DISEASES ASSOCIATED WITH SPIROCH^T^ 213 



The diseases believed to be remotely due to syphilis 

 in England are practically unknown in the Tropics 

 amongst the natives ; these are the parasyphilides general 

 paralysis of the insane, and tabes dorsalis. 



In the treatment of syphilis amongst natives it must be 

 remembered that mercury is not well borne by anaemic 

 persons and that pyorrhoea alveolaris, so common in native 

 races, is often increased by mercury, and must therefore 

 be treated independently. In dealing with large bodies 

 of men intramuscular injections are specially valuable, as 

 a weekly injection insures sufficient treatment. 



The method in use in the Army is essentially that intro- 

 duced by Colonel Lambkin. A cream is made of metallic 

 mercury in lanolin : 



Hydrargyri ... ... ... ... ... ... ... i. 



Adipislanse ... ... ... ... ... ... ... iv. 



Paraffin liquidi (with 2 per cent, carbolic acid) ... ad x. 



The mercury and lanolin are by weight, the liquid paraffin 

 by volume. Great care must be taken to obtain a 

 thorough mixture of the mercury. It should be stored 

 in small quantities, as if kept in bulk the mercury will 

 settle at the bottom. Ten minims of the mixture contain 

 i grain of mercury. Injections must be made into a 

 muscle, preferably the gluteus maximus, and never into 

 the subcutaneous cellular tissue. The skin must be care- 

 fully sterilized before the injection. An all-glass syringe 

 should be used ; this may be sterilized by drawing up olive 

 oil at a temperature of 160 F. Between the injections 

 the point of the needle should be dipped into the heated 

 oil, and the needle should be wiped with a sterilized 

 cloth so that none of the mercury cream is left along the 

 track of the needle. 



It is important that the patient should not take any 

 violent exercise for some hours after the injection, and 

 care must be taken that no injection is given in a place 

 where there is any induration as a result of previous 

 injections. The advantages of the method are : (i) An 

 attendance once a week only is required ; (2) there is no 



