The treatment of venereal disease and scabies in the army : report.

  • Great Britain. Army Medical Department. Advisory Board for Army Medical Services.
Date:
1904
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Licence: In copyright

Credit: The treatment of venereal disease and scabies in the army : report. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    Question VI. Opinions are specially invited as to the methods of injection of the soluble and insoluble preparations of mercury under the conditions ol military service. By whom. Report of Evidence. Lieut.-Col. G. D. C. Mosse, R.A.M.O. I must admit that my personal experience of injection methods is limited ; at the same time I have read and heard a great deal about this method of treatment, and am inclined to favour the same. Some years ago, when I used injections, the formula I used was Bloxam’s formula, viz.: hydrarg. perchlor., 32 grains ; ainmon. chloridi, 16 grains; aq. destillat. to two ounces; 10 mins, for each injection = one-third grain perchloride of mercury—that was the injection I used, but only in a limited number of cases. It seemed to me to be a very satisfactory form of injection ; pain was hardly complained of at all, and was very transient, and no abscess followed. I have had no experience of injections with the insoluble preparations. Mr. Arthuk Shillitoe, F.R.C.S. For injection I think the insoluble preparations are preferable to the soluble, the reason being that you have to inject them only once a week, instead of their having to come once a day. In using soluble preparations there is a great deal more trouble in giving the injection every clay, than in treating them with salicylate of mercury. I do not think the soluble preparations given as an injection are of any special advantage therapeutically in the majority of cases. In the case of insoluble preparation I use a special preparation called grey oil, the formula for which is— Mercury, purified, 40 grammes. Sterilised lanoline, 12 grammes, Sterilised white vaseline, 13 grammes. Sterilised medical oil of vaseline, 35 grammes, that is 40 per cent, of mercury. This is the grey oil which they use in France, exactly the same strength, called Lafay’s grey oil. I have never used Col. Lambkin’s cream. I have seen several of his patients. The reason I chose Lafay’s preparation was, that the particular gentlemen I am thinking about told me that the carbolic oil as used in Lambkin’s preparation gave rise to a considerable amount of pain, and this Lafay's oil gives no pain. Whether Lafay’s oil would keep in the tropics so well I do not know, and I think that was Lambkin’s idea in introducing the carbolic oil, so that it might keep better. I do not find that this preparation gives any difficulty through separating out the mercury from the solution. In cases of Lafay’s prepara- tion I find it remains well in snspension, which is very important, and the patients complain of no pain whatever. I Imve heard about the continual giving of these preparations being sufficient to deter the patients from going to a certain hospital. I think in those cases the soluble solution which did give rise to a good deal of discomfort was being used. My e.\perience with the Lafay’s grey oil is that the amount of pain can be practically neglected. No accident of any sort whatever happened in my expei-ience. No abscesses lormed. Nothing in the nature of severe ptyalism which I have been made to control. I give it about once a week, two or three minims. Perhaps I have given smaller doses than Lafay suggests, because the people who generally come are debilitated, and though we want to get them under mercury quickly, we have been afraid of pushing the remedy too much. I would go ou giving this weekly injection for months at a time, two or three minims of Lafay’s preparation. I have used the soluble preparations, Bloxam’s formula, but gave it up because it gave so much more pain, in- durations at the seat of puncture. The soluble preparations seem to give rise to pain and induration, and so far as the therapeutic value is concerned I would not choose them. I would not prefer them to the salicylate which I give as an ordinary thing. Mr. P, J. Freteu, M.D., M.Ch. I have used injections of hydrarg. perchloridi ; for many years T used them, but I have given them up completely. I did not see any advantage in them whatever. The disadvantages are tliat one is liable to get sloughing and abscesses in connection with the injections. Injections are given once a week, and you are never certain about it. I have had a considerable amount of trouble wdth this method in my experience, so that I have abandoned it completely. Mr. EnoECOMBE Venning, F.R.C.S. Methods of injection. Well, I have thought this matter carefully out, and I do not think that you could have a better plan of treatment than by the intra-muscular injection. For instance, a patient comes into the hospital, and you find he has a chancre, that he has amj'gdaloid glands. You want to cure him. I should then inject him once a week, and on his medical history sheet I should put, “This patient to be injected once a week.’’ 'The man would then show himself at the hospital. Then very likely the secondaries would show themselves, and he would be treated, but would go on with his work regularly. I think it is a cleanly method ; I mean you do not upset the man’s stomach. He takes his food as usual, and he can still go ou with his occu- pation. It is a system by which continuity of mercurial treatment can be carried out all through the service. My ex|)ericnce of it is clear of accidents, 1 would have no hesitalion in recommending it. I have no experience of using the insoluble preparations instead of the soluble.