Prom N. V. Med. Times, June, iS().f. 
Some Remarks Concerning 
(Mercuric Bromide of Gold a>'d Arsenic.) 
MERCAURO. 
With Especial Reference to Its Use in the 
Treatment of Neurotic Conditions 
of Specific Origin. 
-BY 
THOMAS HUNT STUCKY, M. D., 
Professor Theory and Practice of Medicine and Clini- 
cal Medicine, Hospital College of Medicine. 
Read at a Meeting of Louisville Medico-Chirurgioal 
Society, April 1, 1894. Stenographically 
Reported by C. C. Mapes. 
Louisville, Ky., 
DANBURY CONN: 
DANBURY MEDICAL PRINTING CO, 
1894, Some Remarks Concerning Mercauro 
(Mercuric Bromide of Gold and 
Arsenic) with Especial Reference 
to Its Use in the Treatment of 
Neurotic Conditions of Specific 
Origin. 
THOMAS HUNT STUCKY, M. D., I.OUIS- 
VILLE, KY. 
AT a recent meeting of this Society, 
I had occasion to mention the use 
of arsenauro (bromide of gold and 
arsenic) in epilepsy. Being, compar- 
atively speaking, a new drug to this 
market, it was thought of sufficient 
interest to bring it more prominently 
before the Fellows. 
The solution of mercauro (mercuric 
bromide of gold and arsenic) after the 
formula of Dr. Barclay, of Pittsburg, 
is of a beautiful red color, does not de- 
posit, odorless, and tasteless; dosage 
ranging from five to twenty drops, 
each io drops containing 1-32 of a 
grain of bromide of gold, 1-32 of a 
grain of bromide of arsenic and 1-32 
of a grain of bromide of mercury. 
It does not disagree with the stomach, 
nor relax the bowels. It will pro- 
duce ptyalism, yet with less recession 
of the gums than is produced by mer- 
cury or the iodides. 
Dr. Wood, in his admirable paper, 
read at the meeting of the Mississippi 
Valley Medical Association, in In- 4 
dianapolis, laid great stress upon its 
efficacy in diseases termed scleroses, 
incipient phthisis, arthritis deformans, 
in syphilitic diseases in its various 
forms, in hemiplegias, etc. 
I have the pleasure of exhibiting 
three cases to-night, and a record of 
eight others, all of whom, with one 
exception, belong to the neuroses. 
Case I.—No. 436 of my college clin- 
ical records; diagnosis, hemiplegia. 
W. O. M., aged 28, married; residence, 
Denver, Colo. Faimily history fairly 
good; occupation, proprietor of thea- 
tre. Habits, had used alcoholic bev- 
erages rather freely for five years. 
February 28, 1893, following a two 
days’ drunk, patient vomited with 
great straining; passed into uncon- 
sciousness lasting seventy-two hours; 
complete dextra-hemiplegia, ataxia, 
aphasia, sinistra-hemiplegia super- 
vened. December 2, 1893, patient 
presented himself at Clinic having 
complete paralysis of the right side, 
could not count fingers with left eye; 
tongue on protrusion pointing sharply 
to the right; corners of the mouth 
greatly depressed on right side; arm 
on the right side could scarcelyfbe 
lifted away from the body; leg 
dragged after the patient in charac- 
teristic manner; all reflexes greatly 
exaggerated. Patient could answer 
yes and no to questions, but could 
not tell where he lived and had to be 5 
brought to the College. Was placed 
on liq. arsenic et hydrarg. iodide, 
five drops in a wine glass of water, 
after meals. 
December 6,was given the mercauro 
(mercuric bromide of gold and arse- 
nic) in five dropt doses after meals. 
December 9.—Patient developed 
la grippe, treatment was discontinued, 
and acetanilide given. 
December 13.—Condition improved 
and mercauro (mercuric bromide of 
gold and arsenic) was given again. 
December 20.—Some improvement, 
medicine continued. 
January 3, 1894, dose increased to 
ten drops. 
January 26.—Patient answers all 
questions with comparative ease, 
came to the Clinic by himself, can 
lift his arm as high as his shoulder, 
the characteristic tremor taking place 
when he attempts to raise it still 
higher, can walk tolerably well; treat- 
ment continued. 
February 7.—Continued improve- 
ment. 
February 14.—Eating and sleeping 
as good as before attack. 
February 28.—Steady improve- 
ment in gait and speech. 
March 10.—Doing well. 
March 17.—Dose increased one 
drop every other day. 
March 21.—Flas regained self con- 
fidence. April 4.—Walks miles, does not 
have to use cane, no longer drags his 
foot. Secondary contraction of a 
slight degree has taken place in 
fingers only. Students not familiar 
with the case could not detect any 
depression at angle of the mouth. 
Sight in left eye much improved, 
though outer half is still impaired. 
Tongue points nearly in the median 
line. Patient steadily improving. 
Case II.—J. R.,age 35, tobacconist; 
personal and family history good; he 
has never had syphilis nor rheuma- 
tism. His trouble began about eigh- 
teen months ago, with the character- 
istic pains in the lower extremities. 
These pains were felt at irregular 
intervals, sometimes daily and some- 
times not for the space of a week or 
ten days. A short time afterward he 
noticed a change in gait. He also 
had frequent attacks of sick head- 
ache, three or four seminal emissions 
weekly, and difficulty in holding the 
urine. These symptoms ceased about 
four months ago, but the ataxia has 
greatly increased, and the pains still 
continue. He has noticed m the last 
three or four months a decline in the 
sexual power. He was admitted into 
the Hospital February 1, 1894. The 
skin, reflexes and the knee jerk 
were normal; there were no sen- 
sory symptoms; he had the Argyll- 
Robertson pupil; co-ordination was 
6 7 
so imperfect that he was unable to 
stand with the eyes closed and the 
feet together; and he could hardly 
make his way from one place to 
another. 
In treating this case I started Feb- 
ruary 28, with eight drops of the 
mercauro (mercuric bromide of gold 
and arsenic) three times a day. From 
March 14 to April 1, the dose was in- 
creased one drop each day, the total 
quantity given during thirty-three 
days being 1,245 drops, an average of 
thirteen drops at each dose. 
Case III.—W. P., aged 32, painter; 
personal and family history good. 
His illness dates back to February 1, 
1892, the symptoms being constipa- 
tion, difficulty in voiding urine, stiff- 
ness and soreness in the knees. In a 
short time the legs became useless. 
In six weeks he was about on crutches, 
being at the time under treatment at 
Hot Springs. He entered the hos- 
pital July 7, 1892. At that time there 
was very little sensation in the left 
leg, the condition of the right being 
about normal. He had incontinence 
of urine and feces. 
Commencing February 7, I gave 
him five drops of the mercauro (mer- 
curic bromide of gold and arsenic) 
after meals; the dose was increased 
daily until eleven drops were being 
given, making the average dose given 
during the course, of ten drops, thrice 8 
daily. Bladder and bowel symptoms 
restored. 
Case IV.—Mrs. S. (I will refer to 
this case briefly, not being able to get 
the patient to come here to-night.) 
There was loss of sensation in right 
side of face; difficulty in co-ordination; 
ptosis, chronic constipation, loss of 
bladder control, reflexes lost. Four 
months’ treatment followed by com- 
plete relief. 
It could hardly be coincident that 
such decided changes for the better 
should have occurred in so short a 
time. 
There have been and are now many 
preparations on the market which are 
not solutions of bromide of gold and 
arsenic, but bromide of gold with hy- 
drobromic acid, arsenic acid, and arsen- 
ious acid. In the Annual of the Uni- 
versal Medical Sciences, issue 1891, 
Dr. Hare, in his article on Experi- 
mental Therapeutics, concludes in 
reference to the action of bromide of 
gold: 
(1) Bromide of gold undoubtedly 
inhibits the cortical motor centres, 
even when administered in smaller 
doses than other bromides. After an 
internal administration of bromide of 
gold, in the dose of one and a half to 
three and one-tenth grains to the 
kilogramme of the animal’s weight, 
even the strongest and very prolonged 
electric stimulation of the cortex fails 9 
to bring about any epileptic seiz- 
ures. To obtain the same result from 
bromide of potassium, the latter 
should be introduced in the dose of 
nine and a quarter to ten and three 
quarter grains to kilogramme, while 
bromide of sodium should be given in 
still larger quantities. 
(2) Irritability of individual motor 
centres, as determined by the appear- 
ance of contractions in corresponding 
muscular groups, is depressed by bro- 
mide of gold in but trifling degree. 
(3) Excitability of the white sub- 
stance of the motor region remains 
intact. 
(4) The drug seems to affect mainly 
the tracts of communication between 
individual motor centres, as well as 
between remote areas of the cerebral 
cortex. 
(5) It does not appear to possess 
any special cumulative action. This 
action cannot be due to the amount 
of bromide present therein, since it is 
in the weakest (55 per ct. by weight) 
of the three, while bromide of sodium 
is the heaviest (77.7 per ct.), the po- 
tassic salt standing midway. 
Inthe Annual of the Universal Med- 
ical Sciences, year 1892, an authority 
states: “Better results can probably 
be obtained if the drug be given hy- 
podermatically.” 
The opinion as to the efficacy of 
gold in disease has been indeed va- ried. In an article, Medical Record, 
Vol. 34, page 802, September, 1888, 
this appears—referring to an article 
on gold and arsenic. “It is highly 
digestible,” while farther on this 
startling statement appears, “There 
is probably not a sound clinical ob- 
servation showing that gold possesses 
any special therapeutic efficacy in any 
disease.” 
The older therapeutists limit its 
field of usefulness. Bartholow speaks 
most highly of it, recommending the 
double chloride in waning sexual 
force, in granular and fibrous kidney, 
in melancholia, in atonic dyspepsia, 
catarrh of bile ducts, etc. The claim 
made that it produces auric fever has 
not been observed, nor have I seen 
any evidences of gastric irritation. In 
a case of syphilitic nodules with 
marked cephalagia, there was a rapid 
subsidence of the nodes, and relief of 
the head, by the mercuric bromide of 
gold and arsenic, proving clearly that 
there is a most decided alterative in- 
fluence exerted.. 
The fact that the sedation produced 
by the bromide of gold is greater 
than that by the salts of potash and 
soda should give it a front rank in 
the treatment of epilepsy, fortified by 
the alterative influence of the gold 
and the tonic effect of the arsenic. 
It has long been recognized that ar- 
senic is the treatment for chorea. In 
16 three cases of this disease, treated by 
bromide of gold and arsenic, the 
suits were all that could be desired. 
The solutions of gold as prepared 
by the E. M. Johnson Company— 
ist. Increase the appetite. 
2d. Do not irritate the stomach nor 
disturb the bowels, seeming to stim- 
ulate peristalsis without sufficient ir- 
ritation to produce purgation. 
3d. Do exert decided powers of al- 
teration, sedation where there is irri- 
tation, yet stimulation to waning 
powers. 
4th. Are indicated in the majority 
of diseases affecting co-ordination. 
5th. In fact, entitled to a trial in 
all neuroses. 
My sole object in showing these 
cases and in bringing the subject 
before the Society, was not to place 
myself on record that gold would cure 
these conditions, but it struck me as 
being a very peculiar coincidence 
that such marked results and such 
marked improvement should be mani- 
fested in so short a time. Out of a 
series of eleven cases of neurotic 
troubles in hospital and private prac- 
tice, I have been surprised at the 
amount of improvement. One case is 
a very prominent man in a fashion- 
able portion of the city, who has been 
living for a long time almost the life 
of a child, and who has been under 
the treatment of many neurologists. 
i i 12 
While visiting his wife, she heard of 
my having treated another case, and 
suggested the same remedy be given 
this gentleman. He had incontinence 
of urine, incontinence of feces, entire 
loss of control of the lower half of his 
body, lightning pains in the legs and 
over the region of the stomach, rest 
disturbed, and had been in about this 
condition for four years. I first gave 
him ten drops of mercuric bromide 
of gold and arsenic three times per 
day. He had to be lifted in and out 
of bed; his legs would become crossed 
in bed and his wife would have to un- 
cross them at night; he would urinate 
involuntarily during the night; he 
was afraid to go out in his carriage, 
fearing he would have an involuntary 
evacuation of the bowels. He was 
given this treatment for two months 
without any apparent improvement, 
when I increased the dose one drop 
per day until I secured the effect of 
the arsenic; the dose was increased 
until he took twenty-five drops three 
times a day. He waked up one night 
complaining of a tingling sensation 
all over his body; I then ordered the 
medicine reduced to ten drops three 
times per day. His incontinence of 
urine had ceased; he has perfect con- 
trol of the sphincter ani; he has con- 
siderable motion and strength in his 
legs, and can get up and down with- 
out assistance. There has been no further improvement, but certainly 
this has been a great advance over his 
previous condition. There is another 
point about this solution that has 
struck me with force—that is, its pos- 
sible or probable usefulness in the 
treatment of glandular and joint 
troubles. It combines well with lime 
and salicylate of calcium. I have just 
had a case of enlargement of the cer- 
vical glands with calcareous change, 
which has been treated with arsenauro 
(bromide of gold and arsenic,) with a 
decided reduction in the size of the 
glands. His father gave a syphilitic 
history, and this patient had been 
treated for syphilis. I have also tried 
this remedy on other cases of glan- 
dular enlargements, and have been 
surprised at the rapid subsidence. 
Another case, a prominent man who 
returned from Hot Springs some time 
ago, much emaciated, taking daily 450 
grains of iodide of potassium; he also 
had unsteady gait and other nervous 
symptoms. The iodide of potas- 
sium was discontinued, and arsenauro 
(bromide of gold and arsenic) admin- 
istered. While there has been no 
marked improvement in his gait, there 
has been decided improvement in 
flesh. Another case gave the history 
of pulmonary hemorrhage, spitting 
of blood, yet there is no marked 
change to be found in the lung. She 
has been placed upon this agent, 
13 14 
starting with four drops, increasing 
one drop every day until she is in 
better condition and weighs more 
than she has in six years. These can- 
not be coincidences, and the cases I 
have referred to demonstrate the use- 
fulness of this agent in the treat- 
ment of syphilitic lesions. We have 
had several cases of syphilis in the 
Clinic at the college that I did not 
refer to in my paper treated with 
this agent, in all of which there has 
been a more rapid subsidence of all 
symptoms than usually obtains under 
the use of mercury alone. There has 
not been the marked ptyalism, nor 
the marked retraction of the gums, 
and the eruption had dried up very 
rapidly. The fact then that it enters 
into combination with lime, that it 
enters into combination with mercury 
in the form of a solution and is prob- 
ably eliminated by the kidney shows 
that it has a decided advantage over 
the old chloride of gold and sodium, 
which was not readily assimilated. 
Experience thus far has proven that 
this solution has a great advantage 
over iodide of potassium in that it 
does not produce gastric irritation. 
None of the cases in which it has 
been used have exhibited any gastric 
symptoms; it has produced no inter- 
ference with digestion or the secre- 
tions, and it not only seems to have 
an especial action upon the constitu- i5 
tion, but proves to be a general tonic 
in its effect throughout the entire ali- 
mentary tract. 
I have simply shown these cases 
with the hope that it might be of ser- 
vice in suggesting a new field of ex- 
periment. There is one more point 
upon which I would lay special stress. 
I made the error myself a year ago 
when the first specimen was sent to 
me. We are inclined to discard 
its rise too soon. We must push it 
like we do iodide of potassium for 
its full effect. I believe it is a 
good addition to our therapeutics, 
and that its outcome is destined 
to be a great one. Certainly it can- 
not be explained that these three 
cases I have exhibited, and the others 
that have been treated would have 
improved so markedly without its 
use. It has not been my experience 
that cases of locomotor ataxia sud- 
denly turn in three or four weeks 
without treatment into a condition of 
decided improvement. It has not 
been my experience that within three 
or four days cases showing evidences 
of involvement of the lateral columns 
begin to assist themselves. It is not 
my experience that cases of paresis 
of a certain lot of muscles begin to 
take on action, and that patients state 
that they can feel a tingling in that 
part, which I do not attempt to ex- 
plain; nor do I attempt to localize its 16 
action exactly in these cases; I simply 
present the patients and give my ex- 
perience in their treatment to empha- 
size my statement that I believe this 
remedy has a wide field of usefulness 
in the cure of neurotic conditions. I 
have used arsenauro (bromide of gold 
and arsenic) in two cases of incontin- 
ence of urine; in one of these there 
has been decided relief. I would like 
to call especial attention to its service 
in the treatment of choreic conditions; 
we get not only the benefit of the ar- 
senic, but the sedative action of the 
bromide and alterative effect of the 
gold. I have used it with success in 
three cases of chorea without any 
other treatment. 
IMPORTANT CAUTION. 
We have received many complaints of 
stomachic disturbances and other disap- 
pointing results due to the substitution of 
imitations of our Gold Solutions. Investi- 
gation in every instance has shown that 
the substitute does not contain the bro- 
mides of the metals designated by our 
labels and found in our preparations and 
to which the favorable clinical results ob- 
tained from “Mercauro,” etc., are due. By 
specifying “Mercauro” you will insure 
your patients obtaining what you intend 
them to receive. 
Respectfully yours, 
E. M. JOHNSON CO., 
41 Platt St., N. Y,