The employment of large doses of Tartar Emetic in the treatment of acute inflammation was introduced by Rasori, in 1808. His success was reported to be so great that Laennec was induced to make a trial of the system, and he was no less successful, especially in the treatment of Pneumonia. Of 62 unequivocal cases of Pneumonia, only six died, two being moribund on admission; two were old men of seventy, with cerebral congestion and pleurisy; and the other two with disease of the heart. His plan of treatment was as follows: - If the patient was young and robust, he was bled; if old and debilitated, this was omitted. He then administered one grain of Tartar Emetic in infusion of orange-leaf, every second hour for six times. After this, the patient was left quiet for seven or eight hours, if inclined to sleep, or if the symptoms were not urgent. If the inflammation had already made much progress, the same dose was repeated, until there was decided improvement. After the first few doses, a tolerance of the medicine was established, none of the usual effects being experienced, in the majority of cases, twenty-four hours after its first administration. A decided improvement soon followed the establishment of this tolerance in the system. Subsequently, however, Laennec omitted the bleeding in his treatment, and confined himself solely to the administration of Tartar Emetic, in most cases combined with Opium. Laennec's method, with considerable modifications, has been recommended by some of the highest English and continental authorities. Drs. Graves and Stokes,* of Dublin, commence their treatment with a full bleeding, and administer gr. vj. of Tartar Emetic, in divided doses, in the first twenty-four hours. To this they added gr. ij. - iij. daily afterwards, as the urgency of the case may require. Under this treatment a cure was effected in the majority of cases. Dr. Schonlein. a high German authority, recommends the use of the lancet in all cases, previous to the use of Tartar Emetic; and it is not even then given, if the inflammatory symptoms have not in a measure subsided. He directs gr. ij. - vj. of Tartar Emetic to be dissolved in as many ounces of water, one-half to be taken in one dose at first, and a table-spoonful of the remainder every hour or so, until improvement takes place. Dr. Van Roderer prefers a combination of Tartar Emetic and Opium. He administers gr. iv. - vj. of Tartar Emetic, with an equal quantity of Opium, in the twenty-four hours. He abstains from bleeding and all other remedies, excepting an occasional aperient enema. Of 42 cases thus treated, only 13 died. A cure was generally effected in four or five days. The Opium should be omitted, if visible signs of any venous congestion are present. In Great Britain, however, perhaps from a change in the type of disease, the heroic administration of Tartar Emetic in Pneumonia is not adopted so fearlessly or frequently as formerly. Indeed, it admits of a doubt whether, in many cases thus treated, the patients did not recover in spite of the remedy.
* Indian Lancet, Feb. 15th, 1861.
On this point, Dr. West judiciously observes: "Tartar Emetic is a remedy of great value, but I can by no means subscribe to the unqualified recommendation of it by some French physicians, in all the forms and stages of the disease. The cases in which it seems to me to be of the greatest use are those in which the Pneumonia develops itself out of previous catarrhal symptoms, or in which it supervenes upon measles, or in the course of hooping-cough. In such cases, Antimony, given in doses of 1/4 gr. to a child two years old, and repeated every ten minutes till free vomiting is produced, and afterwards continued every two or three hours for forty-eight or sixty hours, has often appeared to me to be of the most essential service, and the preservation of the patient's life has seemed, in several instances, due to its employment. In Pneumonia, too, which has not been preceded by catarrhal symptoms, if, after venAesection, the respiration still continues as hurried as before, and the condition of the patient has been apparently but little benefited by that measure, Tartar Emetic has seemed to be extremely useful. I have been in the habit of giving it in large doses, as gr. 1/3 for a child two years old, and of repeating it every two hours for twenty-four hours, and have observed its use to be followed by a great diminution of the frequency of respiration, and by considerable relief to the patient. I believe that, when given in these cases, it paves the way for the advantageous employment of mercury. In no instance, however, in which the Pneumonia has been neglected, so that the period of depletion was passed, nor in which distinct bronchial respiration was audible, have I seen the beneficial results from the employment of large doses of Antimony, as recommended by many French physicians. In these cases it should not be employed, except in small doses, in combination with other remedies."
* Dublin Hospital Reports, vol. v.
Med. Chir. Rev. Oct. 1845.
Report on the Pneumonia of Children, Brit. and For. Med. Rev. No. xxx.