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Itching - Pruritus.In most cases in which itching is felt at any part of the skin, a cause can be readily discovered in some local irritation. This may consist in parasites, such as the itch mite ; or it may exist merely in the form of an inflammatory rash. Yet there are many cases in which intense and obstinate itching occurs in certain limited parts of the body, for which no cause for the sensation can be discovered. We are all familiar with an occasional itchy sensation lasting but a moment or two, which leads us to look intently at some part of the skin, but without finding anything unnatural in the appearance of the skin. Now, in some individuals, this itchy sensation persists for days and weeks, localized in some limited part of the skin, and yet unaccompanied by any rash or by any unnatural appearance of the skin or its surroundings. It is this condition which is designated by the term pruritus. This symptomatic itching is often most intense and annoying, so that it may make life wretched for an individual who is apparently in perfect health. In many cases the sensation is limited to certain parts of the skin, to be presently described ; in other in stances it is felt over a large surface, or even the entire body. This is especially apt to be the case with elderly people, so that the disease is often called pruritus senilis - the itching of old age. In some individuals this condition exists during the winter, while they are free from it in warmer weather. In some cases doubtless, this itching of the skin is favored by wearing flannel, yet it may occur during the winter in persons who avoid the use of this article. In still other cases the tendency to itch is greater during warm weather; in these cases there seems to be no more apparent cause than in the former instance. Although this itchy feeling may be felt over a considerable part of the body, or even over the entire skin, yet the cases are far more frequent in which the sensation is limited to certain small parts of the body. The parts most frequently affected are the genital organs of both sexes, the palms of the hands, the soles of the feet and the skin between the thighs. In these situations the itching is not constant, but occurs in paroxysms, during which the patient is completely unfitted for active employment, and is compelled to retire to the privacy of his apartment and devote his entire attention to the relief of the itching. The attempt to relieve this feeling by rubbing or scratching the skin, merely aggravates the difficulty and often induces the appearance of other symptoms as well. Thus one of the first effects is eczema of the part, accompanied by deep fissures and furrows in the skin ; in women, itching about the genitals often causes unnatural sexual excitement. This itching in these parts occurs in women with especial frequency during the change in life; it is also a frequent occurrence in those who suffer from disorders of menstruation and from diseases of the ovaries. It often accompanies diseases of the womb and of the vagina, and is a frequent result of the " whites;" when the latter condition has once existed the itching may last for a considerable time, even after the discharge has ceased. In nearly all these cases the paroxysms of itching occur especially at night when the patient has become warm in bed. Itching between the thighs is often caused by the piles. Among the general conditions which are accompanied by itching over a large part of the skin, are chronic Bright's disease of the kidneys and diabetes. The same symptom frequently accompanies diseases of the liver which cause jaundice, catarrh of the stomach and inflammations of the womb. In all those cases in which a careful search fails to reveal the presence of lice or other local causes, the patient should be at once examined, to ascertain the existence of one or another of these conditions. In every case it should be remembered that itching will be followed sooner or later by a rash on the skin, caused by incessant scratching ; care must be taken not to mistake this rash, which is the result of the itching, for the cause. The first item in the treatment of pruritus, whether it be confined to a part or spread over the entire skin, is an attempt to ascertain the cause. This is a far more troublesome undertaking in many cases than one might suppose. The first object of suspicion must always be animal parasites ; even in our first families bed-bugs, fleas, and other vermin are occasionally found ; the constant intercourse with other people upon the streets, in public vehicles, etc., frequently leads to the introduction of these parasites where they are least expected. When the itching is constant, not occurring in paroxysms, but increased at night by the warmth of the bed, it should excite suspicion of scabies or the " itch," and should lead to a careful search of the skin between the fingers, on the wrists, and about the genitals. Itching between the shoulders and on the back is often caused by body lice; itching at the back of the head in children by head lice. Itching between the thighs is often caused by eczema of these parts, and in children by thread worms. Itching which occurs suddenly and ceases abruptly, felt here and there about the body, especially at night, but accompanied by no perceptible rash, may be due to any one of several causes-disorders of menstruation or of the womb in women, nettle-rash, or one of the general conditions which have been already mentioned-B right's disease, diabetes, etc. In case any of these causes can be discovered to explain the itching, the treatment will naturally begin with the removal of the cause, so far as this is possible. In addition, it is necessary to employ remedies which will temporarily, at least, allay the itching, since this will otherwise provoke scratching, and the scratching will result in several additional difficulties, such as eczema. To allay the itching the patient may take warm alkaline baths once or twice a day. For this purpose four ounces of borax may be dissolved in twenty gallons of warm water. In some cases better results will be achieved by dissolving three ounces of sulphurated potash in the same quanity of water. In many cases of itching without appreciable cause, such as the itching of old persons and that form of itchiness which occurs in many individuals in winter, relief can be obtained by an acid bath made by adding one ounce of muriatic acid to twenty gallons of water. Several remedies have been found useful as applications to the skin for the relief of itching. The following formulæ are given as examples : Borax, ------ Half an ounce. Sulphate of morphia, - Four grains. Rose water, ----- Eight ounces. Mix and apply by means of a soft cloth. Dilute hydrocyanic acid, - - Two drachms. Borax, ------ Four drachms. Rose water, ----- Eight ounces. This is often especially useful in the itching of elderly people. Cyanide of potassium, - - - Four grains. Glycerine, ----- Two drachms. Simple ointment, - - - - Two ounces. When the skin is especially irritable the following mixture may be used : Extract of belladonna, - One drachm. Dilute hydrocyanic acid, - Two drachms. Glycerine, ----- Two ounces. Water, - - - - - - Four ounces. Another formula which is often useful is the following : Camphor, - One drachm. Oxide of zinc, ... - One ounce. Powdered starch, - - - . - One ounce. Mix and dust upon the part. Borax, ------ One drachm. Carbonate of soda, - - - - Two drachms. Dilute hydrocyanic acid, - - One drachm. Glycerine,..... Two ounces. Water, ----- Four ounces. In all cases of obstinate itching care should be taken that the clothing over the part is as unirritating as possible ; hence no flannel should be worn next the skin, and the underclothing should be frequently changed, especially if the individual perspire freely. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! 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