The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
The _hypodermic use of mercury_ can be made effective, but there are
but few preparations which can be used that do not cause pain and
subsequent irritation. Perhaps that which gives least pain is the
sozoiodolate of mercury. This is sparingly soluble in water, dissolving
in about 500 parts by weight. As the dose is 9 or 10 Cg., the amount
of water necessary for this solution is so bulky that the dose should
be injected into the gluteal region. Corrosive sublimate is also
used in 1 per cent. solution, made up in common salt solution of the
usual strength of 9 to 1000. Of this 10 minims represent a suitable
dose to commence with, which may be increased to 30 or 40 minims when
necessary. This should be given in the same region, the needle being
driven in its full length perpendicularly to the surface. When this is
done an injection is made into the muscle, where it seems to be more
effective than in the subcutaneous fat. When the dose is increased to
more than 20 minims a 2 per cent. solution may be used and the amount
of fluid correspondingly reduced.
_Fumigation_ is a method now not often adopted, calomel being used for
the purpose, an ordinary cabinet hot-air bath confining the vapor about
the patient. One treatment a day by either of these methods is usually
sufficient.
About the _initial sore_ dry calomel, pure or reduced with bismuth
subnitrate, may be used. The condylomas met with about the
perineum will often shrink and disappear under the influence of
this application. _Mucous patches_ should be treated with absolute
cleanliness; in the mouth a wash of diluted hydrogen dioxide may be
used, and the patches touched with a strong nitrate of silver solution,
pure carbolic acid, or camphophenol. This will not prevent contagion
from such a source, but will reduce it to a minimum beneficial in every
respect.
The various eruptions of syphilis will disappear gradually under the
influence of a local application of one of the mercurial preparations,
either the ordinary mercurial ointment or ammoniated mercury.
In cases of _inherited syphilis_, especially in young children, a
reduced mercurial ointment, or the use of gray powder (mercury with
chalk) will give the best results. The dose should be regulated by
the age of the patient; for instance, of the latter 1 to 2 Cg. for an
infant. The iodides have also proved successful.
_Iodine_ and its preparations have by many authorities been held to
be useful in the later and especially in the gummatous lesions of
syphilis. There are patients who cannot take iodine to any extent
without suffering from such disturbance of mucous membranes, especially
in the nose and intestines, as to make it an exceedingly unpleasant
remedy.
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