The occurrence of "spots" is generally viewed by the average mother with considerable consternation. "Spots" may or may not be of serious importance. They may indicate merely some slight error in diet. They may be due to some infectious skin ailment, or they may be the diagnostic feature of such a fever as scarlatina or measles. Every mother ought to know something of the causes of rashes in childhood. She should try to understand the meaning of skin eruptions, and should be able to distinguish between the commonest of these. The skin of the healthy child should be smooth, clear, and free from spots and blemishes. Such a skin indicates that the blood is healthy and of the right quality. The spotty skin, even when no definite rash is present, means generally some error in health management in the nursery.
The child's face should never be washed with soap at all; soft water will remove the dirt quite easily without soap, and for the body only soap of very good quality should be used. In the case of a sensitive child a rough undergarment, especially if it is at all tight, will often cause excessive irritation to the skin, and even friction with a rough towel will cause irritation. Sweat rash is the popular name given to an eruption of tiny, watery pimples which appear in young children about the neck and head when they are clothed too warmly in warm weather. Proper ventilation, careful washing and drying afterwards dusting with powder) are necessary. one of the commonest causes of skin rashes in the nursery is some error in diet.
Nettlerash, or Urticaria, appears suddenly in the form of little weals, which irritate intensely and appear in groups. This affection is almost invariably due to dietetic mistakes, such as giving the child shellfish or unripe fruit to eat. A simple attack of nettlerash may be the only result, but sometimes there is vomiting and diar-rhoea as well. The rash looks exactly as if the child had been stung with a nettle until its appearance is altered by scratching. As a general rule, the rash fades in two or three days, but by systematic errors in diet it may last quite a long time.
The best reatment is to give an aperient to clear away the poisonous matters in the digestive organs. It is the absorption of these in the intestinal canal and their circulation in the blood which causes the irritation to the skin. A dose of castor oil, cascara, or syrup of figs should be given, and the itching may be allayed by a lotion of bicarbonate of soda. Half a teaspoon-ful of the soda may be dissolved in a pint of water, and applied with a sponge. Another useful lotion is-creolin in the strength of a teaspoonful to a half-pint of water, used in the same way.
Erythema, Sunburn, or redness of the skin is a simple inflammation due to the direct action of the sun upon a sensitive skin. The best treatment is boracic ointment applied at bed-time, and when inflammation is severe the parts should be bathed with calamine lotion, which any chemist will supply. Erythema may be caused by strong soaps or the friction of rough under-garments.
Eczema is a very common skin disease in the nursery. It may be the result of irritation, and in a sense is a further stage of erythema. It often appears in infancy or during the first two years of life. The forehead, scalp, and thighs are the commonest situations. Eczema begins with redness, then tiny blisters form, which break and produce the characteristic discharge or "weeping" of eczema. The discharge may dry up, forming crusts.
In treatment it is most important to remove all sources of irritation. The parts are never to be washed with soap and water, but cleansed with a little sweet oil. Zinc ointment is an excellent preparation to use after bathing the part with bicarbonate of soda as mentioned above. In severe cases a doctor should always be consulted, as eczema is very difficult to get rid of if neglected.
Itch, or Scabies, is a skin irritation due to a minute insect which burrows in the skin. It chiefly affects the hands and feet. The eruption in the case of young children will affect the health, and eczema will follow upon scabies from scratching. The parts must be thoroughly washed with hot water and coal-tar soap. The best plan is to immerse the child in a warm bath for some time, and, after drying, an ointment consisting of balsam of Peru and vaseline, in the strength of a drachm of the balsam to an ounce of vaseline, should be well rubbed into the part. This must be used at night, and in the morning the ointment should be washed off with a warm bath. Absolute cleanliness with regard to clothing must be observed, as the condition is very infectious.
Fever Rashes. It is necessary for a mother to know something of the appearance of the commonest fever rashes which may occur in the nursery. In the first place, if a mother can recognise the rash of measles or scarlet fever she will procure medical attendance at once, and thus improve the child's chances of a speedy recovery.
The early diagnosis of these conditions will guard the health of the other children, because prompt isolation can be ensured. Scarlet fever and measles are, perhaps, the commonest fever rashes, and it is most important that they should be recognised. Searlet fever may be of a very mild description, with the rash, perhaps, as the only characteristic feature. These cases are just as infections as the more severe attacks, and a mother should always beware of any red rash which is of a scarlet fever description. Many cases are known of children having a red rash which has hardly been observed in the nursery until the typical "peeling" begins, by which time the infection has probably spread to others.
The rash of scarlet fever is made up of minute red points, whieh generally appear in one or perhaps two days after the beginning of sickness, headache, and sore throat. The red points intend to run together until a uniform red rash may be all over the body. As the rash fades, peeling or desquamation appears, and the skin comes off in shreds for perhaps a few weeks. In scarlet fever the face, body, legs are all affected. In measles, on the other hand, the rash is not scarlet, but rather a dull mottling on the forehead, which gradually spreads downward over the body. The rash cosists of crescent patches of a dull red colour, and the face may seem considerably swollen. Such a rash is associated with signs of an ordinary cold in the head.
When a rash appears in the nursery it should have immediate attention. The mother who manages her children thoughtfully sees the skin of the body once a day, either in the morning or at night. Thus a rash is not allowed to pass unnoticed At its first appearance it is observed, and if at all suspicious a doctor should be called in. The first thing a mother should say to herself is, "What is the cause of this rash Is it due to improper feeding, to insect stings, to the irritation of rough clothes, or soap If to errors in diet, the food of the child must immediately be altered, and an aperient given. In simple cases simple remedies may be applied by the mother. Calamine lotion is always a safe and soothing application. Zinc ointment and boracic ointment are the best things to use in the nursery for skin blemishes. Unless immediate improvement follows a doctor should be consulted. If the child seems "ill," and such symptoms as headache, sickness„or fever appear, no time should be lost in calling in a medical man.