770 INTERNAL SECRETIONS AND PRESERVATION OF LIFE. 



entire removal of fevers contracted in Algeria and Senegal and 

 which had previously resisted means of various kinds, including 

 quinine and change of climate." Indeed, when we consider the 

 large number of diseases in which arsenic is now recommended, 

 Boudin's reference to a "multitude" of diseases finds its veri- 

 fication. As a prophylactic its value has been extolled by C. F. 

 Bryan in various affections, including scarlatina. 



Directly connected with our views is the fact that arsenic, 

 so extensively employed in skin diseases, is, as stated by Shoe- 

 maker, 102 "valuable in proportion to the absence of irritation 

 or acute inflammation." It is obvious that a peripheral in- 

 flammatory process, in the light of our views, means the pres- 

 ence of the protective elements indeed, an excessive propor- 

 tion of them in the cutaneous tissues. In the so-called chronic 

 processes, on the contrary, some of which recall, by the dryness 

 of the skin, the same condition in myxcedema, cretinism, etc., 

 the main pathogenic features are the absence of these pro- 

 tective elements and the lowered nutrition which this normally 

 involves. Hence the value of arsenic in cutaneous diseases in 

 which desquamation, dryness, etc., prevail: i.e., psoriasis, the 

 dry form of eczema, impetigo, etc. The connection of the 

 curative process with the adrenal system is well shown by the 

 results obtained by Byrom Bramwell 103 in psoriasis with thy- 

 roid extract. Arsenic, as observed by Gautier (see page 156), 

 seems to be a normal constituent of various structures, and, we 

 have seen, is able to counteract the untoward effects of iodine. 

 If the experience of Boudin, Bryan, and others, which illus- 

 trates the value of arsenic in a large number of diseases, is 

 added to that of dermatologists as regards the pre-eminent 

 value of this remedy in cutaneous diseases in which nutrition 

 of the skin is impaired, the whole being traceable, as shown 

 by BramwelFs cases, to the adrenal system, the far-reaching 

 value of arsenic as an immunizing agent seems self-evident. 



Of considerable interest in this connection is the stress 

 laid by C. E. Illingworth 104 upon the use of the biniodide of 



102 Shoemaker: "Materia Medica and Therapeutics," fifth edition, 1901. 

 * Byrom Bramwell: "Atlas of Clinical Medicine," Plate LXI. 

 104 C. R. Illingworth: "The Abortive Treatment of Specific Febrile Dis- 

 orders by the Biniodide of Mercury," London, 1888. 



