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JAMA 100 Years Ago
February 23, 2000


Author Affiliations

JenniferReiling, Editorial Assistant

JAMA. 2000;283(8):980. doi:10.1001/jama.283.8.980-JJY00002-3-1

In the treatment of syphilis it is sometimes desirable to bring the system speedily under the influence of mercury. This might be accomplished by means of subcutaneous injections, but for a number of reasons this method has not come into general employ. As large doses of mercury administered by the mouth are generally not well borne, and as absorption from the gastrointestinal tract is relatively slow, this route will not be employed when speedy physiologic results are acquired. The introduction of mercury through the skin by sublimation has never been popular, and is at present but little if at all employed. Inunction, however, appears to be one of the most efficacious and trustworthy, as well as simple and practicable modes of administering mercury. Kutnerding1 expresses the opinion that when this is applied to the skin it is not absorbed, as it has been shown that it is not present in the deeper layers, even after thorough rubbing, and he suggests that the effects produced are due to inhalation of the vapor of the metal. In support of this view he points out that the therapeutic results are obtained also when mercurial ointment is simply applied to the body, and not rubbed in, or when preparations of mercury are kept near or upon the body. Governed by these considerations, Kutner has patients placed in a closed chamber, in which, by means of an apparatus that they can control themselves, mercury is rubbed on different parts thereof and the vapor evolved inhaled. Heat can, if necessary, be employed, additionally, to increase the vaporization. Kutner suggests, further, that generating the vapor by the application of heat directly to metallic mercury may be better, but the danger of intoxication would have to be carefully guarded against, and the amount of mercurial vapor that can be inhaled with safety determined. Experimental observations have shown that by this means sufficient mercury can be introduced into the body within a reasonably short time to effect therapeutic results. It was found that after a few inhalations of half an hour daily sufficient mercury was taken up to be appreciable in the urine. The actual therapeutic application of the method has proved satisfactory, the mouth being rinsed with a solution of potassium chlorate after each inhalation, in order to prevent the development of stomatitis.