CONSTITUTIONAL SYPHILIS. 779 



tion, for reasons given above, I rather look upon the early appearance 

 of salivation as an advantage, insomuch that, in cases where, owing to 

 idiosyncrasy of the patient, salivation occurs later than I had expected, 

 01 where it fails to appear at all, I have been anxious lest I might ad- 

 minister too large a quantity of mercury, not having this valuable guide 

 to inform me when to discontinue the remedy. To adult patients I 

 usually give a grain of calomel twice daily, or half a grain three times 

 a day. When given in the form of powder, I have it wrapped in 

 a wafer, in order to screen the mucous membrane of the mouth from 

 contact with the drug. Generally, however, I have it made up with 

 liquorice into pills, each of which contains half a grain. Next to calo- 

 mel, I have most frequently made use of the protiodide of mercury. I 

 am not aware that this article possesses any advantage over calomel, 

 and I have generally noticed that its exhibition occasions severe pain in 

 the bowels, which scarcely ever occurs in the diarrhoea induced by calo- 

 mel. On account of these annoying symptoms, Ricord (to whose au- 

 thority the protiodide of mercury mainly owes its reputation and exten- 

 sive adoption) combines it with narcotics ; but, even with Ricord's pills 

 (hydrarg. protiodid., lactucar. gall., aa 3 iss, ext. opii aquaeos. gr. ix, ext. 

 guaiac. aquaeos. 3 j, f. pil. no. xxxvj), I have often been obliged to give 

 opium, on account of severe pain in the bowels, so that I have now been 

 induced to abandon the use of the protiodide. I shall now merely add 

 a few words about corrosive sublimate, for, although I am by no means 

 one of its admirers, and consider it as far inferior to other preparations 

 of mercury, yet it probably is more generally employed in syphilis 

 than any other. The corrosive properties of the drug forbid its ad- 

 ministration in large doses, and I believe a gradual increase of the 

 dose to be improper. Can one expect the stomach to accustom itself 

 to the action of the medicine so as to tolerate large quantities without 

 becoming corroded ? and why should we increase the dose when it is of 

 importance to be able to suspend the treatment at precisely the right 

 moment, in order to avoid introducing too much mercury into the sys- 

 tem ? Corrosive sublimate is valued principally because, hi the first 

 place, it is slow to produce salivation, and because, under its use, less 

 mercury is taken into the system than under other mercurial treat> 

 ment. I cannot regard it as an advantage that the chemical proper- 

 ties of corrosive sublimate should compel us to administer it in such 

 doses that the object aimed at, the introduction of a certain amount 

 of mercury into the system, is only very slowly attained ; and I can- 

 not admit that much more mercury is taken up in a treatment by cal- 

 omel, if discontinued when salivation commences, than in a treatment 

 by corrosive sublimate when pushed to the same point. It cannot be 

 denied, however, that many people are cured of their syphilis by cor 



