The external treatment consists in bathing, sweating, application of soaps and plasters, removal of the scales by rubbing, and softening of the psoriatic plaques, in order to prepare the skin for the real medicinal treatment. Children are given daily warm baths 28°-30° C. (S2-86° F.) lasting half an hour to an hour, applying either sulphur soap or green soap. Simultaneously the scalp is anointed with tincture of soap and cleansed in the bath. Sulphur may be added to the bath, or immediately after the soap treatment in the bath tar may be applied (see Tar Baths p. 434). As soon as the child has left the bath, the body- is treated with medicaments, that is, larger surfaces arc anointed and bandaged, smaller ones and localized foci are painted and a softening plaster applied over the coat (zinc oxide plastermull, salicylic soap plaster). The best and mildest ointment for the skin, especially scalp and face, is a combination of ung. hydrargyri album and tar. I prescribe the ointment as follows: hydrag. precip. alb. 2.0-4.0 Gm. (1-1 dr.) bism. subnit. 4.0 Gm. (1 dr.) anthrasol 0.5-2.0 Gm. (74,-30 gr.) ung. leniens ad 40.0 Gm. (11- oz.). This ointment may be made more liquid by an addition of olive oil for rub- . bing into the scalp, especially' in the case of girls. Salicyl 0.1 Om. (132 gr.) may be added to soften the scales. The best ointment for application on the body, chrysarobin, is now ally introduced and prescribed for children as a 1 per cent. ointment; feu painting 1:100 traumaeine. (Caution on account of serious dermatitis and junctivitis). Kromayer recommends eurobin as a substitute for arobin which is prescribed together wit heugallol (substitute for pyrogallus) as follows:—eurobin 1.0 Gm. (15 gr.)
eugallol 1.0 Gm. (15 gr.) acetone ad. 50.0 Gm. (I!, oz.) for painting the affected places. Pyrogallus too should be used with caution in children, as it may cause poisoning. It is therefore advisable in children to apply a weak 1, to 1 per cent. ointment of pyrogallus. As above mentioned, plasters are now applied over the painted places; or instead of painting, the chrysarobin plastermull, which sometimes has a strongly irritating effect, may be plied. Generally speaking, the arobin and pyrogallus preparations cannot be handled carefully enough, the infant's skin being exceedingly sensitive. A very good effect is obtained by tar baths, which should be given several times a week, after which the affected places should be bandaged with chrysarobin or pyrogallus. Also painting with tar, the colorless liquor carbonis cletergens or the more powerful tincture of tar (pix liqu. 3 per cent. ale. ad 30.0) can be recommended, but should also be used with caution. In carrying these measures out, it is advisable to make regular examinations of the urine. As mild agents may be mentioned sulphur baths and sulphur pomatum (1-5 per cent.) mixed with 1: per cent. anthrasol. For the treatment of the hairy part of the head precipitated bismuth tar ointment and salicylic oil (salicyl 10 Gm., ol. ricini 40 Gm., ol. oliv. 50 Gm.) may be used with or without anthrasol; for the nails, scalp treatment, baths and plasters.