The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 1). 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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![has been derived from changing from a poor to a more generous diet. Lorry relates the case of a water-drinking monk, whom he relieved of this complaint by the moderate use of wine. The constitutional disease with which this complaint appears to be most connected is atonic dyspepsia, with a constipated state of bowels ; it is, there- fore, obvious that a plain moderate diet of animal food is more likely to agree than raw vegetables, cresses, and vegetable acids, used under the notion of correcting the scorbutic state of the humours. [In some obstinate cases of the different forms of acne, great benefit has resulted, as in other chronic cutaneous cachexies, from a thorough change of diet, and especially from putting the patient on the use of saccharine matter between the meals, so as to modify the condition of the chyle, and through it that of the blood and of the tissues. An ounce and a half of simple syrup may be given with this view about three hours after each meal. With the syrup may be associated the iodide or ioduretted iodide of potassium, in the form of the liquor iodini compositus (gtt. x—xx ter die). By a perseverance in this course for eight or ten weeks, some very obstinate cases have yielded, See Dunglison's Practice of Medicine, 2d. edit., p. 129. Philad. 1844; and his Ele- ments of Therapeutics and Materia Medica, Vol. 2, p. 315. Philad. 1843.] But constitutional treatment would be of little avail without the assistance of local means for accelerating the progress of the pustules, or for promoting the resolution of the tubercles. In the early stage of the eruption, mild emollient appli- cations are most suitable, such as demulcent decoctions or poultices, which, if there is pain, may be made with the decoction of poppy heads. When the pustules have suppurated, and are slow in discharging themselves, it is advisable to apply to them, as Turner recommends, the common principles of surgical treatment. After the pus- tules have discharged their contents, either spon- taneously, or by means of the lancet, stimulating alcoholic lotions, containing a small quantity of corrosive sublimate, are chiefly to be relied on, such as have been mentioned for the severer cases of acne simplex. In the hospital of St. Louis, at Paris, the greatest advantage has been derived from rubbing the pustules, as well as the tuber- cles, with the following ointment: R. Hydrar- gyri ammoniat. J}i. ad gi. -, Adipis, gi. But of all the preparations for promoting the resolu- tion of the tubercles of acne indurata, none are, according to M. Bictt, to be compared to the iodide of sulphur, mixed with lard. (K. Sul- phur, iodid. gr. xii. ad gr. xxiv.; Adipis, gi.) M. Biett employs this remedy in the wards of the Hospital of St. Louis with decided benefit. In some severe cases of acne indurata submitted to the friction of ioduret of sulphur, the tubercles were resolved with astonishing rapidity. But the good effects of all these means are very much promoted by the use of the vapour bath, and more especially of the douche of vapour, directed for twelve or fifteen minutes upon the eruption. It is principally in old chronic cases of the acne indurata, where the local affection has completely established itself, that it may sometimes be neces- sary to have recourse to means for changing entirely the action of the part j and for this pur- pose, blisters, used by Ambrose Pare, under the notion of drawing out the peccant humours, and revived by Darwin, have been frequently used in the Hospital of St. Louis, and have been found eminently useful. [Solid nitrate of silver has been rubbed over the parts, and they have been brushed over with one of the concentrated mineral acids with a similar object.] During any recurrence of a considerable fresh eruption, the means adapted to the chronic state of the disease must necessarily be suspended, and recourse had to the constitutional and local means suited to its inflammatory state. M. Biett has found that when the disease has disappeared, a lotion, or douche of cold sulphur- ous water is of great use in establishing the cure, and in preventing a return of the eruption. 4. Acne rosacea, carbuncled face. Syn. Zevtov (Grec.) ; Varus (Roman) ; Gutta rosea et rubedo (Auctorum) ; Gutta rosacea cenopotarum et hydropotarum (Teutonice): Kup- ferbandel (Plenck) ; Bacchia (Linn.) ; Gutta rosea hepatica (Darwin) ; Herpes pustulosus gutta rosea, Dartre pustulcuse couperose (Ali- bert) ; Ionthus corymbifer (Good); Saphirs, Goutte rose, couperose (French) ; Roth-gesicht, Roth-nase (German) ; Red pimpled face. In a correct pathological nomenclature, as the last species might with greater propriety be term- ed acne furunculus, being a complication of the varus with phlegmon, or inflammation of the subcutaneous cellular tissue, so this species would be more accurately distinguished under the name of acne erythema, the pustules of acne being combined with an erythematic inflammation of the skin. In this respect, as regards the local or external disease, acne rosacea differs from the other species, the vari sometimes preceding and developing the erythema, and the erythema, on the contrary, being sometimes the occasion of the vari. From this circumstance has arisen the dis- tinction of gutta rosea, observed by Nicolaus Floientinus, Ambrose Pare, Astruc, and Plenck, dividing it into species, under the terms of sim- plex, or pure erythema,—pustulosa and bacchia- lis, the acne rosacea of Willan, — and squamosa ulcerans and varicosa, the sequelae of obstinate forms of that disease. The nose is, commonly, the first seat of this affection. In persons predisposed, who are gen- erally of the middle age, after any exciting cause, as a full meal, heating drinks, or indigestible sub- stances, the extremity of the nose becomes of a deep red colour, more or less intense, which at first gradually subsides with the removal of the exciting cause; but, at length, by repetition, grows to be habitual. In this red shining ap- pearance of the nose, some elevated points of a brighter red colour, sometimes distinct, sometimes in groups, are afterwards observed. These points enlarge, becoming pustules, which suppurate at their summits; but the suppurative process is always imperfectly established, forming seldom more than a small white acuminated point on the apex of the pustule, which makes a striking con trast with the dark damask red colour of the pus- tule, an appearance which is well represented in Alibert's XXI. plate. This white point of the pustule bursts and forms a thin white scab, which, detaching itself, leaves beneath it a hard phyma- tous tubercle. These pustules succeed each othc I and in this manner the disease perpetuates itself](https://iiif.wellcomecollection.org/image/b21116805_0049.jp2/full/800%2C/0/default.jpg)
