Eczema of the nostrils is usually cured very quickly. The crusts must be first removed from the nostrils by softening them with an oiled plug and afterwards bathing with warm water. Unguentum hydrargyri am monio-cbloridi can then be applied freely to the interior of the nostril with a folded morsel of linen rag or lint.
In eczema tarsi it is often necessary to pull out the eyelashes, and m obstinate cases the operation is almost always necessary. The scabs must be carefully removed with fine forceps or the head of a large pin, and the edges of the lids be afterwards with any of the ointments which have been recommended. A mild mercurial salve, perhaps, answers the best.
Eczema infantile is often a very obstinate complaint, and from the dis tress it occasions to the infant and through him to his mother or nurse, whose sleep is necessarily broken by the wakefulness of her charge, is one upon which it is important to make some immediate impression. When the disease is very acute and the skin red and intensely irritable, a rapid improvement is produced by large doses of quinine. I was led to employ the remedy in these cases from noticing its striking influence upon chronic urticaria in young children. In eczema a dose of two grains given at bed time to a child of six or eight months old, and repeated every second night, reduces, in a remarkable manner, the general redness, soothes the ir ritation, and consequently greatly relieves the child's distress. He begins to sleep better at night, and in the daytime is less irritable and fractious. Perchloride of mercury, given internally in small doses, is also a valuable remedy. A child of eight mouths old may take ten or fifteen drops of the solution (P. B.) three times a clay, and the eruption often seems to im prove greatly under its use. Thirty or forty drops of the infusion of rhubarb with a few grains of bicarbonate of soda, given regularly two or three times a day, Al often also be followed by considerable benefit.
As in older children, the simple tincture of guaiacum is a remedy which sometimes produces very rapid and decided improvement. I have seen the fiery redness of the general surface fade, and the itching almost entirely cease under a week's use of this remedy given in doses of ten minims three times a clay. When it succeeds, guaiacum seems to take all the acuteness out of the complaint, and reduces the eruption to a common vesiculo-pustular rash which yields readily to ordinary applications.
The alkaline bath recommended by Dr. Buckley, and the bath medi cated with the liq. carbonis deturgens (see page 794), are both very use ful. They, the latter especially, have great influence in relieving the itch ing, and the calamine and zinc application already referred to may be used with the same object. Too frequent washing of the infant is bad in these cases, and the mother should be cautioned against disturbing the treatment by the too energetic use of soap and water.
Vaccination of the child is said in some obstinate cases to produce a complete cure of the disease, and many observers have borne testimony to the occasional value of this method of treatment. In successful cases the eczematous rash clears away completely in from one to four weeks after the operation.
A method of treatment by covering the affected surface with some im permeable material, such as caoutchouc cloth, so as completely to exclude the air, has been found useful in many cases. According to E. Bessener this plan is especially applicable to cases of eczema of the scalp where there is much secretion. The india-rubber sheeting must be adapted accu rately to the head, so as to fit like a skull-cap, and must be kept scrupu, lously clean, being regularly removed for washing and drying. By this means speedy improvement is said, to be effected even in obstinate cases, so that the eruption will quickly yield to the ordinary ointments.