Liq. Plumbi 3j.
Hydrarg. Ammon. Chlor. ass. Lanolini et aselin. aura .11?sce.
The proportion of each ingredient may be varied to meet the special indications in every case. Thus, if the secretion be very profuse the amount of lead may be doubled and the tar lessened; should there he dryness, with scaliness, the tar may be safely doubled in amount, whilst the mercurial may be equally increased. The writer's advice to the practitioner is to adopt this ointment, and use it in every case of subacute or chronic eczema which he meets with in the first years of his practice, till he becomes thorough master of the remedy and can alter its propor tions to suit the varying stages or varieties of the disease, and he will very seldom feel the necessity of resorting to anything else.
Dry eczema of the papular type is very rebellious to treatment; the best routine is to employ a tar lotion (I in 8) in the daytime and the above ointment at night, omitting the lead ingredient. Coal tar is preferable to wood tar, being less irritating, but many dermatologists prefer birch tar (ol. rusci), beech tar (ol. fagi), juniper tar (ol. cadinum), pine tar (pis liquida). Sutton advises the use of crude coal tar, and in very chronic scaly cases he applies it undiluted. The B.P. Liq. Picis Carbonis is the official representative of the old Liq. Carbonis Detergens; both are saturated alcoholic solutions of coal tar. Creosote and Carbolic Acid are preferred by some, and a whole series of Naphthol derivatives have been employed, but. they are certainly inferior. The official Ungt. Picis L. is too concentrated for ordinary uses.
As with arsenic internally so with tar externally, both drugs give their hest effects in scaly, dry eciema, and the nearer the case approaches to psoriasis the better the results ohminahle [ruin tar, hut all forms ()f chronic ecirma should he treated by it. When tar fails in the weeping chronic type of eczema. it will hi.'Inci nearly always to heingapplied in too con centrated form. Hutchinson regarded Tar as the one remedy for eczema. I f he Used two. they were Tar and Lead; if three, Tar, Lead and Men ury.
Powders are as a rule unsuitable even in the red weeping examples of the chronic disease, but occasionally they may he applied for short periods. Pastes sometimes may he employed. Lassar's may be used as the vehicle for any of the aboye-mentioned more active remedies, and the jellies, plasters and salve muslin.; introduced by Unna may be also employed
with advantage.
lehthyol is undoubtedly a valuable drug. Unna uses so or 20 per cent., or Sulphoichthyolate of Anlintillia 2 per cent., which may be incorporated with the paste of Lassar. Alorris states that, like Resorcin and Sulphur, its antiparasitie qualities are undoubted. It allays itching, destroys parasites, contracts the cutaneous vessels and checks discharge, hence he uses it also in the treatment of acme eczema.
The weeping stages of all eczemas are treated by Pick with his Salicylic Soap Plaster (5 parts of Salicylic Acid to too parts of liquefied Soap Plaster). When a weaker and more adhesive plaster is required, he mixes parts of the acid with 20 of Olive Oil and So of Soap Plaster. These arc spread upon strong calico, cut into strips, and firmly applied to the moist surface, where they may he allowed to remain undisturbed for several days. The itchiness is replaced by a burning pain, which rapidly disappears. Four days suffice for the first application before removal. Subsequent dressings may remain one week each or longer. After the scaly stage is reached this is treated by painting with Sublimate Gelatin prepared by dissolving 3o parts of pure white Gelatin in water over a water-bath. and evaporating the liquid solution till its weight is reduced to 75 parts; 25 parts of Glycerin and Perchloride of Mercury are then added. This method of Pick's is very suitable for the chronic eczema ciamnon in the legs.
just as Lead preparations are indicated for their astringent action wliere there is ninth Weeping, anti Tar for its stimulating action in sluggish cases, so are indicated for their alterative action where the wisdom of employing tar is doubtful—i.e., in subacute cases where there is still much redness, irritability, and some induration; afterwards they may he combined with Tar to great advantage, hut they should not be employed where a very large surface is affected. A dilute solution of the (r gr. to 3 oz. water) is an excellent alterative, and may be used with great advantage as it lotion where crusts, scabs and dried secretion cover over and irritate the already inflamed surface. The best of all the mercurial preparations is an ointment of the white precipitate (of the strength of about 20 to 30 grs. per oz.).