2. That, In' Some Forms Of Syphilis

Mercury is not only useless, but injurious, when given so as to affect the constitution.

3. That in those cases in which it is admissible, the good effects to be derived from it may be obtained from much smaller quantities than were formeily given.

4. That some of the symptoms and effects formerly attributed to this disease were due to the Mercury itself.

5. That notwithistanding all the forms of Syphilis may be cured without it, yet its judicious administration materially hastens the cure, in many forms of the disease.

6. That the occurrence of secondary symptoms is much less liable to happen after the administration of this remedy than if the disease has been cured without it.

7. That the liability to secondary symptoms is, in a great degree, dependent upon the length of time which the syphilitic virus has had, for being absorbed into the system; and that, therefore, it becomes a point of primary importance to heal a venereal sore as quickly as possible; and as this can generally be sooner effected with Mercury than without it, its employment on this ground is most advisable. (Tuckett.)

8. That in those venereal sores characterised by slowness of progress, and the deposition of albumen or lymph (commonly called hard chancres), the use of this remedy is most essential; whilst in those characterised by rapidity of progress, and the absence of any barrier by the effusion of lymph, or those in which

* Med. Times and Gaz., March 26, 1864.

Trans, of Lond. Pharm., 1851, p. 426.

there is a tendency to rapid ulceration, it is, on the contrary, less beneficial, if not positively injurious.

9. That in the venereal eruptions of a papular or scaly form, it is beneficial; whilst in those of an ulcerative character, as Eethyma or Rupia, it is hurtful.

10. That its administration ought generally to be suspended when suppuration is taking place in a large bubo.

11. That the benefit derived from its use is not proportional to the amount of salivation induced; and that, except as an evidence of a constitutional effect, this resut is undesirable.

The treatment of Syphilis, as usually practised at the present day, is extremely simple; at the same time that it is effectual and perfectly safe, so far as the constitution is concerned. If a chancre be seen immediately after its appearance, before it presents a well-marked indurated base, the ulcer should be cauterized with the Nitrate of Silver, or strong Nitric Acid; and it should be so applied as thoroughly to destroy its surface. This, with rest, quiet, antiphlogistic regimen, saline aperients, and the local application of warm water, will often remove the disease permanently, without any mercurial whatever. Should, however, the ulcer have existed three or four days, and the syphilitic virus have become absorbed into the system, Mercury should be had recourse to. It is a matter of minor importance which preparation is employed. Pil. Hydrarg. is the one most generally eligible, and it should be continued twice or thrice daily, until the gums become slightly sore. This is its proper limit, beyond which it should not be carried. This soreness should be kept up, neither diminished nor increased, for three or four weeks; at the expiration of which period, in the majority of cases, the ulcer will be healed, and the induration removed. The Lotio Nigra, or diluted Liq. Plumbi, may be applied topically, on a piece of linen (lint is apt to produce irritation). Inunction with Ung. Hydrarg. Fort. is regarded by Sir B. Brodie * as the only certain way of effecting a cure. In the Syphilis of Infants, he advocates a similar mode of treatment. He directs diluted Ung. Hydrarg. (3j. to Lard j.) to be spread over a flannel roller, winch is to be bound round the body once a day. The child kicks about, and the cuticle being thin, the Mercury is absorbed. It does not, he adds, either purge or gripe, or make the gums sore, but it cures the disease. In a number of cases this practice has met with success. For internal use the Hydrarg. c. Cret. is the best formula.

1368. In Secondary Syphilis, alterative doses of Mercury, particularly of the Corrosive Sublimate or of Plummer's Pill, have been found highly serviceable; but it has been replaced in a great measure (especially where the osseous system is affected) by the Iodide of Potassium, which produces all the good without the ill effects of Mercury. The great value of both remedies appears to depend upon their property of promoting the absorption of the lowly organized albuminous material which is effused into the tissues in constitutional Syphilis. Mr. Langston Parker * strongly advocates mercurial fumigation. The salts which he employs are the Sulphuret, the Oxide, and the Black Oxide, of which from 3ss. - 3iv. may be used with safety. The fumigation should be continued for twenty or thirty minutes. The Iodide of Potassium or of Iron, or Corrosive Sublimate, is given internally at the same time. He speaks highly of the efficacy of this treatment. Mr. H. Lee recommends Calomel gr. xx. or more as the salt best adapted for the purpose (ante).

* Lectures, Lancet, Feb. 17, 1844.