in which the essence of this whole group of diseases consists. We uniformly succeed in eradicating such offensive and inveterate affec tions by the ordinary antipsoric remedies. As we have already treated of these constitutional blood dyscrasias and of numerous remedies adapted to each of them, it is only necessary here to refer to pages 261, 264, 272, and to present the claims of a few more which we regard as especially useful. Any constitutional treatment to be effectual and permanent must be continued for a considerable time.

Tartar-emetic.-Porrigo, eczema, and herpes are quite prone to attack the penis and scrotum; the itching and burning which they occasion are almost intolerable. One of our most efficient remedies in these cases is a high dilution of Tartar-emetic. It may often be succeeded or alternated with the 12th dilution of Croton-tiglium with much advantage. Administered at the first triturition it has often cured obstinate gleets with promptness. In this form, and by being given nightly for several weeks, it has in two cases cured seminal emissions, which had occurred as often as once in twenty-four hours for many months.

In one case of obstinate porrigo, affecting both hands, and accom panied by intense burning and itching, with acrid exudation on scratching or rubbing the parts, we prescribed the Tartar-emetic ointment externally, until its characteristic eruptions should be produced. Its appearance was accompanied with much pain, although more tolerable than the porrigo irritation. In about the usual period this antimonial eruption passed off, carrying with it all symptoms of porrigo, and leaving the hands cured.

Internally, it is appropriate for itching pustular eruptions upon the arms and hands. In such cases it sometimes proves promptly curative, after Sulphur, Hepar, &c., have failed. We employ it from the 6th to the 12th attenuation.

GENERAL SYMPTOMS.-Spasmodic movements and twitchings of the arms and hands; violent clonic spasms with loss of consciousness; lock-jaw; paralysis; relaxation of the muscles and great prostration; languor; exhaustion; collapse; loss of speech and coldness of the body. Cholera-morbus; contraction of the pupils. Strong, violent convulsions and spasms; tetanus; extreme restlessness and anxiety. Cold; pulseless; speechless. Thirst and burning sensation through the prima via. Prostration of strength; insensibility; faintness; prolonged trembling of the head and hands, at every movement, like para lytic trembling. Symptoms worse on being seated, or manifesting them selves in that position. Watery diarrhoea, with extremities cold, powerless, with cramps in the calves of the legs.

Porrigo Decalvans.-Dr. Carter, an army surgeon, says he has often succeeded in restoring the hair which had fallen out from the

abuse of Mercury, or from acute disease. He used five grains of Tartar-emetic to the ounce of distilled water.

Two cases of partial baldness were cured by Beauchamp. In one case the solution was too strong and brought out a crop of pustules on the head and the whole body, attended with fever. The fever soon subsided and the pustules disappeared, except on the head, where they coalesced and formed an immense scab, resembling tinea capitis.

Hahnemann mentions a variolous eruption on the chin, attended by itching, as a symptom of Tartar-emetic. Porrigo, eczema, and hepatic eruptions on the face are often relieved by the 6th dilution of Tartaremetic. It is sometimes successful in old hepatic eruptions of the face when employed in the form of a mild unguent.

Arsenicum.-Dr. Banks, of New-York, gives a case. A young man of high life in New-York had a horrible itching surrounding the anus, perineum, &c. Some parts dotted with papules entirely denuded with hair, and of a coppery color, resembling secondary syphilis. Arsenious-acid, one twentieth of a grain, three times a day internally; and unguent of Iodide, of Arsenic, tepid baths externally, moderate diet, exercise. In three weeks every trace of the disease was effaced.

2. Mycrosporon circumscripta.-This parasite differs from the preceding by "its numerous waved filaments and by the extremely small size of its sporules. It is not found in the interior of the root of the hair, but forms round each hair a small tube; the hair then becomes opaque, softens and breaks off. The hair rapidly falls off; the dermis is not congested, and the epidermis is thin and smooth.

3. Microsporon mentagrophyta.-Differs from the last by possessing larger spores and filaments. Its seat is between the bulb of the hair and the follicle in which the bulb is seated, and never extends beyond the surface of the skin. Treatment the same as already given.

4. Microsporon furfur.-Discovered by Eichstedt in 1846. It is the cryptogamic plant which forms with the epidermic scales, the yellowish brown scurf seen in pityriasis.

5. Achorion Schonleinii.-This is the mycodermatous fungus which constitutes the characteristic of TINEA FAVOSA, (porrigo favosa. This is an affection of the skin usually confined to the scalp, but occasionally found on the trunk, limbs, or face; almost invariably occurring before the seventeenth year, and peculiar in old countries and cities to the poorer classes.

Symptoms.-"Favus is an affection characterized by the presence of more or fewer crusts, which at first, are of a uniform sulphur-yellow color, having their superior surfaces slightly concave and pierced in the centre by a hair, and their edges slightly depressed beneath the level of the cuticle; they are surrounded by skin which, for some time previous to their appearing, presents a glazed red, and vascular look,

and is more or less covered with desquamated epidermic scales. The crusts, when isolated, have a more or less distinctly round or oval figure, and have in their upper surfaces a depression in form like that of a lupus seed (porrigo lupinosa); but where numerous and confluent, they acquire, from contact with one another a hexagonal or honey-comb appearance, and hence the term porrigo favosa. In the progress of development, the edges of the crusts become prominent, and marked by several concentric rings, whilst their upper surfaces gradually lose the concave and assume the convex form. In course of time, there is observed in the centre of each capsule a whitish spot, which slowly extends into the surrounding deeper yellow portion, and ultimately reaches the edges of the crusts, which gradually sink to the level of the skin, and frequently present numerous cracks or splits. There speedily commences in this central white portion a loss of coherency, or a process of crumbling down into a coarse gritty powder; and when this, in the progress of the disease, has extended to the edges, the capsules lose all definite form, and become broken or split up into numerous pieces presenting the appearance of one continuous crust, irregularly fissured on the surface. The diseased mass crumbles down, and communicates to the fingers, on trituration, a feeling, compared by some to that caused by the crushing of dried putty; becomes a favorite site for vermin and their eggs, and exhales a peculiar odor which has been likened to that of mice. For some time the disease occasions little uneasiness; but ere long the part affected becomes the seat of a disagreeable itching, which gradually increasing, at length becomes so intolerable that the patient cannot resist incessantly scratching and tearing at the diseased mass, the consequence of all which is, that in cases of some standing, we usually meet with more or less sanguineous or serous effusion, with secondary pustular eruptions, and at times with violent inflammation, which in a few cases terminates in suppuraration, and in other instances in unhealthy ulceration."

Pathology-When a recently-formed favus crust is carefully examined, it is found to consist of a capsule of epidermic scales, coated in the interior with a granular matter, constituting a soil on which arise multitudes of a peculiar fungus, named by Gruby in 1841, achorion Schanleinii, in honor of Schoenlein, of Berlin, its discoverer. From the granular mass sprout numerous cylindrical tubes (thalli), which extend themselves towards the centre of the crust, and, branching dichotomously, contain at their extremities (mycelia) numerous spherical or oval bodies termed sporidia. The thalli frequently contain numerous molecules or granules, and are most numerous near the exterior of the crust; whilst the mycelia and sporules, mingled with more or less granular matter, abound at the centre, the whitish color of which has been ascribed to the aggregation of the sporules. In course of time

the thalli and sporules enter the hair-follicles, cause atrophy of the hair-bulbs, and consequently the baldness observed in the subjects of favus, and, as may be witnessed under the microscope, at times extend into the body of the hair. "The sporules are the bodies from which the plant is developed; and from the observations of Remak and others, it appears that, in the process of elimination, their investing membrane gives off shoots or prolongations which ultimately become tubes, enclosing at their extremities sporules, which in time are pressed out and become free."

Dr. Pirrie says, that from the observations he has made on this disease he has reached the conclusion, "that the peculiar matter of favus is an exudation on the surface of the derma; that this exudation becomes the seat of peculiar phytaceous growths, which in the progress of development, penetrate the epidermis and become encysted by its scales; and the hair-follicles are not the seat of the disease, but only become secondarily affected."

Chemical Composition.—In analyzing the matter of favus, Thenard found in 100 parts-albumen, 70; gelatine, 17; phosphate of lime, 5; water, 3; and loss, 5 parts.

Cause.-Extensive examinations of the works of authors who have written on this disease reveal only the extent of the discrepancies of opinion that exist among medical men on its nature and origin. While it is shown to be contagious in many cases it does not appear to be always so. The opinion given by Dr. Pirrie is most nearly in accordance with the philosophy of our school, and is thus given: "The impression produced in my mind by the histories and symptoms of the cases that have come under my notice is, that the fungus, although it occasions a certain amount of irritation, is not the sole or the original cause of the eruption, but a mere accidental growth upon a congenial soil formed of an exudation, which is itself a mere local manifestation of a peculiar constitutional state; in short, that the disease is owing to a blood dyscrasia; that from the blood is formed an exudation which is essential to the existence of the fungus; and that, until this peculiar matter be exuded, sporules of the plant applied to the integument must remain inert and undeveloped." Among all the experiments to produce the disease by inoculation, in no instance yet reported was the attempt successful, till, from irritation caused by prolonged close application of the favus matter, either redness, pain, suppuration, or some other sign of the inflammatory process, had manifested itself." Erichsen says the essential nature of the disease consists in the deposition of the matter of tubercle. Erasmus Wilson thinks that "defective nutrition is the real cause of the disease. Bennett considers favus to be "essentially a form of abnormal nutrition with exudation of a matter analogous to, if not identical with that of tubercle, which

VOL. II.-55

constitutes a soil for the germination of cryptogamous plants, the presence of which is pathognomonic of the disease. Hence is explained the frequency of its occurrence in scrofulous persons, and amongst cachectic and ill-fed children."

Dr. Pirrie gives the following summary of his views of favus:

1. That it is essentially characterized by the presence of fungus, which is easily discovered by the microscope.

2. That it is peculiar to the young, and confined chiefly to the poor. 3. That it is most commonly met with in the scalp, but occasionally on other parts of the body.

4. That the hair follicles are only secondarily affected.

5. That it is by no means a rare disease in Scotland, being exceed ingly common in Edinburgh, and having been more so for several years past in Aberdeen than in Glasgow.

6. That it is considered more common in Ireland than in England. 7. That it is a blood disorder, and that the fungus is not the sole nor the original cause of the eruption.

8. That many are insusceptible to it; and that it is feebly contagious, and very often arises independent of contagion.

9. That the previous state of health has an important bearing on its outbreak.

10. That it is intimately connected with the strumous diathesis. 11. That want of cleanliness strongly predisposes to it.

12. That for its removal, general as well as local treatment is necessary."

TREATMENT OF PORRIGO AND ECZEMA.-Rhus-tox., Arsenicum, Croton-tig., Sepia, Stibium, Sulphur, Hepar-sulph., Petroleum, Mezereum, Apis-mel., Kali-hyd., Calcarea-carb., Mercurius-hyd. Occurring in gouty or rheumatic subjects, Rhus and Kali, in the higher attenuations, are especially indicated.

When a psoric taint is suspected, Sulphur, Calcarea, and Hepar, in the higher dilutions, will be required.

Cases connected with secondary syphilis, will demand Mercuriushyd., Mezereum, and Kali-hyd. in the lower potencies.

The local treatment recommended by Robin, Bazin, &c., as given above, might be to some extent useful if our common treatment after a reasonable trial shall be found to need auxiliaries, which they will perhaps never do when they are intelligently used.

VESICULAR VARIETIES.-1. HERPES.-TETTER.

DIAGNOSIS.-The eruption consists of groups of small vesicles, situated upon red and inflamed bases, and separated from each other by sound portions of skin. As the vesicles increase in size, the color