Part 49

ARABS USED MERCURY MEDICINALLY.

The Arabs, who inherited the medical lore of the Greeks, and probably added to this in the case of mercury knowledge acquired from India, were much interested in mercury. In the chemical works attributed to Geber not only the metal itself, but its compounds, red precipitate and corrosive sublimate, are described. Much use of mercury was made by the Arabs in the form of ointments for skin diseases, for which Mesuë recommended it, and Avicenna was probably the first physician to express doubt in regard to the poisonous nature of the metal. He observed that many persons had swallowed it without any bad effect, and he noted that it passed through the body unchanged.

MERCURY PRESCRIBED INTERNALLY.

Fallopius (1523-1562) remarks that in his time shepherds gave quicksilver to sheep and cattle to kill worms, and Brassavolus (1500-1554) states that he had given it to children in doses of from 2 to 20 grains, and had expelled worms by that means. Matthiolus (died 1577) relates that he had known women take a pound of it at a dose with the object of procuring abortion, and says it had not produced any bad result.

FRICTIONS AND FUMIGATIONS.

Sprengel fixes the year 1497 as that in which mercury was first employed externally for the cure of syphilis. Frictions, fumigations, and plasters were the earliest forms in which it was employed. Berenger de Carpi, a famous surgeon and anatomist of Bologna, who practised in the early part of the sixteenth century, is said to have made an immense fortune by inventing and prescribing frictions with mercurial ointment for syphilis. John de Vigo was a strong partisan of fumigations in obstinate cases. His fumigations were made from cinnabar and storax. It is not quite clear whether this physician gave red precipitate internally in syphilis. He expressly indicates its internal use in plague.

MERCURY A REMEDY FOR SYPHILIS.

Peter Andrew Matthiolus, born at Sienna in 1500, died at Trent in 1577, latterly the first physician to the Archduke Ferdinand of Austria, a botanist and author of “Commentaries on Dioscorides,” was, according to Sprengel, the first who is known for certain to have administered mercury internally. Paracelsus, however, was without doubt the practitioner who popularised its use. He gave red precipitate, corrosive sublimate, and nitrate of mercury, and describes how each of these was made. Sprengel credits him also with acquaintance with calomel, but other authors do not recognise this in any of his writings.

VIGO’S PLASTER.

The Emplastrum Vigonium was a highly complicated compound, which was held in great veneration and is the subject of innumerable comments in the pharmaceutical writings of the sixteenth, seventeenth, and eighteenth centuries. Charas, Lemery, Baumé, and others modified and simplified it. John de Vigo was a native of Naples, where he was born about 1460, and he became the first physician of Pope Julius II. His plaster still figures in the French Codex, and contains 600 parts of mercury by weight in 3,550 parts. This made into a liquid with olive oil and spread on calico makes the sparadrap of Vigo, in which form it is most frequently used, as an application to syphilitic eruptions.

Ambrose Paré gives the earliest formula for Vigo’s plaster, which was then called Emplastrum Vigonium seu de Ranis. It was looked upon as a masterpiece of combination. First 3½ oz. of earthworms were washed in water, and afterwards in wine. Then they and twenty-six live frogs were macerated in 2 lb. of odoriferous wine, and the whole was boiled down to two-thirds of its volume. A decoction of camel’s hay (andropogon schœnanthus), French lavender, and matricaria (chamomilla) was then mixed with this wine. Meanwhile 1 lb. of golden litharge had been “nourished” for twelve hours with oils of chamomile, dill, lilies, and saffron; these were melted down with 1 lb. each of the fat of the pig, calf, and viper. Human fat might be used instead of that of vipers. Juices of elder root and of elecampane with euphorbium, frankincense, and oil of spike were then worked in and the whole melted with white wax. Lastly, quicksilver extinguished by turpentine, styrax, oil of bitter almonds, and oil of bay, were added. In Lemery’s time the minimum proportion of mercury was 1 drachm to 1 oz. of the plaster. There was also a simple Vigo’s plaster made without mercury. In the Codex formula the worms, the frogs, the fats, the herbs, roots, and oils have all gone, but some more aromatic resins are added.

THE FIRST MERCURIAL PILLS.

The first formula for mercurial pills was one which Barbarossa II, a famous pirate and king of Algiers, and admiral of the Turkish Fleet under Soliman, Sultan of Turkey, sent to Francis I, king of France, some time in the second quarter of the sixteenth century. The recipe was published (says Dr. Etienne Michelon, of Tours, in his “Histoire Pharmacotechnique de Mercure”) in 1537 by Petrus de Bayro, physician to the Duke of Savoy. He does not give the exact formula, but Lemery quotes it as follows:--

“Best aloes, and quicksilver extinguished by rose juice, aa 6 drachms;

“Trochises of agaric, ½ oz.; selected rhubarb, 2 drachms;

“Canella, myrrh, mastic, aa 1 drachm; musk, amber, aa 1 scruple;

“Make a mass with Venice turpentine.”

Lemery says you cannot kill the mercury with rose juice, but must use some of the Venice turpentine.

These pills were largely used in syphilis, but they were practically superseded later by the pills of Belloste, which are still official in the French Codex. These were very similar. Belloste was a French Army surgeon, and his formula was devised about the year 1700. A formula for them was published in the Pharmacopœia of Renaudot during Belloste’s lifetime, but after the death of Belloste in 1730 his son tried to make a mystery of the pills and sold them as a proprietary product, which probably had the effect of making them popular. The formula of Renaudot, which is also that of the Codex, was: Mercury, 24 (killed with honey); aloes, 24; rhubarb, 12; scammony, 8; black pepper, 4. Made into pills, each of which should contain 5 centigrams of mercury.

THE TREATMENT OF SYPHILIS.

It was at the close of the fifteenth century that syphilis began to spread through Europe. There are doubtful evidences of its existence in both Europe and Asia long previously, but the theory is generally accepted that it was brought from America by the sailors of the earliest expeditions, while its rapid spread throughout the old world in the decade from 1490 to 1500 has often been attributed to the Spanish Jews in the first place, and also particularly to the siege of Naples by the French in 1495. That large numbers of the French soldiers then engaged contracted it in the course of that war is undoubted, and as they were largely instrumental in spreading the contagion the disease soon came to be known as the French disease, or morbus Gallicus, though it has been questioned whether the adjective was not originally a reference to the skin diseases known under the name of “gale” or “itch.” The opinion that syphilis came from the west is not universally adopted. It has been pointed out that Columbus only reached Lisbon on March 6, 1493, on his return from his first voyage of discovery; and there are several more or less authentic allusions to the French disease before that date.

The rapidity with which this epidemic seized on all the countries of Europe, and the virulence of its symptoms, alarmed all classes and staggered the medical men of the day. Special hospitals were opened and Parliamentary edicts were promulgated in some of the French and German cities, ordering all persons contaminated to at once leave the neighbourhoods. Mercury was one of the first remedies to suggest itself to practitioners. It had been employed by the Arabs in the form of ointments and fumigations for skin diseases, and quacks and alchemists had long experimented with it in the hope of extracting a panacea from it. Before Paracelsus had begun to administer it, Torrella, physician to the Borgias, had prescribed mercurial lotions made from corrosive sublimate, and Jean de Vigo, of Naples, had compounded his mercurial plaster, and mercurial ointment, and had even given red precipitate in pills.

At the time when syphilis was causing excitement through Europe sarsaparilla and guaiacum were much praised as sudorifics, and wonderful cures of syphilis by them were reported. The poet and reformer Ulrich von Hutten wrote a book, De Morbo Gallico, in which he related his own years of suffering from the disease, and his complete cure by means of guaiacum in 30 days. “You may swallow these woods up to the tomb,” said Paracelsus. He had not much more respect for fumigations with cinnabar, which he regarded as a quack treatment by which it was impossible to measure the dose of the mercury, though he recognised that it cured sometimes. Red precipitate with theriacum made into pills with cherry juice was his favourite remedy, and was one of his laudanums. His Catholicon, or universal panacea, was a preparation of gold and corrosive sublimate, which was largely used by his followers under the name of Aurum Vitæ.

Corrosive sublimate was the great quack remedy for syphilis for more than a century, and the so-called vegetable remedies, syrups and decoctions of guaiacum, sarsaparilla, and sassafras, maintained their reputation largely in consequence of the perchloride of mercury, which was so often added to them. Aqua Phagadænica, 1 drachm of corrosive sublimate in 1 pint of lime water, was a very noted lotion for venereal ulcers. It began from a formula by Jean Fernel, a Paris medical professor and Galenist (1497-1558), who dissolved 6 grains of sublimate in 3 oz. of plaintain water. This was known as the Eau Divine de Fernel. By the time when Moses Charas published his Pharmacopœia this lotion had acquired the name by which it was so long known, and was made from ½ oz. of sublimate in 3 lb. of lime water, and ½ lb. of spirit of wine. It yielded a precipitate which varied in colour from yellow to red.

A curious controversy prevailed for a long time among the chemical and medical authorities in France in regard to a popular proprietary remedy for syphilis known as Rob Boyveau-Laffecteur. It was sold as a non-mercurial compound. It was first prepared or advertised in 1780 by a war office official named Laffecteur, whose position enabled him to get it largely used in the army. Subsequently a Paris doctor named Boyveau bought a share in the business, but in time the partners separated, and both sold the Rob. Boyveau wrote a bulky volume on the treatment of syphilis, and in that he strongly praised the Rob. After the deaths of Laffecteur and Boyveau the business came into the hands of a Dr. Giraudeau, of St. Gervais. This was about the year 1829. In 1780 the Academie de Medicine had examined this preparation, and had apparently, though not formally, tolerated its sale. Their chemist, Bucquet, had been instructed specially to examine the syrup for sublimate. He reported that he could not find any, but he was by no means sure that there was none there, for he stated that he had himself added 2 grains to a bottle, and could not afterwards detect its presence. Between that time and 1829 several chemists studied the subject, and came to the conclusion that if corrosive sublimate had been added to the syrup the vegetable extractive or the molasses with which it was made so concealed it or decomposed it into calomel that it could not be detected. In 1829 Giraudeau was prosecuted for selling secret medicines, and for this offence was fined 600 francs. But the interesting feature of this trial was the testimony of Pelletier, Chevallier, and Orfila that the Rob contained no mercurial. They reported that the formula given by the maker might be the correct one, but that in that case the mixture would contain too small a quantity of active substances to possess the energetic properties claimed for it. Guaiacum and sarsaparilla were the principal ingredients, but there were also lobelia, astragalus root, several other herbs, and a little opium. The history of this discussion is related at some length in Dr. Michelon’s “Histoire Pharmacotechnique et Pharmacologique du Mercure” (1908).

RED PRECIPITATE.

Red precipitate was one of the first preparations of mercury known. It is traced to Geber, but when the works attributed to that chemist were written is doubtful. Avicenna in the tenth century was acquainted with it. In his writings he says of the metal mercury that “warmed in a closed vessel it loses its humidity, that is to say its liquid state, and is changed into the nature of fire and becomes vermilion.” Being obtained direct from mercury acted on by the air, it became known to the early chemical experimenters as “precipitatus per se.” Paracelsus obtained it by acting on mercury with aqua regia and heating the solution until he got the red precipitate. Then he reduced it to the necessary mildness for medicinal purposes by distilling spirit of wine from it six or seven times. Charas described a method of obtaining the precipitate by nitric acid but by a complicated process, and to the product he gave the name of arcana corallina. Boyle obtained the red oxide by boiling mercury in a bottle fitted with a stopper which was provided with a narrow tube by which air was admitted. The product was called Boyle’s Hell, because it was believed that it caused the metal to suffer extreme agonies.

OTHER MERCURIAL PRECIPITATES.