Therefore, during my lecturing journey, undertaken recently[348] under the auspices of the German Society for the Suppression of Venereal Diseases, I prepared the following brief account of the therapeutic employment of mercury in syphilis, which in my opinion suffices to throw the proper light upon the value and importance of the mercurial treatment of the disease; it is a sufficient answer to the “Nature-Healers,” who are opposed to the use of this “poison”:
1. In innumerable instances it has been observed by the most experienced and scientific physicians, that cases of syphilis treated without mercury run a very severe course, accompanied by the most dangerous symptoms, such as extensive destructive lesions of the skin, lesions of the internal organs, brain syphilis, eating away of the bones, loss of the nose, etc.
2. In cases which previously have been treated without mercury, the administration of the latter drug immediately arrests the destructive processes, and saves the patient from death, or from very severe illness, and from physical disfigurement.
3. No less an authority than Virchow, in his celebrated treatise “On the Nature of Constitutional Syphilitic Affections,” pp. 7-14 (Berlin, 1859), has shown that the hypothesis of Hermann[349] is entirely devoid of foundation in fact.
4. I should feel conscientiously compelled to denounce myself for the commission of grievous bodily harm if I ventured to-day, after the accumulated experience of four centuries, to treat a case of syphilis without mercury.
What use is it to continue to fight against the disbelief and superstition which clings to mercury? Why should we for ever be occupied in contradicting the false accusations brought against this drug? For four centuries the divine mercury has withstood all attacks, and will continue to withstand them, until a greatly desired and even better measure is discovered—prophylactic immunization against syphilitic infection.[350]
How mercury is to be given, whether in the form of the long-prized “schmierkur” (cure by inunction), or by hypodermic injection, or by ordinary internal use, must be left in individual cases to the decision of the medical man, for numerous considerations, which can only be properly weighed by the physician, have to be taken into account. A mercury cure is a serious matter, but always also one which repays all the trouble that we take. In “En Guérit-on?” Fournier has most admirably described the wonderful results of a critically considered and carefully conducted mercury cure. I do not, indeed, belong to the “doctors who build for themselves a house of pure quicksilver,” when they enter the field against the “French” (= syphilis), as the phrase runs in Schiller’s work “The Robbers.” I hold by a reasonable, measured use of mercury in the course of the treatment of syphilis, and I advise a good “after-treatment” in addition to the treatment with mercury.[351] Mercury, when given in moderate but sufficient doses, not only destroys the syphilitic virus, but also has a very favourable influence on the general condition, and sometimes even gives rise to an increase in the number of the red blood-corpuscles. Thus, mercury is not only not a poison: it is a most valuable restorative and vitalizing means. This is well illustrated by the following case, which came under my own observation, and which I recommend to the Nature-Healers, in the hope that it may lead them to revise their views regarding the action of mercury:
The case was that of an official, thirty years of age, who had been under my care several times before since the year 1898 for other troubles (gonorrhœa, etc.), and who was always pale and with hollow cheeks, in no way giving the impression of possessing a constitution with strong powers of resistance. Late in the summer he was infected with syphilis; the attack proved a severe one, running a serious course, complicated by an extremely painful suppurative inflammation of the lymphatic vessels of the penis, and accompanied by fever, lassitude, and a sense of exhaustion. An energetic inunction cure was immediately begun. Under this not only did the morbid symptoms rapidly disappear, but there occurred a remarkable change in the general condition, in the sense of an increase of strength, such as had not existed before the illness. Notwithstanding slight stomatitis, the patient during and after the cure felt stronger and more fit for work than he ever had before, and even now this favourable state continues unaltered, as is manifested above all by the increase in the body-weight, by the good appearance, etc. The patient, who now, one and a half years after the cure, has had no relapse, informed me repeatedly and spontaneously that this delightful improvement in his health could only be attributed to his syphilis (!) or to the mercury!
A single mercury cure will suffice, in some cases, to cure syphilis for ever! Regarding this, we have numerous trustworthy observations. In most cases, indeed, during the early years relapses occur, and then we need to use the indispensable mercury cure once more with care, and to employ all the other measures which make up the above-mentioned “after-treatment,” the supplementary means being, above all, iodide of potassium, sulphur (in the long-celebrated sulphur-baths of Aix, Nenndorf, etc.) and arsenic (first recommended by me); also the water cure, brine-baths, and iodide-baths, and a visit to the seaside or to the mountains, and massage, are good accessory means to the cure. Above all, however, the State of nutrition of the patient[352] must always be kept under consideration, and assisted where necessary, for which purpose preparations of iron, nutritive preparations like sanatogen, and milk cures, are of value. Strict abstinence from alcohol is always necessary in the treatment of syphilis. Alcohol has a very unfavourable influence on the syphilitic process, and is often the only cause of continually recurring relapses of this disease.
The thorough treatment of syphilis is a matter of several years, during which the patient must repeatedly present himself to the physician for examination, and should any relapse occur, he must be subjected to renewed treatment. Such thoroughness will invariably be rewarded. Attention to detail will always bear fruit. Syphilis is curable. It is purely fanciful to say that syphilis is never cured, that it pursues its victims up to the end of life, that it knows no pardon. That is not true. Treat your syphilitic patients, treat them properly and thoroughly, if necessary for years in succession, and they will be freed from the disease. “Syphilis,” says Fournier, “is a misfortune, but it is a misfortune from which complete recovery is possible.” From the day when the patient becomes aware that he is suffering from syphilis, he must face the situation “in a calm and manly fashion,” and must say to himself: