In each instance, we must proceed very cautiously with the medicine, to accustom the constitution to its irritation.

The other preparations chiefly in use are Plenck's powder, the solution of the sublimate, the mercurius acetatus, and alkalisatus. From these we seem to derive no peculiar advantage, nor are the two latter, as is pretended, less irritating to the bowels. Plenck's gummy solution of mercury sometimes appears to be so, but is not on the whole superior. The solution of the muri-ated mercury, introduced by the baron Van Swieten, was for a long time trusted. It affected the bowels only in a slight degree; and when its menstruum was corn spirit, it sat easily on the stomach. It soon appeared to check the disorder, but here unfortunately its merits rested. When the complaints were diminished, the medicine would affect no more, even though the dose was increased; and in some instances, even during its use, the worst symptoms appeared to return. Fumigations, which were formerly much employed, are now seldom trusted, and seem chiefly useful by bringing on, more rapidly, mercurial effects on the salivary glands.

In a very low state of the constitution, when hectic symptoms prevail, mercury is of doubtful efficacy; but cautiously and gradually administered, it does not increase hectic symptoms; and it is not difficult, even during the progress of phthisis, to arrest, in a great measure, venereal symptoms. Though its action on the salivary glands is necessary to show that it is introduced in sufficient quantities, yet when these are soon affected, as we have said happens in some constitutions from idiosyncracy, and very generally in scorbutic habits, there is no opportunity for its power being communicated very generally to the smaller vessels. In such cases it must be resigned, if a warm regimen and the relaxant diaphoretics, just mentioned, will not direct it to other excretories.

In these and similar cases we must apply to what may be called the accessary specifics, and we fortunately have some active medicines of this class. Among these we may reckon the mineral acids, particularly the nitrous. The nitrous acid was warmly recommended to us from the experience of the Indian practitioners. Our expectations, often deceived by pompous promises, were not raised high when we were informed that its effects were equal to those of mercury; but, though far inferior, it is a medicine highly useful. The nitrous acid will not cure lues, but it will arrest the symptoms and restore the strength in those intervals when mercury can be no longer borne. It will sometimes in these intervals seem even to advance the cure, and we can truly add, that the methodus medendi has not for many years received a more powerful auxiliary. The other accessary antisyphilitics are the bark, opium, china root, guaiacum, sassafrass, astragalus, lobelia, lu-pulus, dulcamara, sarsa, and mezereon. We have arranged them in what seems the order of their efficacy, commencing with the least powerful; omitting the volatile alkali, muriated barytes, the juniper, the cicuta, the green rind of the walnut, the bardana, and sapouaria, as of very inconsiderable, if any, power. On the individuals of the former class we shall add a few remarks.

The peruvian bark has, alone, no power of checking the progress of the syphilitic infection. Yet it is often highly useful in lues, when mercurial ulcers occur hi the mouth; when the ulcers of suppurating bubos assume a livid appearance, or those in the perinaeum are foul, with deep sloughs. It has been contended that it meliorates venereal symptoms; but, in reality, it only lessens their painful irritation by diminishing irritability. The cicuta, and the green rind of the walnut, in the second class, act in the same manner, if indeed they have any effect.

Opium has been celebrated as a certain antisyphilitic, and, in many instances, it has had apparently a powerful effect. This, however, is temporary only, and the symptoms have returned with increased violence. It acts like the former medicine by lessening irratibility, and in some measure perhaps as a diaphoretic. In this way it is peculiarly useful in mercurial ulcers. The china root, the guaiacum, sassafras, astragalus, escapus, lobelia syphilitica, lupulus, and dulcamara, are not found to answer the high expectations formerly entertained of them. The three first are occasionally ingredients in diet drinks, and the three last are, in this country, scarcely ever prescribed.

The sarsaparil/a has retained a considerable credit, and is even now generally employed. What its effects may be in a recent state we know not, but we have found its powers inconsiderable in this country, though we have given large doses in substance. It appears to be chiefly mucilaginous, with few sensible properties, which would lead us to suppose it active.

The mezereon, on the contrary, is a powerfully stimulating diaphoretic, from a plant strongly narcotic, and seems to combine the united virtues of the rest. It has alone often effected all that has been expected from the others, which in many instances seem to overwhelm instead of adding to its powers.

If we examine these antisyphilitics we shall find them in general narcotic; in a few instances merely mucilaginous, and in general diaphoretic. If the sarsa is not merely mucilaginous, it is diaphoretic. From each property we perceive that some advantages may be derived in lues; and when all are combined, the effects may be more salutary. In the mezereon' we combine the diaphoretic and the narcotic; in the sarsa, the former with the demulcent; in juniper, the bardana, the sassafras, and the guaiacum, we have probably only the diaphoretic,or with a less degree of the mucilaginous; in the dulcamara, lupulus, astragalus, the green rind of walnut, bark, and opium, the narcotic only. The same views assist us in forming a judgment of their comparative merit; but their order was long since fixed by experience, before we had occasion to examine the source of their efficacy. Above all we must reflect, that those which have any claim to a diaphoretic power are given in decoction, by which the active particles are attenuated and conveyed to the skin; and these only are useful where the disease has penetrated to the minutest vessels.

Mr. Bell observes, in his Treatise on Ulcers, that those which are the result of a venereal taint of a long continuance, are singular in the appearance of their discharge. It is at first thin, but soon becomes tough and viscid; having a very loathsome, though not the ordinary, putrid smell, and a singular greenish yellow colour. In such ulcers as have a lues of long continuance for their cause, we should depend on the effect of mercury given internally, contenting ourselves with such external applications as will keep the sore clean. In this manner the different ulcers are, as we have said, indices that the disease is eradicated from the habit. Venereal ulcers are apt to inflame, and are then painful; but a saturnine poultice will relieve the inconvenience, and the unguentum cereum Pharmac. Edinb. will be only required. If the ulcer is seated near a bone, the appearance of fungous flesh will lead to a suspicion of caries; and besides the proper treatment for carious bones, mercury must be administered. These ulcers are often obstinate, though every venereal symptom is removed; and this is frequently owing to some other disease, which will require attention. The sores, however, will sometimes not heal from the effects of mercury, and then the bark, opium, or both, with a nourishing diet, a pure air, and moderate exercise, will usually succeed. If the sloughs on these ulcers are tough, dressings that gently stimulate will be required; and two drachms of the nitrated quicksilver may be added to an ounce of the unguentum resinae flavae for this purpose. When a gland is the seat of an ulcer, a salutary suppuration is with difficulty produced, and the gland, at least the hardened part of it, must be destroyed by repeated applications of the argentum nitratum. See Bell on Ulcers, vol. vi. p. 381, etc.

An eruption of the skin is sometimes also the consequence of a free use of mercury, attended with a fever, usually idiopathic. The skin is affected with a prickling sensation, and a rash follows, which terminates in branny scales. The skin, however, is left in a state peculiarly tender and irritable, which is relieved by bark or opium, but, above all, by the mineral acids.

When venereal ulcers appear cancerous, fresh air, a fuller diet, abstinence from mercury, and hemlock applied outwardly, or given inwardly, will sometimes succeed. A more speedy effect has been observed from eating several lemons in a day. See some observations of this kind in the London Medical Transactions, vol. ii. p. 338, etc. Venereal ulcers in the throat may be conveniently relieved with the following: Hydrar-gyri muriati, gr. x. acidi muriatici, gut. v. tinct. lav. c.

i. m. cap. gut. v. - xx. bis. die, in aq. pura vel jusculi avenacei.

Astruc on the Venereal Disease, or Chapman's Abridgment of Astruc; Heister's Surgery; Fordyce's Elements, part the second; Falck's Treatise on the Venereal Disease; Fordyce's Review of the Venereal Disease; White's Surgery, vol. iv. p. 399, 423; Swe-diaur, Plenck, Howard, Bell, and Hunter, on Venereal Complaints; Pearson's Observations on the Effects of various Articles of the Materia Medica in Venereal Complaints.