Part 11

Local.--Cut it open thoroughly by a cross (crucial) cut, like this (x). The cut must reach through the mass to sound tissue beneath and beyond it. Then scrape out all the dead tissue. Dress with iodoform or sterile gauze. An antiseptic like listerine, glyco-thymoline, etc., can be used to wet the gauze, put on as a dressing afterwards and then more dry gauze above, strapped with adhesive plaster. Water and instruments must be boiled, hands must be absolutely clean. Everything around it must be clean. Sometimes it is necessary to go slowly and take out at each dressing only what can be easily removed, It is not always possible to get the whole mass away at once. Opening the carbuncle and giving free drainage afford great relief from the fever and often general symptoms. When the part feels as if it needed redressing, it should be done, for it then gives much relief. The dressings frequently become hard and do not absorb all of the material ready to be discharged. It is usually proper and prudent to dress a carbuncle two or three times a day. There is no danger if the one who dresses it is clean with the instruments, hands and gauze or cotton.

LIVER SPOTS, Moth Patch, Chloasma, etc.--This is a discoloration of the skin of a yellowish to a blackish tint of varying size and shape.

Causes.--It may be due to external agencies, such as rubbing, scratching, heat (tanning and sunburn) blistering; or due to diseases such as tuberculosis, cancer, malaria, Addison's disease, disease of the womb, pregnancy.

PHYSICIANS' TREATMENT for Liver Spots.--Remove all causes if possible.

Local.--This must be carefully used, find out first how sensitive the skin is. Dr. Bulkley recommends this lotion:

Corrosive Sublimate 5 grains Dilute Acetic Acid 2 drams Borax 40 grains Rose water enough for 4 ounces

Shake bottle, mix and apply to the part night and morning. If the skin becomes too scaly, a mild soothing ointment should be substituted for the above. White suggests the following:

Hydrarg. Ammon. Chlar 2 drams Subnitrate Bismuth 2 drams Starch 1/20 ounce Glycerin 1/2 ounce

Mix and apply twice daily.

The application of peroxide of hydrogen has only a temporary effect.

BLACK-HEADS. Flesh Worms, Comedones, Pimples, etc.--This is a disorder of the sebaceous glands in which the sebaceous (fatty, cheesy) secretions become thickened; the excreting ducts, appearing on the surface, as yellowish or blackish points. They appear chiefly on the face, neck, chest, and back and are very unsightly.

Symptoms.--They are easily pressed out, and appear then as thread-like, whitish masses which contain fatty material. The black point may be due to pigment or to dirt from without. Comedones may exist with acne and seborrhoea and excessive secretion of sebum.

Causes.--Want of tone to the skin, which performs its functions sluggishly. Stomach-bowel disorders, menstrual disturbances and anemia are other causes and assist in making them worse. Improper care of the skin and dusty air may be other assistant causes.

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MOTHERS' REMEDIES. For Pimples and Black-heads.--l. Pimples on the face, effective yet harmless remedy for:

Camphor 10 grains Acacia (pulverized) 20 grains Sulphur (precipitated) 2 drams Lime water 2 ounces Rose water 2 ounces

Apply on the face with a soft cloth at bedtime. Allow to dry and brush off the excess of the powder.

Anyone suffering from these eruptions is usually willing to try every known remedy. The above is excellent and very effective and is harmless.

2. Pimples, Alum Water for.--"Take a teaspoonful of alum to a quart of water and use as a wash, say three times a day. This will cure ordinary pimples on the face."

3. Skin Blotches, Cream of Tartar and Sulphur for.--"Two ounces cream tartar and one ounce of powdered sulphur (from the lump). Mix. Dose:--Teaspoonful in a little water three times a day will cure."

4. Rough Skin, Healing Cream for.--"One-fourth cup tallow melted, one teaspoonful glycerin, small lump camphor, dissolved. Mix all together by warming sufficiently." Rub in thoroughly as you do any face cream.

PHYSICIANS' TREATMENT for Pimples.--Remove the cause if possible. The diet should be like that given under dyspepsia and constipation. Menstrual disorders should be remedied.

Local.--Remove the plugs (of sebum) and stimulate the skin glands. For this purpose prolonged (ten minutes at a time) bathing of the face with hot water and soap; tincture of green soap in the more indolent, sluggish cases, should precede the pressing out of the blackheads: Lateral pressure with the fingers or with the comedone extractor, especially contrived for this purpose, will express the black-heads. After they are out, the skin dried and cleaned, various stimulating remedies can be applied in ointments and lotions such as following:

1. "Precipitated Sulphur 1 dram Ointment of Rose water 1 ounce

Mix and rub on at night."

2. Beta-Naphthol 1/2 dram Resorcin 1/2 dram Lanolin 1 ounce

Mix and apply locally.

INFLAMMATION of the Skin. (Dermatitis).--This is due to many causes. It can come from injuries, for instance the rubbing or pressure of ill-fitting clothes, bandages, bites of insects and from scratching.

Varieties.--Dermatitis ambustionis, (burning). This is due to excessive heat upon the skin.

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PHYSICIANS' TREATMENT for Inflammation of the Skin.--Relieve the pain; protect the parts; exclude the air. Paint the burned part with a one to five per cent solution of cocaine, according to the severity of inflammation. Then apply soothing lotions of equal parts of lime-water and olive or linseed oil; cover the whole with absorbent cotton. Dusting powder of soda bicarbonate may also be used, or common soda. In burns with vesicles, etc., open them and then cover with carbolized oil, gauze and adhesive to hold the dressing. The parts can be washed with a solution of boric acid, one teaspoonful to a cup of water; then dust upon the parts sugar of lead once or twice a day. Some use it in solution; I like the powder better. Infusion of lobelia, one ounce to pint of hot water, is good. Also lead and laudanum wash.

ECZEMA. (Humid Tetter-Salt Rheum-Dry Tetter). Definition.--Eczema is an inflammatory disease of the skin, characterized at its commencement by redness, pimples, vesicles, pustules and their combinations, with itching and burning. It terminates in a watery or pus-like discharge with the formation of crusts or scaling.

Varieties.--There are many varieties, red, scaly, fissured, watery looking and hard skin.

Symptoms.--Itching is almost always a symptom of this disease. There is more or less pouring out of liquid (serum). The dry, scaly type, and the weeping type, may alternate with each other. There are six cardinal symptoms; inflammation, itching, moisture, crusting, infiltration (liquid filling of the tissues), fissuring or cracking. Dr. Fox says that nearly one-third of all skin diseases are eczema in some of its stages or varieties. In one kind there is red spot (macule). The skin is dry, of a bright or dull red color, with intense itching or burning, more or less watery swelling in the acute stage. In the chronic stage, the skin becomes thick and covered with fine dry scales, usually in the face (Eczema Erythematosum).

Eczema Vesiculosum. (Vesicular Eczema).--This is preceded by a feeling of heat and irritation about the part. In a short time pinhead sized vesicles appear. These frequently run together and form patches. They rupture rapidly; the liquid is poured out, dries up and forms crusts. The discharge stiffens linen, a characteristic of this variety.

Eczema Pustulosum. (Pustules). Pustular Kind.--This is nearly like the preceding. The vesicles have pus in them from the start or develop from the vesicles. When the pustules rupture, their contents dry up to the thick greenish-yellow crusts. The scalp and face, in children especially, are the favored spots for this kind. It occurs in poorly nourished children.

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Eczema Papulosum. (Papular Variety).--This is characterized by flat or sharp pointed reddish pimples (papules), varying in size from a small to a large pin-head. They are usually numerous, run or crowd together and form large patches. The itching is usually very intense. This causes much scratching, rawness and crusts. The pimples may continue as such, or change into vesicles. In chronic cases they run together, and finally form thick scaly patches, and may run into a scaly eczema.

Eczema Rubrum (red).--The skin looks red, raw, and "weeps." It is most commonly found about the face and scalp in children, and the lower parts of the legs in the old.

Eczema Squamosis. (Scaling).--This may follow any of the other varieties, but usually follows the red and pimple (papule) variety. They are various sized and shaped reddish patches, which are dry and more or less scaly. Thickening is always present, also a tendency to cracking of the skin, especially if it affects the joints. There are other varieties but these are the most important.

RECOVERY.--Eczema has a tendency to persist and rarely disappears spontaneously.

Causes.--Gout, diabetes, rheumatism, Bright's disease, dyspepsia, constipation, nervous trouble, heat, cold, strong soaps, acids, alkalies, rubbing, scratching, etc.

MOTHERS' REMEDIES. 1. Eczema, Lemon or Vinegar for.--"Rub the spots with sliced lemon. This will sometimes relieve the itching. Bathing with vinegar water is better for some as it destroys the germs." The bowels should be kept open, and then constitutional faults removed as the eruption of the skin is but a local manifestation of a functional fault.

2. Eczema, Olive Oil and Powder for.--"Bathe with olive oil and sift over the skin a powder composed of equal parts of fine laundry starch and oxide of zinc powder." Do not bathe with water until healed.

3. Eczema, Herb Tea for.--"A good wash for eczema is made of an ounce of bruised blood-root and yellow dock, steeped well in a pint of alcohol, and half pint of vinegar." Apply gently to the affected parts.

4. Eczema, Potato and Camphor for.--"Make a poultice of a cold potato with a small quantity of camphor. This is very good and relieves the trouble very soon."

5. Eczema, Sulphur and Lard for.--"An excellent eczema cure is made by applying a paste made of sulphur and lard to the affected parts." This is very easily prepared, and has been known to cure many cases.

[SKIN DISEASES 65]

6. Skin Diseases, Burdock Tea a Standard Remedy for.--"Take a handful of the freshly bruised burdock root to two quarts of water and boil down one-half; drink from a half to one pint a day." This is considered one of the best home remedies for skin diseases that is known and is perfectly harmless.

7. Skin Disease, Blood Purifier for.--

"Iodide Potash 192 grains Fluid Extract Stillingia 1 ounce Fluid Extract Prickly Ash Bark 1/2 ounce Fluid Extract Yellow Dock 1 ounce Compound Syrup Sarsaparilla to make 8 ounces

Mix."

8. Tetter, Reliable Remedy for.--"Turpentine 1 ounce, red precipitate 3 drams, vaselin 4 ounces. Mix, rub on the affected parts several times a day." This is a splendid ointment for a severe case of tetter.

PHYSICIANS' TREATMENT for Eczema.--Water is likely to make acute cases worse. In order to cleanse the parts use water softened by starch or bran. Use oily preparations to soften the crusts and then they can be removed with water and good soap.

In Chronic Sluggish Cases.--Water and strong soaps may be used. Cloths wrung from hot water and applied, will frequently relieve the itching. Use lotions in moist and salves in dry eczema. For the acute kind the remedy should be soothing, and more or less stimulating for the chronic forms.

Local Treatment for the acute and sub-acute (between acute and chronic) eczema.

In acute cases, with much pouring out of liquid (serum), lotions have a cooling effect. They should be frequently renewed.

1. Black Wash.

Calomel 1 dram Mucilage Tragacanth 1 dram Lime water 10 ounces

Mix. Can be used full strength or diluted. Bathe the affected parts several times daily for fifteen or twenty minutes with this lotion and apply oxide of zinc ointment afterwards.

2. Lead and Laudanum wash.--When the parts discharge moisture with burning feeling, and are very sensitive the following is good:

Laudanum 1/2 ounce Solution of Sugar of lea 7-1/2 ounces

Mix and apply externally with gauze saturated with it.

3. A solution of boric acid is also a good remedy.

4. Apply the following soothing application frequently, allowing the sediment to remain on the skin:

Powdered Calamine 1 dram Oxide of Zinc 1 dram Glycerin 1 dram Lime water 6 ounces

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5. Dusting powders.--Corn, potato or rice starch powders. Mennen's baby powder is also good. Borated kind is the best for this.

6. Oxide of Zinc ointment alone, applied night and morning, is valuable in many cases.

The Black wash should be used twice a day just before the oxide of zinc ointment is applied. In other cases powdered oxide of zinc is dusted over the part if the discharge is watery or profuse.

7. McCall Anderson's Ointment.--

Oxide of Bismuth 1 ounce Pure Oleic Acid 8 ounces White Wax 3 ounces Vaselin 9 ounces Oil of Rose 5 drops

Make an ointment and apply. The proportions of each ingredient call be reduced one-half, for smaller amount.

8. Pastes are often borne better than ointment. The following is a good one. Lassar's paste:

Starch 2 drams Oxide of Zinc 2 drams Vaselin 4 drams

Mix and make a paste, apply to the part and cover with soft gauze.

9. For the Itching.--

Powdered Oxide of Zinc 1/2 ounce Powdered Camphor 1-1/2 dram Powdered Starch 1 ounce

Mix and dust on as needed.

When the disease is not so acute (sub-acute) applications of a mildly stimulating character are needed. For this purpose, resorcinal in the proportion of two to thirty grains to the ounce of lard, according to the severity and amount of hardness existing. Apply to the part. Stimulant and soothing.

External Treatment of Chronic Eczema.--Applications for chronic and lasting sluggish eczema.

1. Tincture of green soap used with hot water until the skin is bared and then dress with oxide of zinc ointment.

2. Tar in the form of the pure Official tar ointment.

3. Salicylic acid thirty to sixty grains to an ounce of lard and applied for stimulating purposes.

4. Dr. Schalek uses the same remedies in part and the following for a fixed dressing, especially on the eyes. They do not need to be changed often.

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Glycogelatin Dressing.--

Gelatin 10 drops Oxide of Zinc 10 drops Glycerin 40 drops Water 40 drops

Mix and apply to the part.

The above may be made in any quantities,--using drops, spoonfuls, etc. Dress the parts in a thin gauze bandage, over which the melted preparation is painted. I have given many different prescriptions, but those who treat skin diseases know that a great many are needed, for they act differently upon different persons.

Special Varieties of Eczema and what to do for them.--

Eczema of Children.--This is generally acute of the vesicular (watery) or vesicular pustular (pus forming) variety. The parts commonly affected are the scalp and the face.

PHYSICIANS' TREATMENT for Eczema.--Remove the causes, watch the feeding. Keep the folds of the skin dry and free from friction. To prevent scratching, masks must be applied to the scalp and face, or the hands must be tied in bad cases. The local treatment is the same as above except the strength of the drugs used must be reduced in proper proportion.

Eczema of the Scalp, Milk Crust.--Remove the crusts by soaking the scalp with some bland oil for twelve hours, followed by a shampoo, (the hair should be cut in children) then the lotions and thin ointment (see above) should be applied.

Eczema of the Face.--A mask of soft linen with holes cut out for the eyes, mouth and nostrils may be used.

Eczema of the Scrotum.--A well fitting suspensory should be worn, sponge the parts with very hot water and follow with the anti-itching lotion and dusting powders for the itching.

Eczema of the Hands in Adults.--Keep the hands out of water as much as possible. Dry them thoroughly and then anoint. Greatly thickened patches may be softened by soap plasters or bathe the parts in ten or twenty per cent solutions of caustic potash and followed by a salve application. The internal treatment must be given for the cause.

Diet in Eczema.--Avoid salty foods, such as salted fish or pork and corned beef; greasy foods such as bacon and fried dishes; pastry and cheese.

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MOTHERS' REMEDIES for Salt Rheum. 1. Alum Wash and Cathartic for.--"Use an astringent wash as alum, tablespoonful in pint of water, and keep bowels opened by cooling medicines, as cream tartar, rochelle salts, etc." The alum solution will be found very cooling and by keeping the bowels open you will carry off all the impurities thus cleansing the blood, which is one of the essential things to do in salt rheum.

2. Salt Rheum, Ammonia and Camphor for.--"Apply ammonia and camphor to the cracks. Have used this successfully when everything else failed." Care should be taken not to have the ammonia too strong, as it may irritate the skin more. If used properly, it is a good remedy.

3. Salt Rheum, Cactus Leaf Cure for.--"From one large cactus leaf take out the thorns, add one tablespoon of salt, three tablespoons lard, stew out slowly, and grease with this at night. Remarks:--This cured my hand that had been in an awful condition for years."

4. Salt Rheum, Pine Tar for.--"Apply pine tar as a paste." This is an excellent remedy but care should be taken in using it, as pine tar is very irritating to some people, and should be used very cautiously.

BOIL. (Furunculus, Furuncle). Causes.--Boils may appear in a healthy person, but they are often the result of a low condition of the system; they are frequently seen in persons suffering from sugar diabetes.

MOTHERS' REMEDIES. 1. Boil, My Mother's Poultice for.--"Poppy leaves pounded up and bound on are good. My mother has used this recipe and found it to be good." This remedy not only makes a good poultice, but is very soothing, as poppies contain opium. The leaves may be purchased at any drug store.

2. Boil, Soap and Sugar Poultice for.--"Poultice made of yellow or soft soap and brown sugar, equal parts. Spread on cloth and apply faithfully." This makes a good strong poultice, and has great drawing powers and would be apt to create a good deal of pain, but would draw the boil to a head. The above remedy was sent in by a number of mothers, all of whom said they had tried it with success when other remedies failed.

3. Boil, Vinegar or Camphor for.--"May be cured by bathing in strong vinegar frequently when they first start. When it stops smarting from the vinegar cover with vaseline or oil." Bathing the boil in vinegar seems to check the growth and does not allow them to become as large as they would ordinarily. If you do not have vinegar in the house, camphor will answer the same purpose.

4. Boil, Bean Leaf Poultice for.--"Apply snap bean leaves, beat up fine." Bruise the leaves so that they are real fine, and apply to the boil. This acts the same as a poultice.

5. Boil, Another Vinegar Remedy for.--"If taken at first a boil can be cured by dipping the finger in strong vinegar and holding on the boil until it stops smarting. Repeat three or four times then apply a little oil to the head of boil."

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PHYSICIANS' TREATMENT for Boils.--Tonics such as iron, quinine, and strychnine are good. Elixir, iron, quinine and strychnine from a half to one teaspoonful three times a day is a good tonic for an adult. Sulphide of calcium one-tenth grain four times a day is good. Paint the inflamed spot when it first begins, with a solution of gun cotton (collodion) and renew it every hour until a heavy contractile coating is formed. Poultices, if used, should contain sweet oil and laudanum. Alcohol and camphor applied over the skin in the early stages is recommended by Ringer. This I know is good. Another, wipe the skin and use camphorated oil. When boils occur in the external ear, the canal should be washed out with hot water. If it is ripe it should be opened. The following is good for the pain of a boil:

Iodoform 4 grains Menthol 2 grains Vaselin 1 dram

Mix and smear a cotton plug and insert in the ear two or three times a day.

ABSCESS.--An accumulation of pus (matter) in any part of the body.

External Abscess.--Boil the knife, wash your hands in clean, hot, soapy water. Wash the abscess and surrounding parts in hot water and good soap, and rinse off with alcohol, a salt solution, or listerine, etc. Then make a good deep clean cut and scrape out if necessary. Dress with a clean linen gauze or absorbent cotton, Poultices may be used if you are careful. Such an abscess should be dressed twice a day. The inner dressing should be soft and thick enough to absorb all the secretion given out between dressings.

MOTHERS' REMEDIES. 1. Abscess, Beech Bark Poultice for.--"Poultice made of red beech bark and wheat bran," A poultice made of the bark will cause a drawing feeling, and the wheat bran will retain the heat. The proportions for making the poultice should be about half and half.

2. Abscess, Milk and Salt Poultice for.--"Make a poultice of one cup of hot milk and common salt three teaspoonfuls; salt added gradually so it will not curdle. Cook until smooth and creamy, then add enough flour so it will spread but not be dry. Divide this into four poultices and apply in succession every half hour. This will remove the soreness and it should be kept oiled until healed."

3. Abscess, More Good Poultices for.--"Take equal parts of rosin and sugar, mix well and apply for several days until the abscess is broken. If this does not cause the abscess to break, poultice hourly with flaxseed meal."

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FELON. (Whitlow).--An inflammation of the deeper structures and frequently it is under the covering of the bone, (periosteum). If under the latter it must be opened soon or the resulting pus will burrow and destroy bone, joints, etc. The pain is intense, and after the patient has passed one sleepless night walking the floor and holding his finger it should be opened.

How? Place the hand with the fingers extended with the palm up (it is usually under the finger or in the palm of the hand) upon the table; stand by the side of the arm. Attract the patient to something else; have a curved two-edge knife ready and put the point, one-half inch, toward the palm, away from the felon part, press hard and the patient will jerk his hand and the cut will be made down to the bone, the membrane and tissues all opened freely, a vent given for the pus and in ten minutes very little pain. Dress as for an abscess. If opened this way, it need not be reopened.

If in the Palm.--This needs a doctor, and must be opened with care. There are too many blood vessels to be careless there and one who understands it must do it. Open a true felon early before it has time to destroy the bone.

SUPERFICIAL FELONS. Mothers' Remedies. 1. A Cure if Taken in Time.--"If taken in time a felon may be cured without lancing, but if poultice or liniment is used it is important that they should be bound on tightly as the mechanical compression is more essential than the application. A good remedy is finely pulverized salt, wet with spirits of turpentine bound tightly and left two or three days, wetting with the turpentine when dry without removing the cloth."