Treatment.--Ringworm is always curable, provided the patient is watched and treatment carried out thoroughly. It is always absolutely necessary to treat the condition, because it will not get better of itself, and the longer it is permitted to last, the worse it gets, and the more difficult it is to cure. If treatment is begun at once, it may take two months to cure it. If the case has lasted for some time, or if it has been neglected and not treated thoroughly, it will take from six months to one year to cure it. These facts are stated so that parents may not become discouraged.

The first thing to do is to cut the hair as close to the scalp as possible, wherever the ringworm is, and for about an inch outside, and all around it. The entire scalp should be thoroughly washed three times a week. The scales should be kept soft by the use of carbolic soap.

The hair should not be brushed at all, because brushing the hair may spread the disease to other parts of the scalp. Every child with ringworm of the scalp should wear a cap of muslin or one lined with paper, so that others may not be infected. These caps can be burned when dirty and new ones made. One of the best remedies to apply to the affected area is the following: Bichloride of mercury, 2 grains; olive oil, 2 teaspoonfuls; kerosene, 2 teaspoonfuls. This is rubbed in every day until the parts are sore and tender. It is a good plan to apply this mixture to the entire scalp every fourth day, to guard against other parts becoming infected. It is not necessary to rub it in when using it where there is no ringworm.

When the scalp becomes sore from the application it can be stopped for a day or two, or until better; then begin again and repeat the treatment right along. If the kerosene in the above mixture is objected to, a very good mixture is bichloride of mercury, 2 grains, and tincture of iodine, 1 ounce. This may be rubbed vigorously enough to produce a rash. If the disease shows a tendency to spread under this treatment it is best to apply the latter mixture to the entire scalp.

Ringworm on any other part of the body is effectually treated by applying tincture of iodine. It should be painted on every day until the skin begins to peel, when the ringworm will disappear with the skin.

ECZEMA

Eczema is the most important skin disease of babyhood. It is probably the most frequent skin disease of infancy. Any baby may develop eczema.

There are, however, some babies who seem to be very susceptible to it.

The reason of this susceptibility seems to be due to the natural tenderness, or delicacy, of the skin. These children, because of the extreme sensitiveness of the skin, develop an eczema from a very slight degree of external irritation, or a trifling disturbance of digestion.

Children of rheumatic or gouty parents are more liable to be victims of eczema than are others. Eczema of the face is quite common in children who are apparently healthy and fat. It does not seem to matter whether they are breast-fed or bottle-fed. The following conditions may be regarded as contributory to eczema:

Exposure to winds; cold, dry air; heat; the use of hard water or strong soaps; lack of cleanliness, and the irritation of clothing. It frequently accompanies chronic constipation, indigestion, and other conditions of the intestinal ca.n.a.l; overfeeding; too early or too excessive use of starchy foods.

Eczema of the Face:--Eczema Rubrum.--This is the most frequent form.

It affects the cheeks, scalp, forehead, and sometimes the ears and the neck. It begins on the cheeks as small red papules. These join together and form a ma.s.s of moist, exuding crusts. They dry in time and may be so thick as to form a mask on the face. The skin may be much swollen. When the crusts are removed the face looks red and angry and bleeds easily.

It is exceedingly itchy. It causes restlessness, loss of sleep, and it may affect the appet.i.te, though, as a rule, the health remains good.

Eczema of the face is exceedingly chronic; it improves from time to time, but it is cured with great difficulty only.

Infants suffering with eczema of the face begin to improve about the middle of the second year and may be entirely cured about this time. The reason of this is the greater amount of exercise the child is getting at this period. If the disease continues longer it is because of the unnecessary amount of fat that the child has.

Treatment.--Eczema is a notoriously tedious disease. There is very little tendency for it to improve, if left to itself. The age, the severity, and just how much you can rely upon the mother, or nurse, faithfully to carry out directions--upon these its cure depends. At best, the treatment may have to be carried out for months. If the eczema is accompanied with constipation and indigestion in infancy, very little can be done with the eczema until these conditions are removed.

There exists in the minds of the laity, and in some physicians also, an idea that it is wrong, or dangerous, to cure, or "dry up," an eczema. It is never dangerous, but highly desirable, to cure an eczema, whenever possible. It is always wise, because it is always necessary, to get the child in perfect condition before you treat the eczema. Cure the constipation, or indigestion, or cold, or whatever is the matter with the child; then treat the eczema. This is the only plan that offers any success. It is not a simple matter to find out why a nursing child is having indigestion. The most minute care must be exercised to find out the element in the milk that is causing the eczema. It would, however, be foolish, and a waste of time, to apply pastes, etc., to an eczema of the face, while the real cause that produced it was still in existence.

It will frequently be found necessary to change the food entirely.

Strict attention to the bowels is essential, both in infants and in older children. Sometimes to cure the constipation means an immediate cure of the eczema.

If the child is anemic, poorly nourished, and flabby, tonics are advisable. Cod liver oil is of use in quite a number of these cases.

Eczematous children should not be taken out when the weather is very cold or when there are high winds. They should not be washed with plain water, or with castile soap and water. When washing is necessary, do it with milk and water, to which one teaspoonful of borax is added. The clothing must not be too heavy.

In eczema of the face, the child must either wear a mask or heavy woolen gloves, so that he will not scratch the parts. Frequently these fail, and it will be necessary to restrain the child from scratching the face by the use of some mechanical device. A piece of strong pasteboard bandaged on the elbows, so as to prevent the child from bending them, is all that is necessary. If the child cannot bend the elbows he cannot scratch his face, yet he has the free use of his hands.

The use of external remedies is imperative, as frequently the cause is mostly external, and in other cases it must be used in addition to the general treatment. Before external treatment is inst.i.tuted, the crusts should be softened by applying olive oil to them for twenty-four hours, after which they can be removed with soap and water. If there is much inflammation, or if the face looks angry, a very good application is La.s.sar's paste.

Later, when the inflammation has subsided and the itching is severe, a mixture of tar ointment, 3 teaspoonfuls; zinc oxide, 1-1/2 teaspoonfuls; rose water ointment, 6 teaspoonfuls has proved to be one of the very best.

When the eczema on the face is of the weeping, or moist, variety, the application of ba.s.sorin paste gives splendid results.

When an external remedy is applied to any eczematous surface it is necessary to apply it on a cloth. Simply to smear it on will do no good.

In the treatment of eczema, when the children are breast-fed, it is well to remember that the real cause of the eczema may be in the mother. If the mother is constipated, or if her diet is too liberal, if she is drinking beer, or an excess of coffee, or is not taking exercise, the eczema may be caused by one or other or all of these.

For eczema of the scalp the remedy to use is white-precipitate ointment, 1 part; vaseline, 4 parts. Mix together and apply.

POOR BLOOD. SIMPLE ANEMIA

Causes.--There is what may be termed an unnatural tendency toward poor blood during infancy and childhood. The explanation of this anomalous condition is, that the tax or strain put upon the blood to provide for the growth of the child is severe, and is in addition to the great demands made upon it in the exercise of its regular duties. We must, therefore, always take this special duty into consideration, when the question of recuperation, convalescence, feeding, and the administration of blood foods and tonics comes up.

It is not necessary to specify the diseases from which a child may suffer and recover, in an anemic condition. Any disease may leave a child with temporarily poor blood. The conditions which most frequently produce anemia in childhood are improper feeding and unhealthy surroundings. It is not fully appreciated how seriously these conditions can affect the health of growing children. There is one condition that every mother should be warned against, namely, the possibility of unduly prolonging breast-feeding. Children should be weaned at the end of the tenth month. By prolonging the breast-feeding a mother can undermine the vitality and strength of her baby and so impoverish its blood as to invite disease. A bottle-fed baby should be put upon a mixed diet at the same time. To continue feeding a child exclusively on milk for a year or two after weaning, simply because "it will not take anything else,"

is criminal. Any woman guilty of such stupidity should never have become a mother. Once again it must be emphasized that every child must have an abundance of fresh air, must not be confined in close, hot, unsanitary rooms, and must have a daily, satisfactory movement of the bowels to be a healthy child with good blood in its body.

Symptoms.--Children suffering from poor blood are flabby, constipated, hungry, weak specimens of childhood. They are under weight, complain of headache, pains, disturbed sleep, are nervous and irritable. They tire quickly, are short of breath, and may have a tendency to faint easily.

The hands and feet are cold, the pulse is small and irregular. They may have attacks of nose-bleeding and of bed-wetting.

Chlorosis.--Chlorosis is that form of anemia, of poor blood, which occurs in young girls about the time their sickness begins. It is most frequently seen between the fourteenth and seventeenth years, and more often in blondes than in brunettes. The cause is not known. It is thought to be due to constipation. Any occupation which is deleterious to health has a distinct influence on the condition. Employment in factories, confinement in badly ventilated rooms, bad or insufficient food, great grief, care, or a bad fright, mental strain, overstudy, may all produce, or contribute to the production of chlorosis.

Symptoms.--The symptoms of chlorosis resemble those of simple anemia.

Children suffering from anemia are pale; girls with chlorosis have a peculiar greenish yellow tint in the skin. They are short of breath, they have vertigo, palpitation, disturbances of digestion, constipation, cold hands and feet, and scanty or arrested monthly periods. They have various nervous disturbances, such as headache, pains in various parts of the body, neuralgia, especially over the eyes, hysterical attacks, and sometimes cholera. Ulcer of the stomach is sometimes seen in this condition.

The disease lasts for a year or longer; it frequently lasts a number of years. Relapses are frequent.

[Ill.u.s.tration: By permission of Henry H. G.o.ddard

"A Misfortune at Birth"]

Warren is feeble-minded. His family said it was due to "a serious fall of the mother."

[A]"The family history is, however, exceedingly interesting.

"The paternal grandfather, whom we have called Nick, was of good family, although he himself was totally different from the rest. He was weak in every way, and to be considered feeble-minded. He married into a family that was much lower socially than his own, although we have no proof that it was a defective family. The children of this couple were all mentally defective and low-grade, morally as well as intellectually.

"Warren's father, Jake, a thoroughly disgraceful character, married Sal, a woman somewhat older than he.

"The immorality of this family beggars description. A girl named Moll was fifteen years old when Jake brought her into his home: his wife, Sal, was so feeble-minded that she allowed the illicit relations between these two. Moll's child was born in the hospital after the mother had been sent away from one Home because of her horrible syphilitic condition--from which she finally died.

"Our boy Warren's sister Liz with whom the father lived in incestuous relations, was also allowed to live illicitly with a man who worked for her father. She was so simple that she talked openly about her relations with her father and with this man. When a child was to be born the man married her.

"This is not all, but enough: and sufficient to show what feeble-mindedness leads to when it takes the direction of s.e.xual abuses."

[A] "Feeble-mindedness: Its Causes and Consequences, G.o.ddard, The Macmillan Company.

Severe Anemia: Pernicious Anemia.--This is the most severe form of anemia, or the condition in which we have the poorest blood. While this condition frequently results in death the others rarely ever do. This condition is not common in childhood.

Symptoms.--There is intense weakness and prostration. The skin is very pale, the mucous membranes are bluish white. The breath is markedly short and there is often dropsy of the limbs and feet. Fever is often present and quite high. The disease lasts a number of months; the patient often feels better for a time, then relapses into a more serious condition than before.

TREATMENT OF THE VARIOUS FORMS OF ANEMIA

Simple Anemia.--Find the cause and stop it. In infancy special attention should be given to diet and hygiene, giving the child plenty of fresh air, and a change of air to the country or seash.o.r.e if necessary. The general treatment is more important than any benefit that may be derived from drugs. The rules laid down in the articles on "Malnutrition" must be closely followed in these children.

Chlorosis.--In this form of anemia, or poor blood, it is best to give iron. Change of air and change of scene are of special importance in these cases and will frequently cure. The general condition of course must not be overlooked. The diet, exercise, bowels, habits, should receive careful attention. Iron should be continued for a number of months after all traces of the anemia have disappeared.