Mikhail Stunovenkov

STUNOVENKOV, Mikhail Ivanovich (1843–1897), professor of skin and venereal diseases at the University of Kiev. From 1869 to 1883, he was an assistant to Professor Polotebnov in the dermatological clinic of the Military Medical Academy. In 1883, he was elected to the chair at the University of Kiev. Stunovenkov began his work at a time when physicians treated skin diseases rather than skin patients, paying attention exclusively to the morphology of the rash while showing little interest in the general condition of the organism and the function of other organs. Stunovenkov was one of the first to promote the view that a comprehensive examination of every skin patient is necessary. He described in the Russian literature a number of rare skin diseases that were hitherto almost unknown to Russian doctors (mycosis fungoides of Alibert, multiple idiopathic pigmented sarcoma of Kaposi, rhinoscleroma, striae atrophicae in men, pemphigus foliaceus). In the field of syphilidology, Stunovenkov worked on studying the rational foundations of syphilis therapy. To this end, Stunovenkov first focused on studying the excretion of mercury in the urine, proposing a new, easy, and precise "protein" method for determining mercury in urine with a scale showing the amount of mercury. From many thousands of analyses during mercury treatment of syphilis, he derived important indications regarding the threshold therapeutic saturation of the organism with mercury (4–6 mg of mercury in the daily urine volume), beyond which its harmful effect begins. Stunovenkov gave a precise answer to the question that concerned doctors at that time regarding the best method of introducing mercury into the organism. Through numerous observations and analyses of mercury in urine, he proved that only mercury that enters the blood is curative, and that the method of administration is best when the introduced mercury faster and more completely en-

ters the blood. The ideal method of intravenous injection is closely followed by the method of subcutaneous injection of soluble mercury salts that do not coagulate protein (mercuric benzoate); following them in descending order are: soluble salts that coagulate protein (sublimate), insoluble mercury salts, frictions with gray mercury ointment, and finally the administration of mercury through the stomach. Stunovenkov determined the daily amount of mercury entering the blood necessary for the highest therapeutic effect (9–10 mg). The new preparation proposed by Stunovenkov—mercuric benzoate—found widespread use both in Russia and abroad.