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by wiping and rubbing the surface thoroughly dry with a coarse and moderately rough, but not a stiff, towel, instead of with the fine, smooth diapers which are now so commonly employed. At the bath, the fleshbrush usually provided there will supersede the necessity of using the flannel.
The small black spots and marks frequently observed on the skin in hot weather, particularly on the face, generally arise from the accumulation of the indurated solid matter of the perspiration in its pores. When they assume the form of small pimples (acne punctata), and often when otherwise, they may be removed by strong pressure between the fingers, or between the nails of the opposite fingers, followed by the use of hot, soapy water.
The subsequent daily application of a weak solution of bichloride of mercury—as in the form commonly known as Gowland's lotion—or of sulphate of zinc, will completely remove the swelling, and generally prevent their re-formation.
Eruptions are too well known to need any lengthy description here. They are usually classified, by writers on the subject, into: animalcular eruptions, or those due to the presence of animalcula (minute acari) in the scarfskin, which occasion much irritation, and of which the itch furnishes a well-marked example; papular eruptions, or dry pimples; pustular eruptions, or mattery pimples, of which some forms are popularly known as crusted tetters; scaly eruptions, or dry tetters; and vesicular eruptions, or watery pimples.
The treatment of all of the above, except the first, in simple cases, where there is not much constitutional disarrangement, consists mainly in attention to the general principles of health, cleanliness, exercise, food, ventilation, and clothing. Occasional doses of mild saline aperients (Epsom salts, cream of tartar, or phosphate of soda, or of sulphur combined with cream of tartar) should be taken, and warm or tepid bathing, preferably in sea-water, or, if not convenient, rain water, frequently had recourse to. Stimulants of all kinds should be avoided, and the red meats, ripe fruits, and the antiscorbutic vegetables should form a considerable portion of the diet. Lemonade, made by squeezing the juice of a lemon into a half-pint tumbler full of water, and sweetening with a little sugar, should be frequently and liberally taken as one of the best beverages in such cases. To relieve the itching and irritation (except in the pustular, crusted, and vesicular varieties), brisk friction with a fleshbrush or a fleshglove may be employed. The parts should also be wetted with an appropriate lotion after each friction or bath, or the use of soap and water.
In all the scaly eruptions, iodide of potassium internally, and ioduretted or sulphuretted lotions or baths are invaluable. In many of them of a malignant or obstinate character, as Lepra Psoriasis, Lupus, etc., small doses of solution of arsenite of potassa (liquor arsenicalis; the dose, from 3 to 5 drops, gradually and cautiously increased to 7 to 9 drops, twice a day, after a meal) prove highly serviceable. In the forms of psoriasis popularly called baker's itch, grocer's itch, and washer-woman's itch, the application of ointment of nitrate of mercury, diluted with ten or twelve times its weight of lard, has been highly recommended. A course of sarsaparilla is also in most cases advantageous.
The small, hard, distinct pimples—“acne, or acne simplex” of medical writers—that occur on the forehead, and occasionally on the temples and chin, generally yield to stimulating lotions, consisting of equal parts of strong vinegar, or spirit, and water, or to weak lotions of sulphate of zinc, assisted by occasional doses of cooling laxatives, as the salines, or a mixture of sulphur or cream of tartar.
Freckles, or the round or oval-shaped yellowish or brownish-yellow spots, resembling stains, common on the face and the backs of the hands of persons with a fair and delicate skin who are much exposed to the direct rays of the sun in hot weather, are of little importance in themselves, and have nothing to do with the general health. Ladies who desire to remove them may have recourse to the frequent application of dilute spirit, or lemon juice, or a lotion formed by adding acetic, hydrochloric, nitric, or sulphuric acid, or liquor of potassa, to water, until it is just strong enough to slightly prick the tongue. One part of good Jamaica rum to two parts of lemon juice or weak vinegar is a good form of lotion for the purpose. The effect of all these lotions is increased by the addition of a little glycerine.
The preceding are also occasionally called “common freckles,” “summer freckles,” and “sun freckles.” In some cases they are very persistent, and resist all attempts to remove them while the exposure that produces them is continued. Their appearance may be prevented by the greater use of the veil, parasol or sunshade, or avoidance of exposure to the sun during the heat of the day.
Another variety, popularly known as cold freckles, occur at all seasons of the year, and usually depend on disordered health or some disturbance of the natural functions of the skin. Here the only external application that proves useful is the solution of bichloride of mercury and glycerine, or Gowland's lotion.
The Itch—“psora” and “scabies,” of medical authors; the “gale” of the French—already referred to, in its common forms is an eruption of minute vesicles, generally containing animalcula (acari), and of which the principal seats are between the fingers, bend of the wrist, etc. It is, accompanied by intense itching of the parts affected, which is only aggravated by scratching. The usual treatment is with sulphur ointment (simple or compound) well rubbed in once or twice a day; a spoonful (more or less) of flowers of sulphur, mixed with treacle or milk, being taken at the same time, night and morning. Where the external use of sulphur is objectionable, on account of its smell, a sulphuretten bath or lotion, or one of chloride of lime, may be used instead. In all cases extreme cleanliness, with the free use of soap and water, must be strictly adhered to.
The small, soft discolorations and excrescences of the skin, popularly called moles, may be removed by touching them every second or third day with strong acetic or nitric acid, or with lunar caustic. If covered with hair they should be shaved first.
Extreme paleness of the skin, when not symptomatic of any primary disease, generally arises from debility, or from the languid circulation of the blood at the surface of the body; often, also, from insufficient or improper food, want of outdoor exercise, and the like. The main treatment is evident. Warm baths, friction, and stimulating lotions and cosmetics may be here employed, together with a course of some mild chalbeate (as the lactate, protophosphate, or ammonia-citrate of iron) and hypophosphate of soda.
Roughness and Coarseness of the skin, when not depending on any particular disease, may be removed or greatly lessened by daily friction with mild unguents or oil, or by moistening the parts, night and morning, with a weak solution of bichloride of mercury containing a little glycerine.
Rashes and redness of the skin, of a common character, often arise from very trifling causes, among which indigestion, suppressed perspiration, irritation, and the like, are the most frequent. Nettle rash or urticaria, so called from the appearance and tingling sensations resembling those caused by the sting of nettles, in some people, is very apt to follow the use of indigestible and unwholesome food. It is usually of short duration and recurrent. The treatment consists in the administration of mild saline aperients, and, in severe cases, of an emetic, particularly when the stomach is still loaded with indigestible matter. These should be followed by copious use of lemonade made from the fresh expressed juice. The patient should be lightly but warmly clothed during the attack, and exposure to the cold, or to draughts of cold air, should be carefully avoided. The further treatment may be similar to that noticed under “eruptions.” To prevent the recurrence of the attack, the objectionable articles of food, and any other known exciting causes, must be avoided. Red rash, red blotch, or fiery spot, a common consequence of disordered health, a sudden fit of dyspepsia, and, in females, of tight lacing, and rose rash, false measles, or roseola, having commonly a similar origin to the preceding, for the most part require the same treatment.
Scurf—“furfur or furfura”—is a formation depending on the natural and healthy exfoliation of the skin on every part of the body on which hair or down grows, but most extensive and observable on the scalp, on account of the abundance and darker color of the hair there. Scurfiness, or excessive scurfiness, is the result of morbid action, and may be treated by the frequent use of the fleshbrush or hairbrush, ablution with soap and water, and the use of mild stimulating,