A NOTE ON THE TREATMENT OF SYPHILIS. JONATHAN HUTCHINSON. (_The
Practit._, August, 1904, p. 145.)
In this short communication the writer refers at the outset to the
remarkable fact that mercury obtained its reputation in the treatment of
syphilis almost immediately after the introduction of that disease into
Europe, and “the pills—which were known as Barbarossa’s, and of which a
large quantity was furnished for the treatment of Francis the First—were
probably essentially the same as those which Messrs. Burroughs Wellcome
and Co. now supply by the million.” In opposition to a number of
writers, especially on the Continent, the writer is a strong advocate of
the early use of mercury, and of what has been called the “suppression
treatment.” He commences mercurial treatment immediately the syphilitic
character of the sore is definite. The prevention of late or tertiary
phenomena being the most important aim in the treatment of the disease,
efforts should be made to this end, and he considers that the immediate
use of mercury, which may prevent the secondary stage from developing,
has also the effect of reducing the possibilities of the development of
the late stage. With regard to the length of time the patient should
continue to take the mercury the writer strongly believes in the
efficacy of prolonged and continuous treatment. He does not see the
object of intermitting the course and giving the specific virus any
chance of renewing its activity unless the mercury is interfering with
the health of the patient. The plan of treatment usually adopted by the
writer is as follows: “A pill is prescribed containing one grain of grey
powder and one of Dover’s powder, and this the patient is to take after
meals, and only three times a day at first. If no diarrhœa follows, the
pill is to be given four, five, or six times a day.” The diet is
regulated, and the patient is told that the treatment must be continued
without intermission for a year at least. An alum mouth-wash is ordered
to prevent ptyalism. If there is debility, a grain of quinine is added
to the pill. In using the iodides he considers that the iodides of
mercury are much less manageable than the two separated, and prefers to
give the iodide of potassium in a fluid dose along with the mercurial
pills.