Reprinted from the Journal of Cutaneous and Genito-Urinary Diseases 
for March, 1896.] 
A NEW METHOD IN THE LOCAL TREATMENT OF ACNE. 
By JAMES NEYINS HYDE, M. D., 
Chicago. 
IK several of the forms of acne the local treatment most speedily 
effective is that first suggested by my friend Dr. George Henry 
Fox, of New York city. He employs a ring curette, of the kind 
chiefly used by the gynaecologists, and with this instrument the come- 
dones and pustules of the face displaying the lesions of acne are 
raked away in a debris of pus, blood, sebaceous secretion, and epi- 
thelium, with a resulting benefit in many cases which seems well-nigh 
proportioned to the severity of the pre-existing symptoms. 
I have employed this instrument for several years with marked 
advantage in selected cases; but there are distinct objections to its 
use. These are, first, the painful character of the operation, often a 
matter of some moment in the case of a young woman with a specially 
sensitive face; second, a too frequent and unnecessary superficial 
wounding of the epidermis by the relatively sharp edge of the curette; 
third, the inapplicability of the treatment to certain forms of acne in 
which the inflammatory products are subepidermie, or where the dis- 
ease occurs less in pustular type than with the development of indu- 
rated papules. 
It has occurred to me on several occasions, when making use of the 
curette, that its value lay fully as much in the degree of massage it 
produced in the skin of the face as in its action as a knife or as a 
scraper. 
Acting upon this suggestion, I lately devised a massering ball for 
use in the local treatment of acne which has in my hands produced 
satisfactory results. 
The instrument, figured in the appended cut, consists of a stout 
and short handle, constructed of hard rubber, and connected by means 
of a slender steel neck with a ball set in a steel socket, the small 
sphere rotating within the cup of the latter, as in the ordinary ball- 
and-socket joint. The free play of the ball in this case is aided by its 
Copyright, 1896, by D. Appleton and Company. Original Communications. 
bearing upon a smaller ball set in the neck of the cup attached to the 
handle. This handle is fixed upon the socket at an angle sufficiently 
convenient for the operator, whose eye can thus better follow the play 
of the ball. 
The latter is constructed of hard rubber, and the area of its impact 
upon the skin at any moment is about that of the human thumb of 
average size similarly placed. When actually in use the ball travels 
with ease as well along the angles of the nares with the cheeks, the 
bridge and root of the nose, and the regions below the symphysis 
Dr. Hyde’s massering ball 
menti, as over the brow, the temples, the chin, and the cheeks. 
When necessary to cleanse it, the ball is detached by unscrewing; 
but the entire instrument may be boiled without damage to its use- 
fulness. 
When ready for treatment, the skin is first operated upon with 
disinfected needle and comedo-extractor (or “ comedo-presser,” as onr 
English brethren call it) until all pustules and subepidermic foci are 
emptied and conspicuous comedones removed. After this the surface 
is rendered aseptic, either with one of the bichloride lotions commonly 
employed, or, as I much prefer, with a solution of formalin (forty per 
cent of formic aldehyde) in the strength of from one half of one per 
cent, to two per cent., according to the sensitiveness of the patient’s 
face. The massering ball is then rotated freely over the surface, 
and deep pressure is made upon the affected region, with the result of 
bringing into view groups of previously inconspicuous comedones 
which are in turn removed by the extractor or “ presser.” Lastly, a 
massage of the surface is practiced with the ball by the aid of a 
salicylated cocoanut oil or one of the commonly employed sulphur 
unguents. 
All this naturally requires a little time and a modicum of skill, 
but it is not contended that the process here outlined is a routine 
method of treating acne in all stages, or even of treating all cases of 
acne at one stage in its career. The method is suggested as an aid to 
the management especially of indolent and intractable cases; though A New Method in the Loccd Treatment of Acne. 
I am led to believe that when properly employed it may have a 
value in others; and possibly also in other diseases of the skin of the 
face than acne. 
The Messrs. Tiemann & Co., who have been interested in carry 
ing out my suggestions in detail, purpose, they inform me, construct- 
ing an instrument with several balls attached to a single handle, for 
the purpose of producing effective massage over the general surface 
of the body, thus attacking a larger area with greater steadiness and 
to a greater depth. It is, however, for the local management of cases 
of acne that the instrument has been specially devised.