(1) Chancres and Mucous Tubercles. (A) Several superficial excoriations on the glans secreting a white mucus. Lardaceous chancre on the fraenulum, almost separating it from the glans. Lardaceous, suppurating chancre behind the corona glandis. Two large, flat chancres behind the corona. Scurfy, somewhat itching ulcer on the outer surface of the prepuce Chancre near the fraenulum, of the size of a pea, accompanied by an itching ulcer on the outer surface of the prepuce Round, deep ulcer on the glans, with elevated, bright-red, pouting edges.Two ulcers on the upper portion of the glans, with hard edges, which are sensitive to contact, and a pain that seems as if left throughout the whole body. Hunterian Chancres of some duration, having not yet changed to a fungoid growth, but no longer tardy with agonizing, boring pains, from nine o’clock in the evening until three in the morning, depriving the patient of sleep. Simple, and also recent Hunterian chancres on the glans and prepuce. Elevated chancres on the prepuce.
(B) A number of ulcers of different sizes, with pouting edges profuse suppuration, and enormous swelling of the penis and prepuce. Small ulcers in the folds of the prepuce. Seven ulcers on the glans, prepuce, and body of the penis. Two small, red, flat ulcer on the private parts. Dry confirm warts, of the size of split peas, resting upon on oval base, not bleeding firm and undivided at their base, the smallest of them like ordinary condylomata, dotting the glans, prepuce, and body of the penis.
(C) Consensual phenomena: Pains that permeate the whole body. Nocturnal boring pains. Swelling of the prepuce. Pura-phimosis like a cartilaginous ring around the glans, with a bad shaped swelling towards the outer side. Painful inflammation and redness of the inner prepuce. Ulcers on the glans and prepuce, but chiefly on the posterior surface of the glans. Chancres, more particularly behind the corona glandis, chiefly on the fraenulum. Edges surrounded with a copper-colored areola, with somewhat rounded indentations, not very painful, but sensitively to the contact of the linen. Ulcers that eat more rapidly downwards than they spread laterally. The bottom of the ulcer is hard, lardaceous, the ichor firmly adhering, corrosive, having a fetid odor, and leaving stains on the linen like a molten tallow.
(2) Consecutive buboes and ulcers in the throat. (A) Painfulness of the inguinal glands, specially on the left side. Hardness of the left inguinal gland, with slight redness and inflammation. Swelling hardness, and inflammation of the right inguinal gland, with a yellowish softness at the most elevated places, and tension and stinging in the gland when walking. As long as the bubo has not yet outgrown the chancre, and seems to be more like a consensual painful swelling, Mercurius sol. may suffice against these phenomena, and disperse the swelling at the same time as it heals the chancre; if the chancre is on the point of passing into the secondary stage of its existence, and the bubo has become inflamed, Mercurius sol. will be of no use and Mercurius prec. rub. or Nitri acidum will have to be used.
(B) Ulcers in the throat. Three syphilitic ulcers in the throat, with erysipelatous inflammation of the soft parts. Flat ulcers in the throat, with pale redness and stinging when swallowing, itching between the acts of deglutition. Stinging in the throat, as if the parts were excoriated, aggravated by swallowing liquids, specially cold liquids. Excoriation, swelling, and redness of the tonsils and salivary glands, with increased secretion of saliva, and painful pressure in the throat. Evening hoarseness, with troublesome dryness of the fauces.
Dose. –Vehsemeyer; second or third decimal trituration, tow or three doses daily, increasing the dose from one to five grains each. Hartmann and Knorre; first to third trituration, two doses daily, from one half to a whole grain each. Wolf and Seidel: Sixth to twelfth-attenuation; Wolf also gives the third. Jahr: first centesimal trituration, two doses daily, of half a grain each, sometimes only every two or three days, according to circumstances.
Secale 229.–Praecipitatus Ruber.
This preparation is distinguished from Mercurius sol. and vivus by being more penetrating, and is frequently useful when the solubilis does not seem to act with sufficient force. In the case of old chancres that have not yet assumed the fungoid from, I resort to it if no improvement shows itself after having prescribed Solubilis for eight days. We possess clinical records of the curative powers of this drug by the following observers: Buchner, Haustein, Hofrichter, Cl. Muller, Rosenberg, Trinks, and Jahr. The following symptoms have been cured with it:
(1) Chancres. (A) Chancre of the size of a bean between the glans and prepuce. Deep ulcer, with swelling and induration of the prepuce. Lardy chancre on the prepuce, with pouting edges and dirty lining, accompanied by syphilitic excoriation on the glans, and enormous secretion of pus. Chancre between the glands and prepuce, with thick lardy lining, hard edges, and spreading, both laterally and to the subjacent textures, to such an extent that the glans seems threatened with falling off. Cut-shaped ulcers, with red, hard edges, and a lardaceous bottom. Considerable ulcer on the glans, the bottom of which seems to become raised. Hunterian chancres, specially when old and neglected. Ulcer between the glans and prepuce, the latter being so enormously swollen and inflamed that it can no longer be drawn over the glans, together with purulent discharge between the glans and prepuce, nocturnal tearing in the penis proceeding from the ulcers. (B) Five small ulcers on the labia minora. The whole glans is covered with ulcers, with dark brown redness of the prepuce, that can no longer be drawn over the prepuce, and discharge of quantities of pus having a fetid odor. (C) Consensual ailments: Fearful swelling of the penis. Enormous swelling and inflammation of the prepuce, with phimosis. Cartilaginous, violet-red induration, and swelling of the prepuce, following the removal of Hunterian chancres by cauterization.
(2) Consecutive and secondary phenomena. (A) Inflamed, also suppurating buboes. (B) Swelling of the tonsils, with two ulcers on the hairy scalp, of the size of a dime, having arisen from itching pimples, with lacerated edges, yellow pus, smarting and cutting; attended with cutting pain in the right side of the throat, when swallowing solid food, not when swallowing liquids, with ptyalism and phlegm in the throat; after giving Mercurius sol. lardaceous ulcer in the throat, which was cured by Precipitatus albus. (This case, reported by Hofrichter in Allium hom. Zeit., vol. 35 doses not seem very clear to me. The itching vesicles, bursting when using the comb, and forming ulcers of the size of a dime, have been cured by me more than once with Hepar sulph; the Hepar was given in the belief that these ulcers were mercurial symptoms; the fact that they here yielded tom precip. ruber does not show that they were syphilitic ulcers. We have shown, No. 225, that mercurial symptoms sometimes disappear very suddenly, for a time when a second dose of Mercury is administered, after which they either return or may be soon placed by other symptoms. In then present case they were replaced by the lardaceous ulcer in the throat, which I should like to have seen in order to determine the pathological nature of this ulcer for myself; if there is Itching, as was the case with those ulcers on the hairy scalp, there is trouble: mercurial cutaneous affections always itch, syphilitic affections never itch, properly speaking. The “burning from the pit of the stomach to there throat, with occasional choking,: is no syphilitic, but a real mercurial symptoms. The same criticism applies to the other case reported in the same volume, page 84, where the following symptoms made their appearance subsequent to the allopathic treatment of gonorrhoea; itching condylomata on the nates, bleeding when touched; lardy- looking, deep, lacerated, condylomatous ulcer, with uneven base, on the left margin of the tongue ( one of the diagnostic signs of mercurial and syphilitic ulcers is, that the latter never occupy the margin, but always the root or dorsum of the tongue; or, if caused by direct contract with infectious matter, they may be seen at the tip of the tongue; likewise, the nocturnal tearing in the limbs points to mercurial disease rather than to syphilis, Jahr.).
Hanbold recommends this preparation particularly for buboes, chancres in the throat, (specially the true, metastatic, not secondary, but consecutive chancres on the tonsils, Jahr), and for other glandular affections. Trinks recommends it for syphilitic destructions of the tonsils, fauces, and palate, also for syphilitic exanthems (specially tubercular and pustulous, Jahr), for cutaneous ulcerations and osseous affection. More than once I have been able to verify its good effects in obstinate Hunterian chancres, and fully subscribe to Buchner’s and Cl. Muller’s favorable recommendations of this agent.
