The varieties of impetigo are designated according to the distribution of the pustules. Impetigo figurata, is characterized by the appearance of large clusters upon an inflamed and swollen surface, generally upon the face, but sometimes upon the scalp. This form is represented in Colored Plate I, Fig. 4. In impetigo sparsa the pustules are scattered over the whole body.
Causes. The predisposing cause of impetigo is nutritive debility, and the exciting causes are irritation, impure air, and errors of diet.
Gutta Rosacea is a progressive disease, and its successive stages of development mark the several varieties, such as gutta rosacea, erythematosa, papulosa, tuberculosa, pustulosa, according as they are characterized by redness, pimples, tubercles, or pustules. This affection is attended with heat, itching, and throbbing. The pustules contain serous lymph, which exudes if the cuticle be broken, and forms a crust at the summit of the pustule.
This eruption often appears on the face of persons addicted to intemperate habits, and has thus received the name of "rum blossom."
Cause. It is essentially a chronic affection, and depends upon constitutional causes.
Scabies. (Itch.) This disease is characterized by a profuse scaliness of the skin, by an eruption of pimples, vesicles, and, in rare instances, of pustules. Its prominent feature is an intense itching, so aggravating that, in many instances, the skin is torn by the nails. Unlike other diseases of the skin, it is not due to inflammation, but is caused by animalculæ, or little parasites, termed by naturalists the acarus scabiei. This minute animal burrows in the skin, irritating it, and thus producing the scaliness and itching. The vesicles are comparatively few in number, and contain a transparent fluid. The pustules are only present in the severest forms or when the skin is very thin and tender. It is then termed pustular itch.
The parts usually affected are the hands, flexures of the joints, and the genital organs. Cases are recorded, in which scabies appeared upon the face and head, but they are of rare occurrence. The activity of the animalculæ, is modified by the vitality of the victim. In persons of a vigorous constitution, they will rapidly multiply, and, in a few days after their first appearance, will be found in almost every part of the body.
Scabies is not confined to any age or sex, but chiefly affects persons of filthy habits. This disease can only be communicated by contact, or by articles of clothing worn by an infected person. There are certain indications which predispose the system to infection, such as robust health, a hot climate, and uncleanliness.
Treatment. In all the varieties of eczematous affections, except scabies, the treatment of which will hereafter be separately considered, remedies employed with a view to the removal of the constitutional fault are of the greatest importance. The eruption upon the skin is but a local manifestation of a functional fault, which must be overcome by alterative remedies. All the excretory organs should be kept active. To open the bowels, administer a full cathartic dose of Dr. Pierce's Pleasant Pellets. Afterwards they should be used in broken doses of one or two daily, in order to obtain their peculiar alterative effects. The use of Dr. Pierce's Golden Medical Discovery is also necessary to secure its constitutional remedial benefits. As a local corrective to relieve the itching and disagreeable dryness of the skin, add half an ounce of blood-root to half a pint of vinegar, steep moderately for two hours, strain and paint the affected parts once or twice daily with the liquid. Every night before retiring, apply glycerine freely to all the affected parts, or dissolve one drachm of oxalic acid in four ounces of glycerine and anoint the skin freely. The white precipitate ointment, obtainable at any drug store, is an excellent application is most forms of eczema. A tea, or infusion, of black walnut leaves, applied as a lotion to the affected parts, has also proved beneficial. The surface of the body should be kept clean by frequent bathing, and thus stimulating its capillary vessels to healthy activity. The eczematous surfaces should not be bathed frequently, and never with harsh or irritating soaps. All varieties of eczematous affections, except scabies, are only temporarily relieved by external applications, while the radical cure depends upon a protracted use of alterative, or blood-cleansing medicines. Therefore, we would again remind the reader of the necessity of keeping the bowels regular, and removing all morbid taints of the blood and faults of the secretory organs by the persistent use of Dr. Pierce's Golden Medical Discovery. The successful treatment of scabies, or common itch, generally requires only local applications, for the object to be obtained is simply the destruction of the little insects which cause the eruption. Happily, we possess an unfailing specific for this purpose. Numerous agents have been employed with success, but Sulphur enjoys the greatest reputation for efficacy, and, since it is perfectly harmless, we advise it for this class of disease. Take a quantity of pulverized sulphur and mix with sufficient vaseline or lard to form an ointment. Having first divested the body of clothing, anoint it all over freely, and rub the ointment thoroughly into the pores of the skin while standing before a hot fire. The application should be made at night before retiring, and the patient should wear woolen night-clothes or lie between woolen blankets. In the morning after the application, the patient should take a warm bath, washing the skin thoroughly and using plenty of soap. This treatment should be repeated two or three times to be certain of a perfect eradication of the disease. After this course of treatment, the wearing apparel as well as the bed-clothes should be thoroughly cleansed, as a precaution against a return of the disease.