A. Increased temperature, perspiration, and irritation of the skin, 5,234. Formication, Paul, 178, Apr. 19, '60.

Icterus, Knoevenagel, 114, '69, 157; Winckel, 121, '79, 431. Urticarial eruption, Woodman, 146, 2/04, 386. Purpura, Farquharson, 116, 1/79, 266; 206.

C. Eczema, Broadbent, 132, 1/71, 538.

Psoriasis, 4, 82; 55, 17; Eames, 125, Jan. '72; Broadbent, loc. cit.

Lupus, 4, 82; 55, 17; Wilson, 135, 2: 307; Eames, 125, Jan. '72.

Acne, 4, 82.

Cazenave has recommended phosphorus in certain skin disorders, and he appends to his book a formula for its exhibition; which is, however, a very imperfect and dangerous one. In 1850 Dr. Burgess said that he regarded this drug as a most valuable medicine in the treatment of lupus, psoriasis, and lepra. From that date until 1868 no further observation on that subject was published; but in that year Dr. Broadbent, in a paper entitled "An Attempt to Apply Chemical Principles in Explanation of the Action of Remedies," read before the Royal Medico-Chirurgical Society of London, referred to the cure of old standing cases of skin disease with phosphorus in support of his theory, phosphorus and arsenic belonging to the chemical group. In 1871 the same author read before the Clinical Society of London another paper on the same subject. In it the treatment of six cases of eczema and six cases of psoriasis was described. Of the cases of eczema three got perfectly well, two nearly well, and one only was not benefited. Of those which were cured, the most striking case was that of a girl aged twelve years, who had had eczema of the scalp, reaching over the forehead, for three months. She took phosphorus for three months, and had nearly recovered, when she was obliged to intermit the medicine on account of the occurrence of dyspeptic symptoms. After an interval of three weeks, during which some return of the disease was observed, the remedy was resumed; and, after taking it for another two weeks, she was discharged, quite cured. Of the six cases of psoriasis, two were uninfluenced by the remedy. The same year Dr. Eames treated the same subject in a paper read before the College of Physicians of Ireland Medical Society. His experience extended over a greater variety of diseases, and appears to have . been somewhat more successful than Dr. Broadbent's. Thus, a case of acne indurata of four years' standing was cured in six weeks. Three cases of lupus were treated "with similarly satisfactory results;" that is to say, in one, marked improvement was noted in fourteen days, and cure was effected in nine months; in the other two cicatrization was complete in five months; and there was no return of the disease at the eighteenth month subsequent to treatment. In two cases of scrofuloderma the swellings disappeared, in one instance in six weeks, the other in three weeks. Psoriasis, pemphigus, and eczema yielded readily.

Probably, since many of these cases were of old standing and had already resisted other kinds of treatment, some other matter than the difficulty of its pharmaceutical preparation has interfered with a more general trial of phosphorus in skin disease. It is in such diseases as these that phosphorus is likely to be misapplied, and therefore to fall into disfavor. All those remedies which have not a specific power, and many of those which have such a power in one disease only, are liable to abuse in their general application to diseases for which they are unfitted, and are thus overlooked in many instances in which a more accurate knowledge of their mode of action would suggest their value.

According to Mr. Erasmus Wilson, phosphorus being a useful remedy in all those diseases which are due to debility of nerve-power, it should also be useful in those cutaneous disorders which are called nutritive, and in many of those which are called congestive. These conditions are probably the result of a paresis of the neighboring capillary vessels; and quite lately Dr. Colomiatti, of Turin, has ascertained in two cases of chronic psoriasis that a varicose condition of the vessels supplying the papillae is a prominent pathological condition in that disease. Taking this paresis of the cutaneous capillaries as a proximate cause of many skin diseases, a wide field of usefulness is at once opened for phosphorus, for its power over this part of the circulation is evidenced by many facts. A cutaneous disorder coexistent with general nerve debility will very probably then be benefited by phosphorus, for it depends upon a partial paralysis of nerves, over which phosphorus has special power. But this latter condition may exist without any particular evidence of nerve exhaustion forthcoming - it exists thus in some of the febrile exanthemata; other indications for the use of phosphorus must therefore be sought. They will be found either in the mere existence of certain skin diseases, in which cases the action of this drug may probably be called specific, or in a clearer definition of the circumstances under which to remove the capillary paresis is enough to remove the disease without regard to the remote cause of it. Thus, as an example of the first proposition, herpes zoster and intercostal neuralgia so constantly concur that the rash is taken to be a symptom of the nerve disorder which is primarily recognized by pain; and, as I have said elsewhere, I believe I have observed this rash to be cut short in a ease in which phosphorus was given to remedy the pain. Thus, the mere appearance of herpes zoster may be taken as an indication for phosphorus. But to exemplify the second proposition, I apprehend that a disease which finds its exciting cause in syphilis might fail to yield to phosphorus alone, although the proximate cause of the rash in that ease may be the same capillary paresis which is the only tangible patbological condition in cutaneous eruptions excited by more occult morbid states, which are found amenable to this drug.

The indications for the use of phosphorus in skill diseases have yet to be defined. Speaking in general terms, the drug will be found serviceable for two contrary purposes - to remedy a cutaneous disorder, and to prompte the rash in exanthematous diseases. For the former purpose, it must be used in the small or tonic dose; for the latter, in the large or stimulant. Used in the former manner, phosphorus will be a useful remedy in those eruptions which ac-company general nervous exhaustion, or which can be traced to a local nerve derangement; in those which result from a nutrition of the skin, or in which a state of chronic congestion (or varicosity) of the capillaries is a prominent pathological condition. Used in the latter manner, it is useful to promote those eruptions which depend for their development upon an expanded condition of the capillaries - that is to say, in the rashes of the exanthematic fevers. It is interesting in this relation to recall the itching and irritation of the skin which, according to Lobel, occasionally attends on the use of this drug, and the occurrence of phagedenic spots on the surface of the body in some cases of poisoning with it, as recorded by Weickard. Thompson.*

Psoriasis, 208; 209; 210; (H.G.P.).

Lupus, 202; 205; Piffard, 143, July 21, '77.

Acne, 209.

Eczema, phagedena, 208.

Morphoea and neuroses of the skin, 203.

D. Eczema of the lips, 207.