The author enjoins on his readers the necessity for caution in the use of phosphorus. As this agent so readily induces an acute fatty degeneration, when taken in poisonous quantity, the propriety of its administration in large doses for long periods may be questioned.

Phosphorus is indicated more especially in the nutritive failure of the osseous and nervous structures of the body. It is especially in nutritive failure of the osseous and nervous tissue that phosphorus is required. The original suggestion by Wegner of its probable utility in osteomalacia, or softening of the bones, has been acted on by Friese, who found it remarkably beneficial in some obstinate cases. It will prove useful, also, when this condition exists in rickets. That hitherto incurable malady—-progressive pernicious anaernia—has in some instances been apparently arrested by the administration of phosphorus; but it has failed in others. The observations of Fox, Broadbent, and others, as to the utility of phosphorus in lymphadenoma, are very encouraging, the more especially as, hitherto, remedies have had little influence over this intractable malady.

The physiological action of phosphorus in small doses in increasing mental activity finds a therapeutical expression in the use of its preparations in cerebral disorders. It is indicated in pathological states dependent on anaemia, and contraindicated in vascular congestion and excitement. Cases of wakefulness, dependent on cerebral anaemia and exhaustion, are often remarkably benefited by phosphorus in the form of the pill or tincture. It does not procure sleep in the way that chloral and bromide of potassium do. By the use of it in suitable states we supply to the cerebral substance a material which it requires for the healthy performance of its functions. It acts most beneficially in the cases of wakefulness in which the nutritive functions of the body are wanting in activity. The wakefulness of the aged, accompanied with muscular cramps, feebleness of memory, giddiness, and trembling of the voluntary muscles on exertion, is improved by the preparations of phosphorus. Early decay of the mental powers, associated with atheromatous changes of the cerebral vessels, and consequent impaired nutrition of the brain, is benefited by minute doses of this agent. In these states, occurring in the aged, it is better to combine with the phosphorus, or to administer simultaneously, cod-liver oil. The author has seen good results from such a combination in paralysis agitans. Large doses of the medicine in these disorders of advanced life are improper and unsafe. The best results are obtained from the persistent use of minute doses. M. Delpech has obtained excellent results from the use of phosphorus in paralysis. It is obviously adapted to cases of chronic character in which all acute symptoms have subsided. The paralytic symptoms which accompany white softening of the brain (local and circumscribed anaemia) have appeared to the author to be improved by the use of the phosphates, hypophos-phites, and lacto-phosphate of lime.

The preparations of phosphorus are very serviceable in neuralgia. It is true the late Dr. Anstie, in his work on neuralgia, expresses the opinion that "its utility is not very extensive or reliable." Rad-cliffe, Bradley, Broadbent, Mr. J. Ashburton Thompson, on the other hand, report cures in some obstinate cases. Mr. Thompson's experience indicates that large doses are necessary to effect a cure. In his own words: "I now invariably begin by giving 1/12 of a grain every four hours, and this I conclude to be an average dose."The formula given under the title "Tinctura Phosphori" is Mr. Thompson's; each drachm of it contains 1/12 of a grain of phosphorus. With this solution he has treated successfully thirteen cases of neuralgia. Dr. Broadbent has given phosphorus with advantage in "epileptiform vertigo," neuralgia, and "nervous breakdown from overwork."

We have no remedy at present more efficient in the treatment of impotence than phosphorus. In the physiological state, priapism is one of the results of its toxic action. It is, of course, adapted only to cases functional in character, and not to impotence from organic defect.

According to Dujardin-Beaumetz, phosphorus is useful in that very protracted and troublesome disease, progressive locomotor ataxia, or posterior spinal sclerosis. Although the author has not observed any instances of cure of this affection by phosphorus, he has witnessed in a few instances decided amelioration

Phosphorus has lately been employed as a substitute for arsenic in the skin-diseases for which the latter is used—notably acne, psoriasis, lupus. The author has seen excellent results from the use of the compound sirup of the hypophosphites in acne indurata.

Authorities referred to in this article:

Alter, W. Experimentelle Beiträge über die Ursachen des Icterus bei Phosphorver-giftungen. Diss. Breslau. V. u. H., vol. i, 1867.

Andant, Dr. P. E. Bull. Gen. de Thérap., tome lxxv, p. 269. Ibid., tome lxxvi, p. 273.

Anstie, Dr. F. E. Neuralgia and its Counterfeits, London, 1871.

Bamberger, II. von. Wurzbl. med. Ztschr., Band 7, 1. Full abstract in Virchow u. Hirsch's Jahresbericht for 1867, vol. i.

Bennett, Dr. James Risdon. The Medical Times and Gazette, vol. i, 1861, p. 438.

Bernhardt, M. Die Vernsaderungen des Magens nach Phosphorvergiftung. Virchow's Archiv, Band 39, p. 23.

Berthold, A. Archiv der Heilkunde, 1876, p. 258.

Bradley, G. M. The British Medical Joumal, October, 1872.

Broadbent, Dr. W. H. The Practitioner, April, 1873, p. 230.

Dusart, M. The Lancet, vol. ii, 1870, p. 122.

Ebstein, Dr. Archiv der Heilkunde. Quoted in Schmidt's Jahrbücher, vol. cxiv, p. 283.

Eulenburg and Landois. Die Transfusion bei acuten Phosphorvergift. Centralblatt f. d. med. Wiss. Virchow u. Hirsch's Jahresbericht, 1867, vol. i.

Hartmann, Jul. Zur acuten Phosphorvergift. Diss. Dorpat. Ibid., vol. i, 1867.

Husemann, Th. and W. Marme. Ibid., vol. i, 1866.

KÖhler, H. Berlin, klin. Wochen., i, 1870, p. 5. Ibid., Wiener Presse, various numbers, 1873.

Laboulbene, Dr. Gaz. des Hôpitaux, xlvi, 1879, p. 361, and Gaz. Hebdom., 1874, xxxiii, p. 524.

Lecorche, Dr. Archives de Physiologie Norm, el Path., tome ii, 1869.

Lebert, H. and Wyss, 0. Études cliniques et expérimentales sur l'empoisonnement aigu par le phosphor. Archives General de Médicine, September, October, November, and December, 1868.

Munk und Leyden. Die acute Phosphorvergiftung, Berlin, 1865. A. Hirschwald.

Personne, M. Bulletin Genéral de Thérapeutique, tome lxxvi, p. 353.

Radcliffe, Dr. C. B. The British Medical Journal, 1863, p. 489.

Ranvier, Dr. L. Gaz. Med. de Paris, 27, 28, 1867. Recherches expérimentales au sujet de l'action du phosphor sur les tissus vivants, etc.

Rommelaere, Dr. Du Traitement de l'empoisonnement par le phosphore. Bull. Gen. de Thérap., vol. lxxxii, p. 145.

Senftleben, Dr. Virchow's Archiv, vol. xxxvi, p. 530.

Schraube, Dr. Otto. Uebersicht neuer Mittheilungen über acute Phosphorvergiftung. Schmidt's Jahrbucher, Band 136, p. 207.

Sorbets, Dr. Bull. Gén. de Thérap., vol. lxvii, p. 42.

Thompson, J. Ashburton. The Practitioner, vol. ii, p. 13.

Vetter, Dr. A. Ueber die acute Phosphorvergiftung und deren Bchandlung. Virchow's Archiv, Band 58, p. 168.

Virchow, R. Der Zustand des Magens bei Phosphorvergiftung. Virchow's Archiv, Band 31, p. 399.

Wegner, Dr. Georg. Der Einfluss des Phosphors auf den Organismus. Ibid., Band 55, p. 11.

Wolfe, Jean. Disser. Berolini. Full Abstract in Virchow u. Hirsch's Jahresbericht, vol. i, 1868. An Account of the Morbid Appearances in Sixteen Cases of Phosphorus-Poisoning, occurring in Berlin from 1861 to 1868.