the disease of the bone. If the whole shaft becomes necrosed, of course the sore will not heal till this has been got rid of; but suppuration often occurs and yet but little, or perhaps none, of the bone dies. In such a case the sulphides hasten the expulsion of the pus, and if the skin is already broken before they are employed, they improve the character of the wound and the discharge, and the sore heals, leaving a sunken scar adherent to the bone, whilst the finger slowly assumes its natural proportions. Large indolent abscesses may form on the back of the hands or feet. These are similarly affected by the sulphides. Whilst these remedies are thus influencing locally these strumous formations and abscesses, the child's health greatly improves, although failing previously, in spite, perhaps, of the administration of Codliver oil and Steel wine. That the improvement is due to the sulphide is shown by the fact that the amendment occurs where only this drug is administered. On prematurely discontinuing the sulphide, fresh formations are apt to appear, especially on the occurrence even of a slight illness; indeed, a severe illness will often excite a few fresh abscesses, in spite of the sulphides.

The sulphides appear to me to exercise a very beneficial influence in suppurating scrofulous glands in the neck. Here again they hasten the elimination of the pus, and subsequently the cheesy scrofulous matter. After the abscesses have burst, and continued slowly discharging a scanty, unhealthy pus, and when the edges of the sores have become much thickened and indurated, these remedies render the discharge more abundant, thick, creamy, and healthy, considerably hasten the evacuation of the scrofulous matter, which prevents the healing of the wound, and at the same time soften the round indurated edges, so that the sore heals much more speedily. If small doses appear to affect these sores but little, larger doses, as half a grain or a grain, should be given several times a day, or even every two hours. I need hardly say that to compass the results described the treatment must be continued several weeks, for it is vain to expect them to occur in a few days, when the sores have been discharging perhaps for months or even years.

The topical effect of Sulphur ointment, or of an Ointment of the Hypochlorite of Sulphur, or, still better, of the Iodide of Sulphur of the Pharmacopoeia, is most marked on acne indurata and acne rosacea. Here, again, the effects are twofold, and even

opposite, according to the stage of the eruption. If applied at the very commencement of the eruption, as soon as the little hard knot is felt under the skin, further development is arrested and the hardness speedily disappears. For instance, if smeared over the hardness just before going to bed, in the morning scarcely any induration will be felt, though after a time, perhaps from exercise, or the irritation from washing, much of the hardness may return, to be again removed by a renewed application of the ointment, so that in two or at most three days a papule that threatened to become of considerable size may be completely dispersed. When, however, the nodule has advanced further, and suppuration has set in, then the effects of the ointment are much like those of sulphides, administered internally, on boils. The ointment hastens maturation, limits the swelling and hardness, and thus considerably curtails the duration of the eruption. Nay, further, if rubbed over the skin it appears to check the formation of the acne spots. If rubbed over the nose and neighbouring parts of the face in acne rosacea its effects are often striking. Not only does it act as in acne indurata, but the hardened, swollen tissues become softened and reduced to a more natural state. I have found the Iodide of Sulphur likewise useful in bromic acne, reducing the eruption, or at least considerably lessening the size of each spot. In acne the ointment should be thickly smeared over the eruption night and morning.

Any one who gives the sulphides a fair trial in the foregoing cases will, I feel confident, have reason to be gratified with the result.-Lancet, February 21st, 1874.

To read the above in the pages of our old enemy the Lancet almost took away our breath. It is nothing but a homœopathic clinical lecture on our very own medicine, Hepar sulphuris, with the omission of the word "homoeopathic," and the thin veil of Sulphide of Calcium used to conceal the more ordinary homoeopathic appellation Hepar. How comes it that the Lancet, which still wages fierce war against homoeopathy, admits a pure piece of homœopathic practice into its columns, provided the author has made no actual confession of a belief in homœopathy, and no verbal mention is made of the hated system? Had our late illustrious colleague, Professor Henderson, written an article on Hepar in connexion with the suppurative process, or with boils

and carbuncles, he could scarcely have said anything different from what the Professor of Therapeutics in University College has said; but had he sent such a paper to the Lancet, can any one doubt that it could have been insultingly rejected?

It must be very mortifying to Professor Sydney Ringer to find that the sole credit of the discovery of the curative action of Hepar sulphuris in suppurative processes is not left to his peaceable enjoyment. In the very next number of the Lancet Dr. Thorowgood, whose frequent rediscoveries of well-known homœopathic remedies would be surprising did we not know the source whence he derives his information, claims to have used Hepar sulph. in diseases attended with suppuration for ten years; and Dr. Burness, who has just published a book of homoeopathic principles and practice, without the name, expresses his concurrence with what Dr. Ringer says about Hepar, and testifies that he has frequently used it in similar cases. We subjoin the letters of those two "allopathic " practitioners, which will be found highly amusing to all conversant with homoeopathic practice.

. MEDICINAL USE OF CERTAIN SULPHIDES.

To the Editor of The Lancet.'

SIR, Dr. Ringer has done good service in bringing into prominent notice the use of certain sulphides in diseases attended with suppuration.

About ten years ago I had under my care a child afflicted with unhealthy strumous ulcerations in the neck and other parts of the body. The sores had thickened edges; and, in some, a small greenish slough formed. There was no evidence of syphilitic taint. Cod-liver oil and Iodide of Iron had no curative action, but on half-grain doses of Sulphide of Calcium in water a very striking amendment took place.

I have found the Sulphuretted potash of the B.P. an admirable remedy in many cases of glandular suppuration. In follicular tonsillitis, also, I have employed this salt with highly satisfactory results. One grain can be made into a pill, with a drop of Oil of Anise added as an effectual means of overcoming the abominable odour of the salt. When made, the pill may be coated with Ethereal solution of Tolu; this will not only conceal the smell, but will prevent the contained sulphide absorbing oxygen and becoming an inert sulphate.

M. Tiry, of Paris, prepares capsules containing the Sulphuretted potash. In these the salt is perfectly protected from the air, and in this form the drug is readily given to the most fastidious of patients. The capsules that I have seen and used were obtained from Messrs. Corbyn, and imported by that house from Paris.

I am, Sir, obediently yours,

JOHN C. THOROWGOOD, M.D. Lond., Lecturer on Materia Medica at Middlesex Hospital.

SIR,-Your issue of February 21st contains an article by Dr. Sydney Ringer on the Sulphides of Potassium, Sodium, and Calcium, in which he refers to the power of these agents to control suppuration, and states that he has found them to be valuable agents in the treatment of boils, carbuncles, scrofulous glands, and many skin diseases. With his statement I fully concur, having frequently used the sulphides in the treatment of similar cases with great success. But however interesting and curious these facts may be of themselves, I think more valuable instruction may be derived from them if we seek to ascertain how and why they are such valuable therapeutic agents in the treatment of the special affections alluded to, and, having gained this knowledge, we will then have a scientific basis on which to found our treatment. Therefore, having this object in view, I trust you will allow me to quote the following remarks from my work on the Specific Action of Drugs, where I premise that the full therapeutic value of any drug is only to be obtained by first ascertaining its physiological action. Now, as regards the sulphides, when swallowed in a full dose they are, to a certain extent, decomposed by the free acid in the stomach, sulphuretted hydrogen is evolved, and some of the effects produced are due to this gas―viz., an acid taste in the mouth, burning pain in the throat and stomach, dry cough (sometimes vomiting and purging), feeble pulse, faintness, convulsions, or a state of sopor. But in smaller doses, frequently repeated, they produce an anæmic condition, with general nervous depression. Applied externally they cause a papular or vesicular eruption, and it is well known that the sulphides, like Sulphur, are eliminated by the skin in the form of sulphuretted hydrogen.

Now these facts indicate that the specific action of these

agents is upon the skin and mucous membrane in the process of elimination, and also to a certain extent upon the blood-corpuscles (the secondary effects being due to the changes produced in the nature and quality of the vital action of these parts). We naturally infer that the therapeutic actions of these agents will be on the same tracts, and hence we are led to use them in such affections as chronic catarrh, follicular sore throat, chronic bronchitis, abscesses, scrofulous glands, and many skin diseases; also to improve the condition of scrofulous children suffering from indolent abscesses, but in these cases we give a less dose than a physiological one-viz. a restorative dose.

We can thus remove the sulphides from the list of empiric remedies, having facts at our disposal to account for their remedial action, for I have indicated that given in a physiological dose they influence certain specific parts; and daily experience (e.g., the cases communicated by Dr. Sydney Ringer) confirms the truth of the inference that in a restorative dose they will beneficially influence the same parts when deranged, and this they do either by in some manner altering the nature and quality of the vital action of the parts or by removing the state of combination of the elements which excite diseased action, and thus enabling the normal powers of nutrition to restore the healthy constitution; and this I consider applies not only to the sulphides but also to every other drug. Now in reference to the dose mentioned by Dr. Sydney Ringer-viz., one tenth of a grain every two or three hours-I consider the quantity quite sufficient, and this for two reasons. 1st. Because the sulphides are comparatively insoluble and slowly diffusible salts, hence require to be given in small and repeated doses to ensure their being absorbed into the system, for if a large dose be given at once it may pass through the intestinal canal before it can be changed into a condition necessary for absorption; moreover, by giving small and repeated doses we can keep the system longer under the influence of the drug. 2nd. A small dose is indicated because we wish the restorative action of a drug on a part whose functions are deranged, and not its physiological action, at least in the cases mentioned above.

I remain, Sir, your obedient servant,

ALEX. G. BURNESS, M.B., &c.

Green Street, Grosvenor Square; 23rd Feb., 1874.