568 THE ANIMAL PARASITES OF MAN 



after infection. The eczema due to scratching has by this time spread over 

 the entire body; the longer the disease lasts the more marked it becomes. 

 Aside from the irritation and the loss of sleep due to this, no further symptoms 

 arise. 



Spontaneous recovery does not result, but recovery from scabies in the 

 course of concurrent febrile diseases is noted as the consequence of the death 

 of the parasite. The ova, however, do not always die. Therefore, after recov- 

 ery from the disease, the itch frequently reappears. 



The DIAGNOSIS is easy. The location of the efflorescences is particularly 

 characteristic. We can hardly err in making a diagnosis of the itch when 

 a markedly itching cutaneous eruption is characterized by the presence of 

 isolated nodules, particularly upon the anterior surface of the trunk and ex- 

 tremities, of small vesicles upon the fingers and interdigital folds, in the palm 

 of the hand and on the sole of the foot, with pustules upon the fingers, espe- 

 cially in young people, in whom eczema shows itself chiefly in those areas 

 between the nipple and the knees for which the parasite shows a preference. 

 The diagnosis becomes certain by the discovery of the acarus grooves, or of 

 the parasite itself. In all doubtful cases microscopic investigation is necessary. 



Prurigo and scabies are often confounded. Leaving out of consideration 

 the time and place of development of the first prurigo efflorescences, prurigo 

 differs essentially by the localization of the eruption. This is found chiefly 

 upon the lower extremities, especially upon the extensor surfaces of the trunk, 

 but never upon the flexor surfaces of the joints. 



After scabies has been recognized in an individual, it is wise to examine 

 carefully all other members of the family, and to treat simultaneously all 

 who are affected. ■ The aim is to "kill the parasite and heal the eczema. In 

 former times, when the parasitic nature of the itch was not yet understood, 

 the disease was looked upon as almost incurable; we can to-day rapidly cure 

 the affection by a number of remedies such as sulphur, tar, naphthol, balsam 

 of Peru, styrax, petroleum, etc. 



It is sufficient to mention a few among the great number of prescriptions : 



]9 Florum sulphuris, ) _. 



Oleifagi, f^^ 20.0 



Saponis viridis, 



Axungise porcins, ^ '^^ ^^■'^ 



Cretse albae 15.0 



or ^ Styracis liquidi, ) _. 



Florum sulphuris, j ^^ ^O-O 



Saponis viridis. . , 40.0 



Vaselini, ) 



Cretis alb^e, _ \ ^^ 10-0 



or -^ /3-Naphtholi, ) .. 



Cretaealbffl, P*" 10.0 



Saponis viridis 50.0 



Axungise porcinae 100.0 



