HERPES, an acute, non-contagious, in flammatory disease of the true skin, regarded generally as due to a lesion of nerve tissue. It is characterized by an eruption of one or more clusters of vesicles upon a reddened base. Several forms of the disease are recognized by dermatologists, of which the commonest are facial herpes and herpes zoster. Facial herpes constitutes the common fever blister, or cold sore, and is usually seen about the mouth, though it also occurs on other parts of the face. There is often some slight constitutional dis turbance preceding the eruption, which first makes its advent known by a sensation of burn ing or itching in the part, followed by reddish discoloration of the skin and after a few hours by a number of pin-head to pea-sized blisters filled with clear or turbid fluid. After a few days these dry up and form a yellowish trust, which then falls off, leaving a red spot that soon disappears. The usual duration of the disease is about a week and it shows a strong tendency to recur. Herpes often accompanies febrile conditions such as pneumonia and malaria, and a similar lesion is not rare about the genitals. Herpes occurs mostly in those whose skin is irritable or delicate, and is usually the result of some derangement of the mucous membrane of the respiratory, digestive or genitourinary tract. It sometimes is the unfailing harbinger of the menstrual period. Cold, mental depression, and injury or irritation of the skin are other causes. The disease belongs to the class of the neuroses, and in some instances its presence can be ex plained only on the basis of nerve disturbance. In most cases no treatment is required, as the lesions promptly heal of their own accord, but soothing ointments or 'lotions tend to relieve the irritation. The common domestic remedy
is camphor ice. Herpes zoster, or shingles, is a special form remarkable for the fact that the eruption follows the course of certain nerves, and is usually disposed around one side of the body like a half belt. In rare cases it encircles the body. Its onset is preceded by stinging neuralgic pains, and by languor, lassitude, loss of appetite, shiverings, headache, nausea, quick ened pulse, etc., after which the eruption ap pears in irregular patches. The vesicles become enlarged to the size of small peas in 24 to 36 hours, and fresh clusters occur for three or four days, completing the belt-like appearance. As the eruption recedes, by the fifth or sixth day, the vesicles become white and opaque, and the red margins grow livid or purple. Some times the vesicles burst, and several of the patches run together, forming irritable sores, discharging a thin serous fluid, which concretes and forms a crust that falls off as the parts beneath heal. The disease occasionally follows injuries to the nerves, and it is common in damp, cold weather of spring or autumn, when it sometimes occurs in epidemics. It is sometimes produced by sudden exposure to cold after violent exercise, and sometimes follows acute affections of the respiratory organs. The treat ment consists in attention to any systemic de rangement present and in the local use of sooth ing applications like talcum powder, protective dressings of cotton to prevent rupture of the vesicles, and the administrative of sedatives or even opiates in extreme cases. The duration of shingles is usually from 10 days to three weeks. Most cases run a favorable course and second attacks are rare.