at
trochanter once a week. The contents of the syringe are slowly
expressed, and, after withdrawing the needle, gentle massage of the
buttock should be employed. Four courses each of ten injections are
given the first year, three courses of the same number during the second
and third years, and two courses during the fourth year (Lambkin).

_The General Health._--The patient must lead a regular life and
cultivate the fresh-air habit, which is as beneficial in syphilis as in
tuberculosis. Anaemia, malaria, and other sources of debility must
receive appropriate treatment. The diet should be simple and easily
digested, and should include a full supply of milk. Alcohol is
prohibited. The excretory organs are encouraged to act by the liberal
drinking of hot water between meals, say five or six tumblerfuls in the
twenty-four hours. The functions of the skin are further aided by
frequent hot baths, and by the wearing of warm underclothing. While the
patient should avoid exposure to cold, and taxing his energies by undue
exertion, he should be advised to take exercise in the open air. On
account of the liability to lesions of the mouth and throat, he should
use tobacco in moderation, his teeth should be thoroughly overhauled by
the dentist, and he should brush them after every meal, using an
antiseptic tooth powder or wash. The mouth and throat should be rinsed
out night and morning with a solution of chlorate of potash and alum, or
with peroxide of hydrogen.

_Treatment of the Local Manifestations._--_The skin lesions_ are treated
on the same lines as similar eruptions of other origin. As local
applications, preparations of mercury are usually selected, notably the
ointments of the red oxide of mercury, ammoniated mercury, or oleate of
mercury (5 per cent.), or the mercurial plaster introduced by Unna. In
the treatment of condylomata the greatest attention must be paid to
cleanliness and dryness. After washing and drying the affected patches,
they are dusted with a powder consisting of equal parts of calomel and
carbonate of zinc; and apposed skin surfaces, such as the nates or
labia, are separated by sublimate wool. In the ulcers of later secondary
syphilis, crusts are got rid of in the first instance by means of a
boracic poultice, after which a piece of lint or gauze cut to the size
of the ulcer and soaked in black wash is applied and covered with
oil-silk. If the ulcer tends to spread in area or in depth, it should be
sc