General and local. Diet: wholesome diet following laxative:
restricted, generous, vegetable. Rest, avoiding congestion,
perspiration, friction, stretching, pressure. Cleanliness. Diuretics.
Purgatives. Tonics. Alteratives. Sulphur. Antimony. Phosphorus.
Calcium sulphide. Pilocarpin. Baths, tepid, warm, soapy, alterative.
Emollients, simple, medicated. Drying powders. Protective films.
Stimulating and antiseptic applications. Parasiticides. Caustics.
Counter-irritants. Bandages.
These must be general and local, and the first hygienic, dietetic and
medicinal.
The =diet= is especially important in eruptions due to poisons such as
green food, distillery refuse, silage, roots, ergoted or smutty food,
musty fodder, irritant plants in hay or grain feed, buckwheat, etc. In
many cases a change to sound fodder and a laxative to clear the
alimentary canal of the irritant, may be all that is required. In cases
where the feeding has been parsimonious, a judiciously gradual change to
a generous diet may be required. Again when the feed has been unduly
rich, or spiced as in the patent food for stock or the table leavings
for dogs, a plainer, simpler and less exciting diet will be called for.
Indigestions, urinary and hepatic disorders due to diet may be often
corrected by a more judicious ration.
=Rest= is a most important element in horses and hunting dogs. When
pressure of the harness keeps up the irritation, or when active movement
reopens cracks in the tense rigid congested skin of the heel, carpus or
tarsus of the horse, the parts must be kept quiescent. When on the other
hand chaps and fissures are caused and maintained by _stocking_, the
patient may do much better with exercise. In skin congestions which are
aggravated by work and increased cutaneous circulation, rest is
imperative.
=Cleanliness= is no less imperative. Many cases are started and
maintained by filth on the skin and in the air of the stable and hence
sponging, currying, brushing, rubbing, are directly therapeutic. Yet
care must be taken to avoid irritation where the skin is tender. In the
sensitive heels of the horse congestion, chaps, and _stocking_ are often
determined by washing in ice cold water and leaving to dry uncovered, in
a draught of air, or by washing with common laundry soap having alkali
in excess. Even tar soap will sometimes keep up the trouble in a
specially sensitive skin. Apart from such exceptional conditions,
thorough grooming is commendable, not only in cleaning the skin, but in
improving its circulation and nutrition.
=Diuretics= are often beneficial in eliminating from the system the
irritant products generated from disorders in sanguification, digestion,
urinary secretion and hepatic function, as well as those that are
derived from the cutaneous disorder. They tend further to reduce any
existing fever, and to cool and relieve the burning integument. The
alkaline diuretics are often very useful.
=Purgatives= act in a similar way and are especially indicated in cases
due to ingested irritants, and in such as depend on morbid products of
gastro-intestinal or hepatic disorder. In many acute attacks these may
be said to be almost specific in their action as in urticaria, and in
the eruptions due to distillery products or green food.
=Tonics= are often called for to correct dyspepsias, to improve the
general health and vigor, the sanguification and nutrition in weak and
debilitated conditions. Iron, cod liver oil, bitters, quinia, quassia,
calumba, gentian, nux, are often of value in such cases.
=Alteratives.= =Arsenic= may be said to act as a tonic with a special
tendency toward the skin where it affects the epidermis and epidermic
products and is applicable to many subacute and chronic disorders, as
psoriasis, acne, dry eczema, and pemphigus. It has been further supposed
to be most useful in superficial lesions, and in those due to a neurotic
origin, from the known operation of arsenic on the nerves. It is little
suited to acute skin diseases, and though often valuable is not to be
trusted as universally applicable.
=Sulphur= is often useful as a laxative, but also as a stimulant to the
cutaneous secretions when these are impaired.
=Antimony= is similarly a cutaneous stimulant and is sometimes useful in
chronic inactive conditions.
=Phosphorus= has been found useful in obstinate cases and probably acts
on the nerve centres in improving nutrition of the integument.
=Calcium sulphide= is sometimes useful with free secretion from the
diseased surface, but its action is somewhat uncertain.
=Pilocarpin= operates by securing free secretion from the skin as well
as from the various mucosæ, and seems to benefit by elimination, as well
as by modifying the cutaneous functions and nutrition.
=Local Applications.= =Baths= may be placed foremost among these.
Cleanliness is a prime necessity in treating skin disease. Tepid or warm
water is especially required in acute disease in sensitive skins. In
chronic cases with accumulation of scabs a soap wash following a 24
hours inunction with oil or lard may be demanded, but as a rule castile
or other non-caustic soap should be used. In certain cases the baths may
be advantageously medicated, as with calcium sulphide, potassium
sulphide, salt, alum, tannic acid, tar, creolin, lysol, cresol,
chloro-naphtholeum, arsenic, mercury, etc. The water alone is, however,
of great value in soothing and moderating inflammation, softening and
dissolving scabs and epidermis, and relieving the dryness and rigidity.
=Emollients= are used for the same end as calmatives, and relaxing and
protective agents. Fatty bodies occupy a front rank, the bland vegetable
and animal oils being not only soothing but nutritive (cod, lard, olive,
cotton, almond, linseed, rape, pea nut, lanolin, neats foot and goose
oil). Care should be taken that these are pure and in no sense rancid.
Vaseline or petrolatum are free from the risk of rancidity, yet it
should be free from contamination unless a stimulating action is wanted.
Glycerine often used as an emollient has the disadvantage of drawing
water from the surface and of actually irritating some sensitive skins.
Glycerol made with glycerine and starch is more soothing. Glycogelatine
made with glycerine 5, gelatine 3, and water 9, is very emollient and
protective. This can be made the basis of astringent, sedative and
antiseptic preparations by adding zinc oxide, lead acetate, chrysarobin,
salicyclic acid, tannin, sulphur, oil of birch or of tar, etc. An
excellent emollient paste is compounded of zinc oxide and vaseline
one-half ounce of each, salicylic acid, ten grains. Oleate of lead is an
excellent sedative application in irritation or pruritus.
=Drying powders= are found in starch, talc, magnesia, zinc oxide,
lycopodium, bismuth oxide, boric acid, iodoform, aristol, salicylic
acid, tannin, and, above all, magnesia carbonate. A slight addition of
morphia sulphate will render them analgesic. Tar in zinc oxide or
bismuth will secure antiseptic and stimulating qualities.
=Protective films= for irritable surfaces may be had from collodion, or
from a solution of gutta percha in chloroform 1 ∶ 10 (traumaticin).
=Stimulating and antiseptic applications= are found in tar or oil of tar
in suitable excipient and of a strength suited to the case, oil of white
birch, oil of lavender, oil of cade, oil of cashew nut, oil of juniper,
oil of hemlock, Canada balsam, balsam of Tolu or Peru, creolin, lysol,
cresyl, creosote, carbolic acid, chloro-naphtholeum, etc. Ichthyol, of
great value in chronic affections, may be used in oil or vaseline (5 ∶
100), or in the form of Nuna’s varnish: Ichthyol 40, starch 40,
concentrated albumen solution 1 to 1½, and water 20. Add the water to
the starch, then rub in the ichthyol and finally the albumen. Resorcin
is a useful stimulant, alterative, and antipruritic (1 ∶ 30 alcohol and
oil).
As =antiseptics= and =parasiticides=, in addition to the above, are
alpha- and beta-naphthol, iodized phenol, chloral camphor (rub together
till they form a clear fluid), phenol camphor (add camphor gradually to
the melted phenol crystals), mercuric chloride, cupric sulphate and
silver nitrate. Potash (green) soap, medicated or not with tar or other
agent, is of great use in many chronic affections. The phenol
combinations are all more or less anæsthetic, and therefore sedatives
and antipruritic. Quassia, Stavesacre, tobacco, etc., are of great use
in parasitisms though not antiseptic. Sulphur fills both indications,
and is a bland generally applicable agent.
=Caustics= (silver nitrate, antimony chloride, electric or
thermocautery) are useful in luxuriant granulations, hyperplasias, and
often in excessive secretion, or on infected surfaces.
=Counter-irritation= over the vaso-motor centres, is often of value,
when the distribution of the eruption coincides with that of particular
nerves, and indicates a nervous element in the causation.
=Bandages= of various kinds may be demanded to afford support in
threatened dropsical effusion or excessive granulation or hyperplasia,
to protect the surface against outside infection, to confine volatile
applications to the affected part, and to prevent injury from biting,
licking, scratching, or rubbing.
For the same reason it may be desirable to employ a muzzle, beads on the
neck, tying to two opposite rings by short halters, hobbles, or other
means of restraint.