[Reprinted from The Medical News, April u, 1885.] 
IODIDE OF POTASSIUM IN ECZEMA. 
By HENRY W. STELWAGON, M.D., 
PHYSICIAN TO THE PHILADELPHIA DISPENSARY FOR SKIN DISEASES, CHIEF 
OF THE SKIN DISPENSARY OF THE HOSPITAL OF THE UNIVERSITY 
OF PENNSYLVANIA,. ETC 
The importance of having at command a number 
of constitutional remedies which are capable, either 
directly or indirectly, of exerting a favorable influ- 
ence in so obstinate a cutaneous disease as eczema, 
is appreciated by all whose practice calls upon them 
to treat such cases. Probably the most reliable 
remedy in the average case of eczema is arsenic; 
but often enough it fails to have an appreciable effect, 
and, indeed, not infrequently its action is prejudicial, 
even in cases in which the probabdity of its good 
effects was scarcely questionable. 
Iodide of potassium is a remedy, which in a 
number of cases has rendered me good service, and 
is one, moreover, that is rarely capable of seriously 
aggravating the disease, as occasionally happens in 
the administration of arsenic. With the experience 
so far at command, it would be impossible to say in 
what particular c ass of cases.it may be found useful. 2 
The impression formed, however, would indicate 
that it is of greatest advantage in subacute and 
chronic eczema, in which the inflammation is of a 
moderate grade. Moreover, it seems to have a 
greater influence in the eczema occurring in persons 
otherwise apparently in good health. In fact, if a 
positive conclusion were yet warrantable, it would 
be to the effect that the remedy finds its greatest 
use in those cases in which such tonics as cod-liver 
oil, iron, and bark, are contraindicated. In broken- 
down subjects, and especially in cases in which the 
disease has been superinduced by mental worry and 
overwork, it seems to have but little value; and in 
cases in which dyspepsia is the main predisposing 
cause, it rarely benefits, but, on the contrary, will 
often aggravate. In eczema of the lower extremities, 
due in part to a varicose condition of the veins, it 
has but little influence. Nor is its use confined to the 
adult. In several remarkably obstinate and relaps- 
ing cases of eczema in children, it brought about a 
permanent cure where other remedies failed to have 
the slightest effect. 
The beginning dose for a child of the age of six 
months to a year, should be a half grain, increased 
to a grain, or even to two grains, and given three 
times daily. In children past the age of one year 
and under three the dose may be one grain, and in- 
creased to three grains; in older children, five-grain 
doses may be reached with favorable effect. It is 
best administered to children in water flavored with 
syrup of orange-peel or ginger; in some cases in 
which the remedy thus prescribed causes gastric un- 
easiness, a small quantity of a bitter tincture may be 3 
substituted for the syrup with advantage. In the 
adult, the dose at first should be not more than five 
grains, three times daily, and later increased, if found 
necessary. If ten-grain doses fail, it is more than 
probable that larger doses will also be without effect, 
or may even aggravate. The remedy is not to be 
continued if it causes persistent nausea. It is borne 
much more readily when given in Huxham's tincture, 
or the compound tincture of gentian, than in syrup 
mixtures. As a rule, it should be taken well diluted 
about thirty minutes before meals. There are, of 
course, exceptions to such a rule. With some persons 
a dose of medicine before the morning meal excites 
nausea and vomiting; with such, a dose may be 
prescribed before the midday and evening meals, and 
at bedtime. Occasionally it is best borne about two 
hours after eating. Certainly the remedy seems to 
have more effect taken when the stomach is empty, 
provided, of course, it causes no gastric disturbance. 
To rely upon any internal treatment exclusively, 
however, for the relief and cure of an eczema, would 
mean invariable disappointment. With the potas- 
sium iodide, no less than any other remedy, a suitable 
plan of external treatment is a necessity, if relief is 
to be expected. Constitutional remedies will often 
modify the morbid action of the skin so as to pro- 
mote the favorable effect of external treatment, and 
render such favorable results permanent; to expect 
more than this would lead to repeated failures. In 
conclusion, this particular remedy-potassium iodide 
-although of great benefit in some cases, will, un- 
fortunately, be found valueless in others.