the character of the rash becomes much more marked after scratching or rubbing, “so that it is possible, by using the nail of the finger, to write one’s name on the skin;” it is generally worse in the evening, and when the body is exposed to cold air. There is much tingling and burning, and often the eruption, after disappearing suddenly from one part, shows itself in another. “In the Urticaria from irritant food-hyperaemia and burning heat are present in the most aggravated form” (Wilson). The spots contain no fluid, and do not end in desquamation. It is most common in spring and early summer, is not contagious, may occur at any age, and in the same person repeatedly.
CAUSES.- Derangement of the digestive organs, following the use of some particular kinds of the food, among which we may specify shell fish, tinned foods, acid fruits or other articles of diet for which the patient has an idiosyncrasy; and certain kinds of medicines, such as Cubebs Copaiba, Valerian, etc. It may also occur after the injection of serum, e.g., anti-tetanic serum, and is then associated with a group of symptoms to which the name “Serum Disease” is given. Also mental depression, anxiety, defective innervation, and sometimes, according to Hebra, uterine irritation. The skin being extremely sensitive, it is easily excited by external irritants-such as the wearing of flanner next in the skin, the bites of fleas, the sting of bees, etc.
Chronic, also intermittent, Urticaria is frequently associated with uterine or other diseases, and is often very obstinate. Cold, damp, rapid changes of temperature, and Dentition, favour its development in patients predisposed.
EPITOME OF TREATMENT.-
1. Simple Urticaria.- Apis., Urt.-U., Aconite, Chlorum-Hyd.
2. From Gastric Disorder.- Ant.-C. Nux V., Pulsatilla
3. From cold.- Aconite (from draughts and cold winds); Dulcamara (from damp).
4. Associated with other affections.- Bryonia, Cimic., Rush (rheumatic patients); Colchicum (gouty subjects); Arsenicum, Ipecac. (Asthma); Pulsatilla, Hydras. (uterine irregularities).
5. Chronic cases.-Arsenicum, China-Sulph. (intermittent); Apis. Sulph., Chlorum- Hyd.
6. Special Symptoms.- Aconite (febrile disturbance); Chlor-Hyd. (appearing when warm in bed); Bryonia (sudden retrocession); Ignatia, Anacardium (mental depression and confusion); Coffea(sleeplessness and nervous irritability).
ACCESSORY MEASURES.- A general warm both is invaluable; it soothes the skin and often cures at once. When the eruption is thoroughly out, the heat an irritation may be materially alleviated by smearing the whole surface of the body with lanoline, or the parts may be rubbed with slices of lemon.
HYGIENE.- A dry, uniform, and moderate temperature; plain food; plenty of open-air exercise; great cleanliness; Draughts, change of temperature, indigestible food, and all exciting causes must be removed and avoided. If flannel be worn it should be over a garment of a different material.
198.- Prurigo-Itching of the Skin.
DEFINITION.- “A chronic affection of the skin, characterised by a thickened and discolored state of the surface, with excessive itching, and, generally an eruption of papuloe.”
SYMPTOMS.- Intense itching, and creeping sensation; patients scratch and tear themselves till the blood flows; their sleep is frequently disturbed, and their existence is thus often rendered almost unendurable; or the impulse to incessant scratching is so powerful as to induce the patient to seek seclusion. Sometimes the itching is diffused irregularly over the surface; at other times it affects the extremities; frequently it occurs round the anus, or on the scrotum, or on the female genitals. It is often a horrible and most obstinate disease.
CAUSES.- Prurigo is specially apt to occur at the two extremes of life and is probably a blood disorder with irritability of the nerve endings in the skin. Irritation of the alimentary tract by improper food is liable to commence the disease and it is greatly influenced by unhealthy surroundings. In uncleanly persons it may be associated with scabies or pediculi. It may predispose to some existing chronic disease.
TREATMENT.- Aconitum.- Furious itching all over the skin, with febrile symptoms.
Sulphur.- Severe itching, attended with thirst and dryness of the skin, worse in the evening, and in bed. This is generally a prominent remedy, and it is frequently specific, especially in recent cases.
Arsenicum.- Itching with burning; or an eruption emitting watery fluid like sweat, and attended with much constitutional weakness. It is most suitable in chronic cases.
Ignatia.– Itching of the skin, of a fine pricking character, resembling flea-bites, and changing from one part to another.
Other remedies are sometimes required:– Mercurius, Dolichos., Fagopyrum., Carbo V., Rhus., Mez., Apocy., Causticum Radium produces most intense itching, and Radium will sometimes effect a striking cure in this disease, either in potencies or by local application in the hands of an expert.
ACCESSORY MEANS.– The skin must be strengthened by wholesome and regular diet, frequent exercise in a bracing air, and daily ablutions with cold or tepid water, shower-baths, etc. Without these measures medicine will be of the little permanent use. Stimulating food or drink, pastry, rich sauces, pickles, and indigestible food generally, must not be indulged in. The use of ointments is generally injurious. Scratching must be avoided. in several cases, temporary relief may be obtained by bathing the parts with alcohol and water in equal proportions; or with Mezereum lotion ( one part of ten of water); or by sponging the skin, on retiring to bed, with a warm infusion made by pouring boiling water on bran.
The Wet Compress.– Prurigo, if confined to one or two places, is much benefited by the constant use of a wet compress over the affected part; for although it often increases the irritation at first, it finally assists nature in expelling the morbid matter.
SCRATCHING.– Notwithstanding the incentive to scratching in Prurigo and other skin affections, the practice greatly aids in keeping up the irritation and increasing the disease. On this point the following remarks by Dr. Tilbury Fox will express a condition we have often observed:–
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."