PRURITUS, itching, a symptom of vari ous skin diseases. It may occur independently of any structural alteration of the skin, as a purely psychogenic affection and is then fre quently a symbol of unconscious masturbation. It may involve the skin of the entire body or be limited to a particular region, such as the anus, scrotum or vulva. The sensation is described as prickling, burning or crawling. It is very annoying when slight and may be so severe as to destroy all sense of comfort. Excitement and overheating, even the warmth of the bed at night, cause at times troublesome exacer bations. The etiology of this affection is fre quently obsoure. Impaired genetal health and a neurotic tendency are predisposing causes. Pruritus senilis is a distressing form occurring in advanced age and is due to degeneration of the skin. Pruritus hiemalis (winter itch) is peculiar to cold weather. Other causes are the change from light to heavy under-clothing; in gestion of certain drugs, as opium; sometimes hepatic and renal disease; and the circulation in the blood of abnormal biliary constituents, as in jaundice, and of other abnormal material in diabetes. Localized pruritus frequently de
pends upon a venous congestion of the part; thus pruritus ani is invariably aggravated by, constipation and obstruction of the portal cir culation; and in pruritus vulva, uterine en gorgement and pregnancy are exciting causes. Worms not infrequently produce itching of the anus and of the nose, the latter being a reflex condition. The almost constant scratching caused by a persistent localized pruritus is likely to produce eczema.
In treatment the general health is to be improved by hygienic measures; sometimes an entire change of diet, scene, etc., is necessary. Internal medication should be left to the physi cian. A psychoanalysis is necessary to cure certain cases. Local remedies are palliative, only relieving the discomfort until the cause of the itching is removed. Among the palli atives are carbolic acid, borax, soda, starch, chloroform in powder, liniments, solutions and ointments.