Medical

Eczema is really a catarrhal inflammation of the skin, with the exudate (fluid that escapes) concealed beneath the surface, or appearing on the surface after irritation has occurred. The many varieties are best classified as follows:

(1) Eczema of internal origin, including cases due to morbid agencies produced within the body, cases due to drugs, and possibly reflex cases.

(2) Eczema of external origin, including cases caused by occupation, by climate, or by seborrhea.

Eczema of internal origin almost invariably appears on both sides of the body at once, as on both cheeks, or both arms, or both thighs. Its border shades into the surrounding skin, it is dotted with papules (or heads) filled with fluid, and its surface is clean and not greasy. As it spreads, the symmetry of distribution is lost. Among the morbid agencies producing this variety of eczema are the products of indigestion. Among the drugs producing it is cod liver oil.

This variety of rheumatism is quite distinct from the other forms, being in all probability due to some special germ. It occurs in temperate climates during the fall, winter, and spring less often in summer. Persons more frequently suffer between the ages of ten and forty years. It is rare in infants; their pain and swelling of the limbs can be attributed more often to scurvy, or to surgical disease with abscess of joint or bone. Exposure to cold and damp, in persons insufficiently fed, fatigued, or overworked, is the most common exciting cause.

In the nearsighted eye the eyeball is too long for parallel rays entering the eye to be focused upon the retina; they are bent, instead, to a point in front of the retina, and then diverge making the vision blurred. The act of accommodation in making the lens more convex will not aid this condition, but only make it worse, so that it is not attempted.

Earache is due usually not to neuralgia of the ear, but to a true inflammation of the middle ear, which either subsides or results in the accumulation of inflammatory products until the drum is ruptured and discharge occurs from the external canal. The trouble commonly originates from an extension of catarrhal disease of the nose or throat; the germs which are responsible for these disorders finding their way into the Eustachian tubes, and thus into the middle ear. Any source of chronic catarrh of the nose or throat, as enlarged and diseased tonsils, adenoids in children, or nasal obstruction, favor the growth of germs and the occurrence of frequent attacks of acute catarrh or “colds.” The grippe has been the most fruitful cause of middle ear inflammation and earache in recent years. Any act which forces up fluid or secretions from the back of the nose into the Eustachian tubes (see section on Deafness) and thus into the middle ear, is apt to set up inflammation there, either through the introduction of germs, or owing to the mechanical injury sustained. Thus the use of the nasal douche, the act of sniffing water into the nose, or blowing the nose violently when there is secretion or fluid in the back of the nose, or the employment of the post nasal syringe are one and all attended with this danger. Swimming on the back, diving, or surf bathing also endangers the ear, as cold water is forcibly driven not only into the external auditory canal, but, what is more frequently a source of damage, into the Eustachian tubes through the medium of the nose or throat. In this case the plugging of the nose with cotton would be of more value than the external canal, as is commonly practiced. If water has entered the Eustachian tube, blowing the nose and choking merely aggravate the trouble. The wiser plan is to do nothing but trust that the water will drain out, and if pain ensues treat it as recommended below for earache.

The pain is more often in the forehead, but may be in the top or back of the head. The headache may last for hours, or “off and on” for days. Dull headache is seen in “biliousness” when the whites of the eyes are slightly tinged with yellow and the tongue coated and yellowish, and perhaps dizziness, disturbances of sight and a feeling of depression are present. Among other signs of headache due to indigestion are: discomfort in the stomach and bowels, constipation, nausea and vomiting, belching of wind, hiccough, and tender or painful eyeballs.

Cancer of the lip arises as a small lump, like a wart generally, on the lower lip in men from forty to seventy. Sometimes it appears at first simply as a slight sore or crack which repeatedly scabs over but does not heal. Its growth is very slow and it may seem like a trivial matter, but any sore on the lower lip in a man of middle age or over, which persists, should demand the immediate attention of a surgeon, because early removal is more successful in cancer of the lip than in any other form.

This is a peculiar, one sided headache which takes the form of severe, periodic attacks or paroxysms, and is often inherited. It recurs at more or less regular intervals, as on a certain day of each week, fortnight or month, and the attacks appear and disappear at regular hours. The disorder generally persists for years and then goes away. If it begins in childhood, as it frequently does between the years of five and ten, it may stop with the coming of adult life, but if not outgrown at this time it commonly vanishes during late middle life, about the age of fifty one in a man, or with the “change of life” in a woman. While in many instances arising without apparent cause, yet in others sick headache may be precipitated by indigestion, by eye strain, by enlarged tonsils and adenoids in children, or by fatigue.

Eye strain is commonly due to either astigmatism, nearsightedness, farsightedness, or weakness of the eye muscles. The farsighted eye is one in which parallel rays entering the eye, as from a distance, come to a focus behind the retina. The retina is the sensitive area for receiving light impressions in the back of the eyeball. Sight is really a brain function; one sees with the brain, since the optic nerve endings in the back of the eye merely carry light impressions to the brain where they are properly interpreted.

In order that vision be clear and perfect, it is essential that the rays of light entering the eye be bent so that they strike the retina as a single point. In the farsighted or hyperopic eye, the eyeball is usually too short for the rays to be properly focused on the sensitive nerve area in the back of the eye.

There are various forms of inflammation of the mouth, generally dependent upon the entrance of germs, associated with indigestion or general weakness following some fever or other disease. Unclean nipples of the mother or of the bottle, or unclean bottles, allow entrance of germs, and are frequent causes. Irritation of a sharp tooth, or from rubbing the gum, or from too vigorous cleansing of the mouth, may start the disease. Some chemicals, especially mercury improperly prescribed, produce the disease. The germs may gain admission in impure milk in some cases. Inflammation of the mouth is essentially a children’s disease, only the ulcerated form being common in adults.

This, afflicting the patient all day and every day, and increasing in severity at night, is suggestive of some disease of the brain, as congestion, brain tumor, or meningitis, and urgently demands skillful medical attention.