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.)
46/582
![olj m it iv unattended byevi] i S. In children the doses must be smaller—one, two, or three i day. ..al solution IS B remedy thai has been greatly abused in nquami I the ^kin ; Mr. Duffin, however, bas employed i1 in },, along with a decoction of dulcamara, of mezereon ii-ilia with advantage. He supposes thai small doses taken al short mtervals are mere useful and more certain in their than larger doses al longer intervals. It is rarely necessary in this way to prescribe more than ten drops of the arsenical solution mes a day, m\ are generally found sufficient, and before long— ten or fifteen days at most-—the effects of the medicine are apparent lj on the disease, but on the constitution of the patient. The :npiin the medicine produces is a sensible acceleration of the pulse, which, under its continuance, may be found to have risen from twenty to thirty pulsations per minute above its ordinary rate. The pulse further acquires fulness and hardness; the patient soon begins to complain of tingling sensations in different parts of the body, itching and pain of the eyes, &c; the eyelids, especially the lower, become puffed, and the eye is surrounded by a slight dark and livid circle. rhese Minpioras sometimes precede the acceleration of the pulse. If the remedy be still persisted in, the patient complains of weakness of stomach, pains of the bowels, and sometimes of shooting pains in the < lust ; the tongue becomes white, the countenance alters, and the expression acquires a sorrowful cast; anxiety about the pracordia, and other distressing symptoms supervene at last and compel the use of the poison to be suspended—these symptoms, indeed, show that it has been continued too long ; it should always be abandoned when the acceleration of the pulse and swelling of the eyelids are observed. The physicians of America bave also tried the arsenic in several forms of cutaneous disease. Dr. Rush prescribed the arsenious acid in the shape of pills in various severe affections of this nature. The >:<ise he ordered was the 15th, the 10th, and the 8th of a grain twice a day, mixed with soap, causing the patients at the same time to make use of an infusion of the eupatorium perfoliatum. M. Valentin, who makes us acquainted with this fact, bas seen several patients follow the plan of treatment indicated above, during more lhan two months without am good effects on their disease, but also without any apparent alteration of their health. Willan and Baleman also extolled the effects of Fowler's arsenical solution in obstinate cases of lepra, of lichen, of prurigo and of porrigo. They assure us it may be admin- 1 with perfect safety if cautiously managed; but they do not appear to have studied its special effects on the constitution with the suae care as Fowler and tiirdleslone. In the reflections on the use of arsenic, read before the Lyceum of Philadelphia, in 1812, by Dr. I. Redman Coxe, the author, after hav- imbatted the repugnance that is generally fell to the use of this medicine, relates the ease of a ladj who had laboured under leprosy during fourteen \ cars without deriving any benefit from every kind of the most active treatment, but who recovered under the use of the arsenical solution continued for two years and a half, and taken at last in doses of fifty drops three times a day. There was this peculiarity hi the case, that jus; as the disease was beginning to yield, the patient . ould not take more than five drops of the solution three times daily without ha\ ing tumefaction of the face, nausea, loss of appetite, sense ( f weight in the eyes and head,—symptoms that proclaimed the sity of suspending the large doses for a season, (a) Dr. Otto, of Philadelphia, published about the same time an account of three cases stinate eruption which had resisted the use of sulphur, of anti- . the corrosive sublimate, and mercury in other shapes, pushed till the mouth was affected, but which \ielded to the arsenic. Two afterwards there was not the slightest appearance of the disease, no trace of ill consequence from the vise of the medicine. Dr. . of Manchester, has also employed Fowler's solution in but he dissuades from the too long continuance fancied he had observed the arsenic to accumu- also, a paper on the same subject by Dr. D. Theodore Cox< '(..///i. Med. $ Surg.Joum., vol. viii. dical Reports, 8vo. London, lt>07. late in the system and to produce bad effects, such as living pains, flatulence, paralytic affections of the limbs, Ac. If. Foder# used Fowler's solution with Buccess in some obstinate oases of skin disease. A gentlewoman, thirty years of age, exposed, from the particular circumstances in which she was placed, to many privations and hard- ships, was, among other complaints, affected with an obstinate scaly eruption (dartre ecailkuse) of the hands, which obliged her to work in loves. This patient had in vain tried remedies of all kinds. The first effect of the arsenic, which was at length prescribed, was to regulate the menstrual function that had Ion- been disturbed, to render the breathing free, and the complexion clearer; but as yet the disease was untouched, although a considerable quantity of the medicine had already been taken. M. Fodeiv, however, desired its use to be persisted in, and at the end of a month be was desired to visit his patient whom he now found labouring under bronchial al- fection, with bloody expectoration ; at the same time the disease of the skin had disappeared, and the hands weir perfectly whole. The present more pressing malady was treated by soothing remedies, and the arsenic was discontinued for a month. After this period the skin complaint reappeared, but the patient having again resumed the arsenic, the hands were anew restored to their natural condition, with the exception of a slight degree of remaining roughness of the skin. 189. M. Jourdan has collected, under the head Arsenic, in his pharmacopee universelle, almost every preparation of this metal that has ever been employed in medicine ; but I have contented myself by giving those only among my formula? which have been more par- ticularly recommended in diseases of the skin. I have been particu- larly attentive to indicate the occasions proper for the employment of these energetic remedies, to specify their respective doses, and to show their physiological and therapeutic agency, their advantages, and their occasional ill effects. Certain chronic and obstinate forms of eczema of the scrotum, margin of the anus and labia, are, of all the vesicular inflammations, those in which arsenical medicines are most frequently and most successfully employed. This class of remedies ought never to be had recourse to in exanthematous inflammations; they are also rarely useful,'and sometimes dangerous, in chronic bullous inflammations. Among the papular inflammations, the circumscribed, the confluent, and chronic lichens occasionally require their use. They have been often abused in prurigo, in pityriasis, psoriasis, and lepra, which they, nevertheless, sometimes attack with success. When these diseases are inveterate, the prolonged and continued action of arsenical medicines is apt to alter the mucous membrane of the digestive organs, and to implicate the constitution without modify- ing the diseased conditions of the skin for which they were especially prescribed. 190. I shall have occasion to analyze the observations of Mr. Robinson, and those of Mr. (I.) Wilson, on the use of arsenical pre- parations in the treatment of the Greek elephantiasis. Experience has taught me, that not only are the deep alterations of the skin which characterize this disease externally not removed by these medicines, but that they sometimes even cause disorders and grave complications when their use is persevered in for several months continuously, or alternated with other active remedies. In one case of Greek elephantiasis, M. Delpech administered Fowler's solution without any benefit: during two months ; the only effects it had were to cause a diminution of appetite, slight purging and some emaciation. 191. Independently of the changes which arsenical preparations may produce in the digestive organs, and of the tremors and paralytic affections of the limbs, observed by different authors, the following case, as well as two others I possess of the same kind, tends to show that, administered unseasonably, they may induce true paralysis of the genital organs. I had under my charge, in La Charit6, a letter- press compositer, twenty-three years of age, labouring under lepra and chronic enteritis Although of weakly constitution?this man had hitherto enjoyed perfectly good health, lie had been attacked about five years before by lepra vulgaris on the knees and elbows but bv degrees the disease extended to all the other parts of the body ' During the first two years, the disease was treated by simple baths, by baths 2 Journ. compl. des sc. medic, t. 1, p. 117. 3 These will be found at the end of the volume.](https://iiif.wellcomecollection.org/image/b21149495_0046.jp2/full/800%2C/0/default.jpg)
