Internal medication for the relief of the disease while in its course is useless. As a prophylactic, according to Duhr lug, arsenic is of positive value, and will cure the tendency to the disorder. It should be given in full doses: 7„ grain of arsenous acid four times a day, or Fowler's solution, 3 to 7 minims, after meals. Cold sponging of the body each day, especially of the spinal region, fol lowed by vigorous friction, will help to control the tendency.
Herpes at the orifice of the external auditory canal cured by tonics and the local application of yellow oxide of mer cury. L. S. Somers (Amer. Medico Surg. Bull., Oct. 31, '96).
Treatment of herpes of the cornea consists in weak duhoisine and eserine; insulation of powdered iodoform and cocaine, and the same in ointment once daily; occlusion; galvanocantery, if nec essary; and, in infecting progressive ulcer, injections, under the conjunctiva, of antitoxin. Balczowski (Rec. d'Oplital., June, '96).
Herpes Genitalis, Besnier has lately given the appella tion "genitalia" to all forms of genital herpes, and the term is much to be pre ferred to the older designations: "pro genitalis" and "prteputialis," neither of which were strictly accurate.
Symptoms. — Burning and itching, with sometimes pain, precede the ap pearance of the vesicles. Usually there is but one group, but occasionally the number is greater. There are not apt to be as many vesicles in each cluster as is the case in herpes of the face. A reddened oedematous base with a single or at most two or three distinct vesicles upon it is not uncommon. Certain sites upon the genitals seem to be favored by the disease. These, in the order of their frequency in men, are the sulcus, the reflected mucous membrane of the pre puce, the glans, the margin of the pre puce, and the skin on the shaft. (F. B. Greenough.) In women the sites of preference are the skin of the vulva, the inner border of the labia majora, any part of the labia minora, the prepuce, the clitoris,, and the orifice of the urethra. When the lesions are situated upon the 'mu cous membranes the vesicles rupture. early and the patient first notices an ex coriation, covered by a whitish deposit. Upon the integument of the vulva or penis the vesicles look like tiny droplets of water. They rapidly lose their clear shining appearance, however, owing to the increasing turbidity of the contents. Crusting follows, and if the disease is not irritated the process terminates the falling of the scab in from one to two weeks. A pigmented spot remains.
This eventually disappears. There is no scar.
In man the genital herpes is located upon the penis; in woman, either at the urethral orifice or upon the vulva. The base of the ulceration is yellow, but its principal characteristics is its icr o cyclic and polycyclic vesicle. A most important variety is that which, desic cating from the centre to the periphery, assumes a papular aspect and resembles sometimes a chancre, sometimes a mu cous patch. Herpes may arise suddenly or by successive eruptions. Its duration is variable, lasting from a few days to several weeks. Fournier (Revue Inter nat. de 1416d. et Chin, June 25, 'fiG).
Itching is apt to be severe, especially in women. Neuralgic pain simulating that of zoster is sometimes felt. These cases should be regarded with suspicion, but it is not a wise measure to call every attack of this nature shingles.
The lesions in the male are usually situated in the line of the dorsalis-penis nerve. When close set the vesicles may coalesce.
Diagnosis.—The recognition of the disease does not usually present any great difficulty, but care is sometimes needed in arriving at correct conclu sions. The mental distress of the pa tient is generally out of all proportion to the severity of the disorder, and this, coupled with the ease with which the lesions may be confounded with the in itial sclerosis of syphilis, makes the sub ject a fruitful field for the quack and the unprincipled practitioner. Many a yoring man has had his life made bitter and has parted with his years of hard earned wealth because some such scoun drel has pronounced the simple herpetic lesion exhibited a virulent chancre. If the truth might be known many of the wrecks behind the bars of our insane asylums could be traced to this cause. On the other hand, the ease with which syphilitic infection may take place at the site of the herpetic vesicle or excori ation will make the careful practitioner exceedingly guarded in his statements to his patient. He is a physician of very limited observation indeed who has not seen an undoubted case of genital her pes linger along, getting worse instead of better, until it had assumed the classi cal features of a chancre or chancroid, to be followed by the disastrous results of the one or the other.