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334 REPORT OF THE LEPROSY COMMISSION:
diseased parts. The skin must not be broken, and the exuda-
tion must be allowed to dry on, so as to form a crust. After
about twelve days this will fall off, leaving the skin beneath
clear and free from ulceration. It is not advisable to paint
at one time an area greater than that represented by the skin
of the leg or fore-arm. The applications should not be re-
peated at intervals of less than a week.
3. Internal Medicines.
These are perchloride of mercury in doses of one-fifteenth
to one-twentieth of a grain twice a day for adults, and in cases
where mercury is contra-indicated, sodium carbonate, given in
doses of 10 to 20 grains twice a day.
There is no doubt that this was a rational mode of treat-
ment, and one which afforded distinct relief to the patient.
The mistake made was in regarding it as curative. Whatever
merit the treatment possessed lay in the strict regimen which
had to be observed by the patient, and in the attention to
the functions of the skin which was insured by frequent baths
and frictions. The oil of cashew itself merely acts as a caus-
tic, and the same result can be less laboriously obtained in
tuberculated leprosy by free excision of tubercles, as will be
mentioned below.
The influence of the medicines given internally by Dr.
Beauperthuy may fairly be disregarded. According to Dr.
Bakewell a patient taking sodium carbonate progressed quite
as favourably as one taking mercury perchloride.
Internal medication has always been the difficulty in leprosy.
It is not hard to treat the skin complications and even to attain
some measure of success, but so far no drug has been disco-
vered which taken by the mouth will bear the relation to leprosy
which mercury and potassium iodide bear to syphilis. Fresh
crops of tubercles, or ansthetic patches, soon make their
appearance, and, as was the case at Cumana, the condition of

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