hemiplegia, and shaking palsy," in all of which allopathists have long employed mercurials.

4. Crusta Serpiginosa.-This form resembles crusta lactea, but is marked by the appearance of small vesicles behind the ears, which burst, forming a thin, dark-colored scab, from which an acrid fluid is secreted. The face, neck, arms and trunk, eventually become involved. For the cure of this form Schroen advises Sulphur, Clematiserecta, Calcarea-carb., Lycopodium and Arsenicum.

Causes. By many the disease is supposed to be owing to the presence in the skin of minute animalculæ of the species acarus scabiei. It has likewise been attributed to want of cleanliness, and the use of unwholesome food. The remedies should be given in the first or second attenuation, and repeated two or three times a day until the eruption disappears. In recent cases, Hartmann, Schroen, and Schmid, employ the tinctures and the first dilutions; but in obstinate cases they employ from the third to the sixth attenuations.

ACNE,

Is another pustular affection, making its appearance generally upon the nose, face, forehead, and shoulders, first in the form of a thickening redness and induration of the integuments, from which eventually proceed suppurating points or tubercles. The parts affected often acquire a depth of redness and a conspicuousness which much annoy the patient. Plumbe supposes that the malady consists in a diseased condition of the sebaceous follicles, induced by excessive indulgence in the pleasures of the table, sedentary habits, &c. Sometimes it is violent, and extensive inflammation and suppuration occur. Acne consists of hard inflamed tubercular tumors of the face, neck, shoulders, or upper part of the thorax, most common in young persons, suppurating slowly or subsiding after a few days. In the simplest form it begins with small, hard and inflamed tubercles of the size of a pin's head, reaching their greatest size in eight days. They are then darkred, smooth, prominent, shining, hard and painful; in two or three days more a small speck on the apices of some of them, shows the termination in suppuration; a thin humor flows from the surface, dries, and is gradually removed.

A second variety has the tubercular pustules larger, more indurated and permanent. They are numerous, conical or oblong in form; sometimes rose-colored; some suppurate at their apices; others remain hard and elevated, giving the name of " stone pock." Acne simplex is generally connected with some derangement of the general health, occurring most commonly in females, who suffer from menstrual irregularities, especially dysmenorrhoea.

ACNE ROSACEA.-Rosy Drop, Carbuncled Face,-Commonly begins at the end of the nose, and spreads from its sides to the cheeks, covering only a part of them. It consists of small tubercles which suppurate slowly, exhibiting a shining redness and an irregular, granulated appearance of the skin. At first it is pale in the morning, and becomes intensely red from excitement. The cuticle is gradually thickened, and its surface diversified by cutaneous veins, which become varicose and suppurate. Acne rosacea occurs later in life than the former species, and is often caused by the intemperate use of stimulating drinks. In the worst cases the nose is enormously enlarged, the tubercles suppurate and form ulcers which are cured with great difficulty. Acne Punctata.-Crimones.-Maggot Pimple.-A number of black points, surrounded by a very slightly elevated border of cuticle. It proceeds from concreted sebaceous matter accumulated in the follicular glands, and may be squeezed out of these glands or their ducts. They sometimes inflame and form smail tubercles which suppurate partially. Acne Syphilitica.- Venereal Acne. Only caused by the constitutional influence of secondary syphilis. It resembles the acnea rosacea, appearing on the forehead, face, neck, and upper part of the trunk. The vari are round, conical, inflamed, with a copper-colored tubercular base and areola.

TREATMENT.-Acne in intemperate persons: Nux-vom., Ledum,

Sulphur.

Acne Rosacea: Causticum, Rhus, Sepia, Carb.-.animalis.

Acne Punctata: Bell., Ilepar, Natrum, Nitric-ac., Sulph., Sepia. Sepia operates especially on the portal system, retarding the circulation and causing an overloading of the vascular system with venous blood. A plethora venosu gives rise to most of the symptoms of Sepia. (Meyer.) It is appropriate in all cases where this pathological state causes pustular eruptions, complicated with derangements of the digestive and uterine organs.

Hydriodate of Potash.-Acne punctata in young females, pimples thickly strewn over the face, especially the vicinity of the alæ of the nose: two grain doses repeated three times a day. A well-marked case improved in ten days. Cures entirely in seven weeks. (Banks, N. A. Jour. Homœop., 1857, Aug.)

Mercurius-corrosivus.-This remedy, which has so long been employed in the syphilitic form of acne, as well as in obstinate cases of other skin diseases, is much more successful in homoeopathic practice. In the third trituration, repeated every four or six hours for some weeks, some obstinate cases have been cured. In many others due attention to the digestive and uterine functions have been sufficient.

Belladonna.-Acne in young persons, with uterine derangements, dysmenorrhoea, and determinations to the head.

Carbo-vegetabilis-The pustules itching, suppurating, with burning pain, in lymphatic temperaments. Hepar-Sulph., Sulphur, in psoric cases.

Rhus.-radicans.-Red-inflamed tuberculoid elevations on the skin.

PAPULAR VARIETIES.-1. LICHEN.

DIAGNOSIS. Many kinds of this malady are described by writers, although the general character of the eruption is in all instances the samc. Willan gives us seven different forms; and other authors describe even a greater number. But the propriety of these minute sub-divisions is very questionable, since some slight distinctions might be made in almost all cases which occur; and thus lead to a very extensive and inconvenient classification.

The eruption consists of numerous small papillæ upon the breast, arms, and limbs, in the first instance, which afterwards spread over the whole surface of the body, attended with a tingling, and itching, especially when exposed to heat, or when covered up warmly in bed. The eruption is generally preceded by slight febrile excitement, and symptoms of gastric or intestinal disorder. The basis of the papillæ are red, inflamed, and painful, but they do not often suppurate, or become filled with serum, but continue about eight or nine days, when they dry up, and fall off in the form of scurf.

The eruption which is so often seen in infants during the period of dentition, and known as "the red gum," is a form of lichen. In these cases the color of the papillæ may be red or white.

Sometimes the eruption appears in the palms of the hands, the arms and legs, when it receives the vulgar appellation of "Salt-rheum."

The eruption now and then comes out in a mild form upon the trunk or extremities, attended with heat, and troublesome itching on becoming heated, or from rubbing or scratching, but entirely unattended by febrile excitement. This variety is familiarly known under the designation of prickly heat.

CAUSES.-Irritation of the stomach and intestines from errors in diet, worms, and teething. Also protracted exposure to a hot fire; going into the cold air after long exertion while in a profuse perspiration, or sometimes from entering a hot apartment after having been exposed for a long time to intense cold.

TREATMENT.-The following medicines will suffice to cure all forms of this complaint: Sulphur, Graphites, Calcarea-carb., Sepia, Iodine, Antimonium-tart., Copaiba-bals., Acid.-phos., Chamomilla, Dulcamara, Rhus-tox., Hepar-sulphur.

ADMINISTRATION.-Same as for eczema.

2. HERPES CIRCINATUS.-RINGWORM.

A common affection of children. It consists of an eruption of small circular rings of red spots, the skin within the ring having a natural appearance at first; but, subsequently, it becomes rough, of a reddish hue, and scales off as the eruption dies away. It generally appears on the face, neck, arms and shoulders, generally disappearing of itself after two or three weeks' duration, though it often lasts much longer.

TREATMENT.-Sepia.-A dose or two of this remedy will generally remove the disease. When it fails, the alternate use of Rhus-tox. and Sulphur, every four or five days, will cure all common cases.

Calcarea, Causticum, and Sulphur may succeed in more obstinate

cases.

Ring-worm of the Scalp.-This is supposed to be a contagious disease. It affects the hair, though temporally; it never produces permanent baldness. It resists ordinary remedies with great obstinacy.

DIAGNOSIS.-Characterized by patches, more or less circular, varying in size, which when first discovered are not larger than a pea, but may extend so as to reach the diameter of two or three inches, and even more; they are covered with dry mealy desquamation, with the hair broken off at irregular distances from the surface. It may last four weeks or months. It is said to be very common in England, though rare in France. It seems more common now in America than formerly.

3. PRURIGO.

DIAGNOSIS.-Prurigo is believed by some authors to be a severe form of lichen. The papillæ are, however, larger, "more isolated and distinet, and scattered over larger surfaces" than those of that affection. The eruption is sometimes of a red, or pinkish color, at other times white, like the surrounding skin, and attended with the most intense itching and stinging. The papillæ are most commonly distributed about the labia pudendi; but the disease is not unfrequently observed in other parts of the body.

The causes and treatment are the same as those described under lichen.

4. PSORIASIS.

Mackintosh regards psoriasis as an aggravated form of lepra. According to Hall, it "differs from lepra chiefly in the irregular form, in the diffusion of the scaly patches, and in the absence of its inflamed borders, depressed centres, and regular oval or circular forms. The subjacent surface is also more tender, more easily denuded, and more

prone to become affected by fissures." The disease attacks the scalp, face, the arms, the legs, the palms of the hands, the lips, the prepuce and the scrotum. Occasionally the inflammatory action runs so high that the parts become much swollen and highly painful. In these cases there is usually a considerable secretion from the eruption.

5. PORRIGO.

This is a contagious disorder, and presents itself in the form of "straw-colored pustules, sometimes circumscribed, sometimes diffused; generally, but not always confined to the head; the pustules break and give issue to a fluid which concretes into yellowish or brownish thin, or thick, crusts or scabs." (Hall.) It commonly makes its appearance upon the scalp and face, but may occur in any other part of the body. The disease has been subdivided into several varieties, but the divisions are of no practical utility, and tend directly to create confusion and embarrassment. We restrict the term porrigo to the contagious form of the disease.

Characteristics-Scabs, peculiar in their shape and color, odor, process of formation, &c., producing permanent baldness.

Porrigo appears in two forms: 1. Porrigo Favosa.-Scabs or incrustations of a sulphur-yellow or bright-fawn color, when recent; scaly in their shape, hollowed out in their centre in the form of a cup; dry and almost pulverulent, firmly implanted in the epidermis, so that the depression is left when they are removed; so adherent as sometimes to remain for months and even for years; having a peculiar odor, which has been compared to the urine of a cat, or more properly to a place where mice have been. It is most often seen on children from seven to eight years of age. It is commonly on children of depressed physical and intellectual power. It never ceases spontaneously unless for want of material on which to act. It may last twenty years, resist ordinary remedies, and always producing permanent baldness of the the parts affected. No tendency to periodical returns.

Causes. Contagion; imperfect nutrition and other depressing agents. The history of porrigo involves that of other parasitic growths common on the skin, which demand consideration at some length. Treatment. (See Eczema.)

PARASITIC VEGETABLES ON THE HUMAN SKIN.

Ten varieties are enumerated as growing on the human skin.

I. Tinea tonderes or Tricophyton tonsurans.-First described by Gruby, in 1844, as accompanying the disease called rhizophyte. It exists in the hairs of herpes-tonsorans, and in plica-polonica. It con