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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    observed cases which might satisfy the most incredulous. Not merely do the symptoms disappear under the gentle operation of this medicine—not merely does secondary syphilis, thus treated, vanish without bringing in its wake the dreaded tertiary symp- toms—but years afterwards I have examined such patients, and failed to find any trace of a relapse, or any prospect that one would occur. If at the outset we could unfailingly diagnose these cases, I do not know that it would be necessary to treat them with mercury; probably it would be quite as well not to give it at all. I see no evidence that mercurial treatment is here in any way superior to that of iodide of potassium ; it may be equal to it, but that is a different matter. The mercury can only cure after all, and that the iodide seems to do. But it is only too certain that we cannot at the beginning isolate these cases from those not amenable to the potassium, and that a very large proportion of the cases treated with the latter salt run anything but a favourable course. When this is the case, too, no increase of the dose, no degree of persever- ance in the use of the remedy, however valuable such steps may be in the tertiary stage, will avail to remove secondary disease refrac- tory to moderate quantities. I do not understand how any one can maintain that it always yields here to the iodide. My experience runs directly counter to such a statement. It might, indeed, be said that cases which do not disappear under the action of the potassium, resist mercury quite as obstinately. With a certain reservation, there is a good deal of truth in this view, and it is the worst of these cases that so often try the surgeon’s resources when treating them with mercury. I will now suppose that the process of elimination has been pursued far enough, and that we have simply to deal with the cases which remain—that is to say, with all those which we are not warranted in considering as likely to yield to time, to simple treatment, or to iodide of potassium. I suppose I am only endors- ing the common-sense view of the profession, when I say that there remains for these no remedy but mercury. The reader is to remember that I am speaking here strictly of cases which hold out no promise of getting well under any other system, where the expectant method has been tried and found utterly wanting. Whether the surgeon will err on what he thinks the side of safety, and decide to look upon all cases of syphilis as, ab initio, fraught with mischief, is a question I reserve for consideration further on. Paracelsus said, No man knew the amount of vice there might be in an ass; and there can be no doubt that many excellent surgeons have, in the course of their practice, learned to look upon syphilis from much the same point of view, and to distrust it as much in the mildest form as in the most severe. What the surgeon can do with these cases unless he gives mercury, I am quite at a loss to know. I therefore refrain from