NEURALGIA AND GASTRALGIA. — In these disorders arsenic is sometimes of value, especially when combined with counter-irritation.
Arsenic is one of the best agents for the cure of simple gastralgia. Recovery is steadily attained in ordinary cases with a pill of grain of arsenous acid and 2 grains of extract of gentian. Sawyer (Dietetic Gaz., Jan., 'SS).
Favorable opinion of the curative effi cacy of arsenic in the various painful neuroses included under the name "gas tralgia" in doses of I/. grain of arsenous acid made into a pill with 2 or 3 grains of some tonic vegetable extract, such as gentian, three times daily half-way be tween meals. Scarcely any other treat merit is needed in cases of moderate severity. It should be continued for some weeks. In severer cases, counter irritation to the epigastrium added. A varied dietary suits gastralgic patients far better than a restricted one. Trous seau's maxim, that "we should know what a patient does eat before we advise him upon what he may feed," should be followed. James Sawyer (Lancet, July 4, '96).
SKIN DISEASES.—Acute affections of the skin—especially the acute stage of erythema, eczema, urticaria, and prurigo —are not favorably influenced by ar senic. On the other hand, it represents the most effective remedy at our dis posal in the treatment of chronic skin disorders when employed with proper discrimination. Fowler's solution is generally considered as the most useful preparation. From 3 to 5 drops in a half-glassful of pure water after meals are usually well borne. The dose should be slowly increased until the limit of tolerance is reached.
Psoriasis promptly yields, especially if the treatment is begun by the admin istration of a saline diuretic, such as acetate or bitartrate of potassium (Rohe).
Intravenous injections in 28 cases of psoriasis, in 25 of which no other treat ment was adopted. Ten were completely cured, 6 were much relieved, and 9 re ported as under treatment, but greatly improved. The commencing dose of 1 milligramme of arsenous acid increased daily by 1 milligramme up to 15 milli grammes, the maximum dose, which is repeated daily till the eruption disap pears. Herxheimer (La Semaine Med.,
clxii, '97).
Eczema also yields to the influence of arsenic, but only when it is employed in the chronic, dry, papular, or pustular stages of the disease. In the moist form it usually proves hurtful.
Acne, when attended by any degree of active inflammation, is aggravated by arsenic; but in the small papular form and that occurring during the menstrual period it frequently proves valuable, when administered in small doses.
Pemphigus is favorably influenced by arsenic when the latter is given in large doses. Urticaria, lichen, and furunculo sis are also greatly benefited.
TIIMORS.—Fowler's solution sometimes retards the progress of epithelioma. It has proved curative in sarcoma and mel anoma.
Case of spindle-celled sarcoma at head of tibia cured by internal use of arsenic. Koenigsberg (Deutsche med. Woch., Sept. 23, '94).
Case of malignant melanoma cured by Fowler's solution in 5-drop doses, t. i. d. Lassar (Deutsche med. Zeitung, No. 64, '94).
In cancer the local application of Marsden's paste (2 drachms of arsenous acid and 1 drachm of mucilage of gum acacia) is sometimes effective. A layer of paste one inch in diameter being applied over the growth, a piece of dry lint is applied on the part, overlapping the paste half an inch all around. After ten minutes the overlapping linen is carefully cut away and the paste is al lowed to dry. At the expiration of two or three days bread poultices are applied every two hours until the redness and swelling present subside. A true line of demarkation appears, the skin ulcerates, and the fissure formed gradually extends until the cancerous mass comes away.
Case of a woman, aged 28, undergoing treatment for cancer of the breast, after the removal of the epidermis by a fly blister. Within an hour she began to experience the physiological effects of arsenic: objects seen double or treble and marked tinnitus aurium. Within six hours severe vomiting and diarrhoea, which continued for more than a week.