( Originally Published 1927 )
Introduction.—Nature has devised no more wonderful and evenly balanced machine than the human body, yet in spite of all care and precaution, certain weaknesses may become apparent at some time during life. Some have a weak digestive apparatus or weak organs of breathing, while in others the skin is the weak link. This may not be discovered until some opportunity for the testing of the strength of the skin presents itself. The summer with its warmth and sunshine, with its allurement for the wide open spaces, its invitation to get close to its beautiful creations, its flowers, its clinging vines and foliage presents one form of opportunity for testing the resistance of the skin. Who can wander about the woods and parks or sit beside bubbling streams and abstain from touching the beautiful foliage? However, this joy may prove a double-edged sword, if the skin has little or no power to withstand the irritants or poisons within the sap of the leaves or foliage and an inflammation and irritation of that particular part of the skin may result. The extent of the damage to the skin depends upon the type of poison, the condition of the skin and the degree of its weakness. Fortunately, comparatively few succumb to this form of irritation. Those who have suffered from previous attacks and realize their susceptibility, regard the summer almost like a nightmare and every blade of grass, every leaf, a dread. In the vast majority of instances, direct contact with the poisonous material is essential, yet some may be affected through the touch of insects and flies, previously in contact with the sap of these poisonous plants.
Causes: There are many plants which may injure the skin of those highly susceptible, but the most common of the eastern border is the poison ivy plant. The same diseased condition may result from contact with the poison oak, poison dogwood, and flowering primrose seen in homes during the Easter and Christmas holidays, or from handling Mah Jong sets, in the manufacture of which a lacquer obtained from a species of ivy is used.
Description.—After the poisonous substance is deposited on the skin, it works its way underneath the bard, horny cells and as soon as the skin realizes the presence of this foreign material, it at once resents it. Nature sends its first line of defense to the seat of the trouble in the shape of an in-creased amount of blood, so that the affected part becomes red, swollen, and hot. As this does not suffice, the antiseptic fluid of the blood (the serum) rushes out of the blood vessels to overcome the poison. The fluid finally finds its way into the deepest part of the epidermis (the topmost layer of the skin), where it enters into certain canal-like spaces. As these cells reach the top of the skin, the fluid collection contained within the spaces also appears in the shape of small blister-like elevations. It is, indeed, a tribute to the vigilance of the defensive forces of the body that every effort is made to limit the extent of the irritation. Therefore, as a rule, poison ivy most often affects the hands, and the blister-like elevations are most frequently seen on the areas which have been in most intimate con-tact with the leaves. This gives us a most valuable sign for the recognition of this form of inflammation, as the blisters most often form in linelike streaks. While the poisonous material remains on the skin, it may be carried to distant parts of the skin surface by the hands, etc. Therefore, in this condition, the face, the area about the privates, and even other parts of the body may be involved. An attack of ivy poison may last from one to four weeks. It is needless to state that in this affection the patient suffers from itching and burning, often rather intense.
Suggestions for Prevention.—Those who have knowledge of their susceptibility to ivy poison may ward off an attack by following these suggestions, within an hour or so after exposure. A bath should be taken in hot water, using a highly alkaline soap, special attention being paid to the parts exposed. This is to be followed by application of alcohol and finally by a bland oil such as olive oil. It is also advisable to change the clothing. It is now possible, through the use of certain injections, to fortify (desensitize) against poison ivy so that those susceptible cannot readily acquire this disease.
Once the eruption appears, one of a number of applications will be found useful, especially if the attack be mild. The preparations which may be tried are lead water and laudanum or a solution of bicarbonate of soda. Boric acid solution will be found a grateful application if the area about the eyes happens to be affected. Where this condition does not respond quickly to treatment or spreads rapidly, a physician should be called.