Sarcoptidce, or Itch Mites 
77 
great that the general health of the individual is seriously affected. 
Now that the true cause of the disease is known, it is easily con¬ 
trolled. 
Treatment usually consists in softening the skin by friction with 
soap and warm water, followed by a warm bath, and then applying 
some substance to kill the mites. Stiles gives the following direc¬ 
tions, modified from Bourguignon’s, as “a rather radical guide, to 
be modified according to facilities and according to the delicacy of the 
skin or condition of the patient”: 
i. The patient, stripped naked, is energetically rubbed all over 
(except the head) for twenty minutes, with green soap and warm 
water. 2. He is then placed in a warm bath for thirty minutes, 
during which time the rubbing is continued. 3. The parasiticide 
is next nibbed in for twenty minutes and is allowed to remain on the 
body for four or five hours; in the meantime the patient’s clothes are 
sterilized, to kill the eggs or mites attached to them. 4. A final 
bath is taken to remove the parasiticide. 
The parasiticide usually relied on is the officinal sulphur ointment 
of the United States pharmacopoeia. When infestation is severe it 
is necessary to repeat treatment after three or four days in order 
to kill mites which have hatched from the eggs. 
The above treatment is too severe for some individuals and may, 
of itself, produce a troublesome dermatitis. We have seen cases 
where the treatment was persisted in and aggravated the condi¬ 
tion because it was supposed to be due to the parasite. For deli¬ 
cate-skinned patients the use of balsam of Peru is very satisfac¬ 
tory, and usually causes no irritation whatever. Of course, sources 
of reinfection should be carefully guarded against. 
Sarcoptes scabiei crustosce, which is a distinct variety, if not species, 
of the human itch mite, is the cause of so-called Norwegian itch. 
This disease is very contagious, and is much more resistant than the 
ordinary scabies. Unlike the latter, it may occur on the face and 
scalp. 
Sarcoptes scabiei not only attacks man but also occurs on a large 
number of mammals. Many species, based on choice of host, and 
minute differences in size and secondary characters, have been 
established, but most students of the subject relegate these to 
varietal rank. Many of them readily attack man, but they have 
become sufficiently adapted to their normal host so that they are 
usually less persistent on man. 
