SCLERODERMIA.
In the diffuse hide-bound type of this rare affection, warm flannel clothing should be provided, and the patient must be protected from all exposure to cold. The administration of Cod-Liver Oil as an adjunct to the most nutritious diet and improved hygiene should be persevered with.
Drugs are as a rule not to be depended upon, but in those cases associ ated with rheumatic pains in the joints, Salicylates have proved of some value. Vaso-dilators, as Spt. iFther. Nit., and Glonoin, have been recommended, but their value is doubtful. Arsenic, Iron, Phosphorus, Gold and Silver Salts have been tried and usually found wanting in any specific action on the indurated condition.
Several cures have been reported from Thyroid feeding, though in other cases this has signally failed. Some authorities, believing that the pituitary gland is at fault, advise Pituitary feeding, and others recommend mixed Gland treatment, using Martindale's four-gland tablets, one of which contains i gr. each of Thyroid, Suprarenal, Thymus and Pituitary substance.
Massage, hot douching, radiant heat and Turkish baths, combined with the persevering inunction of an animal fat, afford the best routine method of treatment. Passive movements and exercises are always
demanded for the contractures (sterodactylia) which tend to deform the hands. X-ray and Radium emanations have been employed, and the injection of Fibrolysin has been resorted to in order to cause absorption of the proliferated fibroid tissue present around the sheaths of the smaller bloodvessels and lymphatics. Cerebrin or brain extract has also been recommended.
Circumscribed Sclerodermia, known also as Morphcea or Addison's Keliod, is more common than the diffuse type of the affection. It should be treated upon similar lines by persevering massage, electricity, douching and X rays. Electrolysis has proved successful in the removal of small patches, employed as for the treatment of nevoid growths. The injection of 5 to ro mins. Thiosinamin, to per cent. solution, or of 4o mins. Fibro lysin into the neighbourhood of the indurated patches should always have a trial. Thiosinamin Plaster Mulls (to per cent.) may also be employed over larger patches.