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common, and are only two out of a vast number (not all equally bad) that have been, and are still daily witnessed, many of which are on record.
Dr. Hamilton, jun., observes,-In several cases, the author has decidedly ascertained, that alterations of the villous coat of the intestines of infants and young chil dren have been induced by the frequent use of doses of calomel.* Does not this fact call upon the mother to abandon its use altogether; and does it not demand more care or attention on our part in prescribing this oxide than has been of late observed ?
Mercury affects the human constitution in a peculiar manner, taking, so to speak, an iron grasp of all its systems, and penetrating even to the bones, by which they not only change the healthy action of its vessels, and general structure, but greatly impair and destroy its energies, so that their abuse is very rarely overcome. When the tone of the stomach, intestines, or nervous system generally, has been once injured by this mineral, according to my experience, and I have paid considerable attention to the subject, it could afterwards seldom be restored. I have seen many persons, to whom it has been largely given for the removal of different complaints, who, before they took it, knew what indigestion and nervous depression meant only by the description of others; but since they have become experimentally acquainted with both, for
*Bowel complaints of children in the city of Louisville are very frequent, principally caused by the abuse of purgatives and calomel.
they now constantly complain of weakness and irritability of the digestive organs, of frequent lowness of spiritst and impaired strength, of all which it appears to me they will ever be sensible. Instances of this description abound. Many of the victims to the practice are aware of this origin of their permanent indisposition, and many more, who are at present unconscious of it, might here find, upon investigation, a sufficient cause for their sleepless nights and miserable days.
The celebrated Prof. Marshall Hall,* makes the following remarks on mercury, which I desire that every practitioner will take into consideration:
The primary effects of mercury consists in the well known phenomena of ptyalism and salivation. The secondary effect, when injudiciously continued for an improper time, or in undue quantity, is that designated by Mr. Pearson, to whom we owe its detection. The erethismus mercurialis― mercurial excitement. To this affection the late Dr. Bateman, the friend of Mr. Pearson, fell a victim, and that from the want of a prompt diagnosis. The first symptoms of this terrible affection occurred on the ninth day of the mercurial inunction; this was, nevertheless, continued to the thirteenth. Dr. Bateman observes, in the detail of his own case, given in the ninth volume of the medico-Chirurgical Transactions: It is evident that the features of the malady are not sufficiently known, even
See his work, Principles of the Theory and Practice of Medicine; republished Boston, 1839.
to the most enlightened members of the profession; for the failure on the part of the medical advisers, in the instance about to be related, to recognise its first symptoms, and the consequent repetition of the dose of the poison, after its first commencement, had nearly proved fatal.
The detail itself is full of interest: and not the least affecting part of the story is, that eventually the disease did carry off this able physician.
Mr. Pearson observes:-In the course of two or three years after my appointment to the care of the Lock Hospital, I observed that, in almost every year, one and sometimes two instances of sudden death occurred among the patients, admitted to that institution: that these accidents could not be traced to any evident cause: and that the subjects were commonly men who had nearly, and sometimes entirely, completed their mercurial course. I consulted Mr. Bromfield and Mr. Williams upon this interesting subject, but they acknowledged themselves unable to communicate any satisfactory information: they had carefully examined the bodies of many who had died thus unexpectedly, without being able to discover any morbid appearances; and they confessed that they were equally ignorant of the cause, the mode of prevention, or the method of treating that state of the system which immediately preceded the fatal termination.
As the object of my inquiry was of considerable importance, I gave a constant and minute attention of the operation of mercury on the constitution in general, as
well as to its effects on the disease for which it was administered; and after some time had elapsed, I ascertained that these sinister events are to be ascribed to mercury acting as a poison on the system, quite unconnected with its agency as a remedy; and that its deleterious quantities were neither in proportion to the inflammation of the mouth, nor to the actual quantity of the mineral absorbed into the body.
The erethismus mercurialis may come at any period of the use of mercurial remedies. In Dr. Bateman, the first symptoms occurred on the ninth day of mercurial inunction with languor, fever; and, on the next morning, with vio lent and irregular beating of the heart.
Mr. Pearson observes, - The gradual approach of this diseased state is commonly indicated by paleness of the countenance, a state of general inquietude, and frequent sighing; the respiration becomes more frequent, sometimes accompanied with a sense of constriction across the thorax, the pulse is small, frequent, and often intermitting, and there is a sense of fluttering about the praccordia. And further, the erethismus is characterized by great depression of strength, a sense of anxiety about the praecordia, irregular action of the heart, frequent sighing; trembling, partial or universal; small, quick, and somotimes intermitting pulse; occasional vomiting; a pale contracted countenance; a sense of coldness. When these, or a greater part of these symptoms are present, a sudden and violent exertion of the animal power will sometimes R
prove fatal; for instance, walking hastily across the ward, rising up suddenly in the bed to take food and drink, or slightly struggling with their fellow-patients, are among the circumstances which have commonly preceded the sudden death of those afflicted with the mercurial érethis
In Dr. Bateman's case, it was remarked, that the action of the heart and arteries, which was extremely feeble as well as irregular while awake, was so much more enfeebled during sleep as to be, in fact, almost suspended, and thus to occasion alarming faintings and sinkings, so that it became necessary, notwithstanding the extreme drowsiness which had succeeded the long continued watchfulness, to interrupt the sleep at the expiration of two minutes, by which time, or even sooner, the sinking of the pulse and countenance indicated the approaching languor.
The following is a similar case to that of Dr. Bateman's, also described by Marshall Hall:
Surgeon and a West-Indian called upon me to hold some conversation on his own case. He attributed his unhappy condition to a malignant fever, with erysipelas, during which there had been exhibited a great deal of calomel, as much as thirty grains at one dose,* which
*I am informed here, by several persons, that even delicate females have taken as much as a hundred grains of calomel! for a dose, and a thousand grains in the course of a week. I may well assert that a fourth part of lingering maladies in the United States may be ascribed to the abuse of mercury. A modern author has pointed out a number of diseases which originate from the abuse of mercury. In the hope that the western and southern physicians of this