Mr. Macnamara has also found the ointment of red iodide of mercury useful in the treatment of

"spleen," meaning the chronic enlargement resulting from ague or malaria (ague cake): he gives at the same time "ague powders" (quinine). At Netley this ointment forms part of the accepted treatment for such cases, phosphates of iron, quinine, and strychnia being given internally (Murchison: British Medical Journal, i., 1867). Dr. Andrew reports advantage from the same ointment at St. Bartholomew's Hospital (Lancet, i., 1869). Of course, in the enlarged spleen, consequent on mechanical impediments to circulation, heart-disease, etc., or on blood-poisoning, as in typhoid, or on amyloid, or other structural degenerations, mercurial ointments are useless, and even in malarial enlargements harm may be done by them, because splenic disease seems to render the system peculiarly liable to salivation and other ill-effects of mercury. Sir Joseph Fayrer has observed serious results from its use in splenic cachexia, with tenderness of the organ and much debility (Medical Times, i., 1874). Mr. Macnamara, however, as above remarked, has never seen salivation from a judicious use of the iodide ointment, and in all chronic cases it ought to receive a fair trial.

The ointment is equally applicable in cases of strumous enlargement of lymphatic glands.