CHRONIC INFECTIOUS DISEASES. 



sublimate, will acknowledge that we are much indebted to Lewin 

 for its introduction. In my clinic, we at first used Letter's syringe, 

 which holds twelve grains of fluid, and with this injected twelve drops 

 of a solution of corrosive sublimate (gr. j to 3 j). Later, with the 

 best results, we injected a solution (gr. j to ss) with one of Paikrtfa 

 syringes, holding half a drachm (that is, the eighth of a grain of cor- 

 rosive sublimate in a solution one fourth the strength of the former) 

 once or twice daily. We obtained this syringe also from Leiter in 

 Vienna, but, as the canula was rather thick, and consequently the 

 puncture pained and bled, we had a canula made like that on the 

 ordinary hypodermic syringe. 



Nevertheless, the conviction, that the internal administration of mer- 

 curials, cautiously conducted, does not produce any lasting injury to the 

 mucous membranes, has caused me, in spite of the general commenda- 

 tion of injections and the inunction-cure, to adhere to the internal ex 

 hibition of mercury in private practice. The article I generally employ 

 in cases of primary induration and primary sore, is calomel. Of all 

 mercurials, this one is the least open to the charge of causing serious 

 or permanent detriment to the mucous membranes when given in mod- 

 crate doses. If it really were injurious, considering how universally 

 it is employed, especially in diseases of children, the number of persons 

 suffering from its effects would be very large. I will only call to mind 

 that the Plummets powders, used in ophthalmia and other scrofulous 

 complaints, the minute doses of calomel used in infantile diarrhoeas, 

 the larger ones, pushed almost to salivation in croup, pleurisy, and 

 other inflammations, still are among the most common of prescriptions, 

 and that ten or twenty years ago they were even more generally ad- 

 ministered than now. An exceedingly rich experience has taught us, 

 that the innumerable multitude of persons who have used calomel 

 more or less, for other purposes than antisyphilitic treatment, have not 

 suffered any permanent injury to their digestion or their general 

 health, but are now as healthy as they were before. Calomel, how- 

 ever, has no great reputation as an antisyphilitic (at least, in Ger- 

 many), and the corrosive sublimate is preferred to it by most prac 

 titioners, as a means of treating primary and secondary symptoms 

 The reasons for this are twofold: firstly, it often causes diarrhoea; 

 secondly, it soon produces salivation. I do not regard either of these 

 objections as valid. I have never found that the diarrhoea which 

 nearly always sets in at the beginning of a course of calomel (but which 

 usually subsides in a few days) interferes materially with the cure, and, 

 as salivation soon occurs in spite of it, we may confidently infer that 

 the medicine is not all evacuated, but that a sufficient amount of it is 

 absorbed and taken into the blood. With regard to the second objec* 



