Sarcoptida, 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 rubbed 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 scdbiei crustosa, 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 scdbiei 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. 



