7
111
5
the disease, which used to disappear, but broke out afresh over and over again, ulceration and thickening of the tongue being his chief trouble.
When I saw him, besides extensive ulceration of the tongue, he had two large ulcers on the calf of his right leg, the result of gummatous disintegration. On December 20th, 1891, I began the weekly subcutaneous injection of mercury, and I continued them for eight months. Long before I stopped, all signs of the disease had disappeared. The treatment was carried out with no interruption for these eight months. Patient, "who led a very active life," suffered no inconvenience; and when last seen by me (October, 1892) he had had no return of the disease, and was in better health than he had been since he first contracted the disease.
I. I.-aged 27, also an officer, contracted the disease in India, May 1891. Up to the time I saw him he had been under treatment, and had taken mercury steadily for months and months. When he came to me, in January, 1892, he was very weak and debilitated, and suffered much from diarrhoea. He stated that on account of the latter he had been obliged to give up taking mercury. His throat was very severely ulcerated.
This case had a peculiar interest for me, as at the time he came under me he was a patient of a brother officer of mine, who stated that he could get no good of him, and handed him over to me to try my method on him. I will only say here, that from the first injection he made wonderful progress towards recovery- The disease seemed to melt away, and he rapidly regained his former good health. I continued giving him a weekly injection from January 10th, 1892, until the time I went abroad (October, 1892). He suffered no inconvenience. When I first saw him he was on the sick list, and had been for some time. After the first injection he was taken off, and there was no occasion to put him on it again.
I heard from this officer in January, 1893, stating he had had no return of He wrote expressing his the disease, and that he was in the best health. gratitude for the treatment.
Since the time I began the "hypodermic method" (in September, 1891, The until October, 1892) I treated in all ten officers at Shorncliffe by it. remaining seven were very similar in character to the three I quote, and with them I had the same success. All of them were most enthusiastic in singing the praises of the treatment.
None of them suffered the slightest inconvenience from it, and were quite willing, and in some cases anxious, to continue it longer than I considered
necessary.
Among the men, I treated in all, during the above period, fifty cases, were of all descriptions.
which
He Pte. P. C. had been under treatment in hospital for seven months. had taken mercury in every form, as also iodide of potassium. His palate was badly ulcerated, and he was covered with a papular eruption. A brother officer of mine, whose patient he was, stated that the man made no progress, This officer could and he handed him over to me to try my method on him. testify to the marvellous effect the first two injections had on the symptoms. I continued weekly injectious for eight weeks, and then the patient, being quite free from the disease and in good health, he was discharged to his duty, I may mention but he attended weekly for three months longer for injections. that during the last two months he was in hospital he gained 16 lbs. in weight. The treatment in this case was closely watched by the Medical Officer in charge of the hospital, Brigade Surgeon Lient.-Col. Tomlinson, and he was very much impressed at the manner the disease yielded under it.
Pte. J. M. contracted a hard sore 7.7.91; was treated for it in hospital for three weeks. He was re-admitted 11.11.91. On admission he was very anæmic and cachectic, and altogether in a very bad state of health. The trunk and legs were covered with rupeal ulcers, and the nasal bones were exfoliating. On the day of his admission I gave him a first injection, which I continued to do once a week for five months, two of which he was in hospital, and the remaining three at his duty, but attended weekly for an injection." From the first injection this man made rapid progress towards recovery, and at the end of two months was quite free of all symptoms and apparently in good health.
Corpl. H. H., West Kent Regiment, had been under treatment in hospital for six months, and when handed over to me he was suffering from syphilitic
In performing the little operation one thing is absolutely necessary, viz., that the needle be pushed straight as far as it will go into the tissues, so as to avoid abscesses; if the fluid be injected into the subcutaneous tissue, abscess will follow.
As a rule, I have found that one injection per week is enough; but in one or two very severe cases, with cerebral symptoms, I have given two.
Whilst in hospital I give my patients a liberal diet, and often a bottle of stout or beer; allow them up, and insist on their being as much as possible in
open
air.
the
Officers, who were my patients, I advised to avoid spirits, but they might drink a liberal allowance of claret, port wine, or beer, at the same time eating nourishing food, and spending as much of their time as possible out of doors.
Flannel to be worn next the skin, and cold and chills avoided. Exercise was strongly advised.
With these precautions I am sure there is not the least danger of any untoward effects following the injections. Out of all my cases I had not one of salivation, nor was I obliged to stop treatment on account of the gums becoming
sore.
Besides the undoubted advantages as to the results of cases treated by this method, there is one which, in the case of the soldier, renders it still more valuable. Formerly, and indeed at the present time, when a soldier contracts syphilis, he is admitted into hospital, and there treated until all the primary signs or any active symptoms of the disease have disappeared. He is then discharged to his duty, when all treatment, of course, is suspended. The disease breaks out afresh. He remains at his duty as long as he can, but eventually comes to hospital; is readmitted, and under treatment the symptoms again disappear, and he is again discharged to duty, and treatment stopped. Again the disease breaks out, and again he is admitted to hospital, and this series of events goes As he never gets a lengthened treatment he never gets rid of the disease. goes abroad to the tropics, and is there an easy prey to the diseases common in those regions, or to the further ravages of syphilis. Eventually he either is invalided, or dies.
011. He
In the case of the Hypodermic method what would be easier than when a man got syphilis to admit him to hospital and there treat him until all pressing signs of the disease have disappeared, then discharge him to duty, but order him to attend one day a week for an injection. Then he could be submitted to a lengthened treatment, and the disease eradicated before the man is called upon for foreign service.
I feel confident, if this is properly carried out, the invaliding and death rates throughout the Service will be much diminished.
In conclusion, I will say that in this paper I claim nothing original in the treatment above described, as I know that for many years the hypodermic injection of mercury in syphilis has found much favour in Germany, notably at Breslau; also that the identical treatment described by me was, before I thought of it, practised by Drs. Althus and Whitmore in London.
My object in writing it is two-fold:
First, in fulfilment of a promise made by me to Brigade Surgeon Lieut.- Colonel Tomlinson, A.M.S. (who was medical officer in charge of the Station Hospital, Shorncliffe, during the period in which I carried out the treatment), that I would record the results of my cases.
Secondly, in the hope that it may possibly be the means of drawing the attention of the profession, especially that of the Medical Staff of the Army, to this treatment, and stimulate them to give it an extended trial. If they do it I feel certain that before long they will find that, whilst rendering the life of the syphilitic soldier less of a burden to himself, they will also be doing a very great service to their country by enabling him to give his services as a soldier more freely, and lessening the invaliding and death rate of the Army.
NEWCASTLE, JAMAICA,
April, 1893.
F. J. LAMBKIN,
Surgeon-Captain A.M.S.