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CHAPTER II

Skin Diseases and Related Disorders

Household Remedies for Itching-Chafing and Chapping-Hives, Cold Sores and Pimples-Ringworms, Warts and CornsEczema and other Inflammatory Disorder..

No attempt will be made to give an extended account of skin diseases, but a few of the commoner disorders which can be readily recognized by the layman will be noticed. Although these cutaneous troubles are often of so trivial a nature that a physician's assistance is unsought, yet the annoyance is often sufficient to make it worth while for the patient to inform himself about the ailment. Then the affections are so frequent that they may occur where it is impossible to procure medical aid. Whenever an eruption of the skin is accompanied by fever, sore throat, headache, pains in back and limbs, vomiting, or general illness, one of the serious, contagious, eruptive diseases should be suspected, particularly in children, and the patient must be removed from contact with others, kept in isolation, and a physician immediately summoned.

ITCHING (Pruritus).-Itching is not a distinct disease by itself, but a symptom or sign of other skin

or general disorders. Occasionally it must be treated as if it were a separate disease, as when it occurs about the entrance to the bowel (anus), or to the external female sexual parts (vulva), or attacks the skin generally, and is not accompanied by any skin eruption except that caused by scratching, and the cause be unascertainable. Itching, without apparent cause, may be due to parasites, as lice and fleas, and this must always be kept in mind; although debilitated states of the body and certain diseases, as gout and diabetes, are sometimes the source. Commonly, itching is caused. by one of the many recognized skin diseases, and is accompanied by an eruption characteristic of the particular disorder existing, and special treatment by an expert, directed to remedy this condition, is the only reasonable way to relieve the itching and cure the trouble.

It may not, however, be improper to suggest means to relieve such a source of suffering as is itching, although unscientific, with the clear understanding that a cure cannot always be expected, but relief may be obtained until proper medical advice can be secured. The treatment to be given will be appropriate for itching due to any cause, with or without existing eruption. on the skin, unless otherwise specified. If one remedy is unsuccessful, try others.

For itching afflicting a considerable portion of the skin, baths are peculiarly effective. Cold shower baths twice daily, or swimming in cold water at the proper

time of year, may be tried, but tepid or lukewarm baths are generally more useful. The addition of saleratus or baking soda, one to two pounds to the bath, is valuable, or bran water obtained by boiling bran tied in a bag in water, and adding the resulting solution to the bath. Even more efficient is a bath made by dissolving half a cupful of boiled starch and one tablespoonful of washing or baking soda in four gallons of warm water. The tepid baths should be as prolonged as possible, without chilling the patient. The bran water, or starch water, may be put in a basin and sopped on the patient with a soft linen or cotton cloth and allowed to evaporate from the skin, without rubbing, but while the skin is still moist a powder composed of boric acid, one part, and pulverized starch, four parts, should be dusted on the itching

area.

Household remedies of value include saleratus or baking soda (one teaspoonful to the pint of cold water), or equal parts of alcohol, or vinegar and water, which are used to bathe the itching parts and then permitted to dry on them. Cold solution of carbolic acid (one teaspoonful to the pint of hot water) is, perhaps, the most efficacious single remedy. But if it causes burning it must be washed off at once. Dressings wet with it must never be allowed to become dry, as then the acid becomes concentrated and gangrene may result. Calamine lotion (p. 145) is also a serviceable preparation when there is redness and swelling of the skin.

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.

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