LV. Strophulus Red gum. Tooth-rash (Morbi Cutis Apparatus.)
Strophulus may be red or white. Red Strophulus begins as red blotches, slightly raised in the centre; the redness soon fades, and the central elevation enlarge and form flattened pimples. White S. consists of pearly-white, opaque pimples, about the size of a pin’s head, usually on the face and arms.
CAUSES. Unsuitable diet, and consequent digestive derangement. It is most frequent in children who are too much shut-out from fresh air.
REMEDIES. Chamomilla. This remedy is often sufficient. A dose thrice daily.
Ant.-Crud. Associated with Indigestion, white tongue, etc. Pulse. may also be thought of.
Calcarea carb. With Chronic acidity.
ACCESSORY MEANS. The regulation of the diet; abundance of fresh air; clothing sufficient to protect the body from cold, and, at the same time, permit of the free access of air to the skin; and daily use of the cold or (at first) the tepid bath.
LVI Nettlerash (Urticaria).
This is a common eruptive disease, occurring most frequently in children, and running no regular course.
CAUSES. Indigestion; errors in diet shell-fish, honey, mushrooms, cucumbers, almonds, and even acid fruits will induce it in some constitutions. An inactive state of the skin, and exposure to damp and cold, are also frequent causes.
SYMPTOMS. Small elevations on the neck, arms, or other parts of the skin, which itch intensely. When rubbed, they rapidly enlarge, and become more irritable. The eruption is now seen to consist of irregular patches or wheals, of a pale colour, and resembling the stings of nettles. Feverishness, nausea, vomiting, restlessness, thirst, want of appetite, coated tongue, and languor are present in severe cases.
REMEDIES. Pulsatilla; when caused by errors in diet or indigestion.
Dulcamara. When caused by exposure to damp, with bitter taste, diarrhoea, coated tongue, etc.
Aconitum. Much feverish disturbance.
Urtica Urens. Pale, hard eruption, with much irritation.
Rhus Tox. Eruption aggravated by the warmth of the bed, and by scratching.
Bryonia or Sulph. Repressed eruptions.
LVII Eczema Scalled head Milk-Crust.
DEFINITION. Eczema is strictly an inflammation of the skin, marked by more or less redness, and closely-packed bladders, not larger than a pin’s head; these run together, burst, and exude a fluid, which dries up and forms thin yellow crusts. The discharge has the property, when dried, of stiffening linen, which distinguishes Eczema from other skin diseases.
SYMPTOMS. In young children, it commonly commences as an acute attack; the little patient is usually pale, thin, pasty-looking, feverish, and has an indifferent appetite. Locally, we have redness with little bladders or cracks, from which watery fluid exudes, itching, heat, irritation, and crusts of scabs. Eczema affects all parts, but especially the scalp, ears, armpits, buttocks, and bends of the joints. If the eruption be extensive, feverishness, wasting, etc., will be more marked. In mild cases, where no vesicles are apparent, the disease may be known by the skin feeling thick between the thumb and finger.
VARIETIES. Eczema simplex, commonly termed heat spots. The patient complains of heat, and the eruption appears on the face, neck, and other exposed parts. Eczema rubrum often occurs on the inner side of joints, as the high, groin, wrists, etc. Bright red, shining eruption, burning pain, and brownish scabs are the leading symptoms. Eczema impetiginodes occurs mostly on the head of weakly infants. The discharge is soon mixed with Pus, which forms greenish-yellow, thick scabs.
CAUSES. Hereditary tendency; the sun’s rays; heat; cold; stockings dyed with aniline; improper food; friction; irritation of clothes wet with urine; handling sugar, lime, coarse soap, soda, or Croton-oil; poor health of the mother during nursing.
EPITOME OF TREATMENT.
1. Simple Eczema. Aconite and Rhus in alternation; Cantharis, sulph.
2. E. Rubrum. Antim tart; Arsenicum (general weakness); Belladonna (bright- red eruption); Croton-Tig. (severe itching, with sickness, or painful diarrhoea); Mercurius ( with swollen glands); Graphites (soreness behind the ears); Kali bichromicum
3. E. Impetiginodes and Chronic. Kali bichromicum, Croton tig., Ars,, Mercurius, Iris., Hepar sulph., Calcarea carb., silicea, Nux. J., Viola T.
LOCAL TREATMENT. A lotion of Antim tart. or Arsenicum may be applied when the same remedy is used internally. Croton-Tig., IX twenty drops mixed with one ounce of olive-oil, is soothing and healing. When the head is affected, the hair should be cut short, the head well washed, using a little mild soap, and the scabs removed by the application of bran or mashed-turnip poultices. If there be lice on the scalp, or bad smell, Carbolic acid ointment (half a drachm to one ounce of pure lard) may be used. When the irritation is excessive, the following ointment will be of great utility: Nitrate of Bismuth, grs. 30; Lard, one ounce; mix.
ACCESSORY MEANS. Great cleanliness is requisite. General baths of soft water, and friction are of great service. Vegetables, especially lettuce, celery, water-cress, etc., may be freely taken; also Cod-liver-oil, half a tea-spoonful, twice daily.
LVIII Impetigo (Impetigo).
Impetigo is a severe, sometimes catching, mattery inflammation of the skin, with heat or itching. There is an eruption of small flattened pustules, in clusters, having a tendency to run together, forming thick, moist yellowish scabs; it attacks the ear, nose scalp, and face, sometimes covering the face or head like a mask. It is this form of the disease to which the term Crusta lactea (milk-crust Porrigo larvalis) is most correctly applied. no scars are left after healing.
CAUSES. Poor diet; strumous constitution; and irritations of the skin.
TREATMENT. Viola Tricolor for simple Crusta lactea; Antim tart., K.-Bich., Ant.-Crud., or Arsenicum When the scabs become thick and hard they should be softened with fresh butter, and then removed by means of poultices of bran or linseed-meal, and Carbolic-acid ointment be kept smeared over the part for a week afterwards.
LIX. Chafing Soreness of Infants (Intertrigo)
DEFINITION. Redness and chafing produced by friction, especially in fat children, in the groin, armpits, and neck. Sometimes a sharp discharge comes through the pores, which increases the mischief.
EPITOME OF TREATMENT. Chamomilla (in infants); Calcarea carb. (scrofulous children); Lycopodium (obstinate cases); Mercurius (rawness and great soreness); Sulph. The parts should be well washed and carefully dried, two or three times a day; a piece of linen saturated with Calendula-lotion may be laid between the opposed surfaces; or, in bad cases, a lotion of Hydrastis and Glycerine may be applied in the same manner. Dusting the chafed parts with a fine powder consisting of equal parts of Lycopodium and Oxide of Zinc, or of Fuller’s earth, is also useful.
LX Chilblains and Chaps.
DEFINITION. A low kind of inflammation of the skin, attended with burning, tingling, itching, swelling, and sometimes ulceration. It commonly affects the fingers, backs of the hands, and feet.
CAUSES. Exposure to a low temperature, sudden changes, damp, warming the feet by the fire.
EPITOME OF TREATMENT.
2. Simple Chilblains. Arnica; Tamus Communis, as a paint; Belladonna (bright-red, shining swelling, and throbbing pains); Pulsatilla (purple colour; pains worse towards evening); Rhus Tox. (inflamed, chilblains); Cantharis (intense itching); Sulphur (obstinate cases, worse by warmth). Sulphurous acid, well applied to the parts affected, will give speedy relief, and often prove sufficient.
2. Broken or Cracked Chilblains. Petroleum (general bad state of the skin); Agaricus, Belladonna, Rhus Tox. discharge; Petroleum; Phosphorus (bad smelling discharge, and when occurring in unhealthy children).
LOCAL AND GENERAL MEASURES. Glycerine, or Glycerine-of-starch one part of Glycerine mixed with two of Eau-de-Cologne removes the stinging, burning feelings of Chilblains, Chapped-hands, fissures, or cracks. Ulcerated Chilblains require a poultice, or other mild application, until relieved.
As Chilblains generally occur in children whose circulation is defective, plenty of exercise in the open air, the free use of the skipping rope, and wholesome nutritious diet are necessary to prevent their return. Pork, veal, salted meats, and indigestible kinds of food are unsuitable.
DEFINITION. Among the most troublesome skin disorders to which children are subject is a species of Tinea, which appears in the head, on the neck, arms, and other parts of the body, in oval or circular patches, from half an inch to several inches in diameter. It causes considerable irritation and leads the child to scratch. Where the disease is on the body, it has the appearance of red scurfy, circular patches.
REMEDIES. Sepia, given at an early stage, will often stop the progress of the disorder. Calcarea carb. or Sulph. tends to produce a healthy state of the skin. But a cure is best effected by the application of one part of Carbolic or Acetic Acid, mixed with double its bulk of water, by means of camel’s-hair pencil. The lotion should be allowed to act for about half a minute or longer, according to the effect produced upon the skin; it should then by thoroughly washed off with tepid water, and afterwards a wet compress applied for two or three hours to allay irritation. When the patch is large, or there are several patches, it may be advisable to operate upon one part at a time. Where the disease is on the scalp, the hair should be cut close to the skin for a short distance beyond the edges of the patches, before using the application.
Jellurium 6. For obstinate cases, when a great part of the skin is affected.
ACCESSORIES. Strict cleanliness of person; friction; an occasional tepid bath; if the skin become irritable it may be occasionally washed in bran-water (a handful of bran boiled in a quart of water); generous diet; for the impoverished, Cod-liver- oil; change of air.
To prevent contagion the affected child should be kept apart from all others; his towels, brushes, etc., should on no account be used by any one else, and they should be thoroughly disinfected; some disinfectant should also be freely used in his room.
LXII Itch (Scabies).
The disease is caused by the presence of a minute insect which burrows under the skin, and gives rise to an unbearable itching. The eruption presents numerous small watery pimples, and appears most frequently between the fingers, on the bend of the arms, or on the thighs and buttocks, and lower part of the abdomen. The irritation increases at night and in bed.
TREATMENT. The local application of Sulphur-ointment is the most effective means for destroying the insects. After thoroughly rubbing the whole body with soft-soap and warm water, then washing in a hot bath, or with hot water, and wiping thoroughly dry, the ointment should be well rubbed in and allowed to remain all night. On the following morning, a tepid bath, using yellow soap, completes the cure. If the application of the ointment and the ablutions be not thorough, the process should be repeated. All contaminated linen should be boiled in water; other garments should be well ironed with a hot iron, or exposed to hot air at a temperature not less than 150* or 180* Fahr., of well fumigated with the vapour of Sulphur. The cure is often retarded, and the disease conveyed to others, by neglecting to carry out these suggestions. A solution of Sulphur and Soda will eradicate both vegetable and animal insects, and may be prepared as follows:
Rx Common Soda, half-ounce.
Flower of sulphur, half-ounce.
Simmer for half an hour. After well washing with soap, apply the clear liquid to the part, and allow it to dry on. A thin layer of Sulphur is deposited, which may remain for twelve hours, and then be washed off with a little vinegar and water. In very young children, water may be added to the lotion before use.
REMEDIES. Sepia, Calcarea carb., and Sulph are useful, administered internally.