BROMIDROSIS 



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less. Sulphur is occasionally given by us in cachets (3 grains) 

 three times daily after meals. 



In localized hyperidrosis the treatment varies according to the 

 parts being non-excoriated or excoriated. In patients not present- 

 ing excoriations, naphthol or salicylic or formalin-alcoholic lotions 

 (i per cent.), followed by a salicylic, boric, or tannoform powder, 

 are very useful. If there are excoriations or inflammatory signs, 

 no alcoholic lotions should be used, but merely water solutions of 

 boric acid (2 per cent.), carbolic (i per cent.), permanganate of 

 potassium (i in 4,000), and occasionally hydrogen perchloride 

 (i in 2,000 to I in 4,000), after which a salicylic or boric powder 

 is applied. It should be always remembered to sprinkle with the 

 same powder the socks, shoes, and undergarments. 



BROMIDROSIS. 



This term is used to denote offensive sweating. 



etiology. — The bad odour seems to be due to the growth of 

 various bacteria, as observed by Thin, and is due not only to the 

 sweat, but also, and probably in a higher degree, to the sebaceous 

 secretion. The condition is very common in native races — negroes, 

 Indians, and Chinamen ; most natives seem to have it to some 

 extent, in fact. On the other hand, however, it is to be noted that 

 certain natives state that they can detect in almost every European 

 a special, disagreeable odour. Certain authorities are of opinion 

 that each race has a recognizable different odour. 



Symptomatology. — As a rule, when the sweat has an offensive 

 odour, there is also hyperidrosis, but in certain cases the quantity 

 of sweat is not more than usual. The condition is usually localized, 

 occasionally general. The situation of bromidrosis is, in order of 

 frequency, the feet, the axillary regions, the perineum, and genital 

 organs. When the condition affects the feet — the commonest 

 localization — 'the odour is most offensive, and has been compared 

 to that of putrid cheese. When it affects the axillary regions, the 

 odour is offensive, but as a rule is of a different character. 



Symptomatic bromidrosis has been described in pinta, in certain cases 

 of Madura foot, in acanthosis nigricans, after eating certain foods, etc. 



In contrast to bromidrosis, cases have been described of certain individuals 

 having a pleasing smelling sweat, with the odour of violets or musk. There 

 is a tradition that certain saints exhaled a pleasant odour. 



Prognosis. — Except in those cases when the bad smell is due to 

 accumulated dirt — -when a thorough washing with carbolic soap 

 will cure the condition — bromidrosis is not of easy cure, but the 

 bad smell may be hidden in various ways. 



Treatment. — This is the same as for hyperidrosis, but formahn 

 lotions (J to 3 per cent.), alcoholic or watery, are especially useful, 

 Lysoform (2 to 5 per cent.) is efficacious. Afterwards a powder 

 such as ac. salicyl. gr. X., talci ^i., or ac. borici 3i-. talci §i., should 

 be used, and some boric acid should be sprinkled in the socks and 



