Memoir on the treatment of venereal diseases without mercury : employed at the military hospital of the Val-de-Grace / translated from the French of H.M.J. Desruelles ; to which is added Observations on the treatment of the venereal disease without mercury by G.J. Guthrie and various documents showing the results of this mode of treatment in Great Britain, France, Germany, and America.

  • Desruelles, H. M. J. (Henri Marie Joseph), 1791-1858.
Date:
1830
    As soon as circumstances would permit me, I substituted, in place of the animal and stimulat- ing diet, a vegetable and light one, and was promptly convinced that however opposed might be the opinions of medical men on the nature of venereal diseases, diet is to be regarded as the true basis of the treatment, whether in this mer- cury be employed or not* Visit all the hospitals where the old method is employed, and it will very frequently be ob- served that the most distressing consequences ensue where the animal and stimulating diet is prescribed at the same time with mercury; and these consequences will be but seldom met with in the hospitals where patients who take mer- cury are submitted to a vegetable and light diet. Does not this simple remark point out to us that Larrey confided to me the care of a portion of the venereal patients in the absence of Dr. Laroche. * When I entered into the exercise of my duties at Val-de-Grace, there were one hundred and six syphilitic patients—eighty-two afflicted with the primitive, and twenty-four with consecutive symptoms and mercurial af- fections. With the exception of a few who had entered but a few days previously, all the above patients were un- der mercurial treatment, and their nourishment was mate- rially stimulant.
    the dreadful affections which have been consider- ed effects of mercury, are for the most part caused by the copious and stimulant regimen? It cer- tainly cannot be denied that mercury, adminis- tered in excess, often augments the intenseness of venereal symptoms, the system being in a con- stant state of irritation excited by the remedy, but these very symptoms become frightfully danger- ous, when by stimulants we increase the fatal ac- tivity of the mercury. Such consequences are seldom if ever seen with the opposite treatment. Who would believe that the vegetable and light diet, whose soothing effects cannot be doubted, has excited in the breasts of some both envy and ill will against the simple treatment of Val-de- Grrace. These persons have pitied, and with a zeal rather too complaisant, the patients en- trusted to our care. This studied and affected pity was no doubt only a plausible pretext for concealing from the world the unhappy results of the contrary method. The note published in the Journal Militaire must have removed the doubts of those pretended friends to humanity, who always feign to experience the most tender solicitude for some, that by the pretext they may the more deeply injure others.
    The most authentic facts prove that there is no difficulty in pursuing our plan. Physicians who will prescribe it, will perceive how effica- cious it is, although they may have been partial \ to the mercurial method. However, to adopt the vegetable and emollient regimen with due atten- tion to simplicity in dressings, to apply anti- phlogistics to counteract external venereal symp- toms, and to continue at the same time the internal administration of mercury, would be, we think, employing two opposite methods. Would not the effect of such treatment be to produce at the same time asthenia by the regi- men aud simple dressings, and to stimulate the organism by the specific remedies? Such is the plan of treatment we pursued in the very com- mencement of our career, and surely its effect should induce all medical men to abandon the use of mercury—it was at all events one of the principal causes of my doing so. In 1825 I conceived that it was necessary to prepare patients for the administration of mer- curials, by submitting them to a vegetable and demulcent regimen, using antiphlogistics at the same time; but whilst they were undergoing this pretended preparation, (if we can so term it,) it 3
    frequently happened that many symptoms en- tirely disappeared, such as balanites,* simple ul- cers, irritations, and slight vegetations about the anus and penis, pustulse, and orchitis.f I then had to choose the alternative of letting the patients leave the hospital without giving them mercury, or forcibly retaining them in order to administer it. Some of course left me without having taken any of this medicine, and others again, who had taken too small quantities of it for me to consider their cure complete. In order to obviate this inconvenience, I de- termined to administer mercury to the patients, as soon as from the influence of the simple treat- ment, the symptoms began to wear a favourable aspect; but I found the cure not only retarded, but more difficult to accomplish, as there was al- ways some new symptom appearing to impede it. On account of these new observations, I resolv- ed to make comparative experiments on every symptom individually. I devoted the year 1826 to these experiments, and finally being convinced that mercury was unnecessary, when the simple * Inflammation of the glaijs penis, from (ZccAxvos, the glans penis. t Inflammation of the testicle, from op^,^ a testicle.
    and antiphlogistic treatment had been rigidly pursued, I abandoned its use altogether, and since the first of January, 1827, up to the pre- sent day, I have not administered one single atom of mercury, whether my patients were la- bouring under the primitive or secondary symp- toms of syphilis. For more than a year we have sought, without prejudice, for a single case where mercury should be substituted for antiphlogistics, but no one has presented itself. Whenever the cure is retarded, or we find new symptoms appearing, the cause can always be traced to the patient's having de- viated from the proper regimen. Before I had acquired the habit of distinguish- ing by the aspect of the symptoms, whether my patients had deviated from the prescribed regi- men, I thought that those ulcers styled Hunteri- an, required the application of mercurials, but a considerable number of facts have convinced me that I was wrong, and that the Hunterian ul- cers, will as readily yield to antiphlogistics as the simple and phagedenic. Perhaps, until now, the influence of the gene- ral and local treatment upon the progress and ter- mination of venereal symptoms, has not been suf- ficiently considered. The symptoms have been