In the constitutional derangement attendant on dissection wounds, Mr. Adams* strongly advocates the use of Calomel internally; he considers that it annihilates the disease. In this view he is supported by Dr. Colles,t of Dublin. It should be given in such doses as to bring the system under its influence rapidly; and to attain this object, inunction should also be employed. Active purgation is also advised. Many instances are related in which it was used with decided benefit.
Morrison advises the internal and external use of Calomel, in order to bring the system rapidly under its influence, and he speaks highly of its efficacy. Dr. Ligget§ also has recorded a case cured by 3j. doses of Calomel. On the other hand, Larrey|| states, that in the Egyptian campaign, it seemed to aggravate the disease; and in the Peninsular war it signally failed in the hands of Sir J. Macgregor¶ and others; indeed, Dr. "Wells** mentions three instances in which Tetanus commenced while the patient was in a state of salivation. It is now almost universally considered, that in acute traumatic Tetanus, it has little, if any influence. In Chronic Idiopathic Tetanus, it appears occasionally to be useful.
1432. In Hydrophobia, Mercury has been strongly advised, both as a preventive and as a curative agent. It has been employed externally and internally by Dessault, Du Choisel, Andry, James, Sebig, Walther, Frank, Raymond, and others; but experience does not justify our placing any reliance on it, the establishment of salivation not apparently delaying the fatal termination.
Macgregor reports favourably of Mercury carried to slight salivation. Under its use, he found the skin became softer, the pulse more regular, the eye more clear,
* Glasgow Med. Journ., Aug. 1830.
Dub. Hosp. Rep., vols. iii. andiv.
Essay on Tetanus, 8vo, 1816, p. 50.
§ Amer. Journ. of Med. Science, Jan. 1860.
|| Mem. de Chir. Militaire, t. i. p. 257.
¶ Med. Chir. Trans., vol. vi. p. 454.
** Quoted by Dr. Watson, Lectures, vol. i.
the tongue more moist; and the thirst, together with the affection of the head and of the abdomen, entirely disappeared. The evacuations were rendered copious, and approached nearly to their natural colour. The experience of Bulard is unfavourable to its use. (Dr. Shapter. *)
In Psoriasis and Lepra, Rayer first proposed the external use of Calomel (5J. ad Adipis j.); and so great was its success, that he regards it almost as a specific. He advises 3j. - 3iij. to be applied daily, and adds that he never saw it produce soreness of the gums. It has since been employed with marked benefit in various forms of Porrigo, Herpes, Impetigo, Eczema, and other skin diseases. Speaking of this ointment, Dr. Pereira says, that if he were required to name a local agent, pre-eminently useful in skin diseases generally, he should fix on this.
Wardrop § employed Mercury in four cases. It was given in small doses at first, and afterwards increased so as to affect the gums in twelve or fourteen days. When ptyalism appeared, the sores in general assumed a healthy appearance, and the bulbous swelling gradually diminished.
1436. In Acute Periostitis, unconnected with Syphilis, Mercury is a remedy from which great benefit may be derived. After premising local or general abstraction of blood, Calomel and Opium may be given in sufficient doses to bring the constitution under mercurial influence. Even when salivation is established, relief from pain does not immediately follow; but the remedy should be persisted in, until the system is brought thoroughly under its influence, and then the pains will altogether disappear. (Dr. Graves. ||)
1437. In obstinate cases of Hoarseness, when inhalations and other measures fail in effecting a cure, Dr. Graves¶ considers that the sheet-anchor is Mercury, exhibited internally, and by means of inhaling the fumes of Hydrarg. c. Creta. When the mouth is slightly touched, the hoarseness will be found to yield.
1438. In Headaches arising from biliary derangement, or a torpid state of the Bowels, a few grains of Calomel, regulated by the age, strength, &c, of the patient, and by the severity of the symptoms, and followed at a short interval by a saline or other purgative, are often sufficient to effect a cure. The remedy should not be too often resorted to.
Copland** says, that, since 1817, he has found that, in the majority of cases treated by him, great and immediate advantage has been derived from a full dose of Calomel (either with or without Opium), followed in a few hours by fss. of Ol. Terebinth., or 01. Ricini. An enema containing a purgative or bland oil was, in most instances, also employed to assist the operation of the other remedies In Ileus, violent Colic, and Colica Pictonum, a similar plan of treatment, but regulated to suit the severity of the case, is advised by Dr. Copland, and has generally been found effectual by those who have employed it. In Lead Colic, he combines the Calomel (j.) with Camphor (gr. x.) and Opium (gr. ij.). Few practitioners would be now disposed to give Calomel in so large a dose.
* See Lib. of Med, vol. i. p. 213. On Diseases of the Skin, p. 77. Mat. Med., vol. i. § Med. Chir. Trans., vol v. p. 1382
|| Clin. Lect., vol ii. p. 492. ¶Ibid., p. 3.
** Dict. Pract. Med., vol. i., art. Colic.