Page:The American Cyclopædia (1879) Volume XI.djvu/415

MERCURY 403 preparations in very frequent use. The metal should be contained in them in a state of divi- sion so fine that its globules are not made visi- ble by a lens magnifying four diameters or more. A small portion of oxide is probably present in them also, which is more soluble than metallic mercury, and thus renders the preparations more active. When blue pill is taken in small but repeated doses, the first appreciable effect is usually an increased activity of the secretions, particularly of the intestinal canal, the dis- charges from which become liquid and bilious ; the mucous membrane of the lungs and genito- urinary apparatus may display a similarly aug- mented secretion. If there happen to be any- where an interstitial deposit of fibrine, or an exudation of lymph, or effusion of serum, its absorption may now be promoted; although Still6 says if the mercurial influence be carried too far, extensive ulcers will appear, sometimes coated with false membranes or exudations, and the eyelids and ankles may become cede- matous, and even general dropsy may ensue. In the next grade of the unfavorable action of mercury the appetite fails, digestion is im- paired, the secretions become still thinner and more copious, the firmness of the tissues di- minishes, newly formed callus is dissolved, and recently healed wounds open afresh ; the mus- cles waste, the skin has an earthy paleness, with the other consequences mentioned above. These symptoms, says Stille, appear to depend upon the radical change which the blood has undergone by losing a large portion of its nat- ural solid constituents, and perhaps a forma- tion of less highly vitalized compounds of al- bumen with the mercurial salt. Salivation is one of the most ordinary effects of the con- tinued use of mercury, and consists in a copi- ous flow of watery saliva, accompanied with swelling and soreness of the gums and a pe- culiar fetor of the breath. Ulcerations of the mouth may occur. The power of mercury to increase the secretion or discharge of bile, which for many years has been one of the most undoubted articles of medical faith, has recently been called in question ; but although it can be shown clearly enough that in certain dogs the secretion of bile is not increased thereby, yet there seems to be not only clini- cal but experimental evidence to show that, in some way or other, the flow of bile into the intestine is rendered more copious by mer- curial action. The constitutional action of most of the other mercurial preparations re- sembles that first described. Calomel (techni- cally called hydrargyri chloridum mite) is often given as a cathartic, and when so given pro- duces no constitutional action whatever, ex- cept in persons who are endowed with a pecu- liar and exceptional sensitiveness to its action. Corrosive sublimate is an irritant poison even in quite small doses, but when given in doses of ^ to ^ of a grain it is one of the best forms in which to use the drug for its sys- temic action. Turpeth mineral, which is a basic sulphate, is used as an emetic, and only exceptionally is absorbed in sufficient quan- tity to produce constitutional effects. Inunc- tions with mercurial ointment and fumiga- tions with the bisulphuret or other salts may also introduce the metal into the system and give rise to the effects above described. Both calomel and corrosive sublimate have been injected subcutaneously, but when adminis- tered in this way are liable to produce ab- scesses. Mercurial fever an'd mercurial tre- mors, the latter often an extremely obstinate affection, are among the constitutional effects of mercury. Still6 says : " Few medicines produce such a marked sense of depression, both mental and bodily, as mercury even in ordinary doses; but when the system is brought thoroughly under its influence, these effects become distressing; the susceptibility to external impressions, and particularly to that of cold, is augmented, pains in the limbs are felt, slight annoyances disturb the equa- nimity, and sometimes mental debility ensues, so that a moody melancholy and fear of death may overtake the patient." The statements in regard to the resemblance of lesions induced by mercury to those of the later stages of syphilis are probably exaggerated, as the symp- toms of mercurial poisoning, however severe they may be, are not, so far as can be ascer- tained by examining workmen in establish- ments where mercury is used and mercurial poisoning familiar, the same as those of syph- ilis. It is impossible to give in any reasonable space an account of the uses which have been made of mercury in various diseases. It is much less used now than formerly, and its marked constitutional effects when it is em- ployed are avoided, if possible, rather than sought for. It is most largely employed in the treatment of syphilis, but it can be shown that even here it is not absolutely essential, although surgeons of great experience are con- fident that the disease is rendered shorter and more manageable thereby. The general verdict of the medical profession is undoubt- edly in favor of using mercury in the treat- ment of syphilitic disease, but of limiting its use to appropriate cases. It should not be administered indiscriminately in syphilitic any more than in other affections. In tertiary syphilis it should be used with great caution, if at all. It is given most advantageously in the primary, secondary, and hereditary forms of the disease, when these occur in individuals whose constitutions are capable of bearing the action of the drug. Whenever inflammation, especially of serous membranes, is accompa- nied with exudation, the careful administra- tion of mercury is often of advantage in pro- moting absorption of the exudation. Mercury is a dyad, and forms two sets of compounds, the mercurous and mercuric salts ; there are two oxides, mercury monoxide or mercuric oxide, HgO, and mercurous oxide, Hg 2 O. When mer- curic oxide is prepared by decomposing the ni-