M.—S. A teaspoonful in a half gobletful of water after meals.
In some gouty and rheumatic cases wine of colchicum may be added to the above two prescriptions with advantage. Where a scrofulous tendency exists cod-liver oil is a valuable remedy; also in all cases of impaired nutrition, in moderate doses, long continued, it will often prove useful, especially in children.
External Treatment.—The local treatment of eczema is based upon the pathological conditions present. The acute disease requires entirely different management from that employed in chronic cases. The stage of the disease and the amount of skin involved, whether in the form of a circumscribed patch or as a diffuse eruption, are points to be taken into consideration in the selection of a remedy and the mode of its application. The several varieties, the erythematous, papular, vesicular, pustular and squamous, and also the secondary forms rubrum, fissum and verrucosum, all demand applications appropriate to the condition. In acute erythematous or vesicular eczema caution is to be exercised in the selection of remedies. Only the milder applications, as a rule, are tolerated. That which will agree with one may not agree with another. It is advisable to try the remedy upon a small portion of the diseased surface to see if it is acceptable to the skin. In these varieties also soap and water should, as much as possible, be avoided.
For the average case, especially of the vesicular variety, the most successful plan of treatment is with lotio nigra and oxide-of-zinc ointment. The lotion is to be dabbed on by means of a sponge or cloth every three or four hours, ten or fifteen minutes at a time; as soon as dry a small quantity of oxide-of-zinc ointment is to be gently smeared over. In many instances this method furnishes immediate relief to the itching, and under its use the inflammation is soon relieved. Powdering the surface with dusting-powder will sometimes afford ease, starch or lycopodium powder, either alone or together, equal parts, being useful. Subnitrate of bismuth is also of value, proving a more stimulating powder. In some cases a half drachm of finely-powdered camphor to the ounce may be advantageously added to one or another of the simple powders. Powdered Venetian talc is also sometimes useful alone or in combination with starch, a drachm or two of the former to the ounce of the latter. Dusting-powders should in all cases be used freely and often, their chief object being to afford protection to the inflamed surfaces.
Another lotion frequently employed in acute cases of vesicular eczema with free discharge, especially in cases where there is oedema or where the skin is irritable, is one containing calamine and zinc oxide; for example,
| Rx. | Pulv. zinci oxidi, Pulv. calaminæ, aa. | drachm iiss; |
| Glycerinæ, | fluidrachm j; | |
| Liq. calcis, Aquæ rosæ, aa. | fluidounce iij. |
The following may also be mentioned as being useful in similar cases:
| Rx. | Pulv. calaminæ, Cretæ præparatæ, aa. | drachm j; |
| Acidi hydrocyanici dilut., | fluidrachm ss; | |
| Glycerinæ, | fluidrachm ij; | |
| Aquæ, Liq. calcis, aa. | fluidounce iij. |
These lotions, as will be seen, contain more or less insoluble powder, and they are to be applied in the same manner as advised when speaking of the use of black wash.