Clinical notes on psoriasis : with especial reference to its prognosis and treatment / by L. Duncan Bulkley.

  • Lucius Duncan Bulkley
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on psoriasis : with especial reference to its prognosis and treatment / by L. Duncan Bulkley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    15/22 page 11
    full and persistent doses it often serves to remove the eruption and to keep it iu abeyance. Arsenic is a very safe remedy, as the drug is eliminated almost immediately from the system, largely by the urine, and, as far as I can learn, no ultimately toxic eifects occur even from its free and prolonged use. In one instance a patient of mine, a gentleman in whom the eruption began at twenty-two years of age, took nearly eight ounces of the pure Fowler's solution in a single year; and some time ago he calculated that he had taken over half a gallon of pure Fowler's solution in the course of four- teen years. But arsenic constantly fails either to remove the eruption or to prevent relapses, nor could we expect otherwise, for the most that arsenic can do is so to control the nerve-elements that they shall not be irritated by the acid condition of the blood ; when its use is sus- pended, or when it loses its controlling effect, the same condition returns as before. In cases where arsenic has seemed to cure the eruption, the blood-state which called forth the skin-lesions had probably been of but brief duration, and the arsenic had aided the tissue in returning to the normal. In psoriasis, therefore, the patient should be studied rather than the eruption; his diet, habits of life, the state of the emunctories, the condition of the nutrition, and many features which a careful physician notes and takes into consideration in connection with other complaints. My plea is, that one who approaches a case of psoriasis should by no means be content with alone recognizing the local conditions on the skin, and prescribing local measures to benefit them, but that, with broad medical knowledge, he should study the patient, and seek to rectify the causes back of the local manifestations on the skin. Time and space fail to develop here fully the details of this interesting and most important part of our subject, but a few of the most practical matters may be considered. As may be judged from what has preceded, alkalies should never be neglected in psoriasis. They should not be used sparingly; but, taking the urine as a guide, they should be pushed with judgment, and be continued long enough to effect the desired result. Potash, lithia, and soda, in Various forms and combinations, are remedies of incalculable value in this disease. But it would hardly be expected that any one remedy or group of remedies would cure a disease which has been such a bete noire
    digitised image 1
    digitised image 2
    digitised image 3