A theoretical and practical treatise on the diseases of the skin / by P. Rayer.
- Pierre François Olive Rayer
- Date:
- 1845
Licence: Public Domain Mark
Credit: A theoretical and practical treatise on the diseases of the skin / by P. Rayer. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
45/582
![of sublimate and the same quantity of muriate of ammonia to each bath). I have many times prescribed these baths, and have never seen salivation follow their use ; but their good effects have also often appeared to me to be very questionable. I have never ventured to order them in a case of serpiginous ulcerated syphilis, fearing that the sublimate might be absorbed in too large a quantity. The length of time during which the baths are taken, the state of the skin, and especially the degree of aptitude for absorption possessed by the integuments, necessarily influence the advantages and inconveniences of mercurial baths. 179. The sublimate has been employed as a lotion in scabies; Gow- land's lotion has still some reputation in England in rosacea.—At the Hospital St. Louis, a solution of a drachm of sublimate in a pound of water coloured with alkanet root is used as a common wash to cuta- neous affections, especially when they are suspected to be connected with a venereal taint. Serious consequences are said to have followed the application of compresses imbibed with an empirical wash, analo- gous to the preceding in its composition. Concentrated solutions of corrosive sublimate are sometimes used to destroy condylomata. I have already mentioned mercurial pediluvia in the treatment of syphili- tic affections. 180. M. Werneck has tried the brornate of mercury1 in cases of obstinate skin complaint. I have not myself any experience of the effects of this compound. 181. The iodates or iodurets [iodides] of mercury are energetic preparations, the effects of which have appeared to me eminently beneficial under many circumstances, particularly in chronic tuber- cular and papular inflammations of the skin. They are especially available in the treatment of syphilitic affections complicated with scrofula. The deuto-ioduret is even a more active preparation than the corrosive sublimate itself. Externally applied, it has sometimes been found sufficient to leave the deuto-ioduret in contact with the skin for a while, to induce a most intense erysipelatous inflammation. —When it is given internally, it is proper to begin with the sixteenth part of a grain, and to raise the dose gradually to an eighth; very rarely will it be prudent to exceed a quarter of a grain. The proto-ioduret of mercury which is less energetic in its action than the deuto-ioduret, is used internally, under the same circum- stances, in doses of half a grain, which may be gradually increased to one or two grains. Externally, I sometimes make use of an ointment of the proto-ioduret of mercury, to aid the resolution of the tubercles of lupus, of rosacea, of sycosis, &c. 182. The cyanuret [bicyanide] of mercury,2 extolled by Chaussier and by Horn, has recently been recommended by Dr. Thomson, mixed with lard, in rosacea, eczema, and several other chronic inflammations of the skin. This substance has such powerful effects on the animal economy, that the first doses ought not to exceed the sixteenth part of a grain in amount, when it is prescribed internally. 183. The red oxide of mercury enters into the composition of a multitude of ointments, which are often employed with advantage in chronic inflammatory affections of the skin. 184. The proto-nitrate of mercury, mixed with lard, has also been employed, by way of inunction, in the treatment of many diseases of the skin. Dissolved in water, it has been applied successfully in porrigo, and the diseases attended with pediculi. 185. The phagedenic inflammation of lupus excedens, and of ser- piginous syphilitic affections, is often stopped by one or more applica- tions of the nitrate of mercury with the acid in excess.3 A drachm of the proto-nitrate of mercury is dissolved in an ounce of nitric acid ; a pencil dipped in this solution is the best means of applying it to the diseased surface. In case a greater effect is desired, a compress of lint, steeped in the solution, may be maintained in contact with the sore for any length of time. Many cases of lepra and inveterate psoriasis have been cured by this treatment. 186. The sub-deuto-sulphate of mercury (turpeth mineral) which has been mentioned as a preservative against small-pox, has been 1 Bullet, des Sc. medic, de Feruss., t. xxiv., p. 20. 2 Horn. Researches in practical medicine, in German, p. 550; 8vo., 1813—Bul- letin des sc. med. de Ferussac, t. v., p. 262.—Parent. Sur les effets du cyanure de mercure dans le traitement des affect, syphilitiq. (Revue medicale, 1S32, t.iii,p.833). 3 Godart. De l'emploi du nitrate acide de mercure, in-4. Paris, 1626. 11 successfully employed internally in the treatment of many obstinate skin complaints in'doses of one-fourth of a grain repeated two or three times a day. The dose may be gradually increased to two or three grains. By mixing this preparation with lard in the proportion of one to eight, an ointment is formed that may be often advantageously employed in stimulating certain chronic affections of the skin, particu- larly psoriasis of an old and inveterate character. 187. The preparations of gold* have been found available in the treatment not only of syphilis but of favus, and of some other chronic inflammations of the hairy scalp. They appear particularly well adapted for inducing modifications in the constitution of scrofulous subjects attacked with skin disease. M. Chrestien has detailed the mode of exhibiting these preparations, which I shall notice by and by when I speak of syphilis, eczema and pityriasis. 188. The preparations of arsenic5 appear to have been used for the first time in Europe, in the treatment of diseases of the skin, by Adair, and Girdlestone, of Yarmouth. The latter tried the arsenical solution of Fowler, in a case of lepra in which he had existed during fourteen years, and the patient recovered under the influence of small but repeated doses of the medicine. He informs us that he subsequently obtained hundreds of cures of lepra, prurigo, psoriasis and tinea. The second case of lepra in which he tried arsenic, exhibited phe- nomena that particularly attracted his attention. After three doses, each of eight drops of the solution, the whole body of the patient be- came as red as a lobster, and the face appeared as if it were attacked by an incipient erysipelatous inflammation. The use of the medi- cine was immediately suspended till the redness of the skin subsided, and it was then only resumed in doses of half the former amount, under which the leprous affection gradually disappeared. In a third case, the cure of the leprosy was preceded by an eruption of large bulla? on the hips. The curative effects of the arsenical solution indeed were often observed to be preceded by an increase of the eruption, by a crop of blebs, or by chaps in the skin of the feet and toes, and of the hands and fingers. A patient who had laboured for two years under lepra nigricans which appeared in large patches on the cheeks, and had resisted various plans of treatment, was put upon four drops of the arsenical solution twice a day: the first dose pro- duced a great degree of redness of the skin, tension of the belly, and a slight fainting fit. The patient found relief from a grain of calomel, and the lepra was subsequently got rid of by two drops of the solution taken twice a day during six weeks. Having suffered a slight relapse, the patient resumed the medicine in doses of four drops, which caused the same disagreeable effects as at first; but he ultimately recovered without any inconvenience under the continued use of the solution in doses of two drops at a time. The largest dose of Fowler's arsenical solution Girdlestone ever thought advisable to prescribe, was twelve drops three times a day. Six drops, however, he afterwards found to be a sufficient dose for all good purposes. Although he sometimes succeeded within a few days in lessening the severity of the symptoms of the skin disease, he found by experience that he could not consider the cure as accomplished, under any dose to which the medicine could be carried with propriety, unless its use were continued during six or seven weeks at least. One patient took the arsenical solution in the dose of twenty drops three times a day for more than three months before the lepra under which he suffered disappeared. This patient had many nervous symptoms, fainting fits, attacks of diarrhoea, &c.; accidents which, in spite of the greatest care, continued during several we'eks. Weakness, pains of the abdomen, nasal hemorrhage and cough, as also hepatic and dropsical symptoms, all accompany or follow the ill-regulated exhibition of this powerful medicine. Too strong doses cause the urine to acquire a jaundiced appearance. When the bowels are constipated, the arsenical solution suffices oc- casionally to render the motions regular, and when diarrhoea comes on, a quarter of a grain of opium two or three times a day corrects this effect of the medicine. It is always proper to begin the use of arsenical medicines in very small doses, never to be tempted to carry the ordinary solution beyond five or six drops three times a day, and < Niel. Recherches et obs. sur les preparations d'or,in-8. Paris, 1821. 5 Adair. Medical commentaries of Edinb., v. ix., 1, p. 35.—Girdlestone. Lond. Med. Phys. Journ., February, 1806.—Harles (Ch.). De arseniciusu in medicina, in-8. Norimb., 1611.](https://iiif.wellcomecollection.org/image/b21149495_0045.jp2/full/800%2C/0/default.jpg)
