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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..ad1c6bb --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #66016 (https://www.gutenberg.org/ebooks/66016) diff --git a/old/66016-0.txt b/old/66016-0.txt deleted file mode 100644 index 3cdc6ba..0000000 --- a/old/66016-0.txt +++ /dev/null @@ -1,765 +0,0 @@ -The Project Gutenberg eBook of Observation on the Use and Abuse of Mercury, -and on the Precautions Necessary in its Employment, by A. Philips Wilson - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you -will have to check the laws of the country where you are located before -using this eBook. - -Title: Observation on the Use and Abuse of Mercury, and on the - Precautions Necessary in its Employment - -Author: A. Philips Wilson - -Release Date: August 8, 2021 [eBook #66016] - -Language: English - -Character set encoding: UTF-8 - -Produced by: Donald Cummings and the Online Distributed Proofreading Team - at https://www.pgdp.net (This file was produced from images - generously made available by The Internet Archive) - -*** START OF THE PROJECT GUTENBERG EBOOK OBSERVATION ON THE USE AND ABUSE -OF MERCURY, AND ON THE PRECAUTIONS NECESSARY IN ITS EMPLOYMENT *** - - - - - OBSERVATIONS - ON THE - USE AND ABUSE - OF - MERCURY, - AND ON - THE PRECAUTIONS - NECESSARY - _IN ITS EMPLOYMENT_. - - [Illustration] - - BY - A. PHILIPS WILSON, M. D. - Fellow of the Royal College of Physicians, and of the Royal - Society of Edinburgh, &c. - - [Illustration] - - Winchester. - Printed and Sold by JAMES ROBBINS. - - Sold also by Messrs. CADELL and DAVIES, Strand; MURRAY, Fleet-street; - and CROSBY and Co. Stationer’s Court, Ludgate - Hill, LONDON. - - [Illustration] - - 1805. - - - - - OBSERVATIONS, &c. - - -The following Observations are addressed to the Public, with a view, -on the one hand, to do away certain erroneous prepositions respecting -the effects of Mercury, which impede the necessary employment of it; -and on the other, to call its attention to the impropriety of an -indiscriminate use of this medicine, by which much harm is often done, -and the medicine itself brought into disrepute. The best way to effect -these purposes seems to be, to make the public acquainted with what -is really to be apprehended from an improper use of mercury, and the -circumstances in which its bad effects shew themselves; by which every -one may be enabled to distinguish these effects from such as proceed -from other causes, as well as be warned against a use of this medicine -which has become too prevalent. - -Physicians will agree, that we do not possess a more valuable medicine -than mercury. Not to mention the diseases for the cure of which it was -first introduced, which, without its aid, almost uniformly prove fatal, -and in which it is almost uniformly successful, we may appeal for the -truth of this observation to its effects in some of the most dangerous -forms of scrophula, in dropsies of different kinds, in inflammations, -particularly chronic inflammations, and induration and enlargement of -the different viscera.[A] - -[A] If we except worm cases, in which mercury probably acts on the -worms themselves, the various diseases in which mercury is useful, -may perhaps be reduced to the two heads of inflammation and glandular -obstruction. I believe there is nothing more erroneous than the -opinion, that mercury will occasionally succeed in almost all diseases. -This opinion has led to its employment in improper cases, and tended -consequently to bring it into discredit. I have never found it -successful except in the diseases here alluded to. - -For many years after its introduction into practice, it was confined -to a few diseases. At length it occurred to physicians, that a remedy, -which in these proved so efficacious, might produce similar effects in -other cases; and such has been the success of the trial, that during -the last twenty years mercury has been coming into general use, with a -rapidity unequalled in the history of any other medicine. But the more -we are assured of its value, the more cautious we ought to be in its -employment; both because it is of the greater consequence to prevent -any prepossession against it, and because we know that there is no -active medicine which can safely be trifled with. - -The prejudices which prevail against the use of mercury seem to arise -from three sources; the nature of the complaints in which it was -first employed; the uneasiness which even its salutary operation, -when carried to a certain extent, necessarily occasions; and the bad -consequences which sometimes attend an improper use of it. It is -surprising, that the first of these causes should operate against its -use; yet such is the confusion which naturally creeps into our ideas on -subjects in which we are not habitually interested, that the prejudices -of not a few originate from this cause. Of such a prejudice it is -surely unnecessary to say any thing. The other objections to the use -of mercury are of more weight. - -Like all other medicines which increase the secretion by the skin, -the use of mercury tends to debilitate, and render the body more -susceptible of cold. When mercury does not encrease any other -excretion, the debility it occasions seems to be proportioned to the -degree in which it promotes perspiration; and medicines which promote -perspiration in a greater degree produce more sudden debility. We see -a degree of weakness produced by the operation of James’s powders, or -of Dover’s powders, (opium and ipecacuanha), in a few days which a -moderate course of mercury would not occasion in many weeks. - -Such is the tendency of mercury to promote the secretion by the skin, -that it often runs off in this way almost as fast as it is received -into the system, particularly on its first being used; so that it -is sometimes difficult to make a sufficient quantity be retained to -produce its desired effect. Some of the good effects of mercury seem, -in a great measure, to arise from this action of it, particularly its -tendency to counteract the inflammatory disposition and to relieve -actual inflammation. - -This tendency of mercury readily accounts for the bad effects of taking -cold under its influence. It is easy to conceive that the bad effects -of checking perspiration will be most felt when, to use a common -expression, the pores are most open, that is, when the secretion by -the skin is most copious; for the greater the quantity of fluid thus -discharged, the greater inconvenience is to be expected from suddenly -checking its secretion. Hence also the danger of suddenly checking -perspiration, when, by exercise or external warmth, it is rendered more -copious than usual. - -Such is the admirable constitution of our bodies, that means are -provided for more or less successfully counteracting the operation -of every thing which tends to injure them. If a thorn or any other -extraneous body is introduced under the skin, inflammation and -suppuration spontaneously arise, by which the offending cause is -expelled. If a poisonous substance is received into the stomach, the -action of vomiting is frequently excited, or if it passes into the -bowels, nature still endeavours to carry it off by an increase of the -peculiar motion of the intestines, and of the secretion from their -surface; so in the case before us, the morbid fullness which would in -every instance arise, when perspiration suffers a check, is generally -prevented by the sympathy which subsists between the skin and several -other secreting organs, in consequence of which, as soon as a check -is given to the action of the former, some one of the latter, which -secrete a similar fluid from the blood, is called into more vigorous -action, and what should have passed by the skin is thrown off by the -kidneys or bowels, sometimes by the glands of the nose, throat, and -lungs, occasioning what we call a _cold_. - -This substitution of one excretion for another, if I may use the -expression, is particularly apt to occur under the use of mercury, and -seems to arise from the nature of this medicine being so stimulating -that we cannot retain it in the system: if one vent is denied it, it -quickly finds another. Hence it is that people under the effects of -mercury are so subject to an increased secretion from the kidneys and -intestines, and from the glands of the mouth and throat. - -It is of great consequence in most cases, in conducting a course of -mercury, as much as possible to prevent its running off, and as we -cannot wholly confine it, our plan is to direct it to that channel -thro’ which it passes off most slowly; for it is well known that -this and some other medicines, while they particularly excite any -one excreting organ, are not apt to pass off at the same time in -considerable quantity by any other. Now the channel by which mercury -passes off most slowly is the glands of the mouth, and fauces. Our -view, therefore, is generally to direct it to this channel, and the -degree in which it increases the secretion from these glands is a -sufficiently accurate measure of the quantity of mercury in the body, -as we generally find that the effects of mercury in removing disease -are proportioned to the degree in which it affects the mouth. Besides -the discharge, and consequently the debility, occasioned by the same -quantity of mercury, is less when it excites these glands, than when it -acts on the skin and bowels. - -While it increases the secretion from the glands of the mouth and -fauces, it irritates and inflames them, and the inflammation it excites -when the quantity which passes in this way is great, often becoming -considerable and spreading to neighbouring parts, much uneasiness is -sometimes occasioned. - -The symptoms of salivation form the chief of the bad effects, which -are peculiar to this medicine. They are indeed unpleasant, but they -are unattended with danger. It is rarely proper to induce them. A -physician may practice for several years without meeting with one -instance in which salivation is necessary; and the extent to which the -older practitioners were accustomed on every occasion to carry the use -of mercury, may be regarded as one of the greatest abuses which have -opposed the beneficial employment of this medicine. It has certainly -more than any other tended to confirm the prejudices against it. All -its good effects can in most cases be obtained by slightly affecting -the mouth, and keeping up this affection for a longer or shorter time, -according as the complaint proves more or less obstinate. - -In certain formidable cases which, we have reason to believe, if left -to themselves would prove fatal, and in which more gentle means have -failed, it is proper to induce salivation. But may not a similar -objection be brought against the use of most other medicines? There -are few whose operation, is not attended with some inconvenience. How -alarming would be the operation of an emetic were we not accustomed to -see it! Violent vomiting is a symptom occasioned by some of the most -fatal poisons, yet we are easily reconciled to it when assured of its -beneficial tendency. - -From what has been said, the reader will readily perceive, why a sudden -salivation is often the effect of taking cold under the operation -of mercury. We have no means of immediately checking a salivation. -Discontinuing the use of the mercury, employing gentle laxatives, and -avoiding every thing which tends to irritate the inflamed surface of -the mouth and fauces will lessen the inflammation and discharge, and by -degrees remove them. - -When the mercury instead of falling on the glands of the mouth and -fauces, is thrown on the bowels in consequence of taking cold, it -is more in our power to regulate and restrain the discharge. For -the most part this affection of the bowels is a mere diarrhœa. The -griping pains which sometimes attend it seem to arise from the copious -secretion from the intestines washing off the mucus which is the -natural defence against the irritation of their contents. When this -affection is allowed to continue, and no care is taken to defend the -bowels, dysenteric symptoms sometimes shew themselves; these are most -frequently the consequence of mercury taken internally, as I shall -presently have occasion more particularly to observe. - -This affection of the bowels may be induced in another way. It will -have nearly the same effect, whether the fluid, which should pass by -the skin is thrown on the bowels in consequence of the action of the -skin being checked by taking cold, or in consequence of this fluid -being directed to the bowels by any cause of irritation applied to -their surface. Hence it is, that indigestible and irritating food will -often produce such a change in the distribution of the fluids, that the -increased secretion by the skin or salivary glands, occasioned by the -mercury, shall be exchanged for that by the bowels. - -When the mercury is thrown on the kidneys it passes off, as by the -skin, without uneasiness of any kind; and as in this case also, the -only bad consequences are, that the mercury, instead of acting on the -system for the cure of the disease for which it is given, is drained -from the body, and the patient is sometimes weakened by the increased -discharge. Mercury may, to a certain degree, be diverted from the -kidneys by the use of certain astringent medicines. Those which direct -it to the skin, by increasing the action of this organ, will divert it -from the kidneys; but by this we should lose, not gain, as it is thrown -off by the former more rapidly than by the latter. - -In many cases the action of mercury on the kidneys is salutary, and -our aim is as much as possible, by the use of diuretic medicines, to -direct it to this channel; for it happens with respect to the kidneys, -as with respect to the bowels, that whatever tends to irritate and -increase the discharge from them, solicits the mercury to them. It is -partly in this way that it often proves a cure in various species of -dropsy. - - * * * * * - -As far as we have considered the effects of mercury, its debilitating -tendency seems to arise from the evacuation it occasions. But it -debilitates in another way, which has not been sufficiently attended -to. Whatever weakens the stomach and bowels is soon felt in every part -of the system, and even medical men, as far as I can judge, are not in -general sufficiently aware of the bad effects which often arise from -the internal use of mercury. To prescribe calomel, one of the most -active preparations of this medicine, with the same freedom, and for -the same purposes, as rhubarb or senna, is in my opinion altogether a -misapplication of it. - -Few things apply to the stomach and intestines a more hurtful -irritation. I have often seen temporary dysentery induced by a few -doses of calomel, and I am convinced from many cases that its habitual -or even occasional use as an aperient, however innocent it may seem at -the time, seldom fails at length to debilitate the powers of digestion, -and is often productive of still worse consequences. Calomel is -frequently given to children because it has little taste, and may be -given in small compass. But it is better to give a milder medicine, -tho’ a larger quantity may be required. Perhaps the smallness of the -quantity in which it operates is of itself a sufficient objection, -for there is no aperient which operates in very small quantity that -operates mildly, as we might have foreseen, although the trial had -not been made. For my own part, I know of few instances in which the -internal use of mercury seems proper. There are some cases where -powerful means are required to rouse the bowels to action, or a strong -stimulus applied to their exhaling vessels is beneficial; and mercury -is sometimes successfully employed internally for the removal of worms, -but in ordinary cases we can surely with equal advantage use a less -irritating medicine. - -When mercury is not employed as an aperient, but for the purpose of -impregnating the system, what advantage is there in giving it by the -mouth. It seldom happens that we cannot give as much as we wish by -the skin. I have known many who were less debilitated by an ounce of -mercury taken by the skin, than by half a dram received even in the -smallest doses into the stomach. - -In short, the objections to the use of mercury by the skin, seem all -to resolve themselves into the two above treated of, the debility -occasioned by an increase of some of the excretions, and a greater -susceptibility to the effects of cold.[B] While there are the same -objections to the internal use of mercury, there are far more weighty -ones, which are not the less so, because we cannot with the same -precision define them. All that we know of them is, that they chiefly -consist in a debility of the stomach and intestines, which gives rise -to the various dyspeptic complaints, flatulence, acidity, diarrhœa, and -dysentery, effects which I have so often witnessed from the internal -use of mercury, that I have for some years almost wholly abandoned it, -except in the cases above alluded to. - -[B] It is unnecessary to notice a variety of groundless opinions, -respecting the effects of mercury, which prevail among the vulgar, that -it remains for ever in the system, causes a rottenness of the bones, -&c. These are similar to the prejudices which prevailed respecting the -bark for a long time after its introduction into practice, that it was -formed into masses in the stomach and bowels, from which it could never -be expelled; that nobody survived the use of it more than seven years, -&c. - -The precautions suggested by what has been said will, I believe, in -every instance, prevent the bad effects of mercury, with the exception -of the symptoms of salivation, which it is now and then necessary to -induce. It will be proper to take a cursory view of these precautions. - - * * * * * - -As by promoting the excretions, mercury tends to debilitate, it must be -used with caution in weak habits, and its debilitating effects should -be counteracted by the use of such strengthening medicines as are -adapted to the case in which we employ it. The debilitating effects of -mercury, however, are not such as many suppose. In a habit of ordinary -strength, a moderate course of mercury, properly conducted, produces -little debility, and I have seen many under such a course recover both -their strength and flesh. The mercury gives vigour, by removing the -cause which impairs it. With caution there is no danger in making a -trial of mercury in the most debilitated habit. In such the quantity -first employed should be too small to produce any effect whatever. Let -it be gradually increased; if, as often happens, the strength improves, -let it be continued; if the strength be much impaired by it, it should -be laid aside. - -Nothing tends more to debilitate under the use of mercury, than the -unfortunate idea, that the patient should be denied the advantage of -free air and exercise. Under certain circumstances, confinement to -the house is proper. When it is necessary to induce salivation, the -patient should remain at home. The inconvenience, indeed, of going out -is sufficient to prevent it. Under even the gentlest course of mercury, -he should remain at home in damp cold weather, and after sun-set. With -these exceptions, he should be as much in the open air as his strength -will permit. It is not exposure to a cool, or even a cold air, that -checks perspiration. In a dry cold air, with a due degree of exercise, -the insensible perspiration is perhaps freer than under any other -circumstances. All that is necessary with respect to temperature is, -that it shall not be so low that the quantity of exercise, which the -patient can take without inconvenience, shall not be sufficient to keep -up a proper degree of heat. - -All sudden changes of temperature, particularly that from warm to cold, -(which, notwithstanding the refinements of some modern philosophers, -may easily, I believe, be proved to be the most pernicious) are to be -guarded against. The same may be said of partial exposure to cold. -In short, it is not exposure to cold, but exposure to the causes of -what we call taking cold, that is injurious to those under the use of -mercury. - -Strong exercises, I mean such as induce any degree of sensible -perspiration, and all kinds of fatigue, are hurtful. - -All indigestible and irritating articles of food should be avoided -by those under the influence of mercury, both because it is proper, -under the use of all medicines which promote the excretions, to avoid -whatever debilitates, and because every thing that irritates the bowels -tends to solicit a more copious secretion from them, and thus to divert -the mercury from the channel, to which it is our aim to direct it. On -this account much wine, strong and high seasoned food, and whatever -tends to produce flatulence and acidity, are injurious. - -The diet, however, should not be low, as was once recommended under -the use of mercury, which, combined with the confinement, tended to -produce the greater part of the debility attributed to the effects -of the medicine. It should be nourishing, mild, and in some degree -mucilaginous. Wine should be drank in preference to every other kind of -fermented liquor. The stronger wines should be diluted. The quantity -should be moderate, but proportioned to the patient’s habits. - - - FINIS. - - -JAMES ROBBINS, Printer, Winchester. - - - - - Transcriber’s Notes: - - ――Text in italics is enclosed by underscores (_italics_). - - ――Punctuation and spelling inaccuracies were silently corrected. - - ――Archaic and variable spelling has been preserved. - -*** END OF THE PROJECT GUTENBERG EBOOK OBSERVATION ON THE USE AND ABUSE OF -MERCURY, AND ON THE PRECAUTIONS NECESSARY IN ITS EMPLOYMENT *** - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the -United States without permission and without paying copyright -royalties. 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D.—A Project Gutenberg eBook - </title> - - <link rel="coverpage" href="images/cover.jpg" /> - - <style type="text/css"> - -/* DACSoft styles */ - -body { - margin-left: 10%; - margin-right: 10%; -} - -/* General headers */ -h1 { - page-break-before: always; - text-align: center; /* all headings centered */ - clear: both; -} - -/* Chapter headers */ -h2 { - text-align: center; - font-weight: bold; - margin: .75em 0; -} - -div.chapter { - page-break-before: always; -} - -h2.nobreak { - page-break-before: avoid; -} - -/* Indented paragraph */ -p { - margin-top: .51em; - margin-bottom: .49em; - text-align: justify; - text-indent: 1em; -} - -/* Unindented paragraph */ -.noi {text-indent: 0em;} - -/* Centered unindented paragraph */ -.noic { - text-indent: 0em; - text-align: center; -} - -/* Drop caps */ -p.cap {text-indent: 0em;} - -p.cap:first-letter { - font-size: 250%; - line-height: 95%; -} - -/* Non-standard paragraph margins */ -.p2 {margin-top: 2em;} - -/* Horizontal rules */ -hr { - width: 33%; - margin-top: 2em; - margin-bottom: 2em; - margin-left: 33.5%; - margin-right: 33.5%; - clear: both; -} - -hr.tb { - width: 35%; - margin-top: 1em; - margin-bottom: 1em; - margin-left: 32.5%; - margin-right: 32.5%; -} - -hr.chap { - width: 65%; - margin-left: 17.5%; - margin-right: 17.5%; -} - -/* Physical book page and line numbers */ -.pagenum { /* uncomment the next line for invisible page numbers */ - /* visibility: hidden; */ - position: absolute; - right: 3%; -/* left: 92%; */ - font-size: x-small; - font-style: normal; - font-weight: normal; - font-variant: normal; - text-align: right; - color: gray; -} /* page numbers */ - -/* Text appearance */ -.smcap {font-variant: small-caps;} - -/* Small fonts and lowercase small-caps */ -.smfont { - font-size: .8em; -} - -.smallerfont { - font-size: .6em; -} - -.smallestfont { - font-size: .4em; -} - -/* Images */ -img { - max-width: 100%; /* no image to be wider than screen or containing div */ - height:auto; /* keep height in proportion to width */ -} - -img.deco1 {width: 6em;} - -img.deco2 {width: 4em;} - -.figcenter { - margin: auto; - text-align: center; - page-break-inside: avoid; - max-width: 90%; /* div no wider than screen, even when screen is narrow */ -} - -/* Footnotes and sidenotes */ -.footnote {margin-left: 10%; margin-right: 10%; font-size: 0.9em;} - -.footnote .label { - position: absolute; - right: 84%; - text-align: right; - text-decoration: none; -} - -.fnanchor { - vertical-align: super; - font-size: .65em; - text-decoration: none; - white-space: nowrap; -} - -/* Transcriber's notes */ -.tnote { - background-color: #E6E6FA; - margin-left: 10%; - margin-right: 10%; - padding: .5em; -} - -.tntitle { - font-size: 1.25em; - font-weight: bold; - text-align: center; - clear: both; -} - -/* Title page borders and content. */ -.author { - font-size: 1.25em; - text-align: center; - clear: both; -} - -.works { - font-size: .75em; - clear: both; -} - - </style> - </head> -<body> - -<div style='text-align:center; font-size:1.2em; font-weight:bold'>The Project Gutenberg eBook of Observation on the Use and Abuse of Mercury, and on the Precautions Necessary in its Employment, by A. Philips Wilson</div> - -<div style='display:block; margin:1em 0'> -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online -at <a href="https://www.gutenberg.org">www.gutenberg.org</a>. If you -are not located in the United States, you will have to check the laws of the -country where you are located before using this eBook. -</div> - -<p style='display:block; margin-top:1em; margin-bottom:1em; margin-left:2em; text-indent:-2em'>Title: Observation on the Use and Abuse of Mercury, and on the Precautions Necessary in its Employment</p> - -<div style='display:block; margin-top:1em; margin-bottom:1em; margin-left:2em; text-indent:-2em'>Author: A. Philips Wilson</div> - -<div style='display:block; margin:1em 0'>Release Date: August 8, 2021 [eBook #66016]</div> - -<div style='display:block; margin:1em 0'>Language: English</div> - -<div style='display:block; margin:1em 0'>Character set encoding: UTF-8</div> - -<div style='display:block; margin-left:2em; text-indent:-2em'>Produced by: Donald Cummings and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)</div> - -<div style='margin-top:2em; margin-bottom:4em'>*** START OF THE PROJECT GUTENBERG EBOOK OBSERVATION ON THE USE AND ABUSE OF MERCURY, AND ON THE PRECAUTIONS NECESSARY IN ITS EMPLOYMENT ***</div> - - -<div class="figcenter" id="cover"> - <img src="images/cover.jpg" alt="cover" title="cover" /> -</div> - - - - -<h1>OBSERVATIONS<br /> -<span class="smallestfont">ON THE</span><br /> -<span class="smallerfont">USE AND ABUSE</span><br /> -<span class="smallestfont">OF</span><br /> -MERCURY,<br /> -<span class="smallestfont">AND ON</span><br /> -<span class="smallerfont">THE PRECAUTIONS</span><br /> -<span class="smallestfont">NECESSARY</span><br /> -<span class="smallerfont"><i>IN ITS EMPLOYMENT</i>.</span></h1> - -<div class="figcenter" id="i_deco1"> - <img class="deco1" src="images/i_deco1.jpg" alt="decoration" title="decoration" /> -</div> - -<p class="noic">BY</p> - -<p class="noi author">A. PHILIPS WILSON, M. D.</p> - -<p class="noic smcap">Fellow of the Royal College of Physicians, and of the Royal -Society of Edinburgh, &c.</p> - -<div class="figcenter" id="i_deco2"> - <img class="deco2" src="images/i_deco2.jpg" alt="decoration" title="decoration" /> -</div> - -<p class="noic works">Winchester.</p> - -<p class="noic works">Printed and Sold by JAMES ROBBINS.</p> - -<p class="noic works">Sold also by Messrs. CADELL and DAVIES, Strand; MURRAY, Fleet-street;<br /> -and CROSBY and Co. Stationer’s Court, Ludgate<br /> -Hill, LONDON.</p> - -<div class="figcenter" id="i_deco3"> - <img class="deco1" src="images/i_deco3.jpg" alt="decoration" title="decoration" /> -</div> - -<p class="noic">1805.</p> - - - - -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<p><span class="pagenum"><a id="Page_3"></a>[3]</span></p> - -<h2 class="nobreak" id="OBSERVATIONS">OBSERVATIONS, &c.</h2> -</div> - - -<p class="cap">The following Observations are addressed -to the Public, with a view, on the one hand, -to do away certain erroneous prepositions -respecting the effects of Mercury, which -impede the necessary employment of it; -and on the other, to call its attention to the -impropriety of an indiscriminate use of this -medicine, by which much harm is often -done, and the medicine itself brought into -disrepute. The best way to effect these -purposes seems to be, to make the public -acquainted with what is really to be apprehended -from an improper use of mercury, -and the circumstances in which its bad -effects shew themselves; by which every -one may be enabled to distinguish these -effects from such as proceed from other -causes, as well as be warned against a use -of this medicine which has become too -prevalent.</p> - -<p>Physicians will agree, that we do not -possess a more valuable medicine than mercury.<span class="pagenum"><a id="Page_4"></a>[4]</span> -Not to mention the diseases for the -cure of which it was first introduced, -which, without its aid, almost uniformly -prove fatal, and in which it is almost uniformly -successful, we may appeal for the -truth of this observation to its effects in -some of the most dangerous forms of scrophula, -in dropsies of different kinds, in -inflammations, particularly chronic inflammations, -and induration and enlargement of -the different viscera.<a id="FNanchor_1" href="#Footnote_1" class="fnanchor">[A]</a></p> - -<div class="footnote"> - -<p class="noi"><a id="Footnote_1" href="#FNanchor_1" class="label">[A]</a> If we except worm cases, in which mercury probably -acts on the worms themselves, the various diseases -in which mercury is useful, may perhaps be -reduced to the two heads of inflammation and glandular -obstruction. I believe there is nothing more -erroneous than the opinion, that mercury will occasionally -succeed in almost all diseases. This opinion -has led to its employment in improper cases, and tended -consequently to bring it into discredit. I have never -found it successful except in the diseases here alluded to.</p> - -</div> - -<p>For many years after its introduction into -practice, it was confined to a few diseases. -At length it occurred to physicians, that a -remedy, which in these proved so efficacious, -might produce similar effects in other -cases; and such has been the success of the<span class="pagenum"><a id="Page_5"></a>[5]</span> -trial, that during the last twenty years -mercury has been coming into general use, -with a rapidity unequalled in the history of -any other medicine. But the more we are -assured of its value, the more cautious we -ought to be in its employment; both because -it is of the greater consequence to -prevent any prepossession against it, and because -we know that there is no active medicine -which can safely be trifled with.</p> - -<p>The prejudices which prevail against the -use of mercury seem to arise from three -sources; the nature of the complaints in -which it was first employed; the uneasiness -which even its salutary operation, when -carried to a certain extent, necessarily occasions; -and the bad consequences which -sometimes attend an improper use of it. It -is surprising, that the first of these causes -should operate against its use; yet such is -the confusion which naturally creeps into -our ideas on subjects in which we are not -habitually interested, that the prejudices of -not a few originate from this cause. Of -such a prejudice it is surely unnecessary to<span class="pagenum"><a id="Page_6"></a>[6]</span> -say any thing. The other objections to the -use of mercury are of more weight.</p> - -<p>Like all other medicines which increase -the secretion by the skin, the use of mercury -tends to debilitate, and render the body -more susceptible of cold. When mercury -does not encrease any other excretion, the -debility it occasions seems to be proportioned -to the degree in which it promotes -perspiration; and medicines which promote -perspiration in a greater degree produce -more sudden debility. We see a degree -of weakness produced by the operation of -James’s powders, or of Dover’s powders, -(opium and ipecacuanha), in a few days -which a moderate course of mercury would -not occasion in many weeks.</p> - -<p>Such is the tendency of mercury to promote -the secretion by the skin, that it often -runs off in this way almost as fast as it is -received into the system, particularly on its -first being used; so that it is sometimes -difficult to make a sufficient quantity be retained -to produce its desired effect. Some -of the good effects of mercury seem, in a -great measure, to arise from this action of<span class="pagenum"><a id="Page_7"></a>[7]</span> -it, particularly its tendency to counteract -the inflammatory disposition and to relieve -actual inflammation.</p> - -<p>This tendency of mercury readily accounts -for the bad effects of taking cold -under its influence. It is easy to conceive -that the bad effects of checking perspiration -will be most felt when, to use a common -expression, the pores are most open, that is, -when the secretion by the skin is most copious; -for the greater the quantity of fluid -thus discharged, the greater inconvenience -is to be expected from suddenly checking -its secretion. Hence also the danger of -suddenly checking perspiration, when, by -exercise or external warmth, it is rendered -more copious than usual.</p> - -<p>Such is the admirable constitution of our -bodies, that means are provided for more or -less successfully counteracting the operation -of every thing which tends to injure them. -If a thorn or any other extraneous body is -introduced under the skin, inflammation -and suppuration spontaneously arise, by -which the offending cause is expelled. If a -poisonous substance is received into the stomach,<span class="pagenum"><a id="Page_8"></a>[8]</span> -the action of vomiting is frequently -excited, or if it passes into the bowels, nature -still endeavours to carry it off by an -increase of the peculiar motion of the intestines, -and of the secretion from their surface; -so in the case before us, the morbid -fullness which would in every instance arise, -when perspiration suffers a check, is generally -prevented by the sympathy which -subsists between the skin and several other -secreting organs, in consequence of which, -as soon as a check is given to the action of -the former, some one of the latter, which -secrete a similar fluid from the blood, is -called into more vigorous action, and what -should have passed by the skin is thrown off -by the kidneys or bowels, sometimes by the -glands of the nose, throat, and lungs, occasioning -what we call a <em>cold</em>.</p> - -<p>This substitution of one excretion for -another, if I may use the expression, is -particularly apt to occur under the use of -mercury, and seems to arise from the nature -of this medicine being so stimulating -that we cannot retain it in the system: if -one vent is denied it, it quickly finds another.<span class="pagenum"><a id="Page_9"></a>[9]</span> -Hence it is that people under the effects of -mercury are so subject to an increased secretion -from the kidneys and intestines, and -from the glands of the mouth and throat.</p> - -<p>It is of great consequence in most cases, -in conducting a course of mercury, as much -as possible to prevent its running off, and as -we cannot wholly confine it, our plan is to -direct it to that channel thro’ which it -passes off most slowly; for it is well known -that this and some other medicines, while -they particularly excite any one excreting -organ, are not apt to pass off at the same -time in considerable quantity by any other. -Now the channel by which mercury passes -off most slowly is the glands of the mouth, -and fauces. Our view, therefore, is generally -to direct it to this channel, and the -degree in which it increases the secretion -from these glands is a sufficiently accurate -measure of the quantity of mercury in the -body, as we generally find that the effects -of mercury in removing disease are proportioned -to the degree in which it affects the -mouth. Besides the discharge, and consequently -the debility, occasioned by the same<span class="pagenum"><a id="Page_10"></a>[10]</span> -quantity of mercury, is less when it excites -these glands, than when it acts on the skin -and bowels.</p> - -<p>While it increases the secretion from the -glands of the mouth and fauces, it irritates -and inflames them, and the inflammation it -excites when the quantity which passes in -this way is great, often becoming considerable -and spreading to neighbouring parts, -much uneasiness is sometimes occasioned.</p> - -<p>The symptoms of salivation form the -chief of the bad effects, which are peculiar -to this medicine. They are indeed unpleasant, -but they are unattended with -danger. It is rarely proper to induce -them. A physician may practice for several -years without meeting with one instance -in which salivation is necessary; and the -extent to which the older practitioners -were accustomed on every occasion to carry -the use of mercury, may be regarded as one -of the greatest abuses which have opposed -the beneficial employment of this medicine. -It has certainly more than any other tended -to confirm the prejudices against it. All its -good effects can in most cases be obtained<span class="pagenum"><a id="Page_11"></a>[11]</span> -by slightly affecting the mouth, and keeping -up this affection for a longer or shorter -time, according as the complaint proves -more or less obstinate.</p> - -<p>In certain formidable cases which, we -have reason to believe, if left to themselves -would prove fatal, and in which more gentle -means have failed, it is proper to induce -salivation. But may not a similar objection -be brought against the use of most other -medicines? There are few whose operation, -is not attended with some inconvenience. -How alarming would be the operation of an -emetic were we not accustomed to see it! -Violent vomiting is a symptom occasioned by -some of the most fatal poisons, yet we are -easily reconciled to it when assured of its -beneficial tendency.</p> - -<p>From what has been said, the reader will -readily perceive, why a sudden salivation is -often the effect of taking cold under the -operation of mercury. We have no means -of immediately checking a salivation. Discontinuing -the use of the mercury, employing -gentle laxatives, and avoiding every -thing which tends to irritate the inflamed<span class="pagenum"><a id="Page_12"></a>[12]</span> -surface of the mouth and fauces will lessen -the inflammation and discharge, and by -degrees remove them.</p> - -<p>When the mercury instead of falling on -the glands of the mouth and fauces, is thrown -on the bowels in consequence of taking cold, -it is more in our power to regulate and restrain -the discharge. For the most part this -affection of the bowels is a mere diarrhœa. -The griping pains which sometimes attend it -seem to arise from the copious secretion -from the intestines washing off the mucus -which is the natural defence against the -irritation of their contents. When this affection -is allowed to continue, and no care is -taken to defend the bowels, dysenteric -symptoms sometimes shew themselves; -these are most frequently the consequence -of mercury taken internally, as I shall presently -have occasion more particularly to -observe.</p> - -<p>This affection of the bowels may be induced -in another way. It will have nearly -the same effect, whether the fluid, which -should pass by the skin is thrown on the -bowels in consequence of the action of the -skin being checked by taking cold, or in<span class="pagenum"><a id="Page_13"></a>[13]</span> -consequence of this fluid being directed to -the bowels by any cause of irritation applied -to their surface. Hence it is, that indigestible -and irritating food will often produce -such a change in the distribution of the -fluids, that the increased secretion by the skin -or salivary glands, occasioned by the mercury, -shall be exchanged for that by the bowels.</p> - -<p>When the mercury is thrown on the kidneys -it passes off, as by the skin, without -uneasiness of any kind; and as in this case -also, the only bad consequences are, that -the mercury, instead of acting on the system -for the cure of the disease for which it is -given, is drained from the body, and the -patient is sometimes weakened by the increased -discharge. Mercury may, to a certain -degree, be diverted from the kidneys by the -use of certain astringent medicines. Those -which direct it to the skin, by increasing -the action of this organ, will divert it from -the kidneys; but by this we should lose, not -gain, as it is thrown off by the former more -rapidly than by the latter.</p> - -<p>In many cases the action of mercury on -the kidneys is salutary, and our aim is as<span class="pagenum"><a id="Page_14"></a>[14]</span> -much as possible, by the use of diuretic medicines, -to direct it to this channel; for it -happens with respect to the kidneys, as -with respect to the bowels, that whatever -tends to irritate and increase the discharge -from them, solicits the mercury to them. -It is partly in this way that it often proves a -cure in various species of dropsy.</p> - -<hr class="tb" /> - -<p>As far as we have considered the effects of -mercury, its debilitating tendency seems to -arise from the evacuation it occasions. But -it debilitates in another way, which has not -been sufficiently attended to. Whatever -weakens the stomach and bowels is soon -felt in every part of the system, and even -medical men, as far as I can judge, are not -in general sufficiently aware of the bad -effects which often arise from the internal -use of mercury. To prescribe calomel, one -of the most active preparations of this medicine, -with the same freedom, and for the -same purposes, as rhubarb or senna, is in my -opinion altogether a misapplication of it.</p> - -<p>Few things apply to the stomach and intestines -a more hurtful irritation. I have -often seen temporary dysentery induced by a<span class="pagenum"><a id="Page_15"></a>[15]</span> -few doses of calomel, and I am convinced -from many cases that its habitual or even -occasional use as an aperient, however innocent -it may seem at the time, seldom fails at -length to debilitate the powers of digestion, -and is often productive of still worse consequences. -Calomel is frequently given to -children because it has little taste, and may -be given in small compass. But it is better -to give a milder medicine, tho’ a larger -quantity may be required. Perhaps the -smallness of the quantity in which it operates -is of itself a sufficient objection, for -there is no aperient which operates in very -small quantity that operates mildly, as we -might have foreseen, although the trial had -not been made. For my own part, I know -of few instances in which the internal use of -mercury seems proper. There are some -cases where powerful means are required to -rouse the bowels to action, or a strong stimulus -applied to their exhaling vessels is -beneficial; and mercury is sometimes successfully -employed internally for the removal -of worms, but in ordinary cases -we can surely with equal advantage use a -less irritating medicine.</p> - -<p><span class="pagenum"><a id="Page_16"></a>[16]</span></p> - -<p>When mercury is not employed as an -aperient, but for the purpose of impregnating -the system, what advantage is there -in giving it by the mouth. It seldom happens -that we cannot give as much as we -wish by the skin. I have known many who -were less debilitated by an ounce of mercury -taken by the skin, than by half a dram -received even in the smallest doses into the -stomach.</p> - -<p>In short, the objections to the use of mercury -by the skin, seem all to resolve themselves -into the two above treated of, the -debility occasioned by an increase of some -of the excretions, and a greater susceptibility -to the effects of cold.<a id="FNanchor_2" href="#Footnote_2" class="fnanchor">[B]</a> While there -are the same objections to the internal use -of mercury, there are far more weighty ones, -which are not the less so, because we cannot<span class="pagenum"><a id="Page_17"></a>[17]</span> -with the same precision define them. All -that we know of them is, that they chiefly -consist in a debility of the stomach and intestines, -which gives rise to the various dyspeptic -complaints, flatulence, acidity, diarrhœa, -and dysentery, effects which I have -so often witnessed from the internal use of -mercury, that I have for some years -almost wholly abandoned it, except in the -cases above alluded to.</p> - -<div class="footnote"> - -<p class="noi"><a id="Footnote_2" href="#FNanchor_2" class="label">[B]</a> It is unnecessary to notice a variety of groundless -opinions, respecting the effects of mercury, which -prevail among the vulgar, that it remains for ever in -the system, causes a rottenness of the bones, &c. -These are similar to the prejudices which prevailed respecting -the bark for a long time after its introduction -into practice, that it was formed into masses in the -stomach and bowels, from which it could never be expelled; -that nobody survived the use of it more than -seven years, &c.</p> - -</div> - -<p>The precautions suggested by what has -been said will, I believe, in every instance, -prevent the bad effects of mercury, with the -exception of the symptoms of salivation, -which it is now and then necessary to induce. -It will be proper to take a cursory -view of these precautions.</p> - -<hr class="tb" /> - -<p>As by promoting the excretions, mercury -tends to debilitate, it must be used with -caution in weak habits, and its debilitating -effects should be counteracted by the use of -such strengthening medicines as are adapted -to the case in which we employ it. The -debilitating effects of mercury, however, -are not such as many suppose. In a habit -of ordinary strength, a moderate course<span class="pagenum"><a id="Page_18"></a>[18]</span> -of mercury, properly conducted, produces -little debility, and I have seen many under -such a course recover both their strength -and flesh. The mercury gives vigour, by -removing the cause which impairs it. With -caution there is no danger in making a trial -of mercury in the most debilitated habit. In -such the quantity first employed should be -too small to produce any effect whatever. -Let it be gradually increased; if, as often -happens, the strength improves, let it be -continued; if the strength be much impaired -by it, it should be laid aside.</p> - -<p>Nothing tends more to debilitate under -the use of mercury, than the unfortunate -idea, that the patient should be denied the -advantage of free air and exercise. Under -certain circumstances, confinement to the -house is proper. When it is necessary to -induce salivation, the patient should remain -at home. The inconvenience, indeed, -of going out is sufficient to prevent -it. Under even the gentlest course of mercury, -he should remain at home in damp -cold weather, and after sun-set. With -these exceptions, he should be as much in -the open air as his strength will permit. It<span class="pagenum"><a id="Page_19"></a>[19]</span> -is not exposure to a cool, or even a cold air, -that checks perspiration. In a dry cold air, -with a due degree of exercise, the insensible -perspiration is perhaps freer than under any -other circumstances. All that is necessary -with respect to temperature is, that it shall -not be so low that the quantity of exercise, -which the patient can take without inconvenience, -shall not be sufficient to keep up a -proper degree of heat.</p> - -<p>All sudden changes of temperature, particularly -that from warm to cold, (which, -notwithstanding the refinements of some -modern philosophers, may easily, I believe, -be proved to be the most pernicious) are to be -guarded against. The same may be said of -partial exposure to cold. In short, it is not -exposure to cold, but exposure to the causes -of what we call taking cold, that is injurious -to those under the use of mercury.</p> - -<p>Strong exercises, I mean such as induce -any degree of sensible perspiration, and all -kinds of fatigue, are hurtful.</p> - -<p>All indigestible and irritating articles of -food should be avoided by those under the -influence of mercury, both because it is -proper, under the use of all medicines<span class="pagenum"><a id="Page_20"></a>[20]</span> -which promote the excretions, to avoid -whatever debilitates, and because every -thing that irritates the bowels tends to solicit -a more copious secretion from them, and -thus to divert the mercury from the channel, -to which it is our aim to direct it. -On this account much wine, strong and -high seasoned food, and whatever tends -to produce flatulence and acidity, are -injurious.</p> - -<p>The diet, however, should not be low, -as was once recommended under the use of -mercury, which, combined with the confinement, -tended to produce the greater part -of the debility attributed to the effects of -the medicine. It should be nourishing, -mild, and in some degree mucilaginous. -Wine should be drank in preference to every -other kind of fermented liquor. The -stronger wines should be diluted. The -quantity should be moderate, but proportioned -to the patient’s habits.</p> - - -<p class="p2 noic">FINIS.</p> - - -<p class="p2 works">JAMES ROBBINS, Printer, Winchester.</p> - - - - -<hr class="chap" /> -<div class="tnote"> -<p class="noi tntitle">Transcriber’s Notes:</p> - -<p class="smfont">Punctuation and spelling inaccuracies were silently corrected.</p> - -<p class="smfont">Archaic and variable spelling has been preserved.</p> -</div> - -<div style='display:block; margin-top:4em'>*** END OF THE PROJECT GUTENBERG EBOOK OBSERVATION ON THE USE AND ABUSE OF MERCURY, AND ON THE PRECAUTIONS NECESSARY IN ITS EMPLOYMENT ***</div> -<div style='text-align:left'> - -<div style='display:block; margin:1em 0'> -Updated editions will replace the previous one—the old editions will -be renamed. -</div> - -<div style='display:block; margin:1em 0'> -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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