The Mother's Manual of Children's Diseases

by Charles West

Affections of the Skin.—There are a few affections of the skin to which children in early infancy are especially liable, concerning which a few words must be said.

The Latin word intertrigo is used for that chafing of the skin of the lower part of the body of an infant which is by no means unusual, and is often very distressing. It is almost invariably due to want of care. Either wetted napkins are dried, and put on again without previous rinsing in water, or they have been washed in water containing soda, and not passed through pure water afterwards, or attention is not paid to change the infant's napkin immediately that it requires; or a fresh napkin is put on without previous careful ablution of the child; or lastly it occurs almost unavoidably in cases of diarrhœa from the extension of irritation beginning at the edge of the bowel.

Care is usually all that is needed to remove, as it is to prevent this condition. The precautions which I have referred to with regard to cleanliness must be carefully observed, and moreover, each time even after passing water, the child should be carefully washed with thin gruel, or barley water, then dusted abundantly with starch powder, while the napkin must be thickly greased with zinc ointment. After the first six or seven months of life the napkin can be almost always dispensed with, if the child has been brought up in good habits, and in all cases of chafing, it is much the better way to put no napkin on the child when in bed, but to lay under it a folded towel, which can be removed, and a clean one substituted for it as soon as it becomes soiled.

There is a very obstinate form of chafing, with great redness of the skin, and disposition to crack about the edge of the bowel which depends on constitutional causes, and calls at once for the interference of the doctor.

Besides this purely local ailment, there is another skin affection which is seen over the body generally, and is known popularly by the name of red gum, or in Latin strophulus. I mention the Latin name because I have known persons sometimes, misled by the similarity of sound, fancy that it had some connection with scrofula. It is met with less commonly now than formerly, when people were accustomed to keep infants unduly wrapped up, and to be less careful than most are now-a-days about washing and bathing. It depends on over-irritation of the sweat glands of the delicate skin of the infant, the result of which shows itself in the eruption on the body and face of a number of small dry pimples sometimes surrounded by a little redness, itching considerably, and when their top has been rubbed off by scratching having a little speck of dried blood at their summit.

A rash like this, a sort of nettle rash, more blotchy and causing little lumps on the skin, which in a day or two come and go, sometimes appears in the intervals between the pimples, sometimes takes their place, and causes, as they do, much irritation. This nettle rash is usually dependent on some error of diet, on some acidity of the stomach, and, on their being corrected soon passes away, leaving the pimples as they were before, but sometimes being reproduced if the pimples cause excessive irritation of the tender skin.

The matter of chief importance for a mother to know, is that these rashes have no serious signification. Their treatment is very simple. It consists in dressing the child very lightly, in bathing it very frequently with tepid water, avoiding as far as may be the use of soap, and in sponging it often to relieve the irritation with some simple alkaline lotion; such for instance as one recommended by the late Dr. Tilbury Fox, and which is composed of twenty grains of carbonate of soda, two teaspoonfuls of glycerine, and six ounces of rose water. Of course if the stomach is out of order that must be attended to, but a little fluid magnesia, once or twice a day, is all that is usually needed in the way of medicine.

One other affection of the skin, very common, very distressing, very tedious, of which there are many varieties, generally known by the technical name of eczema, from a compound Greek word which signifies to flow, needs that I should say something about it. It is not limited in its occurrence to infancy, nor does it of necessity cease when childhood is over, but continues to recur even in grown persons, and shows itself still from time to time even in the aged.

For the most part, however, it makes its appearance between the fifth and twelfth month; sometimes seeming to be induced by the change of food when the child is weaned, and that even though the weaning may have been wisely managed; at other times showing itself when the irritation of teething begins, and in every instance being aggravated by the approach of each tooth to the surface, and abating in the intervals.

It does not occur in all children with equal frequency or severity, and though there is no doubt but that it is often hereditary, and this especially in families some members of which have suffered from gout, yet it is by no means unusual for two or three of the children of the same parents to be affected by it severely, while no trace of it appears in the others.