The Calomel treatment of dysentery, formerly so much in vogue, has of late years been much modified; the scruple doses of the mineral advocated by Annesley, Johnson, &c, having been entirely abandoned. "In acute uncomplicated cases,'' observes Sir R. Martin, "a moderate bleeding from the arm, followed by a full dose of Calomel (gr. x.) and James's Powder, or Ipecacuanha (gr. x.), given at bed-time; a warm bath or hot fomentations to the abdomen; a morning aperient, followed during the day by sudorifics conjoined with diuretics; a moderate use of demulcent drinks, allowing no other sustenance, will, in a very few days, bring about convalescence " It must, however, be admitted that the majority of cases will not yield to this simple treatment; under which circumstances further measures must be had recourse to. For many years I used with advantage Mr. Annesley's formula: - Pil.Hydrarg. gr. ij. - iij., Pulv. Ipecac. Rad. gr. j. - ij., Opii gr. 1/4 - 1/2, M., ft. pil. 4tis vel 5tis horis sumend. Incipient soreness of the mouth was always taken as an indication of the remedy having been carried far enough. A good formula has also been proposed by Dr. Stewart:* Calomelas gr. 1/2, MorphiAe gr. 1/4, QuiniAe Sulph. gr. ij., M., ft. pil. 2dis vel 3tiis horis sumend. Further experience has, however, shown me, as it has done others, that Dysentery can, and has been cured without Mercury in any form; and that when employed, its use (except as an occasional aperient) is limited to the first or early stage, when inflammation of the mucous intestinal membrane exists. After ulceration is established, no good can be expected from this remedy. Opium and Ipecacuanha, either alone or combined, followed by mineral astringents, are then chiefly to be relied upon. In the asthenic forms of Dysentery, especially in the scorbutic form, Mercury should never be employed. Perfect rest in a recumbent position, a spare, farinaceous diet, a flannel bandage round the abdomen, leeches to the verge of the anus, and anodyne enemata, are accessories which should never be neglected. When aperients are required, the mildest, as Castor Oil, Sulphur and Cream of Tartar, or Rhubarb and Magnesia, should be employed. The "Ipecacuanha treatment," lately re-introduced by Mr. Docker, promises to supersede the mercurial and other modes of treatment.
* Indian Lancet, Feb. 15, 1861. On the Influence of Tropical Climates.
Influence of Tropical Climates, Ed. 1861, p. 441.
1408. In Hepatic Dysentery, Mercury in any form requires to be given with the greatest caution, and never so as to affect the system. Here the Iodide of Potassium, or the Nitro-Hydro-chloric Acid, internally and externally, offer the best chances of success.
1409. In Chronic Dysentery dependent upon Ulceration of the Intestines, Mercury is rarely either advisable or admissible, unless there is reason to suspect hepatic derangement, when it should be given in small alterative doses, and not with a view of obtaining the specific action of the mineral on the system. In these cases, the metallic tonics, but particularly the Nitrate of Silver, are productive of far greater benefit than can be obtained by any of the salts of Mercury. (See Argenti Nitras.)