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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    This comprises all that is necessary to form the basis of treat- ment. Of course there are, especially in the tertiary stage, many complications which require additional means, particularly when we only see the patient after mercury has been used, such as blister- ing in nodes, cauterizing in sore throat, evulsion of the nails for onychia, the removal of dead bone, etc. These are matters of prac- tice which, if discussed in detail, would carry me far beyond all reasonable limits, and I therefore forbear to enter upon them. I must equally refrain from going into the statistics of cure and failure, and content myself with saying that I have seen no system succeed nearly so well, that I have not had so far a single instance of failure or relapse after the full course where I have treated the case from the beginning, and but a small percentage of bad-results in cases previously uucured by mercury; and that it is equally applicable to any stage of the disease, and, so far as Ijcan judge, any severity of symptoms. The reader will perhaps ask if I propose to recommend this method in every case of constitutional syphilis; to which I reply, that I most certainly do, unless the patient consents quite uncon- ditionally to take upon himself the responsibility of failure from doing otherwise. The surgeon’s task is to exorcise the demon of syphilis ; and, as concerns the majority of cases, I think that is best clone by early and energetic treatment. Of the two errors, it is better to err on the side of safety, and safety is only to be found by looking on all cases as dangerous. Granted that a few persons throw off the disease by the inherent strength of their constitutions; they are, after all, exceptions; and any system of treatment, founded on ex- ceptions, is as unsteady as a pyramid standing on its apex. He may also ask if I can explain how the treatment acts; a question which may be met at once by saying that I know nothing about it. Possibly the wonderfully elastic properties of the humoral doctrine will admit of its being adapted to the case, and there is always the elimination of the virus and the enninctory property of the mercury to fall back upon. True, the humoral doc- trine wants a foundation to stand upon, but that shrewd observer, Sir Benjamin Brodie, tells us that this does not interfere with the vitality of a hypothesis, which will continue to exist long after the slender foundation on which it originally rested has melted away. This may be thought improper levity, but really I do not see how the doctrine is to be met in any other manner. Reasoning and experiment are alike lost here. A chancre has been cut out, the blood from the spot unsuccessfully inoculated, and yet the chancrous action has reappeared. There is no evidence that the contamination of the blood is lessened by copiousness of eruption, but plenty of evidence that there is no visible connexion be- tween the severity of secondary disease and the state of the circulat- ing fluid. The supposed elimination of the virus from the blood goes on long after there is any virus to be eliminated ; for we see