Priority claimed in the use in small pox of local applications of watery solu tions of corrosive sublimate. The mer curial applications may he made in any strength. up to a saturated solution even, without danger, except in cases of idiosyncrasy. In the eyes, nose, faeces, and ears a spray of peroxide of hydro gen is used. T. C. Osborn (Tex. Med.
Jour.; Med. Standard, Feb., 1900). Bichloride baths used in 36 cases, of which 1 was hemorrhagic and 13 con fluent. without mortality. The method employed was as follows: A six-foot bath-tub was placed beside the patient's cot and filled with a fairly warm-103 to 105-degree—solution of bichloride, 1 to 10,000, and the patient placed therein, head and shoulders above the solution; the nurse then went over the entire body, using a soft cloth, being careful of force applied so as not to cause much pain. After remaining in the bath about ten to twelve minutes, the patient was removed, thoroughly dried, dressed in freshly laundered clothing, and placed in a clean bed. These baths were given night and morn ing. After removal from the bath the patient expressed much relief, but shortly after, owing to the drying effect, complained of a burning sensa tion "just beneath the skin." All were likewise affected; so, to obviate this, a routine practice was begun of anoint ing patients immediately after the bath with a mixture of carbolic acid, bismuth subnitrate, and olive-oil, with a very happy result.
The authors outline the following ad vantages: The suppurative fever can be shortened four to six clays if patient is treated from the onset; a minimum of pitting is secured and an almost entire absence of the characteristic, disagree able odor; the period of desquamation is materially lessened, owing to the thinness of the scab-formation; pain is much reduced, morphine being rarely indicated; the great distortion of feat ures, which gives such repulsive-look ing patients, is eliminated to a great ex tent. R. L. Yaeger and H. A. Ingalls (Jour. Amer. Med. Assoc., Apr. 2S, 1900).
In the more decidedly-malignant cases—in which the pre-eruptive fever is intense, with great epigastric distress, persistent vomiting, delirium, and very scanty urine; and when the eruption appears, it is accompanied by petechial or hremorrhagic spots and no abatement of the fever—there is but little chance or hope of averting an early fatal result.
The most promising means are a cold pack, to be followed by frequent spong ing of the surface to reduce the tempera ture and the capsule of calomel and mor phine every two hours until the epigas tric distress and vomiting are relieved. If the bowels are inactive they may he evacuated by large, warm, salt-water enemas. If diarrhoea already exists, it has been sometimes controlled by re peated small enemas of normal salt solu tion to which were added from 15 to 30 minims of tincture of opium. If the patient lives through the first week of the disease and the stomach and bowels have become quiet, the greatest care should be given to sustaining him with small and frequent doses of good milk alternated with meat-broth well salted; a dose of Dover's powder and camphor at evening to promote rest, and appro priate doses of strychnine and digitalis to sustain the functions of the vasomotor and respiratory nervous systems through the subsequent stages of the disease. If, during the suppurating stage of the pus tules, intestinal limorrhage occurs, an emulsion containing suitable proportions of oil of turpentine, oil of gaultheria, and tincture of opium has afforded more relief than any other remedy I could use. If not retained by the stomach it may be given as an enema with 2 or 3 ounces of beef-tea, and repeated soon after each evacuation. Perhaps the best external treatment of the eruption after it has be come established in the skin, both for disinfection and to lessen the resulting pits or scars, is to keep the face covered with layers of surgeon's lint wet in a t or 2-per-cent. solution of carbolic acid, and the same solution may be applied over the whole surface once or twice a day. The nostrils should be carefully cleansed and kept as free as possible. If pustules appear in the mouth and fauces, mucilaginous and mild antiseptic gargles should be used freely. If many pustules appear on the scalp, the hair should be cut short to prevent it from becoming matted together and foul during the sup purative stage.