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Salt Rheum - Eczema.One of the most common forms of eczema is that one familiar to those who have much to do with infants and children ; it is the eruption which appears upon the face and head of a child, usually within the first two years of life, and often at the period of teething. It usually begins in the shape of scattered red points or pimples, which soon run together, and in a short time begin to exude a watery fluid ; this is called " weeping. " The eruption is always exceedingly itchy, and causes an irresistible desire on the part of the patient to rub and scratch the diseased skin; even the infant in arms finds means to attempt the relief of this irritation. In a short time after the rash has begun to " weep,'' crusts arc formed ; these are at first thin and scattered, but are soon united into thick yellowish or brownish yellow layers, which may cover the entire scalp and form a mat, through which the straggling hairs project. The disease is especially apt to occur behind the ears and in the crease of the skin under the jaw, though in infants it commonly spreads from these localities, so as to involve the entire scalp and the face as well. If there be a decided tendency to the manifestation of the disease, eczema will soon be found in almost all those localities where two surfaces of skin rub against each other ; in addition to the spots mentioned, it is observed at the bend of the elbow, at the back of the knee, between the thighs, and, in very fleshy children, upon the wrists. In bad cases it may spread so as to cover almost the entire body. Eczema upon the scalp and face of children is often called " milk crust," because it is supposed that it is in some way associated with the milk. This supposition does no harm, though usually unfounded, but the child often suffers greatly from the belief which is also entertained that the " milk crust " must not be treated nor removed. It is popularly believed that if this rash be " driven in," serious injury will result to the child ; hence the infant is permitted to suffer untold torment from the itching and soreness of the skin for months and years. In previous pages we have endeavored to emphasize the remark that no harm can result from " driving in" a rash on the skin; in fact that is quite impossible by any means at present known to us to " drive in " any rash. These remarks are true of eczema, as it occurs in infants ; in every case, the child should be relieved as quickly as possible of the eruption, since it is a constant source of pain and annoyance to the infant, and reacts upon its general health in a marked degree. Furthermore, it is true of eczema, as of so many other diseases of the skin, that the longer they last the more obstinate and difficult to cure they become. It is by no means certain that the rash will disappear when the child is weaned ; and if it does not, it may be quite impossible, or next to impossible, for the physician to control it after it has lasted so long. Sometimes eczema appears during the process of teething, and the child becomes in this case also the victim of the mistaken notion that the rash is a necessary part of the teething process, and must not be interfered with. When the children become somewhat older, they are less liable to these extensive patches of eczema ; the disease occurs in them as smaller patches, moist and red, which are especially often located behind the ears. Another form of eczema, which oiten occurs in children, though sometimes observed in adults also, does not proceed as far as the " weeping " form ; this consists merely in redness and perhaps rawness of the surface in the folds of the skin, and between two opposing surfaces. This redness and rawness, caused by chafing, is often found in fleshy infants, and in warm weather is very apt to affect those parts of the body which are covered by the napkins. This variety of eczema is usually dependent upon the mechanical irritation or chafing in the one case, and upon the contact of wet and soiled napkins in the other. It is, therefore, a much less serious and obstinate affection than eczema of the scalp and face, and yields far more readily to treatment. In adults, eczema occurs in almost all parts of the body; the forehead, the cheeks, the eyelids, the nose, the lips are very often affected. When the disease occurs in the face, especially around the mouth, it is apt to prove obstinate, in consequence of the constant movement of these parts. In men, too, the presence of the beard is an additional obstacle to the cure of the affection, since, if the beard be allowed to grow, it is impossible to reach the disease satisfactorily, while if the face be closely shaven, the eczema is often thereby aggravated. In women eczema is very common around the nipples and on the genitals. Many of the affections of the nipples during nursing are simply cases of eczema. Very many women who are afflicted with diseases of the womb, or of the vagina, suffer constantly from eczema on the neighboring skin, as the result of irritating discharges. In some cases, too, eczema frequently appears periodically during the menstrual flow. Eczema is also frequently found in adults on the leg, especially just above the ankle. This is especially often the case with those who are troubled with enlarged or " varicose " veins. In this location the eczema is very obstinate and is apt to proceed in the course of time to the formation of ulcers. Cause*-Eczema is caused both by external irritation and by derangements of various functions of the body. Among the former is especially the irritation caused by the use of soaps, ointments, powders and liniments. Foremost among these is the favorite tincture of arnica. Every physician of experience has seen cases in which attacks of eczema, sometimes severe and obstinate, have followed the application of arnica to the skin for some trifling bruise or sprain. And there are cases in which all treatment seems to be ineffectual until the patient abandons the use of some particular kind of soap. In some individuals the habitual use of hot baths occasions more or less extensive eczema. The long continued application of water, or of other substances which seem quite bland, occasions eczema in some individuals. Washerwomen, cooks, waiters and people of similar occupations, are often subject to the disease on the hands and wrists. In these cases treatment is unavailing until the patient abandons the employment which compels him to expose the hands to the constant irritation. Bakers are often subject to eczema on the hands and face. In this case the affection seems to result from frequent exposure to a ,gh temperature. This affection is called from the frequency of its occurrence in bakers, by the name " bakers' itch. " People employed in grocery stores are often similarly affected, presumably from contact of the hands with sugars and various irritating articles. Bricklayers are especially prone to suffer from this disease. One of the most frequent among the irritating causes of eczema is the scratching which every one employs to relieve an obstinate itching; hence any disease of the skin which is accompanied by itching, is very apt to be followed by eczema. It has beer* already mentioned that the itch often becomes obscured and mistaken for eczema, because the irritation, which is a prominent feature of the itch, causes violent scratching, and this in turn excites an eczema. Even the pressure of tight clothing, of bands, suspenders, belts, garters, etc. may excite eczema in individuals predisposed to it. Exposure to the rays of the sun, and even sudden changes of temperature, may also provoke the disease. Pregnancy is very apt to be accompanied by eczema in the legs and on the genitals, especially if there be swelling of the feet. Contact with a poison ivy, the use of sulphur ointment, or articles of clothing containing irritating substances, also frequently cause the disease. Among the most frequent of such articles are colored stockings. There is a great difference in the susceptibility of different individuals to this disease, since some are readily affected by causes which do not influence others at all. It may be said in general, that blond individuals are more suseeptible to the disease than those of darker complexion. The internal causes-those conditions of the system which give rise to an attack of eczema without external irritation-are by no means well ascertained. It may be said in general, that those who are afflicted with chronic diseases of the digestive organs and of the kidneys, are far more liable to eczema than others. Scrofulous individuals seem very susceptible ; and so do girls suffering from green sickness " or chlorosis. A coincidence has been observed between certain diseases of the womb and eczema ; and it has been remarked that women are especially often afflicted with the disease during the change of life. Treatment. - In every case of eczema it is highly important to ascertain the cause ; otherwise salves, ointments and powders may be applied for months without improving the condition of the skin. It is impossible to mention in detail all of the constitutional conditions which seem to predispose to eczema, and which should be, therefore, looked for in obstinate cases of the disease. Yet it should always be borne in mind that if the patient be suffering from the green sickness, diabetes, dyspepsia, constipation or other affection, it will rarely be possible to relieve him entirely from the eczema without first improving his general condition. In all such cases it will be necessary to regulate the diet, and to avoid such excesses in eating or drinking as evidently disturb the patient's digestion. The eczema of infants is often due to improper quality or quantity of food. It is especially common among those infants that are nourished partly or completely with artificial food. In every case of obstinate " milk crust, " or of eczema in infants generally, it is a matter of prime importance to secure the best possible diet, whether this shall be mother's milk, that of a nurse, or some of the artificial foods which are recommended at the appropriate place in this book. In some cases the change of diet alone, without other treatment, is sufficient to cure the disease. In fact, in almost every case, whether the patient be adult or infant, careful attention to the diet constitutes an important part of the treatment. In those cases in which the disease is traceable to external irritation, the source of this irritation should be of course removed. In some instances this is, under the circumstances, impossible, since the patient is unable to abandon his employment ; thus the most obstinate cases occur in women who are compelled to have their hands constantly in water. In such instances much good can be derived from the use of rubber gloves. So, too, if the eczema depends upon an irritating discharge from the vagina, it will be necessary to adopt such treatment as will stop this discharge before the eczema can be cured. In general in the treatment of eczema in which there is considerable watery discharge and the formation of crusts, the surface should be softened by oiling the skin thoroughly, or by the use of a light flax-seed poultice. After this is accom plished and the crusts removed, one of the following ointments may be applied : Oxide of zinc, - Two drachms. Lead water, ... Two drachms. Glycerine, - Four drachms. Lime water, To make eight ounces. This may be applied to the surface by means of a soft cloth, such as an old handkerchief, which should be saturated with the lotion and laid upon the raw surface. If there should be much burning and itching, one of the following remedies may be used : Carbolic acid, - Half an ounce. Water, - One pint. This may be applied frequently upon soft cloths. Or Camphor, ----- One drachm. Borax, - Two drachms. Alcohol, ----- Two ounces. Rose water, - Six ounces. For the eczema of the head in children, the following is recom mended by Fox: Ammoniated mercury, - - Twenty grains. Nitrate of mercury ointment, - Twenty grains. Acetate of lead, - Ten grains. Oxide of zinc, - Twenty grains. Purified palm oil, - Half an ounce. Fresh lard, - - - Half an ounce. In many cases of eczema, especially in children, good results can be obtained from the use of diachylon ointment, which may be applied on pieces of soft linen or flannel. If the child's skin be especially sensitive, the ointment may be mixed with one-third of glycerine, after the following formula : Diachylon ointment, - Three ounces. Glycerine, ----- One ounce. These ointments will generally be found more serviceable than the one previously given for all cases in which the skin is sensitive. Whenever the skin begins to chafe in a fold, or where two surfaces come in contact, much good can be done by dusting the parts with the following mixture : Camphor, ----- Half a drachm. Oxide of zinc, - One ounce. Powdered starch, - One ounce. If these cases are not severe, they can often be relieved by the use of a little vaseline, to which there may be added the oxide of zinc in the proportion of ten grains to the ounce of vaseline. Another soothing lotion, which may be used to advantage when there is much itching and burning of the parts, is as follows : Borax, - - - - One drachm. Carbonate of soda, - Two drachms Glycerine, ----- Two ounces. Strong carbolic acid, - Twenty drops. Distilled water, - Six ounces. Mix and apply by means of soft linen or flannel. In some obstinate cases success has been attained by the application of the glycerole of the acetate of lead, even after other remedies have been tried in vain. In those cases in which eczema of the legs occurs as a result of enlarged veins, the cure will be very much hastened by the use of an elastic rubber bandage. In recent years this article has come into general use for ulcers and eczema of the legs. The rubber is made after a special formula, and is sold under the name of " Martin's bandage. " In the hospital wards of the renowned Hebra, in Vienna, success has been obtained, in obstinate cases, by the use of rubber garments. If the hands alone are affected, rubber gloves are worn night and day; if, as sometimes happens, there be extensive eczema of the legs or the trunk, closely-fitting garments of light rubber are made and worn constantly. If such garments or gloves are used, the skin soon becomes softened and macerated from the accumulation of perspiration and of the discharges. Hence it will be necessary to remove these garments every two to four hours, dry them, and wash the skin carefully. It is, therefore, necessary to have at least two sets of garments, in order that one may be worn while the other is drying. Generally speaking, the skin which is affected with eczema must be carefully protected from water and soap. There are cases, it is true, in which it become necessary to wash the skin regularly, but in the majority of instances water should be applied only when absolutely necessary to remove the accumulated discharges. The good effects of such care are seen in those cases of eczema of the hands, in which the individual has been in the habit of washing the hands frequently. Such cases often resist all sorts of treatment until the hands are protected from water ; after this, recovery follows rapidly. The following quotation shows how this disease is managed in Vienna, the headquarters of the world for the treatment of. skin diseases: 11 In eczema of the scalp or of the ears, the crusts are to be removed by inunctions with oil, which are to be made twice a day, about three ounces of oil being used each time. The crusts are thus removed, and the raw places are covered with flannel. If the skin be not much thickened, the salves which have been mentioned above can be applied at once. If the skin be found red and 'weeping,' it will be necessary to apply rectified spirits repeatedly. When the swelling subsides, if the skir continues to secrete freely, tar may be applied in the case of adults; this agent should not. however, be used for children, because their skin is much more sensitive, and swelling, perhaps even suppuration, of the glands in the neck can be induced very easily. If the eczema extend into the ear, one may use injections or astringents ; but in order to bring the salve into contact with the entire surface of the ear, a piece of sponge, properly shaped and covered with lint, should be smeared over with the salve and inserted into the ear. If the eczema extends high into the nostril, we may use suppositories. Each of these may contain : Cocoa butter, ... - Eight grains. Oxide of zinc, - Five grains. This should be inserted into the nostril. " A child suffering from eczema of the face should have a piece of linen smeared with diachyolon ointment laid upon the raw place; this may be fastened with a flannel bandage and renewed constantly until the crusts have been removed."-Neumann. In some cases eczema appears suddenly in consequence eithei of some exposure to irritating substances or of some error in diet. This is what is called acute eczema. There is considerable swelling and heat of the skin and the sore place discharges freely. In the early days of this affection excellent results are ob tained by sponging the diseased surface with alcohol four or five times a day; after which, in the intervals, there may be applied upon linen, one of the salves mentioned above, especially the combination of borax and glycerine, as follows : Borax, - One drachm. Carbonate of soda, - Two drachms. Glycerine, - - - Two ounces. Distilled water, - Four ounces. 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! Also, please consider sharing our helpful website with your online friends.
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