Acne indurata : its treatment / by Henry W. Stelwagon.

  • Henry Weightman Stelwagon
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Acne indurata : its treatment / by Henry W. Stelwagon. Source: Wellcome Collection.

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    treatment must be adopted, although much slower and less satisfactory in their results. Time is usually wasted with the use of the ordinary lotions and ointments successfully prescribed for simple cases of acne, so that from the start resort should be had to strong applications. The three substan¬ ces which in my hands have yielded the best results are, the acid nitrate of mercury, corrosive sublimate, and carbolic acid. These cause slight de¬ struction of the acne surfaces and with the resulting dermatitis more or less exfoliation takes place, and if repeated, the lesions will gradually be made to disappear. The improvement is of course much slower than by the methods by scarification. The acid nitrate of mercury has been used in its undiluted state, and is still so employed, especially by English der¬ matologists. It may be done in some cases with good effect, but extreme care is necessary lest scarring results. It is far better to use it diluted with four or five parts of water, even if it requires a greater number of applications, and consequently a longer period of treatment. Here again I can testify to the equal efficacy of carbolic acid and its absolute freedom from unfortunate accidents, provided that only an amount of care that all such remedies demand, is exercised in its employment. The carbolic acid should be used pure or nearly so (95^). The applications should be made with an ordinary match-stick, somewhat rounded or pointed at the end. Any similar contrivance can of course be employed; a match-stick is always at hand and requires but little time for preparation, and after the sitting may be thrown away. The point should be broader than that used when scarification has preceded, as a greater surface is to be touched and acted upon. The application, as a rule, should be made every third or fourth day. If the irritation is marked, a soothing oint¬ ment should be prescribed. Applications of hot water should be made at bed-time, as in the former methods. Corrosive sublimate, if em¬ ployed, should be used in solution, and applied in the same manner as the acid nitrate and carbolic acid. Instead of making an application every few days, however, it should be applied several times during the day, and after forty-eight to seventy-two hours, omitted for a day or so. Considerable exfoliation follows its use, and in this way mainly improve¬ ment is effected. It should be applied only to the lesions, and care should be taken that it does not run beyond, or a violent dermatitis may ensue. The strength of the lotion required varies according to the sen¬ sitiveness of the skin and the action excited, from five to twenty grains to the ounce of water, or preferably alcohol and water. The weaker lotion should be tried first. This plan—non-operative—of treatment will, if persisted in, effect con¬ siderable improvement and frequently remove the eruption entirely. It is not, however, comparable to that in which scarification plays the principal part. As in the method by puncture, so in this plan a mild ointment or