In scaly skin eruptions, pilocarpus has good effects by maintaining a moist state of the skin. It is the most efficient remedy for alopecia which we possess. In the treatment of this affection pilocarpine may be injected subcutaneously, or the fluid extract can be applied locally. The following is a very successful topical application: Rx Ext. pilocarpi fl., oz j; tinct. cantharidis, oz ss; lin. saponis, §ijss. M. Sig.: The scalp must be well rubbed with this lotion daily. In prurigo Pick had success, but failed in psoriasis, and he also succeeded in two cases of pruritus senilis and in one of urticaria. In alopecia pityrodes, he had good results in ten cases, but not in alopecia areata.

Pick administered one sixth of a grain three times a day by the stomach.

Recently Guttmann has brought forward pilocarpine as a remedy for diphtheria. He reports having successfully treated eighty-one cases without a single death, but these extraordinary results have not been confirmed. Numerous observations have been published, but out of the mass of cases and reports we can select only some of the most important. Soon after Guttmann's paper appeared, confirmatory statements were published by Lax, and directly contradictory by Lashke-witz. The latter lost all his cases treated with pilocarpine. Pitschen and Dilewsky, on the other hand, succeeded in curing many which would otherwise, they think, have died. Archambault treated twenty-one cases according to Guttmann's plan, and of these twelve died, a result which he considers bad. In this country Jacobi was one of the first to make a trial of the new remedy, and he pronounced against its utility. Payraudeau, who has made an exhaustive study of the subject, offers some conclusions which seem to the author eminently sound. The false membrane in inaccessible situations is softened and detached by the action of pilocarpine; it does not effect the elimination of the diphtheritic poison by the sweat which it induces; it is apt to cause nausea, vomiting, and diarrhoea, and may in this way greatly increase the danger of the case; it is positively contraindicated when the cardiac muscle is weakened in any way. Although these positions are perfectly tenable, there are facts more favorable to the utility of pilocarpine. They are well stated by Courtois: The results of the treatment of diphtheria by pilocarpine, without being so good as were at first supposed, are nevertheless worthy of careful consideration. Children of less than five years offer such slight resistance to the action of the morbific germs of diphtheria, that they are rarely cured. Those above this age, in which the mixed form of the disease is most frequent, are especially favorable subjects for this treatment. The false membrane is more thoroughly detached, and has less tendency to be reproduced, than by any other treatment. An experienced German physician of Philadelphia, Dr. Löling, assures me that he finds it highly useful when the condition of the heart does not contra-indi-cate. Having observed cases in the course of the treatment, I am able to confirm Dr. Löling's statements. All are now agreed that efficient support must be given the patient by food and alcohol during the pilocarpine treatment; that cases characterized by extreme depression of the vital powers, and by weakness of the heart, are unsuited for this remedy.

Guttmann exhibited pilocarpine with hydrochloric acid and pepsin by the stomach, giving from 1/16 gr. to 1/6 gr.

This subject must not be closed without some observations on the remarkable aid afforded by pilocarpus in the removal of exudations, under treatment by the remedies most effective for this purpose— iodides and mercurials. Above, attention has been called to the use of pilocarpus in causing absorption of effusions in the pleural, peritoneal, and other serous cavities; but in this application it is used coniointlv with iodine and mercury, chiefly to increase the rate at which the exudates liquefied by these sorbifacients are taken up and excreted. In cases of gummata, for example, the specific action of mercury or iodine is rendered effective by the timely and conjoint use of pilocarpus, exhibited once or twice a day. When the inflammatory deposits in chronic pneumonia, or chronic pleuritis, or in other organs are sought to be removed, the persistent administration of mercury and iodine will accomplish far more if, during their administration, pilocarpine is given after certain periods have elapsed—for example, after one week, and for three or four days in each succeeding week. The size of the dose, and the amount given each day, will be determined by the degree of the action. The author has found that a dose large enough to cause but little sweating and salivation suffices. Authorities referred to:

Anderson, Prof. McCall. Glasgow Journal, 1880.

Archambault, Dr. Revue de Thérapeutique for 1881.

Berkhart, Dr. British Medical Journal, June, 1880.

Castaing, P. Revue de Pharm., 1881.

Dujardin-Beaumetz, Dr. Bulletin Général de Thérapeutique for 1881.

Guttmann, Dr. Berliner klinische Wochenschrift, 1881.

Harnack und Mayer. Archiv für experimentelle Pathologie und Pharmacologie, voL xii, p. 366.

Huchard, Dr. Journal de Thérapeutique and Bulletin Général de Thérapeutique for 1880, 1881, and 1882.

Isham, Dr. Medical News and American Journal of the Medical Sciences, 1881.

LabbÉ, Dr. Bulletin de la Societé de Thérapeutique, November 30, 1881. Abstract.

Morat, Dr. M Journal de Thérapeutique and Lancet, 1881.

Murrel, Dr.

Prochownick, Dr. (de Hambourg). De l'Art Médical for 1881. Quoted.

Ringer and Gould, Drs. Pamphlets.

Vulpian, Prof. Dr. Journal de Thérapeutique and Bulletin Général de Thérapeutique for 1881.