PEDICULOSIS, OR PHTHEIRIASIS.
The ordinary body louse is seldom seen upon the skin, and as it reside: in the seams and creases of the clothing, it cannot he destroyed until the garments are subjected to the action of heat or reagents which kill the parasite. It must also be kept in mind that agents which are destructive to the pediculi may have no effect upon their ova; and since these are not hatched till after the expiration of nine or ten days, the case cannot be regarded as cured till after this period has elapsed. After the total destruction of the parasites and their ova it may be necessary to treat the eczema, impetigo, dermatitis, &c., which the scratching by the finger-nail: has produced.
Pediculus Capitis.—In mild cases which have not been long neglected there is no necessity to cut or shave the hair, hut in hospital this must often he done, and when once thoroughly accomplished there is no trouble afterwards, as the ova arc also removed adhering to the hair shafts. Shaving is, however, almost impossible owing to the numerous crusts and scabs. Close clipping by sharp scissors answers every purpose, and a good washing with soft soap completes the destruction of any straggling vermin or adhering ova.
A local remedy should he prescribed which, though capable of destroying the pediculi rapidly, should not be of such a nature as to injure the patient, even if injudiciously applied. This is a matter of vital importance in charity schools, where mercurial preparations should not be used. The favourite, old-fashioned remedy is a safe one—viz., the Ointment of Stavesacre B.P. This, when rubbed into the roots of the hair or used as a pomade, effectually destroys the lice, but does not destroy the ova con tained in the nits. If the application he continued for a fortnight every trace of the vermin is removed. the young pediculi being killed as soon as they arc hatched. Where there are many crusts a soft linseed meal poul tice, smeared over with Carbolic Oil (r in to)„ speedily destroys the mature parasites; a few minutes under the Carbolic Spray is still more efficacious.
If common Lamp Paraffin mixed with an equal amount of Olive Oil be employed as an ordinary hair oil in charity schools, pediculi soon disappear from the hair, and from the clothing and body. The objectionable odour
of crude paraffin may he overcome by making it into an ointment or pomade with lard or vaseline, and adding some Balsam of Peru.
Where a rapid effect is desired and where skilled nurses are entrusted with the management of children, as in a children's hospital, a weak solution of Perchloride of Mercury may be employed; but one of the best of all applications is the Ointment of the Ammonio-Chloride of Mercury or White Precipitate (1 in so), as it not only destroys the parasite, but effectually relieves the eczema or impetigo which has resulted from the scratching and irritation caused by its presence. When there is much secondary skin affection present, the crude petroleum should be largely diluted with oil.
For the removal of the nits or egg-cases, the hair may he well soaked in Methylated Spirit after washing with soft soap, or Vinegar or Solution of Borax may be applied; and after they have become loosened from their moorings by these solvents, a very fine comb, followed by a stiff brush, easily clears the hair of them.
Many other agents arc employed, such as Naphthol, solutions of Tobacco and Cocculus Indicus, Chloroform, Dalmatian Flowers, Peppermint, Cajuput, Anise or Clove Oils, Decoction of Laurel Leaves, Quassia, Pellitory, Creolin, &c., which possess no advantages over the more commonly used remedies.
Pediculus Corporis can be abolished by cleanliness. As a preventive measure for pediculosis in elderly persons, it is a good plan to dust a little Flowers of Sulphur over the inside of their flannel garments, and these should be changed frequently. As the parasites live and deposit their ova in the seams of the clothing, the most effective method of dealing with them is to place the clothing for a few hours in a hot chamber or disin fecting-room, so as to thoroughly bake the pediculi and their eggs. Boil ing the clothes answers equally well. A dry heat of F. is quite sufficient. Bacot impregnates the clothes with a 5 per cent. solution in water of a compound made by heating equal amounts of Soft Soap and Crude Carbolic Acid.