Symptoms
At first, impetigo appears as a small fluid-filled vesicle usually around the nose or lips. The infection can spread to other parts of the face and occassionaly other parts ofthe body by the child’s irresistable urge to scratch, and also due to presence of bacteria in large numbers. The vesicle rapidly crusts over, forming a yellowish scab which can be easily knocked-off , leaving a raw, weeping surface.

Causes
Impetigo is caused by staphylococci and occassionally by streptococci germs. The organism can spread quickly , particularly among children, causing an outbreak of the disease. Impetigo may also occur as a secondary phenomenon in atopic eczema, scabies and head-louse infestation.
The real cause of the disease, however is constitutional, resulting from malnutrition due to wrong and unhygenic habits of living. It is easily passed from the affected child to other children, who are in a similar state of toxicity and impaired vitality, through contact.

Treatment
Early and adequate treatment of the first small patch of impetigo can prevent the spread of the disease. The childpatient should be kept isolated until the condition is cleared up, so as to prevent the spread of infection. He should be prevented from scratching the scabs. He should have his own sponge and towel. No other member of the familiy should use these articles. They should be changed frequently and washed seperately. The use of harsh detergent should be avoided . Clothes should be thoroughly rinsed.
The treatment of impetigo is essentially constitutional and it should consist of proper diet, correct hygeine and fresh air. The best way to commence the treatment is to place the patient on an all-fruit diet for two or three days. In this regimen, he should be given fresh juicy fruits such as orange, apple, pineapple, grapes, pear, peach and papaya. In case of older children, however, it would be advisable to commence the treatment by placing him on a diet of orange juice and water for about three days. This may be followed by an all-fruit diet for further three days.
After the all-fruit diet, the patient may embark upon a well balanced diet consisting of milk, seeds, nuts and grains, vegetables and fruits. The emphasis should be on fresh fruits, raw salads, fresh milk and whole meal bread. The use of these foods is of utmost importance in the future dietary. The child-patient should avoid tea, coffee and all condiments and highly flavoured dishes as well as sugar, white flour products, denatured cereals and tinned or bottled foods.
It will be desirable to administer warm-water anema daily during the first few days of the treatment to cleanse the bowels. If constipation is habitual, all natural methods should be adopted for its eradication.
Certain home remedies have been found beneficial in the treatment of impetigo. The use of turnip ( salgum) is one such remedy. A few chopped turnip pieces after thorough cleaning should be immersed in rice starch (kangi) or any natural vinegar for about six hours. They should then be eaten by the patient.
Garlic is useful in relieving constant itching caused by this disease. This vegetable should be crushed and spread over irritated areas. One or two cloves of garlic should be chewed for better results.
Other helpful measures for treating this disease are sun and air baths, a daily dry friction ( as explaned in the Appendix), sponge and breathing and other light exercises.

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