When confronted by the challenge of treating this new disease, physicians turned to the theory of four humors.  Too much phlegm was most often blamed for the pox.  To reduce the excess phlegm physicians recommended a variety of treatments to promote spitting and/or sweating.

But syphilis arrived in the Old World at a time when the unerring authority of Greek knowledge was under scrutiny.  In Lecture 6 we introduced Paracelsus (1493-1541), the enigmatic German practitioner who questioned the idea that health and disease was a matter of a one-size-fits-all humoral balancing act.  He wrote:

If the physician is to understand the correct meaning of health, he must know that there are more than a hundred, indeed more than a thousand, kinds of stomach; consequently, if you gather a thousand persons, each of them will have a different kind of digestion, each unlike the others.  One digests more, the other less, and yet each stomach is suitable to the man it belongs to....  Therefore the various dietary prescriptions should be observed not only for the sake of recovery from illness but also for the sake of prescribing one's health.  There are a hundred forms of health in the liver; each man has a different one.  It follows that no one drinks the same amount as another, that no one has the same thirst as another; this is explained by the diverse kinds of health, which must not be described as illnesses.

Paracelsus listed five principles or influences that can act alone or in complex combinations to cause disease:

• the stars
• poisons
• disintegration of the natural constitution
• spiritual causes
• divine causes

To find an effective remedy for a patient's illness, Paracelsus told physicians to look beyond the obvious symptoms to the disease itself:

For there is no sickness against which some remedy has not been created and established, to drive it out and cure it.  There is always some remedy a herb against one disease, a root against another, a water against one, a stone against another, a mineral against one, a poison against another, a metal against one, something else against another.

The nature and force of a disease must be discovered by their cause and not by their symptoms ... for we must not merely extinguish the smoke of the fire but the fire itself.  If we want the earth to produce better grass, we must plow it, and not merely tear out the bad grass.  Similarly the physician ... should direct his thought to the origin of the disease, and not only to that which his eyes see.  For in this he would see but the symptoms and not the origin....

In Paracelsus's view, reducing a patient's excess phlegm would do little to cure the disease.  "A good remedy was worth as much a thousand years ago as it is now," he wrote, "and a bad remedy was then as worthless as it is now....  The tares among the corn are as old as the corn, nevertheless, they cannot be used instead of the corn.  In my opinion, the world should awaken to this fact, and because the good surpasses the bad in worth, we should abandon the bad...."

A key element in Paracelsus's approach to health and disease was his belief that man is a microcosmic reflection of the macrocosm at large:

The mysteries of the Great and the Little World [macrocosm/microcosm; universe/man] are distinguished only by the form in which they manifest themselves; for they are only one thing, one being.  Heaven and earth have been created out of nothingness, but they are composed of three things -- mercury, sulfur, and salt ....  Of these same three things the planets and the stars consist; and not only the stars but all bodies that grow and are born from them.  And just as the Great World is thus built upon the three primordial substances, so man -- the Little World -- was composed of the same substances.  Thus man, too, is nothing but mercury, sulfur, and salt.

For this reason, remedies for what ails the world within us are to be found in the world around us:

Everything external in nature points to something internal; for nature is both inside man and outside man....  [T]here is in the world a natural order of apothecary's shops, for all the fields and meadows, all the mountains and hills are such shops.  Nature has given us all of them, from which to fill our own shops.  All nature is like one single apothecary's shop, covered only with the roof of heaven; and only One Being works the pestle as far as the world extends.  But man has such a shop only in part, not wholly; he possesses something, not everything.  For nature's apothecary's shop is greater than man's.

To prescribe well, a physician must learn "where nature has her pharmacies, where her virtues have been written down, and in what boxes they are stored."  Thus Paracelsus found nature's remedy for syphilis:

Quicksilver manifests itself in three forms.  In the first it is still unborn; in the second it is as it is in itself; in the third it appears such as it has been prepared by the alchemist's art....  Upon these three forms of manifestation of mercurius, or quicksilver, is based the cure of the French disease.

Paracelsus was not the only one advocating the use of mercury as a remedy for syphilis.  It had served as the basis of medicines long used by Arab physicians to treat skin disorders and rashes.  Mercury's use appealed to Galenists as well since it induces copious salivation (a classic sign of mercury poisoning) thus helping the patient to expel excess phlegm.

Mercury metal

• "quicksilver"
• "argentum vivum"

Mercuric oxide

"red precipitate" •
"angelical powder" •

Mercurous chloride

• "calomel"
• "sweet mercury"