in the horse-viz., by fever, great debility, pains in the limbs, profuse offensive discharge from the nostrils, and the formation of a number of pustules and tumours in different parts of the body, which have a great tendency to suppurate and become gangrenous. The pustular eruption does not appear until about the twelfth day; it is accompanied by profuse fœtid sweats, and sometimes by the formation of black bullæ. The disease generally proves fatal before the twentieth day. It occurs for the most part in grooms, stablemen, &c. There is abundant proof of the transmission of the glanders from the horse to man.

No Treatment seems hitherto to have been of any service. We can only recommend stimulants, and a trial of the salts of potass, especially the chlorate.

VII. PARASITICI.

1. TINEA FAVOSA-termed Porrigo favosa by Willan and Bateman-most commonly affects the scalp, in the form of small, cup-shaped, dry, bright-yellow crusts; each containing a hair in its centre, and somewhat resembling a piece of honeycomb, and found to be made upon microscopical examination mainly of the tubes and spores of a fungus. The scabs gradually increase in size, and are highly contagious. At first the small yellow pustules are distinct, but they soon become confluent, and form continuous scabs; they produce troublesome itching; and on removal of the scabs eroded surfaces are left. The parasitic plant causing or accompanying this offensive and troublesome disease is the Achorion Schönleinii.

2. TINEA TONSURANS-Tinea tonsurans, or, vulgarly, ringworm, is a chronic contagious disease, caused by a parasitic mucedinous plant-the Trichophyton tonsurans. It occurs in circular or oval, and slightly elevated scurfy-patches, the hairs of which rendered dry, discoloured, and brittle by the invasion of the fungus, are broken off a few lines from the scalp. In fact the hairs in the patch of tinea tonsurans look as if they had been nibbled off close to the scalp. If one of these short broken-off hairs be examined with the microscope it will be seen invaded by the spores of the Trichophyton. The patches spread at their circumference, and the rings sometimes assume considerable dimensions. In almost all instances we shall find symptoms of deranged nutrition: the child is languid, pale, and-in short-out of health.

The most frequent seat of the disease is the head, but it is often seen on the neck, arms, and other parts of the body. There are no hairs of any moment on the general surface of

the body, and therefore the aspect of the disease is different from that presented when the head is attacked; there are circular scaly non-discharging patches, and the scales on examination are seen to be invaded by fungus elements, especially mycelium. Ringworm of the surface is called tinea circinata. It is often conjoined to tinea tonsurans. Both forms of disease above noticed are contagious. When this disease breaks out in a school, it is for the time a great nuisance.

3. TINEA KERION.-In some cases the hair follicles are specially prominent in consequence of the inflammation of their walls, and a viscid secretion is poured out on to the scalp, the hair being loosened and broken off as usual, the whole patch looking as though it would become a diffused subcutaneous abscess. The presence of short broken-off hairs, loaded with fungus elements, as seen by the microscope, is diagnostic. Suppuration never occurs, and the practitioner should never be tempted to "lance" the apparent abscess.

4. TINEA DECALVANS or Porrigo decalvans-is readily diagnosed by the perfectly smooth bald patches which result from the hair falling off on one or more circular spots; these spots varying in size from a sixpenny piece to five or six inches in circumference. Dr. Tilbury Fox declares that if a patch of this variety of ringworm be carefully examined, there will be seen at the extending edge of the disease short broken-off hairs, smaller but of the same aspect as those in tinea tonsurans; and if these be examined with a high power and a good volume of light, a minute form of fungus will be detected constantly. Most observers fail to see the fungus because they do not use sufficiently high powers. The minute form of fungus here referred to is an active one. The parasitic vegetable is Microsporon Audouini.

5. TINEA SYCOSIS-the last species of tinea-is characterized by inflammation of the hair follicles, causing successive eruptions of small acuminated pustules, occurring most frequently upon the chin and other parts occupied by the beard; it rarely occurs on the scalp, and seldom or never affects women or children. It is called mentagra by Willan and Bateman, and sycosis by Cazenave. The parasite is the Microsporon mentagrophytes.

Treatment. This is the same in all the varieties of tinea. Great attention must be paid to cleanliness, daily washing with common yellow soap and water being attended with great advantage. The hairs of the diseased patch, if loosened in their bed, should be pulled out, and an inch or two may thus be epilated each day. This is especially necessary in favus. In

tinea tonsurans the hairs are brittle and break off, but epilation should be practiced as far as possible. Shaving the head, especially over the diseased patch, may suffice if the disease be recent. Should there be any scabs or incrustations they must be removed by poultices or water-dressing. We then attempt to cure the disease by destroying the spores of the parasitic plant. This may be effected in many ways. Having always been successful with a lotion of sulphurous acid, as first recommended by Sir William Jenner-F. 153 (vide Medical Times and Gazette, 20th August, 1853)-we have always resorted to this agent. Other practitioners employ acetic acid; or a lotion of sulphuret of potash-60 grains to a pint of water; or they paint the affected parts with the acetum cantharidis; or they apply a stimulating ointment, such as the diluted unguentum hydrargyri nitratis, or a mixture of equal parts of the unguentum hydrargyri ammoniate and the unguentum picis liquidæ, or perchloride of mercury, in the proportion of two to six grains to an ounce of lard.

The

In all cases the local treatment must be conjoined with constitutional remedies, since the spores of these microscopic plants find their most congenial nidus in weakly children. child should be also taken away from its books; allowed to be much in the open air; fed well upon plain nourishing food; warmly clothed; and be strengthened by tonics, especially quinine and steel, and take as much fat of all kinds as possible, especially in the form of cod-liver oil.

6. PLICA POLONICA-or Trichosis Plica, or Polish ringworm -is a disease of the hair little known in this country. It is characterized by tenderness and inflammation of the scalp; the hairs become swollen and imperfectly formed; and the hair follicles secrete a large quantity of viscid, reddish-coloured fluid, which glues the hairs together, uniting them into a mass. It is caused, or accompanied, by two parasitic plants-the Trichophyton tonsurans and Trichophyton sporuloides. As regards the Treatment of this disease little is known, but it is usually recommended that the diseased hairs should not be cut; or we may resort to the use of the sulphurous acid lotion, so beneficial in analogous diseases.

7. CHLOASMA.-Chloasma, Tinea versicolor, or Pityriasis versicolor, makes its appearance generally on the front of the chest or abdomen, in the form of small spots of a dull-reddish colour, which gradually increase in size, and assumes a fawn tint. It may last from a few days to many months or years. It is contagious, and is accompanied by itching when the body gets warm. The fawn-coloured patches are slightly raised, and

from them scales may be scraped, in which with the microscope may be detected spores arranged generally in little heaps, and mycelial threads branching in all directions. It is necessary, in order to see the fungus, to take a very thin portion of cuticle and to render it transparent by liquor potassæ. This disease is caused by a cryptogamic plant-Microsporon furfur. It may be cured by the use of the sulphurous acid lotion, or by a lotion of perchloride of mercury in water (gr. 2 to oz. 1), applied night and morning, or the use of a lotion containing half an ounce of hyposulphite of soda in six ounces of water, which is to be freely applied after the normal fatty matter has been removed by soap and water, two or three times a day. In order to prevent a return of the disease in severe cases, the application of remedies should be continued for a fortnight or three weeks after all evidence of actual mischief has disappeared.

8. SCABIES.-Scabies, or psora, or the itch, is a contagious disease-contagious in that sense which implies contact-dependent upon the presence and burrowing of an insect, the Acarus scabiei. It may occur on any part of the body, but it is most frequently found in the interdigits, and on the front of the forearm. An opinion prevails that scabies never attacks the face; but this seems to be incorrect, though it is very rare in that locality. The pathognomonic feature of scabies, is the acarus in its burrow or cuniculus as it is termed. When the acarus gets beneath the skin, the direct result is the formation of a vesicle, as the result of the irritation set up; the acarus then makes for itself a channel, which may be seen if it have not been scratched open by the patient, as a minute raised line running away from the vesicle just spoken of in a straight or tortuous direction for several lines, and even half an inch and more. At the end of this burrow the acarus may often be seen as a minute opaque speck, and may be extracted by the aid of a needle. Now the vesicle and attached cuniculus is the only really certain diagnostic mark of scabies. The other phenomena are accidental. But in addition to the presence of vesicles and cuniculi between the fingers and about the wrists, a papular rash is observed on the front of the forearms, about the abdomen and the front of the thighs, and often about the nipples in women, and along the upper line of the penis. And if the patient be out of condition and scratch much, ecthymatous pustules show themselves. In young children the eruption of scabies may be absent from the hands, and appear first of all about the buttocks, and it is then the disease takes the form of an ecthymatous rash interspersed with papulæ, the feet being

often affected. Scabies in all subjects generally itches a great deal when the attacked gets warm in bed, and oftentimes several members of a family are affected by the disease at the same time.

Treatment.-Scabies never disappears spontaneously. It is readily cured by killing the insect, and perhaps no agent does this so readily as sulphur. Hence, after a good washing, the affected parts are to be well covered with sulphur ointment, in the proportion of half a drachm to an ounce with a little carbonate of potash and essential oil. This should be used night and morning for three days, especially to the interdigits and wrists. Then the patient should take a warm bath, and use yellow soap freely. If there be no itching the disease is probably well, though it may be useful to apply the sulphur ointment gently for a day or two longer. If sulphur be applied too freely to the skin, a troublesome erythematous or eczematous eruption may be set up. This should always be recollected and avoided. As the patient's clothes will probably be contaminated, they must either be destroyed, or at all events thoroughly fumigated with sulphurous acid gas, which may be procured by igniting a rag dipped in melted sulphur.

When scabies is complicated with other eruptions, it must be cured before the relief of the latter is attempted.

VIII. SQUAME.

1. LEPRA.-Psoriasis or Lepra vulgaris, is perhaps the most obstinate and troublesome of all cutaneous diseases. It is a non-contagious chronic eruption; characterized by the development of patches, of various extent and form, slightly raised above the level of the skin, covered by thin, whitish scales of altered epidermis, and accompanied by rhagades or fissures of the skin. The eruption may be local, or it may be diffused over the whole body. The white scaliness is a primary formation, and not the result of any discharging condition. The scales are not made up of inflammatory products, but are entirely composed of epithelial scales. Several varieties have been named, such as Psoriasis punctata, guttata, circinata, gyrata, diffusa, inveterata. There are also local varieties.

Treatment. With regard to local applications, the preparations of tar are the best. The scales should be removed by poulticing or wet packing, and then some "tarry" compound applied by means of a brush. The most useful form is perhaps the pyroligneous oil of juniper in the proportion of one part to four of lard; it should be well rubbed in night and morning. In very chronic cases the addition of sulphur is of