A theoretical and practical treatise on the diseases of the skin / by P. Rayer.

  • Rayer, Pierre François Olive, 1793-1867.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: A theoretical and practical treatise on the diseases of the skin / by P. Rayer. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    be inflammation shows .1 disposition to extend, , rable pain. I have even put this practice in force in •; I elderly people of hale constitutions, with great advanl 126, 1 f sulphur h&vt long and deservedly enjoyed :.illation in the treatment of chronic diseases of the skin, and especially of scabies. Siilr iters taken internally during one or several seasons mod if) the constitution materially, and perhaps accomplish a greater - than any other means. In France, the natural sul- phureous mineral waters of Aix (Provence), of Bagneres,1 of Bagneres I bon, of Billazai (Deux Sevres), of Bareges,3 of Cauterets, of Enghien, of Greoulx (Basses Alpes), of Bagnols (Loyere), of Aix ;e), and of Saint Ainand (Nord), are justly celebrated; in iny, those of Aix-la-Chapelle, of Wisbaden, and of Nenndorf: \i\ and of Saint (iervais, in Savoy; of Baden, of Lapey- f Schinznack, and of Louesche, in Switzerland ;! of Guitra a), of Argui, in Piedmont; of Alhama, and of Hardeles in Spain ; those of Naples ; those of Baden (Lower Austria), of Baden (Swabia); those of Harrowgate, Leamington and Bath, in England, iiy salutary. After having been drunk for several days, some of these waters, particularly those of Louesche, occasion a particular eruption, characterized by small acuminated and itchy and red blotches which appear first on the limbs, but, by and by, extend over nearly the whole surface of the body: a febrile paroxysm, accompanied by anorexia and great thirst sets in, the sleep is disturbed, and the urine is turbid and high coloured. All these symptoms abate within eight or ten days in the order of their appear- the epidermis is thrown off in flakes, and the pruritus is soon the only symptom that remains for some little time longer. This eruption appears to be one evidence of the beneficial operation of the waters, and ought not to cause a suspension of their use. The baths of Baden (Argovie), the waters and baths of Saint Amand sometimes, but by no means so generally, occasion symptoms analogous to those produced by the waters of Louesche. There are many other mineral waters found over the face of different countries of Europe which are also familiarly used internally in skin complaints. 127. I have had ample opportunity at La Charite and elsewhere oi satisfying myself of the virtues of artificial sulphureous baths; but to secure their good effects, it is certainly necessary to regulate the temperature and the dura/ion of these baths, not only by their manifest effects on the skin, but by their influence on the constitution. In a 1 eat number of cases I have found that there were immense ad\ antageS to be derived from gradually increasing the time of remain- ing in the bath to the amount of even five or six hours. This practice, so commonly followed at the natural springs, is by no means to be neglected in our establishments of artificial mineral waters, as some have proposed. I have attended children who have been brought to remain in the bath during three whole hours; and adults and persons further advanced in life, have at length been induced to stay four or five hours without exhaustion in the artificial sulphureous- water bath. The chief obstacle to this practice arises from the patients themselves, who, living in large towns and not duly appre- ciating its importance, will rarely consent to sacrifice so many hours to the care of their health. It is by this means, nevertheless, that those constitutions which make individuals subject to skin complaints are most certainlv modified, and that the relapses so frequent after every mode of treatment, are most surely prevented. The hot air bath and dry sulphureous fumigations, tried in the treatment of skin complaints by Glauber1 anil Lalouette,5 and brought forward anew with convenient modifications by M. Gales,6 are now 1 Lorry. Op. cit.. p. 33*.—Ganderax. Recherch. sur les proprietes phys. chimiq. el medic des eaux bin. de Bagnieres de Bigorre, in-8o. Paris, 1827. - Bordeu (Th.1. L'usage do- eaux de Bareges et du mercure dans les ecrouelles. . 11-18. B-(J.). F.->ai sur les eaux minerales ihermales de Louesche. Paris, 1828, * Glauber (Joan. Rudolphe). Furnei novi philosophici, sive descriptio artis distil- . in-12. Anistelodami, 1661. ;ieue (P.). Nouvelle methode de trailer les maladies vene'riennes par les fumigations. Pans, 1771;. » Gales. Memoire et rapport sur les fumigations sulfureuses appliquees au traite- meni des affections catanees, in-8. Paris, 1816. rendered easih and safe!) applicable by means of the improved apparatus of M. Daivet.' Messrs. Clarke'' and Wallace' have seve- rally published interesting remarks on their effects, which to me, however, seem to be not without a tinge of exaggeration. The same thing may be said of the observations of Decairo, of \ ienna.10 Sul- phureous fumigations are undeniably often serviceable in chronic eczema, but they arc rarely available against pityriasis, lepra and impetigo. They certainly weaken the patients more than sulphure- ous-water baths; they also modify the constitution in a less durable manner, and more rarely accomplish perfect cures. These fumiga- tions, too, sometimes irritate the skin further; they have been known to occasion syncope, a sense of suffocation, &c. It would be imprudent to attempt their use without great discretion among children, pregnant women, asthmatic persons, or in cases where there was any suspicion of tubercles in the lungs. The vapour of sulphur administered by the process of M. Balland is much less irritating than fumigations with sulphureous acid gas, in lieu of which it may often be substituted with advantage. Lotions and ointments of sulphur have the same effects as the baths; their activity may be increased by the addition of different substances; such as iodine and mercury, which are more or less energetic in their actions, or diminished by others that seem to have little or no sensible effect on the economy, such as charcoal and sulphuret of antimony. These tropical applications do not modify the constitution, and are generally less useful than the prolonged employment of sulphureou.v water baths. 129. The sulphuret ofpotassa, of soda, and of lime are made use of, not only for the composition of artificial baths, but in solution inter- nally, in the dose of five or six grains to the pint of water as a drink, or in the same quantity mixed with some vegetable extract. Pure sulphur is also prescribed internally in the dose of from twelve to twenty grains, especially by the vulgar, as a purgative, or in the idea that it may be absorbed and thus affect the constitution generally. 130. Baths of sea-water, cold or hot,11 and those of the mother- waters of our salt-mines12 are very efficacious in many forms of chronic inflammation of the skin, especially in scrofulous subjects. Russel advises the internal use of sea-water before beginning to bathe. Lind has recommended sea-water in scabies and obstinate forms of ulceration. M. Delaporte has treated a great number of individuals affected with scabies by means of sea-water baths, and M. Zompitoute has combined their action with that of the sulphuret of potassa, a method that deserves recommendation, especially in the cases of sailors and of soldiers quartered in seaports during the heats of summer. I have myself seen very obstinate diseases of the skin, and particu- larly chronic eczemas of the verge of the anus, which had resisted arsenical preparations, get permanently well after one or two seasons of sea-bathing. Should the disease return, the sea-bathing must be resumed the following summer, until the cure seems established. This practice is said to be very generally followed in the hospital at Newcastle ; and we may soon expect to be in possession of valuable reports on this interesting point of therapeutics, which has not yet been sufficiently attended to, from the physicians to the establish- ments for sea-bathing which have been formed in France at Dieppe, Boulogne, Havre, and Rochelle. It is of some importance also to point out those cases in which sea-bathing is contra-indicated, as well as those in which it proves advantageous. I have thought that it was prejudicial in spare and irritable temperaments. In very extensive skin affections, and in squamous inflammations, it is generally well to advise a few tepid baths, before entering on those of cold water. It is seldom that sea-bathing, as a remedial means, is em- ployed alone ; it is generally combined with some internal treatment, which, of course, always enters for something in any result obtained. I Description des appareils a fumigations etablis sur les dessins de M. Darcet, 4 l'hopital Saint-Louis, en 1814, etc., in-4. Paris, 1818. s Clarke (Arthur). An essay on diseases of the skin, coniaining practical obser- vations on sulphureous fumigations, etc., in-12. London, 1824. av-11111 uusc' 9 Wallace (W.). Observations on sulphureous fumigations, etc., in-8. Dublin 10 Decarro (J.). Observations sur les fumigations sulfureuses. Vienne l«i<J II Eph. nat. cur. Dec.iii. Ann. vu et viii obs. 68.-Frank.de curand. homin I ,hi„ p. 155.—Ranoe. Act. reg. soc. med. havn., vol. i., p. 331. ■*■*»»UD.iw» ■2 Gotz. Bulletin des scien. med. de Ferussac, t. iv., p. 288. Annales de Montpel., Dec, 1812.