When the itching is confined to small areas, or due to a pimply or scaly eruption on the skin, the following ointments may be tried: a mixture of tar ointment and zinc ointment (two drams each) with four drams of cold cream, or flowers of sulphur, one part, and lard, twelve parts.

CHAFING AND CHAPPING.-Chafing occurs when two opposing skin surfaces rub together and are irritated by sweat, as in the armpits, under the breasts and beneath overlapping parts of the belly of fat people, and between the thighs and buttocks. The same result is caused by the irritation induced by discharges constantly running over the skin, as that seen in infants, due to the presence of urine and bowel discharges, and that irritation which arises from saliva when the lips are frequently licked. The latter condition of the lips is commonly called chapping, but it is proper to consider chafing and chapping together as the morbid state of the skin, and the treatment is the same for both.

Chafing occurs more often in hot weather and after violent exercise, as rowing, riding, or running, and is aggravated by the friction of clothing or of tight boots. It may, on the other hand, appear in persons who sit a great deal, owing to constant pressure and friction in one place. The parts are hot, red, and tender, and emit a disagreeable odor when secretions are retained. The skin becomes sodden by retained sweat, and may crack and bleed. The same redness and tenderness are

seen in chapping of the face and lips, and cracking of the lips is frequent.

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 shellfish, 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 canal, 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. 155) 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.

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 puberty. 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 mass 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 anæmia.

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 pricked with a needle (which has been passed through a flame to kill germs on it). If there is redness of the skin and irritation associated 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. 159) 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