which it is applied, and can be removed with great facility Varges, Zeitschrift, Dec. 1860, p. 412.)

Mercurius-vivus.-In our earlier years of practice, we met with the following case: In a malarious neighborhood two sisters (twins) aged fifteen months, were attacked with intermittent, following remittent fever; both had convulsions at the access of the paroxysm, which was an imperfect chill with imperfect reaction. The chills recurred daily, and were, after some days, suspended with Quinine in impirical hands. The two children had thus far progressed equally towards recovery; in their future course they diverged widely. One seemed perfectly relieved of fever and brain irritation by an eruption over the whole scalp, (a thing common as a sequel of intermittent.) The other girl had no eruption on the skin; and, though she recovered perfectly from the fever, she continued to have returns of the convulsions; became a confirmed epileptic; and grew up a hopeless idiot. We saw them fourteen years after the attack of fever. The idiot had become the larger of the two; her hair and figure were fine, but intelligence was entirely wanting. Her sister was intelligent, but her head continued destitute of hair; the head was entirely covered with a moist, scaly eruption, in many places raw and bleeding. It was supposed that any effort to cure the external disease would consign this girl to the same condition as her epileptic, idiot sister.

We made the effort to cure the constitutional dyscrasia by giving a fine trituration of metallic Mercury in such a form that the quantity of Mercury given was equal to one-eighth of a grain of blue-pill four times a day; and this course was kept up for two months. By this time the appearance of the scalp was so much improved that we ventured to use some external lotions which hastened the formation of the new skin. The hair grew at first very fine and soft; in a few months it was of the usual length and appearance. Her general health instead of being injured by curing the "scald head" was perfected by it, and years afterwards she continued well.

Apis-mel.-Case by Dr. Bayard.-A gentleman, aged thirty, returned to New-York from a tour in the West. He was much troubled with an eruption of a vesicular nature between the fingers, with intense itching, and inclined to ulcerate. The rest of the body was covered with a dry, red, raised eruption, attended with uncomfortable itching. Lycopodium 30° and Sulphur 30° were tried for a few days, at the end of which time he returned, complaining that he had no rest at night from a stinging, burning eruption, which almost set him distracted. Three globules of Apis-mel. 30 were given in the evening, the dose to be repeated every third hour for three times. In a half hour from taking the first dose he was relieved from the burning and stinging sensation. It was permitted to act ten days, after w which

there was a slight return of the symptoms. Under the use of a few globules of the 200th dilution of Apis, the disease gradually disappeared. PSORA GUTTATA.-Arsenicum.-Mr. Hunt, of Margate, England, published in 1847, a volume on certain intractable forms of chronic skin-diseases. He says (page 14), that he cured permanently a case of psora guttata in a family of delicate habit, intolerant alike of all mineral medicines. His remedy was one-fourth of a drop of Fowler's solution of Arsenic, taken three times a day for a few weeks. Fowler's solution is a solution of Arseniate of Potash, in which Arsenious-acid and Potash are present in about equal quantities. The British and Foreign Review (allopathic) says, each of the above doses contained only the 480th part of a grain of white Arsenic or Arsenious-acid; or perhaps equal in comparison to the weight of the person as one to 705,600,000. Perhaps doses still smaller would have answered as well, but they were not tried.

PUSTULAR ERUPTION.-Apis.-Case by Dr. Bishop. It commenced with small pustular formations just under the cuticle, with burning, smarting, stinging sensation; on coming to maturity, deposition of dry, scabby matter in a laminated form, scaly, brownish, and sometimes strawcolored; looseness of the bowels for three or four weeks. No abatement in symptoms followed the use of Rhus or other antipsorics. Apis 1, to be taken every twelve hours, caused a speedy and effectual cure of both the diarrhoea and eruption. There was no return of either.

REMEDIES APPLICABLE IN VARIOUS AFFECTIONS OF THE SKIN.Lycopodium.-Itching eruption at the anus, painful when touched. Freckles on the skin. Yellowish humor behind the corona glandis, with dark-red, soft elevations, which smart and itch; pimples on the arms filled with pus, burning pimples between the scapula; red pimples around the neck, with itching.

Graphites.-Tinea, humid and dry; erythema; humid eruption on the scrotum; itching pimples; small red itching pimples, with their tips full of pus, frequently appearing on the skin; they burn after scratching, and disappear on the following day. Small pimples without sensation at night, all over the body, passing off again in the morning. Itching pimples full of acrid water here and there.

Rhus-toxicodendron.-Scurfs over the body; eruption on the scrotum, with swelling of the prepuce and glans; inflamed blotch on the middle of the finger, with itching-burning pain, sometimes passing into a stitch. Small vesicular tubercles like the bites of insects, in the joints of the hands, feet, particularly around the outsides of the ankles; tubercles and vesicles on the knees, and shoulder joints; tubercles here and there. Zona or shingles.

Rhus-vernix.-Hard elevated blotches, with watery vesicles on the hands. Itching blotches in the palms of the hands, deep under the skin.

Kali-bichromicum.-Small red elevations, with a dark centre and elevated circumference, itching and slightly painful; papular eruptions on the fore-arms, lasting a few days, recurring frequently. Heat and itching of the skin, at night in bed, followed by the breaking out of reddish hard knots on the thighs and legs, from the size of a pin's head to that of a split pea, with a depressed dark scurf in the centre surrounded with an inflamed base, declining in two or three days.

Ammonia-carb.-Red tubercles around the elbow, cutting and painful, sometimes ulcerated, also on the neck.

Ammonia-mur.-Large blotches and indurations deep under the skin, upon a hard base; itching first, then burning after being scratched; inflamed, with red-brown scurf which remains inflamed for a long time, with swelling of the part.

Juglans.-Violent burning and itching on the right fore-arm near the bends of the elbow; violent burning and it hing on a red spot as large as a dollar, in the centre of which a little ubercle was formed; next day the spot had disappeared, the tubercle had grown and was painful; it gradually dispersed without breaking.

GENUS IV.-MALIS.-CUTANEOUS VERMINATION.

1. MALIS FILIARIA.-GUINEA WORM.

FILARIA. A genus of the class vermes, order Intestina.-Body cylindrical, filiform, equal and quite smooth. Mouth terminal, more or less perceptible, simple, with a roundish concave lip. There are about eighteen species.

Filaria medinensis, the thread worm, is found both in the East and West Indies; it is often seen in the morning dew, from which it enters the naked feet of the slaves, and creates a troublesome itching, frequently accompanied with inflammation and fever. There is great difficulty in extracting it from its hold; the only method is, by cautiously drawing it out by means of a piece of silk tied round its head; for if, by being too hasty, the animal should break, the part remaining under the skin grows with surprising vigor and occasions an alarming, sometimes fatal inflammation. It is generally twelve feet long and not larger than a horse hair.

The explorers of Africa in the last century attributed the Guinea worms in their bodies to the water they drank from the ponds; and as a prophylactic they drank sea-water brought up by divers from a depth of fifteen or twenty feet. They described the worm as about one foot long, the size of a hair. They cause intense pain; the patient could neither sit or lie, walk or stand with any comfort; some were affected with a fit of insanity. In some "the symptoms begin with cold shiver

ings, in others with burning heats. In some there comes a large swelling, under which the worm can be plainly seen; in others they break out in carbuncles and ulcers, which are largest in the parts that are most muscular. The negroes did not use any remedy, but permit them to come out, and then they wash the part with salt water and fresh butter mixed with salt. When the worm appears so that it can be taken hold of, they fasten its head to a small stick to prevent its returning when it moves forward. In winding the worm round the stick, if the animal should break, the wound becomes dangerous, and is often fatal. Sometimes when one worm is extracted another shows itself at the same place, and many persons have several of them at a time in different parts, causing a degree of distress that is not to be described. One writer says, "The pain produced by these worms is so excessive that a man would renounce all the prospects of profitable trade on this coast rather than endure it."

GENUS V.-ECPHYMA.-1. CORNS.

Corns are excrescences or thickenings of the skin of the toes or feet, caused and perpetuated by continued pressure; this produces hypertrophy of the papillæ of the derma, which hypertrophy is kept up by the irritation induced by the pressure and friction of the affected part.

Varieties.-1. Soft Corns.-These are always located between the toes. They never become hard, are never deeply seated, do not project much above the surrounding surface, but are kept flat by the pressure to which they are constantly subjected. They are caused by the pressure of the joint of a toe to the side of a toe next to it, by a shoe too narrow. When the pressure is very great it produces inflammation and even suppuration. The soft corn begins with a burning or scalding feeling between the toes. A blister is formed, and the escaping serum irritates the surrounding skin, inflames it, and a new, thick series of layers take the place of the cuticle, and thus the corn is produced. It now feels as if a gravel or seed was between the toes, and sometimes causes a crack in the skin. If a soft corn is not removed, ulceration often follows, with inflammation of the foot, which is painful and may extend up the leg.

TREATMENT.-Remove the thickened skin with fine sand paper, or extract it when sufficiently developed. Then when the spongy part has been removed and the surface looks quite red, the pain will cease. Lint should be worn between the toes to avert pressure. When the disease has lasted long the spongy structure becomes a regular growth. In bad cases, direct perfect rest, and fomentation of the limb may be necessary. For slight inflammations between the toes a piece of lint, wet with cold water will be beneficial; it may be inclosed by a

strip of oiled silk passed round both toes. The application of violent remedies, as nitric-acid or aromatic vinegar should be avoided. Festered Corns.-The toes have in some instances been drawn out of their natural position, so that the joints become prominent; the skin over the joints becomes thin and stretched; severe pressure or friction on these projecting points produces a painful and troublesome festered corn. The skin over the joint first becomes red and sensitive; it then becomes slightly thickened, semi-transparent; inflammation follows, and then suppuration under the whole extent of the hardened surface. The corn formed in the centre of the induration seldom exceeds in size the head of a large pin, decreasing inwardly to a thin thread-like point. This excites vascular irritablility and rapidly causes suppuration in the bursa beneath. When the corn is extracted a part of the sac of the bursa adheres to it. When the bursa is diseased without any thickening of the outer skin, the only external appearance is the redness and swelling of the toes, with a very small white spot, having a minute speck in the centre, usually situated upon the most prominent part of the joint; the serous fluid effused now causes great irritation, excruciating pain, and violent inflammation, extending even to the whole foot.

The treatment is generally limited to soothing local applications, cooling lotions, rest in the horizontal position, until the inflammation subsides.

Mr. Dowie, of Charing Cross,* and Dr. Meyer, of Zurich, have published works which propose to save the suffering caused by badly constructed shoes. The work † of the latter shows that, in the external shape of the foot, a straight line drawn through the centre of the great toe, if prolonged to the heel, would pass through its centre; and he says, the sole of the shoe, in order to fit the normal foot, should be so constructed as to allow the great toe to have its normal position in the shoe. In the sole of the shoe, as usually constructed, a straight line drawn through the centre of the great toe as it lies in the shoe falls to the inside of the heel. The great toe thus pushed out of its proper position is injured at its metatarsal-joint, its ligaments strained, the joint itself partially dislocated; the bruise over the joint produces bunions; and in the case of a gouty subject, the common seat of the gouty attack is this much injured portion of the imprisoned toe.

Nervo-vascular Corns form on the projecting part of the toes of persons whose skins are unusually vascular. They readily inflame from the slightest pressure; the covering of the affected part becomes thickened, semi-transparent, showing villi, or nervous fibres clearly visible,

* The Foot and its Covering. By James Dowie. London: 1861.

†Translation. Edinb.: 1963.