“Quid facies, facies Veneris dum veneris ante? Ne sedeas, sed eas, ne pereas per eas!
II. THE TREATMENT OF SYPHILIS TO THE PRESENT TIME.
Secale 220.–Original Mode of Treatment.
The first impression which syphilis produced upon the physicians who first watched its devastations in the fifteenth century was a feeling of surprise, mingles with terror. No one able to bethink himself of a remedy, through whose influence the rapid spread of this terrible disease, which suddenly invaded every tissue of the organism, could be prevented, or even moderated. Every possible remedy that had hitherto been employed against the various ills that flesh is heir to, was tried, sanguineous depletions, purgatives, cleaning potations of every description, the most violent remedies, as well as the most complicated prescriptions. in short, every thing to be found in the Materia Medica, and the formularies of that period, containing the untied wisdom of the Arabian and Mauric Schools. It is not positively known how the use of Quicksilver was first introduced; some say that it seems to have been suggested by the immunity which the workmen in the Spanish quicksilver mines seem to enjoy from ravages of this disease, or by the remarkable rapidly with which its effects were removed from their systems; others trace the use of this agent to the custom that had been prevalent among the Spaniards, for a long time previous, to employ Mercury as a remedy for all sorts of cutaneous disease; others, again, attribute its use to accidental notion of likewise trying Mercury, where so much else had been tried in vain. Be this, however, as it may, it seems certain that the use of this agent first came from Spain, where it had been employed for long time already against certain forms of lepra; and that its employment must already have been pretty general in the fifteenth century, since a variety of mercurial ointments were already proposed in 1496 by Joseph Grunbeck, of Burkhausen, Secretary to the Emperor Maximilian; in 1497, by John Weidmann; in 1498, by Sebastianus Aquitanus; and in 1499, by Gaspard Torella. These ointments, to which every physician added different ingredients, in accordance with his own taste and judgment, were necessarily composed in so many different ways, and contained Mercury in so many different proportions, that their effect was any thing but uniform, until, finally, Jacob Von Carpi, whom Fallopius wrongly considers as the inventor of the inunction-cure, sought, in the year 1512, to regulate the employment and preparation of these ointments upon definite principles. In 1506 already, then use of the ointments had been associated with mercurial fumigations, for which purpose Cinnabaris was chiefly used, until, in the year 1528, Paracelsus, and afterwards Peter Andreas Matthiolus, substituted the internal use of this agent; in the place of external frictions and fumigations. For this purpose, the last named employed the red precipitate, which he first washed by distilling it with plantan and oxalic acid; he then dried it by the fire, and prescribed it in doses of five grains each daily. Afterwards, Barbarossa (brother of the celebrated pirate), learned from a Jewish physician the preparation of pills composed of Mercury, turpentine and bran, which obtained great favor though the recommendation of Francis, l., King of France, and which afterwards, towards the end of the eighteenth century, were introduced by the Parisian physician, Bellost, as a new article, into the modern anti-syphilitic pharmacopoeia. At the commencement of that century, the mercurial salts, more particularly the sublimate, had been begun to be used. They became more universally known when Van Swieten introduced into practice a solution of this salt which bears his name. More recently, the use of mercurial preparations, and of combinations of this metal with other chemical substances, has become more extensive. In the pharmacopoeias of different countries we not only find calomel, sublimate, the red and white precipitate, with Mercurius solubilis Hahnemanni, but likewise the Nitrate, Phosphate, Sulphate of Mercury, the Iodide and Cyanide of Mercury, the metallic Mercury, and the Cinnabaris of ancient renown, not to mention other preparations such as a combination of the Cyanide of Mercury and the Iodide of Potassium. All these preparations were employed more or less against the syphilitic disease, although other drugs were likewise resorted to, more specially since the danger involved in too liberal use of the mercurial preparations became evident at a very early period in the history of this agent.
Secale 221.–Former Anti-Syphilitics.
As early as the year 1508, only a few years after the introduction of Mercury against syphilis, the first of the so- called exotic sudorifics, the American lignum vitae of Guajacum officinal, was introduced as an anti-syphilitic agent. Since most of those who were treated with Mercury seemed to suffer more from the effects of this metal than from the ravages of syphilis, Guajac, which seems to possess a sort of antidotal power against the ill-effects of Mercury, soon acquired an extra-ordinary reputation, which lasted until, in the year 1530, the Brazilian Sarsaparilla, which was combined with Guajac as a sweating potion, successfully contended with Guajac for pre-eminence. This Smilax-China, which was introduced about the same period, created less excitement, and met with no more favor than the laurus Sassafras and the Saponaria, whereas the Guajac and Sarsaparilla, more specially the later, still enjoy considerable repute with physicians even to this day. However much these remedies may have helped those who suffered from the effect of Mercury rather than from those of syphilis, it was soon found that they do not cure syphilis without the employment of Mercury. Nevertheless, in view of the dread which people had of Mercury, and the belief that it was the metallic character of this agent that destroyed the syphilitic virus, several physicians conceived the idea, towards the end of the seventeenth century, to substitute Gold for Mercury, Already, in the year 1688, Gervay Ucay, and, after him, Lecoq, Loss, and Rebentrost, sang the praises of this metal as an anti-syphilitic agent. The introduction of three new vegetable drugs, towards the middle of the eighteenth century, soon caused Gold to lose its important rank; these new drugs were; (1) the spurge laurel or Daphne Mezereum, which was more particularly praised for affection of the osseous system; (2) the American Lobelia antisyphilitica; and (3) the Astragalus exscapus, the two last named of which are now so entirely ignored by physicians, that the roots are no longer offered for sale by any European druggist. Opium, as well as Silver and Platina, were used against syphilis towards the end of the last, and at the beginning of the present century, after the Volatile Ammonium (Ammonium causticum), and even oxygen had been used in 1774 as anti-syphilitic remedies, to be abandoned again, like the rest, in a short time, with the exception of two officinal preparations, in which they are contained as leading constituents, namely; the soluble Mercury of Hahnemann (sub- proto-nitratum ammonia-mercuriale); and Nitri acidum, containing a large proportion of oxygen. These two drugs are but little used by Old-School physicians, who, since Coindet’s discovery of the medicinal properties of Iodine in the first twenty years of the present century, are more particularly fond of employing as anti- syphilitics the combinations of Iodine with Mercury and other substances, such as Iodide of Mercury, Iodide of Potassium, etc., kin addition of which we now have the combinations of Mercury and Kali with Bromine, such as: the Bromide of Mercury (Mercurius bromatus), the Bromide of Potassium (kali bromatum), the Bromide of Sodium (Natrum bromatum), etc., first employed for buboes, and afterwards, by Martini, of Lubeck, for syphilitic ulcers in the throat. Iodine on account of its dangerous effects upon the organism, was very little used internally until, in the years 1832-1836, Doctor Wallace, of Dublin, recommended the Iodide of Potassium as a much milder and yet equally efficacious remedy for syphilis, Ebers, of Breslau, Haselberg and Kluge, of Berlin, soon after followed his example, recommending this salt strongly8 for secondary and inveterate syphilis, but more particularly for affections of the bone. This agent, which probably will never cure primary forms of syphilis where Mercurius is not used in the first place, is abused at the present time about as much as Mercury has been formerly.
Secale 222. The Physiological Method.
After what we have stated in the preceding paragraphs of the different means of treatment recommended for syphilis, the reader must have seen that these different recommendations are based upon two sets of opinions diametrically opposed to each other: (1) the specific view, according to which syphilis depends upon a specific virus that has to be annihilated by specific remedies and (2) the so-called physiological view, which teaches that the syphilitic diseases can be cured by the simple, restoration of the organic functions to a normal condition, and which, although first reduced to a scientific doctrine by Broussais, had already, long before his time, guided the practice of a number of physicians. The fearful accidents caused by the insensate use of Mercury, in the very first years of the syphilitic plague, caused the lignum vitae to be received with so much satisfaction as early as the year 1508, that the employment of Mercury as an anti-syphilitic was almost abandoned, until it was resumed in 1527. Since then Mercury has been steadily adhered to, Nicolas von Blegny’s attempts, in 1673, to revive the use of Guajac- decoctions were unsuccessful; Payrilhe, who in 1774 sought to substitute the volatile Ammonium for Mercury, remained without imitators; nor was Scott able, in 1796, to replace Mercury by Nitric acid, Nevertheless, the trials which were instituted with mineral acids, in 1799, had somewhat shaken the old belief in Mercury, when Ferguson published a memoir in England, in the year 1813, in which he laid before the public the magnificent results he had witnessed in Portugal, of the treatment of syphilis without Mercury. They were confirmed by Dr. Rose, who had been with him in Portugal, and likewise by a German physician, Dr. Huber. Although Henry Robertson contradicted these statements by asserting the fact, that nowhere in the world were seen so many faces disfigured by syphilis as in Portugal, nevertheless, in several miliary hospitals of England, experiments with this non-mercurial treatment of syphilis were instituted. It would lead us too far to indicate all the results that were obtained by means of this mode of treating the disease; suffice to say that no English physician, in 1838, dared to advocate this method any longer, and that the Profession generally resumed the use of Mercury. Despite the English notion of the non-use of Mercury, the employment of this agent as an anti-syphilitic had been steadily and very generally continued by the French and German physicians, when, In 1813, Broussais’ Physiological School, denying all idiopathic diseases, ascended the throne, and the treatment of syphilis with so-called specific remedies was specially opposed by Jourdan, who set up the antiphlogistic method as the only rational mode of treatment, and would allow the use of Mercury only in its capacity of a powerful revulsive. Since, then, a number of French and German physicians, who embraced these doctrines of the Physiological School, treated all the primary forms of venereal diseases with external local means, such as injections in gonorrhoea, cauterization of chancres, sanguineous depletions to relieve violent pains, swellings, inflammations, until, at last in France, the more deeply penetrating physicians saw that the pathological and therapeutic doctrines of the Physiological School, were absolutely untenable, illogical, and unscientific, and, in 1835, summoned a medicinal congress in Nantes for the purpose of discussing the new doctrines. The opinions of the different medical Societies in France; specially the society of Lyons, represented in this congress, went almost unanimously against the errors of the Physiological School; a viva voce vote likewise showed an opposition of fifty to two against the fallacies of Broussais, who has only a few partisans left, more specially in our own German fatherland. Whatever the present position of the Physiological School may be, it is certain that, at the present day, two opposite views are contending for supremacy among Old-School physicians: (1) the specific doctrine, according to which syphilis, is to be treated with specific means: and (2) the physiological doctrine, denying the existence of this disease, and claiming, as its highest object of cure, a restoration of the normal organic functions, by the best possible use of palliatives very proper and favorable moment. Let us now see what our own School proposes to do to overcome the enemy Syphilis.
