Remarks - Girdlestone was the first, I believe, to use arsenic internally for the relief and cure of cutaneous diseases. Its chief advocate, however, was Hunt, who lays down the following rules for its admin tration:

* An account of the methods pursued in the treatment of cancerous and scirrhous disorders and other indurations. London, 1780.

1. It should never be commenced while signs of active cutaneous inflammation are present.

2. It should be well mixed with the food or drink, and never taken on an empty stomach.

3. It should be given in three or four doses in the twenty-four hours, and with exact regularity.

4. Five minims of the liquor potassae arsenitis is generally a suffi-it dose to commence with, i. e., fifteen minimi daily. As soon as the conjunctiva becomes affected this dose may be reduced, but it is desirable to reduce it gradually.

5. During the administration of the minimum dose, should conjunctivitis supervene, the dose should be further reduced, but it is desirable to reduce it gradually.

6. The minimum (i. e., a dose which given, continuously, affects the conjunctiva in the slightest degree) should be persevered in with unremitting regularity for as many months after the final disappearance of the disease as it had previously existed years. This is often necessary to prevent a relapse.

7. Should the disease appear to advance, instead of receding, during any period of the minimum course, the course should not be interrupted on this account. Leeches or purgatives in sthenic, and quinine with a generous diet in the asthenic cases, will generally be sufficient. 137, 1/46,

At a recent meeting of the British Medical Association, Dr. Robert Farquharson read a paper on the subject of arsenic, in which he said: About thirty years ago, the British Medical Association issued a series of queries to its members, with reference to the use of arsenic in skin disease; and, considering the somewhat haphazard way in which the drug was then used, it was no doubt necessary to reassure the public mind, as was effectually done by the replies, that its use was at all events unattended with danger. We know now much more precisely in what cases to prescribe the remedy with good effect; and the question naturally arises: How do we explain the undoubted fact that, while arsenic frequently relieves and even cures certain forms of cutaneous disorders, at other times it appears to be inert or even to do harm? It has been supposed by some authorities that, following up the analogy of the vesicular and pustular eruptions, which form an occasional, though rare, part of its physiological action, it simply acts as a cutaneous irritant, by stimulating sluggish processes of repair; or, again, we may hold that it effects some ration in the blood, through a general influence on cell-growth; or, thirdly, and most suggestively, we may seek for our clue in the regions of nervous pathology. We know that eczema and psoriasis and lichen, etc., often show their neurotic origin in heredity and symmetry, and itching and tingling; they not uncommonly appear in connection with mental shock and depression; and may alternate with, or accompany, such undoubtedly nervous disorders as chorea. Arsenic is generally held to be a nervine tonic, and, speaking generally, we find it to be an useful and reliable remedy in all the skin affections of the dartrous class (( Clifford Allbut). In pemphigus, it acts almost as a true specific (Hutchinson).

It is most valuable in lichen ruber, and has been recommended as an antidote to bromide acne; although the question might arise, whether the arsenic in any way lessens the restraining influence of the bromide over the epileptic fits. Over impetigo, strumous and syphilitic diseases, it has no influence; and it would be interesting to note its effect on herpes zoster, which has been reported as occasionally following its administration. Concerning the mode of administration, the author preferred to begin with a full dose of ten minims to fifteen minims, and push boldly on, believing that, as with quinine and iodide of potassium, troublesome physiological symptoms are here more likely to follow small quantities than large. Some authorities strongly insist upon the necessity for producing some conjunctival and gastric irritation before we can obtain the full curative influence of the drug; but the author was opposed to this, believing these symptoms to be an unnecessary addition to the discomfort of the patient. When they do arise, they need not cause any alarm; but the sickness which sometimes follows each dose of the medicine is quite a fatal obstacle to its Use. It is important to see that the natural elimination of the drug is not checked by any renal obstruction; and Dr. McCall Anderson warns us that patients, under the influence of arsenic, are specially susceptible to cold. May it not be, however, that the bronchial irritation occasionally observed may really be due to the curative influence of the remedy causing metastasis to the pulmonary mucous membrane? The liquor arsenicalis seems to be, on the whole, the best preparation; the liquor sodae arsenitis being, in the author's experience, in no degree less irritating. Children will bear large doses with impunity; and although it is generally held that girls can take more than boys, the only case in early childhood in which it had been found seriously to disagree belonged to the female sex. Finally, it may be asked: Can we really cure chronic disease with arsenic? and the answer must be in the affirmative, if we get our case early, treat it systematically and carefully, continue the use of the drug for some time after the skin has be-come clear; and remember the importance of good food and air, and mental and bodily rest. 116, 2/79, 292.

The choice of the preparation of arsenic to be used has usually been regarded as of little consequence, the one most frequently employed being the Liquor Potassii Arsenitis, or Fowler's solution. Eighty years ago Barton (27, p. II., 19) said: "I have for several years employed the oxyd of arsenic in substance in preference to Dr. Fowler's solution. 1 think it is a much more certain medicine than the solution." My own experience harmonizes with that of Dr. Barton. I usually employ the arsenious acid in trituration, either the second or third decimal trituration of the homoeopathic pharmacopoeia. Sometimes I combine it with black pepper, as in the ordinary Asiatic pill, sometimes with capsicum. It is a fact beyond question that the Styrian arsenic eaters consume, even at the beginning of their course, much larger quantities of arsenious acid without apparent inconvinence than the average patient can take as an equivalent in the form of Fowler's solution - which latter contains, beside the arsenite of potassium, alcohol, lavender, rosemary, cinnamon, cloves, nutmeg and red saunders. 1 must confess I am unfamiliar with either the physiological or medicinal effects of long-continued doses of these latter substances, and therefore, when I employ the arsenite of potassium, 1 am in the habit of giving it in simple solution in water; but, as before said, I prefer the arsenious acid itself, unless there appears to be some special indication for one of the alkaline salts. The pepper, either black or red, is a useful adjuvant in eases characterized by atonio dyspepsia, in addition to the lesions demanding the use of the arsenic.

Watery solutions of the alkaline salts of arsenic do not keep well, either simply dissolved in distilled water, or with the addition of compound spirits of lavender, as in Fowler's solution. Care should therefore be taken not to dispense an arsenical solution of any kind unless it is perfectly clear and free from sediment.