There are other lotions which are often of service. Carbolic acid, one or two drachms to the pint of water, to which may be added a like quantity of glycerin, is in many cases of value, especially in those in which itching is marked. A saturated solution of boric acid, with or without the addition of glycerin, may also be employed in these cases, especially in erythematous eczema. It is one of the most useful of the milder remedies. In this variety, particularly when confined to the flexures, constituting eczema intertrigo, the following formula containing acetate of lead may be prescribed in some cases with benefit:
| Rx. | Plumbi acetatis, | drachm ss; |
| Acidi acetici dil., | fluidrachm ij; | |
| Glycerinæ, | fluidrachm iv; | |
| Aquæ, q. s. ad | fluidounce vi. M. |
In those cases where lotions do not seem to act happily a mild ointment of salicylated suet (2 or 3 per cent. strength) will often relieve the condition. The fluid extract of grindelia robusta, one or two drachms to six ounces of water, seems to suit some cases, but it should be applied cautiously, as in some instances it tends to aggravate. Weak alkaline lotions, a drachm of the bicarbonate of sodium or borate of sodium to the pint of water, and a drachm of the solution of subacetate of lead to the pint, may be also mentioned. Tarry lotions of weak strength are sometimes useful. A drachm of the liquor carbonis detergens to two or four ounces of water, or the liquor picis alkalinus, a drachm to the half pint of water, may afford relief. The former tarry preparation is made by mixing together nine ounces of tincture of soap-bark2 and four ounces of coal-tar, allowing to digest for eight days and filtering. The formula for the liquor picis alkalinus, the other tarry preparation referred to, is as follows:
| Rx. | Potassæ, | drachm j; |
| Picis liquidæ, | drachm ij; | |
| Aquæ, | fluidrachm v. M. |
A lotion made up of two drachms of zinc oxide, two drachms of glycerin, six drachms of lead-water, and three ounces of infusion of tar is sometimes valuable in the erythematous form.
2 Tincture of soap-bark is made by digesting for eight days one pound of soap-bark in one gallon of alcohol.
As a rule, ointments are not so well borne in acute eczema as lotions, but as soon as the more acute symptoms have subsided, and in some instances even during the acute stage, they may be used with benefit. The oxide-of-zinc ointment is well known, and is one of the most soothing; sometimes it is well to reduce the proportion of zinc oxide. Oleate of zinc, in the proportion of one or two drachms to the ounce of vaseline or lard, is somewhat similar to oxide-of-zinc ointment, but is more astringent and stimulating. The oleate of bismuth, pure or with an equal part of vaseline or other fatty base, is also at times of service. The same may be said of the oleate of lead melted with an equal part of lard or vaseline, in this form constituting a soothing and astringent application similar to the well-known diachylon ointment. The latter ointment, if properly prepared, is in the subacute stage often exceedingly valuable. The same objection to this holds as with the different oleates named—that is, the difficulty of securing properly-made preparations. Many are vaunted as such, but our experience is that good preparations are exceptional, and those furnished, instead of acting as expected, often give rise to irritation or marked aggravation. For the acute and subacute stages of the disease the ordinary cold-cream ointment may be in some cases advantageously prescribed. An ointment of equal parts of diachylon plaster and one of the petroleum ointments, as vaseline, constitutes an elegant preparation, useful when a mild, soothing application is called for.
A paste made up as follows may also be recommended for the subacute condition, and at times suits even during the active inflammatory stage:
| Rx. | Pulv. zinci oxidi, | ounce ss; |
| Mucilag. acaciæ, Glycerinæ, aa. | fluidounce j. |
M.—S. Apply with a brush two or three times daily. To this formula, if there is considerable itching present, carbolic acid or salicylic acid in the proportion of 2 per cent. may be added. Glycerite of tannic acid sometimes proves of value, especially in the erythematous varieties of the disease, more particularly when occurring about the face. In like cases glycerite of subacetate of lead may be prescribed. The following is Squire's formula: Acetate of lead, 5 parts; litharge, 3½ parts; glycerin, 20 parts, by weight. Mix and expose to a temperature of 350° F., and filter through a hot-water funnel. The fluid resultant contains 129 grains of the subacetate of lead to the ounce, which is to be diluted with from two to six parts of glycerin or with water. This preparation may sometimes be used with benefit in chronic eczema of the legs applied on strips bound on with a bandage. In these cases the following paste, suggested by Unna, proves useful: