NITRATE OF SILVER.

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application (Hunt, hand. Med. Gaz. xiii. 129). When the fibrinousexudation of croup commences on the surface of the tonsils and arches ofthe palate, its further progress may be stopped, according to Mr.Mackenzie ( Edin. Med. and Surg. Journ. xxiii. 294), by the applicationof a solution composed of a scruple of nitrate of silver and an ounce ofdistilled water. The solid nitrate has been introduced through an aper-ture in the trachea, and applied to ulcers on the inner surface of thelarynx, in a case of phthisis laryngea, with apparent benefit, (Liston,Elements of Surgery, part ii. p. 256).

In some forms of leucorrhcea the application of nitrate of silver, eitherin the solid state or in solution, is attended with beneficial effects. Thispractice was first recommended by Dr. Jewel ( Pract . Observ. onLeucorrhcea, 1830). It is, I believe, most successful in cases dependenton local irritation or subacute inflammation, and not arising from consti-tutional debility. .The solution may be applied by a piece of lint orsponge, or may be injected by means of a syringe with a curved pipe.Its strength must vary according to circumstances. Dr. Jewel generallyemploys three grains of the nitrate to an ounce of water; but in the LockHospital, solutions are sometimes used containing half a drachm or eventwo scruples to the ounce. In some cases the solid nitrate has beenapplied to the cervix uteri and vagina by means of a silver tube. Ingonorrhoea of the female a solution of nitrate of silver, or even this causticin the solid state, has been used with the best effects. It was firstemployed by Dr. Jewel, but subsequently, and on a much more extendedscale, by Dr. Hannay ( Lond. Med. Gaz. xx. 185), and without anyinjurious consequences. In many cases the discharge ceased, never toreturn, in twenty-four hours. The fear of ill effects has prevented thegeneral adoption of this practice. In gonorrhoea of the male, the intro-duction of a bougie, smeared with an ointment of nitrate of silver, is, occa-sionally, a most effectual cure: but the practice is dangerous. In onecase I saw acute and nearly fatal urethritis brought on by its employ-ment. The individual was a dresser at one of the London hospitals, andhad practised this mode of treatment in many instances on the hospitalpatients with the happiest results. An aqueous solution of the salt hasbeen successfully used in chronic gonorrhoea (Rognetta, Lancette Fran-qaise, Mar. 31, 1836).

In fissured or excoriated nipples the application of the solid nitrate ofsilver is of great service. It should be insinuated into all the chaps orcracks, and the nipple afterwards washed with tepid milk and water.(Lond. Med. Gaz. v. 207 ; xiv. 674, 719, and 754).

The application of solid nitrate of silver is a most effectual remedy forthe different forms of porrigo which affect the heads of children. Thecaustic should be well rubbed into the parts. I have never known thepractice to fail, or to cause the loss of hair. Where the greater portion ofthe scalp is involved, the different spots should be cauterized successivelyat intervals of some days ; for, as already mentioned, I have seen feverand delirium produced in a child from the too extensive use of theremedy. In psoriasis the same medicine was found by Dr. Graves(Lond. Med. Gaz. vii. 520) most effectual. An aqueous solution of thenitrate is also valuable as an astringent wash in other skin diseases, asimpetigo. The solid nitrate is sometimes employed to stop the progressof irritative or erysipelatous inflammation, by applying it in a circular