ERYTHEMATOUS AFFECTIONS.
The prominent features, eruption, and itching of _eczematous_ affections are purely local. _Erythematous_ affections are, however, remarkable for their symptoms of constitutional disorder. Each of these affections is preceded by intense febrile excitement and nervous debility. In brief, the local manifestations are simply signs of general internal disorders; hence, the treatment should be directed to the restoration of the system. This group includes _erythema, erysipelas_, and _urticaria_.
ERYTHEMA. A vivid and partial flushing of the face is produced by a superficial inflammation of the skin, termed _erythema_. There are many stages of this disease, from the instantaneous transient flush caused by emotional excitement, to the protracted inflammation and swelling of _erythema nodosum_.
The affection is characterized by a flush which is at first a bright vivid scarlet, but which changes to a deep purplish tint. There is a slight elevation of the skin, sometimes accompanied by itching. In the second stage of development, the flush subsides, the skin has a yellowish or bruised appearance, and a few minute scales are formed. In _erythema papulosum_, a fine representation of which is given in Colored Plate III, Fig. 18, there is an eruption of red pimples or pustules. The prominent feature of _erythema nodosum_, a variety of erythema which affects those portions of the skin exposed to the sun, is the appearance of a large swelling, usually lasting four or five days and attended by constitutional symptoms, such as nausea, fever, languor, and despondency. The disease is associated with the symptoms incident to a disordered nervous system and sometimes results fatally, in other cases, it terminates in melancholy and mania.
CAUSES. The predisposing causes of erythema are constitutional debility, changes of climate and temperature, and irritating food or medicines.
Locally, it may be produced by friction and the heat of the sun.
[Illustration: Plate III.
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Fig. 18.]
ERYSIPELAS. There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease.
Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. It is characterized by a burning pain and is very sensitive to the touch.
It is not necessary for the information of the general reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the _depth_ to which the morbid condition extends, and not on any difference in the _nature of the affection_.
Suppuration of the tissues involved is common in the severer forms.
Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means should be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom.
The disease is not regarded as contagious, but has been known to become epidemic.
URTICARIA. (_Hives, or Nettle-Rash._) This word is derived from _urtica_, signifying a nettle; it is a transient affection of the skin, indicated by a fierce, burning, itching sensation and a development of pustules, or white blotches of various forms. A representation of this eruption is given in Colored Plate III, Fig. 17. It is appropriately named nettle-rash, from its resemblance to the irritation caused by the sting of a nettle. There is the same sharp, tingling sensation and a similar white wheal or blotch, caused by the muscular spasm of the corium, a layer of the skin.
Urticaria may be either acute or chronic. Acute urticaria is always preceded by febrile symptoms and the attack is indicated by a sudden congestion of the skin, followed by a slight swelling or elevation of the affected part. When the congestion subsides, the skin has a bruised appearance. In chronic urticaria, the febrile symptoms are absent.
CAUSES. The exciting causes of urticaria are gastric disorder, irritation of the mucous membrane, or a sudden nervous shock. The predisposing causes are conceded to be assimilative and nervous debility. Hence, it frequently accompanies purpura or land scurvy and rheumatism. The skin in some persons is so susceptible to irritation that urticaria can be kindled at any moment by excitement, as an animated conversation, or by the simple pressure of the hand.
TREATMENT. The proper treatment for simple erythema consists in applying to the affected parts a little lime-water, or sweet-oil, or glycerine, with the use of warm baths and mild cathartics. This is generally sufficient to effect a cure, if followed up with the persistent use of Dr. Pierce's Golden Medical Discovery taken three times a day.
In _erysipelas_ a hot bath, with warm, sweating teas, or, better still.
Dr. Pierce's Compound Extract of Smart-weed may be given to favor sweating. The whole person should be frequently bathed with warm water rendered alkaline by the addition of saleratus or soda. The whole should be moved by a full dose of the "Pleasant Pellets." Fluid extract of veratrum viride, in doses of a drop or two every hour will best control the fever. The specific treatment, that which antidotes the poison in the blood, consists in administering fifteen-drop doses of the tincture of the muriate of iron in one teaspoonful of the "Golden Medical Discovery," every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm.
A preparation of equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of great efficacy.
_For urticaria_, the "Pleasant Pellets" should be administered in sufficient doses to move the bowels, the skin bathed with warm water rendered alkaline by the addition of common baking soda or saleratus, and, if there be any febrile symptoms, a little tincture of aconite or veratrum may be administered in one drop doses once each hour. In the chronic form of the disease, the diet should be light, unstimulating, and easily digested, the skin kept clean by frequent bathing, and fresh air and outdoor exercises freely taken. The somewhat protracted use of Dr. Pierce's Golden Medical Discovery will result in the greatest benefit in this form of disease.
BULLOUS AFFECTIONS.
The distinguishing feature of this group of cutaneous affections is the formation of _bullae_, or blebs, which are defined as "eminences of the cuticle, containing a fluid."
HERPES is an inflammation of the skin in which the eruption appears in patches of a circular form. On the second day, minute, transparent vesicles appear and gradually develop, becoming opalescent. On the succeeding days, they shrink and produce reddish brown scabs, which soon become hard and fall off, leaving deep, purplish pits. In adults, these vesicles sometimes terminate in painful ulcers, caused by an irritation of the eruption. By some practitioners, herpes is regarded as a purely nervous disorder, from the fact that it is frequently accompanied by severe neuralgic pains. These pains are not _constant_, but _occasional_, and do not appear at any definite stage of the disease.
Sometimes they precede and accompany the eruption. Other instances are recorded in which they remained many years after the disease had disappeared. The local and constant pain of herpes is a severe burning, prickling, itching sensation, which remains after the scabs fall.
The three _general_ forms of this disease are _herpes zoster_, _phlyctoenodes_ and _circinatus_.
In _herpes zoster_, or _shingles_, the clusters of vesicles encircle one-half of the body, frequently at the waist; hence, it has received the name of _zona_ or _girdle_. The vesicles often develop into bullae, and sometimes ulcerate. In _herpes phlyctoenodes_, the vesicles are small, round, and irregularly distributed over the face, neck, arms, and breast. This form is accompanied by febrile symptoms and offensive excretions.
In _herpes circinatus_, or _ringworm_, the vesicles appear in circular patches, or rings. This is the mildest form of herpes, and is not attended by symptoms of constitutional disorder. The various forms of herpes are represented in Colored Plate I, Fig. 3.
CAUSES. Herpes is not contagious. It is caused by vicissitudes of heat and cold, violent emotions, excessive exertion, irritation of the skin, and a general atony of the system.
MILIARIA is the name given to an eruption of vesicles which are larger than those of eczema, but smaller than the bullae of herpes. At first, the serum contained in the vesicles is perfectly transparent, and reflects the red tint of the underlying skin, hence the name _miliaria rubra._ But gradually it becomes milky and opalescent, hence, the term _miliaria alba_. The vesicles of miliaria are generally solitary, and appear on those portions of the body most liable to become heated and to perspire. The eruption is preceded by chills, languor, slight fever, intense thirst, a sharp prickling sensation of the skin, and profuse perspiration. The vesicles soon desiccate and are replaced by a new crop.
CAUSES. Miliaria is almost universally an accompaniment of febrile disease, and all disorders in which there occurs a profuse perspiration.
The causes to which it may be traced in each instance are improper diet, impure air, burdensome clothing, or strong emotions.
PEMPHIGUS is a peculiar eruption which appears upon the limbs and abdomen. The affected part is of a bright red color, and, in a few hours, small vesicles appear containing a transparent fluid. The vesicles soon develop into bullae, entirely covering the inflamed portion. The fluid becomes opaque and in a few hours escapes. The patch is then covered with a yellow scab. Pemphigus may be either acute or chronic. The acute form is subdivided according to the degree of inflammation, as _pemphigus pompholyx_ in which it is severe, and _pemphigus benignus,_ when it is mild. The bullae of pemphigus are illustrated in Colored Plate III, Fig. 19.
CAUSE. Pemphigus is always caused by a vitiated state of the system.
RUPIA is indicated by an eruption as large as a chestnut containing a watery fluid, which desiccates into a yellowish-brown crust. A fine representation of rupia vesicles in both stages of development, is given in Colored Plate II, Fig. 13.
TREATMENT. In all forms of herpes, the administration of a small dose of Dr. Pierce's Pleasant Pellets, with the use of his "Golden Medical Discovery" in one to two teaspoonful doses three times a day, will be followed by the happiest results. The skin should be kept clean by the use of the sponge-bath, rendered alkaline by the addition of common baking soda or saleratus. The portion of the body covered by the eruption, should be bathed with a solution of sulphate of zinc, one ounce to a pint of water.
Miliaria is generally associated with certain febrile diseases, and its proper treatment consists in overcoming the febrile and other constitutional symptoms which accompany the disease. A hot foot-bath and small doses of tincture of aconite, say one drop in water each hour, will suffice to remove the fever. If the stomach and bowels are in a vitiated condition, as they are apt to be, a mild cathartic dose of "Pellets" should be given.
_The treatment of pemphigus_ should consist in frequent alkaline sponge-baths, and in covering the affected parts with poultices of slippery elm, which should be kept moist with vinegar, The constitutional treatment should embrace the persistent use of the "Golden Medical Discovery." When the disease occurs in children, it is most generally dependent upon deficient nutrition, and special attention should be given to the diet of the patient, which should be nutritious.
Fresh air and outdoor exercise ought not to be neglected.
The proper treatment of rupia does not differ from that suggested for pemphigus.
NERVOUS AFFECTIONS OF THE SKIN.
In nervous affections of the skin, the natural sensibility may be increased, diminished, or perverted. These morbid impressions arise from the nervous system. Although there are several varieties of these affections, yet, being of minor importance, we shall omit their consideration and only speak of one of them in this work.
PRURIGO affects the entire surface of the body and imparts to the skin a parched, yellowish appearance. It is characterized by pimples, and an intense burning, itching sensation. Rubbing and scratching only irritate the skin, which becomes covered with thin black scabs. A good representation of _prurigo_ may be seen in Colored Plate II, Fig. 6. The itching sensations are sometimes caused by chilling the body, by violent exercise, and heat; allowing the mind to dwell upon the affection aggravates it. Prurigo is recognized under two forms; _vulgaris,_ which is a mild form, and _senilis_, which chiefly occurs in old age, and is more severe. The external genital parts of females are frequently affected with this disease, and it is aggravated by menstruation and uncleanliness.
This affection may be due to a vitiated condition of the blood, and is common among those who are greatly debilitated. It is frequently occasioned by uncleanliness, intemperance, the use of unwholesome food, or by an impure atmosphere.
TREATMENT. To allay the itching, take glycerine, one ounce, add to it one drachm of _sulphite_ of soda, and one ounce of rose-water, and apply this to the affected parts. A solution made with borax, two drachms, and morphine, fire grains, dissolved in six ounces of rose-water, makes an excellent lotion to allay the itching. If the disease be severe, it will be necessary to correct the vitiated condition of the blood by a protracted use of Dr. Pierce's Golden Medical Discovery, and to aid its effects, give one "Pleasant Pellet" every day, not to operate as a cathartic, but only to exert an alterative influence.