154 An Introduction to Medical Mycology 



When the hands are affected, it is important to keep them from frequent 

 immersion in water. The use of cotton and rubber gloves may protect them 

 to some degree. Improvement in hygiene may be helpful in preventing 

 the development of lesions. Multivitamin supplement to the diet is indi- 

 cated. We have not had much success with low caloric diets. Most of our 

 patients did not wish to reduce their weight. 



Hopkins noted that a patient with generalized cutaneous moniliasis 

 and with involvement of the gastrointestinal tract improved while on 

 a diet free from bread, cereals, potatoes and other starchy vegetables and 

 with the use of dextrose instead of cane sugar. Magnesium carbonate and 

 calcium carbonate were given in large doses. 



(2) Local treatment with gentian violet.— Churchman first introduced 

 this substance as effective in the treatment of infections caused by gram- 

 positive organisms. Gomez-Vega noted that the growth of organisms of 

 the genera Monilia and Torula, when tested in vitro, was inhibited in 

 dilutions of 1:1,000,000 of gentian and methyl violet. Cornbleet found 

 gentian violet more effective when followed by an application of Gram's 

 solution of iodine. W 7 e subscribe to the opinion of many observers that a 

 1 per cent aqueous solution of gentian violet is probably the best single 

 topical remedy against Monilia infections of the skin. It may also be used 

 in the treatment of oral thrush. We have used it with success in supposi- 

 tories (2 gr. |0.13 Gm.] to each) in the treatment of monilial vaginitis and 

 pruritus ani due to M. albicans. The chemical may also be incorporated 

 in zinc paste. Sutton has written a comprehensive article on the uses of 

 gentian violet in dermatology. 



(S) Local treatment with other applications.— Many other advocated 

 local remedies are useful in certain instances. Wet dressings are almost 

 always well tolerated and are often an acceptable means of beginning 

 treatment. A solution of 1:2,000 potassium permanganate or a 1:5,000 

 solution of perchloride of mercury applied for a few days in continuous 

 wet dressings to areas of local infection often brings about considerable 

 clinical improvement. Sodium perborate as a mouthwash and a 1 per 

 cent solution of silver nitrate in nitrous ether have proved of value in 

 many instances of monilial intertrigo. Ormsby recommended chrysarobin 

 in strengths of 5 to 10 per cent, tincture of iodine or an ointment con- 

 taining salicylic and benzoic acids. Mercurial preparations, such as am- 

 moniated mercury ointment (3 to 10 per cent), are more effective against 

 moniliasis than against ringworm infections. Soothing applications, such 

 as zinc oxide lotion or wet compresses of boric acid, are sometimes neces- 

 sary when acute inflammation is present. 



(4) Roentgen therapy.— Roentgen raws are useful in the treatment of 



