GENERAL SYMPTOMS.– In addition to what is stated above, there is often a feeling of malaise– feverishness, Headache, shivering– and, perhaps, neuralgic pain in the inside, which may be very acute, especially in Shingles. The disease is mostly accompanied by sensation of heat, tension, and burning, felt even before the appearance of the eruption, and is followed by weakness and depression. When in the disease occurs in the aged, or in persons of feeble constitution, there is much debility, and Ulceration may arise, further debilitating the patient.
CAUSE.– Irritation of the nerves– as when Catarrh affects the air passages, and Herpes is developed on the nose or lips; or during the course of other diseases.
EPITOME OF TREATMENT.–
1. Earliest symptoms– Acon.( with neuralgia consequent on anxiety, etc.,).
2. DEVELOPED HERPES — Rhus ( in all simple cases); Sulph. ( to follow Rhus if necessary); Ars; (neuralgia and in debilitated constitutions); Phyto., Graphites( ulcerating conditions and in old persons); Phosphorus (tubercular patients); Tellur., Phosphorus, Sepia (Herpes circinnatus)
3. Pleurodynia.– Ranunculus, Bulb.
4. Additional remedies.– Mang., Staphysagria, Cist., Nat.-Mur., Comocladia, Mezer.
ACCESSORY MEASURES.– The daily bath; plenty of out-of-door exercise; and the “Accessory Measures” suggested in Section 91. Locally the patches must be protected by cotton-wool and starch powder. An alcohol compress relieves pain sometimes.
204.– Eczema– Catarrhal Inflammation of the Skin– Scald Head– Milk-crust.
DEFINITION.– Eczema is essentially a Dermatitis or catarrhal inflammation of the skin characterized by more or less superficial redness, of small closely-packed vesicles, usually not larger than a pin’s head, which run together, burst, and pour out serous fluid, that dries into thin yellow crusts. The exuded fluid has the property, when dried, of stiffening linen, which distinguishes this form other skin diseases, Pain, smarting, or itching, are also present.
Eczema is one of the most common eruptions, constituting one- third or more of all skin affections; it lasts a varying time, in consequences of successive local developments, and its tendency to spread. After its disappearance no traces are left of the disease.
SYMPTOMS.– The most usual is a red surface with vesicles or fissures from which the serous fluid exudes. A great plane of interwoven capillaries renders the skin very vascular, and gives rise to a copious exudation. The deeper layers of cuticle, including that lining the sweat ducts, appear most implicated. The vesicles appear in successive crops, may prolong the disease for an indefinite time, and are attended with itching and local heat. The skin is irritable; occasionally excoriations or cracking of the part occur, and sometimes the parts around the patch inflame, probably from the irritating nature of the discharge. If no vesicles be apparent, the disease may be recognised by the skin feeling thick when raised by the finger and thumb, by the starchy nature of the discharge, the formation of thin yellow crusts, and the irritation. The most common seats of the patches are the scalp, behind the ears, the face, the fore-arms, and the legs, and its appearance differs greatly in each of these locations. If the disease be extensive, there may be considerable fever, a pallid appearance, Headache, loss of appetite, etc. The mucous surfaces may become the seat of Inflammation, either by the spread of the disease from the skin or as a consequence of the general condition. The retrocession of Eczema may be followed by other Diseases– Diarrhoea, bronchitis, or Leucorrhoea in the female.
VARIETIES.– The chief are E. simplex, in which the Inflammation and irritation are moderate. This variety often results from exposure to the sun’s rays; or it may be caused by irritants– heat, cold, bad soap, etc. If it occur in hot weather, the patient complains of fever, a “heated state of the blood,” etc., and the eruption follows, appearing on the exposed parts of the body– the face, neck, arms, back of the hands, etc.; this condition is commonly called “heat-spots” E. rubrum is a more highly inflammatory variety, the eruption being very red and shining, and there is much general disturbance; the burning is severe; brownish scabs are formed; and the parts usually affected are the flexures of the body– the inner side of the thigh, groin, elbow, wrist, etc., it is apt to become chronic in old persons, and when it occurs about the legs is called “the weeping leg”, and often leads to Ulcers. It often occurs on legs affected with varicose veins. E. impetiginodes is the variety which occurs in lymphatic and debilitated children, especially those who have a tendency to the formation of pus; the discharge is soon mixed with pus, which forms greenish-yellow thick scabs; it is commonly seen on the heads of infants (Porrigo Capitis, Scalled-head), and is a combination of Eczema and Impetigo. E. chronicum is the common form of any of the foregoing kinds of the disease; it often oscillates between cure and recurrence; and the skin becomes harsh, dry, red, and thickened. Syphilitic or Tubercular complications render the disease very intractable.
CAUSES.– Eczema probably depends upon constitutional irritability, and is sometimes hereditary; hence trivial exciting causes are sufficient to develop the disease– the action of the sun’s rays, heat, cold, the use of cosmetics, paints and washes, and stockings dyed with aniline, etc. In adults, it is common sequel to overwork, anxiety, irregular habits, etc., and is common among the gouty. The strapping of ulcerated legs with plaster, especially if there be Varices and an irritable constipation, is sometimes a cause. The rash developed by sulphur-baths, the rubbing in of Croton oil, and also that following hydropathic treatment, is eczematous. Shoemakers, who sit long with their thighs together, grocers and cooks, from handling sugar, etc. washerwomen, from the frequent use of soda and soap, bricklayers and builders, from the contact of lime, and others, from similar causes, are liable to Eczema. In infants it is often due to friction and irritation of clothes wet with urine, improper food, impoverishment of the mother’s milk, or want of attention to her general health. It is impossible to overestimate the influence of improper diet in the production of Eczema
EPITOME OF TREATMENT.–
1. Earliest symptoms, and in Eczema simplex– Aconite, Rhus., Cantharis, Sulphur
2. E. rubrum.– Ant.-T. Arsenicum, Belladonna, Croton tig. (if there be sickness of painful Diarrhoea); Mercurius-S., Hepar sulph., K.-Bich., Calc-C., Ac.-Nit., Crot.-Tig. (* The homoeopathicity of Croton is shown by the act that rubbing in of this oil quickly develops an eczematous rash.) 2x may be applied externally and often exerts a marked favourable action.
3. E. impetiginodes and chronicum– K.-Bich., Crot.-Tig., Arsenicum, Mercurius, hep.-S., Calcarea carb., Silicea, Nux Jug., Viola Tric., Lycopodium(milk- crust and Porrigo Capitis) When the scalp or other hairy part is affected, Liq. Carbonis Detergens ointment (z3ss to pure lard z3 j) for neutralizing the foetor, and destroying pediculi. The hairs should be clipped short, and semi-purulent scabs removed by bran-poultices, and steeping with the water in which that material has been boiled.
ACCESSORY MEASURES.– The parts should be kept clean by frequent gentle washing with cold or tepid soft water. General Baths, and especially Bran Baths. are of great use in some cases of Eczema, as in other chronic skin disorders, for they stimulate the healthy surfaces to increased activity, and so compensate for the imperfect action of the diseases portions. The great vascularity of the skin, and its great function as an organ of exertion, prove how corrective the healthy play of its function must be in cases of threatened mischief to the internal organs.
Pure soft water is an agent of great value, and in many cases the only remedy needed. Hard water is irritating, and when rain water cannot be obtained, it may be softened by boiling, and the addition of bran, four, and other mucilaginous matters, which further abstract the lime salts. The washing should be done so as not to spread the irritating discharge over unaffected surfaces, and afterwards well dried by pressure with a soft cloth, not by rubbing; Barilla Soap, Petroleum Soap, or Tar Soap, is recommended to be used in washing. Crot.- Tig. 2x or 3x dil., may be used as s direct application afterwards; often a single application will surface, or at most two or three; glycerine (see Secale 27) may then be used to allay irritation. Soft water compresses, especially in the earlier stages of the disease, are very useful. In the weeping stage of Eczema, when the Inflammation is but moderate, Carbolic Acid ointment (Ac.-Carbol. guttae xx., lard z3j) allays the itching and hastens recovery. To relieve the irritation, Bismuth ointment (Bism. 3j, lard z3ij) is invaluable. Varicose veins, and the consequent Congestion, usually lead to Eczema, as well as other eruption on the legs, and suggest the value of elevation as an element of treatment. The clothes should not be allowed to produce friction on the parts. Vegetable food, especially such as is eaten, uncooked- lettuces, celery, watercresses, etc.– may be taken, for vegetables contain potash salts, which are abstracted in the process of boiling. The general health must also be regulated. Cod-liver oil is especially recommended.
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."