LUES VENEREA. 



Sometimes, wlien patients cannot rub in mercurial oint- 

 ment, or fritlions alone have not fufficient effeft, a grain of 

 t!ie hydrargyrus calcinatus, now called hydrargyri oxydum 

 rubriim, is prefcribed, and to prevent bad effefls on the 

 bowels, half a grain of opium is generally direfled to be 

 taken at the fame time. The grey oxyd of mercury, 

 formed by the trituration of quickfilver with fat, is the moll 

 c>.)mm()n, fafe, and efFeftual preparation for the cure of 

 fvphilitic complaints. A piece of this ointment, about as 

 large as a nutmeg, is ordinarily rubbed into the furface of 

 the body, for about half an hour before the lire. Wlien 

 there is a bubo in the groin, the leg and thigbv on the affefted 

 Tide, are genera'ly preferred for the friftions ; but when this 

 is inconvenient, the ointment may be rubbed upon any other 

 par: of the body. Mercurial ointment, provided the fat is 

 not rancid, which it is very apt to be, makes an eligible appli- 

 cation to both primary and fecondary venereal ulcers, when 

 it is fpread upon lint. The iutroduftion of mercury into 

 t!ie conllitution, by friftions with ointment, is one of the 

 oldell and belt methods. When the patient cannot rub in 

 lumfelf, the bufinefs may be done by an attendant, who mud 

 be provided vvith gloves, made of oil-ftin, or pig's bladder, 

 lelt he falivate lumfelf. The fridlions are faid to have the 

 molt eflfeft when made along the infide of the limbs, where 

 anatomy (hews that the largell lymphatics are fituated. It 

 is always a prudent maxim to begin a courfe of mercury in 

 a very gentle way, only fmall quantities of the ointment 

 being at firft ventured upon. Perhaps half a dram is enough 

 to begin with. Nor need the trictions be made every day 

 ui.til the ability of the co ilUtution to bear the medicine has 

 been tried. Thus, the patient may commence with rubbing 

 half a dram of the ointment on the inlide of the leg. After 

 letting one day intervene, he may make the fecond frifti«n 

 on the infide of the thigh. When another intervening day 

 has elapfcd, the third application of the ointment may be 

 made to the hip and lower part of the abdomen. The 

 fourth friftion may be made on the arms, unlefs the patient 

 (hould prefer begnining again on the leg. During fuch 

 employment of the onitment, the patient, if convenient, 

 fliould wa(h hinifeif now and then in a warm bath, and have 

 coftivenefs obviated by mild purgatives. The preceding 

 method is generally commendable, becaufe it removes all 

 chance of too fudden and violent a fahvation, as well as 

 diininifhes the peril, with which the adminiftration of mer- 

 cury is liable to be accompanied in particular conllitutions. 

 Though fuch is the motl prudent plan to be followed in the 

 generality of cafes, it mull: ftiU be remembered, that there 

 are certain inllanccs in which the affeftion of the fyllem 

 with mercury ought to be expedited, for the purpofe of 

 preventing the lerious conicquences, which might aiile from 

 the fpreading of venereal ulceration in particular fituations, 

 as where a chancre threatens to detlroy the whole glaiis, or 

 an ulcer in the throat to eat away all the velum pendulum 

 palati. In every cafe it is highly proper, that the patient 

 ftiould have fome tendernefs of tlie gums, and a copper talle 

 in his mouth, as tells of his conllitution being under the 

 influence of jnercury ; but all violent falivations, attended 

 with extreme forenefs and floughing of the mouth, and vaft 

 f'*ellin'g of the face, are condemned as unnecelTary, and in 

 every refpedl blameablc, by all the moll judicious pradli- 

 tioners of the prefent time. 



The grey oxyd of mercury, made by triturating quick- 

 filver with fngar or honey, compofes the common pil. hy- 

 drarg. or blue pill, which, in ordinary cafes, is the btfl 

 mercurial medicine for internal ufe. It is given, either to 

 aflill the action of the ointment, or when the friftions can- 

 sot be executed. Tbe coBunen dofe is ten gfains every 



Vol,. XXI. 



night, opium being added when any griping or purging is 



excited. 



Such are the preparations of mercury ordinarily ufed by 

 Britldi furgeons in the treatment of fyphihs. 



In addition to the foregoing directions, refpecling the 

 management of a mercurial courfe, there are many olluf 

 circumllances to be obferved. livery furgeon (liould be 

 imprefled with the importance of the patient keeping him- 

 felt warm, and avoiding all expofure to damp and cold, 

 during the employment of mercury. He fliould be re- 

 commended to keep to his room, and wear worllcd fiock- 

 ings, and flannel drawers and waillcoat. Experience hai 

 proved, that expofure to the damp cold air fometimes deter- 

 mines the adlion of mercury viok-ntly either to the mouth, 

 or the bowels, and materially leflens its effect upon the 

 difeafe. 



According to Mr. Hunter, when a courfe of mercury is 

 about to be undertaken, we a'e to coniider two things ; 

 firll, the preparation and mode attended with the lead trou- 

 ble or inconvenience to the patient ; and fecondly, the pre- 

 paration and mode of adminillering it, that moil readily 

 conveys the neceffary quantity into the conllitution. Mer- 

 cury is carried into the conllitution in the fame way ac other 

 fubllances, either by being abforbed from the furface of the 

 body, or that of the alimentary canal. It cannot, how- 

 ever, in all cafes be taken into the conllitution in both ways ; 

 for fometimes the abforbents of the Ikin will not readily 

 receive it, at Icall no cffeft is produced, eitb:;r on the dif- 

 eafe, or conllitution, from this mode of application. In 

 this circumftance, mercury mull be given by the mouth, 

 although the plan may be very improper in other refpefts, 

 and olten inconvenient. On the. other hand, the internal 

 abforbents fometimes will not take up the medicine, or at 

 lead no efl'tft is produced on the difeafe, or the conlli- 

 tution. 



In Inch cafes, all the different prep.ti-ations of the medi- 

 cine flio'.ild be tried ; for fometimes one fucceeds when 

 another will not. In fome cafes, mercury feems to have no 

 effefl, either applied outwardly, or taken into the (lomach. 

 Many furfaccs feem to abforb mercury better than others ; 

 fiich are probably all internal furfaces and fores. Thirty 

 grains of calomel, rubbed in on the fl<in, have not more 

 effcdl than three or fcur taken by the mouth. Drefling 

 fmall ulcers with red precipitate fometimes caufes a faliva- 

 tion. Hunter on the Venereal Difeafe, P- 335, 336. 



Befidcs the praiticablenefs of getting the medicine into the 

 conllitution in either way, it is proper to confider the ealielt 

 for the patient, each mode having its convenience and in- 

 convenience, depending on the nature of the parts to which 

 it is applied, or on certain fituations of life at the time. 

 Hence, it (hould be given in the way moll luitable to fuch 

 circumllances. 



In many, the bowels can hardly bear mercury at all, and 

 it (hould then be given in the miideil form polTible, con- 

 joined with fuch medicines as will lelTen, or correct its 

 violent local effects, although not its fpecific ones on the 

 conllitution. 



When mercury can be thrown into the conllitution with 

 propriety by the external method, it is preferable to ths 

 internal plan, becaufe the ikin is not nearly fo efl'ential to 

 life as the llomach, and, therefore, is capable in itfclf of 

 bearing much more than the llomach. The conilitutiou is 

 alfo lefs injured. Many conrfes of mercury would kill the 

 patient, if the medicine were only given inlernL.ily, becaufe 

 it proves hurtful to the ftonnch and iutedines, when given 

 in any form, or joined with the greated correctors. Every 

 oae, however, has not .opportunities of rubbing in mercury, 

 4F ^aik 



