Selected essays and monographs : (from foreign sources) / by various authors.

Date:
1900
Catalogue details

Licence: In copyright

Credit: Selected essays and monographs : (from foreign sources) / by various authors. Source: Wellcome Collection.

    23/322 (page 13)
    INTERMITTENT TREATMENT. the chronic intermittent form of treatment as unnecessary because he has seen many patients who have remained healthy after a single course, and on the other hand many others who would continually suffer from relapses in spite of frequently repeated courses. He accordingly regards it as the chief point to carry on the first treatment carefully and for a long enough period, a fresh course being called for only if characteristic syphilitic manifestations recur’. He does not believe that a rationally conducted mercurial treatment is injurious to the organism, and therefore he has no objection to a several-times repeated mercurial course during the early years. Neumann43 considers that the advantages of chronic inter- mittent mercurial treatment are not raised abo\e all doubt, and that on the other hand it has certain disadvantages, viz. : — (1) A psychological objection, since it increases the tendency to syphilophobia. (2) To certain individuals the long use of mercurial preparations is not innocuous. On the other hand, he regards the method as having an adequate theoretical basis, since he has shown that after the disappearance of the clinical mani- festations, exudation cells remain for a long time both in the seat of the first lesions and also in other organs, by the increase of which relapses are caused. Nevertheless Neumann remains an adherent of the symptomatic treatment, having regard to the cases in which patients remain free from further symptoms after a single course. In the course of the last ten years he has very fully observed thirty-six such cases in his practice. Since, however, syphilis almost always recurs in the first year, and very frequently in the second, no very great difference exists, as a matter of fact, between his plan of treatment and Fournier’s. Moreover, Neumann agrees that to obviate the transmission of syphilis to their posterity, syphilitic parents should be submitted to mercurial treatment, even at the period when symptoms are wanting, and also that it should be resorted to before marriage, if not more than four years have elapsed since the infection. In conclusion he adds: “ Fears that by repeated use of preparations of mercury and iodine the organism may suffer, are not well grounded, provided that the treatment be conducted on suitable and scientific principles.” “ On the other hand it is true that in some instances, owing to individual peculiarities or variations of quantity, a supersaturation of the organism with mercury occurs,