As regards treatment, I, unfortunately, have not much to say. These forms of the syphilitic disease are very rare, and, in my own practice, I have only seen two cases. In the case of the Russian traveller, mentioned in No. 147, Silicea, after many other uselessly employed drugs, finally effected such a permanent cure, that five years after, when I had an opportunity of seeing the patient again, no new symptoms had made their appearance. In the case of the women mentioned in the same paragraph, and afterwards more in detail i n No. 150, whose symptoms had been palliated by the hydriodate of Potash, the most striking improvement was effected by means of Arsenicum, which I prescribed more particularly for the putrid appearance and the burning pains of the ulcers. For two years parts, I have used this agent with changeable success for dubious affections of the skin, having a syphilitic appearance about them. However, all I can say in favor of this agent is, that it seems to me more worthy of commendation than the hydriodate to Potash. It is undoubtedly true, that the hydriodate of Potash renders excellent service in more than one form of secondary syphilis, specially after the complete disappearance of the primary symptoms; but whenever this agent is capable of effecting a cure, it never need be given in large quantities than a the rate of four grains to four hundred grains of water. The cures which I have so far effected with this drug, have so far proved lasting cures. If I tried to hasten the cure, by giving larger doses of this drug, I have seen the syphilitic phenomena break out again, six or nine months after the supposed cure, taking it for granted that these new symptoms did not indicate an excess of hydriodate-of-potash action. If this agent does not effect a speedy improvement in doses of one-hundredth of a grain, I at once have recourse to some other drug. Further remarks on this subject will be offered in next two following divisions; and more particularly at the termination of the fourth.
