On the treatment of secondary syphilis / by J.L. Milton.

  • Milton, J. L. (John Laws), 1820-1898.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of secondary syphilis / by J.L. Milton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    stitute that which I propose to describe here. The observations on which this system is based extend over many years of trial; during the last four or five years it has been incessantly in force, except during the periods when I was absent from work ; great part of it would consist but of a long history of failures and disas- ters, of slight successes and frequent disappointments, which, though important enough perhaps at the time of trial, would be equally wearisome to recount and to read. I think, therefore, that it will be better to restrict myself to stating the conclusions arrived at. The first is, that beyond all question, a great many persons get well without taking any mercury at all. So far, I think, the opponents of this drug are right. Very possibly these persons would have been cured more quickly and effectually if mercury had been given, but the fact that they get well without it—so far, at any rate, as visible symptoms are concerned—cannot be doubted. Besides, I entirely question the utility of mercury here. The patients of whom I speak are usually careless and refractory, often dissipated. They have so far done nothing for their complaint, and, most probably, would do nothing for it in the only way likely to be of service. For a short time, perhaps, impelled by the fear or suffering which some new and threatening symptom has brought on, they may conform with tolerable regularity to the rules laid down by the surgeon ; but with the first feeling of relief these good resolutions vanish, and they return to their old courses as surely as the comet returns towards the sun : sometimes, indeed, recovering by the aid of a good constitution, fresh air, and high feeding; oftener, perhaps, breaking down in the long-run from the combined effects of syphilis and debauchery; or, perhaps, disappearing from our view, so that we cannot trace their course for good or for evil. To give mercury for such a case means simply to add to the mischief, to damage the reputation of the drug and of the practi- tioner who prescribes it. There is scarcely any fact better estab- lished in medicine than that mercury, to be of any service, must be taken systematically; and that is one of the last things that a patient of this class is likely to do. The surgeon may as well suffer him to go his own road ; for go it he will, whether he be preached to or not. We may put down in the same category with these persons all those who have a great horror of mercury, who believe they cannot take it, who make a point of controverting every rule of treatment, or who cannot be depended on as respects their habits. They may, one and all, be eliminated from the class of cases to be treated by means of mercury. The surgeon who tries to use it here will find that it is a two-edged sword, with one edge a great deal sharper than the other; the patient will blame the mercury for everything that goes amiss, and he will reap nothing but vexation for his pains. Again, there are many cases which do extremely well on iodide of potassium. On this head there is ample evidence, and I have