CONSTITUTIONAL SYPHILIS. 783 



festations are as severe as the former ones, or even more severe, but 

 still retain the nature of the secondary disorders, and if, as is generally 

 the case, the patient's constitution still seems to be unimpaired, I re- 

 commence the mercurial treatment, and, indeed, under certain circum- 

 stances (for instance, in case of rapidly-spreading ulceration of the 

 fauces, liable to become complicated with syphilitic laryngitis), I even 

 make the treatment more energetic than before. I order daily inunc- 

 tions of a drachm of blue ointment, or else give daily, or every other 

 day, two doses of calomel, of ten grains each, after the method of 

 Weinhold. It has often been objected, regarding WeinholcFs treat- 

 ment, that its only action is a laxative one ; that it does not salivate, 

 and that it exerts no important influence upon syphilitic affections. 

 These a priori views stand in direct opposition to the results of my 

 own experience in many cases where I have given half-scruple doses 

 of calomel. 



If the relapse be unmistakably of a tertiary character, or if it be 

 merely of an intermediate nature between the secondary and tertiary 

 forms ; or, if the constitution of the patient have begun to suffer, wheth- 

 er from the disease or the treatment, then mercury is not only contra- 

 indicated, but even dangerous. Never use a grain of it under such cir- 

 cumstances, and I am certain that by such precautions the evil effects 

 of mercurial treatment may be averted. 



I may be brief in stating the indications for the use of iodine in the 

 treatment of syphilis. In all cases where the spontaneous and speedy 

 extinction of the malady is not to be calculated on, and in which the 

 employment of mercurials is contraindicated, the exhibition of iodine 

 is urgently indicated, and then affords the utmost benefit. If we limit 

 the administration of the medicine to the above class of cases, and are 

 as methodical in its employment as we have been with mercury, we 

 shall find that its value in the treatment of syphilis is by no means in- 

 ferior to it. The preparation of iodine most generally employed is the 

 iodide of potassium, from ten to thirty grains of which are usually given 

 daily, in the form of a watery solution. Some physicians give larger 

 doses, or strengthen the solution, by adding one or two grains of iodine 

 to it, but apparently do not thereby augment its effect. According to 

 my experience, Barensprung to the contrary notwithstanding, I have 

 found the iodide of iron to be a very efficient preparation, especially 

 where there is advanced anaemia. I usually employ it in the form of 

 syrup of the iodide of iron (fy syr. ferri iodid. 3 ij, syr. simpl. ij. nj,. S. 

 3j every two hours), and by its means have often produced iodic 

 eruption and catarrh. The appearance of this symptom, like that of 

 mercurial salivation, requires a suspension of the remedy. If the sus- 

 pension be followed by an arrest of improvement in the symptoms, tho 



