to the
The preparation of mercury which I recommended for inje paration follows:-Hydrarg: 5i; Lanoline Pura, zii; Ol: Carbolic (2%); &
dose, 10 mins, for an injection.
ac used.
Disadvan-
mercurial
cream.
I stated that when first I began the Intramuscular treatmen perchloridi solution of grs. to 20 mins., as also Sal: Alemb. various reasons was obliged to give them up, principally on ac pain which followed at the site of injection, and also because a took place after an injection of the perchloridi solution. Her that this is the only abscess I have had following an injection.
To within six months ago I continued to use nothing but cream above described, and with it I have given over 6,000 i-j one of which have been followed by abscess; in some slig remained at the site of injection for a few days, the operati practically painless, and only in a small number did any pai afterwards. I can truly say that not one soldier who has been me has been incapacitated (through the injection or its results his duty.
i
an
t
But with all this success I have always been sensible of the slut toas tages of the mercurial cream possesses very great drawbacks, for it requir amount of care in compounding and dexterity in injecting. In it becomes semi-solid, whilst in hot the reverse, so that in the b the metal is no longer suspended. These defects can, of course, in (I have used the preparation in mid-winter in England and in Jamaica with the greatest success); at the same time a certa of trouble is required to do this, which is sure to militate
I have ever been on the 1- preparation being generally used. suitable substitute. Whilst serving in Jamaica I tried a solutio of mercury, it was supplied to me in tabloids, but I must say th meet with the same success as I had hitherto when using to.... Since coming home, and during the last six months, I have giv sozoidol of mercury a further trial and have used the following sol ion. Y
A enbati- bate for
mercurial
cream.
Com-
cream.
Soda Jodi, grs. x. Hydrarg: Sozoidol, grs. v. Aqua Distil, mius. 200.
This solution is made up 10 mins. to 15 mins. as an injection. hospital dispensary, and I must say that I have met with much mor than when used the tabloids.
The result of my experience from the use of the sozoidol solv parison of compared with the mercurial cream, is----
the two
prepara-
tions.
Sozoidal of
mercury recomm-
mended.
1
1. At the time, and for some time after the injection, a
pain is caused, but this soon passes away, leaving no u 2. It does not seem to me to have quite the rapid effe
disease as the cream.
3
I ought to be remembered that one of the great advantages of giving A great rcury hypodermically is that we can gauge the amount given in that way advantage
better than when administered by any of the other methods, so that the
be'injections and amount given ought to be varied to suit circum- method has.
tances.
muscular
The site of injection is almost invariably the gluteal region. The needle Site of died in a 1-20 solution of carbolic acid, and is then pushed with a rotary injection. tion into the muscle as far as it will
go.
The syringe which I use is made of vulcanite throughout. It is a very The viceable little instrument. The one originally supplied to me by Messrs. syringe. ohne and Sesemann, of London, in 1890, I still use, and it is as good as
rer.
The needles are about one inch in length; I have used longer but found The advantage in so doing. Latterly I have been using Platino-iridium needles. needles. And that they penetrate better and do not bend or rust; one accident is able to Lappen to these latter needles-they very often split at the side, and are must be taken to examine before using them.
The cases of syphilis, numbering some hundreds, which have been treated Cases y me by the Intramuscular injections of mercury have represented the disease treated.
every form, both primary and secondary-the former from the hard papule ithout any abrasion, to the phagedaenic sore rapidly destroying tissue, the ter from the secondary effects of syphilis, as represented by general landular enlargements with cachexia accompanied by one of the milder ashes, to cases covered with rupial sores (these also destroying tissue), and thers presenting symptoms of grave internal lesions.
Although I have before me the notes of all the above cases, with the xception of two I do not intend alluding to them in this paper further than breimark that the Intramuscular treatment was a marked success all round, eing just as successful among the negro soldiers as with the white.
The majority of these cases I was able to thoroughly observe, most of hem were kept under treatment for from five to six months, and others for h longer. They all, without exception, derived the greatest benefit from Average number of days in hospital, 20; average time under treat- Some of these cases I saw two ent, out of hospital doing duty, five months.
ars later, after all treatment had been suspended; they had had no return the disease, but were in the best of health, and all glandular enlargements ad disappeared. It is, of course, impossible to be certain, but I truly believe hat these men were cured of syphilis.
I will mention two of the above cases :——
Pte. P., 1st Leicestershire Regiment, was a patient in hospital in A case. ewcastle, Jamaica, suffering from secondary syphilis. He was in a fearful ate. There was a phagedanic sore on the penis, two-thirds of the glands which it had eaten away; he was covered with rupial ulcers from head foot, totally confined to bed, cachectic, and a mere skeleton-he was go
Although it does not compare in these two points quite so fa with the mercurial crean, still, bearing in mind that it possesses non": undoubted disadvantages of the latter, I have no hesitation in recommeiated. Every known treatment had been tried and mercury given in it for general use in the army.
to worse, until his condition was considered to be most precarious. On But whatever solution of mercury is used, the following has beeny way except by the Intramuscular method, but the patient went from tober 4th, 1893, by order of the senior medical officer, the patient was mode of carrying out the treatment :---
When in hospital, patients undergoing the treatment are keptded over to me for treatment, and on that day I gave him a first injection... liberal dict, and generally allowed a bottle of stout or beer a day. are allowed up and advised to be as much as possible in the open air also to regularly wash their teeth after each meal. Should there be sigus of the gums becoming spongy, they are given a strong mouth was alum and acetate of lead to use frequently.
As a rule, patients in hospital receive one injection per week of 10 of either of the above solutions. I say as a rule, but there can be no deb rule laid down as to the number of injections to be given weekly or t amount, under the maximum dose, given; one must use one's own judgi
in the matter.
ains, of mercurial cream. As this case has already been fully reported, suffice here to state that from the above date the patient began to eve in a marvellous manner, and that he, who was in a moribund ition when handed over to me, five weeks later, having had six injec- was out and about. Subsequently he was kept under treatment for hs, and eventually went to the reserve, apparently quite restored to
The wonderful success of the treatment in this case was the cause of a
deal of interest among medical men locally at the time.
would here mention that from this and other cases which I have had An impor- learnt an important fact, namely, that mercury can be given safely tant fact. ith the greatest success in cases of syphilis accompanied by phagedæna. contrary to the teachings of the late Carmichael, of Dublin, who tically condemns it in such cases. Personally I have seen cases like
from bad to worse when given mercury internally. 1110)
A 2
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