Skin Diseases Caused By Pus Germs
( Originally Published 1927 )
Before describing the common skin conditions caused by pus germs, it would not be amiss to discuss, in brief, the characteristics and the mode of action of these germs. If food, air, or water, for instance, were examined with the aid of the micro-scope, myriads of minute bodies would be seen. These are known as germs or bacteria. They be. long to the vegetable kingdom, are about one-millionth of an inch in length, and possess living properties, for they reproduce just as we human beings, but only in a different manner. Many of these germs are harmless (nonpathogenic), few are harmful (pathogenic), and, considering their enormous numbers, it is really surprising how comparatively few really endanger the human body. The harm germs cause is due to a poison which they manufacture, which may be locked up within the germ or set free.
Now what are pus germs? They are bacteria which produce a certain fluid material called pus.
But how is pus formed? In order to understand this wonderful phenomenon of nature, it is necessary to review the mechanism of the human defense against disease. Normally, the defense of the body resides in the blood. Blood is composed of a liquid portion called "serum" and of solid material termed "corpuscles." The latter are of two varieties, the red and the white corpuscles. The white corpuscles and the serum form the crux of the human defense. When germs invade the body, the white corpuscles are drawn, as if by some magnetic force, to the seat of trouble. They give battle to the germs surrounding them, close in on them and destroy some, but during the struggle, a number of the white cells also succumb. The serum also assists and, occasionally, a few red cells are also present. The fatalities of this combat which include destroyed white cells, dead bacteria, some serum and at times a few red cells, create a material known as pus.
But not all disease-producing germs form pus. The varieties capable of causing pus are two in number: the staphylococci, which resemble bunches of grapes when studied under the microscope, and the streptococci, which occur in chains when similarly studied.
Having laid this groundwork, our attention will now be centered upon those common skin conditions caused by pus-producing germs. They are impetigo contagiosa, ecthyma, barber's itch (sycosis vulgaris), boils (furuncles), carbuncles, and abscesses.
Impetigo contagiosa. — Description. — The eruptions of impetigo contagiosa illustrate the wonderful efficiency of the protective mechanisms of the human body. The pus germs responsible for this condition are rather virulent, yet, almost as soon as they invade the skin, their activity is greatly curtailed.
After passing the horny protective part, the first line of defense, the germs travel to the living part of the epidermis and as soon as their presence is recognized, the defensive aids of the body concentrate for the battle. The first link in this chain of events is an overfilling of the blood vessels in the true skin. But, as the antiseptic portion of the blood (the serum) leaves the blood vessels almost at once, the affected skin shows little or no redness or swelling. The serum soon overflows the invaded part of the epidermis and finally collects into certain spaces formed between the cells. These cells and their spaces filled with serum arrive at the skin surface at one and the same time, and when this occurs, blister-like elevations are present (on the surface of the skin). Their top covering is of necessity thin, they are flat, and the color of the contained fluid is clear and usually water-like.
The combat in the epidermis does not cease, for now the struggle is carried on by the defensive white cells which enter the seat of battle. During the next twenty-four hours, the tide of the struggle goes forth and back, and while some of the white cells are killed, practically all the germs have been overcome and this victory is signalized by the presence of a new material, pus, which, added to the contents of the blisters, gives that fluid a yellowish color.
In a few days the material within the blisters dries, and crusts with peculiar characteristics form. They are of straw color, thin, with the center attached while the rim is curled up, so that part of the area remains uncovered. As healing takes place, the crusts drop off and reddish spots remain which disappear in the course of a few days. The duration of this affection is usually from one to three weeks.
As a rule only such parts as the face, neck, and hands are affected, although the virus may be spread to other regions.
Contagiousness and Transmissibility.—The early recognition of this affliction is most urgent because of the ease with which this virus may be spread to other parts of the body, as well as to other innocent persons. Impetigo contagiosa is very common among children and is far from rare among grown-ups. Adults often contract this disease in the barber shop, the infection residing in the strop and carried by the razor to the skin.
Cause.—Pus germs, either the staphylococci or the streptococci, are responsible for this condition.
Suggestions for Treatment.—This affection should be treated as early as possible by a specialist, so as to minimize the risk of spread as well as of transmission to others. It is important to impress upon the patient that touching the eruptions with the fingers is the surest way of spreading the disease. This is especially true if the blisters are broken and the fingers come in direct contact with the pus. No soap or water should be used on the involved parts until healed, but the skin may be cleansed with boric acid solution, using a separate sterilized wash cloth. Shaving is not permitted during the active period of the disease, but the hair of the beard may be clipped with scissors.
Ecthyma.—Description.—Ecthyma is another disease caused by pus germs, but the resistance to their progress is so lessened that they succeed in entering the true skin before being overcome. The eruption consists of small elevations with surrounding redness and swelling and with the formation of pus. How different is this picture from that of impetigo contagiosa? In this affection the defensive substances are not rushed out to the seat of trouble, but on the contrary await the oncoming enemy. We, therefore, witness a redness and swelling, due to the overfilling of the blood vessels in the true skin, an elevation caused by the cells accumulated for defense, and the formation of pus, indicative of the casualties suffered by the germs and the white defensive cells. In time, the pus escapes and forms rather thick, yellowish or brownish crusts. But in ecthyma the presence of the crusts does not mean that the battle is at an end, for the surviving germs continue their destruction and pus accumulates in the deeper parts. When healing takes place, the crusts drop off and some scarring of the skin usually remains. This disease is found, as a rule, on the legs and thighs.
Cause and Contagion.—This affection is but slightly contagious since the virulent pus is not on the surface. It usually attacks grown-ups rather than children. The behavior of these pus germs furnishes the clew, that this condition could probably never happen unless favored by either body weakness, improper food, lack of cleanliness, etc.
Suggestions for Treatment.—The condition re-quires the services of a physician.