THE VIRTUES OF FEW DRUGS have been so highly vaunted as the supposed virtue of sarsaparilla; scarcely any drug in the Pharmacopoeia is now so much neglected.

In some instances, drugs are discarded for good reasons; they are the invention of a day. In other instances, success depends upon a number of conditions which it is difficult to unite, and methods of treatment fall into disuse on account of some complexity in the conditions of their use rather than on account of any worthlessness in themselves.

The adoption and disuse of sarsaparilla, however, have no such excuse as this; the revelation of its virtues is to be had with little trouble and under simple conditions, and its disuse has been due only to a curious result of routine. The fact is, the antisyphilitic effects of sarsaparilla depend upon the dose in which it is given. The treatment has been in use for a quarter of a century at least in the Leeds Infirmary and no one has yet published the results.

The remedy is used by us as a decoction, which is made in the infirmary in large quantities. Of this decoction, we administer from four to ten ounces three times a day, or prescribe some such quantity as a pint or a pint and a half to be taken at will during the twenty-four hours. This medication is expensive no doubt, but treatment is the cheapest which most quickly cures the patient.

The cases in which sarsaparilla is most useful are cases in which the system is thoroughly infected with syphilis, during the tertiary and visceral modes of its appearances.Two cases will do to illustrate my opinions.

The case of the laundress prostitute

Jane is nominally a laundress, and by practice a prostitute. She is evidently worn down by excesses and irregularities, and will soon be worn out. Her face is sallow and wan, her frame is wasted, her voice is hoarse, her hearing is dull. She has enlarged hard glands in her neck and groin, scars at the angles of her nose and mouth, coppery tubercles about the forehead and eyebrows, a lump of  gummous matter in the calf of the right leg, nodes on her tibiae and open ulcers on her face and upon her legs. These ulcers are large, numerous, indolent, and characteristic.

She makes no secret of her disease, and dates its origin several years ago. She “has had mercury”, and her gums bear the traces of it; her irritable tongue and stomach, her anorexia, and her wasting seem to warn us against the iodides.

She took sarsaparilla, beginning with half a pint a day, and increased the dose to one pint daily. On this treatment her complexion cleared, the ulcers contracted and healed, she gained flesh and appetite, and in two months she was restored to something like good health.

On account of the expense of the drug I often wished to change it for the iodides of iron and potassium, but having found the benefit of the sarsaparilla she begged me not to omit it, and recognized its virtues with the greatest gratitude.

The gentleman of fortune

Mr ------, a gentleman of fortune, who enjoyed every advantage in conditions of life and skilled advice, had never been able to shake himself free from an old syphilis. He had no cutaneous eruption of importance, but was spare, haggard, and sallow; his hair fell out, his appetite was capricious his bowels irritable and his strength deficient.

He was liable also to neuralgias, which were really dreadful, often amounting to great agony. They were chiefly cranial, but also of the nocturnal tibial variety. There were many irregularities of the cranium and of the flat bones.

Mercury and iodides, though administered under first-rate advice both in England and in Germany, had failed to relieve him; for they were so ill borne that no continued course could be prescribed, whether combined with tonics and nutrients or alone.

I advised him to lay in a quantity of sarsaparilla, and to have the decoction made at home, so that he might take it in quantities daily. He took at most about two pints daily of the Pharmacopoeia strength, and he took this for about three months. Altogether he took more or less sarsaparilla for about five months. He found his improvement so satisfactory that I had no difficulty in persuading him to continue the treatment. His general nutrition improved first, and the “cachexia” abated; his neuralgic pains  gradually diminished and disappeared.

Since this time nearly two years have elapsed, and he has remained healthy and vigorous beyond the average of men, being able to hunt four days a week and to carry out many important engagements without any sign of fatigue.

Such is our mode of administering sarsaparilla at the Leeds Infirmary, and such are the cases which need it. I hope soon to hear that our practice has been found useful by our brethren elsewhere.