On the, Treatment of Psoriasis and Lepra Vulgaris. By M. Emery.
M. Emery states, that when appointed to the St. Louis, several years
ago, he tried all the various remedies so warmly recommended by
authors, and of all these arsenic proved the best internal medicine • but
besides the inconvenience which it sometimes gave rise to, its operation
was very slow. The external use of strong tar ointment (3 to J of tar)
produces, in fact, a far more rapid cure than any other means. Of from
1500 to 1800 patients who have employed it, five sixths have been
rapidly cured, and that without any ill consequence, or any greater
frequency of relapse than after internal means. In 228 cases of psoriasis,
the arsenic and tar were used conjointly, and 200 were cured within
two months. Of all the preparations of mercury, the protiodide is alone
efficacious (g ); but it excites much irritation of the skin, and if applied
to large surfaces, produces salivation. The iodide of sulphur is
useful in psoriasis of the head; but if applied to large surfaces pro-
duces erysipelas. The conjoined use of the arsenic and tar-ointment
constitutes, in fact, the best medication. In a disease so apt to recur,
the greatest attention to diet is essential; and on the least symptom
of recurrence, resort should be had to medicine, without waiting until
it has become very bad. Before commencing, the patient takes a
bath, and rubs in the ointment with gentle friction three times a day.
In two or three days the strength of the ointment and activity of the
friction are increased; and when the disease is of old standing, linen
rags smeared with the ointment are to be kept applied. A tepid bath
is taken once or twice a week. It is only in very irritable skins that
the treatment is interrupted by the appearance of impetiginous pustules
or furunculi. In about ten days we perceive, where the squamae have
fallen, a whitish circle circumscribing the patches, and extending from
the circumference towards the centre. This is a sign of a decrease of
the disease, which usually disappears in two or three months. With
respect to the arsenic, we should begin with five drops of Fowler’s solu-
tion, in four ounces of sugared water, which are to be divided into two
doses. Every other day the dose is to be increased a drop, until twelve
are reached. If we observe that the patches are becoming thinner, and
acquiring a blackish-gray colour, this is a sign of saturation, and the
dose is not to be increased ; but even when this is not present, it is
rarely proper to go beyond twelve or fifteen drops. Sometimes the
skin becomes hot and painful around the patches ; but this is relieved
by tepid lotions, demulcent drinks, and diminution of the dose. After
twelve or fifteen drops are reached, a feeling of constriction of the throat,
or severe pain of the stomach, is perceived ; and then the medicine should
be suspended for a day or two, and recommenced de novo with the small
dose. Pain near the heart, with palpitation, sometimes renders vene-
section requisite. If any contraction of the extensors of the limb is
observed, the medicine must be at once abandoned ; and as soon as the
blackish-gray colour of the patches appears, which announces saturation
and an approaching cure (though such spots may remain for months,)
the arsenic must be discontinued.—London J\led. Gaz. from Comptes
Rendus.