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Homeopathic Materia Medica by Farrington
(merc)We begin this morning with the study of Mercury and its combinations. Mercury has long been known and used as a medicine in the old school of practice. Its abuse, when given in excess or inappropriately, has rendered it a very unpopular remedy among the laity. There are many physicians in the so-called old-school practice, who have endeavored to obtain for Mercury a substitute which would answer the same purpose without deleterious results. They have been more or less successful, but they have never really obtained anything equivalent to that remedy in its genuine usefulness. Of late days, there are not so many allopathic physicians who give the great doses of Mercury that used to be so common. This caution, in its administration, is no evidence of improvement of the medical world, scientifically speaking, but only that they have been driven to this course by their unfortunate results and by popular clamor. There are many physicians who are afraid to let their patients know that they are taking mercurials. The eclectics have substituted such plants as Podophyllum and Leptandra for Mercury, especially in liver affections.
We, of the homeopathic school, are not afraid to use mercurials, because we do so according to a fixed law, guided by their effects on the human system; therefore, we are not in any danger of the bad results which follow overdosing or misapplication of the drug. You notice that I have placed on the board a number of mercurial preparations. All of these have some medicinal properties, but we have not the time, nor will it be proper, to dwell on them all. Our main object is to treat of the principal actions of Mercury in general, and then to teach you the principal characteristics which will enable you to prefer one of these preparations rather than others. From the general character of the patient, you know that he needs some mercurial preparation and you want to know which one. We have here two preparations, Mercurius vivus and solubilis, that I have placed on the same line. I do not know enough to separate them symptomatically. The provings have been separately placed in Allen's ENCYCLOPEDIA, but I have not been able to separate them. These preparations are the quicksilver, or metallic Mercury, and the Soluble Mercury of Hahnemann. Mercurius solubilis is not a pure mercurial preparation. It contains some ammonia and some nitric acid. There are only traces of nitric acid, however, and yet these traces must modify its symptomatology somewhat, but to what degree I do not know. The provings of "the solubilis" are excellent. They are complete, much more so than those of quicksilver. These latter are collected more from poisoning cases and from clinical cases than from actual provings. If, then, the symptoms are clearly placed in the ENCYCLOPAEDIA under Soluble Mercury, I would adviseyou to use that preparation. Below the Mercurius vivus and solubilis on the board, we have two preparations of Mercury with chlorine. Next comes Mercurius aceticus, of which we have but few symptoms. Next we have the two Iodides of Mercury, which are very important. The Biniodide is red, the Protoiodide, yellow. Then we have the Cyanide of Mercury. Next we have Cinnabaris. which is the Sulphide of Mercury. Beneath this we have the Sulphate of Mercury and then the Mercurius praecipitatus ruber. Of these, we have but few symptoms. Cinnabaris, the two Iodides, the corrosivus, the solubilis and the vivus are the most frequently used.
You see here on your right, a list of antidotes to Mercury. That is in itself evidence of the numerous ill-effects which may result from its abuse. They are not all equally well indicated. As I mentioned the other day, HEPAR is the most important antidote for Mercury and also for many of the other metals. It is useful for the mental symptoms that may follow a course of Mercury, the anxiety, distress, and even the suicidal mood; also for the bone pains, sore mouth, ulcers and the gastric symptoms.
NITRIC ACID is particularly to be remembered when the lower tissues are attacked, as the periosteum, the bones and the fibrous tissues. The patient has bone-pains worse at night, aching in the shins in damp weather, ulcers in the throat; particularly if secondary syphilis is complicated by mercurial poisoning.
CINCHONA is said to antidote the chronic ptyalism produced by Mercury.
DULCAMARA has been successfully used for the salivation of Mercury, particularly when it is aggravated with every damp change in the weather.
KALI HYDRIODICUM, or the Iodide of Potassium, is a well known antidote for Mercury, and has come into practice of late years, and is given by both schools of medicine very extensively, whether the case be syphilitic or not. Like Nitric acid, it is particularly indicated when syphilis and Mercury combine to make the patient sick, particularly when the lower order of tissues are involved, as the bones, the periosteum and the glands; when there is the well-known syphilitic ozaena, thin watery discharge from the nose making the upper lip sore and raw. You will find it the best drug we have for the repeated catarrhs which may follow the abuse of Mercury. Every little exposure to a damp atmosphere, or even to cool air, causes coryza. This, remember, is a case of mercurial poisoning which the Iodide of Potassium is to antidote. The eyes are hot, and watery, and swollen. There are neuralgic pains in one or both cheeks, the nose feels stuffed up and is swollen, and discharges at the same time a profuse watery scalding coryza. With these symptoms there is more or less sore throat. These symptoms recur at every fresh exposure. There is scarcely any drug which will cure these cases quicker than will Iodide of Potassium.
There is another salt of potash that has an antidotal relation to Mercury, and that is KALI CHLORICUM. This is just as efficient an antidote when the poison has developed a sort of scorbutus, and the gums are spongy, soft, and bleed easily; there are ulcers of an aphthous character in the mouth and throat, and foetor of the breath.
AURUM has next mention. This we find particularly called for in the suicidal mania which may develop after a course of Mercury, and also for the caries of the bones, particularly of the bones of the palate, nose, etc.
ASAFOETIDA also comes in as a drug to be thought of in the bone affections developed by Mercury. Here you have, as a characteristic distinguishing it from the others, extreme sensitiveness around the diseased portion of bone. For instance, in the case of an ulcer communicating with a carious tibia, the parts are so sensitive that the patient can scarcely bear the dressing that you apply: You will find that the tissues are firmly adherent to the bone for some little distance around the inflamed portion. Then, too, you find Asafoetida sometimes indicated for iritis following mercurialization. Here, to distinguish it from other remedies, you have the same characteristic, extreme soreness of the bones around the eye.
STAPHISAGRIA is an antidote for Mercury, and in rather bad cases, too, when the system is very much depreciated by the mercurial poison. We find the patient wasting away, and sallow, dark rings around the eyes, well-marked mercurial mouth and throat, with spongy gums, tongue flabby, ulcers on the tongue and in the throat, and well-marked bone pains.
LACHESIS is an occasional antidote for some of the symptoms, but there are no special characteristics.
IODINE comes in as an antidote when the glands are affected.
MEZEREUM is an excellent antidote when the mercurial poisoning has invaded the nervous system and neuralgia has developed. This neuralgia may appear in the face, in the eyes or in any part of the body.
Lastly, we have STILLINGIA.
Mercury, it is well-known, enters into loose combination with the tissues of the body. It has been found in every tissue and may be excreted by almost every channel. It has been found in the perspiration, urine, bile, faeces and saliva. It has even been found in the child in utero, and again in the nursing infant, when the drug has been taken by the mother. I said that the combination of Mercury with the tissues is a loose one, by which I mean it is easily displaced. If a person is poisoned with Mercury, it will be readily displaced by one of the above remedies. It is only the chronic cases that need alarm you, and the cure of which, you may despair of. When mercurialization is combined with other poisons as with syphilis and scrofula, then you will have greater difficulty.
The symptoms of poisoning by Mercury may be stated as these: After exposure to the poison, the patient has a rather disagreeable odor to the breath, that is a sickening sort of odor hard to describe but easy to remember. There is also a sort of metallic taste complained of. These are very early symptoms and assert themselves long before the well-known characteristics of the drug appear. The patient feels languid and is frequently sick at his stomach. He vomits his food without any apparent cause. His face becomes rather pale, with dark rings around the eyes, the lips are rather livid and purplish. He complains of heat, particularly in the forehead and down the root of the nose. He cannot bear the warmth of the bed. As soon as he gets warm in bed, his aches and pains return. Then his mouth begins to feel sore. The mucous membrane becomes puffed, swollen and redder than natural. The salivary glands begin to secrete more rapidly and the mouth is filled with saliva, which is, however, normal in its composition. In a more advanced case, the saliva becomes vitiated. It is no longer the pure secretion, for the glands are overworked. The breath becomes more and more offensive, the gums swell and are tender to touch, and the teeth become loose. A dark red line sometimes appears on the gums below the teeth. Later, the gums grow spongy and yellowish-white and ulcerate and discharge an offensive matter. The tongue swells and readily takes the imprint of the teeth. The glands then become involved and you find more or less tumefaction of the parotid and cervical glands. If you were to look into the mouth at this stage, you would find the opening of Steno's duct red and inflamed and, in some cases, even ulcerated. Other glands, too, are affected. We find the pancreas attacked by Mercury. The liver also comes in for a share of the poison. You are probably aware that the liver has been said to be affected by Mercury, and that allopathic physicians have been accustomed to give blue mass or calomel in almost every attack of "liver-complaint." Quite recently, several eminent physicians in the old school have declared that Mercury does not increase the flow of bile and hence is not useful for torpid liver; but however that may be, it is certain that Mercury does affect the liver in one way or another. It has caused catarrh of the duodenum, and this catarrh has extended along the bile-duct into the liver. This is a form of trouble which frequently causes jaundice, and a form too, for which Mercury is useful. It has also produced and cured hepatitis, particularly when one or more abscesses have formed in the liver. Individual susceptibility varies these symptoms considerably. You will find that it is more difficult to salivate children than adults. Some persons are salivated by very small quantities, while it is difficult to affect others. The scrofulous are very seriously affected by Mercury, as you all know.
The more remote symptoms of mercurial poisoning are these: You will find that the blood becomes impoverished. The albumen and fibrin of that fluid are affected. They are diminished, and you find in their place, a certain fatty substance, the composition of which I do not exactly know. Consequently, as a prominent symptom the body wastes and emaciates. The patient suffers from fever which is rather hectic in its character. The periosteum becomes affected and you then have a characteristic group of mercurial pains, bone pains worse in changes of the weather, worse in the warmth of the bed, and chilliness with or after stool. The skin becomes rather of a brownish hue; ulcers form particularly on the legs ; they are stubborn and will not heal. The patient is troubled with sleeplessness and ebullitions of blood at night; he is hot and cannot sleep; he is thrown quickly into a perspiration, which perspiration gives him no relief. The entire system suffers also and you have here two series of symptoms. At first, the patient becomes anxious and restless and cannot remain quiet; he changes his position ; he moves about from place to place; he seems to have a great deal of anxiety about the heart, praecordial anguish as it is termed, particularly at night. Then in another series of symptoms, there are jerkings of the limbs, making the patient appear as though he were attacked by St. Vitus' dance. Or, you may notice what is more common yet, trembling of the hands, this tremor being altogether beyond the control of the patient and gradually spreading over the entire body, giving you a resemblance to paralysis agitans or shaking palsy. Finally, the patient becomes paralyzed, cannot move his limbs, his mind becomes lost, and he presents a perfect picture of imbecility. He does all sorts of queer things. He sits in the corner with an idiotic smile on his face, playing with straws; he is forgetful, he cannot remember even the most ordinary events. He becomes disgustingly filthy, and eats his own excrement. In fact, he is a perfect idiot. Be careful how you give Mercury, it is a treacherous medicine. It seems often indicated. You give it and relieve; but your patient is worse again in a few weeks and then you give it again with relief. By and by, it fails you. Now if I want to make a permanent cure, for instance in a scrofulous child, I will very seldom give him Mercury; should I do so, it will be at least only as an intercurrent remedy.
I have placed on the board in tabular form, a list of the mercurial salts together with the parts of the body on which they act. Wherever you notice the cross, you know that the preparation acts on the part of the body placed on that line under the heading of Mercurius vivus. This table is only a convenient form. There is nothing practical or scientific in it.
Taking Mercurius vivus as a type of the whole, as an individual remedy in fact, we find that it is indicated in persons who are of a scrofulous habit, whether of syphilitic constitution or not, in whom the glandular system is active. This glandular activity shows itself in two ways. In the first place, we may have a condition simulating plethora. In more advanced stages, we may find Mercurius indicated in enlarged glands with emaciation and deficiency of blood. We find Mercurius, too, indicated in scrofulous children who have unusually large heads with open fontanelles, particularly the anterior fontanelles. They are slow in learning to walk, the teeth form imperfectly or slowly, the limbs are apt to be cold and damp, and there is a damp clammy feeling to the limbs. You may distinguish from CALCAREA, SILICEA and SULPHUR by these characteristics: The head is inclined to perspire in the Mercurius case but the perspiration is offensive and oily. It is not as often indicated as Calcarea, Silicea or Sulphur, nor is it as certain or as permanent in its effects. But it may come in as a remedy to partially relieve, and it may be indicated as an intercurrent remedy in a course of treatment with Sulphur, when the latter remedy seems to fail. You will find the Mercurius patient illustrating plethora with anxiety and restlessness, tossing about, moving from place to place. It is one of the remedies useful for nostalgia or home-sickness. The patient becomes anxious and irritable. This anxiety seems as if it were in the blood, that is, it is always attended with ebullitions of blood. That distinguishes it from other remedies.
The congestions of Mercurius indicate it after BELLADONNA. There are resemblances between the two remedies, which have been well confirmed clinically. It often follows Belladonna in inflammations, even in inflammation of the meninges of the brain when, as under Belladonna, there are the same hasty speech and the quick nervous talking; the child talks so rapidly that one word runs into another. Its manner is just as quick and nervous as its speech. You will find the face flushed very much as in Belladonna, but you have, in addition, to distinguish it from that remedy, glandular swellings, and tendency to sore mouth.
You find Mercurius often indicated in catarrhal or gastric fevers when the face is puffed, when the throat is swollen, both internally and externally, from involvement of both glands and cellular tissue; when there are aching pains in the joints, which are rendered worse by the warmth of the bed and are not relieved by sweat. In addition to this you almost always find, that there is a tendency to catarrh of the bowels. This is characterized by slimy bloody stool, accompanied by great tenesmus, this tenesmus not ceasing after stool. Here, too, you: find Mercurius to follow Belladonna.
We find Mercurius indicated in haemorrhages. It is often called for in nose-bleed or epistaxis, particularly when the blood coagulates and hangs from the nostrils like icicles. This is a useful hint. Suppose that in a full-blooded patient, a boy at the age of fifteen or sixteen, when congestions are so frequently noticed, or that in a scrofulous child, nose-bleed appears. You have given Belladonna, Hamamelis, and Erigeron, and have failed to check it. The blood is quite bright, and runs in streams. Medicines do not stop it. Then comes this Mercurius condition. You give that remedy and cure, not only that attack, but you prevent the return of others. The same indications apply to uterine haemorrhage or menorrhagia when the flow is profuse, dark and clotted. Then, if the other symptoms agree, glandular swelling, sore mouth, etc., Mercurius is certain to be the remedy.
We find Mercurius often indicated in pneumonia. Here it requires that the right lung be affected, and that there are also icteroid symptoms. The skin is yellow. There is sharp stitching pain through the lower portion of the right lung. There will be other symptoms peculiar to pneumonia present, but these need not be specified separately.
We find it indicated in peritonitis, and here it follows Belladonna when suppuration has commenced and you have tympanitic abdomen, some evidence of effusion, which will be partly serous and partly purulent, sweat, rigors, etc. Here Mercurius comes in and prevents the further spread of the suppurative process.
Another condition in which we may use Mercurius is one of inflammation in which suppuration has occurred, whether the disease be a boil, a tonsillitis, or any other form of inflammation. We here find Mercurius connected with an interesting little group of medicines which you will use very often; they are BELLADONNA, HEPAR, MERCURIUS, and LACHESIS. To these we may also add SILICEA and SULPHUR. We prefer Belladonna in the beginning of inflammation as in tonsillitis. The throat is bright red and swollen, and there are difficulty in swallowing fluids, and sharp pains through the tonsils.
You should change to HEPAR when the sharp sticking pains and chills indicate the beginning of suppuration. It may prevent suppuration when given in the incipiency of that process.
MERCURIUS is suited to a still more advanced state when pus has formed and you wish it evacuated. If you give it too soon you will spoil the case. Mercurius does not prevent the formation of pus, but rather favors it. In felons, if it is given low, it will generally favor the rapid formation of pus.
SILICEA follows Hepar better than does Mercury when pus continues to discharge and the wound refuses to heal. In some of these cases, the benefit under Silicea will cease. Then a dose or two of Sulphur will excite reaction and the Silieea can effect a cure.
LACHESIS is indicated when the pus degenerates and becomes of a dark, thin, offensive character.
Mercurius vivus we find indicated in inflammations in and about the eyes, usually of scrofulous or syphilitic origin. We find that the patient suffers from the glare and heat of the fire, consequently he avoids the fire and warm rooms. You sometimes find it indicated in blepharitis of men who work in and about fires, as foundrymen. The pains are usually worse at night. The lids are thickened, especially at their tarsal edges, and the eyes discharge a thin acrid muco-pus. This makes the cheeks sore, and you find little pimples scattered over the cheeks. Ulcers may form on the cornea. These ulcers are usually superficial, and have an opaque look as though pus were between the corneal layers. In syphilitic iritis Mercurius solubilis will be sometimes indicated when there is hypopyon. Now let us distinguish between this and other preparations of Mercury.
The Biniodide of Mercury is indicated in inflammations of the eye. The symptoms are very similar to those of "vivus," but there is more glandular swelling under the Biniodide.
The Protoiodide is more frequently indicated in eye diseases than is the Biniodide. It is called for in corneal ulcers, which look as if they had been chipped out with the finger nail. There is usually, when it is the remedy, a thick yellow coating on the base of the tongue, the anterior portion being clean and red.
MERCURIUS DULCIS, or calomel, is selected more by its general symptoms, which are these: It is indicated in scrofulous children who are pale, and who have swelling of the cervical and other glands. The skin is rather flabby and ill-nourished. The flabby bloatedness and pallor are the indications for calomel.
Next to this we have Bichloride of Mercury or Mercurius corrosivus. This is indicated in inflammatory symptoms of the most violent character. There is no mercurial that produces such intense symptoms as does the Bichloride. It produces burning agonizing pains, with most excessive photophobia, and profuse excoriating lachrymation, making the cheeks sore, almost taking the skin off, so excoriating is it. There are tearing pains in the bones around the eye. There is ulceration of the cornea, with tendency to perforation. In such cases you will, as a matter of course, have hypopyon. Mercurius corrosivus is almost a specific for syphilitic iritis. If the symptoms of the case do not point to some other drug as the remedy, you should give it in this disease. If you choose to use atropia locally, do so in order to prevent the adhesions which will otherwise almost inevitably take place in these cases. You will also find Mercurius corrosivus indicated in retinitis albuminurica.
CINNABARIS is next. That is a remedy for a variety of inflammations of the eye. I will only give you one symptom for it, and that is pain which shoots across the eye from canthus to canthus, or seems to go around the eye.
Next, the action of Mercury on the nose. We find Mercurius vivus indicated in catarrhs of the nose and throat, which are provoked by damp, chilly weather and by the damp cool evening air. The nose itches and burns and feels stuffed-up; with this there is thin coryza. The throat feels raw and sore. There is aching in the various joints. These are the symptoms which will indicate Mercurius, both as to their exciting cause and as to the symptoms present. You may have with these a hot feeling. The face flushes up and gets red, perspiration breaks out but it gives no relief. There is another form of coryza in which you may give Mercurius, and that is when the cold is "ripe," when the discharge from the nose is yellowish-green, thick, and mucopurulent.
Here it rivals PULSATILLA, which is also useful for these thick, yellowish-green nasal discharges. Pulsatilla, independently of its other symptoms, is distinguished by the fact that the discharge is never irritating, but is perfectly bland.
You are also to distinguish Mercurius from NUX VOMICA, which is suited to coryza caused by exposure to dry cold, and when there are soreness, roughness, and a harsh, scraped feeling in the throat. Mercurius always has a smarting, raw, or sore feeling.
Now the throat symptoms of Mercurius vivus may lead you at times to think of it in diphtheria. Think of it as much as you choose, but think of it only to reject it. It is not indicated in diphtheria. I do not believe it indicated even in diphtheritis. But there are preparations which may be used here. We first notice the Mercurius biniodatus. Both the Biniodide and the Protoiodide of Mercury are indicated in diphtheritic sore throat, or even in true diphtheria. The Biniodide is of use when the membrane is on the left side, when the left tonsil is inflamed and there is a yellowish-gray membrane forming there. The glands of the neck are swollen. There is also some involvement of the cellular tissue around the throat. The patient may have an accumulation of slimy or sticky mucus in the mouth and throat. The symptoms are worse from empty swallowing. The simple attempt to swallow saliva excites more pain than does the swallowing of food.
The Protoiodide of Mercury is more to be thought of when the deposit begins on the right side of the throat, with swelling of the glands in the neck and with the accumulation of this tenacious mucus in the throat. Here there is almost always present that thick, yellow, dirty coating on the base and posterior part of the tongue, the tip and sides of that organ being red. These two remedies are often indicated in diphtheria and diphtheritic sore-throat.
Next you will notice the Cyanide of Mercury, which is a combination of hydrocyanic acid and mercury. We have in this drug one of the very best remedies in diphtheria, especially when it is of a true adynamic or malignant type. By reason of the presence of the prussic acid you will find it indicated in cases in which the patient is very much prostrated from the beginning. The pulse is quick. It may be as high as 130 or 140, and it has no volume to it at all. The membrane at first is white, covering the velum palati and tonsils. The glands soon begin to swell, however, and then the membrane becomes dark, threatening even to grow gangrenous. Weakness is extreme. The breath is foetid. There is loss of appetite. The tongue is coated brown, or, in severe cases, even black. Nose-bleed sets in, and this you know is a dangerous symptom. It may also be used in diphtheria of the larynx. The expectoration is thick and ropy. There is harsh, barking, croupy cough, with dyspnoea. Here, too, the Cyanide of Mercury has saved life, but it will not always do so.
You will notice its resemblance to KALI BICHROMICUM in diphtheritic croup. The resemblance lies in the position of the disease, that is, in the larynx and in the thick, tough, tenacious expectoration. The distinction lies in this: The Cyanide of Mercury has great weakness. Now this weakness is not a simple prostration which should come from the efforts of the child at breathing. It is due to poisoning of the blood, which is represented by the blueness of the surface, coldness of the extremities, and quick, weak pulse. If you have not these, Kali bichromicum is to be preferred.
CINNABARIS is a remedy not often thought of in catarrhal troubles. It is indicated in nasal catarrh when there is great pressure at the root of the nose, a feeling as though something weighty was pressing on the nose, a heavy pair of spectacles for instance. We also frequently find throat symptoms with this form of catarrh. The throat is swollen and the tonsils are enlarged and redder than normal. There is great dryness in the throat, and this is more annoying at night, waking the patient from sleep. Remember this sensation across the bridge of the nose and the character of the throat symptoms in connection with it. These symptoms may occur in the syphilitic, in the scrofulous, or in persons in whom there is tendency to catarrh. We have found Cinnabaris of use in the sore throat of scarlatina, which is often diphtheritic in its character, when there is quite an accumulation of stringy mucus in the posterior nares. That symptom being prominent, Cinnabaris will be the remedy for the emergency.
I have used MERCURIUS CORROSIVUS successfully when the accumulation of mucus in the nose is quite thick ; in fact, almost like glue. In some cases of syphilitic disease of the nose, you find Mercurius corrosivus indicated from the fact that the ulcers perforate the septum of the nose. In these cases there are burning pains, the discharges are acrid, corroding the tissues over which they flow.
The throat symptoms of Mercurius corrosivus are very violent. I can conceive of cases where it would be required in diphtheria, and yet I have never given it in that disease. The uvula is swollen, elongated and very dark red. There is intense burning in the throat, just as intense in fact as that of ARSENICUM ALBUM, ARSENICUM IODATUM or CAPSICUM. This burning pain is rendered intolerable by any external pressure. It is accompanied by violent constriction of the throat. Any attempt to swallow, be the matters swallowed solid or liquid, causes violent spasm of the throat, with the immediate ejection of the solid or liquid.
You here recognize a resemblance to BELLADONNA in the spasmodic character of the symptoms. Mercurius corrosivus is at once distinguished from Belladonna by the inflammatory tendency of the symptoms as indicated by these extreme burning pains. Thus it has the constrictive quality of the Belladonna PLUS the most intense, destructive inflammation of the throat. You may further distinguish between the two remedies by the pulse. In Mercurius corrosivus the pulse is quick, weak, and irregular, and not full and strong as under Belladonna.
Next, a word or two about the Mercuries in their action on the genitals and the glands. The Mercuries have long been used in the treatment of syphilis. Mercurius solubilis or vivus is indicated in primary syphilis for the so-called soft chancre or chancroid. The ulceration is superficial rather than deep, and the base of the sore has. a dirty, lardaceous appearance. Mercurius sol. has produced such an ulcer as this, and, therefore, it ought to cure it. The sore throat which often ushers in the syphilitic fever six or seven weeks after the appearance of the primary lesion, is also found under Mercurius solubilis.
The IODIDES OF MERCURY are the preferable remedies for the Hunterian or hard chancre. That is a form of ulcer which the Protoiodide and Biniodide have both produced, therefore they will cure it. There is no necessity whatever for such external applications as caustics, for the proper internal remedy if it does not entirely prevent the onset of secondary symptoms will at least lessen their intensify.
MERCURIUS CORROSIVUS is to be preferred to any of the drugs mentioned for syphilitic symptoms when the ulceration is very destructive. The ulcer is serpiginous; it has a ragged edge, eating out and destroying in a FEW days nearly half the penis.
Secondary syphilis may be treated with one or the other of these preparations, if the drug has not been abused in.the primary stages.
Mercurius solubilis very quickly helps those syphiloderms on the palms of the hands. They are red, itch slightly, and scale off.
Returning to Mercurius vivus, I want to say a few words concerning its use in diseases of the liver. The tongue is coated a dirty yellowish-white, and takes the imprint of the teeth. There are scorbutic symptoms frequently present. The gums ulcerate and become spongy. There is a foetid or disagreeable odor from the mouth. The skin and conjunctiva have a well-marked jaundiced or icteroid hue. There is tendency to rush of blood to the head. The region of the liver is sore to the touch. The abdomen is rather tympanitic and swollen, particularly across the epigastrium and in either hypochondrium. The patient cannot lie on the right side. You will find the liver enlarged and often indurated. The stools are either clay-colored, from absence of bile, or there are yellowish-green bilious stools, passed with a great deal of tenesmus and followed by a "never-get-done" feeling.
Mercury is indicated in dysentery, especially when it occurs in a season when warm days are followed by cold nights.
NUX VOMICA has many resemblances to Mercurius, but it differs in that the pains and tenesmus usually cease after stool; whereas, with Mercurius they continue after stool.
ACONITE often precedes the exhibition of Mercury in the weather I have spoken of, hot days followed by cold nights. In the incipient stages, such troubles may be checked by Aconite. If Aconite fails, then Mercurius will be indicated. Often, after the tenesmus and blood have ceased, and the mucus still persists, SULPHUR will be the remedy.
There is another remedy to be remembered in connection with Mercury in bilious troubles, and that is Leptandra. Both of them have these yellowish-green stools, and stools black like pitch, and horribly offensive stools. The distinction lies here: Leptandra has urging to stool, griping continuing after stool, but not the tenesmus. Leptandra frequently has dull, aching, burning pains in the posterior portion of the liver.