CHAPTER VII
DISEASES OF THE CUTANEOUS SYSTEM
73. Strophulus (Teething Rash)
DEFINITION.- A rash characterized by red papules (red strophulus) or white papules (white strophulus), round, of the size of a pin’s head or millet-seed, and very itchy, which appears first on the body, afterwards on the face and limbs.
CAUSES.- It is found only in infants and children, and is due to digestive disturbance and overclothing, and is often associated with the first Dentition.
INDICATIONS FOR TREATMENT
Ant.Crud.- Associated with Indigestion; white tongue, Vomiting, etc.
Calcarea carb.- With chronic acidity; delicate children.
Chamomilla.- This is generally the most efficacious remedy.
Pulsatilla- Indigestion, tendency to Diarrhoea.
ACCESSORY MEANS.- An exclusive diet of milk; abundance of fresh air; moderate clothing; dusting the affected parts with a mixture of zinc oxide and starch powder.
74. Eczema.
DEFINITION.- Eczema is a dermatitis (inflammation of the skin) which shows “the successive phase of Erythema, vesication, and an exudation which dries into scabs and which stiffens linen fabrics” (Graham Little).
Eczema is one of the most common of skin affections, and lasts a varying time according to the constitution of the patient, the treatment adopted, and other conditions.
No traces remain after its disappearance.
SYMPTOMS.- In very young children it commences as an acute attack, which is prone to subside into a chronic form and as such to persist for a long time. The patient is usually rosy, healthy- looking, plump – perhaps if anything over-fat – of fine, fair complexion. Locally, we have redness; vesicles from which serous fluid oozes copiously and dries into yellowish scabs and crusts; itching, heat. Later, especially if the site of Eczema is scratched, pus-producing germs get in the cause pustules which form greenish-yellow scabs. In children Eczema typically and chiefly manifests itself on the race and head, starting usually below the eyes and spreading downwards over the face and upwards over the scalp.
CAUSES.- Eczema within the definition given above may be due to any one of a large number of irritants : mechanical (such as are due to the friction caused by working a machine, riding a bicycle, or the irritation of woollen clothing); chemical (such as is due to the irritation of sugary urine in Diabetes or of faeces in the so-called “Napkin-rash” of infants); occupational (such as is due to handling paints, petrol, antiseptics, photographic materials, shavings of certain woods, hair-dyes, soaps, etc.); parasitic (such as is due to the irritation of lice, itch-mites, etc.); but the eczema of children described above, though it may be precipitated by exposure to cold or, less often, to heat, it an affection from within, and expression of a constitutional and hereditary predisposition, and might fairly be called “idiopathic” – hence at once (a) the necessity for “constitutional” treatment, and (b) the danger of strong outward applications which may “drive the trouble in.” It is remarkable in the connexion that Eczema often alternates in the same individual or in members of the same family with such a constitutional disease as spasmodic Asthma.
INDICATIONS FOR TREATMENT
Ant.Tart.- For Eczema impetiginodes;vesicles surrounded with red areola, especially about the nose, eyes, ears, neck, and shoulders.
Arsenicum.- Burning, corrosive discharge from skin. In chronic cases it is of the greatest use.
Calcarea carb.- Thick scales, with pus underneath; stools chalky; nutrition defective.
Croton Tig.- Severe itching, with sickness, or painful Diarrhoea.
Hepar.-Sulph. In chronic cases.
Mercur.- Sol.- Bright-red, shining eruption, burning pain, brownish scabs swollen glands.
Rhus Tox.- Much itching, worse at night. The most useful medicine for simple acute Eczema.
Sulphur.- When situated chiefly on the head or vulva; violent itching; during convalescence.
ACCESSORIES.- Crusts and scabs should be softened by means of compresses of warm olive-oil and gently detached. Serous or purulent fluid should never be allowed to accumulate under cakes of dried secretion. When the head is affected, the hair must be cut short.
A lotion of Antim tart., Arsenicum, or Croton Tig. may be used topically when the same remedy is being used internally. Ten grains of Trit. Antim tart. 1x, ten drops of Tinct. Arsen. 2x, or twenty drops of Tinct. Croton Tig.1x may be added to eight ounces of distilled water, and used once or twice a day, or twenty drops of Ol. Croton Tig. mixed with an ounce of olive-oil may be employed instead of Croton lotion. When the irritation is excessive the following ointment will be of great utility : Nitrate of Bismuth, grs.30 : Lard, one ounce : mix. When the Eczema ceases to weep and reaches the scaly stage, a dry powder (such as plain starch powder or an ordinary dusting powder, composed to zinc oxide, boracic acid, and starch powder) may be used. Or an ointment may be used, such as plain lanolin or calendula ointment. The face must be protected from cold wind and hot sun, and must not be washed with soap. Oatmeal-water or tar- water may be used.
In acute Eczema involving large areas it is often good to put the child on a exclusive diet of milk or whey or rice and water for a few days, keeping the patient in bed at the same time.
In the more chronic Eczema the practice of drinking considerable quantities of plain water should be encouraged.
75. Impetigo ( Contagiosa).
Impetigo, a common disease of infants, is a severe, contagious, purulent inflammation of the skin, with heat, or itching, and has been described as Pustular Eczema by some writers. It is characterized by an eruption of pustules grouped in clusters, having a tendency to run together, forming irregularly-shaped, thick, moist, yellowish scabs or incrustations; and attacking the ear, nose, scalp, and face. No scars are left after healing.
CAUSES.- Inoculation with pus-producing germs. It spreads rapidly in school from child to child.
TREATMENT.- The scabs should be softened with warm olive-oil and carefully bathed off; each raw spot should then be touched with a weak mercurial ointment (Ung. Hydrarg. Nit. Dil.) This should be done daily. Internally, Hepar Sulph. or Viola Tric. should be given.
76. Urticaria (Nettle-rash).
DEFINITION.- An eruption of round or oval wheals, pale in the centre, and red at the circumstance, attended with smarting and excessive itching, as though the parts had been stung by nettles – hence the popular name.
SYMPTOMS.- Towards evening, or when getting warm in bed, the patient feels an intolerable itching on the neck, arms, or body, and on scratching soon discovers large wheals (the eruption rapidly enlarging under the irritation of scratching) which burn, tingle, or smart, and prove the source of great discomfort.
CAUSES.- The acute form as seen in children, is often due to Indigestion or eating particular articles of food, as bitter almonds, shell-fish, oatmeal, etc. It may also perhaps be induced by a chill, or changes in the weather. Often there seems so cause for it.
INDICATIONS FOR TREATMENT.
Aconitum.- When caused by a chill, or accompanied with fever symptoms.
Antimonium Crud.- When caused by shell-fish, or almonds.
Apis Mell.- Sensations of stinging, burning, and prickling.
Dulcamara.- Cases occurring in damp weather; much irritation.
Pulsatilla.- When caused by fat, pastry, or pork.
Rhus Tox.- Small spots resembling flea-bites, with purplish swellings and intense irritation, particularly on the joints. It may also be used locally, replacing the Veratrum V. of the prescription below the Rhus Q.
Sulphur.- Chronic Urticaria. Coming on when warm in bed.
Veratrum Viride.- Intense pain and tingling. In the following preparation it may be used locally with great benefit.
Rx Verbascum-Viride Q, gtts xx.
Aqua,
Spiritus V.R. a a M.
ACCESSORIES.- Remove the dietetic or other cause if there be one. Hot soda baths are often useful; so also is tar lotion.
77. Intertrigo – Chafing – Soreness of Infants.
DEFINITION.- Redness and chafing produced by the friction of two folds of skin, especially in fat children. It is seen in the groin, armpits, and neck. Sometimes a fluid is exuded the acridity of which increases the local mischief, and an offensive raw surface is soon produced.
Intertrigo differs from Eczema in its acute course, and in the character of the secretion, which is clear, and does not stiffen linen. When confined to the buttocks and perineum, it may be difficult to distinguish from the rash of congenital Syphilis.
INDICATIONS FOR TREATMENT
Calcarea carb.- In scrofulous children.
Chamomilla- Very efficacious in infants.
Lycopodium.- In very obstinate cases.
Mercurius Sol. Rawness and great soreness.
Sulphur.- In chronic cases; much itching.
ACCESSORIES.- The parts should be well washed with cold or tepid water, and carefully dried, two or three times a day; a piece of line, saturated with Calendula lotion (a teaspoonful of the tincture to a tumbler of water), may be laid between the opposing surfaces; or, in bad cases, a lotion, composed of one part of Tincture of Hydrastis to five parts of Glycerine and five parts of water, 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.
78. Chilblains (Pernio) and Chaps.
DEFINITION.- “A localized Erythema attended with exudation, occurring…in certain predisposed persons in cold and damp weather” (Sequeira). It commonly affects the fingers and toes, but also the ears and nose.
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."