Google
This is a digital copy of a book that was preserved for generations on Hbrary shelves before it was carefully scanned by Google as part of a project
to make the world's books discoverable online.
It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject
to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books
are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover.
Marks, notations and other maiginalia present in the original volume will appear in this file - a reminder of this book's long journey from the
publisher to a library and finally to you.
Usage guidelines
Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing this resource, we liave taken steps to
prevent abuse by commercial parties, including placing technical restrictions on automated querying.
We also ask that you:
+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for
personal, non-commercial purposes.
+ Refrain fivm automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the
use of public domain materials for these purposes and may be able to help.
+ Maintain attributionTht GoogXt "watermark" you see on each file is essential for informing people about this project and helping them find
additional materials through Google Book Search. Please do not remove it.
+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner
anywhere in the world. Copyright infringement liabili^ can be quite severe.
About Google Book Search
Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web
at |http : //books . google . com/|
iHt HEALIfl_O^THE i.KlN
E.B. SuuLDUAii.M.D.
X/06/
/890
THE POPULAR HOMCEOPATHIC SERIES.
1. The Health of the Skin and Chief Skin Rem-
edies.
2. Hahnemann and Homoeopathy — A Sketch of
THE Life of Hahnemann and the Principles
and Present Status of Homceopathy.
3. Headaches, Their Causes and Homceopathic
Treatment.
4. The External Remedies of Homoeopathy. Their
Uses and Special Preparations.
5. Food and Diet in Health and Disease.
Other Volumes in Preparation.
THE
HEALTH OF THE SKIN,
BY
E. B. SHULDHAM, M.D. Trin. Coll. Dublin.
AMERICAN EDITION,
WITH A CHAPTER ON THE
Chief Skin Remedies
AND THEIR HOMCEOPATHIC USES.
PHILADELPHIA :
HAHNEMANN PUBLISHING HOUSE.
1890.
• 9
V
1. t.
L
%.*
W k>
• • •
• «
••• •
• • •
•• • •
•• • • • •
• •
• • •(
PREFACE.
THE raison d'etre of the following pages. What is
it? To give the laity a few plain directions to
guide them in health matters relating to the skin.
To some this may appear to be a very simple affair,
but when we consider that the health of the skin bears
so close a relation to the health of the body it will be
seen that the subject at once assumes an interest and an
importance of its own.
The skin is a barometer, and varies in its aspect as
the bodily condition of the patient may vary.
What first meets the eye of the physician when he
visits his patient? The face — and the conditions of
weakness or of strength can be quickly noted by look-
ing at the patient's face. It is this first glance which
tells the observer a tale of suffering or of ease, of illness
or of health.
Therefore if the skin should be such a tell-tale as it
tryly is and ever will be, should we not make every
effort to "keep each hidden organ of the body in a state
of health ?
4g Seymour Street ^ W.
e>rr?^^-
THE HEALTH OF THE SKIN.
CHAPTER I.
The suggestions that I am about to offer are, as
it were, answers to certain questions that may have
been asked. The most probable queries in refer-
ence to the matter in hand would be somewhat as
follows :
What is the best plan for keeping the skin in
good order ?
What kind of diet should be adopted in a case of
acne or of eczema ?
What soap should be used for cleansing the skin?
Or should any soap at all be made use of?
What powder or ointment should be applied
after the skin has been cleansed by soap ?
Should warm or cold water be used in the
cleansing process ?
Are baths of any value, and if so, of what kind ?
Are there any special health-resorts which should
be visited by patients suffering from chronic skin
affections ?
8 THE BBALTH OF THE SKIN.
What medicinal treatment should be adopted b
patients who are troubled with chronic i
acne?
The first question embodies all those that follow, \
for, naturally enough, it will be admitted that thej
hygiene of the skin includes the subject of diet,J
local applications of all kinds, baths, climatology, 1
and medicinal treatment.
Diet.
I will begin with the subject of diet, for the rules ^
I shall offer are easy of application. I will first point
out the fact that in the management of skin diseases
we have not always a state of plethora to deal with.
Indeed, in the majority of cases of chronic eczema ■
the life-power is low, and consequently a starving J
dietary is quite out of place. The truth is that only I
too often during the progress of eczema and z
the nervous system is at fault and not the stomach.
Let us learn the history of the patient's illness, and
we shall in all likelihood hear that till quite recently
the skin has been in good order, but that since the '
long strain of nursing a friend or relative, or the
anxiety of business, or the fretting care of neglect,
the skin has gradually lost its delicacy of texture,
and has been defaced by some form of eruption.
The nervous system has been overtaxed ; and if we
consider for a moment that the whole frame is
under the immediate influence of nerve power, we
cannot be surprised that the skin should suffer in
sympathy with the deeper tissues. Take the finest
needle you can buy, touch the skin with it, and
there is not on& single little miscroscopic fragment
of its surface which will not feel the needle-point.
Compared with this nervous machinery the ex-
cretory apparatus of the skin appears coarse and' j
unwieldy ; and yet how often do we read of the •
marvels of the sweat dui:ts and glands, while little
mention is made of the infinitely more subtle '
structure of the nerve branches and their fairy fila-
ments.
Before laying down the law in matters of diet,
the condition of the patient requires our first con-
sideration.
Let us take a case of eczema of the neck and
face involving the scalp. Let the patient be a
young women of one or two and twenty. Let her
have a ruddy complexion, and be inclined to embon-
point. Let her take life easily, enjoying all the
good things that are set before her at table. Let
her prefer a saunter to active exercise. And after
some little stomach upset, let her get heated and
chilled, and if she has the gouty inheritance she
may wake up one fine morning in spring to find her '
face and neck hot and irritable, and in the course of |
a few more fine mornings she may discern, without i
careful looking for it either, a rash on her face and
neck which burns and itches, and which, worst of |
all, spoils her good-looks. It must be taken for \
granted that she is good-looking. Now here i
THE HEALTH OF THE SKIN,
case for cooling measures, Here we must give a
light dietary. For instance, meat must be avoided
by the patient. Alcohol in every shape must be
abstained from. Fish, fowl, eggs, and farinaceous
food of different kinds, must be given for support-
But take the opposite case of a young girl of i6 or
17. who has been overworked at school, and pos-
sibly underfed, whose nerves have been worried
by the fearful looking forward to an examination,
whose thoughts by day have been in the direction
of the cube root, and whose dreams by night have
been haunted by problems in algebra — unsolved
problems, 1 may add, then, if this candidate for
llhigher education should suffer from an attack of
Leczcma, rest for the weary nerves and a generous
Idiet should be prescribed, not merely permitted
but actually ordered. In the latter case instead of
I'.a gouty history, we may probably find that there is
\ tendency to struma or tubercle in the patient's
In all cases of eczema it is almost needless to
isay that salted meats and highly-spiced foods of
levery kind should be avoided. Pepper, mustard
land salt should be banished from the patient's table.
rOf course, a very small quantity of salt must be used
fin cooking the vegetables, but no more should be
I added to the patient's plate at meal-time. Green
vegetables should be eaten freely, The root veg©^
tables are not so generally wholesome, as they con<J
tain a good deal of sugar, and this in gouty caseB^
wis very apt to turn acid and disagree. Raw celery
■js very difficult of digestion, but if stewed with a
piittle beef stock is soft and delicate enough for the
rmost sensitive stomach. There is a true medicinal
Tquality in this popular herb, some medical authors
r.esteeming it highly in rheumatic and gouty cases,
Twhilst others find in it an excellent sedative for irri-
I table nerves.
Indeed, when I speak of the medicinal quality
I possessed by celery, I am touching on an almost
J unexplored field in therapeutics. There is, undoubt-
I'edly, medicinal virtue in asparagus, in celery, in let-
K'tuce. Why, therefore, should therapeutic power be
[denied the cabbage, the cauliflower, spinach, or the
|. onion ?
Onions contain a large quantity of sulphur, andJ
I the cabbage holds potash salts in its tender JibresJ
f In the old days of the naval merchant service, scurvy!
■'■was the sailor's curse, for in long voyages vegetable
tifood was a rarity. Now. thanks to a better know-
[e of disease, scurvy is almost unknown, for
Memon juice and tinned vegetables defy its attacks.
In gouty eczema I am sure that the formation of
J uric acid in excess is greatly checked by the patientL|
rtaking a plentiful supply of green food at his mealai
f Some very curious cases of night blindness cams!
Pander my notice some few years ago when I was
p attending a large school in the country. The super-
'intendent noticed that the boys who left their green
food and only took meat and bread for dinner v
THE HEALTH OF THE '.
the sufferers from night bhndness, and having made
this very shrewd observation, he cured the night '
bhndness by full doses of cabbage and cauliflower ■
taken at dinner-time.
As there were 1 50 boys in my friend's charge,
there was ample opportunity for noting this matter.
From a hygienic point of view 1 consider it was
most noteworthy.
It is hardly necessary for me to say that shell-
fish of all kinds, except oysters, should be put in j
the list of prohibited foods. A crab or lobster taken T
for supper has been known to bring on symptoms 1
of acute gastritis followed by an attack of nettle-rash
severe enough to make the patient think that he has
been poisoned. So far, he has been poisoned for
the time being.
I would note one fact in reference to food — namely, '
that warm food of all kinds is more digestible than j
cold. I have been told by patients many a time |
that they cannot understand why they suffered s
much from indigestion at bed-time, for they had i
only taken a little cold faeef and cold rice-pudding I
for supper, The fibres of a bit of cold beef are 1
compact, and the cold milk of a rice-pudding to 1
many persons is as solid and indigestible as cheese.
A cutlet sen.'ed hot, with a warm rice-pudding to '
follow, makes a light meal. Fruits of all kinds in •
their season are as a rule wholesome food, but acid
fruits that require much sugar cannot be recom-
mended in cases of gout}' eczema. Apples are v
BEVERAGES.
apt to set up a kind of acid fermentation, which is
neither comforting to the patient's stomach nor
soothing to his skin. Nuts of all kinds must be
abjured ; they are just so much woody fibre, with a
little oil and sugar to make them attractive ; and
when I read of Cobbett's having lived for days on
cobnuts and apples during a walking tour in Kent,
1 am lost in wonder at his powers of digestion.
Here was a man capable of digesting anything, from
his old shoes to the British constitution.
Now comes a vexed question — Is it wise for pa-
tients suffering from chronic eczema or acne to take
alcohol with their food, or should they pledge them-
selves to total abstinence ?
There is no hard and fast line to be laid down in
this matter. Each case must be a law unto itself.
Without doubt alcohol is most injurious in some
forms of acne and eczema, but I suspect, when it
disagrees, that the patient is of the gouty habit, or
that the alcohol has been taken in too potent a
form. The light wines of France or of Germany
diluted with water and taken at meal-times would
harm very few patients, and might often help a weak
digestion. Champagne, sparkling hock, burgundy,
and malt liquors, should be conspicuous by their
absence.
Beverages.
Another vexed question is the one concerning
tea, coffee and cocoa as beverages. Some medical
men condemn the use of tea and coffee, regarding
• 14 THE HEALTH OF THE SKIN.
them as nerve irritants ; they advise the use of cocoa 'J
1 instead. But here again in this humble arei
, must not take sides too fiercely for or against the?
, refreshing cup of tea, the stimulating cup of coffeej
k or the nourishing but somewhat greasy cocoa,
Tea has its peculiar qualities, and therefore its
firm adherents. Coffee has a charm of its own, ■
which to some ts irresistible ; and cocoa comes witil
a friendly spirit to those whom tea weakens or coSee ^
sets on fire. Let me offer one suggestion in refer-
ence to tea. Pay a good price for it, and do not Ie(
it stand many minutes before drinking it
Cocoa is a fattener, but itwouid not suit the biliout"
for any length of time. The Dutch cocoa
beautifully made, and for nutritive qualities I almost ■
think bear the palm.
(To sum up, then, I would say that salted foodsJ
spicy foods, cold foods, strong alcohol, sweetenecfl
alcohol, acid fruits, pastry, nuts and shell-fish, rauatfT
be forbidden to all those who wish to keep the-JI
stomach in good humor and the skin in good orderri^
For if the simple rules of diet which I have laid!
down are transgressed, those tiresome little nerves I
of the stomach will telegraph the transgression to i
the brain, and, by reflex action, the nerves of the
skin will be irritated, and a chronic state of irritation
will be exchanged for an acute.
CHAPTER IT.
NERVE INFLUENCE IN SKlf
I CANNOT help thinking that the nerve element
in skin disease has not received the attention it de- j
serves. >
The intimate relationship that exists between the
superficial nerves and the deeper structures has been
clearly shown in many diseases of purely nervous
origin, and I am anxious to show that the health of
the skin is greatly dependent on the health of the
great nervous centres, brain, spinal cord, and sym-
pathetic system.
The circulation of the whole body is under ner-
vous control. Dilated or contracted bloodvessels
give visible signs of their disorder in the skin, but
the outward signs of this unrest are due to dis-
turbances which are going on within.
To illustrate my theory I will give the following
cases: Some few years ago I treated a distinguished
singer for an attack of eczema of the hands. The
skin affection rapidly followed a nervous shock,
which, in its turn, was due to the patient having
seen a poor fellow killed at a railway crossing. My
patient distincdy traced his attack of eczema to this
i6
THE HEALTH OF THE SKIN.
sudden shock. His own words were: "It madeT
me feel quite sick at the time, and I have not feltj
■ well since." The eruption appeared twenty-foufJJ
■ hours after witnessing the accident. Here was nq,3
case of gouty hyper.iemia, nor of bilious disorder,, I
but a powerful shock to the nervous centres, Mjr J
patient was a man of the most temperate habits withj
regard to eating and drinking, but his nervous o
ganization was finely strung. Another case of skin^
disorder, due to nervous shock, comes to memoij
as I write. It is that of a lady I attended for somea
time, years ago, for an attack of gout. In the course*!
of my inquiries as to my patient's previous condi:!
tion of health, she said to me : " You must not at-1
tach too much importance to the state of my comJ
1 plexion, for that was suddenly and permanentlj^T
faltered by a great shock— hearing the news of thq
Ideath of my husband and my son in the Indiai
Ijoautiny." The patient's face was of a darkish-red,^
ind there were little tubercular masses strewaj
f broadcast over the cheeks, chin, nose and fore-^
head — a kind of tubercular acne. She said : " My I
face became burning red when the sad news wasr.J
brought me, and the color has never died away^S
But it is darker now, and the spots are harder a
more raised above the surface than before."
I have yet another instance of a skin afTcctioOj
following mental trouble. It is the case of a yountf
married woman, whose happiness has been deJ
stroyed by the shameless conduct of her husband.'
NERVE IHFLUENCE IN SKIN DISEASE.
The patient is very good-looking, and. until the ]
worry brought on by her husband's behavior, she I
had a singularly dear skin. But after awhile spots '
of acne began to show themselves on her face, and
as I had full opportunity of watching the case, I
noticed that any mental upset was always followed
by a fresh crop of acne. The most careful atten-
tion to diet made little, if any, impression on the
spots. A prolonged change to the seaside certainly
did good, for by strengthening the nerve power the
skin assumed a healthier aspect.
Acne.
The more I see of acne, the less inclined I am to
lay down rigid rules of diet in this affection. There is
certainly what might be called a physiological acne,
which comes on in youth, when the body undergoes
one of its first great changes, and which also shows
itself at another great change in the life of woman.
This, I contend, is most intimately connected with
bodily development and bodily decay, and is more
under the influence of the nerve-centres than of the
digestive organs. Fills and potions of a laxative
character are worse than useless in these cases, as
indeed, they are in nine-tenths of the chronic forms
of skin disease which medical men may be called to I
prescribe for.
Sh^ngthen the nerves^ oxygenate the blood, here
is the true secret of success in the treatment of
chronic skin disease.
l8
THE HEALTH OF THE SKIN
What good can an opening pill do?
It gives a patient a stomach-ache which, in hiaj
innocence of heart, he thinks must be good for him, I
It makes him feci weak ; and this, also, to his think-
ing, is a sign of the curative power of the medidne. I
But it has no more power over the nervous irritatioa I
of the skin than so much raspberry jam, which, hyA
the way, would have been far pleasanter to swallow, I
and more wholesome in action. And yet people I
will go on taking pills by the score, because so fewJ
medical men in this country condescend to learn the I
first principles of therapeutics. I was discussing I
the subject of opening pills with a distinguished f
medical friend of mine, and he said that " for c
pill taken in France, Germany, or Switzerland, there J
are a hundred taken in Great Britain." As my j
friend has lived a great deal on the Continent he is fl
in a position to make a reliable statement, Takings
an aperient pill on the Continent is a serious affair^
and so it should be.
Another familiar instance of skin disease whichfl
is set up by nerve irritation is that of ecsema wIucHm
comes on during teething. Here we have undoubt* ;
edly nerve disturbance within setting up a surface I
trouble, and the surface trouble remains until nature J
has finished her task of tooth eruption. Of course j
some children will go through teething without
eczema, diarrhcea, or convulsions, but these children
have cast-iron nerves, and are absolutely devoid of J
medical interest, The herpetic eruptions known a
NERVE INFLUENCE IN SKIN DISEASE.
"shingles" is a pure neurosis, due to the irritation
of superficial and.^gep.--seatfid-a«rves.
The furious itching that attacks the aged is
another instance of nerve weakness and of nerve
irritation.
My friend, Dr. Barry, who has a large experience
of .skin diseases, related to me a case of acne of the
iace which entirely disappeared after the successful
treatment of a prolapsus uteri. This condition of
the skin had been kept up by this internal mischief
for years, and when this latter trouble was judi-
ciously treated the reflex irritation of the skin gave
way.
It was only a few days ago that I saw a lady in
consultation with another medical friend. He asked
my opinion as to the state of the patient's skin.
The most trying part was acne of the face and neck.
Its first appearance dated back to girlhood, and was
synchronous with a course of many months of
under-feeding at a school in Germany. Here was
undoubtedly another instance of nerve weakness
being followed by a skin disease. .
// is of the utmost importance to feed liberally both f J
girls ami boys during their first change of life. I \
There is far too great anxiety on the part of pa-
rents and teachers to crowd a number of fects into
young people's brains at the expense of their bodily
health. The result of this misplaced enthusiasm is
that very soon the facts, as they are called, are for-
gotten, and some very tangible form of bodily weak-
THE HEALTH OF THE SKIN.
ness remains. In one case acne makes its appear-
ance, and does not always disappear during the ^
vacation, when brain work is less imperative.
In another case the foundation is laid, pretty sol-
idly too, for the occurrence of nerve headaches; in
a third case the stomach suffers. But gastric .
troubles are more easily remedied and tolerated also '
than affections of the nervous system. In yet J
another case, from faulty school hygiene, a lateral ]
curve of the spine is developed.
Is it at all wonderful that the skin should suffer ]
when the nerves are irritated, when we note that in J
the Malpighian layer of the skin there is a ]
network of nerve fibres? and that intimately asso- I
ciated with nerve fibres all over the body we have a
vast system of minute bloodvessels?
If a shock should be given to the nervous systemj
how can the bloodvessels escape the blow ?
when nerve and bloodvessel run their varied course; J
hand in hand, as it were, to the most sensitive partar j
of the body's surface, can we be surprised that if the^
nerves hasten or check the course of the blood cor-
puscles, the results of this stimulus, or check, should J
be plainly recorded on that huge chart of the body. J
which we call the skin?
In many cases of skin disease our great c
should be to give the nerves of the skin rest, for the*
surface irritation not merely exhausts the nervous- j
centres, but prevents a healthy action from being I
kept up in the various structures of which the skiit j
NERVE INFLUENCE IN SKIN DISEASE. 21
"itself is composed. If the ner\-es are irritated there
is invariably irregularity in the local blood supply ;
this often leads to congestion and inflammation. In
such cases soothing ointments and protective plas-
ters will be found of great service, and, indeed, are
often the chief means of bringing about that happy
result known as a cure. In lupus erythematosus
the local use of one of them, as salicylic acid plaster,
forms undoubtedly a very important part of the
treatment.
By this means we get protection from the air,
diminution of local blood supply, and destruction of
excessive epithelium.
I have come to the conclusion that in unhealthy^
states of the skin we get too much cell growth, and ^
iherefore the great point for consideration is how
can best soothe the surface nerves, and not
mulate them.
By protecting the skin from the mere action of
3ie external air we give relief, and heroin lies the
alue of nearly all the greasy applications which are
Made to the skin. When we add to the grease a
mineral or vegetable sedative we ensure comfort to
'he nerves of the part. Local comfort is central
; comfort, and therefore local sedatives are
pever to be despised, as indeed they often are by
who treat disease solely from the constitu-
standpoint.
Take the case of a child who is suffering from
widely diffused eczema of the body. Is it a littlm
THE HEALTH OF THE SKIN.
matter that this child should be soothed to sleep
by a sedative application, instead of tossing about
half the night, hot, irritable, restless, peevish and
thirsty, and upsetting the nerves of parent or nurse,
for lack of some local help ? I think not.
The local sedative may be perfectly harmless;
indeed, if it bear a close affinity in action to the
disease it must be harmless.
The same influence is very marked in all cases
where desquamation of epithelium is a character
of the disease. Take, for instance, Bright's disease.
Here is an organ, the kidney, shedding its epi-
thelium freely when the nerve power of the body is
at a low ebb. So it is in seborrhosa, there is nerve
weakness in nearly all the cases, and free shedding
of the surface skin is the usual accompaniment irf
this condition.
Not only in the course of eruptive fevers, but
also in many other illnesses, shedding of the scarf
skin is a common sequel.
This shows the great disturbance which has
taken place in the superficial nerves of the body.
That the health of the skin depends greatly on the
health of the nervous system should be an axiom
in the treatment of four out of five cases of chronic
skin disease.
I have lately been attending a patient who has
been suffering from a severe attack of gouty ec-
zema, and the attack can be distinctly traced to hia
having been annoyed by one of his workmen.
NERVE INFLUENCE IN SKIN DISEASE. 23
i.I have observed over and over again that the
anxious, ill-fed, badly-clothed patients that come
to special hospitals for advice as to the state of
their skin are the most difficult to treat, and suffer
more frequently from reiapses than those in easy
circumstances. Often when the question is asked,
"What is your occupation?" the patient hesitates
in his reply, then says, apologetically, " Oh, well, sir,
I have been out of work for some time." The medi-
cal man then knows that he has got a tough case
for treatment. Or it may be the badly-paid, ill-fed
needlewoman who is suffering from acne rosacea.
She is questioned as to her diet, and it is very
evident that the so often prohibited roast beef
rarely figures in her diet sheet. Tea and bread-
and butter and a bit of salt fish make up her food
supplies. If she should happen to suffer from
eczema of the hand, it is of little avail to tell
her to rest her weary fingers. The best prescrip-
tion for her would be made up at the butcher's,
instead of white mixtures to cool the blood. Her
poor blood wants to be set on fire a little bit-
Indeed, in half the cases that come to the hospital
or dispensary for relief from their troubles a good
general conflagration of the blood would bring
about the happiest results.
Feed up, stimulate, warm the poor half-starved
bodies of these patients, and magical cures would
crown the practitioner's efforts.
There should always be a provision store in the
THE HEALTH OF THE SKJN.
■immediate neighborhood of every hospital, and'|
i-tickets might be issued for distribution amongstj
the really poor and destitute patients. Instead ofj
ijnerc. oxide a chop might be ordered.
Medicines which have a distinct alBnity for the'J
diseased tissues should be given to patients suffer- 1
ing from skin disease ; or else medicines which J
have a direct action on the nervous system. Let"-]
us, for example, call some of them tissue remedies J
and others nerve stimulants. Such medicines aS:"!
arsenic, mercury, sulphur and phosphorus, may btfij
called tissue remedies, whilst mix vomica, beU»^
donna, kyoscyamus and ignatia, may be cited as]
nerve remedies.
Far too much reliance has been placed on thH
value of aperients in the treatment of this disease.)
This is the outcome of indifferent pathology. Be-j|
cause a patient happens to suffer from constipation J
as well as from eczema, the medical man consulte
for the eczema often jumps to the conclusid
that the eczema is due to the constipation, (
any rate aggravated by it, and he at once pre^
scribes an aperient pill or mixture. He is und^
the belief that the contents of the lower bowelil
unduly delayed in their exit from the body must
act as a kind of poison to the blood. Most lam e
and impotent conclusion ; for if this were the cas^^
blood poisoning would be more general than it isM
and the cure of eczema an affair of a few dayffl^
treatment. But in spite of three, four, five dayajl
NERVE INFLUENCE IN SKIN DISEASE.
25
Bxonstipation, patients live and flourish, to all in-
Vtents and purposes, in perfect health ; and in spite of
i long course of laxatives, patients suffering from
■■chronic eczema come again and again to special
llospitals for relief.
One of the finest and healthiest babies I ever had
ie pleasure of prescribing for had a natural action
©f his bowels once a week. It was a model baby.
: parents came to me about this phenomenal
;n days' action. I asked as to the child's gene-
ral health. It was perfect. I asked whether the
tiild was distressed by this constipation. " By no
Bmeans," said the mother and the nurse in a breath.
Then, I said, " Why need you trouble about the
"pnatter at ail ? "
Weil, the interview ended by my advising the
Kirents to let the child have its own way in this
■|)articular line, and if any distress should occur then
they were to give the little patient a few doses of
B<bitu rated sulphur.
Constipation is more often associated, like psori-
:, with a state of robust health than one of weak- 1
Relaxation of the bowels is never associated
Kwith robust health either in the human race or in
|lhe lower animais, with the exception of the cow. '
L horse, a dog, a pig, a fowl, even a bee, that i
relaxed in the bowels is in a state of ill-health.l
»s are decimated by attacks of dysenteric diar-J
iSfhcea when they are overcrowded and when theV
26 THE HEALTH OF THE SKIN.
ventilation of their hives is imperfect. "Throw
physic to the dogs " is a stale proverb, but the dogs
are far too wise to take any of the poisons which
human beings are so fond of when they are out of
health. They do not invite colic by a little simple
grass eating. But men swallow irritants by the
handful, and think that they have science on their
side for so doing. Is it not a blind following of
tradition ? I think so.
r^i:*
great fatigue, and with proper protection against I
cold wind and hot sun, is one of the best prescrip-
tions I can write for a good complexion.
But there are sure to bo some of my readers who
will not be satisfied with this simple formula, and
who will ask plaintively for " some nice cooling lo-
tion for the face," or " some powder that can give a
color to the cheeks," which the cheeks are sadly in
want of My reply to these readers would be, " Try
the exercise-prescription for three months running,
and then if, after this course of out-door treatment,
the complexion fails to come up to your ideal stand-
ard, there is something amiss with the health, and
your medical attendant should be consulted." . The
liver, or stomach, or nervous system, may be at
fault ; and I may safely say that nothing plays such
havoc with the complexion as disordered nerves.
The liver can, as a rule, soon be put to rights by ,
28
THE HEALTH OF THE SKIN.
using the appropriate medicines, the stomach w||
give more trouble, but the nerves will give t
greatest trouble of all. They control everything 1
the body for good or for evil. They are mOj
easily put out of working order, and they are mo!
difficult to put into good working order. I mayaa
incidentally that nothing puts the nerves so quicl^
into tune as the open air prescription. I)<^|
exercise out-of-doors quickens the circulation, 1
nerves are better fed, as it were, by the purer blex
which flows beside them, they in their turn stiin
late the bloodvessels to healthy action, and the gifl
of health is visible in the face, which is onlyanoth
term for healthy nerve and bloodvessel. Can a
" Bloom of Ninon " or " Poudre d'Amour " compelj^
vith this condition ? I hardly think so. These face
E powders are, as it were, supports to a broken limb ;
they do not mend the fracture. If the complexion
wants some artificial help, then there is but little
objection to patients using some simple face pow-
der. Those made of rice, starch or French chalk,
are the simplest, and therefore the best. The addi-
tion of coloring matter is an affair of pictorial art,
and not a question of therapeutics.
In reference to exercise, I would say : Always let
it be. properly timed. For the delicate, the so-often
prescribed walk before breakfast is quite a mistake,
unless the walk is of about five minutes' duration.
Actual exercise should never be taken soon after a
full meal ; and after active exercise there shou]
always be a quiet interval of rest before food is
taken, especially before sitting down to a really
serious meal.
The good results of exercise are shown by the
body being evenly warmed in every part. If the
patient conies home with cold feet and hands, or a
pale face, then the walk has been too long, or the
heart is hi a weak state. Here the mode of taking
exercise must be altered. Riding may be exchanged
for walking, or a short, but lively, game of lawn
:ennis may be tried as a variety. A long walk is
by no means advisable for delicate women ; indeed,
walking exercise is, for some people, the most fa-
:igiiing, and the least profitable that can be taken
For their health. When there is a weakness of the
uscles that support the spine, long walking and
■ng standing are most injurious, and lead often to
ateral curvature. In these cases there is no kind
of exercise so helpful to the body as rowing. But
every young woman who handles an oar must
always row more with the muscles of her back, and
not so much with her arms.
Massage is so universally used nowadays that itis
like telling a twice-told tale to mention it even, but
I would offer one suggestion in reference to its use,
and this is not to fatigue the patient by too long or
too energetic manipulations. It is a form of passive
exercise, and the muscles and nerves of a delicate
woman will not stand an overdose of massage, any
4
30
THE HEALTH <
THE SKIN.
more than a weakly patient will bear an overdose o
strong medicine.
I have heard many patients say that " they c
not bear massage, it is too fatiguing." It fatigue!
because it is pushed to excess, or it fatigues becaus^
the wrong movements are given, or it fatiguet
because the operator, instead of vitalizing
patient, absorbs the patient's animal electricitj
himself. This may seem fanciful to some of i
readers, but to those who have used scientifa
exercises for many years it is a matter of the com
monest experience, and it is almost too trite to beai
repetition. Massage is after all only a little s
branch of the great system of scientific exen
which Ling's wisdom introduced. Ling's name h
unknown to many of those who use this branch of
therapeutics, and certainly the medical profession
rarely have his name on their lips. Poor Ling is
out of fashion ; massage is the mode.
Ling's system requires knowledge and careful
application. Massage can be learned, so they say,
in a few weeks, and certificates of aptitude are given
after a short course of training. Is it wonderful,
therefore, that massage should be the mode and
that Ling's exercises should be lost sight of?
Baths.
The use of exercise wilt naturally lead me to
speak of baths, a most important part of my sub-
ject. Bathing has in some periods of the world's
history ranked as a fine art, and there are some
reasons for thinking that at the present time even,
it can be raised to such a dignity. So far it is a
question of cleanliness, of comfort, and therefore of
health. There is a wrong way and a right way of
carrying out the simplest principles of hygiene, and
this is the case in the mere taking of an ordinary
bath. If a chill can be given by taking a cold bath,
and the chill can lead to an attack of pneumonia,
bathing is not such a simple affair as at first sight it
may appear to be. Therefore I will now give a few
suggestions as to the proper use of the bath as an
accessory to the toilet. The first suggestion is:
Never to take a cold bath when the nerve power
is much lowered.
The second is — Never to take a cold bath when
the body is heated and fatigued. Nerve power low
again.
The third is — Never to take a bath of any kind
whatever soon after a meal. Nerve power wanted
for process of digestion.
The fourth is — Never to take a cold bath of hard
water when chronic eczema is present.
These are the negative suggestions.
Now for the positive.
Tepid baths followed by splashing of cold water
over the body are the most suitable for those who
suffer from a weak circulation, whose nervous sys-
tem is at fault, or who are liable to disturbance of
the liver or bowels.
32
THE HEALTH OF THE SKIN'.
Warm baths of plain water or medicated ia J
different ways are most suitable for sufferers froml
chronic skin disease.
The oatmeal bath, the soda bath, the linseed-,
meal bath, the marshmallow bath, are all excellent^
for those who want a sedative action on their skin.
The sulphur bath, the acid bath, are stimulating,: I
and the electrical bath stands midway between!
soothing and stimulating. The choice of the appro-j
priate bath must always be left to the judgment ofij
the medical man in attendance.
Besides the application of water en masse to t
patient's body, we have most powerful help at oui
disposal in the shape of vapor baths and Turkish'!
baths in their various modifications, and indeed I^l
am inclined to think that these are more soothtn
«nd at the same time refreshing than any other fora
of bath.
The great caution I would give in the use of thes^
baths, is to take the bath quickly and to dres|
quickly soon after. There is no doubt whatevrafj
that great harm is done to patients in weak health;
by a very long sitting in a hot room, and by a veryj
slow cooling after the douche in the dressing rootnj
At the end of the bath the patient is exhausted, andT
on leaving the bath-room is very apt to get chille<
on going out into the cold air of the street.
To those who want a very soothing bath for the
skin, I would recommend one with oatmca! in it, t(q
which a good supply of milk has been added.
CLOTHING. 33
must give a word of caution in reference to
sea bathing.
In cases of eczema it should never be indulged
in, the action of the sea salt is far too irritating.
Some forma of gouty eczema are made worse by
the mere fact of visiting the seaside, and also some
cases of acne which are complicated with erythema.
Clothing.
After the bath clothing must be considered.
Now I approach a disputed field. Flannel is the
subject ofthe dispute. All dermatologists are agreed
in condemning the use of flannel worn next to the
body in chronic skin disease. In acute and in semi-
acute disease, I agree with them. But there are
cases of chronic psoriasis, of chronic nettle-rash,
and of chronic eczema, where the nerve power is
low, the circulation weak, and where a very fine
woollen material may be worn with comfort, espe-
cially if any local spots of suffering are covered with
fine linen.
Indeed, in psoriasis of the elbows and knees, and
in — let us cal! it — patchy eczema, the affected parts
would almost be sure to be protected by a wrap of
medicated linen.
The very fine Jaeger, Morley's finest woollen un-
derclothing, and the cellular, are all well worth the
consideration both of patient and medical man.
When patients perspire freely, and are exposed to
3 of temperature, or when the circulation is
THE HEALTH OF THE SKIN.
weak, so long as the skin is not inflamed there can
be no question as to the superiority of woollen
underclothing over linen goods. It is not merely
safety for the weak but also comfort for the strong.
Jaeger's suggestions are eminently practical, and
the marvel is that in such a trifling matter as that
of the leather hat linings and the leather shoe and
boot linings we have gone on mopping our fore-
heads and inflaming our feet needlessly for some
centuries when a little bit of flannel inside the hat
or boot would have made us all so comfortable.
Rowing men invariably used flannel linings to their
straw hats when I was an undergraduate at Oxford.
Why they discarded their flannel when they left the
University and donned their beavers I cannot tell,
but they all have done so, till Jaeger came and coi
vinced the world of its error. I for one faa^
repented of my error. But the leather lining to
hat, like the silk outside, is such a respectable
tradition, that it will take another half century
get rid of it,
In cases of acne or of eczema of the forehead the
leather lining is a positive irritant to the skin; in-
deed, it has been found to irritate a healthy skin,
from the presence of some injurious compound ap-
plied to enamel the leather linings. Arsenic has
been found in these enamelled linings.
the
tel l. I
1
CHAPTER IV.
LOCAL APPLICATIONS.
With reference to these local applications I can-
not help being struck by the more frequent use that
is made of mineral compounds than of vegetable
extracts. One has merely to run the eye down a
list of formulte of lotions or ointments prepared for
the skin, and prescribed by the best dermatologists,
and one finds the constant recurrence of mercury in
its various forms, bismuth, lead, copper, silver, and |
zinc. These potent minerals meet the eye at every '
turn. But the vegetable extracts are few and far
between. Is this a matter of clinical experience, or
is it a matter of tradition ?
I think it is due to both influences. The mineral
traditions are not as yet very old, for dermatology
has been a subject of scientific interest for barely
half a century. But here is an instance of a curious
phase of human thought — this constant acceptance
of another man's teaching, without asking a few
questions as to " the why " and " the wherefore " of J
the doctrine taught.
In the first place, there is yet much to learn as to J
36 THE HEALTH OF THE SKIN.
the mode of action of the simplest wash or ointment.
Is the agent which is locally applied always ab-
sorbed by the skin when the skin is unbroken? or
does it act by stimulating the superficial nerves and
bloodvessels ?
In the case where the skin is unbroken there is a
double action — absorption takes place and also local
stimulus is given to the surface nerves.
The most direct way to investigate this local ac-
tion would be to experiment on portions of the body
where the skin is very thin and watch the result of
local medication by using a magnifying lens of a
moderately low power.
In the meanwhile, I think it would vary the mo-
notony of these mineral formulae if some of the
flowers, the leaves, and the roots of our plants were
called into requisition.
The marigold, to my thinking, takes a place in
the front rank. The daisy has soothing properties,
according to a few unprejudiced observers. The
marshmallow is well known for its soft mucilaginous
qualities. The juice of the cucumber has been
popular as a toilet accessory for some years, and Its
popularity is by no means on the wane. An infu-
sion of the common watercress has a stimulating
character, and has been used in this country for
some years past for chronic irritation of the inner
part of the eyelids.
As a local pain soother the chamomile has found
favor with students of both the old and the new
LOCAL APPLICATIONS.
37
schools of medicine, but the internal use of this
flower is more acceptable to adherents of the new
school. The witch hazel (Hamamelis) has won
golden opinions for the relief of congested veins,
and can be used with advantage in heat and flushing
of the face following exercise. Besides, it makes an
elegant eye-lotion for conjunctival irritation. The
powdered bark of the slippery elm is well worth a
trial in the case of boils or pustules.
For face powders I should recommend very
finely ground Indian corn, rice, wheat-flour, starch,
orris root, which belong to the vegetable kingdom,
and very finely powdered oxide of zinc, bismuth,
and boracic acid, and silicate of magnesia, to be
chosen from the mineral world.
I should always eschew the use of lead or mer-
cury unless ordered by medical advice, especially
when the skin is broken.
A mixture of boracic acid and starch powder is
very helpful incases of excessive action of the skin.
It is cooling and deodorant.
A mixture of boracic acid and starch powder, to (
which a drop of the strong tincture of calendulai'
has been added, can be used with advantage in cases (
of eczema where the skin is cracked and irritable,'
There is no fear of its setting up irritation. I have
dusted this preparation on deep wounds of the scalp,
arm and leg, and on large superficial abrasions of
the skin, to the great comfort of the patient, and
with rapid healing up of the wounds. The term
3? THE HEALTH OF THE SKIN.
"acid" is a little alarming to the laity; they think
that an acid must, of necessity, be an irritant, but
this particular one is a soothing antiseptic. As a
nose snuff in anterior nasai catarrh it has won its
laurels, but this mode of application is known to
very few. I introduced the use of it in my private
practice some months ago, and have no reason to
regret my first trial of it in a severe case of chronic
nasal catarrh.
Some of my readers may think that any allusion
to the nose in a work devoted to the hygiene of the
skin is out of place, but when we consider that the
nose is one of the most striking features of the face,
and is attractive by its beauty of form and color, a
little attention paid to its troubles and defects might
after all be in season. The internal trouble to which
it is chiefly subject is, I need hardly say, catarrh,
and, in many cases, chronic nasal catarrh leads to
serious mischief within and to disfigurement with-
out. Indeed, this last condition appears to many
worse than the first. Mischief in the lungs, mischief
in the bowels, mischief anywhere, so long as it is
only out of sight, is bearable, but disfigurement, ?A!7?
is the condition so much dreaded by human beings.
The nose, therefore, should not be neglected, A
chronic catarrh may lead to the formation of a
growth; this growth may and does alter the shape
of the nose. Again, a state of chronic ill-health is
apt to be followed by acne of the face, and, in many
instances, the acne spots are tiresome enough to set
LOCAL APPLICATIONS. 39
Kiip their little tents on the nose. But even the
very mechanical irritation which catarrh induces is
followed by an attack of herpes and sometimes
eczema. It is well, therefore, for all those who
value their good looks to pay especial attention to
the state of the nose, and it is equally important
for every well-trained physician to question the
nose in all cases of chronic catarrh or chronic ill-
health. The daily use of a small speculum will be [
the means of his gaining much valuable informs- '
tion.
The same spirit of inquiry should lead medical
men to examine the eyes and ears of their patients.
Constant irritation of the eyelids in childhood, due
to blocked sebaceous glands, if uncared for, is fol-
lowed by mischief that takes months and years to
remedy. A little timely notice and care would
obviate the occurrence of a lifelong trouble. The
hidden mystery of the ear should be left entirely to
the charge of a skilled practitioner. Thatvillainous
habit practiced by some nurses of trying to clean
children's ears with a hair-pin, must be mentioned
simply to be condemned. The use of a soft towel
moistened with water is all that is required for the
proper cleansing of theear. Pain or deafness should
z medical attention.
Soap.
The question of soap with reference to skin dis-
ease is all -important. Therefore, I shall make no j
40 THE HEALTH OF THE SKIN.
apology for devoting a few paragraphs to its con-
sideration. Now-a-days there appears to be no
difficulty in obtaining a good soap for the toilet, or
one that is suitable for delicate skins ; that is, if we
are to judge by the written testimony given by some
beautiful women and some learned men in favor of
a very popular soap.
There are soaps and soaps. The qualities of one
particular soap are by no means commendable to
every member of the community. We do not all
want a soap that lathers well, for this generosity of
lather implies an excess of alkali, and this is cer-
tainly irritating to some skins. Neither do we all
care for the presence of tar in our soap, nor of
glycerine either. The presence of tar in the soap
is most hurtful to patients who suffer from acne sim-
plex, and the merest trace of glycerine in a soap will
re-light the fire of a slumbering eczema in others.
So that we must admit, in spite of all the big letters
on all the big boards, that there is no one soap suit-
able to every skin any more than that there is one
medicine which can cure all diseases.
Patients with delicate skin, or suffering from
chronic acne or eczema, should be most careful in
their choice of a soap.
It may be naturally asked then, "What are the
essentials of a good soap?" Let us reply to the
question briefly. A good soap should first of all
be pure. This is a sine qua non. By purity I
mean freedom from all products of animal or vege-
(able decay and from the adulteration by |
lotato starch, sugar, chalk, or clay. The animal
s should be clean and the vegetable oils should
"be sweet. The next essential is that the soap
should be non-irritating.
If there is impurity in the soap then irritation of
the skin will be set up ; or if there is an excess of
alkali we shall have a like result.
Thirdly, a soap must have good cleansing pro-
perties, and tliese will depend on the proper adjust-
ment of alkali and fat. Indeed, it is the co-relation
of the first two essentials that gives us the third in
its perfection. Color and scent are merely acces-
sories and by no means essentials.
From a sanitary point of view, then, all that we
should expect of a good soap is that it should free
the skin of foreign particles without hurt to the
surface cells of the epithelium. Dr. Eichoff says,
in his most excellent monograph " On Soaps,"
"As a hygienic means soap should not act chemi-
cally on the skin, but mechanically." Further on
he says, " As a rule we call a soap hygienically bad
which contains more or less of excess of alkali, for
such a soap will always be harmful to a norma!
skin. By saponifying the skin it will rob it of its 1
normal fat and will cause the cells of the horny j
layer to be shed prematurely." For this very
reason cocoanut oi! soap is by no means to be re-
commended, as it requires an excess of alkali for
its manufacture. It lathers well, and removes dirt
42 THE HEALTH OF THE SKIN.
and grease from the skin readily, but its constant
use is very apt to be followed by skin irritation and. i
chapped hands.
" A good soap, from the hygienic point of view,
therefore, should be neutral," says Dr. Eichoff,
" and to speak more accurately it should contain
no free alkali."
This naturally leads us to the mention of Uona's
admirable choice of materials for the making of his
I over-fatty soap. He has united beef-suet, olive oil,
ipotash, and soda, in the proportion of about 67 per
jcent. of fats to the soda and potash. The resulting
compound is one that can never hurt any healthy
skin, and which can benefit nearly all irritable or
dehcate skins.
He has gone a step further, and medicated this
soap in various original fashions ; and any one who
is interested in the subject can have their interest
gratified by reading Dr. Eichoff's admirable mono-
graph on the subject.
There is a great objection made by some medical
men to the scented soaps on account of the scent
being sometimes added to mask impurities, which
without the scent, would be objectionably promi-
nent. This may be the case in some instances, but
I there are many high-class soaps — Pears' soap for
example — to which a little scent adds a charm with-
out spoiling any of its good qualities. Only let
the soap be pure and the scent refined, then no
LOCAL APPLICATIONS.
43 (
n of s
n befall the skin by a combination c
I and soap.
Finally, I will briefly point out the conditions
Ejwhere the use of a pota.^h soap is commendable. In |
■that greasy state of the skin where acne simplex
^and seborrhea of the scalp are met with the use of '
a potash soap will give excellent results. In the
hickened state of skin where psoriasis occurs, or
'here eczema makes a prolonged stay with fish-
ike scales, the potash soap will be of good service
Wm softening the upper layer of epidermis.
And in cases where the presence of vegetable
rasites is suspected its use will admirably precede
3 hand in hand with suitable germicide treat-
But this potash soap should be of the purest
iquality, otherwise the skin will suffer severely.
What is known as soft soap, or green^jap of the
^karmacopaia, should be used, and always bought
J a good chemist,
Before I bring this bundle of miscellanies to a
; I must say a few words on the use of face
wwders, lotions, and ointments. It is a difficult
bject to handle, as after all I can only speak in
jeneral terms. Every face requires its special
featment, and therefore when I offer a suggestion
S to any particular face powder or ointment I can
only speak guardedly. I may certainly describe a
. few type skins as a ground-work for my suggestions,
for the more I see of skin disease the more difficult
44
THE HEALTH GF THE SKIN.
I find it is to put the right labels on the symptoms
I meet with, or any labels at all sometimes. Take
for instance, the dry skin of gout; it will vary with
the perspiring skin of rheumatism. The skin chai
acteristic of one form of strumous disease will be (
sometimes irritated with the catarrh of ec
and on another part of the body will be seen the j
thickened tissue associated with lupus, and its long j
lasting disfigurement. To speak in general terms j
I would advise those whose skins perspire easily to I
use warm stimulating washes, followed by a light, j
quick touch with a sponge dipped in cold water, and (
then a little dusting of a simple face powder. Wash
Uke the canaries and sparrows. Hot vinegar and
water in the proportion of one part of vinegar to
six of water to which a few drops of Eau de Cologne
or lavender water has been added, is a most re-
freshing form of stimulating wash to the face, neck,
and arms. It must not be used if there is any
actual irritation in the skin. But when the face is;1
flushed from exercise or from the atmosphere of a 3
heated room, then it may be used with great ad-"
vantage. Rimmel's toilet vinegar is an admirable i
preparation for this purpose, but the price limits its J
general use.
I For those whose skin is tender, and chaps -(
i roughens easily, the vinegar lotion is too stimulating^
In this case I should advise by preference the u
a toilet water composed of simple herbs. Thejiiari-J
gold has great healing properties in all cases ofg
IjOCAI. APPLICATIDKS.
wounds or abrasions. Procure the aqueous rincture /
of calendula. /
If we wish to keep the skin in a good state of
health we must use all our endeavors to keep the
whole body in good health. For. though sometimes
the appearance ofarash will relieve internal mischief,
yet, unless the deeper tissues in the body itself were
disordered, there would be no trouble on the surface.
To the medical man a rash is often a cause for
rejoicing, as he knows by its appearance tliat im-
portant organs have been spared a blow. Bui the
patient too often looks upon a rash as an unmiti-
gated evil, and wants to get rid of it at all costs, and
as soon as possible. Undoubtedly, some kinds of
rash should be got rid of as soon as possible; for
instance, those which are due to the presence of
animal or vegetable parasites, and some of the
squamous affections ; also, long-standing eczema,
where the patient's health has suffered from the
very local irritation set up by the eruption; therefore
the best treatment for the skin is that which puts all
the organs of the body into the most perfect state
of health, before one word is breathed as to the ad-
visability of using this pot of salve or that bottle of
lotion. When the appropriate medicine has been
I prescribed, and a suitable health regimen ordered,
f then the patient all expectant for the wonderful new
[ soap with the unpronouncable name, may have his
I feeling.s relieved by hearing somejudicious remarks
1 his medical man on the subject of soap.
46
THE HEALTH OP THE SKIN.
Now, there are some skins that require soothing,
and others that require stimulating, so that the local
treatment in all skin affections may be broadly dii-
vided into s timulating and soflUiiag ; and in three
cases out of five the skin requires soothing applica-
tions.
There might be added a third form of treatment,
which is really a sub-branch of the soothing ; and
this I would call "' protective." In some patients '
the skin is very sensitive to the contact of air, and
here we can give great relief by covering up the
affected parts, either by the use of wet compresses
of plain warm water, or medicated with some sooth-
ing vegetable tinctures, or else by the use of sooth-
ing ointments, or by the absolute protection given
by one of the gelatine pastes. AH cases of acute |
eezema, and many cases of chronic eczema, require a
soothing treatment. When the affection has run a J
long tedious course, and the skin has lost a gr
deal of its nerve force, then a stimulating treatment J
is attended by good results. But great judgmoit i
is required on the part of the medical man who
stimulates an angry skin, and some endurance on
the part of tlie patient.
I would now say a word on the local use of water
in skin disease. The hard chalky waters have much
to answer for in keeping up the irritation of a chronic
eczema, and they greatly favor the formation of i
those painful little fissures that bite and sting the J
patient like angry ants whose quarters have been dis-
LOCAL APPLICATIONS. 47"!
^iturbed ; therefore, all those who have a dehcate skin 1
ihould boil and soften their toilet water. The mere I
aprocess of boiling the water causes the chalk to be-l
(deposited in the kettle; and the softening process '
■can be further carried out by pouring this same
■water in a boiling state over oatmeal, straining the
ffltmeal, and using this mucilaginous fluid for the
toiiet. We can even go a step further in softening
: water by adding warm milk to the oatmeal
water, in the proportion of one part of milk to two
s of water.
I usually recommend patients when making the
loatmeal water, to take a good heaped-up handful of
B-meal and to pour a pint and a half of boiling water
^on it. Then the water should be strained through
muslin, and warm milk added, and the fluid used
D the face lukewarm.
There is no doubt that rain-water is the softest
pirater that can be used for toilet purposes, but in
J few householders have a butt or tank to
^llect it in. I will give one word of caution to those
ippy householders who possess a rain-water butt : J
"hey will do well to boil this water also, to free h
from organic impurities.
I would offer another suggestion in reference tarn
; local use of water. I have known patients whoj
Were very careful of their soap, water, powders ofj
ointment for the face, but when actually sufleringf
n'om eczema of face, legs, and arms, they have r
Jbesitated to take their morning bath of hard utb
48 THE HEALTH OF THE SKIN.
softened water* Now, it is just as important to use
soft water for the body-bath as it is for the face.
In many cases of chronic eczema the use of soap and
water at all may be dispensed with for weeks to-
gether.
This may sound very dreadful to some fastidious
readers, but soap and water are not the only dirt
removers available for human beings. Gently
smearing the face, neck and arms with any well
made cold cream, and then as gently rubbing
the skin so treated with a very soft towel, is a good
equivalent for a face bath of soap and water.
CHAPTER V.
SHORT NOTES ON SOME OF THE COMMON FORMS OF
SKIN DISEASE.
Some short notes on the common forms of skin
disease may be an acceptable addition to the sug-
gestions already offered. The truth is that the
laity take as deep an interest in spots and pimples
as medical men — that is when they are sufferers
themselves.
They wish to be clear of their spots for their
own appearance' sake, and the medical men wish to
get rid of them for their reputation's sake, always
allowing some exceptional cases, where the eruption
is really a benefit to the patient for the time being,
But I cannot help thinking that we are all glad
enough to have a clear skin, and a comfortable one
into the bargain, and the sooner it is clear and com-
fortable the better we are pleased. The very fact
of the skin suffering from discomfort is a proof of
its unhealthy condition and of general bodily ill-
health.
Let us name some of the commonest forms of
skin disease :
i Ecsema stands at the head of the list.
50 THE HEA1,TH OF TKB SKIN.
Acne in its various forms follows closely next.
Sebon-li(Ea is a natural sequence to the two first 1
mentioned. Psoriasis may come next,
The erythematous affections, with nettle-rash at"
their head, make a good fifth, and herpes may com-
plete the list.
I will not now speak of those skin affections
where vegetable or animal parasites give rise to the
symptoms, as I wish to pay attention to those
troubles of the skin which have more or less of
a constitutional basis. It is of the latter that I
would say a few words.
First of all, because they are of so frequent ap-
pearance ; and secondly, because some of them are
easily recognized; and thirdly, because nearly all
of them are easily aggravated.
I think I must qualify ray second proposition as
to their being easily recognized, for to take the
very first on the list, eczema, is to meet with a
difficulty.
In many cases of old standing, squamous
eczema, the eruption may be often taken for pso-
riasis, and both animal and plant parasites will,
after a while, set up an eczematous eruption, while
the true cause of the mischief lies beneath the
surface.
Eczema.
However, I will give a brief description of ec-
zema — simply as a guide to the patient.
What is to be seen in a case of acute eczema?
Redness of the surface skin, swelling of the
deeper tissues, an erythematous rash of fine papules
or a rash made up of small vesicles.
What is felt by the patient?
Heat, itching, throbbing and aching in the
affected part, and a general sense of malaise.
Accessory symptoms may be a disordered state
of the stomach, liver or bowels. Headache, nausea,'
thirst and occasionally slight feverishness, may
complete the list of symptoms.
Here is the beginning of trouble, but what
follows is even more difficult to bear. The acute
stage runs into the chronic. Now what is visible?
The skin is still very red, in parts it is more
swollen, and in parts the skin is broken, and a
watery fluid escapes by little cracks and crannies.
The escape of the fluid at first relieves the tension
of the swollen tissues, but it adds to the surface
misery by drying and hardening on the fissured
portions. Later on, in the progress of the disease,
the fissures widen and deepen, the inflamed patches
have a larger area, and when the patient is of a
strumous habit matter forms, and where matter
forms pain is sure to be its associate. When the '
exudation of watery fluid has gone on for some
time, the skin comes away in flakes and scales, and I
in certain portions the surface gets very dry and
hard. Furthermore, the itching of the affected ,
parts is so great that the patient, in search of 1
THE HEALTH OF THE SKIN
ptemporarj' relief by scratching, aggravates his con-
edition.
Here, then, is a sHght sketch of eczema. It is
4jut a sketch ; the finished picture of disease must be
[looked foriin the classic works of Wilson, Hebra,
>r Tilbury Fox.
The next point for consideration is. What is the
cause of this trying affection?
There are many causes.
Inheritance is one, and a very important one.
Ill-health is another, whether we call the ill-health
gout, struma, diabetes, or nerve breakdown.
Occupation is another, such as the handling of
materials covered with aniline dyes, sugar, arsenic,
or mercury, or exposure to heat and cold.
Improper diet, whether this errs on the side of
surfeit or starvation. Dives and Lazarus were both
fit subjects for eczema.
Again, parasites, whether of animal or vegetable
kind, can so inflame the skin that a chronic eczema
is the result.
Here, then, are some of the causes of this skin
affection. It may be asked, "What is the cure?"
To this I reply, " Prevention must be thought of
by the patient, and the cure left to the medical
man."
The prevention of eczema requires of the patient
that he should strictly follow a rule of healthy life.
The gouty must be careful in matters of diet, the
.strumous must be well fed; those whose nervous
COMMON FORMS OF SKIN
system is at fault must be well fed, well clad, and
not overfatigued either in mind or body.
The use of hard water for cleansing the skin, or
of strong alkaline soap, or of any soap whatever,
must be given up.
The irritation of either cold wind or hot sun must
be guarded against, and of course the handling of
all irritating substances must be abandoned.
This is the outline in brief of a very important
affection, and one that has tried the ingenuity and
wisdom of some of the best dermatologists, and is
doing so still.
Acne.
Let us now take acne, for I think it certainly
stands next in order of frequency on the list of skin
diseases.
It is undoubtedly easier to recognize than eczema,
but unfortunately it is by no means easier to cure.
It is simpler in type, that is the kindest word I can
say of it The two forms which are so commonly
met with are acne simplex and acne rosacea.
There may be little difficulties connected with its
recognition — as, for instance, when little patches of
roughness and scaliness surround the spots of a
chronic pustular acne, which have appeared again
and again in spite of all efforts to make a clearance
of them. These little patches may partake of the
character of eczema or psoriasis. They are spots J
of thickened tissue, with scales of epidermis at their J
edges.
I
54 THE HEALTH OF THE SKIN.
But yet, with ordinary care, acne of both kinds
can be readily distinguished from all other affections
of the skin.
What is the cause of simple acne ?
The cause is due to defective nerve force at the
time of puberty. The immediate local cause is
arrested secretion in the ducts of the sebaceous
glands or hair follicles, i
The eruption appears chiefly on the face, chest
and back. It consists of enlarged and inflamed
hair follicles. Some of the pimples have little black
heads in their centre, "comedones" as they are
called. Others are simply red and angry hillocks
on the surface of the skin. Others, which contain ■
matter, have a reddish base with a creamy-looking
summit, and then we have the condition known as |
pustular acne.
The chief trouble of acne in all its forms is thatit
disfigures the patient, and that it is such a tedious
fixture. One of the commonest remarks I hear
made by those who have suffered some time from
this affection is, '"I have tried everything for my
spots." This often means very little, and sometimes
it means everything but the right thing. And then
I am asked almost in the same breath, "Can you
not give me something to do them good?" And
to show the ail-absorbing character of the spots the
patient usually asks for "something to do /AfWfgoc
not to do her good. She would be well enough, so '
COMMON FORMS OF SKIN DISEASE.
55
^he thinks, but for these little spots, Macbethian in
■their undying character.
The next point to be considered is the general
tnanagement of this acne simplex.
This, in a few words, is to keep the body in the
■i)est possible state of health, the mind free from
rorry, and the skin free from accumulated secre-
In the treatment of acne simplex one of the sim- I
plest and best of applications is warm soap and I
Freely rubbing the skin with a flannel
Kjnoistened with warm soap and water clears the
^enings of the sebaceous glands and thereby allows
jent-up secretions to escape without let or hind-
ince, thus preventing in many cases the formation
Jpf pustules. By so doing we have a simple form
■of acne to deal with. Greasy applications do more
Ijiarm than good, for they block up the outlets for
K&e escape of secretion. A pure soft potash soap
Wis the most appropriate. But I would again ira-
s on my readers the fact, that though acne is
issociated with a local trouble, and therefore local
reatment is essential to its cure, yet at the same
[time there is always a constitutional defect in the
>atient which must never be lost sight of. Some
lermato legists insist too strongly on the local treat-
ment of these cases without having due regard to
flie constitutional element in disease. Why is it,
ien, that acne chooses to attack some faces and
Vieaves others to go scot free ? Because one patient
$6 THE HEALTH OF THE SKIM,
inherits some peculiar defect in the hair follicles,
and another, from her mode of life or unhealthy
surroundings, has gradually acquired a bodily weak-
ness;, which shows itself by developing the local
trouble called acne. Therefore, at the risk of being
thought tedious, I repeat once more that to treat
acne with success we must improve the general
health in every way, and we must keep in mind
that acne is one of the accessories of a great physi-
ological change in the body. It is the result of a
crisis which Nature takes part in, but in which she
requires a little help to play her part successfully.
Just as eczema is such a frequent incident during
the teething of infancy, so is acne a frequent accom-
paniment of the change of life that takes place
when the boy's voice changes to that of the man.
And furthermore, as acne rosacea, it shows itself
not unusually during another great physiological
change in the woman's life. This is at middle age.
Acne is a trouble which requires the help of
good nourishing food and vitalizing agencies of all
kinds, rather than a low diet and medicines that
depress the system.
The old senseless tradition of poor food and
aperients should be forgotten as quickly as possible,
especially in the treatment of skin diseases.
Here is a case of traditional error, A young
woman is attacked by pustular acne. Her mother —
the usual house physician — sees the redness and the
pimples on her daughter's face. At once she jumps
COMMON FORMS OF SKIN DISEASE.
sf
Kto the conclusion that her daughter's blood is on M
|>£re and wants cooling. She invests in a box of thosfi I
pwonderful pills which cure everybody of everything, f
li'and whose great virtue is that they "cool thcB
fblood," whatever that means. Her daughter has!
nnow two discomforts instead of one. I need hardly ■
It say that this poor girl's diet is of a less liberal char-
f iicter than before. Outraged Nature is silent at first,
Phut finally shows her disapproval of the treatment
Ifby sowing fresh crops of acne pustules.
To come back to the local treatment of acne. The
p first step is to keep the skin clear of dust, dirt and
|£xcessive secretions by the daily use of warm soap
(and water. The next step is to sponge the pustules
I'With very hot water, to which a dash of calendula
Itincture has been added, then to dry the skin with
it very soft towel, and lightly to dust the face with a
■simple absorbent powder, which should be removed
1,'ln a minute or two after its application, is a good
^'3nd simple way of treating acne.
Squeezing the pustules, unless they are quite
lature, is very apt to be followed by greater irrita-
ISfion, and sometimes by permanent thickening of the
^tissues.
In the case of acne rosacea — especially if there is
lany gouty tendency — careful attention must be paid
ito the diet. Rich food, indigestible food, malt
I liquors, fiery wines, must be avoided. This form of
Pacne is often met with in patients at the middle
period of life, and women are more often suiTerersJ
THE HEALTH OF THE SKIN.
than men. Acne rosacea is a great enemy to the
complexion when a woman has entered upon the
change of life ; for there are so many rapid ebbs and
flows in the local blood supply of the face, that the
circulation is apt to get sadly irregular. Sudden
waves of heat pass over the face, the capillaries can-
not always stand the shock, and a state of chronic
congestion takes place which is most difficult to re-
move. Therefore, patients who are passing through
the change of life should be careful of their diet and
careful of all local irritation of the face; they should
avoid applying cold water to relieve the heat of a
glowing skin, but rather use hot or warm water ; this
is safer, and in the end more cooling to the sur-
face. Moist heat relaxes tension of loaded blood-
vessels.
Nettle-kash.
I will now touch on the subject of nettle-rash, one
of the few skin diseases which has a characteristic
name. For it is very like the irritation caused by
the touch of the stinging-nettle. Large wheals of
rosy outline form on the skin, which itches and
burns, — the wheals suddenly appearand as suddenly
disappear. The finger-nail passed across a wheal
leaves a white line, and then a faint pink line, which
quickly fades away. In the centre of the wheal
there is a whitish elevation. Fresh wheals may be
produced by scratching the edges of nearly faded
spots, and also by irritating healthy interspaces.
The rash may attack any part of the body ; for in-
COMMON FORMS OF SKIN DISEASE. 59
^ stance, the face, the back, the chest or the abdomen.
But the face and the back are the most favorite
localities for its fire to break out in. When the face
is attacked, tlie patient presents a sorry sight : the
eyelids are so puffed and swollen that he can hardly
see out of them, the nose has lost its delicate out-
line, the lips swell, the ear lobes are like pendent
raspberries, and at first sight the suspicion of measles
crosses the observer's mind, for dislike of light is
often complained of and the eyes run with water.
But, as a rule, there is no fever, and the rash disap-
pears on some parts of the body to reappear on
others. Besides, the patient is often depressed in
mind as well as body, and some error in diet, a
chill, or a nerve upset, can be noted on careful
inquiry.
Here is a skin affection whose origin can be
plainly traced to nerve disturbance. It is a true
neurosis, and the skin is one of the safest localities*
on which the ner\-e storm can expend its force.
It is neuralgic in character, for it sometimes .
becomes chronic, and then it has an unhappy habit j
of appearing at the same hour of the day or night,
and, at times, it will take the place of asthma, which 1
affection is so often met with in patients of highly
nervous temperament.
The causes of nettle-rash are nerve-irritatioa, j
errors of diet, exposure to sudden changes of tem-^
perature and local irritation.
Thus, anger or grief may cause an attack in those 1
6o
THE HEALTH OF THE SKIN.
predisposed. Shell-fish, acid fruits, pickles, pastry,
cheese, may so irritate the nerves of the stomach or
bowels as to induce an attack, and even such
humiliating irritants as fleas, ants and microscopic
parasites are potent enough to cause this fiirm of
neurosis.
In the case of the nettle-rash of childhood,
nothing is too lowly for our investigation. A child
may have its night's rest destroyed by a miserable
little parasite, which requires all a mother's inge-
nuity and address to capture and destroy. Some
mothers would overlook the parasite, and murmur
something about "a little cooling medicine for her
darling in the morning."
Seborrhea.
A natural sequel to acne is the condition known
as seborrhea, or, by some writers, sebaceous acne.
It is of frequent occurrence; its good quality is that
it gives the patient but little discomfort; its bad
quality is that it leads to premature baldness when
it attacks the scalp, and it mars the beauty of the
complexion when it is found on the face. Occasion-
ally it predisposes to eczema. Dr. Unna, of Ham-
burg, looks upon it as a frequent associate of eczema.
In cases of Seborrhea we have a greasiness of the
skin, with free shedding of the surface cuticle. The
greasiness is due to excessive secretion from the
sebaceous glands, and excessive secretion leads to
lowered vitality of the glands themselves, so that
:iN DISEASE.
when the scales of the epidermis are removed, the
mouths of the folHcles gape from relaxation. The
chief seat of the seborrhea is the scalp, but it may-
extend to any part of the body.
When the scalp is carefully examined, we find
masses of yellow, greasy scales, which are readily
kdetached, and the scalp itself looks pale — I might
y ansemic. It is rarely reddened, but in this case
s may find patches of eczema mixed up with the
Seborrheic state.
There is a greasy seborrhea, and there is a dry
Seborrhea. The former is seen in infancy, youth,
md adult Ufe ; the latter is a concomitant of middle
e and senility. Thus we see that it may occur
t any period of life — from earliest infancy to ex-
reme old age. It may attack any constitution —
e strumous, the gouty, the tubercular, the syphi-
ind at the same time it refuses to spare the
Strong, It shows a singularly impartial spirit. It
way last for years unrecognized, and therefore un-
treated ; whereas if noticed in infancy or youth, a
V weeks' careful treatment may cure the trouble,
r Certainly keep it at bay.
The greasy form of seborrhea is undoubtedly met
1 in patients who suffer from acne simplex, and
'he dry seborrhea is a frequent companion of acne
rosacea. At any rate, this is my own experience in
the matter. Some dermatologists note a parasitic
. "element in this affection of the skin ; and judging
l^om the way in which it spreads in circles and semi-
62
THE HEALTH OF THE SKIN,
circles, and from the microscopic evidence given in
some advanced cases, I have a strong leaning
towards this belief myself.
The treatment consists in keeping the skin clear
of epidermic scales by the use of potash soap, thus
giving the skin greater freedom in breathing, and
then applying some suitable lotion or ointment to
the affected parts.
An ointment of tannic acid and cold cream in
cases of greasy seborrhea is one of the best.
For the seborrhea which affects the trimk of the
body and the limbs, the use of a germicide ointment
will be followed by excellent results, preceded by
free supplies of the potash soap. Indeed, I am
inclined to think that alcoholic potash soap is in
itself an excellent germicide. A colleague and
< friend of mine — Dr. Barry — has lately treated a case
of tinea versicolor most successfully by the free use
of potash soap. The patient had suffered from this
tinea for three or four years, and had consulted va-
rious medical men both in Paris and London, and —
until Dr. Barry began to treat him — had found but
little relief from their suggestions. After a week's
treatment on the new lines, he made rapid improve-
ment, and in less than a month was quite free from
his trouble,
I need hardly say that any defects of health which
are met with in seborrhea must be attended to, but
the local treatment of this affection is all-important.
common forms of skin disease. 63
Herpes.
Herpes and psoriasis require but short notice at i
bur hands. The first-named is due to nerve irrita-
tion. The affection popularly known as "shingles"
3 principally a nerve disease with a surface indica-
jtion of the mischief within. The ring of vesicles
which forms round the body follows the course of
)eripheral nerves which communicate with the poste-
rior roots of the spinal nerve.
In the case of herpes of the upper lip, which oc-
;urs during an attack of pneumonia, we have reflex
|i irritation set up from the inflamed King.
In the herpes of the upper lip, which comes on
1 the course of an ordinary cold in the head, we
Jtave a double case ; nerve weakness from the cold,
Wd local irritation from acrid secretions.
Psoriasis, on the other hand, attacks the gouty
ind the strong, not that these are always inter-
fehangeable terms; but I have more often seen the
^ng, persistent trouble of psoriasis in patients of
»ugh fibre and of a gouty and rheumatic inheri-
ince, than in those who are in delicate health.
Psoriasis.
At the same time, the statement that psoriasis is
ways associated with robust health requires some
tpodification, for there is a form of psoriasis met
irith in women who are nursing their children which
lincreased during lactation, and which disappears
64 THE HEALTH OF THE SKIN,
when the child is weaned and when the patient has
regained her normal strength. I have also seen
occasionally cases of psoriasis occurring in delicate
children, and which subsided under liberal diet and
a restorative treatment. Even here we see that
lowered life- pow er is a cause of this trouble.
What are the chief characters of psoriasis?
The body is marked with dry patches of thick-
ened skin, redness not being a conspicuous feature,
but a white, silvery scaliness being ever present in
the centre and at the edge of the patches which are-
raised above the level of the skin. When the white
scales are detached then redness is visible, and there "]
is slight redness at the free border of the patches, '
which have an abruptly different aspect from the 4
surrounding skin. Psoriasis may extend all over j
the body, but as a rule it attacks by preference the I
elbows and the knees. In these localities the skin
is naturally dry and hard, and here also soap and
water too often play a subordinate part. Therefore
one of the first and best methods of giving relief in
this condition of affairs is to apply a flannel well
charged with soft soap .^Bd_water to the affected
part. Then, when the surface scaliness has been
softened and rubbed away, an ointment with tar for
its chief ingredient should be applied to the skin. I
have lately followed up the soaping and tarring by
the use of one of Unna's salicylic acid and kreosote
plasters. The results obtained have been of the
most satisfactory character. My last case treated
COMMON FORMS OF SKIN DISEASE. 65
' in this way, and still under treatment, is that of a
man in apparently good health, who had patches on
both elbows, both knees, and on the calf of the right
- leg. He had the first symptoms four years ago. He
had been medically treated at different times with
varying success. I began my treatment with an
y alcoholic soft soap well rubbed in. Then I applied
[the huile de cade, and in a week's time there was a
I decided improvement, but the salicylic acid plasters,
38 per cent., made a visible improvement in three
days' time, and in ten days' time the hardened
patches were getting thin and pliable and the harsh,
constricted feeling was giving way to a sense of
comfort. I have not given my patient a dose of
medicine for this trouble. Should there be a relapse,
as is quite possible, I may then combine constitu-
tional with local treatment. But at present I am
more than satisfied with the local treatment.
The patient who is affected with psoriasis is, I
might almost say, a fit subject for congratulation,
because this affection is not often visible ; secondly,
because it so often attacks the naturally strong ; and
thirdly, because it has neither the burning fire of
eczema nor the irritating glow of nettle-rash.
But it has one great fault, and that is its unamia-
ble sense of constancy. A temporary separation is
often possible, but a good honest divorce is very
difficult to obtain, even in the higher medical courts.
The best local preventive is the unswerving daily
use of soft soap and water.
66
THE HEALTH OF THE SKIN.
As I am not writing a scientific treatise on der-
matology, I will not touch on the rare or serious
forms of skin disease. 1 have put together these
short notes as a guide to lay people when they find '
a little spot of roughness, hardness, or redness onl
their bodies which ought not to be there, and thei
nature of which they may have a difficulty in find-
ing out. And when they have discovered this spot
of irregularity, I offer some suggestions for simple'^ ■ -
treatment, which may prevent a vesicle from always
growing into a pustule, or put some obstacle in the
way of an eczema becoming an impetigo, or give a
hint that may stay the progress of an ordinary boil,
which so often begins in a blocked hair follicle.
The beginnings of mischief are more easily con-
trolled than the established fact of a chronic trou-
ble. Unerringly to note the beginnings of mischief .
requires the trained eye and the practiced hand;,
but it is far better to know the outlines of d
than to be in hopeless ignorance of every form (
ill health. What shall we think of the harm i
by a nurse or a mother who treats scarlet fever as
nettle-rash for twenty-four hours or more? Some
may say that mothers are not always expected to
know the character of a scarlet-fever rash. Granted,
But every mother should have knowledge enough
of the commoner eruptions to make her careful i
the treatment of any rash, which may certainly, on
the one hand, be harmless, but which, on the other
COMMON FORMS OF SKIN DISEASE. 67
hand, may spread disease like wildfire if not isolated
on its first appearance.
Only a few months ago I was called in to see a
little girl who had " a nasty rash on her body, and
had been feverish with it." The patient was in
bed ; the feverishness had nearly departed, but there
were unmistakable symptoms of scarlet fever. The
mother, being short of servants, had brought her
baby up-stairs to the patient's room, and in due time
the baby suffered also from scarlet fever, and the
mother herself had an attack of diphtheritic sore
throat. Fortunately, all the patients made a good
• recoveiy, but if this very mother had only learned
enough of disease to make her hesitate, she would
have not run the great risk of losing her youngest
child.
Corns.
My work would not be complete without a few
words on the subject of such minor troubles as warts,
corns and moles, so I may as well tell my readers
at once that warts and corns are due to excess of
the surface-tissue of the skin — in fact, epithelial
scales piled up in great lumps on the top of an en-
larged papilla, and thoroughly out of place.
Hard corns are often due to local pressure, whether
they fall on the hands or the feet ; but those who
' suffer from periodical attacks of acute pain in
their corns have often a gouty history to tell
when medically questioned. And when the foot
throbs, or is exquisitely painful, we know that a
I OF THE SKIN,
small abscess has formed in the neighborhood of
the corn —generally at its root ; and as the tissues
around the abscess are hard and unyielding, what
appears to the unskilled observer as a very slight
matter, is agony to the sufferer. The constitutional
element in corns is by no means a trivial matter.
The local trouble must be treated by local measures,
but at the ^ame time the general health of the patient
should always be carefully looked into.
A suppurating corn with its fiery circle of in-
flamed tissues, and its sensitiveness to pressure,
should be treated, like any other surface-gathering,
by the application of moisture and heat, so as to.
soften the skin and relieve the tension of the con-
gested bloodvessels. Rest for the foot should be
strictly enjoined at the same time, and medicines
that relieve the local inflammation should be given,
such as belladonna alone, or conjointly with hepar
sulphuris to favor suppuration.
The local treatment of hard corns is, of course,
carried on with a view of removing all causes of
pressure, and of applying some strong solvent to
the skin, such as dilute acetic acid, or salicylic acid,
which solvents are, according to my own experi-
ence, the simplest and the best.
I strongly deprecate the cutting of corns, How-
ever often the corns may be cut, or however skil-
fully, if the local condition^ which gives rise to them,
is neglected, these little growths will reappear, in
spite of the most approved cutting or extraction. A
COMMON FORMS OF SKIN DISEASE. 69
. soft Jaeger boot or shoe is one of the greatest com- ,
^forts to those who suffer from corns or bunions, and 1
Jaeger stockings, with divisions for each toe, are the 1
Lmost suitable for those who suffer from soft c
fcThis kind of corn is due to excessive perspiration, j
ind the woollen partitions gently separate the toes
fom each other, and prevent undue action of the i
A word of caution as to the local use of salicylic^
Acid in treating these soft corns. Let the acid 1
■simply touch the corn itself, and let the application ■]
Mbe only used about three times a week, otherwise
w&e skin in the neighborhood of the corn is very apt
■ to become inflamed and tender, and then the remedy
1 certainly be found worse than the disease,
Warts.
For the destruction of warts on the hands I find
fnothing so locally useful as the salicylic acid. Un-
doubtedly, there is a strong nerve-element in the
(-■constitution of those who suffer from warts, and
I like acne simplex, warts are often associated with
t the change that goes on from childhood to youth,
f Therefore, nerve-remedies and tissue-remedies can<d
W\k used conjointly with local measures. The so-callectjl
■ cJiarming away of warts by wise women of the vil- '
Mlage. and by dealers in simples, is clear proof of the
lerve-element in the patient.
A bunion is a more serious matter than either cortiia
70
THE HEALTH OF THE SKIN.
or wart, and should, therefore, be consigned to the
care of the medical practitioner.
But I may suggest the wearing of soft Jaeger
shoes to relieve pressure, and advise a careful con-
sideration of the patient's general health, as gout
plays a most important part in the aggravation of
this local trouble.
But, indeed, what organ or what diseased condi-
tion does not gout aggravate ?
If a patient has a tendency to bronchitis, gout
will make his attack more acute, and will keep up
the agitation longer than is necessary for any weli-
behaved attack of bronchitis.
If the patient should suffer from eczema, gout
will so poison his blood that the patient will be-
come frantic with the surface-irritation, and the
medical man will be sorely pressed to find a remedy
to relieve the skin without too greatly disturbing
the gouty influence, and thereby endangering the
patient's life. I have lately been trying to solve this
interesting but difficult medical problem of soothing
local irritation without prejudice to constitutional
well-being. The field of experiment was in a case
of gouty eczema of some fourteen years' standing.
My patient is now in better health than he has been
for many years. 1 have reduced the irritation to a
bearable degree, but I have not cured his eczema.
It is very doubtful whether I ever shall, but good
health and a tolerably comfortable skin are condi-
tions not quite to be despised.
COHUON FORMS 0* SKIN DISBASB.
71
There is a very prevalent idea that all the victims
■of acne rosacea are thirsty souls, and that they have
■a habit of trying to quench their thirst with alcohol
[■more or less diluted with water. This idea, like
r many otherwidelyaccepted'ones,isniistaken. Acne
cea attacks the physically weak and the men-
llally distressed, and I learned from one of the medi-
1 cal officers of St. John's Hospital for skin disease.
Lthat a large proportion of his cases of acne rosacea
[were found amongst the ranks of total abstainers.
Undoubtedly alcoholic excess will lead to attacks
I- of acne rosacea in those who are predisposed to this
[affection ; but excess in the use of alcohol is by no
■.'means the sole cause of this affection. Mental dis-
l tress, uterine mischief, and a weak circulation, are
tfer more potent factors in causing this trouble than
F strong drink.
This leads me to consider the part which is played
fcby a weak heart and inefficient bloodvessels in
rkeeping up the irritation of chronic skin disease.
We speak of cardiac asthma and cardiac dropsy,
twhy should we not speak of cardiac eczema, or car-
F'diac acne ? For there is not the least doubt that a
tweak-acting or organically diseased heart will cause
nation in the surface circulation, and thus will
r aggravate a chronic eczema which has attacked the
L'legs. Is not varicose ulcer often met with con-
[ 'jointly with eczema ? In the acne rosacea of middle
I life the local trouble is often kept up by a condition
|. of cardiac weakness. It would be a mistake to
72^
THE HEALTH OF THE SKIN.
withhold alcohol in such cases, under the impression
that by giving alcohol we are sure to inflame the
skin. In the case of a weak-acting heart, our great
aim must be to balance the circulation, for by so
doing we give the heart less work to do, and we
prevent stagnation in the surface bloodvessels.
Another point for careful consideration is that of
mechanical rest. That is, rest to the affected part
by posture and physiological rest which can be given
by the use of local sedatives.
In eczema of the legs posture is all-important.
/ 1 have found the use of a 4 per cent, cocaine olnt-
jment of great service in soothing the irritation of
/ eczema when the skin is broken. And the very fact
' of soothing the surface nerves has greatly helped to
cure the skin affection.
Possibly the very grease which formed the basis
of the ointment was in a measure protective to the
broken surface ; but this was not all, as I often found
that the use of a non-sedative ointment was not
followed by the same results as when cocaine was
applied.
I think this rest to irritated surface nerves will
help to cure many a skin affection, for undoubtedly
excessive cell growth occurs when the local nerves
are weak and therefore irritable.
The excessive desquamation that goes on in cases
of psoriasis, pityriasis, and seborrhea, points to a
want of inhibitory power in the local and sometimes
the central nerve cells. In treating the skin we
COMMON FORMS OF SKIN DISEASE.
73
should always keep in mind the importance of this
local irritation, for, after all, is it not central also by
reflex action? Therefore we should take every
means in our power to soothe and comfort these
surface nerves, not merely to stifle their cry for help,
but to gently modify their condition of distress.
The treatment of skin disease can be briefly sum-
marized thus :
Soothe surface irritation. Reduce thickened
I surface.
Stimulate in case of venous stasis.
Remedy defects of health. Destroy all parasites.
In disease of parasitic origin it is the surface irri-
tation which drives the patient frantic, and which
tnakes the unskilled practitioner diagnose eczema
instead of itch. Kill the parasite by surface meas-
res, and there quickly follows a great calm to the
taervous system.
In eczema it is the angry surface that makes the
patient irritable by day and restless by night. Soothe
iie surface by appropriate means, and the patient
in a new world of comfort by day and peace
f night
he Vienna school of dermatologists has attached
r importance to the local treatment of skin dis-
ise. This was simply a breaking loose from a
:, unscientific, unpractical pathology, which
n vogue during the first half of the nineteenth
»ntury. Hebra was the first strong iconoclast in
Taa direction ; he certainly broke a good many idols
'/
7 [ THE HEALTH OF THE SKIN.
that had been worshipped without question by
medical devotees.
But in tlie endeavor to be exact, and to trust
solely to surface phenomena, the more subtle and
less visible symptoms of disease were apt to be neg-
lected. The constitutional defects of a patient were
lost sight of, the gouty, strumous, nervous weakness
was forgotten, and merely inflamed areas of skin
were placed under investigation. There was a use-
ful noting of the difference that lay between papule
and vesicle, and between vesicle and pustule. The
whole study was devoted to the inspection of the
skin surface — and a very good thing for suffering
humanity that a surface could be so full of interest
to the scientific observer, for indeed it must be ad-
mitted that the local treatment was in many cases
eminently successful, and is so still ; for instead of
giving the patient hundreds of pills and gallons of
liquid horror, Hebra applied an ointment to the irri- 1
tated surface, and gave the patient some simple rules I
of health to follow, and recovery was the result. (
But if the constitutional element in skin disease
is lost sight of relapses are frequent. This is the
experience of British dermatologists, and of those
who attack the enemy in the open instead of under-
mining his fortifications.
Therefore, if we wish to treat skin diseases with
success we must not lose sight of constitutional de- /
feet, nor must we fail to relieve local irritation. /
Protection of an abraded surface is a matter of
COMMON FORMS OF SKIN DISEASE. 75
great importance, but daily exposure to the air of
unbroken skin is equally important, so as to keep
the nerve and blood supply in a state of health.
It may be natural to ask " What should be
avoided by those who have an irritable skin ?"
In reply I would say:
Avoid late hours and crowded, ill-aired rooms.
Avoid rich and indigestible food.
Take care to keep the skin clean and sweet, but
avoid the eternal dabbling in water, and especially/
in hard water. /
Avoid excess in alcohol.
Avoid the use of dyed underclothing;, and avoid
keeping the skin in a perpetual vapor bath by non-
porous or too heavy clothing.
Avoid excess in tea or coffee drinking, so that
the nerves may be kept in a state of health.
Avoid habits of indolence. Keep body and mind
active by daily physical and mental exercise.
Avoid the use of aperient medicines.^.---
The late Hebra, once the greatest dermatologist
of Europe, is on my side in this matter, for he
laughed to scorn the idea of curing skin disease
with pills or potions of aperient action.
Try and keep the mind free from care, for fret-
ting sadly weakens the nervous system, and the
nerves are masters of the skin.
Also avoid secret medicines which promise great
things, but perform little.
76 THE HEALTH OF THE SKIN.
Avoid exposure to hot sun, cold wind or ex-
treme heat of the fire.
Keep the circulation active by daily exercise,
for those who suffer from cold hands and feet will
also be liable to suffer from chilblains, and broken
chilblains are often associated with chronic eczema
or even tubercle. We know that eczema is a fre-
quent associate of varicose veins.
If, of necessity, exposed to the action of heat or
cold, use some simple ointment as a protective, but
avoid blocking up the pores of the skin by the
free and daily use of absorbent face powders. And
remember, above all things, that a beautiful com-
plexion is, as a rule, the visible warrant of perfect
health.
CHAPTER VI.*
THE CHIEF SKIN REMEDIES.
Skin diseases being, as a rule and with some ex-
ceptions, constitutional disorders manifesting them-
selves thus locally, the remedies employed in their |
treatment must of necessity, if the cure is to be per-
manent, be selected chiefly on account of their rela-
tion to the general state of the patient rather than
merely for their local effects on the skin. In other
words, all the disordered conditions that the patient
may be conscious of, whether apparently connected
with the skin trouble or not, must be taken into
account and the remedy chosen to correspond with
this totality of symptoms.
It is a fact that the chief skin remedies are also-
medicines of wide range of use and affect the
body in a great variety of ways.
We will give the chief guiding indications of j
some of those most frequently called for in the j
treatment of skin diseases, which symptoms, if pre-
sent in any marked degree in the patient, will be I
cured by that remedy.
The remedies for aczite skin diseases, inflamma-
tory disorders, etc., are not considered here, but 1
* This chnpter has been written for this edition by Wm, \
THE HEALTH OF THE SKIN.
K4m)y those disorders spoken of in the preceding
ipa^es — the sub-acute and chronic common mala-
lies. like eczema, acne, nettle-rash, herpes, etc.
Sulphur.
A very deeply-acting and far-reaching remedy j
I often eradicating chronic skin diseases or troublesq
I iiue to their suppression. It is well to give a dose4
I'.of sulphur in all chronic troubles associated witlil|
•skin diseases, even if the latter should have disap-
■■peared. Sulphur may again bring it to the surface,!
Ksnd in this way help to thoroughly cure the patient*J
1 It is not necessary- to repeat the dose often, once 1
lor twice a week being quite sufficient. Besides
■fthis eradicative use, sulphur should always be given ,
(when the skin is apt to be dry, dirty looking, scaly,
liirritable with a tendency to itching eruptions,
iimples, black pores of the skin, particularly in
Ki^ie face, called comedones, all worse at night in ,
M>ed, and from bathing, so that the patient dislikes '
t-the use of water. Now, any part of the body may J
■ .be affected when sulphur is the remedy, but sorfr-J
D|iess in the folds of the skin or along the margin o
■jthe hair form especially a favorite locality. The-'
ttypical sulphur patient has hot, burning feet; he
■puts them out of the bed to cool them ; wherever
f the skin and mucous membrane meet the parts are-
jVery red and burn ; he is apt to be constipated and .
FJiave a poor digestion, feeling very faint and weak ,
about II o'clock every morning.
A so-called scrofulous constitution is peculiarly '
the field for sulphur — here we find many of the
above symptoms, as well as swollen glands, ulcers,
etc.
Hepar.
The next remedy in importance is a relative of
sulphur — the sujphuret of lime, kepar sulphuris. It,
too, is a remedy of very wide usefulness. Here,
also, we find an unhealthy skin but much greater
tendency to suppuration ; every little injury suppur-
ates, the skin is hard to heal. There may be deep
cracks and bloody suppuration, which very often
smells very badly, perhaps like old cheese. Then
the sore skin is extremely sensitive, even the cool
air hurts, so he wants the affected parts covered i4p
warmly. There is sometimes a feeling of pricking,
stinging, like a splinter in the sore. Around a boil
or ulcer there will be a number of small suppurating
pimples — outposts of the larger sore — there may
be throbbing pain and the glands generally be
swollen.
Then the hepar patient has always cold hands
and feet, he is very sensitive to every draft of air ;
he sweats readily ; takes cold so easily ; this sen-
sitiveness may show itself mentally as well ; he is
irritable and offended at the slightest cause. It is
especially to be selected if the patient has taken
calomel or any mercurial preparation or applied
salves on the externa! surface. Hepar is of great
service in skin affections of scrofulous children with
[ OF THE SKIN.
mattery crusts and glandular enlargements, espe-i"
cially if they are "croupy " children.
Graphites
Has similarity with sulphur in dry skin which,
rarely perspires, and it has Hepar's unhealthy,
readily suppurating skin, but it is easily distin-
guished by the fact that the eruptions for which
it is the curative remedy, oo::e out a sticky fluid.
Humid tetters, then, with this sticky, gluey exuda-
I tion always indicate graphites. The favorite locali-
I'ties are the groins, neck, behind the ears, bends of
limbs, palms and around the anus, here sometimes
showing its tendency to chap and crack by producing
fissures. Now if these conditions are met with
graphites will be of lasting benefit, and should
they be found in women inclined to grow stout,
with digestive and menstrual troubles and constipa-
tion it will probably 'show its benefits in other
regions besides the skin. The nails of the graphites
patient are apt to be brittle and crumbling, ingrow-j
ing nails ; the hair is apt to fall out and there majfj
be intractable uicers.
Arsenic.
The skin troubles calling for arsenic are charac^^
terized by very marked burning. They are gener-J^
ally chronic troubles, with bran-like scales, with t!
most intense burning itcMng. The patient i
scratch until the parts bleed, which makes the bui
THE CHIEF SKIN REMEDIES.
ring all the worse. The disease may be anywhere,
biit chooses especially the forehead about the margin
of the hair, but elsewhere the skin is harsh, dry, and
has this burning itching. Besides there are many
other conditions like pustules, ulcers, blisters,
herpes, carbuncles, for all of which arsenic is a won-
derfully effective remedy, but they all have this
symptom most marked — ikey burn like fire.
This may be so bad that the patient gets very
anxious and restless ; can't find rest anywhere; he
gets dry and parched, and must drink frequently,
but only a sip at a time ; is cold ; wants to be in a
warm room, although he has this frightful burning
pain; he is much worse at night after midnight, and
is rapidly losing strength. Now such a state of
affairs shows a constitutional trouble of serious
aspect. Arsenic is the remedy for just such severe
types of illness. He may have dropsical symptoms
also, such as swelling of the face, around the eyes,
especially, feet, ankles, etc. Indurations and tumors
also come within its legitimate sphere. In these
chronic and severe types of illness we find the skin
wrinkled, dry, cold and blue, or with cold perspira-
tion, and with the characteristic burning aggra-
vated by scratching.
Rhus tox.
Any one who has ever seen or experienced the
effects of the poison ivy knows exactly what the
ideal condition for the use of rhus is. It is, first of
82 THE HEALTH OF THE SKIN.
all, characterized by itcldng, by the appearance of ,
little vesicles and sometimes by swelling. Its favor-
ite sites for attack are the face, hands and genitals.
With this as our guide we may use rhus confidently
in all ^noist eruptions characterized by a great deal
of itching, which is worse in changes of the weather,
especially in wet weather or winter. The eruption
begins with these little vesicles, which run together
and exude a watery fluid and form crusts. This
almost describes one form of erysipelas — the vesicu-
lar form — and rhus is indeed an excellent remedy
for it But in any form of skin disease where these
symptoms, especially the itching and vesicles are
present, it will be indicated. Sometimes after get-
;ing wet, or in the course of rheumatism, nettle-rash
or some other form of cutaneous affection will show
itself, which rhus quickly cures. All the rhus cu-
taneous affections have a tendency to invade large
surfaces rather than penetrate deeply into the tissues.
Sepia.
This is pre-eminently a woman's remedy, and we
find it most frequently indicated in skin affections
connected with irregularities of the uterine life. In
such cases we are apt to have "liver spots," yellow
spots in various parts, and a yellow, earthy color of
the skin; a yellow saddle across the nose is fre-
quently seen. The eruptions themselves may be
composed of little vesicles and pustules, with itching,
and they appear in circular spots like ringworms;
THE CHIEF SKIS REMEDIES. S3
arc apt to crack and show theroscl^'es around joints
especially.
An?.
A very different remedy from these is apis, the
honey-bee. It is indicated in all sorts of skin
aflections where there is a great deal of rapid swell-
ing, itching, especially of a stinging character. Such
a condition we find in neUU-rask, and apis is one of I
the principal remedies in this complaint In er>'-
sipclas and other affections, where there is a rosy hut
to the skin and much swelling, with more or less of
this stinging, a few doses of apis will rapidly bring
relief. In these acute affections the patient may be
abnormally drowsy, which would be an additional
indication for this drug.
Administiution.
Except in nettle- rash and the acute effects of poi-
soning where the medicine may be taken every two
or three hours, it is best to give in chronic skin dis-
eases, only one dose a day, preferably at bedtime.
When improvement shows itself all further medica-
tion should be discontinued so long as this lasts.
With the above few remedies, a majority of the skin
affections can be modified favorably, and many per-
manently cured. But there are many other reme-
dies the selection of which is more difficult and
must be left to the judgment of the physician.
INDEX.
(f
n
Absorbent powders, 37.
Acne, nerve influence, 19, 20.
" rosacea, 57, 71.
" simplex, 54, 55.
sebaceous, 53-58.
treatment of, 55-57.
Administration, 83.
Alcohol in acne, 13, 71, 72.
Apis, 83.
Arsenic, 80.
** in hat linings, 34.
Barry, Dr., 62.
Baths, 30-33.
" Vapor, 32.
Boracic acid snuff, 38.
Cabbage in night blindness, 12.
Cardiac eczema, 71.
Celery in skin disease, ii.
Chamomile, 36.
Chief skin remedies, 77.
Chilblains, 76.
Clothing, 33, 34.
Corns, 67-69.
Daisy, ^6,
Diet, 8-14.
Eczema, 50-53.
Eichoff on soap, 41, 42.
Eczema from nerve shock, 15,
16.
Eczema in teething, 18.
Exercise, 27-29.
Face powders, 37.
Flannel, use of, 33, 34.
Graphites, 80.
Hamamelis, local use of, 37.
Hebra, 73.
Hepar, 79.
Herpes, 63.
Jaeger's clothing, 34.
shoes, 69.
stockings, 69.
ti
u
Ling's system, 30.
Local sedatives, 21, 22.
Marigold, 36,
Marshmallow, 36,
Massage, 29.
Morley's underclothing, 33.
Nasal catarrh, 38.
Nettle-rash, 58-60.
and parasites, 60.
Night blindness, 12.
86
INDEX.
Oatmeal, locally, 47.
Psoriasis, 63-65.
Pills, aperient, 17, 18.
Potash soap, 43.
Rain water, 47, 48.
Rhus tox, 81.
RimmeVs toilet vinegar, 44.
Salicylic acid for corns, 68.
" plaster, 64, 65.
Seborrhoea, 60-62.
Sepia, 82.
Skin, nerve influence, 15-26.
Slippery elm bark, 37,
Soap, 40-43'
" Unna's overfatty, 42.
Sulphur, 78.
Treatment, Protective, 46.
Sedative, 46.
Stimulating, 46.
u
u
Unna's overfatty soap, 42.
" salicylic acid plaster, 64.
Warts, 69.
Water, Local use of, 47, 48,
Watercress, 36.
Weak heart in eczema, 72.
THE
STEPPING STONE
TO
HOMCEOPATHY AND HEALTH.
BY
DR. RUDDOCK.
New American Edition, with Chapters on
DISEASES OF WOMEN,
AND
THE TWELVE TISSUE REMEDIES,
BY
WM. BOERICKE, M.D.
PRICK9 ^ - - |(i.oo.
This is undoubtedly the most popular work on domestic
homoeopathy. Over one hundred and thirty thousand copies
have been sold of the English edition. This new American
edition contains entirely new matter, adapted to the needs of
homoeopathic families and to the general conditions found in
this country. It has besides chapters on the Twelve Tis-
sue Remedies.
HOl^COIHBB. DR. w. H. Hoiv I Became i
■lomfeopalta.. Pp. 28, 8vo. Paper cover. Price (pe.,
.io7.,$].25), *0 ISJ
JOKES, DR. SAMVEL. A. Tbe GroandH of a]
HoBKeopath^s Faltb. Pp. 92. 12mo. Cbih, . |0 3
SHARP'S TRACTS ON HOIHIEOPATBT, ei
$0.05; Complele set of twelve numbers, J0.50; Twelve nL._
bere, bound, ]I0 759
HAHH-'AEOFIIOMtEOPATHlCVETERIIVART
PRACTICE. Pp.684. Sto. Half morocco, . , $5 00j|
RVSH.DR. JOIinr. Teterlnarr Surgeon. Pp.l5(
IBruo, Cloth, ■ to 5
^ SCUPPER, J. C. Xew IHanaal of Homi
patbic Velerlnary Meillclne.. Pp. 321.
Cloth 9
1 GCERNSEV, DR. E. Honiceopatblc DomestU
Practice. P[>, 653. Half leather. New Edition. "
F HERING, DR. COnrSTAnTTIIVE. Domeatlc Pfay:
§tclan. Seventh American edition. Pp. 464, . . . $3 ff
JOII.\SON, DR. I. D. A Oulde to HoDiceopaf bl^
Practice. Pp. 404. 8vo. Cloth, "'■ "*
LAURIE and mcCLATCHEY. Tbe Ilotiifeo»>]
palblc Domestic Medicine. Pp. 1044. gvo. Hal'
K.VT2E, DR. A. Manual of Hotnfleopalbl.
Tbeory and Practice. Deslsned for tbe V»m
orPbysiclana and Vamlilei. Pp. 750. Svo. 3a^
leather, £2
MAEAN, U. Family Guide to Ibe Admlnlstri^
tlonofHonifleopatblc Remedies. Pp.112. 32ma
Ciolh, $0 5^
MORGAN, DR. IV. Tbc Text-Book for Domed
lie Pracllce. Pp. 191. 32mo. Cloth, 80 5
r ERDI, DR. T. S. Maternity, a Popular Trea^
Use for Young mves and Motbera. Pp. 45ij
12n]o. Cloth, J2 01
VERDI, DR. T. S. Mothers and Daugrbterd
Pp. 2M7. 12mo. Cloth, "■
mLEIAHSOiY, DR. W. DlHcases of FemalQl
and Children, and their llomccopathu
Treatment. Pp. 256. Cloth *' ^
FCBLISHED BY
THE HAHNEMANN PUBLISHING HOUSEiJ
PHILADELPHIA.
!
X1061 Shuldham, E.B. 6576S
S56 The health of the
lH9n sk1n.
DATE DUE
^^1
^H
^H
^H
J
- 1^^
■
Live Music Archive
Librivox Free Audio
Metropolitan Museum
Cleveland Museum of Art
Internet Arcade
Console Living Room
Books to Borrow
Open Library
TV News
Understanding 9/11