III. THE HOMOEOPATHIC TREATMENT OF SYPHILIS.
Secale 223. Theoretical Views.
There was a time when a homoeopathic physician, who should have undertaken to demonstrate to Hahnemann’s adherents the specific idiopathicity of syphilis, and the necessity to opposite it with specific remedies, would have been deemed slightly crazed for putting himself to the trouble of advocating and defending a proposition which every homoeopath believes in as religiously as he believes in the existence of his own soul. Some of our physicians still cling to this doctrine, but there are others who, influence by the doctrines of the Physiological School, have been led to regard a chancre as a purely local affection, and who, with a show of dictatorial assumption and superior knowledge, would fain impose their opinions upon the rest of our brotherhood. Hence, the property of touching on this subject. That syphilis is a special disease, emanating from some specific virus, had already been shown in a previous division of this work (No. 152-154 and No. 167-170) with so much clearness, that it now behooves Hahnemann’s opponents to refute our opinions by cogent and scientific arguments; that is, if they wish us to abandon the master’s doctrines, and to change our present mode treating syphilis. That the breaking out of the chancre is preceded by a general subjugation of the organism by the syphilitic virus, has likewise been shown in No. 190-192 where when speaking of the period of incubation, we have given our reasons for an immediate absorption of the poison at the very moment when the infection takes place. For the benefit of those who assert the total absence of all precursory symptoms previous to the breaking out of the chancre, we shall offer a few additional statements. We have stated in previous paragraphs, that we, too, have observed these precursory symptoms; what is particularly noteworthy, in reference to this matter is that, according to the unanimous statements of Gaspard Torella, Massa, Fracastorius, Fallopius, and other physicians who lived during that first period of the syphilitic epidemic, when the disease was much more violent than it now is, every patient who was attacked with it walked about for several months in a drooping and miserable condition, without the least local symptoms having been perceptible, until, finally, the chancre broke out in all its fury, after which the general constitutional symptoms at once moderate. This evidently shows that the appearance of the chancre is preceded by a general disharmony of the organism, that can only be removed by internal treatment. But, if evidence of this kind should not be deemed sufficient to settle the existence of preliminary symptoms with positive certainty; and if such evidence should only be accepted as proof that preliminary symptoms may possibly take place in the organism, would it be proper, from a mere spirit of opposition to Hahnemann, to assert with Girtauner, Hecker, Ricord, and others, that the removal of chancres by cauterizing agents is not succeeded by pernicious consequences? The time is, fortunately, no more when a faithful adherent of Hahnemann could be denounced and laughed at by a set of pretended critics among us, who were in the habit of setting up their authoritative ipse dixit in the place of his own teachings; though we are sorry to admit that there are good and trusty homoeopaths, at the present day who do not hesitate to cauterize the chancre at the same time as they employ internal treatment. If we consider (see No. 207) that the sole reliable sing by which we recognize the total eradication of the virus from the organism is the spontaneous disappearance, as it were, of all external sings of syphilis, in consequence of internal specific treatment; it must be evident that a removal of the characteristic syphilitic product by purely external applications is no safe criterion for the radical cure of the disease, which, indeed, may break out again from its latent condition, either on the patient thus improperly and unreliably treated, or even upon his offspring. How much better it would be to effect the cure more tardily, but to effect it safely, without entailing upon the poor victim of a rash and unscientific treatment with the danger of seeing the disease break out again, at a later period, in a much more destructive and more obstinate form.
Secale 224. Homoeopathic Specifics.
Fortunately we possess specific remedial agents that render all use of cauterizing agents superfluous. If one specific doses not seem to reach the case, we have others that may be more specifically adapted to the symptoms. Whether primary or secondary, the therapeutic range of our remedies extends over every form and period of the syphilitic disease, including all its characteristic modifications and metamorphosis (see No. 195- 198 and No. 177, 178). He who knows from experience what Mercurius and its different preparations are capable of effecting against the primary chancre; Nitri acidum, Thuja, Cinnabaris, against the fungoid vegetations of the chancre; Kali iodatum, Aurum, Lycopodium, Sarsaparilla (Iodide of Mercury, Ed.), and other remedies for such modified forms of the disease as have lost their infectious must admit that, in spite of all existing imperfections, we are much more successful in the treatment of syphilis than the Old School, with all its caustics, starvation- cures, inunction cures, and mercurial poisonings. It is to be regretted that, as yet, we have no other specific for chancre than the mercurial preparations, which never show their curative powers in as small doses as almost any other drugs, and even in half-grain doses of the first centesimal trituration, are still capable, by a too long continued use, of exciting artificial symptoms in the mouth, throat, and upon the skin. Even the preparations which some of our physicians have imported from the old school, such as the combinations of Mercury with Iodine, Bromine, Nitri and Phosphori acidum, have not lessened the danger involved in the use of mercurial preparations, since mercury is the chief constituent in all these combination. The Nitrate of Mercury, recommended by Trinks, is even much more dangerous than the corrosive sublimate. As yet, few of those remedies have been proved, so that, in case aggravations should occur after their use, it is difficult to decide whether such aggravations are caused by an overdose of the drug, or constitute natural exacerbations of the disease itself. It is true that, among the affects of the different mercurial combinations, the effects of Mercury always hold the most prominent rank, and that the preparations of Mercury with acids seem more energetic, probably on account of their great solubility. On the other hand, do we know whether some of the characteristics effects of Mercury are not neutralized in those combinations, and whether the diagnostic signs by which we recognize an excess of mercurial action in contradistinction to syphilitic phenomena, such as itching the milky-white color, and other properties of mercurial ulcers, etc., are not suspended in these newly-imported agents? Considerations like these deserve the most careful attention of our practitioners. It is more particularly to be regretted that our provings of the Iodide of Potassium are, as yet, very imperfect. For, if the mercurial preparations are best calculated to destroy the chancre-virus and its primary products; Nitri acidum and Thuja to reach the fungoid vegetations of chancre; the Iodides, on the contrary, are best adapted to that phase in the secondary period of the syphilitic disease where it seems to have undergone a radical metamorphosis, and perpetuates its products in the tissues by sending off shoots in the diseased organism, but is no longer capable of producing new parasites in other organism by its own inherent fecundating power. This statement is not impaired by the fact, that the Iodide of Potassium has shown curative effects against products of the infectious period of syphilis; since, in spite of all the modifications which the virus may undergo, it remains essentially the same thing; like the caterpillar, its chrysalis and the butterfly, or the child and the man, growing out of it even to old age; all of which, in their different stages of existence, have a great many characteristics in common, and, on the other hand, have each their individual wants.
Secale 225. Dose.
It is well known that a few pellets of the thirtieth potency, which Hahnemann has recommended as sufficient for the cure of chancre, are entirely inadequate to destroy this enemy. Any one who finding even half a grain of the first centesimal trituration of Mercury insufficient, prescribes one or two grains of the same trituration, may deviate from the letters of Hahnemann, but, nevertheless, remains true to then spirit of his doctrine. This doctrine demands that the dose should be sufficiently small not to produce any unnecessary or injurious effects; but hat, on other hand, it is to be sufficiently large to effect a cure a s radically and promptly as possible. A physician who, knowing that a dose of one-tenth of a grain is sufficient to effect a cure, or who, seeing that the exhibition of Mercury is followed by an evident exacerbation of the symptoms, should continue this agent in increasing doses. or go even so far, as was done even recently by one of our Paris homoeopaths, as to prescribe one hundred grains of Calomel in ten days, and to give out such a murderous proceeding as an improvement on Homoeopathy is not only on adherent of Hahnemann, but is no rational physician, since Hahnemann’ exceedingly rational maxims demand that a physician should constantly seek to know how far a dose can be reduced without impairing the efficiency of the remedial agent in bringing about a speedy, safe, and permanent cure. Starting from the principle of effecting a safe cure with mild and perfectly safe means, one- half of a grain of the first centesimal trituration, twice a day, seems to be a sufficiently small dose to avoid all dangerous effects of the drug, and, on the other hand, sufficiently large to effect a sure cure; whereas a similar dose of the first decimal trituration not only seems unnecessarily large, but even dangerous, although it may not develop its medicinal effects at once. What is particularly worthy of notice is, that medicinal symptoms, caused by large doses of Mercury, sometimes disappear again after a second dose of the same drug, a phenomenon that has already been substantiated by Old-School experience; on which account symptoms, that really were mercurial effects are frequently mistaken form syphilitic manifestations, for which repeated doses of Mercury are given, until the cumulative effect of the poison breaks forth with a dangerous and scarcely controllable violence. It is very strange, indeed, that such large doses of this most dangerous and most insidious of all metals, should be required for the cure of chancre, whereas Nitri acidum, Thuja, and other drugs, will cure the fungoid vegetations of chancre and other analogous symptoms in the thirtieth attenuation, provided these drugs are in specific rapport with the cause. Perhaps, by giving three or six globules of the third, sixth, or twelfth attenuation of Mercury in half a tumbler of water, in tablespoonful doses, and thus treating a chancre as we would in any other acute disease, we might achieve a cure still more rapidly; I confess, however, that I have never yet dared to pursue such a course. What I can affirm with positive certainty is, that if the virus has once been subdued by repeated doses of Mercury, and the chancre seems to be in a fair way of improvement, the further use of this agent may be safely discontinued, and the cure may be expected to take place without any further medication. I have seen acute recent chancre improve after three doses of Mercury one dose in the evening, one next morning, and a third the following evening. to such as extent that I have felt authorized to discontinue the further use of the drug, after which the chancre continued to improve, and finally to cicatrize; in one case this happened in ten days. In other cases I have seen chancres get well in twenty days, from a dose of Mercury every other day. I speak, of course, of the simple and Hunterian chancre, to which Mercury seems to be more specifically adapted than to phagedaenic chancre. In many cases of elevated chancres, if I have charge of the treatment at the outset, three or four doses of Mercury, every other day, are sufficient to control the disease, after which the chancres gets well much more rapidly without any further medicine than old chancres, where the Mercury has to be given in frequently repeated doses. moreover, as Vehsemeyer has noticed of the Sublimate, too large, and too frequent doses of Mercury may have the effect of causing a premature cicatrization of the chancre, and simply masking the disease. Here, too, it is better to progress slowly and safely, than rapidly and with danger to the patient. Medio tutissimus ibis.
