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Pemphigus

vesicles, blisters, eruption, oil, days, skin and disease

PEMPHIGUS (WATER-BLEBS).—A serious, often fatal, skin-disease, which is characterised by the eruption of watery vesicles on various parts of the body. It attacks very suddenly, and may occur in adults as well as in children. The disease begins with the appearance of red spots and blotches on the skin. These are followed by the formation of vesicles of various sizes ; and sometimes a hundred or more of these blisters may be present at the same time. The vesicles contain a watery fluid, which is at first clear, but later cloudy ; and in a few days they either dry without rupturing, or break, forming scabs, which fall off after a time, leaving dark red spots. During this time new blisters are constantly appearing, running the same course. The surrounding skin, often a considerable area, is hot, red and inflamed. The eruption is accompanied by intense itching, pain, and fever ; and these symptoms are aggravated by the formation of crusts, and the consequent scratching. The resulting sleeplessness and loss of appetite greatly reduce the patient's strength during the course of the illness, which may extend over several weeks or months. When the eruption sub sides, recovery usually takes place very rapidly, but the disease is certain to recur after a longer or shorter interval. After several such recurrences, the patient may entirely recover ; but, if the attack he very malignant, the long continued illness, together with possible complications, may bring about a fatal ending.

The cause of this eruption probably resides in some affection of the nervous system, and there is very little hope of preventing it. The medicinal treatment consists mainly of baths, the application of ointments, and the administration of remedies to alleviate pain and produce sleep. In addition to this, the patient may be made more comfortable by careful nurs ing, extreme cleanliness of his surroundings, and by applying cooling lotions to the affected parts. Above all, the patient must be prevented from scratching himself.

Pemphigus of infants is characterised by the eruption of a larger or smaller number of yellowish blisters, varying in size from that of a pea to that of a bean. These blisters, which resemble those caused by burns, usually appear on the head and trunk ; seldom on the limbs. They are filled with a watery fluid which, at first clear, gradually becomes more thick and cloudy. The vesicles soon rupture, and in the course of a few days the

skin dries up and falls off in scales, the site of each blister retaining a shiny appearance for some days. This disease may attack babies a few days after birth, and may occur also in older children. Slight fever is usually present at night. if the disease runs a protracted course, and the child becomes more and more restless and emaciated, medical assistance is requisite. The mild form of the affection requires strict cleanliness, moistening of the ruptured blisters with a boracic-acid solution, and dusting with baby-powder.

A syphilitic form of pemphigus, which may be present already at birth, can readily be distinguished from the foregoing by the circumstance that the vesicles appear on the soles of the feet and on the palms of the hands. This affection calls for prompt medical interference.

PENNYROYAL.—See HEDEOMA.

PEPO.—The seed of the Cucurbita Pepo, or common pumpkin. Its active principle is said to be a resin. Pepo is used in the form of an emulsion for tapeworm. It should be given in the morning, breakfast being with held, and should be followed in a few hours by a cathartic. The dose is two ounces. It is harmless.

PEPPER.—The unripe fruit of the Piper nigrum, a vine growing in the East Indies. The three active principles of pepper are piperine, an irritating volatile oil, and a bitter resin. Pepper is principally used in certain corms of dyspepsia, when it is given together with some simple bitter. Externally, it is sometimes employed as a counter-irritant.

PEPPERMINT.—The leaves and tops of the llentha piterita, an European herb which has been naturalised in the United States. It has a characteristic odour and taste, and contains a volatile oil from which menthol is obtained. Peppermint is largely used for colic and flatulence, and as a flavouring substance. The oil of peppermint is a powerful local anesthetic, and is often applied over the site of a neuralgia or over rheumatic joints. It causes redness and burning, and should be removed when the burning gets too severe, being replaced by vaseline. If left on too long, it will blister the skin. The oil is sometimes applied to an aching tooth. The dose of peppermint-water is one or two teaspoonfuls.