if the tongue is much coated and shows prominent papilla, the following is recommended:— 13, Sodium bicarb., 10 grains.
Ext. of cascara sagr. liq., 10 to 20 minims.
Tinct. of nux vomica, 7 to 10 Peppermint-water, enough to make 1 fluidounce.—:1I.
After this has been taken for a week or ten days, if there is any indication for iron, a pill of reduced iron of 2 or 3 grains may be given after dinner or oftener.
Constipation should be counteracted by gentle aperients. Any condition capable of maintaining the sympathetic system in a state of tension—such as genito-urinary troubles or affections of the nasal fossfe—should be eradicated if possible.
If the patient is lymphatic and has a good digestion, codliver-oil is of value.
Much benefit obtained from syrup of lactophosphate of calcium in acne, espe cially when lumps are large. A favorable and palatable mixture when codliver-oil is required is the following: 3 Gum arabic, 10 drachms.
Water, 1 ounce.
Syrup of lactophosphate of calcium. 3 ounces.
Codlivcr-oil, 4 ounces.
Essential oil of bitter almonds, 3 The gum, water, and syrup should be rubbed together until a smooth mucilage is made, then the codliver-oil is to be added gradually, with constant stirring, and last the essential oil of bitter almonds. Made in this way, each table spoonful of the mixture contains 4 grains of lactophosphate of calcium and 50 per cent. of codliver-oil. H. S. Purdon (Dub lin Jour. of Med. Sei., Feb., '9S).
Anremia or chlorosis call for the use of chalybeates with arsenic. Iron often does harm unless its constipating effect is counteracted by using aperients. When the patient is arthritic, alkalies, espe cially alkaline waters, are indicated.
No really specific treatment is known against acne, but the following have been recommended: Sulphur alone: powder or tablets, or with equal parts of honey.
Ichthyol (Unna):— 4 Ichthyol, 1 to 2 drachms.
Dist. water, 5 drachms.
M. Sig.: Fifteen to fifty drops in water, to be taken morning and evening.
Ichthyol is very beneficial, both in acne vulgaris and acne rosacca. The
best results are obtained when external and internal treatments are combined. In some cases of acne rosaeea in which the skin is too thin and irritable to bear even weak solutions, the internal administration of ichthyol alone, with steaming, will be beneficial. Five grains of ichthyol may be given thrice daily after food, increasing the amount to 10 grains. Every night and morning the face is steamed for fifteen minutes, and is then washed with ichthyol soap. The lather is allowed to dry on the face, after which it is gently washed off with water. After each washing ichthyol salve. if it can be borne (often com bined with ammoniated mercury), is applied. In acne vulgaris, after steam ing, strong sulphur and ichthyol soap is used, with brisk rubbing with a flesh glove. Brownlie (New York Lancet, May, 1901).
Arsenic bromide in weak doses, grain, in acne pustulosa. (Piffard.) Mercurial preparations, such as cor rosive sublimate or calomel. either alone or with jalap or colocynth extract, have been found useful.
Ergotine,—alone or with calcium sul phide,—digitalis, belladonna, hamamelis, and quinine have been recommended by lirocq. In stubborn cases iodide of potas sium has been found efficacious.
In stubborn eases iodide of potash in 5-grain doses three times a day in milk recommended. When a moderate iodism, showing itself in urticarial lesions is pro duced and when the urine gives traees of iodine, the iodine medication should be discontinued, and local treatment substi tuted. Leviseur (Med. Record, Nov. 11, '99).
Potassium iodide in doses of 5 grains, three times daily, recommended. It should be discontinued when local reac tion occurs or iodine appears in the urine. When inflammation subsides, the treat ment should be repeated. Ichthyol soap and sulphur ointment are to be applied in the intervals. J. Galloway (Practitioner, May, 190G).
— Constitutional treatment will rarely succeed alone, while in a large proportion a local treatment by itself will be found efficacious.