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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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