ECZEMA. 295 
This should be used twice daily. 
Eczema that has existed for several weeks and become chronic requires 
somewhat different treatment than it did in the early stages, because of the 
changed conditions. Inflammation persists, but it is scarcely so active and 
severe. Scabs, crusts or scales continually form, fall off, and are renewed ; 
fissures or cracks occur in the skin; the disease spreads and appears in dif- 
ferent stages in different parts; the skin, still tender, is thickened, dry, and 
hard; the hair falls out; and the itching continues, although it may not be 
quite as intolerable as at the beginning. 
The first indication is to uncover the skin so that the remedies may reach 
it, and to that end the crusts must be softened and removed. 
For this purpose fresh lard, whale, linseed, olive, or cod-liver oil, or vaselin 
may generally be used. Or if the crusts are very hard and horny, a five per 
cent solution of salicylic acid in castor-oil should be applied. 
The remedy chosen for removing the crusts must be vigorously rubbed in 
several times daily, in generous quantities, that they may soften and crumble. 
Twenty-four hours at least, and possibly several days, will be required to 
render them easily detachable. When so, there should be a thorough washing 
with soap and hot water. As to the kind of soap to be chosen, it may be 
carbolic, sulphur or glycerin, if the skin is yet tender and sensitive. If, how- 
ever, it is thick, dry, and hard, and there is not much active inflammation, the 
green soap kept on sale in drug stores, tar soap, or even the soft soap of the 
kitchen, may be employed; and strong soaps are best always if the skin is 
much thickened, for they help remove the morbid products that caused the 
thickening. 
After the crusts are off and the surface is clean, a good application is lin- 
seed-oil if the affected parts are kept well lubricated with it. That failing to 
effect a gain, a mixture of the oil of cade and olive-oil, in equal parts, should 
be tried. 
Another application which very generally acts well is the following: 
Tar, one ounce ; powdered sulphur, one ounce ; green soap and lard, of each 
two ounces. 
This should be freely and vigorously applied twice daily unless it increases 
the inflammation. In which event it should be thoroughly washed off, and 
for a few days some such simple ointment as sulphur and lard, vaselin, or the 
oxide of zinc ointment, employed; after which it should be again tried. Or 
instead of the simple ointments advised some preparation of lead might be used ; 
and one of the most serviceable is made by mixing diachylon plaster with lin- 
seed-oil, in equal parts. This may be applied freely several times daily. 
Itching is quite sure to continue, more or less severe, throughout every 
attack of eczema, until a cure is complete; but it may be expected to subside 
somewhat as improvement occurs. If after the crusts have been removed it 
