"Complications. - Their treatment has not been invariably one and the same, except as regards iritis. Here a seton at the nape has been in general use when the disease has run in the subacute stage, to be kept open for months to prevent a recurrence of the disease; small doses of the iodide of potassium and of the bi-iodide of mercury in the compound extract of the Hydrocot. asiat. being given at the same time, as well as Chaulmugra oil. In the acute stage the ordinary treatment of iritis has been followed. I must mention a very frequent complication in the eye in cases of some standing, whereby vision is impaired by the deposit of tubercular matter in the anterior chamber, where it settles in the form of a crescent, occupying most generally the upper margin of the cornea. This deposit may go on increasing gradually and steadily until vision is lost, unless it be checked in time by washes with the strong decoction of the Hydrocot. asiat. and the bicarbonate of soda, the same salt or the iodide of potassium being at the same time administered inwardly, and the general plan of treatment continued.

"Ulcerations in the nostrils are best treated locally by frequently washing out the nose with a lotion of the Hydrocot. as. and carbonate of soda, and by the direct application of the ointment of the hydrocot. as., pure or in combination with the white precip. ointment. Another excellent topical application is the ointment of the white precipitate suspended in equal parts of glycerine and sweet-oil. In obstinate cases a wash of sulphate of copper answers well. Under such local treatment it is seldom that ulcerations do not heal up quickly, tubercles disappear, and the passage of air through the nostrils rendered more easy and free. At the same time that this takes place either in the nostrils or on the septum of the nose, the organ assumes a more normal appearance, the voice becomes clearer, the patient can breathe with his mouth closed, and snoring at night disappears.

"Ulcerations or tubercles in the buccal cavity, on the tonsils, palate, uvula, or pharynx, are best treated locally by the direct application of the acid nitrate of mercury in doses varying from 5 and 30 in a sufficient quantity of glycerine. Under the combined influence of this local treatment and the constitutional treatment there supervenes a rapid improvement in the condition of the parts. Ulcerations on the hands and feet and on the extremities generally get well under the influence of the alkaline baths mentioned before, and by proper and constant dressing with the same wash. Cold-water dressing has in many cases been tried and preferred by many patients; some have been benefited by the Hydrocot. as. ointment, some by the red precipitate ointment, by the tincture of aloes, by the sulphate of copper ointment, etc. Do what we may, however, of all the ulcers most difficult to heal, those which are situate at the sole of the foot are by far the worst, and they will for a time continue open, whatever care and attention the patient may devote to them; they may or may not be attended with pain, and may or may not interfere with walking.

"Another complication in the calves, with exacerbation of suffering and pain at night, is the constant burning sensation felt by the patient in many cases of some standing. This severe symptom is best treated by the exhibition of the iodide of potassium in grain doses every hour, combined with laudanum, until the symptoms abate. Morphia, chloroform. and cold applications have given relief too. Perhaps subcutaneous injec-tions of morphia might answer well. This is a complication to be met with more in the atrophic or the mixed form of leprosy rather than in tubercular leprosy. Mortification of the soft parts, principally in the legs, in old cases of tubercular leprosy, where the mortification extended from the knee to the foot, threatening amputation at the ankle, has been stopped and cured by the administration of general tonics, bark and phenic acid, by poulticing with the S. orientalis, sprinkled over with phenic acid, and by dressing with carbolic-acid lotion when the sphacelus had come off.

"The atrophic form, just as the tubercular, springing from the same dyscrasia, the plan of general treatment I pursue is very much the same, save that in the atrophic form neurine tonics come in for a large share. Chaulmugra oil, the compound extract of Hydrocot. as., are exhibited, medicated baths prescribed, the spine is rubbed with stimulating liniments, wherein ammonia, cantharides, turpentine, and other rubefiants enter. Phosphorated oil is given in small doses preferably to strychnia or the ergot of rye. Electricity is employed with a view of stopping the atrophy in its onward march, and of restoring tone to what muscles may yet remain.

"Such is a summary of the means I have been using for the last ten years, with marked benefit to many who have applied to me for relief; and I am glad to say that up to this very moment those means have not failed. The treatment just as I have laid it down is not to be followed uninterruptedly. When 1 have to deal with patients who are in earnest, and willing to live in the enjoyment of comparatively good health, all active treatment is now and again suspended. Mineral waters, alkaline or sulphur, as the case may be, are prescribed, cold shower-baths, the arseuiate of iron, cod-liver oil, and other alterative and tonic medicines. Many a patient, especially of the higher class of society, continues well in this way. Not so when we have to do with a class of patients who will be steady only the time they cannot help doing otherwise; with them the immunity from the disease will be of comparatively short duration, relapses will be frequent, and with each relapse there will come some new complication, until the disease, getting the better of them, will run a rapid course to terminate in death."

The following drugs may also be considered: Arsenic, 25; Aurum, 29; Cantharis, 39; Fumaria, 55; Iodine, 70; Psoralea, 96; and Sul-phuris lodidum, 109.