ANIMAL PARASITES SCA BIES The penetration of the scabies mite (actin's scabiei, sarcoptes hominis) 16 revealed by the formation of subcutaneous so-called scabies ducts, being fine small ducts 2 to 15 mtn. in length and of whitish color. The skin is either of normal appearance or raised in the shape of a ves icle or hypertemic papula. It may assume a dark appearance from dust and dirt and in consequence of the intense itching there are scratch marks, signs of inflammation of the skin, and small pus pustules to be seen everywhere between the ducts. The. affection is chiefly situated between the fingers, around the wrists, in the axillary folds, at the nipple, navel, and penis, at all places subject to pressure (belt, etc.); in little children also at the plantar surface and the interior edge of the foot. The face is always free. The affection which in the beginning is difficult to recognize, spreads comparatively rapidly, and there are com plications such as furuncles, impetiginous eczema, glandular enlargements, ete. The disease is highly contagious and children are principally infected by sleeping with adults who suffer from scabies. Consequently it is met with in every stage of childhood.
mite which is about 0.2 to 0.3 mni. in length, can still be seen with the naked eye, burrows itself into the skin and forms the so-called scabies ducts where the female deposits its eggs. The male lives in small fossa• in the vicinity of the ducts. The latter contain the oval eggs and brownish granules—the feces of the mites.
Etiology. —The disease is spread by direct transmission (cohabi tation). In how far clothes and body linen may transmit the disease has not yet been established. Alexander has also found children suffer ing from dog scabies, which consist of a papulovesieular exanthema, and lasts six to eight weeks, healing spontaneously and easily controlled. There are no typical duets, and mites are not always demonstrable.
diagnosis is secured by the demonstration of the ducts or the mites. The skin is smeared with ink to make the ducts more visible and the duct is pricked with a needle, upon which the mite will be found at the blind end of the duct. If a microseopic exam ination of the duct is desired, it is removed with a pair of scissors and examined in a 10 per cent. solution of potassium.
children the prognosis is favorable, but often in consequence of the strong antiparasitic ointments a dermatitis re sembling scabies may remain and continue to exacerbate if the treat ment for scabies is persisted in.
Treatment. the available rer»edies balsam of Peru and its derivatives stand in the first place. For children inunction of the body with balsam of Peru 20 Gm. (5 dr.) olive oil 100 Gin. (3 oz.) on sev eral successive evenings is advisable. If there is considerable dermatitis, the ointment should consist of ung. zinci 50 Gm. (11 oz.), balsam of Peru 2.0 to 4.0 (30-60 gr.). Substitutes emitting less odor are peruol and peruol soap which should be applied daily. Styrax is similarly applied (10: 20 Gm. olive oil), while the strongest remedy consists of naphthol ointment (Kaposi), axungia porei 100 G111. (3 oz.), sapo virid. 50 Gm. (11 oz.), naphthol 15 Gm. (1 oz.), sulf. prtucip. 10 Gm. (2,1 dr.) il.s., to be used as an inunction every evening. In the place of naphthol a 10 per cent. epicarin ointment may be used. After 3 or 4 days' application of these ointments the children are given a bath, and as after-treatment to heal the dermatitis. 5 per cent. salol oil (with castor oil 40 per cent.) or zinc ointment (zinc oil or paste) is applied. As a matter of course, careful attention should be paid to changing and disinfecting the clothes and body linen, and in the case of a family epidemic the entire family should be treated simultaneously.