not yet all consumed. The prescription was renewed after the first supply was finished, and the patient kept under it till the 17th July.

17th July. Quickly as the tumour in the throat had diminished, the remaining small portion of it only yielded slowly and imperfectly to the continued use of the Spongia, just as happens with the tumours on the outside of the neck, for which Spongia is indicated. At first a rapid improvement, but the remainder of the tumour, generally a small hard gland, continues; the medicine seems, by this, to act more on the cellular infiltration surrounding the gland, than on the gland itself; in which, besides, the conditions are not favorable for producing absorption. Externally the neck was almost of its normal size, there were seven superficial small openings, with a slight discharge, and a small fresh abscess made its appearance. In the throat we could see and feel on the right side behind the posterior crus of the palate, a certain amount of fulness, that seemed to have its seat in the cutaneous cellular tissue, and there was a slight narrowing of the posterior crus towards the left. Since the glandular swelling of the neck, the patient had a numb feeling on the chin and down the front of the neck, which went off very slowly.

1st October. The superficial fistulous ulcerations on the outside of the neck, which the patient would not allow to be slit open, were pretty well dried up, the throat externally was of its normal size, the remainder of the swelling behind the velum on the right side was gone, and all that remained was only a slight contraction of the posterior crus of the velum from the right side towards the root of the tongue, such a slight deviation from the normal state, as scarcely to be observed by any one who had not watched the whole course of the disease. After taking the Spongia, the patient had again taken Hepar, and as since the end of July, she suffered from an obstinate irritating catarrhal cough, she had since then taken Hyos., Nux vom., Cham., and Bell. She is now, after the lapse of two years, without a relapse, and very well.

ON THE TREATMENT OF SYPHILIS.*

By Dr. CLOTAr Müller.

IN primary chancre, whether simple or indurated, the Merc. precip. rubr. acts on an average still best and most certainly, only it at times leaves us in the lurch with the phagedænic sores. Cinnabar and nitric acid are then not unfrequently of more service. But the fact is not to be overlooked that the external treatment is of importance, and consists in diligent covering of the sore with charpie dipped in cold water and well squeezed out, so that the pus may be hindered as much as possible from irritating the sore and environs. Bodily rest, warmth, and strict low diet, are also of great influence. On the other hand, in constitutional syphilis the low diet seems to be of no consequence; on the contrary, the patients who are in a low state of health, must be strengthened by an abundant and tonic diet. If the bones become affected the Hydriodate of Potash is obviously the remedy, and one which almost never disappoints our expectations, and in this respect affords one point in the treatment of syphilis where we can to some extent speak of certainty. Only, however, we must not give it in weak doses, but undiluted, and to the extent of 3 to 5 grains daily. It is true the hydriodate cures very often the bone affections alone and not the whole lues. Aurum is also a medicine at times useful in bone affections, especially those of the nose and palate, as also it appears more indicated for caries and necrosis, while the Hydriodate of Potash suits better for nodes and bone pains. Against ulceration of the throat and mouth, and the so-called mucous patches, the corrosive sublimate is still the best medicine, much oftener than nitric acid, which only does good at times where mercury has been already abused. From Thuja, Sanguinaria, and Kali bichromicum, I have never, or only very seldom, seen any decided action. Merc. hydrocyanicus and Schweikert's combination of Merc. biniodat. and Kali hydriod. have been

From the Report of the Leipzig Policlinik for 1863, Hom. Vierteljahrschrift, vol. xv, p. 468.

urgently recommended for lues; up to the present time I have had no particular success with either. Besides, it has been on the whole sufficiently proved that seldom, or never, can a lues be thoroughly cured with one single remedy, or at least one single preparation, unless, indeed, it be by a carefully regulated inunction cure, as I have seen a few times in the hands of other medical men. This much at least is certain, that of all the so-called quicksilver cures, this is the one that acts most surely and offers the fewest dangers and after evils.

The cure of condylomata frequently gives us great trouble. Thuja and Cinnabar are, often enough, of no use whatever. On the whole, this disease is still mysterious and unexplained in its nature, because it is often quite certainly a symptom of true lues, while at other times it seems to arise alone as an independent and more or less local disorder, without displaying any distinct signs of which class it belongs to. If the warts follow and arise in the course of a simple gonorrhoea, they are generally removed permanently by the application of Tincture of Sabina, or Muriate of Iron. But if they come as a symptom of general lues, little or nothing can be effected by the local treatment alone, for they generally come back again shortly. In one case they vanished in a wonderful manner after Lycopodium in two or three doses. In another case I saw warts of the prepuce from gonorrhoea return pretty suddenly after they had been cured by Lycopodium inwardly and Sabina outwardly, sixteen years before, though no fresh infection had taken place, and no sign of dormant lues had shown itself all that time.

ACTION OF ARSENIC ON THE EXTERNAL GENITAL PARTS.

By DR. IMBERT-GOURBEYRE.*

SALMUTH is, as far as I knowt, the first observer who

From the Gaz. Med. de Paris, quoted in the Bul. de la Soc. Méd. Hom. de France, Dec. 1st, 1864.

+ Sallin (Receuil periodique, t. viii, an. viii) speaks of the action of arsenic

mentions the elective action of arsenic on the external genitals. In his Centuries (Salmuthi, Observationum medicarum centuriæ tres, Brunswige, 1648, I. Obs. X), he mentions having been summoned one morning to see a prisoner who had poisoned himself in the night with arsenic, and who died a quarter of an hour after his visit. A post mortem examination was made in the evening; the back of the corpse was livid, imprimisque pudenda nigra prorsus.

'Deinde," says Stahl (Stahlii opuscula, Halæ Magdeburgicæ, 1715, p. 454), "accidit fere in viris specialissima repentina sphacelatio, et post mortem præceps putredo in genitalibus." Stahl, when mentioning this special action, cites the preceding observation of Salmuth, and corroborates it by two observations of his own. The first is the case of a husband poisoned by his wife, cujus genitalia pari modo plane denigrata reperta fuerunt; in the second, membrum virile extensum, turgidissime inflatum et penitus nigrum.

Two soldiers washed their genitals with an arsenical solution to cure the itch, which it did. Sed utriusque genitalia tanta inflammatio atque intumescentia invasit, ut aspectu horrendum esset. . . . totusque locus affectus brevi tempore contrahebat nigridinem gangrænosam, ut de perfecto sphacelo jam sollicitus essem. Tandem vero, multa adhibita cura, separatio sphacelati succedebat, et paulatim laborantes restituebantur (Degner, Acta nat. curiosorum).

"On the eighth day of the poisoning of a miller," says Pfann, in his Samml. verschied. merkwürd. Fälle (Nürnberg, 1750), "all the body was covered with black and burning pustules; the glans penis was ulcerated and quite black. The poisoning was effected by means of cobalt; the learned doctors of Erlangen were consulted with reference to the eruption and the affection of the genitals, and they replied they did not know if cobalt was the cause."

Dumont, an apothecary's boy, pounded in two days three

on the genital organs, and refers to the observations of Fabricius, Libavius, Wepfer. I have found nothing on the subject in the last named, nor yet in Fabricius ab Aquapendente. I have not been able to consult either Libavius or Fabricius Hildanus.

quintals of arsenic; he wore his cap over his eyes, and a towel folded in four over his chin, mouth, and nose; three days afterwards, to the ordinary symptoms of poisoning were added swelling of the penis, with insupportable pain and scalding of the urine. The following morning he had agonising pains in the kidneys, bladder, and penis, the urinary excretion was stopped. (Dehenne, Jour. de Méd.

de Vandermonde, 1759.)

Scheffer, in his Gesundheit der Bergleute (Chemnitz, 1770), mentions the ulcerations of the genitals occurring in those employed in the manufacture of arsenic.

Caëls then was right, when in his general description of arsenical poisoning, he says: "Gangræna aut sphacelus ventriculi et intestinorum, et nonnunquam etiam genitalium." (Ratio occurrendi morbis a mineralium abusu produci solitis. Amstelodami, 1781.)

Hahnemann, in his work Ueber die Arsenikvergiftung (Leipzig, 1786), speaks of the lividity and swelling of the genital parts, without citing, contrary to his usual habit, any authority; he classes this action among the rare effects. Later (Reine Arzneimittellehre, 1816), he contents himself with quoting Pfann and Degner, in addition to an observation taken from the Neue med. chir. Wahrnehmungen (Altenburg, 1778), where mention is made of very painful swelling of the genitals in a case of poisoning.

Towards the end of last century, Gmelin, in his continuation of Murray's work (Murray, Apparatus medicaminum, t. viii. Göttingen, 1795), notices also the elective action of arsenic. "Videas partes nonnullas et præsertim genitales, viridi, luteo, nigro colore fœdatas et tumidas." Some years later Frank alludes to the same fact in his Manual of Toxicology (1803).

In Pyl's Magazin für die gerichtliche Arzneikunde (Stendal, 1784), we read the history of a person poisoned by arsenic, who died in two or three hours; in this case the posterior part of the body, the lips, the nails, the glans, and the scrotum were quite blue.

In an old man who died very soon after taking the poison,