BRITISH MEDICAL J OURNALI suggest that toleration, kindness, and understanding are not enough. We have failed if our methods perpetuate receptivity. The psychopath requires treatment which will replace that by simple measures that are biologically analogous to the stage which he has reached oi' has regressed to.
ConclusionTwo objections to the suggestions are not insurmountable the difficulties of organizing any such scheme, and the danger that it would be used for merely punitive reasons.To summarize, if the problem of chronic and subacute neurosis is recognized as one of social repudiation and parasitism in which the patient lives suicide, our task is to help the psychopath to return to the stringencies of life. These are not always wholly painful, though they appear so. The recent increase in the incidence of scabies and impetigo is generally known (Buxton, 1941 ; Carter, 1941). This has created an important medical and economic problem. Industry and the military have both felt the pinch caused by the loss of time due to minor skin illness, which in toto creates a major problem. As a con'sequence a good deal of attention has been focused upon scabies and its complications. The purpose of this report is to call attention to an improved method of dealing with impetigo, a method which materially reduces the length of treatment.Choice of Drug for Local Therapy Accepted treatment to-day consists in the use of three chief groups of drugs-the mercurials, the organic dyes, and the sulphonamide compounds. In choosing a satisfactory agent for the local therapy of impetigo one should demand the following qualifications: rapid action, ease of application, freedom from local irritation and systemic toxicity, and non-staining to bedding and clothing. The success of local therapy depends upon two conditions: (1) contact between the drug and the infectious agent, and (2) bactericidal potency of the drug employed. The former is generally interfered with by crust formation, and the latter by the choice of a preparation which is not actively lethal for all of the organisms that may be presefit. The importance of softening and removing crusts as a preliminary cannot be over-emphasized, and will be referred to again. Bacteriological examination of 25 patients suffering from impetigo revealed interesting results, quite in keeping with the findings of others. As will be pointed out, these findings led to the adoption of the treatment noted in this report. Briefly, the 25 patients gave the following cultural results: haemolytic streptococci (pure culture) in 12 cases; Staph. aureus (pure culture) in 8 cases; and a combination of these two organisms in the remaining 5 cases. Thus, in addition to haemolytic streptococci, it can be said that Staph. aureus was present in half of these cases. Whether or not it is present as a " secondary invader" is important from the standpoint of epidemiology but is of no consequence from the point of view of selecting local therapeutic agents. If the organism is present in abundance, then it must be d...