476 DISEASES OP THE SKIN. 



two or three times a day, or, what is preferable, apply it upon linen 

 compresses). In very extensive eczema accompanied by great itching, 

 especially in eczema universale, the shower-bath is strongly to be rec- 

 ommended. Some patients are quite unable to tolerate the irritating 

 remedies to be mentioned presently. Hebra directs the shower-bath 

 to be used two or three times a day for ten or fifteen minutes at a 

 time in a warm room. By this means the most obstinate eczemas, 

 which have defied all previous treatment, are often made to heal, but 

 only after a somewhat persistent employment of the shower. A suit- 

 able apparatus may be made at little cost. In partial eczema, which 

 does not tolerate irritating remedies well, cold compresses may be 

 substituted for the cold douche, especially in recent cases. When the 

 eczema is of very long standing, and particularly when the disease has 

 extended from the surface into the substance of the true skin, and the 

 more difficult it is to pinch up the skin in a fold, so much the more 

 often shall we be compelled to resort to that class of remedies which, from 

 the vigorous alterative action which they exert upon the skin, play 

 an important part in the therapeutics of nearly all inveterate cutaneous 

 affections. Experience teaches that of this class the preparations of 

 sulphur are the least adapted to the treatment of eczema, that it is 

 only in exceptional instances that they do good (as in eczema mar- 

 ginatum, according to Hebra), and that in most cases they actually do 

 harm. On the other hand, " green soap," tar, and caustic potash, are 

 of the utmost benefit in old cases of eczema accompanied by infiltra- 

 tion of the corium ; hence we shall briefly relate Hebrcfs directions for 

 their employment. The green soap must either be rubbed once or 

 twice daily into the affected surface, or else a piece of flannel is to be 

 smeared with the soap and laid upon the sore spot. This application 

 is also to be renewed once or twice daily, and the procedure should be 

 continued for from three to six days. It must then be discontinued ; 

 but the soap which has been rubbed in ought not to be removed. Af- 

 ter three days more the patient is to take a bath, when there must 

 be a pause in the treatment. This course is to be repeated until 

 all the infiltration has disappeared, and until the transudation has 

 ceased. At this stage, when a previously moist eruption has changed 

 into a dry scaly one, Hebra directs applications of tar to be substi- 

 tuted for the soft soap. Of the various kinds of tar Hebra prefers the 

 birch-tar (oleum rusci) and the oil of cade, prepared from the wood of 

 the Juniperus oxycedrus, as having a less offensive smell than the com- 

 mon pine-tar, or oleum empyreumaticum coniferum (pix liquida). In- 

 stead of pure tar, or tar-ointment, I for years have used a solution of 

 tar in alcohol (picis liquid., alcohol, aa, or else picis liq., sapon. virid., aa 

 3 ss, alcohol f j) ; for it answers every purpose, is much more con 



