generally prevent the itching, when applied to the bite of any insect. A solution of sodium salicylate 1 Gm., formaldehyde solution I mil, and water up to 100 mils will attract and kill flies. IVY POISONING The poisonous juice of the Rhus Toxicodendron (poison ivy, poison oak, mercury) is the same as that of poison sumach, and a very minute portion may cause an inflammation of the skin. This poison, toxicodendrol, is contained in the leaves, is of a resinous nature, and is non-volatile, in spite of the declaration by many susceptible individuals that they cannot pass by a plant without being poisoned. Therefore, direct or indirect contact must occur. The hands and face of course are the parts most affected, but it is easy to transplant the irritant by the hands to other parts of the body. The softer and more pliant the skin, the quicker does the irritation develop, and a minute amount of the resin will cause vesication. While most individuals are susceptible to this common poison, some can handle it with impunity without danger of poisoning. Some few individuals do not develop symptoms of poisoning for several days after exposure to the plar.ts. Internally the rhus toxicodendron, which has been unnecessarily termed a drug, and was formerly officialized in the Pharmacopoeia, is, except in minute doses, an irritant and a poison. Symptoms after absorption are dilated pupils, faintness, irregular pulse, increased perspiration, muscle weakness, tremblings, and even convulsions. Later symptoms are those of kidney and bladder irritation. Protections against poisoning from the ivy are rubber gloves and fats or oils smeared over the parts of the body which might be exposed to contact with it. If contact with this plant is known to have occurred, immediate washing the exposed parts with hydrogen dioxide solution, then scrubbing with soap and water, then with equal parts of alcohol and water, and later (after the thorough cleansing of the exposed parts) a hot bath is the preventive treatment advisable. It must be noted, however, that the outer clothing may carry the irritant poison, and hence a thorough brushing and perhaps washing of the clothing is advisable. When the inflammation has occurred, the patient should be treated much on the plan, as to catharsis, diet, and alkalies, as though he had an acute urticaria. A useful lotion is magnesium sulphate, in strong solution. It is not often advisable to use the lead solutions so long recommended, as, if there is an abrasion, poisoning may occur. Besides mopping on the magnesium sulphate solution, powdered cornstarch applied to the inflamed area is advisable. Ichthyol preparations have been recommended, but are no improvement on the above simple treatment. If blisters occur, they should be treated as burns. The duration of the inflammation varies from a few days to nearly two weeks. PRIMROSE POISONING It is not generally recognized that the primrose can cause an acute inflammation of the skin resembling an acute eczema, and many patients are treated for eczema while the cause remains active in their house or garden, and the inflammation persists. It is the hands and arms that are most affected by this plant, and many a cure has immediately occurred when the plant was removed from the house. The irritation occurs only from contact. The treatment is the same as for any other acute eczema, but it is not permanently successful until the primrose is abolished, and all contact with the plant ceases. ECZEMA This common, multiform, troublesome disease of the skin requires investigation of the diet, of the excretions, of the ductless glands, of the clothing, and of the hygienic surroundings. Some foods and some drugs cause eczema in susceptible individuals. External poisonings are a frequent cause of eczema of the hands and face. The eczema of children is a study in itself. The proper diet for a child with eczema cannot be outlined; the child must be studied. Many times too much fat has been given; at other times too much sugar; at other times too much cereal. Consti pation in a child may be a cause of eczema, and insufficiency of thyroid secretion may cause moist eczemas in young children and dry eczemas in old age. The seborrheic eczema of the scalp of infants requires skilled treatment by one who has made a study of this subject. Again no one treatment is always successful. Some forms of eczema require local sedatives, and some local stimulation. A much used sedative is Lassar's paste, and a satisfactory formula is: Salicylic acid. Petrolatum. I Gm. 10 Gm. 10 Gm. 25 Gm. and various There are various other sedative ointments, sedative powders, as noted in the first part of this book under the headings of "Dusting Powders" and "Emollients." The stimulating ointments vary, and consist mostly of oil of cade, ichthyol, sulphur, and resorcin in various combinations. Which preparation is best and what strength is advisable can only be determined by the kind of eczema and the susceptibility of the skin to stimulation. CHAPPED HANDS Chapping of the hands is due to cold weather and an insufficient amount of oil or fat in the skin, and in cold weather the sebaceous secretions of the skin are at a minimum. Chapping may also occur from irritation of a dry, chilled skin. The preventive treatment is to keep the hands warm, and to rub on some bland oil or fat; cold cream and other animal fats are very satisfactory. Wool fat thinned with oil and water makes a good ointment for the dry skin of the hands. Some skins will tolerate glycerin in from 30 to 50 per cent. strength, while on other skins even dilute glycerin will cause irritation. Gelatinous lotions are often very satisfactory, and quinceseed lotions are much used. A useful preparation is made by melting 1 Gm. of white wax with 4 Gm. of spermaceti and 15 mils of almond oil, and gradually adding 10 mils of glycerin, gently triturating, and then allowing to cool. Pusey suggests a tragacanth lotion as follows: Any perfume may be added to suit the individual desire. The boric acid, glycerin and water are mixed, and then the tragacanth gradually added, and the mixture shaken until it has dissolved. This combination makes a thick mucilage, but it can be made thinner by using less tragacanth. This preparation or some other mucilagenous lotion may be used to cleanse the hands, as soap makes chapped hands worse. Water, unless it is softened with bicarbonate of sodium, boric acid, or borate of sodium, is irritant to all eczemas as well as to chapped hands. CHILBLAINS Chilblains develop in cold weather in parts where the circulation is impaired or is insufficient. They frequently occur on the feet, especially if the shoes are tight, or they may occur on the fingers when the gloves are too tight, and can occur on any exposed part of the body, as the nose or ears. A part once chilled or suffering from chilblain is always more or less susceptible to cold, and recurrences readily occur. The unpleasant sensations are heat, burning, sometimes itching, and always more or less redness. These symptoms are likely to be worse when the individual goes into a warm room or becomes warm in bed. Sometimes the part may be quite inflamed, even to the extent of a mild subacute dermatitis. If the part is cold, brisk rubbing is of advantage, or putting the part into hot water benefits, i.e., anything that stimulates the circulation is of advantage. If the part is burning and hot, then it should be cooled. Sometimes the application of equal parts of tincture of iodine and tincture of opium is very soothing; also diluted glycerin and menthol preparations may soothe the parts. Any part that has the circulation impaired, as the toes and the feet, is improved by exercise; therefore not only massage, but exercise and use of the part of the body that has been chilled will tend to make the circulation better, cause better nutrition, and therefore less likelihood of a recurrence of the chilblains. Warm clothing of the susceptible parts of the body, as warm mittens and warm stockings, is preventive of this disturbance. The patient's general condition should be improved, and circulatory stimulants, iron, and extra food are often advisable. Electrical treatment that warms and stimulates the chilled part is often of benefit. Sometimes chilblains and a burning sensation of a part, or blanching of a part with later burning and increased heat, is due to Raynaud's disease, and a subthyroid condition often predisposes to chilblains. If breaking down of tissues occurs, the treatment is the same as that for blisters and ulcerations from blisters. If the skin is irritated, the same soothing lotions that are suggested for chapped hands are of benefit. ACNE It should be remembered that acne has been shown to be due in very many instances to the acne bacillus; also that intestinal putrefaction and toxins absorbed therefrom, and the toxins produced by the colon bacillus are predisposing and promoting causes of acne on any part of the body, and particularly on the face. It is necessary to correct all of the various functions of the body as well as to properly treat, locally, acne of the face. A disturbance of the menstrual function in young girls seems to be a particularly frequent cause of acne; and the age of puberty in boys seems to be a period when acne is frequent. Good healthy cleanliness of the face is essential in the cure of acne and the prevention of so-called "black-heads." Too hot water and too cold water used on the face may predispose to, or perpetuate, an acne. The exact local treatment is so varied, added to the necessary individual determination of the proper diet and the proper care of the bowels, that it cannot be outlined here. An acne patient should be studied by his physician or by a dermatologist. |