from an accidental laceration of the skin form the excoriations so common in the cutaneous folds of the groin and other parts. Sometimes the disease begins in the form of a dark-red, shining spot, which quickly extends in size and becomes of purplish color; there is little swelling, but the skin becomes tense and hard; (see Induration of Cellular Tissue in the following chapter). When the erysipelas commences in the abdomen, vesications, destruction of the cellular tissue and gangrene of the skin quickly follow; the genital parts are not unfrequently destroyed. In such cases the fever is of a typhoid kind and the whole disorder exceedingly malignant and capable of carrying off the child in a very short time. In this disease, even under its milder forms, it is easy to see that the vital force are so greatly depressed, and the blood in such a depraved condition, that there is little power or hope or recuperation. Still much may be done even in malignant disorders, if we can remove thee constantly sustaining cause. Where there is reason to think that the bad state of health of the mother or her general enfeebled condition, is the cause of the difficulty, the child should be provided with nourishment from other sources. Study the following remedies; and others which may be indicated.
Aconite. When a high state of febrile excitement prevails, a real synochal fever, this remedy alone, will prove sufficient.
Apis. When the child screams out suddenly, as if from stinging pains; sleepless nights; the eruption inclines to spread all over the child, or to become gangrenous.
Arnica. When thee disorder seems to result form bruises; or from rough handling of the umbilical cord.
Belladonna. The eruption is very red, and extends in radii form a centre; jerking, twitching and moaning; the skin seems to be very hot.
Bryonia. The inflamed parts seem indurated, pale and tender. Lips dry and parched.
Graphites. The eruptions assumes a vesicular appearance, or it exudes a transparent, glutinous fluid. Or the disease may assume a chronic form; and the child be very costive, with stools large and almost impossible to evacuate.
Mercurius. In cases of syphilitic origin.
Pulsatilla. This remedy is often required when the disease appears about the buttocks, and inclines to spread.
Sulphur. Useful in cases of strongly-marked herpetic constitution. Study also Lachesis, and Rhus toxicodendron.
URTICARIA-NETTLE-RASH-HIVES.
The characteristics of this eruption upon the skin are found in the elevation of the patches, and in the burning-stinging nature of the pains, in their dependence upon some recent disorder of the stomach or heat of the weather, in their usual sudden appearance and frequent, equally sudden retrocession. By Dr. Condie, urticaria is described as “an eruption of red inflamed patches, (they may however be like white wheals), irregularly distributed upon different, and often distant parts of thee body; sometimes small in extent and number, at other times occupying a considerable portion of the skin. This eruption both in external appearance and in the sensations which it occasions remarkably resembles that produced by the application of the stinging nettle, Urtica urens, to the skin. In such cases this medicine will be found capable of affording immediate and very sensible relief to the distress of the little patient. When the eruption seems to be principally brought out by the heat of summer, the warm bath will be found very useful in relieving the intense burning-itching.
In some instances thee eruption disappears from one part of the body to reappear almost immediately in another and quite distant part. Most ceases of urticaria are comparatively rifling and evanescent; but with some appears concomitant symptoms of more gravity, such as burning fever, diarrhoea, &c. These symptoms may be found enumerated under the various medicines.
Aconite. Much fever restlessness and anxiety.
Apis. Red, inflamed, raised patches, with burning-stinging pains; valuable and curative in many of the severest cases.
Arsenicum. Eruption worse at night, with much tossing, May be particularly suitable when the disorder is caused by unsuitable food.
Belladonna. Red face and eyes; the eruption is also very red; moaning and starting in sleep; head hot.
Bryonia. The eruption has been partially suppressed, so that it looks very pale, and there is oppression of the chest and difficult and rapid breathing.
Calcarea c. The eruption is white and elevated quite above the skin; it is hard and seems to itch very much, causing the infant great uneasiness.
Dulcamara. The eruption appears every time the babe is exposed to the damp cold air.
Hepar. Catarrh of the chest, head, &c., accompanies the eruption.
Nux v. Urticaria accompanied by gastric derangements, constipation, &c.
Pulsatilla. Urticaria with diarrhoea, worse at night.
Rhus t. When rubbing the parts affected seems to increase the eruption.
Sulphur. The child appears to suffer from a suppression of the eruption.
Urtica urens. When the eruption looks pale, like the stings of nettles, and requires to be rubbed all the time.
CRUSTA LACTEA-PORRIGO LARVALIS-SCALD-HEAD.
This eruption has been variously named by different authors, being termed porrigo larvalis, by Willan; Impetigo larvalis, by Bate man; Eczema impetiginodes, by Rayer; and Tinea muciflua, or granulata, by others.
Description and Symptoms. This eruption is called larvalis, because it covers the face like a mask. It usually occurs during teething, and appears to be much connected with that process; it commonly commences on the forehead and cheeks by the breaking out of a number of small yellowish pustules, confluent and crowded together upon a red surface. These pustules excite great itching, and are quickly broken, discharging a viscid fluid, that subsequently concretes into thin, greenish-yellow scabs. The scabs are frequently rubbed off, but form again; fresh crops of pustules appear around the scabs, which quickly extend to the scalp and even the face. When the scalp becomes engaged, the lymphatic glands at the back and sides of the neck enlarge, and sometimes suppurate. The eruption appears upon or behind the ears; and patches will sometimes appears also upon the neck or breast. The discharge form the pustules is caught by the upon the head, and concretes into small irregular, friable masses, which may resemble the bruised yolk of a hard-boiled egg. ( Evanson). The pustules, or achores, as the small superficial ulcerations which they form upon the skin are sometimes called, have an acuminated form; contain a straw-colored fluid; rest upon an inflamed base and are succeeded by a thin, brown or yellowish scab. There is much irritation; heat of the scalp and itching; the discharge is very profuse, and with so much itching that it is rubbed off, leaving the surface raw and excoriated. Wherever this discharge is brought in contact with skin, in the face where it trickles down, upon the breast where if falls, and upon the backs of the hands violently used by the child to rub with, it proves so acrid as to produce there a fresh eruption. The same is true even of the arms of the nurse upon which the child rests its had at night.
The itching and burning acridity of the eruption and discharge are much worse at night. All external applications should be sedulously avoided, with the exception of tepid water; or cold cream, which has sometimes proved very grateful. The recession of the eruption should thus be carefully guarded against, since it would most certainly be followed by a dangerous attack of hydrocephalus.
Study the following remedies; and any others which may more accurately cover the symptoms and conditions present.
Indications will also be found among these medicines for various other forms of chronic cutaneous disease, which have not been particularly described.
Aconite. Where we find much fever, restlessness, anguish, the parts much inflamed, Aconite may remove every vestige of the complaint, if we wait patently upon its action, as long as the improvement continues.
Arsenicum. Eruption very dry scaly; it even seems, sometimes, to cause the destruction of the hair if such places as are affected.
Baryta c. Particularly when the cervical, submaxillary and parotid glands become swollen and hard.
Bryonia. In cases complicated with some other affection which is always made worse by motion. The scalp is very tender to the touch; the child cannot bear even a soft brush upon it.
Calcarea c. In children of leucophlegmatic temperament, eruption with thick scales and yellow pus underneath. Stools having a chalky appearance. Sometimes the eruption appears in the form of a ringworm.
Chamomilla. When the child has been kept too warm; it is very fretful; must carried more than usual.
Cicuta vi. Thick, whitish scurfs appear on the chin and upper lip; they secrete a dampness; sometimes scurfs form the nose.
Clematis e. There appears a dark, burning miliary eruption with violent itching; a dampness constantly exudes form this which dries into scurfs as the disease spreads on wards.
