Diagnosis.—For purposes of differential diagnosis strophulus and urtiearia come in for consideration; also scabies and the various forms of eczema. If there is a suspicion of scabies, their ducts have to be looked for in the skin; if there is prurigo with excessive eczema, prurigo will always remain behind after the eczema has healed. The facts that the articular flexions in prurigo always remain free and that typical prurigo papultr are present aid in the diagnosis.
prognosis is favorable under appropriate treat ment. J ust in this affeetion it is of importance whether the parents are in a position always to attend to their sick child, or whether they leave it at home unattended. The prognosis is generally favorable in prurigo mitis, unfavorable in prurigo ferox. Ehlers has communicated with every prurigo patient who had visited the Commune Hospital in Copen hagen during twenty years and has thereby arrived at the following statistical figures: Cured 23, improved 4, not cured 25, dead 7, not found 112.
object of the treatment is: (1) to cleanse the intestine as soon as there is a suspicion of putrefaction; (2) to improve the general condition by- good nutrition; (3) to relieve the subjective complaints and (4) to establish maceration and to remove all the super ficial cutical layers. Internal medication for intestinal putrefaction: benzol naphthol 0.50-1 Gm. (7-15 gr.) per clay, carbolic aeid pills 50 to 60 cg. (10 gr.) per day, and the salicylic preparations previously
mentioned, or lactic acid. The general condition should be improved by goocl nutrition, iodide of iron or eodliver oil. To relieve the itch ing, internal administration of antipyrin 5.0 Gni. (11 dr.), syrup simplex 25 Gm, (1 oz.), 1 to 2 teaspoonfuls every evening, or massage as recom mended by Murrey and IIatschek. To soften and clesquamate the skin, baths take the first place. Sulphur baths are the best (with 50 Gm. powdered sulphur or 30 - 100 Gm. Ilemingkx solution, or 50 Gm. sodium hyposulphite for each bath). The effect of the sulphur baths is increased by washing with sulphur soap (Berger's, Unna's, Eichhoff's).
Joseph recommends baths with lye, once or twice a week. Aside from sulphur baths I have been very successful with diaphoretic meas ures, prescribing wood tea (decoctions of sudorific woods) ancl syrup jaborandi (proposed by O. Simon; 1 to 2 tablespoonfuls in the tea), or 20 drops of a 1 per cent. solution of piloearpin. Baths and diaphoretic measures should be administered alternately; after each bath or diapho retic procedure the child should be rubbed with a weak epicarin or naphthol ointment (Kaposi, 1-5: 100) or with ung.Wilkensonii, or band aged with a mild tar-sulphur salve. (When the entire body is rubbed ovet with naphthol or tar, frequent examination of the urine is necessary.)