At the commencement of an attack, when gastric disorder was very marked, an antimonial emetic was formerly much commended. Dr. Gregory often employed it in these circumstances, but he also pointed out the danger of inducing irritability of the stomach, and even inflammation. Dr. Graves and others have taught that such an emetic, given within thirty-six hours of the initial rigor, would often abort the fever, but this is difficult to prove, and is not generally accepted. Modern practice has rather taught us that nausea and vomiting are usually needless annoyances to the patient, though if induced in the early stages vomiting may certainly relieve headache and severe gastric congestion when dependent upon accumulated mucus and bile.

Dr. Graves originated, and highly praised also, the administration of antimony in fever (especially typhus) at a stage when cerebral complications are sometimes very severe, e.g., from the seventh to the ninth day. Thus, to a strong adult, suffering with complete insomnia, illusions of the senses, delirium, continued tremor and subsultus, "cerebral" respiration, very quick and weak pulse, sordes, and every symptom of the worst augury, 1/4 gr. of tartar emetic in water was given every hour: the patient vomited freely (though not directly) after each of the first four doses, then purging began, the general condition improved, and the man slept: after temporary omission of the medicine, 2 min. of "black drop" (opium) were given every two hours, and on the following day there was free perspiration, natural sleep, and a rational mind; ultimately a good recovery followed ("Clinical Lectures").

In other equally severe cases the same dose of antimony has been given from the first with 2 or 3 min. of laudanum, and the results have been such as to warrant much confidence in this method of treatment; it is necessary, however, to use it cautiously, and to bear in mind its weakening effect upon the cardiac muscle, which is already enfeebled from the effect of the disease (Murchison).