Scrofula is like Syphilis in many of its characteristics. It is like it in its power of propagating itself from parent to child. It is like it in affecting nearly all the children of diseased parents. It is like it ~a the variety of the structures it attacks, affecting the skin, the mucous membranes, the bones, etc. Like syphilis it produces hard tumors, ulcers of the skin, abscesses, and decaying of the bones. And finally, the great remedy for tertiary syphilis, iodide of potassium, is likewise the great remedy for scrofula; and, indeed, almost every remedy which acts favorably upon one, is found useful for the other. This could hardly occur were not the diseases identical in nature.
We can scarcely be surprised that a disease so widely diffused as scrofula should be the product of syphilis, when we reflect how frightfully prevalent were the causes of this latter affection during the earlier and the middle ages of the world.
To pass over the records of earlier times, with merely mentioning Abraham, and Lot, and Jacob, and Reuben, and Samson, and David,, and Solomon, and numerous females, of whom some singular things are written in the older scriptures, and omitting all mention of the incredible and almost universal debauchery and prostitution of Greece, and Rome, and Persia, and Media, and Egypt, I may say that Europe, in the middle ages, was well nigh converted into a vast brothel.
Foremost in the race of profligacy were those in authority, kings, and emperors. The licentiousness of Childeric knew no bounds. He carried off and violated the wives and daughters of his vassals, without' regard to any right, human or divine. His successors were generally a race of lecherous men, who spread debauchery on every hand. The French monarchs, from Pepin and Charlemagne, were a race of debauchees. Their courts were national brothels, in which the finest women in the land were trained in the arts of seduction and lust. Francis 1, in 1515, endeavored. to invest prostitution with elegance and chivalry, and even to ennoble, it, by abandoning the public women of the palace to his subaltern officers, and substituting for them ladies of noble blood. In this movement, the nobles and the officers gave the king their support.
“They are all gone aside; they are altogether become filthy; there is none that doeth good, no, not one."
Brantome justifies Francis in his selection of girls of noble blood, on the ground that ,they could not communicate the venereal disease to the noblemen of the courts, like the common prostitutes." But the king, who was previously diseased, infected them; and these noble women, so called, passing from the arms of the prince to those of the courtiers, presented to them the fatal infection received from the king.
The way in which Francis himself was infected illustrates, in a most shocking manner, the morals of the times. His illicit loves with the Belle Ferroni Are were not concealed from her husband, who, though obliged outwardly to regard the dalliance of his wife with the monarch as an honor, was inwardly indignant, and determined to become infected himself, and thus disease his wife, and revenge himself upon the king. This plan was suggested to him by a noble who had another motive, namely, that of punishing Francis for some personal spite. , How," said the husband, when the suggestion was made, ,shall I give this disease to my wife, when we are both sound? " Go visit an infected girl," said the noble, , and to render the matter certain, as I am infected, I will see your unfaithful wife.". The result was such as the husband desired; and in 1547, Francis I, the gay and chivalric monarch, perished of the most foul and loathsome of all diseases.
Debauchery did not die with him. It was cherished by his successor, Charles IX, and his mother, Catherine de Meclicis, and his grandson, Henry III. The reigns of Henry IV, Louis XIII, Louis XIV, the Regency, and of Louis XV, were stained by the same licentiousness and disregard of public decency, until the whirlwind of the revolution came to purify the moral atmosphere.
The reader will now, I think, be in no mood to wonder that the men and women, and many of royal progeny, whether the, dishonored occupants of thrones, or the more private recipients of the public bounty, are a scrofulous and degenerating race. Nor need it be much wondered at, that so large a portion of men and women every where have more or less scrofula in their frames. Happy are those who can find no trace of this complaint in their constitution I They should rise up and call their virtuous progenitors blessed. They should especially thank God that they have sprung from the loins of a race more noble and kingly in the eyes of Heaven than all the royal lines of the world.
Treatment. With the well drawn picture of the results of this terrible disease before the reader, he can appreciate the importance attached to proper treatment. If there should be any doubt in the matter whether he has the disease or not, he should at once obtain the opinion of his medical advisor. For instance, the sore on his penis known as the chancre may not be syphilitic but be of the so called soft chancre or chancroid type due to connection with unclean partners, but not due to constitutional infection. They are in reality ulcers but in some cases are markedly similar to syphilitic ones. But their treatment would be distinctively local and entirely different from the treatment of true chancre.
Personally I think time is gained rather than wasted in waiting for an exact diagnosis to be made, and if the train of symptoms beginning with the chancre which will appear from two to six weeks after infection and followed by the ulcerated throat, copper colored rash, sore and enlarged glands in groin, hair falling out and gastric disturbances often accompanied by fever, show that we have a case of syphilis to attend to, then the way is clear. It was formerly the universal treatment to cauterize the sore at once. The writer has seen so many unsyphilitic sores cauterized unnecessarily, and on the other hand has seen many cases of true syphilis that had been cauterized, and that the only treatment given which is almost malpractice, that he earnestly advises moderation in this matter and desires that the too often assured security promised be at least accepted with reservation. The reason why cauterization is not successful in many cases is because the virus or poison has entered the system before the pimple or sore demonstrates its presence. This will appeal to your reason if you realize that sometimes six weeks elapse after impure connection before the chancre appears.
As in some cases, in my opinion a great minority, thorough cauterization minimizes the trouble and perhaps prevents constitutional troubles, its application is described. The general belief is that poison remains in the sore for a time before it is absorbed into the constitution. It is of the utmost importance that it be destroyed before the absorption takes place.
The caustics used are nitrate of silver (stick nitrate), nitric acid, chloride of zinc, potassa with lime, caustic,, potassa, and the painless caustic.
The nitrate of silver is much used, but the best surgeons now regard it as useless. It does not prevent the absorption of the poison. The caustic potassa, the potassa with lime, and the painless caustic, are the sure remedies, that is, if applied in season. But they must be employed with caution. It will not do to trust them in bungling hands. A little vinegar and water must be immediately used to neutralize the caustic when it has accomplished what we desire. After the sore is cauterized, a piece of lint, dipped in a solution of watery extract of opium, one dram to four ounces, should be laid on it; and the organ enveloped in another piece of lint soaked in tepid water, and covered in oiled silk. The patient should remain at rest as much as possible, keeping the penis elevated, and repeating the opium dressing to the wound, and the water dressing to the whole organ, night and morning. In addition, the patient should take two pills (19), to be followed, night and morning, for three or four days, with a tablespoonful of (20). In some cases, a piece of lint, wet with the tincture of muriate of iron, diluted and kept upon the chancre will cause it to heal kindly, and with safety to the patient.
If this treatment be adopted early and properly, the patient is cured, and nothing further needed. But time is generally lost. The poison is absorbed before the patient is seen by the physician; and the question then is, how it is to be driven out.
To accomplish this, the diet should be regular and unstimulating; alcoholic drinks and tobacco should be forbidden; the mind should be kept at rest; a cold or tepid bath should be taken daily; the action of the bowels and kidneys should be kept properly regulated. These things will put all the expelling agencies in proper condition for work; and no single medicine will put them all into action like mercury. For this reason, no other single drug has enjoyed a reputation for curing pox so wide as this.
But it must be used with judgment. No remedy is more safe, if judiciously employed, or more destructive if abused. Abuse made mercury a curse; judicious use makes it a blessing, at least in this disease.
Of the many varieties of mercury we have to choose from the protiodide known as the yellow iodide can be handled best. It may be obtained in one sixth grain pills in bottles of one hundred, and beginning with one pill at meal time worked up by degrees to six a day. For example, the first week one pill morning, noon and night, the next week two in morning, one at noon and one at night; the following week two in morning, two at noon and one at night, etc. If symptoms of "mercury saturation" appear such as sore, or bleeding gums, dripping of saliva from the mouth, griping pains in the bowels or diarrhea, then immediately drop back to three or four a day and find the limit of each individual. The point is to find how much the patient will take and then keep that dose constantly for three or four months. At the end of that time the iodide of potassium may be used in conjunction with the mercury. The form of the "mixed treatment pill, Number 2," compounded by eight or ten reputable
6'nemists is very useful. Each pill contains:
Iodide of Potassium, 2 grains.
Syrup of Iodide of Iron, 5 minims.
Corrosive Sublimate, 164 grain.
Solution of Arsenic and Iodide of Mercury, 2 minims.
Tincture of Nux Vomica, 2 minim's
And the dose is three to six pills during the day, or in a solution is desired: Iodide of Potassium, 4 drachms."
Corrosive Sublimate, I grain.
Compound Syrup of Sarsaparilla, 4 ounces.
Give one teaspoonful in water after meals.
This treatment is continued for nine months steadily, then for the next six months to a year it is taken on alternate months and if faithfully carried out the patient may rest assured that he has followed the line of treatment that science has found to give the best chance to escape the clutches of the most loathsome as well as one of the most prevalent diseases known since the beginning of the world.
In the third or tertiary stage, where the bones are affected, where the mind gives way, as in dementia and paresis, or the muscles refuse to obey the bidding of the brain, as in loco motor ataxia and kindred spinal chord troubles, enormous doses of iodide of potassium, even to six hundred grains a day may be used.
Salvarsan, “ 6o6” Of equal efficiency to mercury is salvarsan, or “606 " as it is sometimes called, a chemical (Dioxydiamidoarsenobenzol) having a specific action on the spirochcete pallida, or syphilis germ, which was introduced by Ehrlich. , 606 11 was hailed at first as the , sure cure," but later reports, while crediting the drug with results which are sometimes marvelous, advise caution in its use. The great value of mercury must not be lost sight of. Indeed it is probably through the combination of the two drugs that we shall be able to check this disease. Only a physician can apply 606 to the patient, as it has to be injected into the veins.
The Bubo, if not attended with pain, may be treated with compression, by a piece of plaster of ammonia with mercury, or by touching it with nitrate of silver. Should there be inflammation, and the formation of matter be inevitable, the bubo should be opened by touching it with the caustic potassa; and the resulting sore must be treated with the solution of opium and water dressing. Should the sore need stimulating, it my be touched lightly with nitrate of silver.
Eruptions upon the Skin. In treating the disease after it appears upon the skin, etc., we shall derive great advantage from the use of either the warm or the vapor bath once a clay. With this, if the case be not very old, we may employ (148) or (150); but if the disease be an old one, showing itself in the throat, or attacking the bones of the face, we must give iodide of potassium (138), combined with compound decoction of sarsaparilla. This is the great remedy for tertiary syphilis; but when the case is obstinate, it may sometimes be discontinued, and the corrosive sublimate (139) be substituted for it.
It is to be observed that the older the disease grows, and the more chronic its character, the more does mercury lose its control of it. In the first attack, the blue pill is the best; in the second, as a general thing, the iodide or the biniodide of mercury; in the third, the corrosive sublimate; in the attacks subsequent to this, particularly in the tertiary form of the &ease, the iodide of potassium. When the throat and nose are so ulcerated as to make a case absolutely terrible to contemplate, it is surprising to see how rapidly the recovery will often take place under the influence of this latter remedy.
For syphilitic iritis, apply frictions twice a day on the eyelids and eyebrows with ointment (172), (173) ; and administer internally two pills of (136) daily.
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