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Volume 1

[-21-]

THE TOILETTE.-I.

WE propose, in a series of short articles, to give a concise account of the every day management of the Skin, the Hair, and the Teeth, when these are generally in a healthy state; and, moreover, to indicate very briefly the nature and causes of the more common disorders which [-22-] affect these parts of the body, and the means which should be employed to prevent and to remove such disorders. We hope to afford such information as the reader may use with daily advantage - such as will oftentimes prevent not only discomfort, but even the visit of the doctor, conducing also in some degree to the preservation of a good exterior, and the satisfying therefore of that amount of personal vanity, the existence of which in the individual is in reality essential to the exhibition of true politeness. The first subject for notice, then, is 

THE MANAGEMENT OF THE SKIN.

    Structure and Functions.-A few words may suffice to describe the skin, and they are necessary for the simple reason that it is manifestly imperative to know the construction and properties of an organ, in order that we may appreciate how best to use it, to preserve its proper functions from irregularities, and to prevent the action upon it of injurious influences. The skin is a soft membrane composed of cuticle or scarf-skin - the part which is raised on the application of a blister - made up of small cells flattened together, and of the true skin, or derma beneath, whose structure is that of a mass of fibres arranged in network fashion, projecting at the upper part into little finger-like processes, called papillae, which we see through the cuticle on looking at any part of the skin. The true skin is furnished with blood-vessels, called capillaries, which form a horizontal layer, and send offshoots into the papillae. The nerves are distributed like the blood-vessels. Besides these elements, the whole thickness of the skin is perforated by the ducts of the little sweat glands and by the hair follicles into each of which two little fat glands open by their proper ducts. The scarf-skin does not block up the openings of these ducts, but opens down. and lines their interior. The cells of which it is composed are constantly shed as scurf, and it is the tardiness of this shedding which blocks up the pores of the skin. The little glands secrete a fatty matter, which also tends to choke the pores of the skin; the action of soap is to soften up and remove this fatty matter. The true skin or derma is that part which is made into eather. The little projections or papillae each contain a nerve twig, and are in fact the "feelers" or sensitive organs of the skin - the parts which constitute the organs of touch. Beneath the skin is a layer of fat, which forms an admirable "cushion," breaks the force of blows, and allows the movements of the skin to take place freely. The little sweat glands are tubes which open on the exterior, and run down in a spiral direction; till they end in a little coil, surrounded by blood-vessels, from whence the fluid sweat is derived. Now it is very important to be aware of the number and length of sweat-tubes. There are nearly three millions of these tubes in the body, and it is calculated that they are in all twenty-eight miles in length. It will be at once evident how important it is to keep the pores of the skin open, in order that the body may be properly purified by allowing these sweat glands and tubes to perform their functions properly. This may suffice for the structure. Then what useful purpose does the skin serve? What are its functions? In the first place it is the organ of sensibility; secondly, it is a protection to the body; thirdly, it is a great breathing organ, really an extensive lung. The dark and impure blood circulating through its veins becomes changed by the action of the oxygen of the air, and fitted to nourish the tissues more perfectly. Hence the need of keeping the "pores" of the akin open by proper washing. The importance of the breathing function of the skin can be easily shown by experiment, for if we varnish over the skin the subject so varnished often dies of what is nothing more nor less than suffocation. Insects breathe entirely through their skin. The skin does about one-thirtieth of the work similar to that performed by the lungs, and in disease of the latter it is very likely much more active in purifying the blood. Then, fourthly, the skin carries off by the sweat much solid matter, that would be, if retained in the body, very injurious. Under ordinary circumstances about a pound and a half of sweat is given off by a man in a day. The body is also kept at a proper temperature by the evaporation of the sweat; hence the importance of keeping the skin in order, especially in cleanliness, in order that nature may regulate the heat of the body. Inattention to these points gives rise to various disorders of the system, especially colds, coughs, and the like. The fluid which is sweated out of the body comes from the blood-vessels in the deeper part of the skin. A word more about the work of the little fatty glands, and this part of the subject may be left. These little structures give exit to fatty matter; that by inducing a slightly greasy state of skin, prevents too great evaporation; it acts as a protection to the skin against irritants, and it also carries off certain fatty acids from the body. In an inactive skin these glands get choked up by the retained fatty matter, and we then have pimples, as about the face,.
    To keep the Skin in Health.-It is necessary that it be properly nourished, that all things that will irritate it be avoided, that it be kept in a proper state of warmth and above all things that the utmost and constant cleanliness be observed. Now, in the first place, with regard to the influence of food on the health of the skin may simply be said that in proportion as plain food is regularly taken will the skin be preserved in health m common with other parts of the body. The skin of infants is very liable to get out of order when the milk they take is poor; and it is very important that mothers should attend to this matter, and see that the milk they give infants is really good; or if the natural food which their babies get from them is poor, that means be taken to improve the supply. Fair mothers of fair children should be particular in this respect. If parent or child be weakly, then it may be advisable to give a special meal to a child - say between three or four months of age - of milk with a little water, perhaps thickened with bread, jelly, or a little fine baked flour. A child at seven or eight months should be taking two pints of milk a day; and after the teeth are shown, broths and the like may be taken. By such a plan as this there is the best chance of keeping the skin of infants firm and healthy, so far as diet is concerned. More will be said in speaking of bathing. The growing girl or boy of five, seven, or eleven years of age, requires a full supply of meat, otherwise the skin is liable to be deranged, and such abominations as scald head, ringworm, and the like may probably show themselves. Such young persons as are here indicated require enough food not only to repair the ordinary wear and tear of their bodies, but to provide for the actual increase in growth from day to day. The dietary of schools should be much improved. The following is a capital meal chart, we believe suggested by Soyer, for those in charge of boys and girls:-" Bread and milk at eight; dinner at one: roast mutton and apple pudding; roast beef and currant pudding; boiled mutton with turnips, and rice or vermicelli pudding; occasionally a little salt beef with suet dumplings, plain or with currants in them or pease pudding;" and to these we should add bread and butter and milk and water for tea, and a fair meal of bread and cheese or butter for supper. In the case of those youngsters who look under-fed, a piece of meat at night and a glass of beer or milk in the day time should be added. There is one other point ifs reference to young persons worth notice. It is the importance of eating a certain amount of fat with the food. Children who have unhealthy skins are often those who seem to avoid eating fat. This is a point which parents would do well to [-23-] notice. Fat is a very influential item in the food as regards the skin, and if it cannot be taken in the ordinary way, it is just a question whether it should not be given in an artificial form, by way of cod-liver oil, which has great effect for good on the skin. The dose for a child of a year old is ten to twenty drops; for those of five, half a teaspoonful With regard to adults, the guide to what is best to be taken for the good of the skin, is the effect of food upon the stomach. If there be any article which in being taken does not sit lightly upon the stomach, or flushes the face, that should be avoided, for its use will very likely lead to the development of pimples and red blotches. It has been said that tea and coffee act injuriously upon the skin. There is no foundation for this opinion, but this is certain that a very close sympathy exists between the face and the stomach and when there is a feeling of heat, or the appearance of a red gush after taking beer or wine, or any particular article of diet, in young persons, we may expect the face to become disordered, and blotches and pimples to appear.

[-45-]

THE TOILETTE.- II.

THE MANAGEMENT OF THE SKIN (continued from p.23).

Warmth.- If we would have the skin doing its duty properly, we must be sure that we do not subject it to too great changes of temperature, at least that we protect it sufficiently against surprises in this respect. This we are enabled to do by means of properly selected clothing, which prevents the heat from being conducted, as it is termed, too rapidly away from the body. Flannel garments are the best for this purpose, since flannel is what is called a bad conductor of heat. Merino is the next best protector. The young and the old require more clothing than the middle aged. Now in cold weather the young should, in this variable climate, be provided with flannel or woollen garments next the skin; the feet should be kept especially warm. The custom of allowing young children to be dressed in a half-naked style is fraught with considerable danger. It may be fashionable, Spartan-like, and so on, but it is not sensible. The chest should be well protected, and the sensitive stomach of the child as well. Flannel may be irritable to the skin ; in that case merino should be substituted, or a thin layer of linen placed inside the flannel. When the skin (be it in the infant, the lad, or the man) is kept uniformly warm, the circulation through its texture is much facilitated, and diseases, both of skin and internal organs, are warded off. In summer time, however, flannel is to be dispensed with, and cotton under-garments used instead, as the keeping the body too hot is then followed by various summer rashes, the most uncomfortable of which is the "prickly heat." When we say that infants should be warmly clad, we do not mean that they should he boxed up indoors or in stuffy rooms all day; they should be clothed warmly, in order that they may get the benefit of open air and the like, without running any risk of being injured by it, or the alternations of temperature that characterise our variable climate in England. So, in the summer time, when the average temperature of the day is high, the child should not be muffled up as though he or she were in a vapour bath; nothing so readily induces little red rashes, which result from the excessive perspiration. These rashes are known by the name of the red gum, "red gown," &c., and are most frequently an indication that the sufferer from them requires to be kept much cooler. Clothe well and wisely in winter, but lightly and thinly in the summer. Flannel encasing the chest and stomach, especially in children, in cold weather, must give way to thin garments of cotton in the hotter days of the summer. This is a matter of common sense.
    Exercise is absolutely necessary to a healthy state of skin. The only remark we would here make is this that exercise should be regularly taken each day, and that it should not be taken for at least two or three hours after a meal, since it then stops digestion; and that exercise before meals is certainly the best kind to take, as it puts a man in the fittest condition for food taking Any kind of exercise, when excessive, is of course accompanied in warm weather by perspiration. When the latter is too great, it should never be checked by plunging into cold water, sitting in draughts, or by throwing off the clothes and going to sleep. If the surface be too rapidly cooled, it is not at all unusual for eruptions of various kinds to follow.
    Cleanliness.- The virtues of the use of soap and water have been more appreciated of late. It is impossible to define the amount of good which results from habits of cleanliness, and this can very readily be understood by the reader, if he has comprehended the description of the structure of the skin already given. The skin is a great breathing organ: oxygen enters the blood through it and helps to purify the blood; then the glands of the skin carry off, in the sweat and fatty secretion, matters that if retained would act as poison in the blood. The tendency of an unwashed skin is to become sluggish, the pores get blocked up, the oxygen cannot reach the blood, the perspiration does not readily escape, so as to keep the temperature of the body equable; the injurious action of outside heat is therefore not counteracted by the free evaporation of the perspiration, the circulation gets deranged, and inflammation may be set up. Any one may guess for himself what an unwashed skin can do in choking up the ducts of the skin, if he examine the mass of cuticle and dirt which can be rubbed off the skin of a man who, not having had recourse to a bath or the application of soap to his skin for some time, takes a Turkish bath, or a hot bath, and remains under the influence of heat and moisture sufficiently long to soften the skin and the useless scales of cuticle which should long before have been cast off from the body. Nature can be helped by art in the preservation of health and vigorous action of organs. The application of water to the skin should be part and parcel of the daily toilette. From oldest time "purification by water" has been inculcated as part of man's daily duty, and not without sound reason. By its aid the accumulation of a layer of worn-out and useless cuticle is prevented, which otherwise forms a complete barrier to the entrance of the life-giving oxygen, and prevents, to a greater or less degree, the exit of poisonous products. So far, then, as to the necessity; now as to the mode in which the skin should be cleansed. The use of soap is the most sure way of purifying the surface of the body. Soap contains what chemists call an alkali-a chemical substance (potash or soda) which, brought in contact with animal membranes or substances, softens them. Moreover, it emulsifies fat. The effect of soap on the skin is therefore clear; it softens up the cuticle, and it enters into combination with the fatty layer, so enables the water to gain free access to the skin, and by friction to remove the loose particles of cuticle and dirt. But there are good and bad soaps. Same have too much alkali in them, and then they dissolve or soften up the cuticle too much, and so expose or irritate the delicate deeper layers of the skin. We should use a soap that has a small amount of alkali in it. Some of the best of all the soaps made, considered from a medical point of view, are, in the writer's opinion, the transparent soaps, the well-known old brown Windsor, and the glycerine soaps. Some of the nicest to use are, however, somewhat expensive. Those mentioned are among the best for babies, and may be used freely with them. Well, having obtained a nice mild soap, it should be used to the face once a day, the heads of children twice a week, and the whole body once a week at least. This is in addition to taking the daily cold water bath to be by-and-by noticed. If persons can afford the time and have the inclination, there can be no question that the best possible results follow the use of soap to the arm-pits, the groin and parts about, and the feet, each day, and to those who luxuriate in the thing, it cannot hurt to employ good soap to the body generally each day. We have, however, stated that at least once a week the whole body should be soaped. Ordinary yellow soap does not meet with any favour at our hands, and we condemn it in the case of young children. [-46-] There is one more point on this head. The face, when very hot or dirty, or after a walk, should not be washed in soap. It is better to bathe, not rub, it in a little warm water, and then powder it with ordinary baby powder and let it dry.

THE BATH, AND BATHING IN GENERAL.

    There are very few individuals who could not take daily ablution in the way of the sponge bath. It is true that the majority of people are quite unacquainted with such a thing, from childhood to old age, as the morning dip or the cold douche, but this is the reverse of what really should be the case. It is, perhaps, hopeless to expect that any reformation can be effected in the case of those who have up to the mid period of life avoided the bath, but we may be able, perhaps, to persuade mothers of families to train up their children in the way they should go, and the young portion of our readers to adopt a means of promoting health, which will alone do very much, if persistently followed, in even prolonging life. The babe should be subject every morning to a good sponge all over with in the winter time, warmish water; soap being used as wel1. Those parts in contact with the napkins should be washed carefully at night as well as in the morning The temperature of the room should also be good in winter, and the babe dried rapidly by the use of towels warmed before the fire. In the summer a dip into tepid or nearly cold water itself, or in the case of ruddy children, quite cold, is to be given. When the child comes to be three or four months old it should have become accustomed to its "tub" regularly in the morning, and in the summer time the water may be. even cold, provided the skin feels warm after the child comes out of the bath, and after gentle friction 11 with a warm or dry towel. The head should be washed first of all with soap and flannel. When the child is in the bath the back may be freely douched with the sponge.
    When children are given the bath from an early age, they take it each day with peculiar enjoyment. There need be no difficulty in the way of expense; a wooden bath suitable for infants can be bought in the turners' shops for a few shillings, and the ordinary sponge baths, fitted for youths, girls, and adults, of a common sort, cost something inconsiderable.
    If the cold douche bath is taken at an early age, it should be persevered with throughout life, and only relinquished temporarily in febrile ailments. The best time for every one to take the cold bath is immediately on getting out of bed, before the body becomes chilled. The test whether the bath does good or harm is to be found in the occurrence of shiverings, cold feet, a sense of coldness over the body, and an absence of "glow" over the surface. In such circumstances, the water taken must be tepid, and friction with towels must be freely employed.
    Hot baths should only be taken, as a rule, as a cleansing operation; in fact, for the "Saturday night's wash," so to speak. Those who are taking active exercise, on the one hand, in their occupation, and those, on the other, who lead a sedentary life, are benefited by a good soaping all over and a rinsing in warm water every fortnight, in addition to their cold douche each day.
    So with the Turkish bath. It may be taken as a cleansing operation; it cannot supersede the cold bath in the morning. When the skin gets dry and inactive, and the cuticle feels rough, the forced perspiration and the thorough wash and soaping one gets in the Turkish bath, tend to remove the worn out and dead cuticle which collects on the skin. The Turkish bath should be taken before a meal, not at least until three hours after a meal, and the bather should be perfectly quiescent in the bath, lying down as much as possible. He may drink a little water from time to time, and place a little water on the head if it gets dry and hot. Turkish baths, however, for healthy persons, do not find much favour with us. 
    A good deal has been said with regard to the efficacy of flesh gloves and brushes. These are very good in their way, but there is no better way of promoting the proper circulation of the blood (for flesh brushes and the like act in this way) than by rubbing the skin freely, but moderately and firmly, with a fairly rough towel. If, from long-continued cold weather, or east winds, the perspiration has been retarded, the skin may become harsh to the feel from the plugging up of the little sweat glands by dead cuticle; then a vigorous application of the flesh brush, after a good soaping of the surface, may do very much good.
    In addition to the home or douche bath, there is the plunge bath, river or other, to be considered. Bathing in general, such as we now refer to, is very injudiciously practised, and it is much to be regretted that parents, heads of schools, and others, are so extremely ignorant generally of the best rules for bathing. The proper time is when the body is moderately heated with exercise, and when the process of digestion is at an end, and the water into which the bather goes has been somewhat warmed by the sun.
    The reason for bathing when the body is heated slightly by exercise is simply this, that the circulation is excited and active, and is on the qui vive, as it were, to prevent any bad effect of the shock of the plunge. If the body is cool, or the bather fatigued, the vital powers are depressed rather than stimulated by the cold plunge. The whole body should be immersed. As stated before, in reference to the cold douche, the test of a bath agreeing with any individual is to be found in the occurrence of what is termed "reaction.! If after the plunge the blood circulates freely through the skin, and a feeling of warmth and freshness is experienced, we know that the bath has acted as a tonic. If the bather feels shivery and cold, the bath does harm, and when this latter condition is found to exist in weakly subjects, it is better that medical advice should be at once taken, before bathing is again permitted. The following rules, drawn up by the Royal Humane Society, are good :-
    1. Avoid bathing within two hours after a meal.
    2. Avoid bathing when exhausted.
    3. Avoid bathing when the body is cooling after perspiration.
    4. Bathe when the body is warm.
    5. Avoid chilling the body after bathing by sitting naked on banks or in boats.
    6. Avoid staying too long in the water. Leave it directly there is the slightest feeling of chilliness.
    7. Avoid bathing altogether in the open air if, after having been a short time in the water, there is a sense of chilliness or numbness of hands and feet.
    8. The vigorous and strong may bathe early in the morning on an empty stomach.
    9. The young and the weak had better bathe three hours after a meal-best after breakfast.
    10. Those who are subject to attacks of giddiness and faintness, or palpitation, &c., should not bathe without first consulting their medical adviser.

[-62-]

THE TOILETTE.-III.

THE MANAGEMENT OF THE SKIN (continued from p. 46).

 Sea-Bathing.- Sea water is rather more stimulating than ordinary water, and this difference is perhaps the only one of any importance to be considered in reference to this subject - that is to say, so far as the action of the sea water itself upon the body is concerned. It can be readily understood that if ordinary bathing is sometimes followed by disagreeable results, because it is employed. in an injudicious manner, or at an improper time, ill effects are much more likely to arise under similar circumstances when the skin is stimulated by sea water. We do, indeed, discover that sea-bathing occasionally does harm ; it is said not to "agree with" this or that person or child, and such an opinion is now and then firmly held by parents and others. But it is often an unfair conclusion, for the simple reason that proper precautions have not been taken to use the sea douche, as before observed, fairly and at the right time. It is also true that in some exceptional instances sea-bathing cannot be taken with comfort under any circumstances - when the best precautions are taken to prevent its disagreement. But these examples are rare; and in the majority of cases in which it seems objectionable, sea-bathing can be had recourse to with benefit, if it be used with proper regulations. Now, as in the ordinary bath, we should be particular not to bathe when the surface is too much cooled, nor allow the body to be chilled. Half should not be out and half in the water for any length of. time, but the whole immersed. The bather should not go into the sea too soon after a meal, nor when he is exhausted, but when moderately warm by exercise, or on first getting up in the morning, if he or she be in very vigorous health. 
    In the case of children, it is best that they wait till the sands have become thoroughly warmed by the sun, when the water is consequently warmest. They should not be permitted to go into the sea late in the evening, especially if the weather be in the least degree inclined to be chilly. The best time of all, perhaps, is in the afternoon; but there is no reason why a dip, as before observed, should not be taken in the morning, if the weather be suitable. The bather should be careful not to alter his usual habits. Children, of course, dine in the middle of the day. They are ready for their plunge two hours afterwards. We think it best that the sea water should be allowed to come into direct contact with the body, without the intervention of any dress. It is best to follow this plan where it is convenient to do so. On entering the sea, bathers should go thoroughly into it, and not dabble about, to get chilled knee-deep in the water. There is more harm done in this than in any other way, and it is the fault of young ladies. Bathers should keep moving about, frequently dip, and, at the outset of sea-bathing, be a short time in the water. The latter is a most important consideration, and must be noticed a little more in detail. When an individual commences bathing, it is best that he or she take one or two plunges, and then leave the water. After the next two or three days, five minutes' immersion may be allowed; but it should be noticed if there is any feeling of chilliness. If so, the time should even be lessened, when a glow is felt after one or two plunges into the sea, but a coldness if the bather remains longer in the water. It may be well to take the bath twice a day; but for short intervals each time. The majority of persons, however, especially if they bathe in the afternoon, when the water is somewhat warmed, will be able to remain immersed for ten minutes, and this is quite long enough for the majority of persons. At all events, when the first sensation of chilliness or coldness is experienced, the bather should leave the water. Much harm is done by a protracted stay in the water, so as to check the reaction of the skin. Instead of the sea water acting as a stimulant, it then acts as a depressant. The bather on coming out of the water should dress at once and rapidly. The conveniences at our watering places are not what they should be; towels should be dry and warm, and it should be possible to have a pail or foot bath, with warm water to stand in, especially for ladies and children, so as not only to rinse the feet, but as a preventive against the body being chilled. Reaction should be encouraged by vigorous friction of the body, and the bather, when dressed, should take a short and brisk walk, which will call the circulation into activity, if it be at all inclined to flag. If there be any actual shivering or chilliness, a little warm tea or wine and water, or some warm simple, may be required.
    We have finished with the treatment of the skin in health, and now proceed to speak of its management when it becomes disordered.

DISORDERS OF THE SKIN.

    Dry Skin.- The skin may be dry generally or only in certain places. In the former case it may be a congenital disorder. Every now and again one sees children at six months or a year old exhibiting a peculiar harsh, dry, and somewhat wrinkled state of skin. They never perspire, feel the cold very much, and winds chafe their skin. There is more or less scaliness, and often little dark plates collect about the ankles, knees, and other parts of the body. These can be picked off, leaving the skin harsh and rough, like a nutmeg-grater almost. In these severe cases much may be done, under medical advice, by the use of baths and frictions, with oil or glycerine, to make the sufferer comfortable. In other cases a dry skin is not an affair which is congenital, but it comes on in after life - in the child as well as the adult. The skin looks dirty and muddy besides feeling dry; it itches, and scratching produces pimply eruptions. This state usually arises from a neglect of the [-63-] proper use of the bath in those who do not take much exercise and who are not very strong. In other cases the skin generally perspires properly, but some one part is harsh and dry, such as the face or hands. Washing the face with strong soap will make it rough and uncomfortable, and so will exposure to cold winds. The remedies here are simple-the avoidance of all irritants, tepid bathing, and anointing the face with glycerine and water- or, what is often better, painting it over with a little whiting paste at night for several times. There is just one remark worth making here, and it is this Glycerine should generally be used to the skin diluted. It has much affinity for water, and if the skin be very dry and harsh, pure glycerine may, by rapidly uniting with the water of the tissue, occasionally do harm. The remark just made will apply to the skin when rough. It is the localised forms of dryness and roughness that trouble persons, and, as before observed, these are often the result either. of the too free use of soap or the action of irritants.
    Moist Skin.- This is one of the most unpleasant disorders to which the skin is subject, and it is a source of very great annoyance to most persons. In some cases the whole skin is affected, being cold and clammy. In children it is a sign - especially if the perspiration occur particularly about the head, soaking the pillow through and through at night - of deficient nutrition, and of a tendency to or actual rickets. No mother should make light of it, but consult a doctor when it occurs. The use of all that is bracing, plenty of fresh air, of good milk, and steel wine, will do wonders in these cases. In young persons and in adults, moist skins imply a very weak constitution, or some special kind of debility and need the physician's care. We shall refer here particularly to those cases only which are partial - such as uncomfortable moisture of the hands or feet or arm-pits. Every one knows what a cold clammy hand is. It may be a constitutional peculiarity, and it is not at all unfrequently seen in persons of a lymphatic, lethargic temperament. Here it is very troublesome in warm weather. It is possible in many cases to find out nervous debility, unfair treatment of the stomach, an inactive skin as a whole from neglect, or some cause of weakness. Locally much may be done. Bathing the hands or feet in very hot water twice a day, the use of a solution of alum and salt (two or three teaspoonfuls of these to a pint of water), putting on prepared chalk made into a paste, sponging with a lotion made of strong ammonia solution (one part to four or five of water), may be tried without fear and with success. But in other cases the perspiration is offensive, especially about the feet. In these cases it is often due to uncleanliness. The feet should be washed most sedulously twice a day with warm soap and water, and then bathed with a solution of carbolic acid in water (one part to twenty or thirty). Clean socks must be put on. Oftentimes the perspiration soaks into - the boots, and there becomes rancid, and the unpleasantness will not be removed until the boots are once and for ever dispensed with.

[-70-]

THE TOILETTE.-IV.

DISORDERS OF THE SKIN (continued from p. 63)

Pimples and Rashes of the Face.-Infants at the breast when they are much wrapped up or heated, suffer from the development - on the cheeks, neck, arms, body - of little vivid red, soft, raised pimples, the size of pins heads sometimes scattered about, often congregated together and accompanied by a little red blush. This eruption is called the "red gum," or "red gown," "tooth rash "and the like. It is a simple affair, due to congestion and slight inflammation of the skin, and it is a sign, as a rule that the babe is kept too warm. Formerly, when infants were half smothered in clothes and close rooms, red gum was very common indeed. As regards medicine, it may be well to give a few grains of carbonate of soda, to correct acidity, two or three times a day - in the food is as good a way as any - and to use locally several times a day a simple. lotion composed of a quarter of an ounce of oxide of zinc, a half tea-spoonful of glycerine, and six ounces of rose water. A little borax and glycerine, or lemon juice and water will also be of service. In young persons who are passing into adolescence, "pimples" on the neck are common, in the shape of black specks, or red pimples which are hard and raised, and often exhibit a central yellow spot a little fatty matter may often be squeezed from these spots, and from its form it has been mistaken for a worm. The extruded mass is, however, only a plug of cuticle and fat which fills up the tubes of the little fat glands. The disease of which we are speaking is technically called acne. Some persons think that acne is due to a superabundance of nutritive fluids in the body but this is not the case. About the age of puberty the whole glands of the body become active, and if anything interferes with the circulation through the skin, that is makes it sluggish, the glands will not secrete their oily matter properly, and will become, therefore, choked up with secretion, and the collection of dirt from the external air upon the top of the choked-tip gland appears as a black speck this is the simplest kind of acne. It will be seen that vigorous use of soap and water, and rubbing with a fairly rough towel is best adapted to get rid of acne because by these means the skin is roused from its torpor but in other cases the glands will not only be choked up but inflamed, the acne spots will be red and tender, and the face hot and uncomfortable. Here we must use soothing remedies. The same remark applies to those cases of face pimples which form a rosy rash in middle-aged females or in those who drink. As regards the general health there is frequently indigestion present, and the face may flush after every meal. This must be prevented as the rush of blood to the face only aggravates the acne The best medicine is about half a teaspoonful of carbonate of soda, with a little ginger, in water, an hour before every meal, and aperients must also be regularly taken if in the least degree needed. After the indigestion is gone the sufferer may take five drops of dilute nitric acid flue of dilute hydrochloric acid, and a tea-spoonful of tincture of gentian in water, twice a day. Arsenic may be required in severe cases; but it should only be taken under medical advice. The face should not be roughly used, but bathed with warm gruel and water night and morning; soap should be avoided, and the following lotion should be applied several times a day with a piece of sponge; it is a panacea for pimples of all kinds about the face:-Take of oxide of zinc powder sixty grains fine calamine powder, as prepared at Apothecaries' Hall, half-an-ounce; bichloride of mercury, one grain glycerine, one teaspoonful; and rose-water, six ounces. For use, shake the lotion up, pour out, and dab on to the face allowing the powdery substance to dry on, then brush off the superabundant powder with a soft handkerchief so as to make the appearance passable. Everything that flushes or heats the face, especially beer, should, of course, be avoided. The same remarks apply to red blushes of the face. In the one case the disease is in the fat glands; in the other, the skin substance. The same remedies are useful in each case. 
    Skin Cosmetics.-This is the place to say a few words on the use of cosmetics. Some of them are harmless, some are dangerous, and most of them injurious to the skin. Cosmetics are used either to give a delicate complexion or to heighten the colour, and they include soaps, lotions, powders, and creams. The whites are formed of magnesia, starch, bismuth (which hardens the skin), lead, zinc, white precipitate, &c. The red paints are rouge and carmine. The only admissible substances arc zinc, magnesia, and starch (violet powder). But those who use these should be very careful to well wash their faces night and morning, so that no cosmetic powder may remain behind to choke up the pores. We would recommend to all who "will use something," the use at night of perfectly freshly prepared or well-preserved elder-flower ointment, and the use of the following lotion as a cosmetic ; a little practice will soon enable the user to finish off the application with a brush in such a .way that it cannot be seen:- Powdered borax, five grains ; oxide of zinc powder, two drachms ; finely powdered calamine powder, as made at Apothecaries' Hall, two drachms; glycerine, eighty drops ; dilute nitric acid, four drops; spirits of wine, thirty drops ; distilled water, four ounces. Some of the compounds sold under the name of milk of roses, bloom of beauty, and the like, contain lead or bismuth in large quantities, which may after awhile harden the face and injure the complexion. As we have already said, only the mildest soaps should be used to the face.
    Dandriff or Scurfiness is a common and troublesome complaint affecting children and grown-up persons alike. The skin scales over very freely, bran-like pieces being constantly shed, and there is more or less itching; occasionally heat and redness are present. The scalp is the part most usually affected. In some cases the scurfiness is a symptom that there is debility in the system or a slightly gout tendency, when internal medicine is needed; but usually local applications suffice. When the scalp is rather tender, very irritable, and inclined to inflame, we know of no better application of a simple nature than an embrocation made of equal parts of olive oil and lime water well shaken together. The scalp should be welI cleansed with warm water, but without rough handling, and then the embrocation should be applied with a piece. of sponge directly to the scalp. This may be done every night. In some cases the washing is only needed every other day; no soap should be used. This is for the irritable cases. In the more indolent instances, where there is no heat of head, but mere scaliness, it may be best to apply at once some slight stimtmlant, either in the form of ointment or a wash, according to the taste of the user. The ointment should be made of five grains of the nitric oxide of mercury to the ounce of lard, or three drops of carbolic acid to the ounce of lard. The wash should be of the following ingredients :-Spirits of wine, two drachms ; spirit of rosemary, one ounce; strong ammonia solution, a teaspoonful ; glycerine, a drachm ; and rose-water, sax ounces. Where the disease is obstinate, medical advice must be sought. The lime-water and olive-oil embrocation above referred to may be scented according to taste, and is the best application for general use. It should be mixed in small quantities, because it does not keep long in warm weather.
    Eruptions.- These are very numerous, and occur over different parts of the body, and it would be an uauprofitable task to describe them in any fulness. We shall therefore make some general observations upon them, and give r few plain directions how to treat the simpler and more common forms. Whenever a child is feverish and really ill, and any eruption shows itself, it should be kept very quiet and warm in bed. It is not difficult even for a non-medical person to see when a child is distinctly feverish, by the flushed face, the languid look, the headache, red tongue, quick pulse, and hot dry skin. If a rash shows itself about the face first, and there be much sneezing, running of the eyes, and a little cough, we suspect measles. If the child "comes out" with a scarlet rash of uniform character, if the skin be pungently hot, the fever very marked, and there be sore throat, with a strawberry tongue, we suspect scarlatina. If the rash show all over the back first, and then above the face and head and other parts, as little watery heads, it is probably chicken-pox. When modified small-pox occurs, there is a good deal of fever, and pains in the back, and the eruption appears first of all in the face, which is distinctly pitted in a day or two. All these cases require medical care.
    Red Blushes of various sizes occur about the bodies of children in summer-time, and are known as rose-rash they demand the employment of a slight aperient and the use of a little weak spirit lotion, or, better still, smearing over with benzoated zinc ointment.
    Sometimes, on the legs of young people, raised red lumps of an oval shape appear; they arc painful, and they look like circles of erysipelas, or as if an abscess were going to form, but this is never the case. After they have existed a few days the circumference assumes a bluish tinge, and then as the places disappear, hues similar to those seen in a bruise which is going away are noticed. These cases require rest, quinine, mild aperients, and the outward application of a little whitening and water. They soon get well with rest.
    Whenever a child about a month old is attacked with eruption about the soles of the feet and the parts adjoining the bowels behind, and there be loss of flesh, with sore mouth and the "snuffles" (cold in the nose), it should be taken to a doctor.
    Very frequently mothers are distressed by the occurrence of chafings and sore red patches in their infants about the buttocks, the bend of the thigh, the root of the neck, and the armpits, just, in fact, where two portions of skin come into contact ; the irritation is accompanied by great soreness and more or less thin discharge, which stains the clothes put to the child and gives them an offensive odour. These chafings are frequently an accompaniment of thrush; in that case we should treat the thrush at once; the best remedy for ordinary cases is a mixture made of chlorate of potash and honey. For a child a couple of months old we should give as follows - Chlorate of potash, ten grains; honey, half a teaspoonful; hot water, an ounce. When cold, give a teaspoonful three times a day, and wash the mouth out after each time of feeding with a little honey and borax. When there is no thrush, and the child is weak and thin, or very fat and flabby, cod-liver oil and steel wine-five to ten drops of the former and half a teaspoonful of the latter- should be given twice a day; but the local treatment is the most important. When the chafings are slight the parts may be dusted over with fuller's earth, or, what is very much the best, equal parts of starch powder and the finely-prepared calamine powder made at Apothecaries' Hall which we have referred to so many times before. The object is to keep the parts very dry indeed; night and morning they should be well washed with oatmeal gruel, but gently handled, the powder being used afterwards. The child should be kept scrupulously clean and dry, its napkins changed on every necessary occasion, and the nurse should be most careful that the napkins are not washed in soda. Whenever the child is changed, the powder should be dusted on to the sore places. In severe cases at may be advisable, when there is much discharge, to apply an ointment, and there is none better than the lead ointment of the old London Pharmacopoeia, spread thinly on burnt rag, and changed twice or thrice a day. Where, however, the case is severe, there is something radically wrong, and medical advice should be sought, as also in those cases in which the simple remedies named fail after perseverance.

[-123-]

THE TOILETTE.-V.

MANAGEMENT OF THE SKIN (continued from p. 71).

Discharging Eruptions.-These are generally matters that cannot be trifled with, and it may possibly lead to more harm than good if we do more than indicate what may be done for the simpler cases, or for those instances in which it is inconvenient or impossible to obtain medical advice at the moment. In all cases, the parts attacked about the trunk of the body should be kept at rest and very cleanly, but without any rough usage. If the diseased part is very red and tender, it may be as well to apply a little water dressing ; or if this do not agree, as is the case in some instances, the surface may be covered over with a little whiting paste; this may be removed by warm water fomentation each day or so. A variety of scabbed eruptions occur about the heads of children, and constitute scald-head; and mothers are by far too fond of putting a host of messes recommended them as cures, upon the discharging surface, or the scabs which form; the hair then becomes matted together with the scabs, and the whole presents a most uncomfortable appearance. The great thing in these cases is to keep the head perfectly free from scabs by judicious poulticing (bread and water), and then to apply to the surface, at least at the outset, a little oxide of zinc ointment, which can be got from any chemist. The surface should be cleansed every day with sponging or poulticing, but only just sufficient to loosen the scabs and not to sodden the scalp. These cases of free discharge about the head (and the remarks just made may apply to those about the face) are generally contingent upon the existence of distinct conditions of ill-health or mal-nutrition, that require cod liver-oil and steel wine, with alteratives; and for that reason it is best at once to seek medical advice, if the simple plans of treatment just mentioned do not answer.
    Chilblains.-These are the result of the action of cold upon the skin of weakly individuals; and they occur on the parts of the body most distant from the centres of life, so to speak - viz., the nervous centre and the heart. The cold benumbs the foot or hand, heel or ear, or whatever part may be attacked, arrests its circulation and disorders its sensibility. Then, when the chilled part is brought near the fire, or becomes warm, inflammation sets in with troublesome sensations. Every one knows, by common report, if not by experience, what chilblains are, how they itch, and thereby torment the sufferer, and how they crop up in fresh places from time to time, in those who suffer from them, in the winter-time. It is a very bad plan to bring the feet or hands too near the fire after being out in the cold, as the heat, acting after the chill, induces chilblains. In some cases the inflammation is severe, and there is effusion beneath the skin, which gives way, so that what is called a "broken" chilblain is produced. Now the treatment of chilblains involves the employment of means for their prevention, in the first place ; these consist in the use of garments to keep the feet and hands protected from the cold - such as woollen socks, proper exercise, and, if there is a threatening of mischief, friction, with some slight stimulant, such as camphor liniment. If the subject is weak, tonics must be given. When chilblains have formed, however, it is necessary to relieve the intolerable itching by sedatives applied locally, and then to use stimulating friction. When they are not broken, any of the following recipes may be employed:-

No.1
Soap liniment . . . 2 ounces
Oil of Cajeput  . . . 2 drachms
Tincture of belladonna . . . 2 drachms

No.2.
Two yolks and whites of egg . . . 2 ounces
Spirits of turpentine ... ... 2 ounces
Distilled vinegar ... ... 2 ounces

To be well shaken together; and if there be very much itching add half an ounce of laudanum.

No. 3.
Strong ammonia solution . . . ½ an ounce
Camphor liniment . . . 2 ounces
Laudanum . . . 1 ounce

No. 4.
Soap liniment . . . 2 ounces
Tincture of belladonna . . . 2 drachms
Friar's balsam . . .  1 drachm
Tincture of aconite . . . 2 drachms
Camphor . , , 10 grains

This is useful in allaying itching.
    No. 5.- Dr. Balfour, of the Royal Military Asylum at Chelsea, uses with success amongst the boys there equal parts of compound tincture of iodine and strong solution of ammonia; painting it in night and morning gently with a brush.
    [-124-] N.B.-These recipes are not to be used to broken chilblains.
    For broken chilblains the following application is perhaps the best. It should be applied on strips of lint

    Calamine cerate ... ... 1 ounce.
    Carbonate of lead ... ... 1 drachm.
    Camphor ... ... ... 5 grains.

    Warts.-These occur mostly about the hands, also the wrists, the forehead, and the scalp, particularly in the young and aged. They may be congenital, solitary, or in the form of a regular crop of extensive nature. In the latter case a long course of arsenic is needed for their removal. When they are few, they may be got rid of readily by caustics. Mason Good, an eminent writer, says that in Sweden they are destroyed by the wart-eating grasshopper-the Gryllus verrucivorus - with green wings, spotted brown; the common people catching it for this purpose: and it is reported to bite off the wart, and discharge into the root which is left behind a corrosive liquid. In some parts of our own country the juice of the Chelidonium majus is used with more or less success; but our readers had better trust to none of such things, but use caustic potash, or acid nitrate of mercury - both, however, powerful things, to be used with caution. The wart should be soaked in warm water, then touched each day at its centre with a solution of caustic potash and water in equal parts until it becomes sore. The solution is to be applied with a piece of wood. After a few applications the wart will shrivel and come away. When the acid nitrate of mercury is used, the same system of application is to be followed, but the acid should be carefully rubbed on to the wart until it smarts; this must be repeated several times, and care must be taken that the acid does not trickle over the skin so as to ulcerate it.
    Corns. - These always arise from pressure. They are of two kinds, soft and hard. The former occur between the toes, from the pressure of the joints of the smaller toes against the skin opposite. Corns are not limited to the feet, but are seen on the hands of workmen who use tools that press much on the palm of the hand. The effect of pressure is to stimulate the skin, then to cause an increased flow of blood to the part whose activity is excited, so that the cells of the cuticle are more rapidly produced than natural, and become pressed together into what we know as corns. In the soft corn there is a collection of fluid under the cuticle, and the corn is constantly bathed in perspiration ; so that we have a more or less circular white softish elevation, exuding a moisture. Now the cure of corns is really an easy matter. The first thing is to have an easy soft boot, with a good broad square toe, so that the toes of the feet are in no degree pressed together. Small-toed boots and corns go together. Then corns must be soaked in warm water, scraped or shaved down, touched with a little acetic acid now and again, whilst a corn-plaister should be worn - we mean a circular one with the hole in the centre, so as to take off the pressure from the centre of the corn. The sufferer should never wear a boot which is in the least worn away at the heel. The extraction of a corn is only a temporary palliative. It does not remove the cause. In the case of a soft corn we must take care to be very cleanly, to remove as much of the white loose cuticle as we can, to keep the toes betwixt which it is, separate by a bit of cotton wool; then we may use a little "glyceral tannin," which can be got at the chemist's, painting it in each night for a week or so, and when it has become less tender and moist we may apply caustic gently. This will generally, if we keep pressure off it, remove the corn.
    Moles and Mothers' Marks .- These may usually be removed by caustics, or by ligaturing, and it is best that they be destroyed at the earliest possible time, I because they frequently increase with some rapidity, and fill with blood to an extent which makes their removal the more difficult. It is of no use giving further details. In all cases they must be left to professional treatment.
    Discolorations of the Skin. - These are of various kinds. We shall only speak of the more common. First we have freckles, or the little brown specks developed about the face and hands in the summer-time by the action of the sun upon the skin in hot weather. There is a second form, which occurs on the covered parts of those who are of a bilious temperament. This latter form requires careful medical treatment. The former may be more or less removed by the use of local remedies :- 

No. 1.
Elder-flower ointment ... ... 1 ounce.
Sulphate of zinc, finely powdered ... 25 grains. 

To be applied with the finger night and morning.

No. 2.
Sal-ammoniac ... ... ... 60 grains.
Distilled water ... ... ... 1 pint.
Lavender water ... ... ...½ ounce.
Bichloride of mercury ... ... 2 grains. 

To be used with a sponge every night and morning. 

No 3 is an elegant form:-
Red rose-leaves ... ... ... ¼ ounce.
Fresh lemon-juice ... ... ... ¼ pint.
Rum ...  ....  .... ¼ pint

Digest these for a day, and squeeze away the fluid, to be used by means of a piece of sponge, night and morning.

No. 4.
Carbonate of potash ... ... ... 5 grains.
Citrine ointment ... ... ... 1 drachm.
Otto of roses ... ... ... ... 1 drop.
Simple cerate ... ... ... ... 1 ounce.

To be smeared on every night.
    It not unfrequently happens that persons are attacked with a discoloration about the chest, especially where flannel is worn. The parts become itchy-slightly red, perhaps-and then little light pale straw-coloured spots appear on the front of the chest ; they itch, and a few bran-like scales can be scratched from off the patches, which gradually join, and form a pale, fawn-coloured eruption. This is due to the presence of a vegetable parasite, and is called Chloasma. It is readily cured by first washing the skin with soap and water, in order to get away the natural fatty matter, and then applying freely what are called parasiticides, viz., agents that destroy vegetable life. The recipe No. 2, recommended above for discolorations, maybe given a trial. This should be applied night and morning after the use of soap, and be continued for three weeks or so. If this do not radically cure the affection, medical advice must be sought, since stronger remedies of an active kind will be needed, and most likely internal medicines.
    Chapped Hands and Lips. - These are well known, and equally simple to cure. Those persons whose hands are constantly in the wet in cold weather, get chapped hands because they make the skin thereby moist and soft, and remove the natural fatty secretion, which is protective against cold. It is said that those who work amongst tallow and oil never get chaps of any kind ; and this simple fact is in keeping with the proper mode of curing chapped hands, which is to keep the hands as dry as possible, and to apply a layer of grease night and morning. Cold cream, or a little weak zinc or camphor ointment, will do. Where the hands are livid and cold, it will be well to use the camphor-balls sold in the shops Occasionally an ugly and obstinate crack occurs. This may be cured by applying a little friar's balsam once or twice, or if it be in the middle of the lip, by drawing the two sides together and keeping them in close apposition, when the crack heals. The muscles about the mouth in constant action tend to stretch open the crack, and to prevent it healing.

[-157-]

THE TOILETTE.-VI.

MANAGEMENT OF THE SKIN (continued from p. 124).

The Shingles.- Every mother ought to be able to recognise this form of eruption. The shingles attacks one side only - it may be the face, the trunk, or the limbs, generally it is the side of the chest. The disease is often preceded by sharp neuralgic pain - it may be severe - followed by an eruption of little bladders, the size of millet-seeds or small peas, in clusters of some ten, twenty, or more, on a red base. The pain is relieved by the eruption. Fresh crops appear, so that the eruption, after a few days, is observed to extend in a band- like form from the spine behind round the side to the middle line of the chest before - that is, encircling half the chest. The band of eruption is not continuous, but made up of several patches. After a few days, the little bladders dry, and scabs succeed. In ten or fourteen days all trace is gone, save a little pitting and redness. The disease must not be meddled with. We should take care not to let it be irritated by the clothes, or by any rubbing; but apply at first a little starch powder, and after a day or so a little zinc ointment spread on linen. If there be much pain after the rash has come out, special remedies will be needed, which the medical man must prescribe ; but in the majority of cases the treatment is to be a let-alone one. When shingles occurs in the face, it attacks one side ; and when in the arms or legs, it does not encircle them, but runs down the limb parallel to its long axis. On the trunk, the eruption is, so to speak, horizontally disposed.
    Sore Nipples.-These chiefly result, first, from the suckling of the child at nipples that have been flattened, so to speak, or pressed upon by tight dresses ; and, secondly, by the want of cleanliness. Mothers should, therefore, always take care to prevent any pressure by the dress. The nipple, after nursing, where there is a tendency to soreness, should be sponged with warm water and washed with a little weak rum and water, or borax and glycerine, and this should be removed before the child is put to the breast. On no account should milk be permitted to remain about the nipple, for when it gets sour it causes irritation. Another good plan is to get very thin leaden shields, to wear when the child is not at the breast. [-158-] If the nipples are actually sore, nothing is better than then application of a little glyceral tannin, applied night and morning with a camel's hair pencil. It must be removed with a sponge and warm water when the child sucks. If the child's mouth is hot, it should be washed each time after being put to the breast with a little borax and honey.
    Nettle-rash.- This is a very troublesome affair, sometimes, in children. It is known by the sudden appearance of little places, like those produced by the sting of the nettle, after itching in a part; and the special features of the spots is, that they rapidly vanish - in a few minutes, oftentimes. They are excited by scratching, and appear specially at night, when the child gets warm. Mothers should be careful to examine in these cases for bugs about the room and bed in which the child sleeps, for they very often produce the disease in irritable skins. Flannel should not be worn next the skin. The child should take a little aperient, and be placed each night in a tepid bath for five or ten minutes, in which is dissolved three ounces of carbonate of soda and two pounds of size ; after which it should be dried by gentle "dabbing," and should have "whitening" applied to the irritable parts, with a brush. Several lumps of whitening may be softened up with water into a semi-liquid paste. The powder is allowed to dry on at night, and it is sponged off in the morning. This plan is good for simple cases of nettle-rash. 
    Chronic nettle-rash is often very troublesome, generally making its appearance periodically as the night comes on. This disease usually depends on a disordered state of the digestive organs, and endeavours should be made in the first place to ascertain whether the rash is caused by any particular article of diet; if this be not the case, the state of the digestive organs generally must be improved, if possible.
    The Itch.-This unpleasant disease is very common, and often occurs in the most cleanly person. It is caused by the burrowing under the skin of a little insect called the Acarus scabiei. These acari prefer to attack the thin skin between the fingers, and hence itch, most commonly - in fact, practically always in adults - begjns between the fingers. It then spreads to the wrists and the front of the arm. The irritation set up by the acari, together with  the scratching, induces a pimply rash pretty generally over the front of the body. The pimples are always separate. Between the fingers they look like little pointed watery bladders, the size of a pin's head, and the most characteristic appearance is the presence of a little black line the breadth of a human hair, and in length about two or three lines, running away from the little vesicle, as the bladdery pimple is called. This is the burrow of the insect. Those who are accustomed to the disease can at once pick out the insect from the end of the burrow, which looks like a minute white speck but just discernible to the naked eye. In many cases it has been scratched out, and its burrow opened by the finger-nails. The itching is bad at night, when the patient gets warm in bed, or at any time when the sufferer remains too near the fire, because the itch insects then become active and lively. But how are mothers and others to know when the itch is amongst members of the family? - whenever a minute rash occurs between the fingers in the form of small watery pimples, spreading on to the front part of the  arms, and is accompanied by itching, especially at night. When the rash spreads to the front part of the body, and more than one member of the family is attacked, the suspicion of itch should at once be entertained. The rash of itch does not occur on the outside of the arms, or on the back, except in very severe cases, and these should at once be taken to a doctor. The itch commences chiefly about the hands in adults; in young children it may be absent from these parts, and may commence about the seat, whilst it also attacks the feet. It leads in children to places like little boils, besides a pimply rash. When a child comes out with an itchy rash about the seat, and this is followed by little boil-like scabbed spots on the same place and about the feet, it probably is troubled with the itch; and this is all the more likely to be the case if the nurse has a pimply rash about the hands or on the arms. There are many pimply rashes which occur about the child's back, but then these are, in every case, uniform, whereas in itch the rash is multiform. There are red pimples, vesicles, and boil-like eruptions, together with great itching; and sometimes the irritation is sufficient to induce spots like those produced by the sting of the nettle. Now the itch if it be recognised at an early date, is very easily cored, and the remedy. is sulphur, which kills the acari. The general mistake which is made is in the too long-continued and too extensive use of a much too strong sulphur ointment. The acari, or itch insects, are found chiefly about the hands, and it is to this part that the sulphur should be applied. Once kill the acari here, and the general irritation and rash subside. It is quite sufficient to use the sulphur for about three days, and to rub in an ointment, composed of thirty grains of sulphur, five drops of oil of camomile, five grains of white precipitate, and five of carbonate of potash, with an ounce of lard, to the parts between the fingers, and about the wrists, if there are any pimples, night and morning freely. Smear the ointment very gently over other pimply places for three days. At the end of that time, the whole body should be thoroughly washed with soap and water, and the disease, if it is of recent origin, will be well. If the itching do not then cease, it may be advisable to continue the ointment for a couple of days, using it gently, and rubbing it in only to any little bladdery pimples that appear about the hands. An eminent authority recommends this simple treatment; he condemns sulphur baths, or the ordinary sulphur ointment of the shops, and he says that he is often consulted about cases in which the too free use of sulphur has cured the itch, but has set up an artificial irritation and inflammation of the skin, which is even more tormenting than the original disease, and is sometimes troublesome to cure. The clothes worn by persons attacked with itch should be thoroughly well baked, or scalded in the hottest water.
    Ringworm of the Body.-This is a very common and often a troublesome complaint. It generally occurs in little circular red scurfy itching patches ; indeed, we may say that any patch which is quite round, of the size of from a sixpence to a five-shilling piece, which does not discharge or weep, which is covered, not by crusts, but thin scales, and which "clears" in the centre, is ringworm. If it occur in one member of a family in connection with ringworm of the head in other members, we have no doubt of its nature. There is a circular form of eruption, in which there are red hard elevations of a dull red tint, much like ringworm; but true ringworm is never elevated - never much raised above the level of the skin. The disease mostly occurs about the back of the neck, the forehead, or the arms. It is caused by a vegetable fungus with roots between the cells of the scarf-skin, and sets up the irritation we notice. The cure is easy in the early stage. Ink, repeatedly applied, is a favourite and useful remedy. If severe, the application of acetic acid is of service; it will blister, and must not, therefore, be rubbed in too strongly. The following ointment may be recommended for general use:- White precipitate, 3 grains; creasote, 3 drops; citrine ointment, 1 drachm ; adeps, or cerate, 1 ounce. Rub in night and morning pretty freely, till all itching or scaliness disappears. The other forms of ringworm will be described in speaking of the hair.
    Lice, or Pediculi.-These unpleasant visitors sometimes make their appearance in the heads of those children who are either uncleanly, or who are debilitated by severe disease. If they are numerous, it is best to cut the hair short, to wash the head very thoroughly with soap and [-159-] water, and to apply, under a cap, a little benzine, so as to confine the vapour. This will destroy all the live creatures. Ordinary stavesacre ointment maybe used, or- an ointment smeared over the scalp for a day or two - not rubbed in - of ten grains of white precipitate, to an ounce and a half of lard, scented strongly; for pediculi hate scents as much as they do soap and water. Tonics must be given to the weak, and pomade scented with oil of lavender should be constantly used to prevent their reappearance. In those who are uncleanly, the remedy is obvious.