"Solution Of Sulphuret Of Calcium (Kalksch Wefelleber-Losung). - This application was first recommended by Vlemingkx, a staff-officer in the Belgian Army Medical Service, for the cure of scabies, and has proved to be of considerable value. 1 have likewise tried it in many other cuta-neous diseases, and among them in psoriasis, and have found it very useful. A Viennese chemist, Professor Schneider, has altered the method of preparing it; and, for Some years past, that which I have employed in the General Hospital has been made according to his formula, which is as follows: R. Colds vivae libram, sulphuris citrini libras duas. Coq. c. aq. fontis libris viginti ad remanentiam librnnim duodecin. Fluidum refrigeratum filtretur, et detur usui. This process yields a dark orange-yellow, slightly caustic fluid, which smells strongly of hydrothion. The remedy should be applied immediately before giving the patient a bath, and the best way of doing it is the following: A bit of flannel or a piece of pumice-stone is dipped into the fluid, and with this each patch of psoriasis is rubbed till slight bleeding takes place. The solution is then once more applied to the spot and is left on it to dry. When this has occurred, the patient is put into a warm bath, in which he is left an hour. At the end of that time he is further washed with pure cold or warm water, and his skin is then anointed either with simple oil or fat, or with one or other of the ointments (to be hereafter specified) which are compatible with the sulphur-compound. This is essential, because even by the most careful cleansing the sulphur cannot be entirely removed from the surface of the skin.

This treatment is so painful that it cannot be applied to a large part of the surface at one time. The affected spots must be attacked separately: and this is the more practicable, because a single application of the solution of sulphuret of calcium to a patch of psoriasis, if done properly, is sufficient to destroy it completely.

"If, however, a less painful (but, at the same time, a less effectual) method be preferred, the solution may be rubbed in less forcibly on each occasion; but it will then be necessary that it should be applied more frequently, or to a larger part of the surface.

One effect of the energetic application of this solution is that black crusts, formed from dried blood, appear in the place of those patches which had been rubbed until they bled. At other spots, where the skin has been excoriated, a superficial suppuration may take place. This likewise leads to the production of crusts, but they are of a brown color. The new epidermis which is developed beneath them is always healthy.

"Frictions with Vlemingkx's solution must be applied more gently to the skin over the elbows and knees, and over other joints, lest the tension and pain produced by them should needlessly interfere with the movements of the limbs. This method is therefore most suitable to cases in which psoriasis occupies the trunk, thighs, or calves of the legs; and generally to cases in which the seat of the disease and its intensity are such as to render an energetic treatment practicable and even advisable.

"The frequency with which the application of this solution must be repeated varies with the degree of force employed, and the severity of the disease. If the less energetic method is adopted, the sulphuret of calcium must be applied every day, and be followed by a warm bath on each occasion. But if it is thought desirable to use such forcible friction as to make each patch of the psoriasis bleed, sufficient time must be allowed after each application for the disappearance of the effects produced by the caustic action of the liquid, or, in other words, for the separation of the black or brown scabs which result from its use. For this, as a rule, a week is long enough.

"In addition to the therapeutical measures which I have hitherto been describing, adapted to cases of extensive psoriasis, I have still to mention certain remedies which are often made use of in the less severe forms of the disease, or are employed in conjunction with other applications, or, lastly, after other plans of treatment, for the purpose of removing the last marks of the patches. Among these are the white precipitate, the acid nitrate of mercury, the proto-iodide and the deuto-iodide of mercury, and naphthalin.

The first three of these compounds (the white precipitate, the acid nitrate, and the proto-iodide of mercury) are especially adapted to cases of psoriasis of the scalp and face, their value in these local forms of the disease being due partly to their having a less powerful irritant action, and (in the case of one of them) partly to the absence of color. They are prescribed in ointments of the strength of a drachm to the ounce of Ung. simplex. One of these may be forcibly rubbed with the finger several times a day into the parts affected, which must first have been cleaned so as to remove the masses of scales; but, when practicable, it is still better to spread the ointment upon linen, and to lay this upon the patches. Even when such an ointment is applied, particularly if the scalp is the seat of the disease, an occasional washing with soft soap or the spiritus saponatus kalinus will considerably hasten the cure. This, however, might easily be inferred from what has been already stated.

"The deuto-iodide of mercury, on the other hand, is a far more irritant substance, especially when, having been previously prepared, it is made up into an ointment in the proportion of ten or twenty grains to the ounce of lard. In the form suggested by Rochard, of Paris, its effects are, however, less severe. The salt is then made at the time by fusing together iodine and calomel. Rochard's formula is as follows: R. Iodinii puri grana septem; calomelanos, scrupulum unum. Leni igne fusis adde unguenti communis uncias duos. A disadvantage of this preparation is that sometimes only a proto-iodide is formed, the ointment being then of a yellow color, while at other times the deuto-iodide is produced, so that the ointment is reddish. This, of course, shakes the patient's confidence, and therefore, to avoid such a result, I employ instead of the Ung. simplex the Ung. rosatum, which is itself red.

"The Ung. hydrarg. deuto-iodidi, in the form recommended by Rochard, must be used with greater caution than the other preparations of which I have been speaking. It may either be used as an auxiliary in cases which are at the same time being treated with baths or by the water cure, with soft soap or with the solution of sulphuret of calcium; or it may be employed by itself and independently of all other remedies. In the latter case it is applied to the patches once or twice daily for several days in succession, until excoriations are formed, or considerable swelling occurs, sometimes even attended with the formation of bullae. Another method of employing it, like the ointments above mentioned, is to spread it upon small pieces of lint, of exactly the same size as the patches of psoriasis, and to continue applying these until the inflammatory symptoms of which I have just been speaking make their appearance.