SCABIES.
In mild cases of itch the use of almost any one of the innumerable parasiticides will kill the acarus and its ova, but the most harmless to the patient and the one most certain and cleanly in its action is Sulphur when properly used.
The speediest cure is Vlemingkx's solution, by means of which a sharp attack of itch may sometimes be removed in a few hours. This solution is prepared by boiling Lime or Lime Putty with Sulphur in a large quantity of water, and after the sediment subsides a brilliant clear yellow solution remains, which is the remedy under consideration. The proportions of the ingredients are of little matter, but it is well to have them in excess, and the water will only dissolve a small amount of the Pentasulphide of Cal cium. 8 oz. of Sublimed Sulphur and 4 oz. of Slaked Lime will make a gallon of the fluid, and with this a large school of children affected with scabies may be effectually treated when the ailment is not of long standing. All that is necessary is to take a small sponge and swab the solution freely into the skin. As the liquid comes into contact with the organic matter contained in the secretions of the skin it gives off free sulphuretted hydrogen, and leaves a fine powdery residue, filling up the furrows on the cutaneous surface. The patient may have a previous hot bath with soft soap; little irritation is caused by the remedy, but when there is already much traumatic eczema preient, and where the liquid is rubbed in or applied frequently, it may produce considerable irritation.
The patient may put on his clothes immediately after the sponging, when the excess of the liquid will cause destruction to any wandering male or young female insects adhering to them, but upon the whole it will he safer to fumigate the clothes and bedding by burning sulphur in the room or by baking them in a hot chamber. Tt is well to make several applications to insure complete destruction to any young which may have escaped the action of the liquid owing to their deep position in the burrows.
Sublimed sulphur may also be applied in its dry state, and well rubbed into the skin and sprinkled over the inner surface of the flannel or woollen under-garments and over the bed-sheets every night. It can he rubbed into the hands and between the fingers, after which a leather glove may be worn. This method, which is cleanly, is not at all so efficacious as the solution.
The most certain and reliable of all methods of using sulphur is to give the patient a hot bath, in which the body is to be thoroughly scrubbed with a hair-brush and soft soap, so as to open up the burrows of the itch insect, after which Sulphur Ointment is to be rubbed in for several minutes with the palms of the hands into every part of the cutaneous surface, except the face and scalp. This can he best done before going to bed, the patient sleeping in a combination dress. This treatment must be continued for several days—three or four at least—to insure a thorough permeation of the furrows by the sulphur. In patients with tender skins, an ointment of half the B.P. strength may be employed. The patient should be directed to change his clothing every day whilst under treat ment, hut not to wash off the ointment by bathing in the morning. In military practice, after the bath, scrubbing and rubbing in of the ointment, or of a mixture in equal parts of Soft Soap and Sulphur Ointment, a blanket, smeared over with the ointment, is wrapped round the patient's body. Bruce and Hodgson treat scabies successfully by exposing the patient after a hot bath and scrubbing to the fumes of burning sulphur for so minutes in a specially constructed box which permits the patient to breathe pure air during the fumigation.
Where much dermatitis follows this thorough method, a bath containing starch gives great relief. Thorough disinfection of the inner clothing by baking them in an oven or by boiling is necessary in all cases.
Beta-Naphthol, Peruvian Balsam, Storax, Tar, Stavesacre, Green Soap, Cocculus Indicus, Creosote, Oils of Cade, Cajuput, Anise, etc., have been used from time to time, but Sulphur meets every requirement. Peruvian Balsam and a r in To ointment of Beta-naphthol are very satis factory methods of treating the disease when it is confined to the hands, but these applications are unsuitable when a large area of the skin is to be acted on.
It may be necessary to treat the eczema and irritation, partly the result of the parasite, and partly the result of the remedy; some bland unirritating ointment, lard or oil easily accomplishes this, but it is un necessary to remind the practitioner that dermatitis cannot be removed till the destruction of the parasite has been effected.