The views of Hebra, on the treatment of Psoriasis and of skin diseases generally, are, in the main, diametrically opposite to those of Wilson. It is but right, therefore, that they should receive a fair exposition, and this can best be done by giving them at length and in his own words. The quotation will be a long one, but I believe every reader will feel himself amply repaid for the time spent in its perusal.

Hebra says:

"For the cure of psoriasis, and indeed of chronic diseases of the skin generally, two methods have from early times been proposed. The first of these started from the supposition that all the chronic dermatoses are the children of one parent, the products of one and the same dyscrasia or morbid change in the blood; and, therefore, that these diseases are to be cured by purifying and correcting the state of the circulating fluid, or by expelling acrid matters (acrimoniae sanguinis). For the practice of this mode of treatment, no accurate diagnosis was required. It came to much the same thing whether the patient was suffering from psoriasis, prurigo, or ecthyma. In each case the same remedies were employed, namely, the so-called haemato-cathartica.

"By some physicians, then, this was regarded as the only legitimate method of dealing with such diseases. They would not hear of any other plan of treatment, and condemned as dangerous all local applications, on the ground that such applications might "drive inward" the cutaneous affection, causing it to " recede" from the skin and undergo "metastasis" to some important internal organ. And even those more intelligent and experienced practitioners who did not entirely oppose the use of local treatment nevertheless considered it to be admissible only when the fluids of the body had been thoroughly purified, and freed by a course of medicine of some kind or other from the acrid matters of the eruption (von den Scharfen der Flechte). The history of past centuries shows sufficiently how far this notion could be carried, although it rested on an utterly speculative basis.

"The unsatisfactory results yielded by this plan led physicians to enter upon an entirely different path, that of experiment and observation. Now this path is, I must confess, the one which I myself follow exclusively in the treatment of cutaneous affections, and, indeed, of disease in general. I set not the slightest value on any remedies except those which (after repeated trials, and when I am accurately acquainted with the complaint) I find to produce a favorable change in its course, or, in other words, to cure the patient. I never attribute therapeutical powers to a medicine unless I observe its employment to be invariably and constantly followed by some change in the morbid products, and by the termination of the disease in a shorter time than when it is allowed to undergo spontaneous involution. I do not care in the least whether this result is obtained by introducing the remedy into the patient's alimentary canal or by bringing it into contact with his skin.

"In the previous volume, I have drawn attention to the fact that the skin, as well as the intestinal canal, has the power of absorbing medicinal substances, as well as contagia and other noxious agents, and that remedies applied to the exterior of the body reach the blood, like those which are swallowed. In reference to this, I need but point to the well-known fact that a short time after their application to the cutaneous surface, preparations of mercury or iron, and even tar. appear in most of the secretions and excretions, and can be plainly detected in them by chemical reagents. And not only is the skin well adapted to absorb medicinal substances, but their external application, when the skin is diseased, has the advantage of bringing them into direct contact with the part affected; a very great gain indeed, when it is desirable to dissolve, soften, or macerate the morbid products, or to modify them in any other way. A further advantage of introducing remedies through the skin is, that the whole intestinal tract is left undisturbed, so that the disorder of the nutritive functions is avoided to which medicines often give rise, and that proper nourishment can be taken by the patient at the same time that he is undergoing the treatment from which a cure of his disease is looked for.

"It must not, however, be inferred, from the remarks I have been making, that I am entirely opposed to the administration of internal remedies, and would in no case have them employed. On the contrary, I never hesitate to prescribe such medicines in all cases in which their success has established their value. I object merely to those inert, obsolete drugs, the belief in the curative powers of which has been transmitted from teacher to pupil without inquiry, and from text-book to text-book without examination or criticism, and which are prescribed in practice without thought and as a matter of routine. Unfortunately, too, these medi-cines are not always entirely negative in their action, as are, perhaps, the homoeopathic medicines; so that we cannot but regret, instead of smiling at, their administration.

"Of the drugs which I have been condemning in the preceding sentences, I think it well to mention expressly those which are most commonly employed, and many of which I have myself repeatedly tried. Such are the following: - The Stipites Dulcamarae, Millefolium, Trifolium fibrinum, Fumaria, Inula helenium. Ulmus campestris, Flores Pedemontanae, Viola tricolr, Radix et Baccae Juniperi, Juniperus sabina, Rhus radicans, Rhus toxicodendron Dufresnoy), Eupatorium cannabinum et perfoliatum (Barton), Conium macubtum (Valentin), Pulvis foliorum Belladonnae (Theden, Sohack), Pulsatilla nigricans (August Gottlieb Richter), Solatium nigrum (Alibert), Herba Scabiosae arvensis. Daphne mezereum (Loisel-leure and Delongohamp), Orobanche virginiana, Saponaria, Radix Phyllidis amarae, Decoctum Carbonum (Busch), Infusum Sassafras (Sachse), Ledum palustre (Schopf), Succus Nicotianae, Folia et putamina Nucum juglandum, Sarsaparilla, Bardana, Guaiacum, and the Species lignorum.