A CASE OF RHUS POISONING AND A REMEDY,
DROPSY,

SOME CONSIDERATIONS CONCERNING THE HEART IN
RELATION TO ITS OWN AND OTHER MALADIES,
HAHNEMANN'S FOUR RULES,

H. W. WESTOVER, M.D.

W. H. HANCHETT, M.D.

T. E. ROBERTS, M.D.

W. J. MARTIN, M.D.

J. W. MEANS, M.D.

T. P. WILSON, M.D.

C. WESSELHOEFT, M.D.

GEO. H. MARTIN, M.D.

J. W. DOWLING, M.D.

E. R. SNADER, M.D.

J. C. MORGAN, M.D.

PARASITIC FUNGI OF SKIN DISEASES.

BY H. W. WESTOVER, M.D, ST. JOSEPH, Mo.

SKIN diseases are often of a very intractable nature, and prone to greatly annoy the general practitioner. Many of us are not as completely master of the situation as we should be, and may be liable

to confound those of parasitic origin with those not thus produced. If the true cause of the disease is fully understood, we are more apt to be successful in its treatment than when groping among the unknown.

Some Homœopathic practitioners make the broad statement that a parasite will not infest a healthy individual, and that, by the administration of the proper internal remedy, as indicated by the general symptoms of the patient, the system can be brought to such a perfect state of health that the parasite will be cast off. They contend that the presence of the parasite is positive proof of a vitiated constitution, or lowered vitality, and that, by the internal administration of the indicated remedy, the host will rise superior to the parasite.

They claim that this is true, whether the parasite be of an animal nature, as scabies or tænia, or a vegetable, as tricophyton penicillium. My moderate experience does not accord with this view. Patient and careful medication has resulted in apparent good health, and the parasite still clung to its host. If the patient is in such good health that neither he nor his doctor can find aught of which to complain, except the parasite, it does seem the parasite should not persist, if the foregoing theory is correct.

It has been my privilege to meet cases where careful medication. and regimen were followed with no relief from the parasite, and relief was afforded and good health continued, with no ill after effect, when the proper local treatment with parasiticides was inaugurated. It may be true that a parasitic skin disease is more likely to infest a person in poor health and in a debilitated condition, or of filthy habits, but I do not think they infest only such.

We all know, that a person in rugged, robust health, is better able to throw off the attack of a contagious or infectious disease, but it is equally true that those in good health, as far as the doctor and the patient can discover, do, at times, succumb to such maladies. As well might we say, that every person who contracts a venereal disease, or every child that succumbs to diphtheria or measles, was therefore in ill health prior to the attack.

Therefore, I consider it important that we fully understand which skin diseases are produced by the invasion of a fungus, that we may more fully meet the indications for treatment, and guard against its dissemination; and also, that we endeavor to learn from whence it.

comes, that we may intelligently endeavor to prevent contamination, as well as avoid suppressing the cutaneous manifestation of a constitutional disease by ill-advised local measures; because, it is quite true that disastrous effects have followed such ill-timed unscientific treatment. A clear-cut, intelligent diagnosis is looked upon as a trivial matter by some practitioners, and a thorough knowledge of the pathology of a case as, at least, unnecessary. If a man persistently seeks out the pathology of a case, he may be dubbed materialistic, and be told it is unnecessary to name a disease.

In former years, when Homœopathy was young, pathology was crude and inexact; fact mingled with fancy, and much was unknown that now is demonstrated; at that time, the young giant was emerging from thraldom, and well needed to bend all its energies to fitting symptoms to patients, and with such crude weapons as were at hand the fight was made and the victory won.

To-day, we measure capabilities with a much better equipped competitor, and, if we maintain the prestige of the past, we must avail ourselves of all possible information about disease and its

treatment.

If the fungus is the cause of the disease, by removing this cause we would be but following the dictum of Hahnemann, who ever taught his followers to remove the cause. "Tolle Causam "has ever been a watch word with Homoeopaths.

In this paper, we will consider only the diseases produced by mycelial fungi, not drifting into a discussion of the disease-producing properties of the schizomycites, although they are sometimes denominated fungi :

Microsporon furfur causes tinea versicolor, not a serious disease. Achorion Schonleinii causes tinea favosa, which may be followed by permanent loss of hair.

Tricophyton causes tinea circinata, tinea sycosis, and tinea tonsurans; it may produce extensive inflammation and suppuration.

Tinea versicolor does not attack the hair or nails, and invades the epidermis only, not dipping down to the true skin or rete mucosum. It forms irregular shaped furfuraceous macules, generally on the chest or shoulders, but never on the face or hands. It is a disease of mature years, rarely being seen in the young or aged.

The mycelium is a mass of delicate threads woven through the epidermal scales, and the spores are often in clusters. By scraping

off some of the epidermic scales, and placing them in a drop of liquor potassæ, the interlacing threads and spores may be seen with a microscope of 500 or 600 diameters. The spores are highly refractive, and may develop from the mycelium or from fission of pre-existing spores.

TREATMENT.

The affected parts should be thoroughly freed from the greasy, sebaceous matter of the skin. The ethereal soaps prepared for surgical cleansing should be satisfactory for this purpose. After a warm bath, the parts should be thoroughly scrubbed. This loosens and softens the epidermis, making it easier to successfully attack the parasite.

Then daily apply a weak mercurial ointment or the oleate of copper. I can offer nothing better than the treatment of the latest text-books. There should be a complete change of clothing, and great care used to prevent reinfection and consequent relapses.

Favus. Tinea favosa is a contagious disease produced by the Achorion Schonleinii. It may attack only the hairs and their follicles, or the epidermis, or it may attack the nails. It generally first attacks the scalp, and is more frequently met with in children than adults.

It infests the lower animals, the mouse and the cat often being its host, from whom it may be readily transferred to mankind. Unna claims several different species of favus, differing more or less in the appearance of the mycelium and spores. Possibly this may be an illusion, as different experimenters have noticed varying appearances of the same plant on different culture media, it being susceptible of culture off the body on various nutrient media. I have never personally experimented with the fungus of favus; but have noticed other microscopic fungi change their appearance on different media, and even on the same medium, under more or less favorable surroundings.

The disease is characterized by cup-shaped, yellowish crusts perforated by hairs. These are fungus masses that surround the hairs, penetrating their shafts and ramifying in the epidermis.

At first they are separate, but gradually coalesce, forming large crusts, in which the circular form of the favus-cups may often be noticed. If the disease continues, atrophy of the follicles may

occur, and the hair, in falling out, is liable to leave permanent bald spots.

Favus produces an unpleasant odor, likened to mice or mouldy straw. If the diagnosis is doubtful, the microscope will settle it. A few of the hairs being covered with a solution of caustic potash, a power of 500 or 600 diameters will reveal the presence of the achorion. The mycelium consists of narrow, flattened threads matted in all directions, some empty and some containing minute spores. It penetrates the hair follicles, attacks the root-sheath of the hair and often invades the shaft.

If it attacks the nails, it may be found in the nails themselves. It may be cultivated on bouillon, ager ager and various nutrient media. In debilitated and scrofulous subjects constitutional treatment should not be neglected; however, local treatment must be persistent and thorough. The crusts should be removed by keeping them saturated with oil for twenty-four hours. Oil of ergot is said to be the best, but I have never used it.

Poultices should be avoided. An excellent plan is to sponge the parts with a 25 per cent. solution of boroglyceride after the oil has been on for twenty-four hours. Do not apply ointments or oils immediately after removal of the crusts, but wait until the parts are dried, when the parasiticide can be used. An ointment of resorcin is a favorite remedy with me, but authors recommend oleate of copper, dr., to lard, 1 oz., also oleate of mercury, chrysarobin, boric acid, aristol, etc.

Generally, the health of favus patients is good, but any ill-health should be met by the indicated remedy. The indications will generally be met by Calc carb., Dulcamara, Graphites, Hepar, Mezereum, Oleander, Psorinum, Sulphur, Viola tric., etc. Great claims are made for internal medication, but if the indications and reports are carefully studied, it appears that the cases are not parasitic. However, if any parasite cases present ill-health, as is often the case, the proper internal medication should be carefully sought, and not unfrequently the antipsorics will meet the requirements.

TRICOPHYTOSIS.

The tricophyton is a vegetable fungus which has been cultivated off the body on decaying wood and in non-acid culture fluids. It infests the horse and other domestic animals, and may thence be