Part 2

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. 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.

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.

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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.