ECZEMA. 



4T7 



venient to apply than pure tar, or than tar-ointment, and is much 

 easier to remove from the skin. The solution is to be rubbed in once 

 a day until the brown coat which forms, instead of being quickly de- 

 tached, adheres for several days, and until the skin ceases to look red 

 after the brown coat has been shed. As long as the tar-crusts con- 

 tinue to shed rapidly, leaving a reddened surface beneath them, the 

 disease is not extinct. Although the external application of tar is 

 generally borne without inconvenience, yet in some patients the first 

 inunction occasions such an intense irritation of the skin as to render 

 further prosecution of the treatment impracticable. It is still more 

 common for the continued use of tar over a large extent of surface to 

 be followed by violent irritation of the intestine and kidneys, accom- 

 panied by vomiting, diarrhoea, the discharge of a blackish-looking 

 urine having a distinct odor of tar, which becomes still plainer upon 

 the addition of one or two drops of sulphuric acid ; these symptoms 

 being accompanied by fever and distress in the head, thus necessitat- 

 ing an immediate suspension of the treatment. Not only is the appli- 

 cation of soft soap or of tar inadmissible in some cases of eczema, but 

 there are also examples in which, although the remedies are well 

 borne, they do not produce the desired effect. It is in these instances 

 that the cauterization of the part, with a concentrated solution of 

 caustic potash, is indicated (potassae caustic. 3 j, aquse 3 ij). The 

 cauterization is not to be repeated oftener than once a week. A swab 

 of charpie dipped in the solution is rapidly to be passed over the dis- 

 eased surface, which is immediately to be covered with cold com- 

 presses, in order to allay the intense pain which the application al- 

 ways occasions. Even the most inveterate cases of eczema usually 

 recover after five or six repetitions of the cautery. 



Since local applications will merely rid the patient of his eruption, 

 but will not insure him against its return, the question finally arises, 

 whether we should limit ourselves to an exclusively local treatment, or 

 whether the topical applications should be combined with a general 

 internal medication, even when there is no evidence of scrofula or of ra- 

 chitis, and when the disease is not a consequence of chronic dyspepsia or 

 menstrual derangement, ffebra pronounces decidedly against such 

 practice. Veiel, on the other hand, who attaches quite as much im- 

 portance to local treatment as Jlebra does, combines it with laxative 

 tisans and with iodide of potassium in increasing doses, even when 

 there is no perceptible constitutional taint. The success obtained at 

 VeieVs institution is very brilliant ; and moreover, it being a private es- 

 tablishment, to which most of the inmates return if they have a relapse, 

 its superintendent has the opportunity of taking note of the ultimate 

 fate of his patients. 



