Eczema is a disease of the skin which first appears either as minute blisters, pimples, or small elevations covering pus; these three forms may more conveniently be designated the vesicular, papular, or pustular. The first is the more common form, and the vesicles are minute, transparent, and glistening; slightly elevated, and pressed together in irregular patches with little or no redness between. The fluid in the vesicles soon becomes gummy and cloudy; it may be absorbed but is more commonly discharged; adheres to the surface, dries rapidly, and forms crusts beneath which is the beginning of the disease.

The skin becomes reddened, moist, and swollen. Successive crops of vesicles form, the discharge from which is a constant source of inflammation, and the disease spreads showing different stages in different parts. The progress of the pustules is identical with that of the vesicles.

When the disease appears in the form of papules, they either change into vesicles and run the course described, or they dry into scales and crusts.

Eczema rubrum, eczema squamosum, and other terms are used to designate certain forms of the disease belonging to the subsequent stages. In the first the skin is reddened and inflamed in patches covered with shining vesicles; in the latter the eruption is dry and scaly.

Pityriasis rubra is a form of eczema rarely met with. It is characterized by a skin reddened in large patches, and covered with branny crusts or scales, which if removed the skin will be found dry and reddened, but not bleeding. This disease usually attacks the whole surface of the body, and is distinguished by its obstinacy and tendency to recur.

Eczema simplex is the term used to designate the mildest form of the disease yielding more readily to treatment. Kumberiess subdivisions have been made by authors who have chosen terms to designate different varieties ot eczema having more or less perfectly marked stages, but they merely represent the different forms of the diseaso in various situations and subjected to dissimilar influences.

Eczema may be acute or chronic; the latter form is far more frequent and may attack every portion of the body, while the former may be confined to certain locations. All forms of the disease are accompanied with intolerable itching.

Causation

Eczemas are in part primary diseases and in part symptomatic The primary result from immediate irritation of the skin, as caused by acrid medicated applications in ointments, etc., by extremes of temperature, and by mechanical injuries affecting the skin directly. Croton oil, strong mercurial ointments, alkaline soaps, iodine, etc., when applied are frequent causes of eczema. Mechanical causes are illustrated by the irritation of the skin produced by the nails in scratching; eczema accompanying parasitic diseases is generated in this way. Prolonged, very hot baths are sufficient in some cases to induce the disease under consideration.

The symptomatic causes are not so apparent; we know that attacks of eczema occur in consequence of certain internal diseases, but their analogy has never been positively determined. Among the symptomatic causes are indigestion, injudicious feeding, want of exercise, and impoverished blood.

Eczema frequently appears as a sequel to long exhaustive illnesses, and is very often associated with liver derangements. In highly nervous temperaments there seems to exist a predisposition to eczema, and " inbreeding" has been condemned as a possible cause. That the disease is hereditary as asserted by some has never been clearly proven. That want of cleanliness might possibly induce the affection can be readily appreciated. An excess of animal food is another cause assigned, but further proof is necessary before this can be accepted as indisputable. The feeding of starchy food in excess induces disturbances of the nutritive functions, and eczema frequently results.

Worms by intestinal irritation and other influences on the system might give rise to the affection. Puppies during the period of dentition sometimes suffer eczematous attacks. Many other causes have been assigned, and many cases occur, the origin of which it is impossible to explain.

Eczema is not contagious, but in certain stages when the secretion is profuse, the disease can be communicated by actual contact of a sufficient duration. To be more explicit a healthy dog might be allowed to play with one affected with eczema, and be many times in momentary contact without acquiring the disease; but were they allowed to occupy the same sleeping-box, and the healthy skin of one remain sufficiently long in contact with the diseased skin of the other, from which there exuded a profuse secretion, through this secretion the disease could be transmitted and the previously healthy animal become eczematous.

Prognosis

Eczema is a curable disease. An animal once attacked is liable to be again affected. In longhaired dogs the disease will prove more rebellions and difficult to core. In pityriasis rubra, certain degenerative changes occur in the skin, rendering a cure of that form of the disease exceedingly difficult.

Treatment

While the internal treatment of eczema is positively essential in very many cases, it must not be employed indiscriminately, but only after a diagnosis of the disease associated is determined beyond a reasonable doubt. The connection with diseases of the internal organs may not be clear at first, but careful study will ultimately develop a clue sufficient to direct internal medication; until then it were wiser to depend entirely upon external remedies.

When eczema first appears especially in puppies, considerable fever is associated and a laxative is indicated. It were better to increase the activity of the bowels by divided doses rather than administer purges. Epsom salts or calcined magnesia are to be preferred; the dose of the former, two teaspoonfuls, of the latter, one teaspoonful, once or twice daily until the fever subsides, after which they are to be given cautiously if at all, as intestinal derangement and debility will result from their prolonged use.

In rare instances eases will be met with in which a feverish condition exists for a long time, the animal being full blooded and of inflammable tendency. In such cases a restricted diet and the use of laxatives is indicated; to obviate depression iron should be combined as in the following -

℞ Magnesiae Sulphatis ℥i.

Ferri Sulphatis ℥ i.

Acid. Sulph. Aromatici ℥ ss Aquae ℥ viss.

Ft. Mist. Big. One teaspoonful three times daily.

When dogs are reduced nutrition must be improved, and the most generous diet be allowed into which meat largely enters, and it may be given cooked or raw. If the loss of weight is very marked, cod liver oil in tablespoonful doses should be added to each feeding.

In cases of debility an iron tonic is indicated, and if the skin eruption has existed for sometime, Fowler's solution of arsenic may be combined as follows -

℞ Ferri et Ammon. cit. ℥ i Sol. Fowleri ℥ ij.

Ft Mist. Big. Four drops three times daily with the food. Very many cases will be met with where this preparation of iron and arsenic, also cod liver oil, should be given at the same time. Frequently loss of appetite is a prominent symptom which demands especial treatment first, and before other internal remedies can be employed.

In such cases quinine in two grain doses four times a day should be given, and the animal urged to eat raw beef, milk, beef teas, etc., and if partaken of sparingly he should be tempted with food every few hours.

When gastric derangements exist, they should be treated as advised in indigestion.

One cause of eczema which the writer does not recall having seen mentioned, and which he desires to dwell upon, is to be found in torpor of the liver and other hepatic derangements. Cases have been observed by him which have proved obstinate, and remedy after remedy has been used without success until treatment was especially directed to the liver, and then improvement immediately followed. When a sluggish action of this organ is suspected, it would be well to discontinue other internal remedies and give the following -

℞ Mass. Hydrarg. gr.iv Pulv. Ipecac. gr.i.

Ext. Taraxaci ℥ ss Ft. Pil. No. xij. Sig. Dose one three times daily.

After these pills are taken, the treatment previously employed can again be instituted. The importance of regularly enforced and sufficient exercise in plethoric, overfed animals, cannot be too strongly insisted upon.

In fact every abuse must be corrected, and every influence tending to improve the general health of the animal should be encouraged.

While the internal treatment is important, the local is no less so, and in very many cases of even greater importance. In no known disease which the canine race is heir to, has a larger number of remedies and methods been advised than for the treatment of eczema, and much harm has been done by the injudicious and indiscriminate use of irritating applications in the acute form, while much time has been lost by using the wrong application, and neglecting to employ a proper and valuable remedy.

To carefully study each case is imperative; not alone to know its causes and complications, but the stage of the eruption is of great importance, for be it remembered, remedies which are valuable in the ohronio stage are not only pernicious in the acute form but do much to intensify the disease, and invite its extension over the entire body, when had judicious treatment been instituted at first, and far simpler remedies and methods been properly applied, the eruption would have remained a mere localized patch, have been of but little consequence, and immediately recovered from.