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ON THE VALUE OF FREQUENTLY REPEATED DOSES OF ARSENIC IN' THE TREATMENT OF BULLOUS DISEASES OF Taxotere And Cytoxan TtlE SKIN, ESPECIALLY IN CHILDREN* By L. DUNCAN BULKLEY, A. M., M. Cytoxan And Taxotere D. Arsenic is perhaps the most frequently used and the Order Cytoxan most commonly abused of all the remedies employed Cytoxan Tablets in the treatment of diseases of Buy Cytoxan the skin, and it is Buy Cytoxan Online safe to say that a large share of all patients with eruptions have this drug administered to them by some one at some time during their course; and yet the experience of every one will tes- tify that it is by no means the specific which could be wished for in these affections when they are taken as a whole. The cause of disappointment in the use of this therapeutic agent will be found unquestionably, as in the * Read before the Section in Dermatology and Syphilography of the American Medical Association, May 10, 1888. April 13, 1889.] BULKLEY: ARSENIC Iv Cytoxan IN BULLOUS DISEASES OF THE SKIN. 401 case of all therapeutic agents, in the failure to adjust the remedy to Cyclophosphamide Cytoxan the particular diseased state for which it is valu- able, and to use it in proper and sufficient doses with, if necessary, such other adjuvants to treatment as may be re- quired. It is needless to add that in this lies the secret of the successful practice of medicine. Arsenic is not an indifferent therapeutical agent, and there is no question in Taxotere Cytoxan regard to its power to influence the skin ; but there is also no question but that it is useless, or even harmful, in many of the diseased states to which this organ is liable. It is not the purpose of the present paper to enter into the general subject of the use and value of arsenic in the treatment of diseases of the skin, nor to dwell on the neces- sity of an absolutely correct diagnosis and sound therapeu- tical indications in its administration ; this subject was fully discussed by the writer twelve years ago,* and the literature of the subject presented, with also clinical records and illustrations, and later experience has further confirmed the statements there made. The aim of the present communi- cation is to call especial attention to the undoubted and al- most specific action of arsenic in one certain form or variety of skin disease, and to place on record a few cases Cytoxan Cyclophosphamide illustra- tive of the same; also further to show not only the harm- lessness but the value of frequently repeated and seemingly large doses of the drug in proper cases, especially in chil- dren. The most notable and striking of all bullous diseases, in which arsenic seems at times to exert almost a specific in- fluence, is pemphigus vulgaris. My attention was first called to the value of efficient doses of arsenic in this affec- tion by the Cytoxan Generic writings of that brilliant, versatile, and inde- fatigable worker, Mr. Jonathan Hutchinson, who, in 1854, reported a number of Oral Cytoxan cases of pemphigus, some of which had been treated successfully with arsenic ; this report was followed by subsequent records of Cytoxan Taxotere cases by himself and others ; and in 1877 the present writer f reviewed the litera- ture of the subject and reported on five cases of pemphigus treated successfully with arsenic in free doses, in one of which cases the drug had twice appeared to save life. As this latter case was a most important one, demonstrating the specific action of arsenic in pemphigus in an absolute man- ner, I shall take the Cytoxan And Adriamycin liberty of again briefly alluding to it; the other cases here mentioned have been treated since Adriamycin And Cytoxan : Case I. — Annie S., aged sixteen years, had had an eruption of bullae, especially on the limbs, coming and going for a year previous to the date of my first seeing her; it had never given great trouble until a few weeks previously, when it increased with severity, the bases of the lesions taking on a diphtheroid character, and she rapidly sinking. When first seen there was every appearance of extreme exhaustion, with rapid and feeble pulse, and death was Cytoxan Adriamycin expected shortly by three physicians who had seen her. The eruption had affected the mouth, and the tongue Cytoxan And and buccal cavity, as far as could be seen, were covered with ulcerating lesions, rendering speech and deglutition almost impossible ; Cytoxan Oral there were some large and distinct buUfe on the * "New York Medical Journal," August, 18*76, p. 113. f "American Journal of the Medical Sciences," October, Adriamycin Cytoxan 1877, p. 408. elbows and lower legs, but most of the lesions consisted of

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