R Emplast. saponis, 3iij; 90
Olei olivae opt., 3ij; 8
Acid. salicylici, 3ss; 2 M
For a 5 per cent. plaster (Hyde):
R Emplast, sasponis, 3j; 30
Olei olivae mxxiv; 1 6
Acid, salicylici, gr. xxic; 1 6 M.
For a 10 per cent. plaster:
R Emplast, saponis, 3j; 30
Acid. salicylici, gr.xlc; 3 M.
For a 20 per cent. Plaster:
R Emplast. plumbi, 3j; 30
Cerae flavae, gr.xlv; 3
Acid. salicylici, gr.xc; 6 M.
Tar in some form is a valuable remedy but the weaker preparations should always be employed at first, or a mild ointment alternated. The following will illustrate:
R Pricis liquidae, 3j; 30
Sapon, virid., 3jss; 45
Glycerin., 3j; 30
Spt.vin.rectif., 3viij; 240
Ol. rosmarin., 3ss; 2
M. Sig. To be rubbed gently into the skin with a flannel rag.
R Ol rusci(vel cadini), 3iij; 12
Potass bicarbonat., 3ss; 2
Unguent.aq.ros., 3jl 30
M. Ft. ungt.
Bulkley’s “liquor picis alkalinus is as follows:
R Picis liquidae, 3ij; 60
Potassae causticase, 3j; 60
Aq. distillat., 3v; 150
M. Sig. Dissolve the potash in the water, and add slowly to the tar in a mortar with friction.
If used as a lotion, dissolve one dram of this solution in a pint of water, or if an ointment is desired, the same amount is added to an ounce of cold cream or other fatty base.
Special External Treatment of Regional Eczema
Eczema of the scalp in children may demand that the hair be cut short, but this is not necessary if the lesions are small or few in number. The scales or crusts must be softened with applications of fresh lard or oil, and a close-fiting cap or handkerchied tied about the head for several hours. The, after the crust has been removed with a coarse comb, the whole head may be cleansed with a mild, warm solution of borax. After drying of the surface, some simple oil or fat, such as one part of lanolin to four of sweet almond oil may be applied, and this application should be repeated once or twice daily. If pediculi complicate the local disorder, they should be destroyed first. Occasionally lathering the scalp with a mild antiseptic soap (boric acid 5 per cent.( and washing it off in hot water may suffice. the object, however, is not so much the removal of the oily application as it is the removal of the accumulated exudations of the disease. Even wiping of the old application with gauze and renewing with fresh oil will often suffice for days after the first dressing. In sqamous eczema, oxid of zinc ointment, which may be diluted with a fourth part of sweet almond oil makes a good protective dressing. Disastrous effects have followed the indiscriminate use of medicinal applications on the scalp of children. Hence, I prefer simple, non-medicated on the scalp of children. Hence, I prefer simple, non-medicated applications, except in some few cases of adult eczema of the scalp. The latter is seldom acute or exudative. When needed, the hair over the patches may be separated, the crust or scales loosened by friction with any bland oil or fat, and, after being washed or wiped off, the following application may be used:
R Boroglycerini (50 Percent), 3ij; 8
Cera. alb.,
Lanolin., aa 3j; 4
Adipis, 3jss; 45 M.
This may be repeated one or twice daily, as required, the preliminary frictions with oil being omitted. Another excellent application, recommended by Piffard, is as follows:
R Ol. ricini, 3ss; 60
Spts. vin.rect., 3ijss; 10
Ol. eucalypti, 3jss; 6 M.
A small oil-can may be employed to deposit a drop in the parting of the hair over the patch, which is well rubbed in with the finger; then another parting of the hair made and treated as before, until the whole patch has been covered. In this way only so much oil as is needed is used, and the hair away from the patch is not impregnated with it. Either of the foregoing can be used less and less frequently, as improvement goes on. If much fluid exudation is present or intervenes, the application should be discontinued and protection given to the part in the manner suggested for similar cases in children.
Eczema of the face. In children, the protection of the surface by a simple ointment or Lassar’s paste is demanded. When severe or extensive, the wearing of a linen or cotton mask may be necessary. If the ears are affected, the mask should cover them, and it is well to sterilize the surface of the ears with a solution of peroxid of hydrogen before applying an oleaginous protection. When the auditory canal is involved, applying an oleaginous protection. When the auditory canal is involved, applying an oleaginous protection. When the auditory canal is involved, small tampons smeared with the necessary ointment can be left in the canal. When the eyelids are affected care in removing and softening the crusts with bland oil, followed by a light application of benzoated lard with or without one per cent of resorcin or the yellow oxid of mercury, five grains to an ounce of vaseline, will often prove beneficial. If the nostrils are affected a boric acid or weak citrin ointment may be employed as well as the remedies just mentioned. The treatment of the conjunctiva, or of the eye proper, or of the inner portion of the lips are affected, a tendency to crack may be averted by frequent applications of bland oil, cold cream or equal parts of benzoin, alcohol and glycerin and the same applications may be made to the outer borders.
In adults, acute moist eczema of the face is treated in the same general way as with children. Erythematous eczema of the face and neck may call for the use of alcohol 5 to 20 per cent. instead of water in the bathing of the face, and the application at night of a simple ointment with the addition of an antipruritic, such as carbolic acid, 1 to 5 per cent. Eczema of the bearded part of the face must be treated as a true folliculitis. The pustules should be opened, the hairs extracted, shaving insisted upon, and hydrogen peroxid, hot borax solution or dilute electrozone used as a cleanser. During the day the patient may apply a boric acid, starch or compound stearate of sinc powder to the surface, but upon retiring a 5 to 10 per cent. ammoniated mercury ointment should be applied. It may even be necessary to X-ray the affected area. The methods mentioned for the treatment of eczema of the eyelids, nostrils, ears and lips in children may be used in the case of adults, although the relative strength of the medicaments are usually increased.
Eczema of the male genitals is most often seen in the chronic form, with much induration of the scrotum. Warmth, moisture, and the dependent position of the parts serve to perpetuate it. Careful cleansing, the application of a hygroscopic powder and the use of a suspensory bandage are to be employed. Later, a protecting ointment, covered with a few layers of antiseptic gauze, all within the supporting bandage, may be serviceable. For local pathogenetic use, iodin, soft soap, diachylon, carbolic or mercurial ointments, a 1 per cent. solution of formulin, or the high-frequency currents, may be used until the counterirritation is developed, when the soothing application is applied but the patient should always be advised of this proposed course, and his assent obtained. If the penis is involved, the inflammation is usually milder than on the scrotum, often seborrheic in character; hence, resorcin may be used in a simple basic ointment. Shaving is often necessary if the pubic region is affected before lotion or ointments can be applied. In acute forms, rest in bed is often essential, and the application of hot boric acid water, as hot as it can be borne, for a minute or two at a time, followed by boric ointment, may give relief. If the itching is severe, 3 to 6 per cent. of carbolic acid in glycerin and water, calamin, hydrocynic acid or other agents mentioned in the treatment of acute and subacute eczema may be needed.
Eczema of the female genitals is rarer and less severe than in males and ordinarily ointments should not be used. Equal parts of alcohol and rose water, or weak solutions of hydrogen peroxid, electrozone or potassium permanganate will be found effective and more convenient. If necessary any of the formulas mentioned in the previous paragraphs may be used. A T-bandage or simple napkin may be useful in some cases. The X-rays and radium have effected brilliant cures and in my opinion are more apt to relieve itching and promote healing in the female suffers than in the male cases.
Persistent eczema of the genitals in either sex should lead to examination of the urine to determine the presence of glycosuria or other irritating qualities of the secretion. Dribbling of urine from the bladder, or discharges from any of the mucous outlets may prove causative. Many genital eczemas in both sexes follow pruritus and are due to repeated and too vigorous scratching.
Eczema of the nipples and breasts occurs usually in nursing women, and the reddened, thickened, fissured and weeping surface makes nursing very painful; in fact, impossible in extreme cases. If nursing is continued, poisonous applications must not be employed even between the periods of active use. Any mild soothing lotion or ointment may be applied, such as zinc oxid, bismuth, ichthyol (one dram to the ounce of water) or a weak solution of liquor carbonic detergens, but these should be carefully removed before nursing with sweet or by a lotion of boric acid and glycerin.
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war