LUES VENEREA, 



claims to that charafter. It (hould be carefully remem- 

 bered, that it is tiie nilric acid, not the nitrous, which feems 

 to drferve a further trial in fyphilitic cafes. 



The common way o( giving the nitric acid, at firft, is to 

 mix Sj with a pint of dillillod water, the mixture beiiiir 

 fweetened with fimple fyrup. This quantity is to be drank, 

 at different times, in the courfe of twenty-four hours, 

 through a fniall glafa tube, which is ufed to keep the teeth 

 from bciniT injured. If no inconvenience is fell, the dofe of 

 tlw acid may be incrcafed to 3ifl> 3ij) and even, in certain 

 eafes, to 3iij. 



The acid is faid to incroafe the appetite, and fecretion of 

 urine ; to caufe more or lefs thirtt, a white tongue, fizy 

 blood, and an incre.ife in the aflions of the whole fyflem, 

 but nothing hke mercurial falivalion is produced. It does 

 rot agree, however, equally well with all conftitutions. 



The nitric acid is beneficial both in the primary and fc- 

 condary fymptoms of the venereal difoafe ; more fo, how- 

 ever, in the former. But, in the latter, even mercury itfcif 

 frequently fails, and proves hurtful, fo that the nitric acid 

 fuffers no difparagement from this faft, A change is faid 

 to be produced on the difeafe, by the acid, in fix or eight 

 days, aiid a cure very often in little more than a fort- 

 right. 



The oxygenated muriate of potafh, which contains an 

 immenfe quantity of o.-tygen, is faid by Mr. Criiikfiiank to 

 be more efficacious than the nitric acid, in relieving venereal 

 fym.ptoms. 



Richerand informs us, that experiments, confirming the 

 fupcrior efficacy of mercury, in the cure of fyphilis, were 

 made for the fpace of a year, in the hnfpital of the Ecole de 

 M6dicine at Paris, before a committee of gentlemen ex- 

 prefsly appointed for the purpofe. It is ftated, that fome 

 patients derived only temporary relief from the oxygenared 

 fat and nitric lemonade ; that a very few got quite well ; 

 aHd that others, after appearing to be entirely rid of the 

 difeafe, fuffered fuch relapfes as evinced the fuperiority of 

 the ordinary method. Nofographie Chir. torn. i. p. 352. 

 edit. 2. 



It appears to us, that there is one very important circum- 

 ftance made out by the trials of various medicines in the 

 treatment of the venereal difeafe. According to the Hun- 

 terian opinions, we are to fuppofe that it is the invariable 

 charafter of the diftemper to proceed regularly from bad to 

 worfe, unlefs checked by the fpecific remedy, mercury. 

 This doctrine is taught in fome of the prefent fchools, and 

 feems to be adopted by Dr. Adams in his work on morbid 

 poifons. Were this idea a matter of faft, it would be of 

 material confeq".ence in praftice ; for, in many difficult and 

 ambiguous cafes, we might often form a juft decifion, by 

 obferving whether the complaints recede at all, without the 

 aid of mercury ; fince, if they do fo, they cannot in reality 

 be fyphilitic. This affertion. however, is by no means 

 eflablidied ; and from the oblervations pubhlhcd by Pearfon, 

 and other writers, on the effeiHs of difterent remedies on the 

 difeafe, we are to conclude that it is erroneous. The re- 

 marks, which we have quoted above, tend to fhew that, 

 even under the mere adminiftration of bark, venereal buboes 

 and fyphilitic ulcers in the throat may fometimes be healed. 

 The tellimony of Mr. Pearfon alfo confirms, that the mu- 

 riatic and fulphuric acids will improve venereal fores, and 

 reftrain for a time the progrefs 6f the difeafe. The com- 

 mittee at the Ecole de Medicine, we find, announce that 

 fome few cure?, were efTeiled by oxygenated lard and nitric 

 lemonade. Thefe ftatenients, joined with the large body 

 «,£ refpeftable evidence from feveral other quarters already 



fpecified, can^not fail to ioduce a fufpicion, that many medi- 

 cines, befides mercury, have a certain degree of power in 

 refilling the ravages of the venereal difeafe ; and that even 

 fyphilitic buboes and ulcers will fometimes recede, look 

 better, and heal, without mercury. We do not wiffi to 

 infiuuate, that thefe things are dccifively cftablidied ; the 

 diagnofis of imie venereal complaints being often fo difficult, 

 that m<in of great judgment and experience are liable to 

 millakes. 



Ohfer-valions on ll}e Treatment of particular Symptoms. 



Treatment of Chancres Belbre the virus has been taken 



tip by the abiorbents, a chancre is (Iriflly a local afledtion, 

 quite unatteiided with any contamination of other pans. ■ In 

 this ftate, there can be no doubt that tlierc is a poffibihiy of 

 accomplifliing a cure by deltroying with c.iuftic the fore, 

 and adjacent part affeftcd with the venereal atlion. Such 

 an endeavour muft be the more likely to fucceed, wdien it is 

 made while a chancre is fmall, and in an incipient Hate. 

 The argentum nitratuni is commonly employed for this 

 purpofe : but perhaps it n.ight be preferable to ufe the kali 

 purum and quicklime, wliich operate with more eifcft and 

 quicknefs. Unfortunately, the period at which the abforp- 

 tion of the virus begins is fo uncertain, that the foregoing 

 method is fcarcely ever deferving of fuch implicit reliance, 

 that mercury need not be employed at all. Small puftulcs 

 and ulcerated points on the penis are frequently dellroyed 

 with cauftic, and a lading cure is eiTcdled without mercury. 

 Poffibly fome of thefe cafes may not be venereal ; and when 

 the pratlitioner infers that he has fucceeded in preventing . 

 the abforption of the virus, he may be deceived. In other 

 inftanccs, the endeavour to iuperiede all occafion for mer- 

 cury, by extirpating a chancre with cauftic, is only at- 

 tended with a temporary appearance of fttccefs ; ulcerations 

 of the tonfils, and other fymptoms, denoting a general af- 

 fetlion of tiie conftitution, coming on foon after the healing 

 of the fore. Hence it is generally deemed prudent, not to 

 be content with the attempt at extirpatkm with caullic, but 

 to exhibit, at the fame time, for a few weeks, the pil- 

 hydrarg;yri. The mercury may fometimes, indeed, be given 

 unneceffarily ; but with its exhibition, and the cauftic, the 

 patient has a double chance of fecurity againft the extenfion 

 of the difeafe to his conftitution. 



We fliall firft confider the topical application to chancres. 



Mercurial ointments have been commonly ufed as dreffings 

 to chancres ; but Mr. Hunter was of opinion, that if the 

 mercury were joined with watery fubftances, inftead of oily 

 ones, the application, by mixing with the matter, would be 

 continued longer to the fore, and would prove more effec- 

 tual. This, he obferves, is one advantage, which poultices 

 have over common dreffings. He has often ufed mercury 

 rubbed down with fome conferve inflead of ointment, and 

 it anfvvered extremely well. Calomel ufed in the fame way,' 

 and alfo the other preparations of mercury mixed with 

 m.ucilage, or honey, aniwer the fan^^e purpofe. Such dreff- 

 ings, according to Mr. Hunter, will eiTecl a cure in cafes 

 which are truly venereal, and free from other morbid ten- " 

 dencies. ' 



Some chancres are indolent, and require a little warm 

 balfam 'or red precipitate to b* joined with the mercurial 

 dreffing. Mr. Hunter fays, that calomel mixed with falve 

 is more aftive than common mercurial ointment, and is 

 attended with better effeds, when the cafe requires ftimu- 

 lants. 



Solutions of blue vitriol, verdigris, calomel, &c. have 

 been recommended. But Mr. Hunter very judicioufly ob- 

 ferves, 



