"Naphthalin. - This substance, which has quite recently been introduced into medical practice, is used in the form of an ointment containing one drachm of naphthalin to an ounce of lard. According to the laudatory statements of those who devised it, it has proved of service in cases of psoriasis of no great severity. I can say very little as to its value from my own experience; for I have as yet employed it in too small a number of eases to be able to express a final opinion with regard to it. It is certainly a desideratum to find a preparation which should offer to the practitioner the advantages possessed by tar, without the black color and disagreeable smell of that substance.

"I have now described, in regular order, the different remedies and the various methods of treatment used in psoriasis. But I must not forget to state that more than one remedy, and different methods, must, in most cases, be employed in order to cure the disease. Sometimes, for instance, the cold-water treatment may be combined frith the use of tar, the patient being first 'packed' and treated with the cold douche, and afterward rubbed with an ointment, soap, or tincture of tar. In other cases, if the patient, for some reason or other, objects to the application of this substance, we may have to employ instead of it Rochard's ointment, or one containing white precipitate or naphthalin. In a third class of cases, it may appear advisable to begin by applying soft soap, and when this has softened and removed the epidermis, to employ those remedies (such as the preparations of tar or the above-mentioned ointments) which are shown by experience to extirpate psoriasis most rapidly. The quickest possible way of curing the disease is to use the solution of sulphuret of calcium, rubbing it energetically into the skin before giving the patient a warm bath, and after the bath applying the Rochard's ointment or some preparation of tar.

It is, of course, to be understood that whether for the purpose of satisfying the patient or on account of our own convictions as to their value, we may combine the administration of internal medicines with any of these local methods of treatment. Thus, whatever external applications we employ, we may at the same time give the Fowler's solution or the Asiatic pills, or any other preparation of arsenic, or, indeed, any one of the many medicines already enumerated.

"In prescribing any of these remedies, however, it is always necessary to remember the patient's age and sex, and to allow for the individual peculiarities of the skin. In all cases, too, it is advisable to employ at first applications which have not very irritant properties, reserving for a later period those which are more decidedly caustic in their action. Due regard must also be paid to the conditions under which the patient lives. Not every one who suffers from psoriasis is able to devote his whole time to the cure of the complaint. Most persons have to gain their living by their own labor, and this often demands their whole time and activity. Under such circumstances, it generally happens that treatment, however rational, fails to remove the disease. Hence, if we can arrange the treatment in such a way as to interfere but little with the ordinary occupation of the patient, and yet (though more slowly) to attain the desired result, we shall certainly receive his thanks. It is just in these cases that skill is required, to combine our remedies and applications so as to suit the circumstances. For example, I have sometimes had patients who in the day were occupied with their business, so that only the night was available for the treatment of the disease by any of the methods above described. I have then ordered 'packings' and frictions with cold water, and inunctions with tar or with Vlemingkx's solution in the evening when the day's work was ended. Other patients, again, affected with psoriasis, have been able to devote an hour or two every morning and evening to the cure of the complaint, and I have then availed myself of this short time to apply one or other of the irritant ointments, such as the Ung. hydr. deuto-iodidi" (97, Syd. Ed. 2: 19-50).

Having given at great length the views of others, the author will briefly indicate the principles that guide him in the management of this affection.

Believing that the eruption is but the outward expression of certain pre-existing constitutional and diathetic conditions, the rational treatment from this standpoint involves the use of such measures as are capable of combating this predisposition. These have already been considered in connection with the treatment of the Rheumic diathesis, and need not be here repeated. This brings us to the consideration of a few drugs that appear to have an almost specific influence on the eruption itself. Before touching on these, however, it may be stated that the principal indications are to dissipate the eruption and to prevent its return. The best way to fulfil the former is the judicious application of both internal and external remedies, and of the latter the use of internal remedies in connection with a proper dietary and suitable hygiene. The special combination that will, in the author's experience, most quickly remove the eruption is the free use of Chrysophanic acid externally, and of phosphorus or arsenic in poisonous doses* internally. It is of course understood that such treatment is not advised. Of the various remedies that have been recommended for the specific treatment of Psoriasis the author's experience is limited to but a comparatively small number. These are: