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

  • Rayer, Pierre François Olive, 1793-1867.
Date:
1845
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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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    131. At Paris, artificial alkaline baths, which approximate, in a cer- tain degree, in their composition to those of sea-water, are prescribed under similar circumstances. These are prepared in the hospitals by dissolving from four to six ounces of the subcarbonate of soda, in an ordinary tepid bath. Common culinary salt sprinkled on the sur- face of cutaneous eruptions, has been recommended by Schelling.1 The salt-water contained within oysters, is a vulgar remedy for ulcers of the leg; and I know a patient who succeeded in getting rid of a very disagreeable eczema podicis, by employing this water as a lotion. [The brine of salt-meat is another popular remedy, in England, against various forms of skin disease.] 132. Baths of saline, natural mineral-waters, have also been occa- sionally employed in affections of the skin, the species of which, however, have not been particularly described. 133. Soap lotions, formerly much recommended in skin diseases, are still generally used as a means of cleanliness, and have lately been advised by M. Lugol, in cases of scabies. 134. Local baths—(manuluvia—pediluvia—hip-bath)— have been prescribed, not only as topical applications, but with a view to promote the absorption of various medicinal substances. Foot-baths contain- ing corrosive sublimate or nitro-muriatic acid, have been tried in several eruptive diseases, and in syphilitic affections, but with very variously-reported effects. 135. Saliva, which is spoken of by Galen and Celsus,2 is still a popular application to the scales of pityriasis, and to lichen of the face. Nurses often employ their spittle to allay the violent itching which children surfer who are attacked with strophulus. 136. The urine, especially that first passed in the morning—urina sanguinis— was an ancient remedy, and is still used by the vulgar, when they are attacked with itch, pediculi, and chronic eczema of the hairy scalp. 137. General and partial vapour baths* may be of service in restoring to the exterior certain inflammations of the skin that have receded, in the removal of squamae and of scabs, in exciting the circulation in those regions of the skin to which they are particularly applied, and in stimulating inflammatory affections of an indolent nature. They are further usually employed under a great variety of circumstances which I shall be careful to expose in their proper places. P. Frank even tells us that the vapour which exhales from the body of an animal just killed, has proved a remedy in certain cases of cutaneous disease.4 138. Several chronic forms of inflammation of the skin have been successfully treated by iodine and its compounds.5 This medicine has been particularly recommended in cutaneous affections occurring in scrofulous constitutions. I have seen good effects from the combina- tion of iodine with mercury, sulphur, and opium in scrofulous lupus, and in tubercular and ulcerated syphilitic affections. These com- pound remedies, as their action is very energetic, require to be care- fully watched. Like all the preparations of iodine, they have a very marked effect on the constitution. Externally, an ointment or pomatum of iodine and of the proto- ioduret of mercury, as also solutions of iodine of various degrees of strength, general or local iodated baths, iodated cataplasms, caustic iodine (a solution of an ounce of iodine and an ounce of ioduret of potassium in two ounces of water), &c, have all been employed by M. Lugol and others, in the treatment of scrofulous lupus {scrophules esthiomenes) and of some other cutaneous affections. I have myself particularly tried the action of the iodurets of mercury and of sulphur. 1 Marcus unci Schelling. Jahrbucher der Medicin als Wissenschaft, ii B. 1 St. p. 42. 2 Galenus. De simpl. medic, facultatibus, lx.—Celsus. Lib. v., cap. 1, De papula.— Schurig. Sialogia, p. 132. 3 Atumoneilli. Memoire sur les eaux minerales de Naples et les bains de vapeurs. Paris, 1804.—Assalini (Paolo). Ricerche mediche su i bagni a vapore e di calorico, e sulle fumigazioni di sostanze ammoniacali e balsamiche, di zolfo, di mercuric etc. Naples, 1820.—Rapou. Traite de la me'thode fumigatoire, 2 vol., in-8. Paris, 1823. Philouze. Essai sur les bains de vapeurs employes a Saint-Louis, in-4. 1826. * Frank (P.). De curand. homin. morb., lib. iv., p. 63. s Gimelle. Obs. sur l'emploi de l'iode dans le goitre, les scrophules et les dartres (Revue medic, 1821, t. vi., p. 81, and Journ. univ. des scienc. med., t. xxv., p. 5).— Kelley. Emploi de l'iode dans le goitre, les scrophules et les dartres (Journ. compl. t. c. xvii., p. 307).—Belliol, Essai sur les avantages de l'iode dans le traitement de la dartre furfuracee, etc. Paris, 1825, in-4.—Lugol. Mem. sur l'emploi de l'iode, in-8. Paris, 1829. Troisieme Memoire sur l'iode, in-8. Paris, 1831. (Scrophules cutanees ulcereuses et esthiomenes, pp. 46-61.) Masson (Th.). Sur l'emploi de l'opium joint a l'iode dans la scrophulecutanee ulc£reuse (Journ. de med., t. iv., p. 117). Internally, the iodated mineral water, prepared according to the formula of M. Lugol, appears to me the best of all the forms devised for the exhibition of iodine. The medicine may also be prescribed in the solid state in gradually increasing doses of half a grain, three- quarters of a grain, one grain, one grain and a quarter daily. I shall have occasion to revert to the effects of this active remedy under tin- heads lupus and syphilitic affections. 139. Styptics and astringents to the skin have been strangely abused by quackery. Lorry cites a serious instance of their ill effects.0 He is, nevertheless, of opinion that the cure of old and obstinate cuta- neous affections having been once obtained, it is proper to endeavour to give tone to the affected parts of the skin by the use of various styptics, such as washes of the acetate of lead, acidulated baths, so- lutions of alilm, &c.; and it is undeniable that this practice, much extolled by Bell, is often advantageous. The ill effects of the salts and oxides of lead have been greatly exaggerated.7 These preparations are often useful in allaying certain inflammations of the skin, accom- panied by morbid secretions. Preparations of zincs are used under similar circumstances, and with the same views. 140. The sulphate of alumina9 in solution as a wash, in the pro- portion of an ounce, or an ounce and a half of the salt to a pint ot water, lessens the morbid secretions of the skin in eczema fluens. lichen agrius, &c, and greatly relieves the itching that accompanies these diseases. This means, recommended by Turner, is not duly appreciated by Lorry. Borax10 has also been employed externally, united with hog's-lard and alum, in the treatment of pityriasis and several other chronic inflammations of the skin. The sub-acetate of copper, or verdigris, besides a multitude of other preparations of this metal,11 have long been familiarly used as external applications in cutaneous affections, especially in those of a syphilitic nature. 141. Lotions and fomentations of simple cold water may be advan- tageously employed in a number of cases to diminish uneasy sensations of heat and itching. Compression12 recommended by Bell, and particularly by Baynton in the treatment of ulcers, by Bretonneau in phlegmonous erysipelas of the legs, and by Velpeau in cases of severe burns, has been tried in eczema, scirrhous tubercles, nam, and Arabian elephantiasis. The situation and disposition of parts may sometimes render compression difficult or painful, and as it does not attack the conditions that lead to the formation of cutaneous diseases, it is generally to be regarded as a remedy of secondary importance.13 142. Charcoal14 has been tried internally and externally as a remedy in scabies, which may be cured more certainly and easily by other means. Thomann obtained the cure of tinea in three cases, in the space of from three to five days, by the use of charcoal in powder, and soapy lotions. M. Brache did not succeed by the same means in less than a month. According to Hunold, charcoal made into a paste with rum is a popular remedy in various skin complaints in the city of New York. The trials I have myself made with charcoal, either alone or combined with sulphur, have satisfied me that it is of no use in favus, and that the other affections of the hairy scalp yield 6 Vidi hominem suppressos per saturnini effectum herpetes longis atque atrocibus malis ventriculi atque hepatis redimere. (De morb. cutan., p. 342.) i Alexandri Tralliani, lib. i., c. 13.—Pauli^Eginetas, lib. iv., c. 2, p. 20.—Aitkin (John). Observations on the external use of lead. London, 1771,8vo. Goulard. Traiie sur les effets des preparations de plomb, etc. Montpellier, 1766.—Delabrosse. Journ. de med., t. xxv., p. 576.—Frank. De cur. homin. morb., lib. iv., p. 67 (non esse tain perniciosum). s Journ. gener.de med., t. xxvi.,p.465.—Hanke. Emploi duchlorurede zinc (Arch, gen. de med., t. xx., p. 277).—Bell. On ulcers. o Lindt. Diss, de alumin. virtut. med. Gcett., 1784.—Alexandri Trail., lib. i., c. 13 seq.—Paul. iEgin., 1. iv., c. 20. (Terra cimolia succo solani subacta.) 10 — Reinhart. Utilite du borax contra les dartres furfuracees. (Revue medic, t. xvi., p. 462.—Arch. gen. de med., t. xiv., p. 458.) 11 Desault. Journ. de Chirurgie, t. iii.—Stark. Inst, clinic, p. 30. 12 Bretonneau. Avantages de la compression dans les inflammations de la peau,in-4. Paris, 1815.—Guerin. Journ. analyt., t. i., p. 93. Nouv. Bibliotheque, med., aout 1816. 13 This remark certainly will not, and is not probably meant to apply to the treatmeni of ulcers of the legs, in which graduated compression is one of the most valuable curative means we possess.—R. W. «* Duval. Obs. et Reflexions sur le traitement de la gale idiopathique par la poudre de charbon. Bulletin des Sciences, t. viii., p. 228.—Thomann. Ann. inst. clinici de Virceb., 1799. Extract in Journ. gener. de med., t. xix., p. 223.—Grioris (F. B.). Con- siderations sur l'utilite de la poudre de charbon de bois dans le traitement de lateigne de la gale et de quelques autres affections cutanees, ia-4. Paris, an xii.