Home' Australian Pharmacist : April 2011 Contents Vol. 30 -- April #04
used to treat syphilis. As mentioned
above, one of the adverse effects of
mercurials was to produce excessive
saliva. When used in primary or
secondary syphilis, the mercurials
were pushed to the point of
Calomel was also widely used in
syphilis, but it was more regarded as
an important diuretic, liver stimulant
and agent used to promote the flow
of bile as well being a commonly
used laxative. Calomel was used for
both adults and children and was
prescribed in doses of up to 5 grains
(32 mg) for an adult.
As will be seen from Table 1,
prescriptions containing calomel made
up more than half the total number of
prescriptions containing mercurials.
In fact, if one medical practice had
not changed hands during 1917, the
number of prescriptions for calomel
would have been much greater. The
man who took over that practice still
used mercury but preferred to give
Grey Powder to children.
External use of mercurials
Because it could be absorbed through
the skin, metallic mercury in the form
of an ointment (about 50% mercury
in a fatty base) was widely used as an
external application in the treatment
of syphilis. A piece about the size of a
pea was rubbed onto the inside of the
thigh or applied on flannel to the skin.4
Excluding the external use of metallic
mercury in syphilis, the most
commonly used external mercurial
preparation was mercuric chloride.
It was mainly used as a disinfectant,
as a powerful antiseptic for cleaning
ulcers and to treat fungal disorders
such as ringworm. It was used in a
dilution of as little as 1 part in 10,000
as an antiseptic or as a 1 in 1000
solution to cleanse ulcers, especially
those due to syphilis. Another
powerful antiseptic of the time was a
solution of the red iodide of mercury --
mercury biniodide, HgI2.
Table 1 also shows the 25
prescriptions for external use. The
yellow oxide of mercury ointment was
used in skin infections and a weaker
Table 1. Mercurial preparations in the prescription register
A of Perry's Pharmacy. The names in the first column are
as used in the prescription register. 'MHP' is Melbourne
Adult Child Total Common name
Pil. Hydrargyri Laxans (MHP)
Pil. Calcium et Hydrargyrum
Pil. Hydrargyri, digitalis et
Hydrargyrum cum Cretae
Mercury and Chalk Pill
Pil. Diuretica (Guy's Pill)
Unguentum Hydrargyri Oxidi
Ung. Hyd. Oxid. Flav. Diluti
Ung. Hyd. Iodidi Rubri
Ung. Hyd. Sububchloridi
Ung. Hyd. Ammoniati
Ung. Hydrargyri Compositi
Ung. Hydrargri Nitrati
Yellow Oxide of Mercury
Golden Eye Ointment
Red Iodide of Mercury
(1%) preparation was the basis of
'Golden Eye Ointment', used until
quite recently for the treatment of
conjunctivitis and other eye infections.
Another widely used mercurial (12
items in the register) was ammoniated
mercury or 'White Precipitate'
Ointment. This was used to treat skin
parasites, fungal infections and skin
infections in children. This, too, stood
the test of time and was used until
quite recent times.
Mercury and mercurials played a
significant therapeutic role a century
ago. Mercury and its preparations
were still an extensively used
treatment for syphilis because the
arsenicals, such as Salvarsan, were
introduced only in 1910.2
It should be pointed out that in 1916
mercurial diuretics and the well known
antiseptic mercurochrome were yet
to be discovered5 so other mercury-
based agents were used to treat
skin infections, dropsy and childhood
conditions such as teething.
Thus it is not really surprising
that in 1916 there were so many
prescriptions for mercurials. In the
context of the times, Bruce was right:
it was a drug 'of the first therapeutical
1. Prescription Register A, Perry's Pharmacy,
Murrumbeena, Victoria 1916--1917.
2. Harrison, LW. The diagnosis and treatment of venereal
diseases in general practice. 3rd ed. London: Oxford
Medical Publications; 1921.
3. Bruce JM. Materia medica and therapeutics: an
introduction to the rational treatment of disease. 4th ed.
London: Cassell; 1886.
4. Bruce JM, Dilling WJ. Materia medica and
therapeutics: an introduction to the rational treatment
of disease. 9th ed. London: Cassell; 1912.
5. Vogl A. The discovery of the organic mercurial diuretics.
Am Heart J. 1950; 39:881--3.
6. Goodman LS, Gilman A. The Pharmacological Basis
of Therapeutics. 4th ed. New York: Macmillan; 1970.
7. Shoemaker HA. The pharmacology of mercury and its
compounds. Ann NY Acad Sci. 1956; 65:504--10.
8. Clarkson TW. The pharmacology of mercury
compounds. Ann Rev Pharmacol. 1972; 375--406.
9. Martin J. Diseases of Men and Women. Sydney: RE
10. Children's Hospital Pharmacopoeia. Melbourne; 1950.
11. Melbourne Hospital Pharmacopoeia. 12th edn. 1916.
12. Cheek DB, Hicks CS. MJA. 1950; i:107.
13. Hicks CS. Some typical data from cases of Pink
Disease. BMJ. 1951; i:317--22.
14. Dally A. The Rise and Fall of Pink Disease. Soc Hist
Med. 1997; 10(2):291--304.
15. Pharmacopoeia of The Children's Hospital.
Links Archive March 2011 May 2011 Navigation Previous Page Next Page