parts being kept covered with portions of linen constantly wet with the mixture. Care should be taken to remove entirely, by frequent ablutions with tepid water, the morbid secretions, so as to admit the lotion to be applied directly to the diseased surface; nothing, we are assured by Plumbe, is more efficacious than this in subduing the irritation accompanying the eruption. Perseveringly employed, it will sometimes rapidly remove every vestige of the disease, 1 R.-Acid. hydrocyanic. 3iij. Aq. destil. 3vijss. In the more obstinate cases, the internal exhibition of sulphur, or of the sulphuret of potassa, from five to ten grains, three times a day, in milk the decoction of dulcamara-Plummer's pill, or the hy drargyrum cum creta-with the external use of sulphur baths, or sulphur vapor baths, should be resorted to. When, from the long continuance of the disease, a degree of debility ensues, the decoction of sarsaparilla, or the infusion of gentian, cascarilla, or calomba, with the hydrochloric acid, may be resorted to. A pure, fresh air, and the utmost cleanliness of person, are important auxiliaries in all cases. ERUPTIONS CHIEFLY CONNECTED WITH GASTRO-ENTERIC DISEASE. 5.-Erythema. Erythema consists in a slight continuous redness of the skin, varying in extent and shape, and continuing from two or three, to ten or twelve days. It may occur in patches, successively on the arms, neck, breast and face (E. fugax). This variety is usually observed in the progress of some febrile disease, or at the period of dentition; or it may be produced by slight irritations of the digestive organs. In other cases, the eruption appears in the form of bright, red, irregular patches, chiefly on the arms, neck, breast, back part of the fore-arm, and back of the hand. The patches are at first somewhat papulated (E. papulatum). The slight swelling decreases within thirty-six or forty-eight hours, but the redness continues somewhat longer, and assumes gradually, a bluish tint. The general disorder is usually trifling, though it is sometimes attended by symptoms of depression, and a quick, irritated pulse. The eruption sometimes assumes the form of a rose-colored tuberculated swelling (E. tuberculatum); or of a raised, indurated efflorescence. This variety generally continues seven or eight days, and is attended by considerable heat of the skin, and some degree of febrile excitement. Erythema frequently occurs in large oval patches, of a deep red color, upon the anterior part of the leg, in females towards the coming on of the menses, and in boys of a lymphatic temperament. The patches vary in number in different cases, and rise gradually above the level of the skin (E. nodosum), and are more or less painful when touched. They soften and subside in the course of eight or ten days; the redness slowly disappears, assuming in its decline a whitish tint. The tumors never suppurate. The eruption sometimes commences on the face, by a small, circular, red spot, slightly papulous, which gradually extends in circumference, and may, in this way, spread over the whole face (E. centrifugum). The patches are usually about an inch in diameter. There is considerable redness as well as heat, principally at their margins, which are elevated, whilst the centre is depressed, and of the natural color of the skin. They are attended with neither pain nor itching, and generally leave a slight depression of the part affected. The disease is usually of some continuance. Erythema may be produced, in children of a robust and plethoric habit, by external irritation; it is more generally, however, dependent upon some affection of the alimentary canal. Certain articles of diet, of an indigestible or unwholesome quality, will, in some constitutions, cause its sudden appearance. It occasionally occurs, also, after the use of some medicinal substances-as rhubarb, balsam of copaiba, opium, &c. The eruption in these cases is generally of short duration. When it results from gastro-intestinal disease, it is commonly more severe and of longer continuance. In languid and unhealthy constitutions, the eruption sometimes assumes a deep crimson, or a dull, dark purple hue, and is accompanied by symptoms of a typhoid character. In the slighter cases of the disease, little else is required, in the way of treatment, excepting a removal of the exciting cause, a proper regulation of diet, mild aperients, and the tepid or warm bath. When the eruption is attended with considerable irritation, heat, and itching, dusting the part with dry powdered starch, or bathing it frequently with tepid water, or any simple mucilaginous wash, will, usually, afford prompt relief. When it has arisen from an overloaded state of the stomach, or improper food, an emetic of ipecacuanha should be administered. If it occur during teething, the state of the gums should be inquired into, and if swollen or inflamed, freely lanced. Whatever irritation may exist in the alimentary canal should be combated by an appropriate course of treatment. Severe cases occurring in robust, plethoric habits, and accompanied by considerable local heat, pain, and swelling, with symptoms of febrile excitement, will demand the application of leeches, or even bleeding from the arm, saline purgatives, a restricted diet, and cooling lotions to the part affected; the patient, at the same time, being kept quiet and free from excitement. In languid habits, a course of mild alteratives and light vegetable tonics should be prescribed, with pure fresh air, a nourishing diet, of plain digestible food, and the daily use of the warm bath, followed by friction of the surface. At the close of all severe cases, light tonics will be proper. 6. Eczema. Prickly Heat. Eczema is characterized by an eruption of small, pearl-colored, or brownish-colored pink vesicles, with a very light rose-colored base, preceded by a sense of heat or tingling. The delicate and irritable skins of children render them peculiarly liable to the production of this form of vesicular eruptions on parts exposed for a very short period to the heat of the sun (E. solare). The application of heat from any other source will also produce the disease. It frequently arises also from irritations seated in the alimentary canal. When the vesicles of eczema occur between the fingers, especially if aggravated by scratching, they may be mistaken for those of scabies; but, the suddenness of the eruption, the more pointed vesicle, and the sensation of smarting, rather than of itching, readily distinguish them from the latter. When the eruption is more generally and extensively diffused, the vesicles, occurring in closer proximity to each other, with their interstices of a bright red color, it constitutes the eczema rubrum. Between the sixth and eighth days, and sometimes earlier, the redness diminishes, the serosity is absorbed, the vesicles shrivel up, and a slight desquamation takes place, leaving, however, the skin redder than natural, and presenting, when carefully examined, a number of minute, round spots, surrounded by a thin, white, ragged rim of cuticle, which indicates the extent of desquamation of each vesicle. The milder cases may quickly subside, without the occurrence of desquamation, the lymph of the vesicles becoming opaque, and being then absorbed. In other cases, new vesicles arise, of larger dimensions; upon the rupture of which, a brownish scab forms, leaving the skin in a rugose state. In the more aggravated cases, there occur febrile symptoms and a general derangement of health from the extent and persistence of the irritation (E. impetiginodes). By long and repeated application of the exciting cause, the eruption may become more permanent, and less inclined to yield to simple remedies (Chronic eczema). The chronic form is, however, of unfrequent occurrence in children. Vesicles resembling those of eczema are often produced by the application to the skin of plasters, ointments, and poultices. In the slighter cases, the treatment will consist in the removal of the exciting cause, the exhibition of mild aperients, a well-regulated diet, and the use of the warm or tepid bath, with slightly acidulated barley or toast water for drink. As local applications, tepid water, mucilaginous washes, or simple bread poultices are the best. Where there exists gastro-intestinal disease, this will demand its appropriate remedies. In the acute stage of the more severe forms, occurring in robust and plethoric habits, leeches, as well as bleeding from the arm, with saline cathartics, diaphoretics, and the antiphlogistic regimen generally, will be occasionally required. In protracted cases, the alkaline bath may be tried; or, as a local application, the hydrocyanic acid. and alcohol, as directed in impetigo, with the cautious internal use of dulcamara. When great irritation, and loss of sleep occur, the tincture of hyoscyamus may be given during the day, or an opiate at bed-time. In the impetiginous form, when the eruption has become chronic, a weak solution of alum, or of the acetate or sulphate of zinc, in diluted alcohol, will be found useful. In all cases, the patient should be exposed to a pure atmosphere; his linen should be repeatedly changed, and friction of the surface carefully avoided. When, on the subsidence of the eruption, the patient remains in a languid, debilitated state, light tonics should be administered, with a plain, wholesome, nutritious diet. Change of air, under such circumstances, will be advisable. 7.-Urticaria-Nettle Rash. The characteristic of urticaria is an eruption of red, inflamed patches, irregularly distributed upon different, and often distant parts of the body-sometimes small in extent and number, and at others, occupying a considerable portion of the skin. At the centre of each patch is situated a white irregularly formed spot, sometimes long and narrow, at others, broad or round, considerably elevated above the surrounding cuticle, and generally attended with a severe sense of itching, smarting, and tingling. The margin of the colorless tumor is very irregular, and when the finger is passed lightly over it, it presents to the touch considerable inequality of surface. The tumors, in the smaller patches of inflammation, are not unfrequently in the form of small, distinct, circular tubercles, about the size of a spangle; when several occur upon the same spot, they generally coalesce, and form a lengthened streak or wheal. The larger spots or wheals are mostly formed by the clustering together of a number of the circular white tubercles. In proportion to their size, they are surrounded by a more or less vivid inflammatory redness; and a corresponding degree of heat, itching, and smarting attends them. When punctured with a finely-pointed instrument, there escapes from the white tubercles a thin, transparent fluid, and the swelling immediately disappears. The eruption, in the simple forms of the disease, seldom continues long, and is frequently so evanescent, as to disappear, after a few moments' continuance, from one part of the body, leaving no vestige of its existence; while, almost immediately afterwards, a distant part will be found occupied by it to a considerable extent (U. evanida). In very severe cases, suddenly produced by eating certain kinds of food, the tumefaction about the neck and face is often very considerable, not unfrequently closing up the eyes and obliterating every vestige of the natural features. Even in these cases, the irritation and tumefaction will generally begin to subside at the end of thirty-six or forty-eight hours. The symptoms of the febrile form of urticaria (U. febrilis) are much more violent, and the duration longer. The eruption is preceded by pain and sickness of the stomach, headache, great languor or faintness a sense of drowsiness and anxiety; there is increased quickness of the pulse, and a white coating upon the tongue. In two days or later, a coldness and shivering are experienced, and patches of a vivid red, or even crimson hue, appear upon various parts of the surface, attended with a most troublesome itching or tingling, which is greatly increased when the patient is in bed or heated from any cause. On the appearance of the eruption, the pain and sickness of the stomach, are in general relieved. The patches often coalesce, so as to produce a continuous redness, particularly on the shoulders, loins, nates, thighs, and about the knees. They are often elevated above the surrounding cuticle, and form dense tumors, with a hard distinct border-the interstices being of a dull white color (U. tuberosa). The patches appear and disappear irregularly, first on one part, then on another. They may be excited, on any part of the skin, by strong friction, or scratching. When the patches are numerous, the face, or the limb occupied by them, appears tense, and considerably swollen. Towards the close of the disease, the eyelids are often red and tumefied, and swelling and inflammation occur on the sides of the feet. During the day, the redness of the eruption fades, and the wheals, in general, subside; but both increase, with a slight febrile exacerbation in the evening. As the eruption declines, the tongue becomes clean, the pulse natural, and the disturbed state of the functions generally ceases; the efflorescence assumes a light purple or pink appearance, and then gradually disappears, being followed by a slight exfoliation of the cuticle. The whole duration of the febrile nettle rash is from seven to eight days. The exciting causes of urticaria are various. Emotions of the mind; exposure to excessive heat or over-exertion. In certain constitutions, particular kinds of food or drink, as almonds, kernels of nuts, mushrooms, cheese, cucumbers, pie-crust, honey, different kinds of fruit, or food rendered unwholesome from being out of season, or from having undergone certain changes, as muscles, clams, oysters, lobsters, crabs, and certain kinds of fish. In individuals whose skin is peculiarly irritable, slight external irritations will give rise to it; in such, particularly if of a full habit of body, simple excess in any kind of food will act as the exciting cause. The treatment will depend upon the nature of the attack, and in some degree, also, upon the character of the exciting cause. The milder cases require little else than rest, a cooling regimen, diluent drinks, gentle aperients, and tepid baths. Where the eruption has been caused by the ingestion of certain articles of food, a brisk, emetic (the sulphate of copper), followed by a dose of purgative medicine, (calomel and jalap), should be administered. If accompanied with severe nervous symptoms, the sulphuric ether, in doses of from five to twenty drops, according to the age of the patient, given every half hour, will generally be found very efficacious. When it becomes chronic, or repeatedly occurs in the same individual, great attention |