appeared to do as much good as any one of the many other remedies which I have tried. If something more parasiticidal in its action is desired, an ointment of chrysarobin from three to ten per cent in strength can be recommended as an effective application. In prescribing this the physician must not forget to mention the fact that it will stain the bed linen, and caution the patient not to get any ointment in his eyes lest a severe conjunctivitis result.
The plan long recommended and often practised of shaving the scalp and blistering the patches with cantharis, croton oil, or pure carbolic acid, may be of some value, but not enough to compensate for the suffering which it involves. Although patients will sometimes stand any amount of painful treatment in order to get cured, there is no justice in submitting them to harsh measures when milder ones are of equal value.
Epilation of the loose hair at the margin of the bald patch is advisable, since it seems in some cases to prevent the spread of the disease; but general epilation is unnecessary, and, so far as I know, is never practised in America.
A patient seen recently by the writer has had alopecia areata for ten years. Two months after marriage his wife found three bald spots upon her own head. At a European health resort the physician who was consulted, evidently believing in the parasitic origin of the disease, ordered the hair to be epilated not only on the scalp but on other hairy parts of the body. The spots persisted, and complete epilation was repeated in the case of both husband and wife. The lady's maid complained of slight falling of the hair, and her scalp was ordered to be thoroughly epilated, in spite of her indignant protest. In these cases, which illustrate the absurd extreme to which theoretical therapeutics may be carried, the vigorous treatment would have been pardonable had it been successful, but the gentleman, an extremely nervous individual, has still bald patches upon his scalp and chin.
Of internal medication it need only be said that neither arsenic, jaborandi, nor any other drug in the pharmacopoeia is capable of producing any manifest result in most cases. They may be of some value, as has been claimed, but reliance upon them is usually disappointing. The restoration of hair after administration of a drug is no proof of its value in a single case. The absence of improvement after its use in repeated cases is at least suggestive of its inertness. Any internal medication which will improve the physical condition of the patient is of
