appeared to possess immunity, but he was afterwards successfully inoculated by M. Ricord.

"What do we witness," demands M. Follin, "as the results of this practice? Secondary symptoms which disappeared very slowly; forms of secondary disease very intractable in their nature; tertiary symptoms which did not disappear at all; a very protracted treatment, very painful, altogether disgusting; recurrence of symptoms which did not appear to be inferior in number to those which followed mercurial treatment."

En résumé, this author adds, "It is not at present proved that repeated inoculations to the point of immunity rendered the system less liable to secondary disease; and when the symptoms disappear under syphilization, no proof is given that the patient possesses immunity from the manifestation of lues venerea.'

In reference to modes of treatment, my own sentiments fully accord with the following wise observation of Dr. Graves:-" The rational practitioner is neither a mercurialist nor a non-mercurialist; he acts according to the state and peculiar exigencies of each case, and selects his plan of treatment according to the form, condition, and duration of the disease, as well as the constitution of the patient."

397

CHAPTER VI.

ON THE ALLEGED INJURIOUS EFFECTS OF MERCURY AS A THERAPEUTIC AGENT.

THE prevailing objections against the employment of mercury in the treatment of syphilitic affections have arisen on the Continent, probably among the disciples of Hahnemann, and the prejudice has extended to this country,―its total abandonment in this branch of practice being advocated by not a few. The reasons assigned for the rejection of so valuable a remedy-its insufficiency, namely, for the effectual cure of syphilis, and its tendency to induce other troubles-are, in my belief, ill founded. If injudiciously or incautiously administered, if given, for instance, in cases where its use is not indicated, or in immoderate doses, and especially if regardless of certain precautionary conditions necessary for securing its effectual operation, and for protecting the vital organs, during the process, against atmospheric and other vicissitudes; or in habits of body known to be intolerant of it, as the tuberculous, the scrofulous, or the cancerous diathesis; it may certainly be productive of evil. But the same may be said of any remedy whatArsenic is known to be a valuable medicine; but, if used incautiously, it may not only be productive of ills of great gravity, but may produce death as certainly as when given with criminal intent. Strychnine is a curative agent of great efficacy; but it is also a deadly poison, and is little less dangerous in the hands of an incautious

ever.

practitioner than in those of the felonious homicide. As much may be said in reference to opium, iodine, aconite, belladonna, and many others of equal potency; and scarcely less of a number more, commonly deemed innocuous. No remedy is a safe one in the hands of the reckless or unwary. But how insignificant the amount of mischief inflicted by drugs, whether the result of malpractice or of premeditated wickedness, in comparison with that produced by overfeeding and the immoderate use of ardent spirits-and perhaps tobacco, with the certain entailment upon the offspring, of organic evil which is liable to become constitutional and persistent!

The terms in which mercury has been condemned by some authors are almost unqualified. Of these the fol lowing is an example:-"One dosing of mercury, to salivation, you may rest satisfied, is enough, and often more than enough, for a syphilitic patient; for I have little doubt it will last him for every day of his natural life." Such is the opinion of an author of enlarged experience, and a clinical teacher: he, in common with others, believing that the employment of mercury is not only powerless as a remedy in syphilis, but is capable of entailing troubles of a serious and lasting character.1

Not a few entertain opinions very similar to those contained in the preceding paragraph; and some, with M. Ricord, believe also that the destruction of an indurated chancre by local measures is alone sufficient for the eradication of the syphilitic poison (of that particular infection) from the constitution.

The new doctrine of syphilization has been introduced, in the writings of each of its advocates, by a preamble on the insufficiency and danger of mercury as a remedy

1

See Lectures, by F. Skey, Association Journal, 1856, p. 211.

for syphilitic affections. Among this number, M. Sperino seems to be the most explicit in his remarks, and in his premature attempt at generalization has included forms of disease which are altogether exceptional, if not gratuitous. 'Mercurial preparations," says this author, "of whatsoever kind,-protoiodide of mercury, the pills of Sedillot, the mercure gommeux of Plenck, or any other, frequently cause intense stomatitis, gastro-enteritic inflammation of grave character, accompanied with obstinate diarrhoea. They render the patient eminently impressionable to atmospheric vicissitudes, and subject to inflammations more or less severe, and to rheumatic pains. The chemical action of mercury alters the crasis of the blood, diminishes its plasticity, engenders a disposition to scorbutus, and develops the lymphatic diathesis. Respecting the use of the oxymuriate, which is still a favourite remedy with many practitioners, I should say that they who regard it as hurtful are not deceived; for it sometimes promotes the development of tubercular phthisis, lesions of the brain, paralysis, dementia, and epilepsy." M. Boeck, although less positive in his charges against mercury as an injurious agent, has also his objections; and, apparently as an incentive to the adoption of syphilization, asserts his belief that mercury has a tendency to bring about neuralgic and mental disorders, and thinks it capable of producing inconveniences even more serious than those caused by the disease for the relief of which it is administered."2

1

SPERINO, la Syphilisation étudiée comme méthode curative, et comme moyen prophylactique des maladies vénériennes, traduit par Trézal, 1853.

2

* WILHELM BOECK, professeur à l'Université de Christiania, Syphilisationen Studeret von Sygesengen, 1854.

There is not a doubt in my mind that in these sweeping condemnations of a most valuable remedy, the writers have been influenced by prejudice, imbibed probably through a questionable knowledge as to its mode of administration, and the degree of effect necessary to be produced by it; or else through an enthusiastic preference in favour of the new practice which they advocate, but which, thus far, has certainly failed to furnish results so satisfactory as we were led to expect from it. These observers have manifestly mistaken the effects of mercury for those of syphilis. Neuralgic and rheumatic pains, for instance, of the severest character, are among the commonest accidents of secondary and tertiary syphilis; and exostosis, exfoliation of cartilage, arthritis, glandular disease, scorbutus, alopecia, obstinate cutaneous affections, and certain morbid conditions of the reproductive organs, leading to infertility or to the propagation of unhealthy offspring-all owing to a dyscrasic condition of the blood, due to the presence of the syphilitic poison, are curable by mercury, and, so far as I know at present, by no other remedy.

M. Follin says, and I think very justly: "that this act of accusation against mercury pleases, by its sombre colours, the vulgar-always greedy to swallow anything marvellous-we do not doubt; but that it is sufficient to satisfy the practical physician accustomed to the obser vation of facts on syphilitic diseases, we crave permission to doubt." This author adds, however: Quoi qu'il en soit, et malgré nos réserves, il faut reconnaitre que nous ne possedons pas encore de donnés rigoureusement exactes sur la guerison de syphilis par le mercure; nos syphiliographes les plus autorisées restent à cet égard dans un vague qui doit encourager de nouvelles re