Observations on the Operation and Use of Mercury in the Venereal Disease

by Andrew Duncan

CHAP. VI.

Of the Mercurial Preparations intended to act in the cure of Lues Venerea by entering the System.

An attempt has already been made to explain the operation of mercury, and the manner in which the venereal poison may be supposed to exist as a cause of disease. From these it might perhaps be concluded, that the introduction of mercury into the system was seldom requisite. And it might seem reasonable to infer, that all the advantage which could be obtained from mercury, might be had from its application in one or other of the ways already mentioned. So far, however, is this from being the case, that it is no uncommon thing with practitioners to inveigh, in the most express terms, against all external applications, those excepted which are of the mildest and most inactive nature. Mercurials have not been excluded, and the healing up of sores, by whatever external means it may be effected, has been considered as highly prejudicial.

It can by no means be asserted, that these accusations against the external use of mercury are entirely without foundation. If properly understood, however, they may be true, without being any objection to the theory. It can never be imagined, that, from the destruction of the venereal virus at a particular part, by any application made there, it should be destroyed in the rest of the system. When, therefore, the venereal virus has already been absorbed, a radical cure cannot be expected from the healing of an ulcer. It may even sometimes happen, that, from a partial destruction of the virus in an ulcer, it may be healed externally, and, at the same time, absorption more considerably promoted than if it had remained open.

From these circumstances it is easy to see, that, upon the theory formerly adopted, the introduction of mercury into the system is, in many cases, not only proper, but even necessary. But, at the same time, the advantages which, from that theory, we are led to expect from the immediate application of mercury to parts affected by the venereal virus are not less true.

As the first method of using mercury was by external application, for an action on the parts affected; so external application was likewise the first means employed for introducing it into the system. For that purpose, all the various modes of applying mercury, which have already been mentioned, have, at different times, been used. Applications of mercury to the surface of the body by unction, plaster, fumigation, and lotion, have each, at different times, and by different practitioners, been recommended as the safest and most effectual method of introducing it into the system. But, after longer and more accurate observation than could at first be obtained, the application of mercury in the form of unction is the only method of introducing it into the system, by external application, which is now in practice.

Whatever may be the means used for introducing mercury into the system, it is certain, that, if it do enter it in an active state, it will cure the disease. Its introduction by unction is still by no means an uncommon practice. By several modern practitioners, this method of introducing it into the system is still recommended, as preferable to every other. When properly viewed, however, it must be allowed, that if it be attended with advantages on the one hand, it is by no means free from inconvenience on the other, and in certain circumstances only is a preferable practice.

In the mercurial ointment, the preparation which is here used, the mercury, as was formerly observed, is rendered active from division by triture. The mercurials prepared in this manner are in general the mildest in which mercury is in an active state. It may be laid down as an undoubted fact, without pretending in this place to assign any cause for it, that the milder mercurial preparations have a greater tendency to operate by salivation than the more acrid. But there is perhaps no method of exhibiting mercury in which it more certainly operates by salivation, than when it is applied externally in the way of unction.

After what has been said by the greatest authorities in medicine against salivation, it would be unnecessary to add any thing here. It may be sufficient to observe, that it has been pronounced to be a practice not only attended with very great inconvenience, and no inconsiderable danger, but even unnecessary. The tendency, therefore, which this mode of introducing mercury into the system has of exciting salivation, may be considered as no small objection to its being put in practice.

But, while it cannot be denied, that salivation is attended with many inconveniencies, it must at the same time be allowed, that the degree in which it takes place, is, in general, proportioned to the quantity of active mercury which enters the system. And it occurs chiefly in those cases where the medicine is not so acrid as to find an outlet by some other excretory. When, therefore, the disease has been of long standing, and obstinately rooted in the system, altho’ salivation may not be necessary for a cure, yet it will be the unavoidable consequence of the employment of that quantity of mercury which is requisite in the system for overcoming the disease. This mode of employing mercury, then, is not in every case to be rejected from the tendency which it has to excite salivation.