TWO FATAL CASES, ONE OF APOPLEXY, AND THE OTHER OF EPILEPSY, OCCURRING IN THE SAME FAMILY: WITH REMARKS

beath this, peraps to the extent of an inch d:ep. This vriety of pustule, when situated on the forehea, is very fb aidable; the ulceration to which it gives rise commonly extends to the bones of the head, the upper laminse of which become carious in consequence. The pustule, the crust, and the ulcer are, then, three stages of pustular secondary syphilis. When the ulcer heals under the crust, the crust falls off, if you adopt a proper plan of treatment; and you will find that the cicatrix which marks the healing of the ulcer underneath the crust is always depressed to a greater or less extent in the skin, sometimes very much so, and is vividly red. If you put the patient into a hot or vapour bath after the healing of the ulcer, you will find that this redness will be very apparent; and it will continue until the whole of the syphilitic virus is cradicated. The treatment resolves itself into three modes: a treatment by diet; a local treatment in certain stages; and a constitutional treatment. The diet depends very much upon the age of the patient and his constitution. If you have a young strong man of 22, put him on low diet, on broth and milk. You rarely have, however, pustular secondary syphilis at all, or certainly not to any formidable extent in persons otherwise of good health; it is a disease of a feeble habit of body, and marks essentially that condition described as the syphilitic temperament. If, on the other hand, you have a patient where the skin is white, pulse frequent, and pustules large, he must be put on good diet, plenty of animal food, and porter or ale. The treatment by sweating, starving, and purging, is generally an unsatisfactory plan, although recommended by some persons. Under a low diet, I have seen the sores of pustular syphilis rapidly spread. At the head of all remedies in the treatment of pustular secondary syphilis must stand the mercurial vapour bath, prepared and used as I have frequently shown you, accordmig to the printed directions* I have more than once had occasion to allude to. The bath should be used to the extent of gentle diaphoresis three times a week. A generous diet should be associated with it. The next best remedies are the iodides of mercury, with the iodide of iron, and the iodide of potassium, with sarsaparilla and bark, according to circumstances and particular indications. There are two iodides of mercury, a proto-iodide or ioduret, a yellow salt, and the biniodide, of a beautiful red colour. The former may be given in doses of half-a-grain to two grains, the latter in doses of one-sixteenth to one-eighth of a grain. Their properties are said by Cazenave to be injured by their union with opium. As far as my experience goes, patients in this country rarely bear the iodide of mercury well. They always complain of the griping pain and nausea it produces. They may then be treated with the biniodide of mercury, which is generally borne better; but that requires to be given in small doses, the twentieth or twelfth of a grain; and you may give it two or three times a day in a solution of iodide of potassium. Patients generally bear this better than the iodide. This form would answer very well. HXd. biniodidi gr. i. Potass. iodidi 3ii. , i. A\quic distillatoe Ji. MI. A teaspoonful to be given twice or three times a day in some decoction of the woods, such as saponaria, guiacum, or sarsaparilla. I generally prefer, however, giving from five to ten grains of Plummer's pill at night, with the iodide of potassium in the daytime. The iodide of potassium I believe rarely cures without the assistance of some preparation of mercury. One of the patients now in the hospital has been treated in this way, and the result has been most satisfactoryv. The other patient has been treated rather differently, by five grains only of Plummer's pill at night, and the iodide of potassium in fifteen grain doses twice in the day. He has a deep secondary ulcer secreting a great quantity of