ACACIA DRESSING.—This constitutes another fixed dressing that is readily ap plied and which may be used on dry parts. A good formula is the follow ing:— IP Mucilage of acacia, 5 or C parts. Glycerin, 1 part.
Zinc oxide or calamin, or a mixt ure of both, 2 parts.
Carbolic acid or any other drug may also be added if desired.
This is painted on with a brush or smeared over in a thin layer with the finger; it dries in a few minutes. If at all sticky or for further prevention against this, a dry powder of zinc oxide or talcum can be applied over it.
Another method of treating these cases 1-vhich can at times be employed with great benefit is by means of the so called salve- and plaster- mulls (made by Beiersdorf). These are variously medi cated. The mild salve-mulls and the moderately strong salve-mulls, and the moderate strength plaster-mulls are adapted for the subacute cases. While especially useful in some cases, occa sionally their action is not so satisfactory. Their disadvantage is their costliness.
In eczema of a chronic sluggish type strong applications must be usually made before a result is brought about. The different remedies and combinations referred to in speaking of the treatment of the subacute type may be first tried; later, when necessary, treatment may as sume a bolder character, various reme dies being used in stronger proportion. Of value in many of these cases may be mentioned—ointments of calomel, 40 to 80 grains to the ounce; white precipi tate of about the same strength; salicylic acid ointment, 20 to 60 grains to the ounce; resorcin, about the same propor tion; sulphur, 10 to 60 grains to the ounce (used at first with caution); tar ointment, either in official strength or somewhat weakened; or the liquor car bonis detergens, with simple cerate or as a wash, pure or diluted.
Zinc-oxide paste containing 1 to 2 per cent. of yellow oxide of mercury is recommended in the squamous or the milder grades of papular or vesicular eczema of children. L. Leistikow (Monats. f. prakt. Perm., Sept. 1, 1900).
Silver nitrate applied in the form of a 1-per-cent. solntion favorably affects eczema in all its forms. J. C. Dunn Pled. :News, Sept. 29, 1900).
An ointment of 20 to 40 grains of pyrogailic acid to the ounce may be cautiously tried in obstinate cases. The same may be said with regard to chrysa robin; but this latter should not be used about the face. The various fixed dress ings referred to in the treatment of the subacute variety will also be of value in the chronic type. Collodion may also be used as a basis for fixed dressing, in local ized areas of disease. The stronger salve and plaster- mulls and the medicated rubber plasters, the latter especially in the sclerous and verrueous forms, are also of distinct advantage in these cases; in sluggish, thickened areas repeated shampooing with green soap and hot water, rinsing off, and immediately fol lowed by a mild ointment applied as a plaster acts admirably in some instances. Painting such areas with solutions of caustic potash. 1- to 5-per-cent. strength, allowing to act for a few minutes, then rinsing off and applying a mild ointment is a somewhat similar inethod of treat ment which is serviceable at times. In some obstinate eases thoroughly stirring the skin with a strong remedy, insti tuting a substitutive inflammation, and then applying mild remedies will not in frequently bring about the desired result.
Superficial scarification of patches of eczema employed in certain selected cases. The patches are scarified in par allel lines, one to oue and ft half milli metres apart, in one direction only, by a very pointed instrument pehetrating to the superficial layer of the dermis. These areas are then encouraged to bleed and bathed with boiled water, and then covered with tarlatan dipped in boiled water. On reaching home cold potato starch poultices are applied until the next treatment—generally three or four days later. Before beginning the treat ment the patches are prepared by the ap plication of continuous cold plain starch poultices. Six to sixteen treatments suffice for a cure. A reaction is set up in the patches, but no scars result. This treatment is to be used only in special cases characterized by isolated disks in limited number. Jacquet (Bull. Ca. de Th6rap., Jan., '98).