GRANULOMA INGUINALE 469 



GRANULOMA INGUINALE. 



Serpiginous ulceration of the genitalia is widely spread in its dis- 

 tribution. It is a chronic vascular granuloma, probably of protozoal 

 origin, attacking the external genitals of both sexes, and spreading to 

 tile inguinal region and perina?um. It does not tend to suppurate 

 or caseate. 



The condition is painful, disfiguring, contagious, and exceedingly 

 difficult to cure. It may by becoming oedematous simulate elephan- 

 tiasis in its early stages. It occurs between puberty and 45 years of 

 age. The general health is but slightly affected. Scarring may lead 

 to ultimate healing. 



TREATMENT. 



Radiotherapy has been found effective. 

 Excision and scraping in later stages are helpful. 

 Neosalvarsan has its advocates. Tartar emetic may be useful. 

 Iodides in large doses can be tried. 



GRAIN ITCH. 



An itching eruption of weals and vesicles, some of- which become 

 pustules, affecting the neck, chest, abdomen and back, found in work- 

 men who handle new straw mattresses which are infected with the 

 Pediculoides ventricosus. The hands, strangely enough, nearly 

 always escape. 



TREATMENT. 



1^ Beta-naphthol 30 grains 



Sulphur prsecip. ... ... ... 40 ,, 



Adipis benzoat. ... ... ... i ounce 



HAIR AFFECTIONS. 



These are caused as a result of : — 



(A) Inflammation wuth subsequent atrophy of the hair follicle, 

 leading to increase or decrease of the hair pigment, atrophy, 

 and total destruction of the hair. 



(B) Concretions formed on the hair shaft. 



(C) Parasitic diseases such as ringworm. These are dealt with in 

 another place. 



(1) Alopecia. 



This condition is usuallv due to one of the following causes : — 

 A senile change which is sometimes congenital, at other times 

 syphilitic (second stage). 



A febrile or any other general disease interfering with 

 nutrition. 

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