If in a state of minute subdivision, as found in blue pill, and in triturations with chalk or milk-sugar.

The foregoing applies simply to cases of syphilis that come under treatment in its early stages. In many instances, however, we will be consulted at a later period, and for lesions of a more serious character. This will often compel us to modify the treatment, and to introduce an additional therapeutical agent, namely, the iodide of potassium. This drug is extensively employed in syphilis, more frequently, we think, than it should be. Its popularity is due principally to the fact that it exerts a very prompt control over certain manifestations of the disease, and to the idea possessed by many that its effects upon the system are less injurious than those of mercury. This opinion we cannot altogether share The iodide, however, has its special functions to perform, and under certain circumstances is indispensable; but before employing it we must understand exactly what it is capable of effecting. Mercury cures the disease, and by so doing removes the cause that produces the various symptoms. The iodide, on the other hand, relieves certain symptoms with wonderful rapidity, but does not eradicate their cause. In other words, relapses are far more frequent after its use than after the judicious employment of mercury. The conditions to which it is appropriate are affections of the periosteum and bones, extensive ulcerations, gummata, and affections of the nervous system. In cases accompanied with severe periosteal pains, the aid of the iodide may be invoked for the relief of this symptom, a re-lief which, if given in sufficient doses, it usually affords. In cases of ex-tensive ulceration, or other processes involving the integrity of important organs, and where there is not time to wait for the more tardy action of mercury, or when this latter is contraindicated by the patient's general physical condition, the iodide should be used promptly and freely. The cutaneous eruptions and ulcerations pertaining to the tertiary period disappear more rapidly under the use of the iodide singly, or combined with the mercury, than under the use of mercury alone. The size of the dose will depend somewhat upon the patient's previous familiarity with the draff. The less be has taken on former occasions the less he will probably need, and vice versa. In the former case a dose of 0.30 - 0.60 (five to ten grains), three times a day, will usually be sufficient. It should be given in an abundant menstruum, either water or some simple syrup agreeably flavored, or with compound syrup of sarsaparilla, or with com-pound tincture of cinchona, if a tonic is needed. It is generally advisable to give mercury in addition. This may be ordered separately, or in combination with the iodide. In the latter case the vehicle or menstruum should not contain an alkaloid, as the probable result would be the precipitation of an iodo-hydrarffyrate of the alkaloid. In this case, unless the mixture is well shaken, the patient will get little or no mercury in the earlier doses; but, as he reaches the bottom of the bottle, will get more mercury than he bargained for. This accident we have several times known to occur. In early syphilis the proto-salts of mercury are usually preferred; but in late disease, especially when used with the iodide, it is the almost universal custom to employ the persalts, the bichloride and biniodide being the favorites. These may be given ordinarily in doses of two to five milhgr. (gr. 1/32 - 1/12) three times a day. Under this treatment the lesions under consideration will usually improve in a satisfactory manner. As soon as they have disappeared, the iodide should be discontinued, and a persalt of mercury be given in small doses (one to three milligr.) for a considerable period. If the patient is already habituated to the use of the iodide before coming under treatment, somewhat larger doses than those mentioned may be required.

In cases of extensive or advancing ulceration about the tongue, soft palate, or fauces, the iodide is required, and in considerable doses. No definite dose can be named. The drug must be pushed until it checks the progress of the lesion, which it will usually do, if enough of it is given. As soon, however, as the trouble is checked, and fully under control, a persalt of mercury should be prescribed, and the iodide gradually diminished and finally abandoned, the mercury being continued for a few months longer.

In lesions of the nervous system also, our chief dependence is upon the iodide. If the symptoms are not urgent the drug may be given in moderate doses of about a gram (15 grs.) three times a day. If the trouble, however, is grave, the dose must be rapidly increased. When the symptoms are finally mastered, the iodide is gradually diminished and supplemented by mercury.

From the above it will be seen that mercury and iodide of potassium both have important roles to fill in the management of syphilis. Their properties and powers, however, are not identical, as many seem to think, and consequently they are not interchangeable. They cannot be given one for the other, in the hope of attaining the same end; but each must be used according to the special indications of the case, the iodide to relieve symptoms and lesions in the later periods of the disease, mercury to cure the disease itself in all its stages. The foregoing are the principal agents to be employed in the specific treatment of syphilis, but a few words are necessary in regard to their administration. As a rule, mercury is given by the mouth; when, however, the stomach or bowels are particularly irritable, the drug may be used hypodermically, or by fumigation. In the former case, the bichloride or bicyanide may be employed; in the latter, calomel.

In iritis dependent upon syphilis, specific treatment must, of course, be employed; mercury, if the eye trouble appears early, mercury and iodide of potassium, if it comes on later. In addition it is absolutely necessary to dilate the pupil, and to keep it dilated, so as to prevent, as far as possible, adhesions between the iris and the capsule of the lens. To accomplish this a solution of atropine or the extract of belladonna should be frequently applied to the eye.

In affections of the hard palate and of the nose, especially ulcerations connected with carious bone, the chlorides of gold, and of gold and sodium, appear to possess specific and directly curative powers. These salts should be given in doses not exceeding one milligr. (gr. 1/64) well diluted, two or three times a day. Larger doses are apt to disorder the stomach and aggravate the local disease. The results attained with gold in the conditions specified have been surprisingly prompt and exceedingly gratifying. Per contra, we have not been able to obtain as good results from it in other syphilitic manifestations. The bichloride of platinum, in the same doses as gold, sometimes affords relief in the nocturnal bone pains, and when it does so is to be preferred to the iodide of potassium. Mezereon, guaiac, sarsaparilla, stillingia, are often useful adjuvants, but probably do not possess any specific power over the disease.