DEFINITION.– Large vesicle, or small blebs, distinct from each other ( not confluent as in Eczema), occurring in patches on different parts of the body, having an inflamed base, and containing fluid– at first clear, then milky, afterwards quickly disappearing,– and ultimately shriveling, leaving scabs, or being ruptured, then dry up into light-brownish scabs.
VARIETIES.– H. zoster or zona, commonly called Shingles– derives its name from its manner of encircling one-half of the body. It is an acute disease, lasting from fourteen to twenty days, and follows the course of one or more of the cutaneous nerves, generally stopping short in the middle, and has the appearance of a line of patches, like a belt half round the body. It generally affects the trunk, chiefly on the right side, but occasionally the face, shoulder, abdomen, or upper part of the thigh. Ordinary, simple Herpes frequently appears on the lips of persons suffering from pneumonia, Intermittent Fever, Ephemera, and epidemic Cerebro-spinal Meningitis, and often in the course of a common cold. It is most common in the young, particularly during change of weather, and is often preceded by neuralgic pains, the eruption following in the same locality. In some rare cases, ulceration may supervene; there may be much pain, smarting, or burning; and the scars may remain for same time, Herpes zoster is due to an irritation of one of the ganglia of the spinal nerves, and it is preceded, accompanied, and often followed by agonising neuralgic pains. Zona is much dreaded, and uninstructed nurses foolishly state that if the patches extend round the body death is certain to result. There is, however, no danger unless the patient be very old and feeble. it has been found recently that it is in some way connected with exposure to cases chicken pox.
GENERAL SYMPTOMS.– In addition to what is stated above, there is often a feeling of malaise– feverishness, Headache, shivering– and, perhaps, neuralgic pain in the inside, which may be very acute, especially in Shingles. The disease is mostly accompanied by sensation of heat, tension, and burning, felt even before the appearance of the eruption, and is followed by weakness and depression. When in the disease occurs in the aged, or in persons of feeble constitution, there is much debility, and Ulceration may arise, further debilitating the patient.
CAUSE.– Irritation of the nerves– as when Catarrh affects the air passages, and Herpes is developed on the nose or lips; or during the course of other diseases.
EPITOME OF TREATMENT.–
1. Earliest symptoms– Acon .( with neuralgia consequent on anxiety, etc.,).
2. DEVELOPED HERPES — Rhus ( in all simple cases); Sulph. ( to follow Rhus if necessary); Ars; (neuralgia and in debilitated constitutions); Phyto., Graph.( ulcerating conditions and in old persons); Phos. (tubercular patients); Tellur., Phos., Sep. (Herpes circinnatus)
3. Pleurodynia.– Ran., Bulb.
4. Additional remedies.– Mang., Staph., Cist., Nat.-Mur., Comocladia, Mezer.
ACCESSORY MEASURES.– The daily bath; plenty of out-of-door exercise; and the “Accessory Measures” suggested in Section 91. Locally the patches must be protected by cotton-wool and starch powder. An alcohol compress relieves pain sometimes.