MILIARIA (PRICKLY HEAT).
Definition.—A vesicular eruption of the skin due to profuse sweating.
Symptoms.—The eruption of miliaria consists of minute vesicles developed near the pores of the skin. These may be acuminated and red (lichen tropieus) and discrete and irregularly dispersed over the surface; or they may be confluent and red at the base (red miliaria). At first they contain a pellucid fluid, which occasionally tends to become turbid, then purulent. The eruption is apt to present in parts of the body- covered by clothing. The vesicles usually dry up into minute. scales. Sometimes the case is attended by lesions simulating those of eczema.
The active symptoms generally consist of a prickling sensation as if thousands of needles were being forced into the skin. This is followed by pruritus, and the ease then proceeds to recovery if the irritating factor (heat) is avoided.
Etiology and Pathology.— The im mediate causes of miliaria are heat and profuse perspiration. In an examination of specimens removed from patients of different ages, and from different por tions of the body, Politzer found that the same conditions were present in all of the sections—an (edematous Fete Mal pighii, containing dilated sweat-ducts, 1 1 0 ..114111r.l. 111 111e C1111S except in the apil:an r. the horny layer of the L p. rni, being swelled by imbibition.
Treatment.—The treatment is mainly r hxlactie: measures calculated to re I e undue exposure of the body to heat.
1.L ii unavoidable climatic conditions Lause. frequently repeated bran baths (a pound of bran packed in a towel L ing allowed to soak) are sometimes soothing. A solution of ammonia, a
a..IL spoonful to a quart of water, gener ally allays the itching very promptly. -Tonging- with lime-water is preferable children.
lit the graver form Holstein states that ti,orcugh cleanliness must be insisted rpon; the clothing; should be boiled, and soblimate washes or ointments employed.
some cases the crusts of the lesions may be removed and peroxide of hydro c.en applied. This should be repeated daily for several days. antiseptic oint mints being. applied between-times. The perexide of hydrog.en may be injected into the boils. Carbolic acid, aristol. europhen, resorcin, etc., and lotions of (2 to 5 per cent.) made with a saturated solution of boric acid are rec ommended by various authors.
When the perspiration evaporates rap idly or can be drained away by absorbent underv. ear, there is little or no prickly heat. Personal experience showed that el. en the thinnest cotton underclothing \ as not the proper material to wear in the tropics. When wool was \vorn next to the skin, prickly heat ceased and has never troubled the writer since, except on those parts of the body not covered by worl or exposed to the air: the fore , rms, for instance. Wool absorbs the perspiration as fast as it is secreted, so that the epidermis never becomes sod den. and consequently the orifices of the eat-ducts remain patulous. St. George Gray Jour. of Tropical _Medicine. Aug.. '99..