SYPHILIS. 
BY 
WM. F. BARCLAY, M. D., 
PITTSBURGH, PA. 
Compliments of 
V. F. Barclay, fl. n„ n. D. SYPHILIS. 
BY WM. F. BARCLAY, M. IR, PITTSBURG, FA. 
Syphilis is an infectious disease that is believed to be of germ 
origin, but bacteriologists have as yet failed to definitely describe it. 
It is transmissible in its different stages. It affects the germs that 
enter into embryonic life, and thereby the protoplasmic development 
of every child who is so unfortunate as to have the spermatozoon or 
ovum of syphilitic progenitor or progenitors. 
It is the only disease that proves alike infectious to all persons, 
and has affected more members of the human race than any other 
disease. In its course it has produced more suffering than all other 
maladies. 
The leprous are placed beyond the pale of human society for its 
protection. It may be remarked that leprosy comes to its unfortunate 
victims without the transgression of any moral law of society. 
Syphilis is a much more infectious disease than leprosy, and it is 
believed more painful and loathsome. 
The larger number of syphilitics are the subjects of their own 
indiscretions, and are morally censurable. Many persons afflicted 
by the disease are innocent of having violated any moral laws of 
society, and are the legitimate victims of the transgressions of others. 
The infectiousness of syphilis cannot be overestimated, and society 
is becoming very fully aware of this truth and the dangers arising 
from contact with the toxic germs of the disease. The great preva- 
lence of the disease and the dangers from different means of infection 
have been pointed out so forcibly by the members of the medical 
profession that society recognizes the great danger of infection. The 
subject is already beyond that point where mention and discussion of 
it is forbidden in society and public print. It is freely discussed and 
measures have been adopted for the protection of the people. 
The precautions now being used, and the education of the people 
as to the dangers arising from the presence and carelessness of those 
afflicted with the disease, will bring about a demand on the part of 
the public for its protection, that those suffering from the disease be 
isolated. The churches, the religious and secular press are discuss- 
ing and pointing out the dangers arising from the commingling of 4 
syphilitics in society, and will not much longer tolerate the danger. 
It is impossible to point out all the means by which the toxic 
germs may be transmitted. The Bible used by those who affirm, the 
communion cup, drinking cups, bath tubs, towels, combs, surgical 
instruments, money, books, and many other ways through which 
infection might take place. Recently my attention was directed to 
this subject by a refusal on the part of a woman to employ a physician 
who gave professional care and treatment in houses of prostitution, 
not from a moral, but sanitary sentiment. 
History does not definitely point out the origin of the disease, 
but enough is known of it to definitely settle its antiquity. Conjec- 
ture as to its first cause is the merest speculation. We know no more 
about the original germs than we do of the first causes of any other 
contagious or infectious disease. It is a wise philosophy that studies 
its entrance into the body, its action upon the economy of life, and its 
transinissibility to others. To one who has carefully studied syphilis 
it is a hydra-headed enemy of the human race, and more to be 
dreaded than any other disease, and perhaps more than all other 
maladies. To be exposed to the toxic germs of pestilential disease, 
is to be dreaded, and there is a chance of immunity, but not so of 
syphilis. No one is exempt from its poisonous effects who has not 
already been impressed by it. The most learned observers who have 
had the largest experience entertain and hold the most diversely 
opposite views as to its pathology and treatment. To one unac- 
quainted with the disease the medical literature would confuse and 
confound the most learned and intelligent mind. The physicians and 
surgeons who have given the disease the largest consideration and 
most earnest study are unanimously of the same opinion as to its 
gravity. It may seem strange, but is nevertheless true, that a very 
limited number have attained any distinction in the care and success- 
ful treatment of syphilis. 
All authorities who have written on surgery have reviewed the 
literature of syphilis, but have added little to it that is important, and 
special writers very little except that which photography has made 
plain in the rare lesions of the skin which characterize certain mani- 
festations of the disease. Nothing can be more vague and misleading 
than the different views set forth on the subject of diagnosis. The 
expert opinions given as to chancroid and chancre—the former more frequently followed by constitutional symptoms than otherwise—is 
calculated to create a large distrust, on the part of the unfortunate 
patients, in the medical profession. The opinions given by physicians 
and surgeons as to cures effected are alike unreliable and calculated 
to create distrust in the knowledge and skill of the members of the 
medical profession. A very large part of the members of the medical 
fraternity believe, and teach, that syphilis is incurable (once a syphi- 
litic, always a syphilitic). My own observations lead me to the honest 
conclusion that irreparable wrong is done to the unfortunate sufferers, 
and that it is a stigma and shame to a learned profession, such as the 
medical should be, to have such persons in its membership. I believe 
that syphilis is curable when scientifically and judiciously treated. 
Any attempt to treat the disease without the necessary knowledge and 
skill to do so is an outrage upon suffering humanity, and very highly 
censurable. It is beyond the power of human knowledge and skill to 
prognosticate the course and manifestations in a case of syphilis, as no 
structure of the body is exempt from its ravages. The nervous system 
in recent years has seemed to afford more cases than in the past. I 
would remark that some methods of treatment now in use have seemed 
to me to be a fruitful cause of such results. 
Syphilis of the nervous system is the most dangerous to the well- 
being of life. Reason, the senses, locomotion, sensation, are likely to 
be impaired or destroyed. A prompt recognition of the symptoms and 
a correct diagnosis, with the best treatment, is all-important to the 
welfare of the patient. There is less consensus of opinions by writ- 
ers on syphilis than any other disease. Authorities in the past have 
advised that constitutional treatment should be deferred until positive 
symptoms of systemic poisoning were present. Recent observers ad- 
vise that the treatment, local as well as constitutional, should begin 
as early as possible after the local manifestation or lesion is observed. 
It is certainly established that this course arrests the disease in the 
primary stage. The germs are identical in the different stages of the 
disease, which is positively established by the results that follow the 
transplantation of the virus and the syphilization of the subject inoc- 
ulated. A logical reason for deferring treatment is difficult of com- 
prehension. It has been alleged that the arrest of the progress of the 
disease simply defers it until a later period, but such observations are 
not based on sound theoretical and scientific treatment. It is an old 
5 adage that one night spent with Venus oft requires several years with 
Mercury. Contact with the poison is all that is required for the in- 
oculation of the body; an abrasion of the skin or mucous membrane 
facilitates the admission of the germ—first, the implantation of the 
toxic germs; second, their absorption into the circulation of the 
blood; third, their action upon the nutrition of the body. Recent ob- 
servers declare that syphilis causes rapid tissue disintegration and 
waste of the body. Thirty-two men syphilized lost over 200 pounds 
in weight in the first sixty days after being poisoned. No two cases 
had exactly the same local and general symptoms, but all lost in 
weight. All had a rise in temperature at some period of the first sixty 
days. The lowest rise in temperature was one-half degree, and the 
highest was three degrees. Loss of appetite was present in all these 
cases. The lymphatic system was affected with glandular enlarge- 
ment and tenderness, preceding manifestations on the skin and mu- 
cous membranes. It is entirely problematical as to the most danger- 
ous phases of the disease, and beyond human wisdom and skill to 
prognosticate the course of the disease. Even when science and the 
largest experience are possible in a given case, the most unfortunate 
phases may arise and baffle the most skillful. The disease is sq preva- 
lent that the dangers seem not to be taken into consideration. It is 
transmitted in different ways, and the initial lesions are so slight that 
they are frequently unobserved. Ibi irritatifyibi fluxus, there is in- 
creased blood pressure at the point of entrance of the poison into the 
system. After the system is saturated the local manifestation disap- 
pears, the inguinal glands are surcharged with the poison and sup- 
puration frequently follows: otherwise there would be nothing, in 
many instances, to indicate that the system had been poisoned. All 
diseased germs of a toxic nature first enter the circulation and act up- 
on the normal cells. 
Ptomaines and leucomaines are the result of the introduction of 
toxics. Pathological conditions are the result of the disturbance of 
the nutrition of the body. All treatment must be directed toward the 
destruction of the first cause of disease and the normal elimination 
will throw off, through the emunctories, all effete matter. A restora- 
tion of the normal conditions when treatment is instituted is prirna 
facie evidence that the treatment is well directed. The prevalent 
opinion prevails that the suffering brought about by syphilis is mer- 
6 7 
ited by the transgression of the moral law of society, and that the vic- 
tim justly merits the physical punishment. Society fails to sympa- 
thize with those persons who suffer from syphilis, and it may be failly 
stated that this sentiment largely prevails in the medical profession. 
Science and humanity demand the same honest, earnest considera- 
tion from the medical profession that any other disease requires. 
Nothing short of the most profound knowledge, skill and sympathy 
for those suffering from syphilis is adequate and a just appreciation 
of personal responsibility. Thus far bacteriological research has 
failed to discover a germ that is diagnostic in syphilis. It would be 
a great advance in medicine if this were accomplished, and would for- 
ever put at rest the question of doubt as to correct diagnosis. It 
would determine the treatment and save the loss of valuable time, and 
in many instances avert much human suffering. 
TREATMENT. 
The synthetic union of several agents known to have the power 
to destroy the toxic germs of syphilis has been a great advance in the 
treatment of the disease. 
If the toxic germs of syphilis are the cause of the disease, then 
only those agents which devitalize the germs are curative. Gold, 
mercury, and arsenic are known to have the best curative powers of 
any agents, but the great objection to their single or combined use has 
been their poisonous effect upon the system. Many persons were un- 
able to take - sufficiently large doses for any length of time to derive 
much benefit from their use. From the known poisonous effects, 
there is a constant dread on the part of patients, partly real, and in 
many instances imaginary. From the complexities in the treatment, 
there is a large failure on the part of physicians and surgeons to even 
approach a reasonable success. Iodine in different combinations modi- 
fies the disease, but it is doubtful if it ever cured a single case. In 
the primary and secondary stages it is positively and certainly injuri- 
ous, and should never be administered. Lesions of the nervous and 
cutaneous systems are apparently brought about by the administra- 
tion of iodine in the first and second stages of syphilis. Gold, mer- 
cury and arsenic are curative, and can be depended upon when pro- 
perly administered in the different stages of the disease. Iron is pro- 
perly classed amongst the curative remedies in syphilis; it is certainly 
in many cases a valuable adjuvant in the treatment. The tartrate of 8 
iron and potash is beyond doubt the most valuable preparation of iron 
in the treatment of syphilis. A simple and useful formula is: 
Jt Ferri et potassi tart 
Glycerine (purai aa 1 oz 
Aqua dist.ad 7 oz 
M. Sig.: One teaspoonfal before eating. 
The preparation of medicine which has given the best results in 
the treatment of syphilis is the synthetic compound of gold, mercury, 
arsenic and bromine in solution—on account of brevity called Mer- 
cauro, to which I directed the attention of physicians in a short article 
in the Brooklyn Medical Journal in February, 1894. I am pleased 
that my observations have been verified by a very large number of 
the most distinguished physicians and surgeons. It is at this4 time 
a less embarrasing task to write of the use of this preparation of 
medicine in the treatment of syphilis than it was at that time. 
While I was certain in my own mind that the results were more satis- 
factory than I had observed from any other known medication, I 
realized that a modest conservatism would be more likely to cause 
physicians to give it a trial than a full and complete statement of the 
truth. I can now refer to a very large complimentary verification of 
my research and observation. In formulating a remedy to meet 
pathologic conditions we are governed entirely by the known action 
of medicines. All known remedies modify the action one of the 
other, and when combined it is by a careful and accurate observance 
of this law that we arrive at successful therapy. It is certain that the 
results in the treatment of syphilis by Mercauro are due to the com- 
pound, and cannot be attained by the administration of either of the 
metals when not in combination. The therajieutic application is 
simple, and no unpleasant effects have been observed, immediate or 
remote, from this treatment. The time required to bring about a 
modification of the symptoms and a cure of the disease would seem to 
place a distrust upon the permanency of the results obtained. The 
truth seems to rest in the statement that the fullest therapeutic effect 
is obtained from the toleration of the largest doses of these curative 
agents without unpleasant or injurious results to the system. 
April 3, 1895.