488 DISEASES OF THE SKIN. 



of tar and green soap (aa f j), in alcohol ( f ij), to the pure tar or the 

 tar-ointment. If, from the first, there has only been a moderate degree 

 of infiltration of the cutis, we may begin with two or three daily applica- 

 tions of the above solution immediately after the bathing and removal of 

 the scales ; and we shall nearly always effect our object in two or three 

 weeks by this means. Similar results, of which, however, I have no 

 personal experience, may be obtained by the use of ointment of iodide 

 of mercury or of sulphur and iodide of sulphur. For a time, Hebra 

 used to recommend the application of a concentrated solution of sul- 

 phuret of lime, in psoriasis (Vleminckx's solution). (IjL sulphur, 

 oitrini Bbij, calcis vivae fi>j, to be boiled in three gallons of water down 

 to a gallon and a half; the liquid to be filtered when cool.) Hebra 

 orders the solution to be rubbed vigorously into each diseased spot, 

 upon a bit of flannel, until all the scales have come off and the papillae 

 are exposed. He then puts the patient in a warm bath, where he is 

 to remain for an hour. After the bath, the diseased spots are to be 

 rubbed with any unctuous substance (such as cod-liver oil) or else with 

 tar-ointment or ointment of chrysophanic acid. 



The above plan of treatment is adapted for psoriasis in its more 

 severe and extensive forms. Pencilling the affected spot with a solu- 

 tion of corrosive sublimate (hyd. chlor. corrosiv. 3 j ; alcohol f j) is 

 an excellent way of treating slighter efflorescences of the disease. Such 

 pencillings have the advantage of being much simpler, but they cause 

 such severe pain that they cannot well be used where the eruption is 

 at all extensive. 



Although the quickest and surest way of treating psoriasis is by 

 making topical applications, yet it cannot be denied that the same 

 object will be attained by the internal exhibition of arsenic. In view 

 of this, as well as of the fact that the treatment just described is quite 

 unable to prevent relapses, and bearing in mind the well-known harm- 

 lessness of treatment by arsenic, if carefully conducted, I hold it to be 

 ioctrinary and incompatible with the interests of the patient to adopt 

 one or other method of cure exclusively, and not to combine the two. 

 Arsenic is usually given in the form of Fowler's solution. At first, six 

 drops are to be taken daily ; and the dose is to be increased one drop 

 every fifth day, until it amounts to about thirty drops. Veiel uses the 

 " Asiatic pills " almost exclusively, because he can regulate the dose 

 much better when the arsenic is in this form than when it is in the 

 form of drops. He dissolves white arsenic in boiling water, mixes it 

 with bread and pepper, and makes it into pills, each of which contains 

 the thirtieth of a grain of arsenic. Of these, at first, he gives three 

 daily, gradually raising the dose to eight or nine pills daily (that is, to 

 a quarter of a grain of arsenic per diem). As soon as any sense of 



