The Home Medical Library Volume II Part 8

In chafing the first requisite is to remove the cause, and then thoroughly wash the part with soap and water. Then a saturated solution of boric acid in water should be applied with a soft cloth, and the parts dusted with a mixture of boric acid and powdered starch, equal parts, three times daily. If the lips are badly cracked, touching them, once daily, with a stick of silver nitrate (dipped in water) is of service.

=HIVES; NETTLERASH= (_Urticaria_).--Hives is characterized by the sudden appearance of hard round or oval lumps in the skin, from the size of a pea to that of a silver dollar, of a pinkish-white color, or white in the center and often surrounded by a red blush. The rash is accompanied by much itching, burning, or tingling, especially at night when the clothes are removed. The peculiarity of this eruption is the suddenness with which the rash appears and disappears; the itching, the whitish or red lumps, the fact that the eruption affects any part of the body and does not run together, are also characteristic.

Scratching of the skin often brings out the lumps in a few minutes.

The swellings may last a few minutes or hours, and suddenly disappear to reappear in some other place. The whole trouble usually continues only a few days, although at times it becomes a chronic affection.

Scratching alters the character of the eruption, and causes red, raw marks and crusts, but the ordinary swellings can be seen usually in some part of the body. Rarely, the eruption comes in the throat and leads to sudden and sometimes dangerous swelling, so that suffocation has ensued. With hives there are no fever, sore throat, backache, headache, which are common to the contagious eruptive disorders, as measles, scarlet fever, etc.

Indigestion is the most frequent cause. Certain articles of diet are almost sure to bring on an attack of hives in susceptible persons; these include sh.e.l.lfish, clams, lobsters, crabs, rarely oysters; also oatmeal, buckwheat cakes, acid fruits, particularly strawberries, but sometimes raspberries and peaches. Nettlerash is common in children, and may follow any local irritation of the skin caused by rough clothes, bites of mosquitoes and fleas, and the stings of jellyfish, Portuguese man-of-war, and nettles.

=Treatment.=--Remove any source of irritation in the digestive ca.n.a.l, or externally, and employ a simple diet for a few days, as bread and milk.

A dose of castor oil, one teaspoonful for children; one tablespoonful for adults, or some other cathartic is advisable. Locally we use, as domestic remedies, a saturated solution of baking soda (or saleratus) in water, or equal parts of alcohol or vinegar and water to relieve the itching. The bath containing soda and starch (p. 141) is the most useful treatment when the nettlerash is general. Calamine lotion is one of the best applications which can be employed for this disorder.

It should be sopped on frequently with a soft cloth and allowed to dry on the skin.

CALAMINE LOTION

Zinc oxide 1/4 ounce Powdered calamine 1/4 "

Limewater 6 ounces

Mix and shake before applying to the skin.

If choking is threatened, give an emetic of mustard, one teaspoonful, and warm water, half a pint.

=PIMPLES; BLACKHEADS= (_Acne_).--This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of p.u.b.erty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. After three to ten days the matter is discharged, but red elevations remain, which later become brown and disappear without scarring, except in rare cases.

"Blackheads" appear as slightly elevated black points, sometimes having a yellowish tint from which a little, thin, wormlike ma.s.s may be pressed. Pimples and blackheads are both due to inflammation about the glands of the skin which secrete oily material; the mouths of the glands become plugged with dust, thus retaining the oily secretion and causing blackheads. Then if these glands are invaded by germs producing pus, we have a pimple, which usually results in the formation of matter as described above. Constipation and indigestion favor the occurrence of pimples and blackheads; also a poor state of the blood, or anaemia.

=Treatment.=--Tea, coffee, tobacco, and alcohol should be avoided, together with veal, pork, fats, and cheese. The bowels must be moved daily by some proper cathartic, as cascara tablets containing two grains each of the extract. The dose is one to two tablets at night.

The blackheads should be squeezed out with a watch key, or with an instrument made for the purpose, not finger nails, and pimples containing matter must be emptied after being p.r.i.c.ked with a needle (which has been pa.s.sed through a flame to kill germs on it). If there is redness of the skin and irritation a.s.sociated with pimples, it is sufficient to bathe the skin with very hot water and green soap three times daily, and apply calamine lotion (see p. 145) at night. In other cases, when the skin is not sensitive, and zinc or mercury has not been used, the employment of sulphur soap and hot water at bedtime, allowing the suds to dry and remain on the face during the night, is to be recommended. An ointment consisting of half a dram of precipitated sulphur with half an ounce each of powdered starch and vaseline applied each night, and hot water used on the face three times daily are also efficacious. Sulphur lotion is better than sulphur ointment.

=COLD SORE; FEVER BLISTER.=--Cold sores occur usually about the lips or at the angles of the mouth, although they may appear anywhere on the face. Cold sore has a round, oval, or irregular outline, from the size of a pea to that of a quarter of a dollar, and is seen as a slightly raised patch on the skin on which is a group of very minute blisters, three to twelve in number. Cold sore may be single or multiple, and near together or widely separated on the face. Having first the appearance of a red patch, it later becomes covered with a brown crust from the drying of the contents of the tiny blisters. Cold sore often gives rise to burning, itching, or tingling, the disfigurement usually causing more annoyance, however, than the pain.

The duration of the trouble is from four to twelve days.

Cold sores are commonly induced by indigestion and fevers, and also are occasioned by local irritation of any sort, as from nasal discharge accompanying cold in the head (from which the name is derived), by the irritation produced by a pipestem or cigar, and by rubbing the skin.

=Treatment.=--Picking and scratching are very harmful, and cigar or pipe smoking must be stopped. Painting the sore with collodion, by means of a camel's-hair brush, is poor treatment in the early stages.

Better use spirits of camphor, and afterwards, if there is much itching or burning, sopping the eruption with calamine lotion (p. 145) will relieve the discomfort.

=p.r.i.c.kLY HEAT= (_Miliaria_).--This is a common eruption of adults in hot weather, and very frequently attacks children. It consists of fine, pointed, red rash, or minute blisters, and occurs on parts of the body covered by clothing, more often on the chest. The eruption is caused by much sweating, leading to congestion and swelling of the sweat glands. Burning, stinging, and itching accompany the disorder.

The condition must be distinguished from the contagious skin eruptions. In the latter there are fever, sore throat, backache, headache, and general sickness, while in p.r.i.c.kly heat there is no general disturbance of the system, or fever, unless the eruption comes out in the course of fevers, when it is of no significance except as one of the symptoms of fever.

=Treatment.=--The treatment of p.r.i.c.kly heat, occurring in hot weather, consists in avoiding heat as much as possible and sponging the surface with cold water, and then dusting it with some simple powder, as starch or flour, or better, borated talc.u.m. To relieve the itching, sponging with limewater or a saturated solution of baking soda (as much as will dissolve) in water, or bran baths, made by tying one pound of bran in a towel which is allowed to soak in the bath, are all good remedies.

=RINGWORM OF THE BODY; RINGWORM OF THE SCALP.=--This skin disease is caused by a vegetable fungus and not by a worm as the name suggests.

The disease on the body and scalp is caused by the same parasite, but ringworm of the body may attack adults as well as children, and is readily cured; ringworm of the scalp is a disease confined to children, and is difficult of cure. Ringworm is contagious and may be acquired from children with the disease, and therefore patients suffering from it should not be sent to school, and should wear a skull cap and have brush, comb, towels, and wash cloths reserved for their personal use alone. Children frequently contract the disease from fondling and handling cats and dogs.

=Symptoms.=--On the body, ringworm attacks the face, neck, and hands.

It appears first as small, red, scaly spots which may spread into a circular patch as large as a dollar with a red ring of small, scaly pimples on the outside, while the center exhibits healthy skin, or sometimes is red and thickened. There may be several patches of ringworm near each other and they may run together, or there may be only one patch of the disease. Ringworm of the scalp occurs as a circular, scaly patch of a dusty-gray or pale-red color on which there are stubs of broken hairs pointing in different directions, and readily pulled out. The disease in this locality is very resistant to treatment. There are no crusts or itching as in eczema.

=Treatment.=--The application of pure tincture of iodine or carbolic acid to the spots with a camel's-hair brush, on one or two occasions, will usually cure ringworm on the skin. On the scalp the hairs should be pulled out of the patch of ringworm, and each day it should be washed with soap and water and a solution of boric acid (as much acid as the water can dissolve), destroying the cloth used for washing. The following ointment is then applied: sulphur, one part; tar, two parts; and lard, eight parts. It is desirable to secure the services of a physician in this disease, in which various remedies may have to be tried to secure recovery. If untreated, ringworm is likely to last indefinitely.

=FRECKLES, TAN, AND OTHER DISCOLORATIONS OF THE SKIN.=--Freckles appear as small, yellowish-brown spots on the face, arms, and hands, following exposure to the sun in summer, and generally fading away almost completely in winter. However, sometimes they do not disappear in winter, and do occur on parts of the body covered by clothing.

Freckles are commonly seen in red-haired persons, rarely in brunettes, and never on the newborn. Their removal is accomplished by the employment of agents which cause a flaking off of the superficial layer of discolored skin, but after a few weeks the discolorations are apt to return. Large, brown spots of discoloration appearing on the face are observed more often in women, and are due to disorder of digestive organs of the s.e.xual organs or to pregnancy; they also occur in persons afflicted with exhausting diseases. Tan, freckles, and discolorations of the skin generally are benefited by the same remedies.

=Treatment.=--Prevention of tan and freckles is secured through nonexposure of the unprotected skin to the sun, though it is doubtful whether the end gained is worth the sacrifice, if carried so far as to the avoidance of the open air and sunlight whenever possible.

Boric acid (sixteen grains to the ounce of water) is an absolutely harmless and serviceable agent for the removal of skin pigmentations.

The skin may be freely bathed with it night and morning. Corrosive sublimate is the most effective remedy, but is exceedingly poisonous if swallowed accidentally, and must be kept out of children's way, and should not be applied over any large or raw surface of skin or on any mucous membrane. Its application is inadvisable as soon as any irritation of the skin appears from its use. The following preparation containing it is to be painted on the skin with a camel's-hair brush, night and morning:

POISONOUS SUBLIMATE SOLUTION

Corrosive sublimate 7 grains Alcohol 1-1/2 ounces Glycerin 1-1/2 "

Oil of lavender 10 drops

Mix.

The following lotion is also efficacious:

Zinc oxide 30 grains Powdered starch 30 "

Kaolin 60 "

Glycerin 2 drams Rose water 2 ounces

Mix.

DIRECTIONS.--Shake and paint on spots, and allow the preparation to dry; wash it off before each fresh application.

It is best to use only cold water, rarely soap, on the healthy skin of the face. Warm water favors relaxation of the skin and formation of wrinkles.

=IVY POISON.=--The poison ivy (_Rhus toxicodendron_), poison sumach (_Rhus venenata_), and poison oak (_Rhus diversiloba_ of the Pacific Coast, U. S. A.) cause inflammation of the skin in certain persons who touch either one of these plants, or in some cases even if approaching within a short distance of them. The plants contain a poisonous oil, and the pollen blown from them by the wind may thus convey enough of this oil to poison susceptible individuals who are even at a considerable distance. Trouble begins within four to five hours, or in as many days after exposure to the plants.

The skin of the hands becomes red, swollen, painful, and itching. Soon little blisters form, and scratching breaks them open so that the parts are moist and then become covered with crusts. The poison is conveyed by the hands to the face and, in men, to the s.e.xual organs, so that these parts soon partake of the same trouble. The face and head may become so swollen that the patient is almost unrecognizable.

There is a common belief that ivy poison recurs at about the same time each year, but this is not so except in case of new exposures.

Different eruptions on the same parts often follow ivy poisoning, however.

=Treatment.=--A thorough washing with soap, especially green soap, will remove much of the poison and after effects. Saleratus or baking soda (a heaping tablespoonful of either to the pint of cold water) may be used to relieve the itching, but ordinary "lead and opium wash" is the best household remedy. Forty minims of laudanum[9] and four grains of sugar of lead dissolved in a pint of water form the wash. The affected parts should be kept continually wet with it. Aristol in powder, thoroughly rubbed in, is almost a specific.

=WARTS.=--Warts are flattened or rounded outgrowths from the outer and middle layers of the skin, varying in size from a pin head to half an inch in diameter. There are several varieties.

_Seed Warts._--These have numerous, little, fleshy projections over their surface, which are enlarged normal structures (_papillae_) of the middle layer of the skin, together with the thickened, outer, h.o.r.n.y layer.