The mercurial preparations are the first to be employed in treating syphilis, and no homoeopathic grounds, for the pathogenesis of these preparations corresponds to the syphilitic infection in the majority of cases.
Mercurius corresponds to the majority of symptoms of secondary syphilis, to the syphilitic fever, to soft chancres and to buboes. The sore throat and the nocturnal syphilitic pains which banish sleep as soon as the patient goes to bed are well met by the remedy. The chancres and ulceration have dirty, laradaceous bases and foetid discharges. It suits especially the phagedenic sores, which bleed easily. Jahr recommended not lower than the second centesimal trituration in this affection.
Mercurius proto-iodide corresponds to the Hunterian or hard chancre, which is painless, with no tendency to suppuration. It also suits well the secondary eruption. Helmuth prefers this preparation to any in the early stages.
Mercurius bin-iodide is useful in chancre and bubo when they are particularly indolent. It also is useful in syphilides.
Mercurius corrosivus [Merc-c]
Is the most active of the preparations of mercury, and corresponds to active and destructive cases, as in syphilitic ulcerations, which are very destructive, serpiginous ulcers with ragged edges, phagedenic ulceration and acute buboes.
Is one of the most useful forms of mercury in the secondary and tertiary stages, and it is especially suitable to syphilis in scrofulous subjects.
Mercurius dulcis. [Merc-d]
A remedy often under-estimated. It corresponds to phagedenic ulcers in the mouth and throat. Infantile syphilis frequently calls for this remedy. The lower homoeopathic preparations are to be preferred.
This remedy has been used in syphilis from early homoeopathic times. Teste, in his Materia Medica, published in 1854, writes of an arsenical preparation then in vogue called Feltz’s Anti- Syphilitic Decoction, which enjoyed a very extensive popularity, and was stated to cure the disease as by magic, where it had proved rebellious to mercury. This anti-syphilitic arsenical craze of sixty years ago is repeated in the Salvarsans of to-day, of which much has been hoped but which are now conceded to be practically useless in the disease unless mercury be given at the same time. Teste says Arsenicum is a very useful remedy in constitutional syphilis, and Berjeau gives precise indications therefor. It is indispensable in the phagedenic variety of ulcerations with the intense burning pains and in desperate cases of syphilitic infection with general constitutional symptoms of the drug which frequently correspond so closely to those of some cases of the disease.
This remedy is of no use in the primary or secondary stage of syphilis; all of its manifestations belong to the tertiary stage. It has gnawing bone pains, throbbing and burning in the nasal and frontal bones. Papules which ulcerate, leaving scars, rupia; the ulcers are deep eating. It also meets the nervous lesions of tertiary syphilis. It is a valuable remedy with which to antidote the abuse of mercury.
Kali bichromicum has ulcerations, with tendency to perforate deep down into the tissues, and is useful in syphilitic affections of the mouth and fauces.
Kali-iodatum suits the infantile coryza in syphilitic children and the scaly syphilides. Scrofulous subjects where the tendency to ulceration is marked require the remedy.
Hepar sulphur. [Hep]
This remedy is indispensable when mercury has been abused; indeed, it more of an antidote to mercury than to syphilis itself. It may be indicated in this disease, as may any remedy, by special symptoms, and those of Hepar are chancres with diffuse borders and red base with sticking pains in them, secreting a watery pus, also in the swollen glands and their suppurative tendency. There are nightly pains, chilliness and the sores are sensitive. It has also falling of the hair.
Nitric acid. [Nit-ac]
This suits especially mercurial-syphilitic cases and secondary syphilis, phagedenic chancres with exuberant granulations, bleeding easily; also ulceration and mucous patches. The ulcers have raised and ragged edges and splinter like pains in them; the buboes, threaten to suppurate. There is soreness of the skin and cranial bones, worse from damp weather. There are ulcers in the throat irregular in outline, with sticking pains in them and yellowish brown or copper colored spots over the body.
Lycopodium has ulcers in the throat and a dark grayish coppery eruption on the forehead. It suits also indolent chancres. Jahr praises this remedy in these manifestations.
Secondary syphilis with ulcerations in the mouth, especially in cases complicated with mercurial symptoms, calls for Aurum. More especially is it indicated when the nose is implicated and there is caries of bones, a stinking discharge and pieces of bone are discharged. There are also pains in the bones of the face. It has also a correspondence to many tertiary manifestation. Aurum muriaticum may in some cases prove more useful than Aurum metallicum. A melancholic, low spirited condition should be present with this remedy.
This remedy is of great value in relieving the nightly bone pains of syphilis. There is pain and swelling in the shin bones; a syphilitic periostitis; the parts are sensitive to the slightest touch. It also is beneficial in syphilitic neuralgia and pustular eruptions.
Asafoetida suits syphilis of the shin bones with nightly pains. The ulceration are most sensitive, discharging a thin offensive pus. Syphilitic caries and necrosis, with extreme nocturnal pain, call for Asafoetida.
Stillingia suit severe bone pains, especially in the long bones, and nodes on the head and shin bones, where there is extreme torture therefrom.
Carbo animalis. [Carb-an]
In constitutional syphilis after abuse of mercury this remedy may be indicated. It has copper colored blotches on the skin, especially on the face; there is induration of the inguinal and axillary glands, which is as hard as a stone, and this hardness extends even to the surrounding tissues; this is the indurated bubo.
While this is essentially a sycotic remedy, it has a useful field in syphilis. Moist excrescences on the prepuce and glans, or whitish chancres, will indicate it.
Staphisagria has soft humid excrescences about the genital organs and dry fig warts.
Silicea may also be indicated in suppurative conditions about the genitals.
Phytolacca has numerous syphilitic manifestations. It is especially useful in syphilitic rheumatism, with pains at the attachments of muscles, worse at night and in damp weather.