Mercurius Corrosivus

[CORROSIVE SUBLIMATE, THE DEUTO-CHLORIDE OR BICHLORIDE 01?

MERCURY.]

We may obtain this salt by first distilling to dryness three parts of metallic mercury dissolved iji five parts of concentrated sulphuric acid, and afterwards triturating the resulting salt with equal parts of common salt. The triturated mass is then sublimed in a sand- bath. This is the dry way of obtaining the salt. The wet way consists in dissolving red precipitate in hydry chloric acid, and after- wards evaporating the solution to dryness, or allowing the salt to crystallize.

"It occurs in the form of colorless crystals, or of white, semi- transparent masses, of an acrid, metallic, styptic and very persistent taste, soluble in sixteen parts of cold and in three of boiling water. It is at once distinguished from the other mercurial preparations by its color, taste, and solubility, and by its forming a yellow precipi- tate with lime-water." (Dr. H. C. Wood, Jr.)

This is the most poisonous and corrosive of all mercurial salts. Many cases of poisoning by it are reported in works on toxicology. The poison acts with destructive force upon the mucous lining of the mouth, oesophagus and stomach, causing softening and gangren- ous disorganization of this membrane. Its external use is not with- out danger, and one case is on record (Dr.

Meers, in the Lancet, September, 1871,) in which a solution of two grains of the salt to one fluid ounce of water, caused death in a child to whose scalp it had been applied with a camel's-hair brush for the cure of an erup- tive disease.

In swallowing an acrid poison, pain need not necessarily be pres-

3G2 MEECURIUS C0RR0S1VUS.

ent. Mackintosh, in his Practice of Physic, mentions the case of a soldier, who died in eight or ten days after swallowing two drachms of corrosive sublimate ; there were no local pains, though the stomach was found ulcerated, and the great intestines were studded with large, gangrenous ulcers, and the mucous membrane was hanging loose in shreds.

The following case of poisoning, reported by Devergie, illustrates very fully the destructive action of the poison:

A woman swallowed a quantity of corrosive sublimate about sis o'clock in the evening. Her husband found her shortly after, very restless, vomiting continually and tormented by constant urging to stool. A physician was sent for who found her at eleven o'clock at night extended on her bed, without control over her limbs; skin cold and dripping with perspiration ; face pale, colorless ; eyes dull and dim and expressive of agony; lips and tongue whitish' and shrunk; thirst intense; deglution so difficult and painful that the least attempt to swallow a drop of liquid caused spasms of the (esophagus and stomach, with vomiting of whitish, slimy, tenacious masses which became mixed with bile if the vomiting continued any length of time.

Pressure on the throat was painful ; the patient experienced a sensation of warmth and burning along the whole of the oesophagus ; the skin on the abdomen was cold ; the epigastrium was painful even from the least pressure. Alvine evacuations and frequent and violent urging with tenesmus and violent burning. She complained of violent burning and horrid distress in the stomach ; the beats of the heart seemed remote and slow ; pulse small, filiform, scarcely perceptible ; respiration slow.

In spite of treatment the patient died next day.

A post-mortem examination showed a congested condition of the cerebral vessels, effusion of red serum in the lateral ventricles at the base of the brain ; the larynx slightly violet-colored, and the inside of the trachea and bronchi lined with a vascular network. The stomach was covered with violet and reddish-brown spots; the mucous coat was of the color of bricks. The lining membrane of the bowels was slightly red. The liver was of a normal size, colorless, and having the appearance and consistence of fatty liver.

The uterus was completely clogged with albuminous mucus.

A young girl, fifteen years old, swallowed a teaspoonful of a strong solution of corrosive sublimate. She did not inform any one of her act, until half an hour later, when "white of 'eggs" was given her. Dr. S. 0.

Warren saw her also, after this. She then suffered from severe burning pains from the mouth to the stomach, with intense thirst, and vomiting of everything taken into the stomach, extreme hoarseness, could speak only in a whisper, expectorating bloody mucus and clear blood, considerable fever and restlessness. The

MRRCURIUS COREOSIVUS. 3U3

bladder sympathized, and there was great tenesmus, with retention and almost complete suppression of urine, at least only a very small quantity was obtained by means of tbe catheter. There was great tenesmus of the bowels, and frequent but ineffectual attempts were made to evacuate them. There was high and active fever, the pulse run up to 130, the bowels were distended, hard, and sensitive to pressure. She vomited everything taken into the stomach, and, at times, what appeared to be fecal matter, clotted blood and large pieces of detached mucous membrane.

She bled profusely at the nose, at one time nearly a quart ; there was an eruption all over the surface, which itched intensely, and bled profusely upon being scratched. She had frequent spasms, affecting the whole system, crumps of the bowels and lower extremities. Frequent and sudden shocks, at times like electric shocks, convulsed the whole system ; these were occasionally so severe that she would spring to the ceiling, and had to held on the bed. She was delirious, her face red, the eyeballs red and injected and seeming to. start from their sockets.

Every motion she made was quick and decided ; when rising in bed it was done very quickly, and if she attempted to do anything, it was done on the instant; if she desired anything done, she could not wait a minute, every minute seemed to her an hour, her appearance indicated great suffering. At the expiration of ten days the intense symptoms gradually subsided. The fever assumed a typhoid char- acter. There was prostration ; dry, cracked tongue ; quick, small pulse, 130 per minute; the eyes were half closed; sub.-ultus tendi- num ; drowsiness ; she would rouse up with an effort, but immedi- ately drop into a sleep again.

These symptoms gradually lessened in intensity and the fever disappeared in two weeks. The secretion became natural, the patient gradually recovered her health and strength, and is not now suffering from any effects of the poison. ■{Halm. Monthly, October, 1875.)

Masselot instituted on his own person comparative experiments with arsenic and corrosive sublimate, with a view of determining the relative degree of intensity of the action of these poisons. He commenced with one-thirteenth of a grain of arse- nic daily, and gradually increased the dose until, after the lapse of twelve days, he took two-fifths of a grain every day which he swallowed in four parts of one-tenth of a grain each, at intervals of four hours. He took this quantity for six days without experiencing any other results than an increased appetite, a more rapid and easier digestion, a slight increase of the urinary secretions, great ease and readiness in walking, and a slight degree of sexual excitement, but not the least febrile heat.

Corrosive sublimate produced quite different results. Already after swallowing the second portion of three-sixteenths of a grain he experienced a feeling of obstruc- tion and anxiety in the prtecordia and epigastric region, followed by slight palpita- tions; after the third dose: a general feeling of malaise, some pain in the stomach, passing colic, feeling of weakness and shivering in the limbs, palpitation ; after the fourth dose: painful pinching in the stomach, lassitude in the limbs and trembling when standing up and without moving; increased anxiety, more frequent palpita- tions, creeping chills, sensation of coldness, paleness of the face, attacks of nausea,

364 MERCURIUS CORROSIVUS.

bloated bowels, borborygmi, colic and tenesmus, and six discharges during the night. On the following day the experimenter only experienced some malaise and a little less appetite than usual. Three days after, the experiment was repeated in the same order, and the same effects were experienced, only more intensely; the anxiety, paleness, disposition to chilliness, lassitude and tenesmus especially were more marked. He had moreover several attacks of vertigo, and twice he experienced a spasmodic vomiting of a serous substance, without any previous nausea.

The effects of the poison continued more or less for two days.

These experiments show that corrosive sublimate affects power- fully the vegetative system, and that the poisonous doses may readily destroy its vitality.

The poisonous effects and corresponding curative range of corrosive mercury may be comprehended under the following categories :

CEPHALIC GROUP.

HEMICRANIA. — Frightful paroxysms of hemicrania every even- ing and night.

SPECIAL SENSES.

OPHTHALMIA. — Rheumatic, scrofulous, and syphilitic ophthal- mia, especially when the sensitiveness to light is very great. In

RETINITIS AND IRITIS, the sublimate has done good service, especially in persons of a scrofulous or syphilitic taint, or after operations.

BUCCAL GROUP

STOMACACE with complete softening or gangrene of the mucous lining ; it looks whitish or greenish, bloody.

CHTLO-POIETIC GROUP.

MUCOUS GASTRITIS, with vomiting of blood and mucus, burning in the stomach, unquenchable thirst, vomiting when attempt- ing to swallow the least liquid.

GASTROMALACIA of children, pain, swelling of region of stomach, soreness, vomiting, diarrhoea.

DYSENTERY, frightful tenesmus, discharge of blood and mucus, retention of urine. In our own practice we have found the lower and middle attenuations to act with particular promptness, especially if the discharges were of clear blood, attended with agonizing tenesmus.

ULCERATION OF THE BOWELS, with watery diarrhoea, also bloody; with cutting and burning pains in the bowels, tenesmus-.

PARALYTIC WEAKNESS and paralysis of lower limbs, inar-

* MERCURIUS COREOSIVUS. 365

ticulate speech, distortion of facial muscles; irregular, small, contracted pulse, also quick and jerking, not full pulse. The paralyzed limb is cold, the skin dry. A similar effect has been wit- nessed from the acetate of mercury.

THORACIC GROUP.

In scrofulous and syphilitic ulceration of the lungs, the sublimate is highly spoken of. The sudden sujipression of a chancre or of a syphilitic eruption by external means may lead to ulcerous phthisis which corrosive mercury may be alone able to cure. The same remarks apply to headaches which sometimes appear years after such suppression.

FEVER GROUP.

SLOW HECTIC FEVERS, springing from a syphilitic source, yield to the corrosive sublimate. The patients complain of extreme prostration and fetid sweats. In

TYPHOID ENTERITIS, with foul, bloody stools ; burning in the bowels, tympanitic distention of the bowels, soreness to pressure, this agent may prove very useful.

SEXUAL GROUP.

Nearly all of the mercurial salts play an important part in the treatment of venereal diseases. The corrosive sublimate has been used more especially in

GONORRHCEA with yellowish, green, purulent discharge and much swelling and inflammation of the parts. There is, also, burn- ing and itching, stinging and throbbing in the urethra, the urine passing with a feeble stream. The symptoms are worse at night.

CHANCRE, of a phagedenic appearance ; secretion of thin, ichorous pus ; much pain and swelling of the glans of the penis ; chancres which bleed easily, with ichor adhering firmly to the bottom of the ulcer ; ulceration of the soft tissues in the mouth and throat ; bubo.

Various complications arise from the suppression of syphilitic diseases ; the corrosive sublimate frequently plays an important part in their treatment. Trousseau reports a case of

EPILEPSY, of several years' standing, in a young gentlemen who had contracted syphilis. After the suppression of chancres by cauterization the epileptic paroxysms broke out« They were cured, promptly and readily, with corrosive sublimate, in doses of one- hundredth part of a grain.

366 MERCURIUS CORROSIVUS. *

A young man had a chancre suppressed on himself by cauterization. Soon after a phagadenic sore broke out on the bridge of the nose, rapidly extending toward the eyes. The right eye was considerably inflamed, when we prescribed a solution of two grains of corrosive sublimate in eight ounces of water, a teaspoonful to be taken every two hours, making also an external application of the same drug, in the form of an ointment, to the inflamed eye. Within a fortnight the patient was dis- missed cured ; there was not even a scar left.

EXANTHEHATOUS GROUP.

Corrosive sublimate is eminently useful in syphilitic eruptive diseases of a secondary character ; in lepra, psoriasis, herpes, maculae, papulae, ulcers. If these eruptions can be traced to a scrofulous diathesis, this agent has likewise been employed with success. A case of leprosy, for instance, is reported in Hufeland' Journal char- acterized by thick, white crusts over the whole body, with bleeding rhagades, where the sublimate effected a cure.

NODES, CAKIES. — In syphilitic diseases of bones, nodes, caries, corrosive mercury may prove eminently useful, and may compete with the iodide of mercury and the hydriodate of potash.

SYPHILITIC ERUPTIONS with furious itching and burning require the sublimate. Many alloeopathic physicians use the subli- mate baths on such occasions, dissolving from one to four hundred grains of sublimate in a tubful of tepid water. If these baths are used, the patient should be kept in a uniform temperature until the cure is completed.

SMALL-POX frequently calls for the exhibition of mercury. The corrosive sublimate is indicated when the mucous membrane is greatly affected, when characteristic intestinal disorders show them- selves and when the throat is sore. During the epidemic, which raged in Europe in 1870, this salt proved of the greatest service in such conditions, used internally and as a gargle for the throat.

NERVOUS GROUP.

The peculiar effects of the mercurial preparations, as a class, will be treated more fully in a subsequent study. Experiments made by English physicians with mercurius corrosivus (in the 3d decimal trituration) show that it has a marked and peculiar effect upon cer- tain branches of the fifth pair of nerves, viz. : the frontal branch of the ophthalmic, the superior maxillary and the inferior maxillary. The pains which it cured, were long-continued, intense, darting pains, (but also steady and continuous at times), they remitted during the day, with nightly aggravations, especially before mid- night; they were located on the left side.

•! MERCURIUS CTANATUS. oGT

We use the sublimate in solution, dissolving one part of it in twenty parts of water. This makes the strong or concentrated solu- tion. The second attenuation is made from this solution by means of dilute alcohol in the proportion of 1 to 10 ; all subsequent attenu- ations are made with strong alcohol.

In a case of poisouing by this salt, we give an emetic of sulaphte of zinc, if we have time ; or we resort at once to large quantities of the white of eggs, milk, sugar and water, mucilaginous drinks. The sulphuret of potassium, oleaginous beverages, and liquids containing a good deal of tannin, are likewise good antidotes.

MERCUKITTS CYAl^ATUS.

[CYANURET OE MERCURY ; CYANIDE OR BICYANIDE OF MERCURY ; PRUSSIAN MERCURY.]

The cyanuret of mercury was discovered by Scheele. It occurs in square, four- or six-sided prisms, heavy, white, transparent or opaque. It is odorless and has a disagreeable, metallic taste. It is soluble in water, hot or cold ; less so in alcohol. The dry salt subjected to heat yields metallic mercury and cyanogen gas. Nitric and sulphuric acid, diluted, dissolve it without decomposing it ; heated with hydro- chloric acid it evolves hydrocyanic acid.

Dr. Kapeler (Orfila, Toxicologic Generale i., page 334,) relates the case of a man who took twenty-three grains of cyanuret of mercury. He was at once taken with bloody vomiting, frequent and copious stools, and severe pains in the whole abdomen. Dr.

Kapeler found the patient, four days after the poisoning, in the following condition : Face serious, animated ; the eyes fixed ; conjunctiva in- jected ; severe headache ; strong palpitation of the heart ; frequent, but full and hard pulse ; respiration free ; slight cough ; the lips, tongue and the inner cheek are full of ulcers, covered with a grayish white membrane ; the salivary glands are swollen and tumefied ; salivation with mercurial odor from the mouth ; difficult deglutition ; great thirst, with nausea and continual desire to vomit after drink- ing; the stomach is soft, without pain on pressure; frequent desire for stool, preceded and accompanied by tenesmus ; stools small, bloody ; suppression of urine ; the genitals are of a dark-blue color.

From the fifth to the eighth day the palpitation iu creased; he was restless at night ; the salivation diminished, but the condition of the mouth and throat remained the same ; slight convulsive motion in the extremities. On the eighth day : general debility, frequent faint- ing, continued convulsive motion of the extremities; drowsiness ;

368 MERCURIDS CYANATUS.

he wakes easily ; pulse small, slow ; less vomiting ; no pain in the stomach ; suppression of urine and the blue appearance of the genitals continues. In the evening: slow, hard pulse ; cold extrem- ities ; no vomiting, but continual, fatiguing hiccough ; no urination. On the ninth day : extreme prostration, repeated fainting, suppres- sion of stool and urine ; death.

Examination eight hours after death showed the following : color of the skin pale-white ; the superior and inferior extremities are con- tracted in such a manner, that the body rests on the back as on a pivot ; the larynx, trachea and bronchi contain a whitish mucus, so copious that a part of it runs out through the nostrils ; the pleura, otherwise healthy, contains some ounces of a pinkish serum; the lungs are healthy, and when cut an abundance of serum escapes. When the skin, muscles and blood-vessels are cut through, some pale and very fluid blood runs out; the vena cava inferior is filled with a large, elastic and very tenacious clot; the ventricles are almost empty ; the right auricle contains a fibrinous clot.

The cavity of the mouth exhales a peculiar, fetid odor. The mouth and the inner gums are full of ulcers, covered with a gray skin ; the tongue is larger than natural, ulcerated on its edges and covered with a gray, tough layer, dry and harsh to the touch and difficult to remove. The pharynx is sound ; there is, in the middle of the oesophagus, a red marbled spot of the size of a dollar, darker in the center than at the circumference. The peritoneal cavity contains some yellowish serum.

The gastro-infcestiual mucous membrane is of a brown-red color near the small cul-de-sac and pylorus ; near the cardia and large cul-de-sac it is of deep' red color, greatly puffed up and all the vascular ramifications are fully developed. The duodenum and jejunum are also puffy, darkened and in some places even blackish, in others somewhat gangrenous, especially near the caecal valve ; the redness is of the same character in the ccecnm, rather pale in the ascending colon, of a deeper red in the transverse and pale in the descending colon ; intensely red in the rectum.

Throughout the whole length of the intestinal tract the mucous membrane is puffed up, and in some places, especially in the small intestines, granulated and rough ; an abundant serous infiltration can be observed in the submucous cellular tissue. The pancreas is large, hard and dry, tears easily and gives a noise under the scalpel. * * * The sub- renal capsule and the kidneys are enlarged ; the tissue of the kid- neys is pale; the bladder is contracted, containing a small quantity of milky urine ; the genitals are nearly black.

Chemical analysis of the blood and feces showed the coloring matter to be darker than natural ; no mercury could be detected in the blood or feces.

M. H., aged nineteen years, took, by mistake, on March 13, 1SG3, a glass of sugar-water, which contained a strong dose of cyanuret of mercury. Shortly after swallowing the poison, the patient felt an icy coldness, followed by nausea, vomiting and frequent diarrhceic

MRRCURIUS OYANATUS. 369

stools, preceded by severe colic. A sensation of general weakness accompanied the stools, followed by a fainting spell, during which he fell down on the carpet ; when he recovered consciousness lie found his clothes covered with vomited and fecal matter. When visited in the morning, he looked like a person suffering from intense cholerine ; the face was pale-bluish and wan, the eyes sunken, the skin icy-cold; the pulse was small, weak and about 70 to 76; the tongue was dry, thirst excessive, but liquids were at once rejected by the stomach; there was a styptic, disagreeble taste in the mouth.

The abdomen was flat aud not sensitive to pressure. When seen in the evening, he had twice vomited bilious matter, without relief from the nausea, and has had six foul-smelling diarrhoeic stools. During the two months of illness which followed, the gastro-intestinal track and the mouth aud throat seemed particularly affected. There was violent diarrhoea, with much thirst and with tenesmus ; this diar- rhoea was wholly absent for several days, when he was suffering intensely with his mouth ; as the latter grew better, the diarrhoea returned, consisting of black, watery, foul, frequent stools, with severe colicky pains and symptoms approaching collapse.

At a later date, severe pains in the rectum and anus were followed by a copious haemorrhage, haemorrhoklal tumors, and even a deposit of grayish diphtheritic membrane at the anus, with exudation of a liquid of gangrenous odor, assuming the appearance of purulent matter after a day. On the fifteenth day of March the mucous membrane of the mouth became invaded ; the gums were swollen and covered with a white layer, under which was found a violet border ; the tongue was swollen, red on the borders and covered by an adherent grayish coat- ing.

The mucous membrane of the pharynx and mouth were red and injected. On the day following, a white opaline layer had formed on the columns of the velum palati and on the tonsils ; on the inside of the right cheek was a round ulcer with a grayish base, the borders as if cut out, and surrounded by great redness. During the next few days the ulceration of the mouth had extended, char- acterized by the same deposit of membranous matter, but got much better about March 20th, when the diarrhoea, which had been absent since the diphtheritic inilamination in the mouth developed, returned in a violent form.

During the long period of illness there was also present: much thirst; headache, at times with vertigo; scanty or suppressed urination ; severe pains in the calf of the leg, where the veins formed two hard strings, which united a little below the ankle, with great sensitiveness to touch.

An examination of the cases given shows that mercurius cyanatus resembles the other salts of mercury in its action upon the mucous membrane and underlying structure. It differs from them in the peculiarity and intensity of the mouth and throat symptoms ; it is true, the iodides of mercury have a similar and well-defined group of symptoms, but they do not stand forth as prominently in their

370 MERCURIUS GYANATUS.

pathogeneses, nor is the one symptom, "deposit of false membrane" found in them with any degree of uniformity. On the other hand, glandular swellings and a tendency to the formation of ulcers in the buccal cavity, complicated with glandular enlargements, are far more clearly marked in the iodides than they are in the cyanuret of mercury.

The cyanuret of mercury resembles the corrosive sublimate in the intensity of its action upon the intestines. When we take into con- sideration the violence of the intestinal disturbance experienced, the long-continued and painful diarrhoea, the tenesmus, the burning in the rectum and anus, the haemorrhage from the bowels and the post- mortem appearance of those parts, as described in the first case quoted, we are led to expect promptly curative action of the remedy in violent inflammations of the intestines, more particularly of the the rectum. At this date, however, we have no clinical experience with the remedy in this class of diseases.

DIPHTHERITIS. — The cyanuret of mercury has been used, with excellent success, in diphtheria, involving the mouth, fauces, larynx and pharynx, with a tendency to putrescence ; the membrane is grayish and tough ; salivation is profuse ; there is rattling and whist- ling in the throat ; dry, hot skin ; scanty urination.

Mary, seven years old, has never been sick. She had been coughing for a week, and for four days had complained of a sore throat, expectorating, after violent efforts, glairy mucus, and for three days suffocative paroxysms woke her up during the night, with a barking cough. Emetics had been given with only momentary relief. I found the child sitting up, the muscles of the face contracted, the face cyanosed, the skin burning, the eyes injected and staring; the voice was extinguished; respiration showed laryngotracheal whistling ; the nasal cavities were obstructed by false mem- branes, the submaxillary ganglia engorged and saliva flowed constantly from the open mouth.

Examination of the throat showed the tonsils, the velum palati, in fact the whole throat covered with false membranes. The child had refused all nourish- ment for twenty-four hours. Prescribed bromine3. Next morning the child was worse, the dyspnoea more intense, the suffocative paroxysms more frequent, the child refused to be examined, and force produced suffocative fits.

Prescribed tartar emetic3. In the evening, no change for the better ; prognosis unfavorable. Prescribed cyanu- ret of mercury, every two hours. On the next morning I found the child quiet; the voice was still gone, but the laryngotracheal whistling was less and cough and expectoration more easy.

The parents stated, that after taking the second dose of the cyanuret the child expectorated a quantity of thick, gieenish masses, like green ribbons. On the seventh and eighth days, constant amendment under the same prescription; pulse ioo; there was still a large diphtheritic spot on the left tonsil; the child called for food. On the tenth day an aggravation set in, the pulse rose to 130, suffocation and whistling rales reappeared, and, looking for the cause of it, I found that the medicine had not been given for the last sixty hours.

Its regular use, every two hours, was again followed by amelioration during the eleventh and twelfth days ; hepar sulphur'2 was then given, because of the great hoarseness of the patient. On the fourteenth day the child's condition again demanded the exhibition of the cyanuret, which she took regularly and with benefit to the nineteenth day, when phosphorus6 was given on account of the aphonia. (Dr. Roguin, Hahn.

Monthly, December, 1872.)

MERCURIUS CYANATUS. 371

Boy, aged four years, lived in a bad cellar-tenement. One brother and sister had just died of diphtheria, without treatment. The tonsils, velum palatinum and fauces were much swollen, dark-red and thickly covered with exudation ; great diffi- culty in swallowing; hoarse cough; rough, dry cough with anxiety; skin hot and dry; pulse 1 30, small; great weakness ; apathy; emaciation. Cyanuret of mercury 6th centesimal, one drop to a half a glass of water, one spoonful every two hours.

In twenty-four hours the swelling of the velum and fauces had diminished one-half; the color of the mucous membrane was almost natural ; there was only a trifling- vestige of the exudation, pulse 90, skin almost normal. The second night, quiet sleep and appetite, and no more symptoms. (Dr. W.

H. Burt in Am. HoniceopatJiist, January, 1878.)

A scrofulous girl, aged three years ; the mother scrofulous and the father syphi- litic. On the fourth day of diphtheritis the following condition existed : The child was lying on its back with hanging under-jaw and half closed eyes ; sopor, but easily aroused when spoken to ; mouth and fauces completely covered with whitish-gray exudations; the lips were dry and bled upon opening the mouth ; the nose was stop- ped up ; swallowing impossible ; the patient could utter only a few croaking sounds ; emaciation and flabbiness of muscles; extreme weakness; skin hot and dry ; pulse excessively weak, and so fast that it could not be counted ; dark, scanty urine with- out sediment; no stool for two days.

Prognosis very unfavorable. Aconite and belladonna proved ineffectual. Prescribed cyanuret of mercury30, three globules every two hours. Improvement began after the fourth dose ; complete recovery on the fourth day. {Ibid.)

There is on record a large amount of testimony to the efficacy of the cyanuret in the treatment of diphtheritis, even in its most aggressive form. Dr. Villers, a prominent homoeopathic physician, used it with such excellent results, that his example was imitated by his alloeopathic colleagues, among them Dr. Erichsen, who describes the effects of the remedy as follows: "In a short time the membranes became thinner and less adhesive, so that even where they had spread into the larynx and induced obstruction, with cyanotic coloring of the face, they still separated and rendered the larynx free again.

This was the case in three instances occurring among young children, the symptoms, which seemed to threaten death or to require tracheotomy, yielding to the internal use of the cyanide and the local application of hot sponges." How frequently our colleagues of the physiological schools thus blindly pay tribute to the truth of that law whose very existence they claim to doubt !

TONSILLITIS. — Mercurius cyanatus has been used in tonsillitis with ulceration, profuse flow of ropy saliva, and the local and con- stitutional symptoms, which usually call for the exhibition of mer- cury.

Mrs. D., aged twenty-four years, has been suffering since morning with severe sore throat. She feels very weak; pulse 120; skin hot and diy; deglutition very pain- ful ; has frequent pains, which dart from the throat to the ear and head. Examina- tion shows the tonsils greatly inflamed and enlarged.

Prescribed aconite and bella- donna in alternation. On the day following, the fever was somewhat diminished; the tonsils are less acutely inflamed but much ulcerated. The ulcers are deep, and many of them filled with greenish-yellow pus. The pain in swallowing is very severe.

Prescribed mercurius cyanatus, two grains in half a tumblerful of water ;

372 MERCUEIUS DULCIS.

two teaspoonfuls every two hours. Next day she felt much better; appearance of the throat has greatly improved; the tonsils are much less swollen: ulceration nearly gone. The remedy to be given once in three hours. The patient was discharged cured on the following day, with her tonsils free from ulceration and reduced to almost their normal size. (Dr. Geo. W. Richards, in the New Eng. Med. Gazette, March, 1871.J

A few weeks ago, the writer was called to see a child, three years old, suffering from a severe attack of tonsillitis. She had suddenly been taken with a chill, fol- lowed by a reasonably high fever and a violent sore throat. The tonsils were very much enlarged and covered with deep, grayish looking ulcers. Deglutition was impossible, because of the exquisite pain caused by the effort.

There was frequent cough and expectoration of thick, ropy saliva. The cervical glands were slightly enlarged and somewhat sensitive to pressure. Mercurius cyanatus, 3d trituration, every two hours, cured the case in thirty-six hours.

CHRONIC LARYNGITIS— Dr. Charge recommends the cyanu- ret in chronic laryngitis when there are present : ulcerations of the middle of the palatine arch, with inverted edges, uneven and cal- lous. The whole palate, the columns of the velum and the tonsils are swollen, and of a pale color. The breath offensive.

MEKOUKIUS DULCIS.

[PROTO-CHLOEIDE OP MERCURY, CALOMEL, SUBMURIATE OE MERCURY.]

This preparation is obtained by making a solution of nitrate of mercury in sixteen parts of water, and precipitating the chloride from the solution by gradually adding a solution of one part of common salt in nine parts of water.

This mercurial salt has been most commonly used by the regular school as an alterative agent. It has been used as a means of ex- citing salivation or diarrhoea, thus seeking to divert the morbid pro- cess that was going on in other tissues.

The sialogogue and cathartic properties of calomel have been more particularly resorted to for the purpose of altering the course and nature of the morbid process. In a case of dropsy, for instance, salivation is excited for the purpose of carrying off the effused fluid. This is what is meant by alterative action. One pathological process is substituted for the original morbid condition.

The disease is not cured, the pathological process is simply altered in its character, an artificial, medicinal irritation being substituted in the place of the original malady. What a vague, uncertain and frequently danger- ous proceeding! How often does the original malady remain unal- tered, and is moreover complicated with an artificial disease ! And how often does this artificial malady prove a devastating scourge

MERCURIUS DULCIS. 373

which remains entailed upon the constitution until death wipes out all traces of this unpardonable destruction of human power and happiness ! Calomel must alter the pathological process. If five grains will not do it, ten must, and if ton will not it, we will try fifty or an hundred. This is the law, not the law of nature, but the law of professional infatuation.

In the Latin of old Juvenal : "Sic volo, sic juheo, stet pro ratione voluntas!" Thus I will try it, this is my command, let my will stand in the place of common sense !

As examples of the alterative action of calomel in the hands of old-school physicians, we may mention the use of calomel

1. In hydrocephalus, which disappeared and was speedily followed by enteritis terminating in gangrene.

2. In croup; a boy of fifteen months was given nine grains of calomel in three days ; no membrane was formed ; there was simply expectoration of a puriform, tenacious substance ; bilious diarrhoea set in for eight days; in the second week the mesenteric glands became hard and swollen, so that they could be distinguished one from the other; several weeks after, the child died of tabes mese- raica.

3. In dropsy, which disappeared ; in its place foul sores broke out upon the legs.

In the hands of an homoeopathic physician, calomel is an excellent mercurial preparation. We make triturations of it, and use it in syphilitic and scrofulous affections. It is especially in derangements depending upon functional or organic disorders of the liver that this agent may prove useful ; such as, ascites ; mucous, watery and bloody stools, with tenesmus and piles; cholera infantum, colic and rest- lessness of nursing infants.

CONSTIPATION, the discharges being dark -green, or brown, or lumpy, or fecal masses composed of a number of little balls slightly cohering by means of intestinal mucus ; or partial constipation, the first part of the discharge being solid, and the latter half thin, watery. In this form of constipation a discharge is apt to be pre- ceded by spasmodic, griping, twisting, bilious pains.

DIAEEHCEA. — Kopp recommends calomel for the colic and rest- lessness of children when the discharges are preceded by crampy, cutting pains ; the stools may be watery, or bilious, greenish, or the bowels may be constipated.

In Hufeland's yournal, vol. 91, the use of calomel in the diarrhoea of children, is strongly recommended by Dr. Amelung. In the case of an atrophied little girl of eighteen months, who was suffering with watery diarrhoea which had been fruitlessly

374 MERCURIUS JODATUS.

treated with a number of remedies, one-eighth of a grain of calomel was finally given every three hours. The child, who heretofore had cried and moaned day and night, became quiet, slept, her appetite returned, and she became a blooming little girl. Since then, Amelung has employed the drug in numberless cases of watery, and greenish bilious diarrhoea with perfect success.

Amelung has the candor to admit that he is indebted for this use of calomel to Kopp, although he repudiates homoeopathy and thinks that Kopp may have accidentally stumbled upon this use of calomel. Yet he, and all other alloeopathic physicians who use calomel for this diarrhoea of children, know perfectly well that it produces this very condition in children or full grown persons in a state of health. Amicus Plato, amicus Aristoteles, sed magis arnica Veritas! Calomel may prove useful in

ANGINA PUTRIDA or putrid sore throat, with livid ulcers, foul smell and bleeding from the mouth, scraping, burning pain in the throat, hoarseness. Also in

GLANDULAR SWELLINGS which calomel has caused in many cases. In

SALIVATION, in the common stomatitis of children (thrush), it may be used in preference to other mercurial preparations. In Hufeland's Journal we find the following pretty cure of a case of ptyalism recorded by an alloeopathic physician.

A man of thirty years had been sleeping against a damp wall. The consequence was that his face, especially in the region of the submaxillary glands, became cede- matous, and he lost every day a large quantity of watery saliva. All the remedies employed were without effect. A few grains of calomel a day cured him in a few days. Yet calomel causes swelling of the submaxillary glands and ptyalism !

MEROUEIUS JODATUS.

[iodide of mercury.]

We have two combinations of iodine and mercury, one of which contains one element of iodine and one of mercury, the protoiodide of mercury or mercurius protojodalus, or also designated as the yellow iodide of mercury, mercurius jodatus llavus ; and the other, two ele- ments of iodine and one of mercury, the biniodide of mercury, or mercurius bijodatus, or also designated as the red iodide of mercury or mercurius jodatus ruber.

This preparation is used in scrofulous, and also in syphilitic affections of a primary, secondary and tertiary form. The biniodide is more frequently used than the protoiodide. In many cases of primary chancre where the soluble mercury fails, the iodide eliccts

MERCUK1US JODATUS. 375

a cure. It prevents the suppuration of a bubo by a speedy dispersion of the swelling. "Regular" physicians frequently apply an oint- ment of the iodide externally.

The mercurial iodide is eminently adapted to the eradication of the secondary disorders which the violent suppression of a primary chancre or bubo sometimes entails upon a patient.

A man of forty years, apparently in the enjoyment of good health, had a breaking out on the forehead, hairy scalp, on certain parts of the trunk, and on the extremities. The eruption consisted of numerous, copper-colored elevations of the size of small peas and slightly covered with scaly scurfs. The patient had likewise paroxysms of ■ violent pains in the limbs which disturbed his sleep and caused a sort of rigidity, accompanied with partial impotence, exciting apprehensions of paralysis in the patient's mind.

He applied to Dr. Gilbert for relief, who declared the eruption syphilitic. The patient admitted that nineteen years ago he had had a chancre ; that he had been treated with mercurial frictions, after which salivation had set in and the chancre had disappeared. Since then he had been subject to slight but transient excoriations on the inner surface of the prepuce.

Three years after the cure he had got married, and himself, wife and child had always enjoyed good health, until the year 1845, eighteen years after the original infection, when he was attacked with violent, obstinate headache and irregular febrile motions which were attributed to a violent catarrh of the brain. This attack was treated with venesections, after which the present eruption showed itself. The patient's wife was attacked in a similar manner. Both were treated with a syrup of the iodide of mercury, and their health was entirely restored in one fortnight.

SYPHILITIC HEADACHES.— The biniodide of mercury has been used in syphilitic headaches with maddening pains in the bones of the skull. Sometimes, during an attack of such a headache, a tumor develops which is occasionally soft and spongy to the touch and again possesses considerable hardness. With the appearance of this tumor the headache moderates and often disappears entirely. We have cured such cases, in our own practice, with the lower trit- urations.

CHRONIC BRONCHITIS— The late Dr. Cook, who has written an interesting paragraph on the iodide of mercury, recommends its use in scrofulous irritations of the air-passages, more particularly in chronic bronchitis of scrofulous individuals, with heat, tickling, sore- ness and cough, attended with expectoration of a purulent mucus, moderate fever.

POLYPUS OF THE NOSE— Kopp informs us that he has

cured polypus of the nose with the iodide mercurial ointment.

A man of sixty had been affected with polypus of the nose for many years. His breathing was considerably interfered with, for the polypus began to protrude from the nostrils. About the size of a pin's head of the ointment was applied to the polypus morning and evening by means of a camel's hair pencil. In eight weeks the polypus had entirely disappeared and the obstruction of the nose was completely removed.

GOITRE In goitre the mercurial iodide has likewise been used

376 MERCUE1US JOPATffS.

with good effect. In a case reported by Kopp the ointment was rubbed in morning and night, about the size of a pea each time ; the cure was completed in a very short time.

In a case of long standing, a double goitre, impeding the breathing and materially interfering with the circulation, a portion of the ointment of the size of a small pea was rubbed in morning and night. In a very short time the goitre had dwindled down to such a small size that all treatment was discontinued, the patient being no longer incommoded by it. Other similar cases are likewise reported.

Whenever the scrofulous and syphilitic miasms are conjointly at work undermining the constitution, the iodide of mercury may prove a most valuable agent in counteracting their deleterious influence.

In our own practice we have treated cases of goitre with the lower triturations of the iodide of mercury, depending wholly upon con- stitutional symptoms in the choice of the remedy. We have repeat- edly cured cases' of long standing, without the use of ointments; to the best of our knowledge these cures were permanent and in every case attended with decided improvement in the general health of the patients.

CHRONIC SWELLING AND INDURATION OF GLANDS. — In scrofulous affections of the glands, chronic swelling and indura- tion of glands, even as a sequela of scarlet fever, the iodide of mercury has been used with good effect.

MESENTERIC GANGLIONITIS.— In scrofulous affections of the lymphatic system, more particularly in mesenteric ganglionitis, when the lymphatic glands are swollen and hard, and the patients are frequently troubled with diarrhoea, the iodide of mercury may afford much relief.

DIPHTHERITIS. — This agent occupies a conspicuous place among the remedies which homoeopathic physicians resort to in their treatment of diphtheria. Dr. II. D. Paine, in an interesting essay on diphtheria, published in the sixteenth volume of the Transactions of the American Institute, furnishes the following indications for its use :

"As soon as the least appearance of membranous deposit was observed, or there was any swelling of the glands of the neck, the iodide of mercury was freely administered and generally continued until there was a complete obliteration of those symptoms. We have given it mostly in doses of the first trituration, and the effect in arresting and detaching the false membranous formation has been in many ca?es most gratifying."

Both iodides of mercury have made an excellent record in the

MERCURIUS PRiECIPITATUS ALBUS. 377

trealmcnt of diphtheria. You may add to the indications given by Dr. Payne : a yellowish-whitish, slimy, dirty-looking coating of the tongue, mainly on the back of the tongue, while the tip and the edges of the tongue are tolerably clean and at times red ; frequent desire to swallow, from a collection of saliva in the mouth or a sen- sation of a lump in the throat; empty deglutition is very painful; hawking of stringy mucus; the diphtheritic patches are mainly on the left side, and the exudation is easily detached ; livid appearance of the throat.

MEKCUKIUS PR^ECIPITATUS ALBUS.

[WHITE PRECIPITATE.]

This salt is obtained by dissolving corrosive sublimate, from which solution the salt is precipitated by the addition of liquid ammonia.

This preparation has very irritant properties. It is sometimes used for the purpose of irritating a very torpid chancre, after which the ulcer becomes more susceptible of the curative influence of mercury administered internally.

A case of poisoning by this salt, which terminated fatally, is re- ported in Frank's Magazine. Forty grains of the white precipitate were swallowed, by mistake, for magnesia. Beside the usual symp- toms of poisoning by corrosive mercurial salts, such as: vomiting, purging, burning in the oesophagus, and horrid thirst, the patient was attacked with contraction of the muscles, especially of the lower extremities, down to the toes ; contraction of the bauds and fingers ; excessive dryness of the skin in the palms of the hands and soles of the feet; increasing paralysis of the muscles and gradual death about a week after the poisoning took place.

MEROTJRIUS PE^EOIPITATUS PvlIBER.

[red precipitate.]

This is an oxide of mercury, obtained by dissolving quicksilver in nitric acid, from which solution the red powder is obtained by evapo- ration. This powder is triturated together with a little more pure quicksilver into an homogeneous mass which is dried by exposure to gentle heat, and kept for use in blackened bottles.

378 MERCURIUS PEiEOlPITATUS RTJBEK.

I have alluded to the red precipitate as eminently adapted to the treatment of secondary syphilitic affections, torpid chancres, erup- tions, and will relate a few cases illustrative of the remarkable cura- tive virtues of this agent.

A girl of twenty years was affected with condylomata at the anus and chancrous ulcers at the labia, on the lips and in the fauces, of which she was cured in five weeks by means of corrosive sublimate. Subsequently she was attacked with dry, itching, venereal tetter on the hairy scalp, forehead and on the left nates, which showed a tendency to spread, and seemed very obstinate. She was put on the use of the red precipitate in doses of one-fourth of a grain morning and evening, and an ointment of the same preparation was applied externally to the eruption.

After having used ten grains of the red precipitate, the eruption disappeared entirely and permanently. The gums became slightly affected.

Another interesting case is that of a girl of fourteen years, born of a syphilitic mother. For seven years past she had been affected with fetid otorrhcea, hardness of hearing, swelling of the tibia and a fetid ulcer in the nose. When she was first placed under medical treatment, we found the soft and cartilaginous portions of the nose, the roof of the mouth, the upper jaw and alveolar processes as far as the rami, destroyed ; the tongue was exposed ; a fetid ichor was dischai-ged from the ears ; the bodily and mental development very much retarded ; symptoms of general cachexia; the animal functions normal. She was put on the use of the red precipitate in doses of one-sixteenth of a grain once, and afterward twice, a day; in three weeks she was cured perfectly, and the hearing was likewise restored.

These two cases were extracted from Hufeland 's yournal. Another case is re- lated by Kopp. A woman of forty-nine years had been afflicted for seven years past with a seated pain in the region of the malleolus ; the leg from the malleolus upward was very much swollen and the lower portion of it stiff. During all this time the patient had been troubled with an eruption on the left arm.

All this trouble had been inflicted upon her by her syphilitic husband. The red precipitate in doses of one-eighth of a grain cured her entirely and permanently. Kopp saw her five years after, when she still enjoyed the best of health.

In the fifty-fifth volume of Huf eland's Journal, we find the follow- ing case of poisoning of a woman in the seventh month of pregnancy, who, by mistake, had taken as much of the red oxyde as would cover the point of a knife : Nausea, vomiting, oppression of the chest, pains in the stomach and whole abdomen: afterward, violent vomit- ing of blood, with subsequent fainting; after this, the patient was attacked with a copious diarrhoea and intolerable pains in the abdo- men, with burning in the mouth and throat, and unquenchable thirst.

On the third day : trembling of the whole body, excessive redness of the whole face and eyes, staring and wild looks, and ptyalism, with a specific and intolerable smell. She vomited twice a quantity of blackish blood ; the gums were swollen and inflamed, the tongue was so big that it filled the whole cavity of the mouth and seemed perforated in several places; the buccal cavity itself looked as if covered with the outer crust of decayed cheese. The larynx was swollen as much as the mouth, and was even inflamed externally ; the pulse was quick, small and rather hard.

The abdo- men (otherwise distended by pregnancy) was swollen unto bursting, and so sensitive that the patient was unable to bear the least touch. The patient did not feel the movements of the foetus the whole day.

MEECURIUS PILECIPITATUS RUBER. 370

Stomacace of the highest degree of intensity; there were two holes in the tongue, into which a finger might be inserted. The tectli were scarcely visible on account of the swelling of the gums and sordes.

By administering suitable antidotes, more particularly the sulphu- ret of potassium, of which an ounce was boiled in half a quart of water, to be given in cupful doses every half hour, and. by the use of mucilaginous drinks and antiphlogistic means, the patient was restored, and was afterward delivered of a healthy child.

STOMACACE. — These symptoms of poisoning resemble the symp- toms caused by the black oxide and the common quicksilver, except that they surpass the latter in intensity. We infer from cases of poisoning by the red precipitate, that in stomacace of a malignant and very foul character, this agent may bo very useful. In

COLIC, bilious and inflammatory, characterized by vomiting of bile and blood, horrid tormina, internal trembling, spasms, cold sweat, dreadful tympanitis, unquenchable thirst, the red precipitate may prove an admirable remedy.

In a proving by Dr. Eiselt, an inflammation of the meibomian glands, with which the Doctor had been afflicted for several years, disappeared under the effects of this agent.

Another remarkable symptom elicited by the Doctor, is "painful colic accompanied with constant urging to stool, which went on increasing in violence, spread through the whole of the intestines, and especially in the anus, caused a sensation as if a red-hot iron were pushed up and down." In spite of the violent tenesmus, only a little reddish blood was passed with cutting burning. Nausea and burn- ing distress in the stomach supervened likewise.

BILIOUS DYSENTERY.— This group of symptoms shows that in bilious dysentery, the red precipitate may prove a valuable remedy.

ULCERS. — In the treatment of old ulcers with hard, callous edges, secretion of fetid ichor and formation of bloody crusts, the red precipitate has effected fine cures. In Grcefe's Journal several cases are reported, Avherc such ulcers, which had arisen from injuries, were speedily cured, even after they had existed for years, by the application of thin layers of the red precipitate ointment spread on soft lint. If these ulcers are seated on the leg, it is indispensable to keep the leg quiet and in an horizontal position.

380 MERCUR1US SOLUBIL1S HAHNEMANN!.

MERCUKIITS SOLUBILIS HAHNEMMNL

[BLACK OXIDE OF MERCURY, MERCURIUS OXYDULATUS NIGER.]

The provings, instituted by Hahnemann, and embodying the most remarkable and characteristic features of the mercurial preparations, were made with reasonably large doses of the drug. Homoeopathic practitioners of his time preferred this particular preparation in the treatment of syphilis, reserving the mercurius vivus, or quicksilver, for non-syphilitic affections.

CEPHALIC GROUP.

Among the symptoms which Hahnemann has obtained in proving this drug, vertigo occupies a prominent rank. Mercury is therefore homoeopathic to

Upon close examination we find that this vertigo is symptomatic of bilious derangement; it does not arise from any primary irritation of the cerebral nerves. We find it accompanied by sallow complexion, dryness of the mouth, coated tongue, chilly creepings followed by flashes of heat, want of appetite, flow of water from the mouth, etc.

HEADACHE to which mercury is homoeopathic, is principally of a catarrhal, rheumatic and bilious order. Mercury causes a number of symptoms which may be said to constitute a group resembling

RHEUMATIC HEADACHE is distinguished by similar symp- toms as a common catarrhal headache, in addition to which the rheumatic symptoms are more marked, among which we distinguish such as these : tearing pains in the bones of the skull and in the scalp, the parts feeling moreover bruised; boring and stitching pains in the forehead, digging pains in the anterior parts of the head.

Rheumatic headaches are likewise accompanied by general chilli- ness, cold hands and heat of the cheeks ; one of the provers of mercury has recorded such a combination of symptoms.

Lachrymation is likewise present in catarrhal and rheumatic head-

MBR0UR1US SOLlJilLIS HAHNEMANN!!. 381

aches, as may be seen from this symptom: "contractive headache, the head feels as if in a vise, at times the fore part, at others the back part of the head ; with discharge of water from the eyes."

RHEUMATISM OF THE SCALP— By a rheumatic headache we may sometimes understand rheumatism of the scalp, with shiver- ing over the scalp, a sensation as if the scalp were drawn tightly over the skull, soreness of the scalp, sensation as if the hair were standing on end. This group of symptoms sometimes requires aconite, especially if the chill is very marked, and fever, with a hard, jerking, hurried, but not full pulse, follows after the chill. Mercu- rius will be found indicated, if the pulse is quicker than usual, but not very resisting, the patient looks sallow and wants to be near the fire.

These symptoms characterize bilious congestive headache. In its worst form, tills headache may be characterized by a pain as if the brain were on fire, with excessive sensitiveness to noise and light. During the height of the paroxysm, the face may look red and the eyes congested, with excessive thirst, and vomiting of bile. In the slighter forms of bilious headache to which mercurius is homoe- opathic, the patient may feel a violent aching pain in the whole head, with a feeling as if the brain were sore ; this pain is accom- panied by a copious flow of water from the mouth, vomiting of green and yellow bile, sallow complexion.

In these headaches, the bowels, as a general rule, are constipated, though bilious diarrhoea may likewise be present.

SYPHILITIC NOCTURNAL HEADACHE— There is one form of headache to which mercury is eminently adapted as a spe- cific homoeopathic agent; it is syphilitic nocturnal headache, with nocturnal paroxysms, which often increase to a frightful degeee of intensity ; hard, maddening bone-pains, as if the bones of the skull would be dashed to pieces; the patient is driven about the room by the violence of the pain.

382 MEECUEIUS SOLUBILIS HAIJNEMANNI.

a case of chronic mercurial poisoning, reported iu the third volume of Kopp's Denkivurdiglceiten (Memorabilia), and which terminated fatally, a post-mortem examination revealed effusion into the ventri- cles, with softening of the cerebral substance.

The mercurial cachexia, to which this patient fell a victim, had been gradually induced by exposure to the fumes of mercury, while gilding silver. The symptoms are so remarkable that I will briefly narrate them.

The first effect of the mercurial fumes was trembling of the hands and feet, so that the patient, a corpulent man of fifty-five years, with a delicate skin, was unable to write. This was in the year 1823. In the winter of 1824, lie complained of pains in the extremities and ahdominal muscles, rose with a headache every morning, was low- spirited, looked pale and lost his appetite. He was attacked with fever, sweats and a loose cough, which finally was accompanied by such acute pain in the chest that leeches were applied in order to relieve it.

The leech-bites bled for upward of twenty-four hours, and the blood seemed very thin. I may here remark, that it is one of the common effects of mercury to thin and impoverish the blood. In spite of treatment, the decay of the bodily and mental powers went on increasingly, he lost his memory, occasionally his mind seemed to wander, the pulse became full, tremulous, frequent ; he evinced a constant disposition to lie down, inclined to sopor, coma, muttering delirium set in, the breath and whole body smelled foul, ,the feces passed off involuntarily, and he finally died with symptoms of apoplexy, one side and the tongue being paralyzed.

This case of poisoning is instructive to us, not only as an illustra- tion of the deeply penetrating effects of mercury, but we learn from it two important therapeutic facts : first, that mercury may be useful in hydrocephalus; and, secondly, in softening of the brain, or encephalomacia.

It is doubtful whether mercury will accomplish any good in hydrocephalus, if the patient is endowed with a highly organized sanguineous system, of a plethoric habit of body and a nervous- bilious temperament. Mcrcurius seems to be more adapted to chil- dren of a bilious constitution, with spongy flesh, sensitive but yielding temper, easily depressed spirits, and irritable mucous mem-

MERCURTUS SOLUBILIS HAHNENANNI. 383

branes, that are liable to derangements from the least exposui'e to a draught of air, to dampness, unfavorable changes in the weather, etc. In h\Tdrocephalus where the effusion, in the course of an inflamma- tory condition of the brain, sets in gradually, not suddenly, and with a paroxysm of convulsions, but as a consequence of a gradually increasing impoverishment of the sanguineous fluid in the cerebral vessels, mercury may be found useful.

ENCEPHALOMACIA, or softening of the brain, may possibly be favorably modified by mercury in slow, chronic cases, resulting from continued exposure, constitutional tendency to cerebral conges- tions in impoverished, cachectic constitutions, venereal excesses, etc. The cerebral degeneration is attended with imbecility, fits of Avan- dering, dull and staring expression of the eyes, sallow complexion, haggard features, tremulous, feeble, hurried pulse, desire to lie down, sopor.

NERVOUS GROUP.

"We have seen that mercury is capable of causing neuralgic pains in the extremities ; the pains are fine, pricking pains, apparently in the bone ; also wandering pains which afterward become seated in the knee and other joints.

384 MERCUKIUS SOLUBILIS HAHNEMANN!..

Among the rheumatic symptoms recorded by the provers of mer- cury, there are three which I desire to point out to your attention : Spasmodic contraction of the calf of one leg, resulting in the forma- tion of knotty tumors ; one of the calves is very much elongated ; oblong furrows in the calves.

I have met with a case where rheumatic exposure in the field developed these symptoms for which mercurius was of course the remedy.

Rheumatic affections to which mercury is homoeopathic are gen- erally attended with a sense of coldness or chilliness ; patients like to be near the fire, they feel thirsty, the mouth and tongue feel dry, cold water is exceedingly palatable to them. The palms of the hands generally feel dry and warmer than usual.

PARALYSIS is another nervous affection which may require mercury. It is owing to similar causes as the trembling, continued exposure to dampness or cold, sudden retrocession of the perspira- tion ; the limb feels cold, the adipose tissue dwindles away, the skin is dry, shrinks and peels off; the parts feel dead and numb.

PSELLISMUS MERCURIALIS.— Mercury also causes stam- mering, a species of tremor of the tongue which we have already mentioned under the name of psellismus mercurialis, or mercurial stammering. An affection of this kind could probably not be reached by mercury except under peculiar circumstances. If this stammering is a symptom of rheumatic paralysis of the tongue, attended with ptyalism, or if the stammering should have resulted from the suppression, by artificial means, of a process of ulceration in the mouth, or of an irritation of the salivary glands which should

MERCURIUS SOLUBILIS HAHNEMANN!. 385

have been treated with mercury, then mercury will undoubtedly prove an efficacious remedy for this weakness.

In relating these cures, Trousseau and Pidoux observe that they do not wish to be understood as holding the doctrine that mercury cures epilepsy ; they simply wish to state that epilepsy may some- times be owing to exostosis of the skull, to vegetations of the dura mater, or to some either appreciable or inappreciable lesion of the nervous system depending upon the venereal infection, and that it is in such cases that mercury will cure epilepsy not by its anti-epileptic but by its anti-syphilitic virtues ; in the same way it may cure mania and paralysis, if these affections depend upon the syphilitic poison. Paraplegia, hemiplegia, amaurosis and deafness have been cured by mercury in cases where their syphilitic origin- was unmistakable.

A very remarkable effect of mercury, and to which we have already alluded on several occasions, is liquefaction of the blood. This alteration of the blood seems connected with a general decay of the nervous functions, and we therefore range this effect of the murcurial preparations in the category of nervous disorders.

VOL. II. — 24.

386 MERCUKIUS S0LUB1LIS HAHNEJIANKI.

There are morbid conditions, where this tendency to passive hemorrhages may be made available as an indication for mercury. We may mention

PUEPUKA HEMORRHAGICA, where the sanguineous effusion from the capillaries may be owing to precisely such a condition as mercury is capable of exciting.

CHLOROSIS may be another condition of this kind. In a case of menstrual suppression with oedema, a tendency to haemorrhage from the lungs, stomach, nose or gums, or effusion into the cellular tissue, may be advantageously treated with mercury. Of course, in selecting your drug, you will always have to consider the totality of the symptoms before you, and not prescribe in accordance with a mere pathological notion or theory.

DEBILITY. — States of general debility, characterized by passive haemorrhage from orifices or tissues, bloating, weariness of the lower extremities, dryness of the skin or uupleasant, sour night-sweats, especially when resulting from exposure to rheumatic influences in bilious climates, may require the internal use of mercury.

You will have to regard these broad outlines of the action of mercury, as the prominent figure in the background of a picture where the particular groups will have to be supplied by your own study and judgment in the course of your professional career.

INFLAMMATORY GROUP.

Although mercury is exhibited in diseases of an inflammatory character, yet it cannot be said to rank with aconite in the treat- ment of acute inflammations. The inflammatory diseases to which mercury is homoeopathic are seldom, if ever, characterized by that full, bounding and rapid pulse which characterize acute inflamma- tions requiring aconite or belladonna as their specific remedy, except perhaps in violent bilious congestive fevers or violent cases of congestive dysentery; these may require mercury, and yet the pulse may be full, hard, bounding and considerably accelerated.

MEltCUltlUS S0LUJ31LIS HAHNEMANNI. 387

tions finally react upon the pulse, increasing its frequency, expanding its volume, rendering it more resisting to pressure with the finger, and generally imparting to it the characteristics of an erethic, not of a synochal pulse. We say, then, that mercury cannot really be said to be homoeopathic to inflammation, and that the phenomena which characterize the inflammatory process to which mercury is homoe- opathic, are phenomena denoting congestion, not inflammation.

Remember then, gentlemen, that mercury primarily depresses the lymphatic system, and that the immediate consequences of this de- pression is a corresponding sluggishness or depression of the venous system which receives from the lymphatic system in a great measure its power of manifesting vital phenomena.

Necessarily, if the venous capillaries become clogged or engorged, as we term it, the arterial capillaries reacting against the veins, must become similarly affected, and a state of congestion is indirectly brought about where fever is present, but of a different character from the pure synocha, with full, rapid and bounding pulse. In conditions of hyperasmia, where mercury is indicated, we shall find the pulse fuller than in its normal state, but not bounding ; it is a somewhat accelerated, undulating, soft and rather full pulse. The symptoms which generally characterize an attack of sanguineous congestion are likewise present, viz., a chill corresponding in in- tensity with the functional importance of the organ, and followed by heat and dryness of the skin, thirst, coated tongue, dizziness and headache, restlessness, constipation, deep-yellow urine which has an offensive ammoniacal smell, and at times has the odor of burnt sugar. This last symptom is particularly marked if the hepatic system, the liver and its appendages, are congested.

388 MEKCUKIUS SOLUBILIS HAHNEMANN!.

complaint. These chronic congestions of organs and tissues will be indicated by their specific names as distinct groups of symptoms under their respective categories.

ACUTE CONGESTIONS of organs may be as numerous as there are organs in the body which are liable to such a derangement. From the brain to the most external tissue, congestion may take place, and mercury may be required for its removal. Some of the more important forms of this derangement may be mentioned more in detail. One feature in acute congestions to which mercury is homoeopathic, should not be lost sight of; it is this : that these con- gestions generally exacerbate in the evening or fore part of the night.

They may consist of a series of paroxysms as it were, a paroxysm occurring once in the twenty-four hours, and separated from the succeeding paroxysm by a distinct remission of the pains and fever. Generally, every paroxysmal exacerbation is ushered in by a slight chill, shiverings, chilly creepings, which are speedily suc- ceeded by fever, heat and dryness of the skin, dryness of the mouth, thirst, restlessness, and prominence of the pains and uncomfortable sensations that characterize this peculiar congestion.

It seems hardly necessary to observe that the chill is proportionate to the in- tensity of the congestion and to the importance of the congested organ. In congestion, of the brain, for instance, the chill is much more severe than in congestion of the bowels.

The character of the congestion likewise influences the nature of the chill. The chill which marks bilious congestion is far more searching than the chill which characterizes a simple rheumatic congestion.

The violence of the chill may likewise depend upon the more or or less complete character of the intermissions. These intermissions may be so perfect as to simvdate the fever and ague type, and yet the pathological process before us may be an acute congestion of some organ, which may require mercury for its specific remedy. Nice powers of discrimination may be required in order not to con- found intermittent congestions, to which mercury is homoeopathic, with paroxysms of fever and ague. It is more particularly in congestions of a bilious character that these misapprehensions may occur.

Nevertheless, no careful observer will find it a difficult matter to discriminate between bilious congestions of an intermittent character and paroxysms of intermittent fever, The fever-chill is more

MERCUKIUS SOLUBILIS HAHNEMANN!. 389

violent, lasts ravioli longer and is followed by a more intense fever than the chill of simple congestion. Moreover, the signs of con- gestion are much more localized in simple congestion than they are in fever and ague, where they may be scattered through a number of organs, affecting the heart, lungs, brain, back, bowels, whereas in simple congestion the signs of this pathological condition are cir- cumscribed, and limited hy the boundaries of the affected organ, be this organ the brain, lungs, liver, heart, bowels or any other viscus . or tissue. We may likewise add that in fever and ague the inter- missions may be more or less complete, whereas in acute congestions of organs the intermissions are still characterized by marked symp- toms of derangement, such as loss of appetite, prostration, feeble and somewhat accelerated pulse, and abnormal sensations in the congested organ ; in the brain for instance : a feeling of heaviness, constriction, dizziness ; in the lungs : oppression, irritation, tight- ness, desire to cough with occasional paroxysms of a hacking or spasmodic cough ; in the liver : a feeling of fulness, weight, heat aud aching pain ; in the bowels : a sensation of soreness, fulness, heaviness, and dragging and bearing-down sensation, with constipa- tion, or a feeling as if diarrhoea would set in ; in the muscular tissue : a feeling of heaviness, lameness, and a sensation as if the parts had been bruised. There cannot, therefore, be any difficulty to an accu- rate observer, in distinguishing the acute congestions, with regular intermissions between the paroxysms, from intermittent fever.

Let me remind you of the fact that aconite is eminently homoe- opathic to acute congestions of organs and tissues generally, and belladonna to congestions of the brain, womb, lungs, heart, larger bowels and perhaps other organs. As far as my experience bears me out, I am inclined to assert that the intermissions in acute con- gestions to which aconite or belladonna is homoeopathic, are never so perfect as they are in the case of mercurial congestions ; in the case of aconite and belladonna, the intermissions are simple remis- sions of the paroxysmal exacerbations of the symptoms.

RHEUMATIC CONGESTIONS OP THE BOWELS, for instance, the bowels may feel sore as if bruised, sometimes even as if full of little pebbles : the least jar is painfal to the muscular integuments, and motion causfis a dragging, heavy feeling in the

390 MEliCURIUS SOLUBILIS HAHNEMANNI.

RHEUMATIC CONGESTION OF THE LIVER the patient may complain of heaviness and fulness, hard, aching and tearing pains in the region of the liver ; in bilious congestion the liver feels very sore, hot, with stitches darting through the organs ; the accom- panying gastric symptoms are likewise more marked, the tongue is more thickly lined with a yellow and grayish coating, the taste is foul, the appetite entirely suppressed. In

RHEUMATIC CONGESTION OF THE LUNGS the patient complains of oppression and a feeling of constriction across the chest; aching and tearing pains, soreness, especially when coughing; the cough comes in paroxysms, and is generally excited by an intolerable tickling in the air passages or a desire to remove obstruc- tions from the lungs, mucus or feather dust that seems to fill the bronchia in the interior of the pulmonary parenchyma. In bilious congestion of the lungs the pains are more acute; the oppression and anxiety more violent ; the cough is more spasmodic ; the bilious symptoms are more prominent ; stitches flying through the lungs ; the patient may complain of a burning distress ; he looks jaundiced, the tongue shows a thick, bilious coating. Finally in

RHEUMATIC CONGESTION OF THE BRAIN the pains may consist of a feeling of constriction in the head, a sensation of pressure on the brain, aching pains in a portion or in the whole of the brain. In bilious congestion the brain feels constricted, and a burning distress may characterize this derangement, with intense aching and throbbing pains, and extreme sensitiveness to noise.

MERCURIUS SOLUBILIS HAHNEMANN!. 391

ORBITAL GROUP.

CATARRHAL CONJUNCTIVITIS Among the poisonous symptoms of niercurius, conjunctivitis occupies a prominent rank. Hence in catarrhal conjunctivitis, we shall find mercury a capital remedy. The symptoms of this natural disease are as nearly as possible those which characterize the mercurial affection : injected appearance or suffused redness of the conjunctiva; smarting and burning in the canthi, with secretion of eye-gum and agglutination of the lids in the morning; sensation as if sand had got between the lids, or as if some sharp body were wounding and irritating the eye- ball ; the lids may be swollen ; a flood of tears may sometimes gush from the eye.

The pulse is slightly irritated, though soft, about 85 or 90.

SORE EYES. — This catarrhal irritation of the conjunctiva may become a chronic affection in consequence of mismanagement or neglect ; or it may assume a chronic form at the outset, and consti- tute what we term sore eyes, where mercury may be an indispensable remedy.

392 MERCURIUS SOLUBILIS HAHNEMANNI.

We have seen that mercury is capable of producing inflammation of the iris and retina; this is denied by Pereira, though strongly insisted upon by some of the most experienced occulists in Europe. We therefore suggest the use of mercury in

IRITIS AND RETINITIS.— In these affections, the mercurial salts have always been used by allosopathic practitioners in alternate doses, upon the principle that salivation was necessary in order to carry off the morbid humors or counteract the existing inflammation by a counter-stimulant irritation of the gums and lining mem- brane of the mouth. If mercury is specifically adapted to these in- flammations, it will care them without resorting to this roundabout method of treatment. Iritis and retinitis may result from the sec- ondary action of the syphilitic virus ; in all such cases mercurius will be found indispensable.

AMAUROTIC CONDITIONS.— These symptoms show that mercury may be useful in amaurotic conditions, or in

SCROFULOUS OPHTHALMIA, with granular enlargements of the Meibomian glands, ulceration of the lids, profuse lachrymation and intense photophobia, mercurius may be eminently useful. In

MERCUR1US SOLUBILIS HAHNEMANNI. 393

AURICULAR GROUP.

The effects of mercury upon the organ of hearing, and more par- ticularly upon the internal ear, are exceedingly remarkable. They might be considered under four distinct heads : 1, inflammation ; %, pains; 3, discharges, and 4, abnormal noises.

Under the head of inflammation, we may range such symptoms as these: "The left ear is painful as if inflamed; the meatus is likewise painful as if inflamed." "Internally both ears feel sore and as if excoriated, the right ear being worse." "Stitches in the inner ear, when stooping."

OTITIS. — Hence we may recommend mercury in otitis, inflam- mation of the ear, where mercury is not only indicated by the par- ticular pains, but likewise by the accompanying discharges, such as : discharge of pus from the ear, or discharge of pus and blood ; and by the abnormal noises which the patient fancies he hears, such as : buzzing, fluttering and so forth. You will find all these symptoms recorded among the provings of mercury.

In otitis to which mercury is homoeopathic, the petrous and mastoid portions of the temporal bone, and even the maxilla may be involved in the inflammatory process. The bones seem swollen, and the boring and tearing pains characterizing this inflammation are most agonizing, especially at night, when the mercurial pains are generally worse.

In a case of otitis, where the patient was a scrofulous girl of fourteen, and where the inflammation had been going on for a week, with pale rose-colored appearance of the inner ear, sense of fulness in the ear, discharge of fetid yellowish pus, swelling of the mastoid process and the ascending ramus of the inferior maxilla, agonizing aching and sore pains in the inner ear, aggravations of the pains at night, more particularly when resting the head upon a feather pillow, buzzing and blowing noises

394 MERCUEIUS SOLUBILIS HAHNEMANN!!.

in the ear. A cure of this distressing affection was effected by means of a single dose of the j6th potency of mercury which the patient took in the evening.

OTALGIA or earache, more particularly when resulting from rheumatic exposure, with tearing pain in the ear, sensation as if the ear would be pulled out, discharge of fetid water or pus from the ear, nocturnal aggravation of the symptoms, may require mercury.

NASAL GROUP.

These symptoms are eminently characteristic of catarrhal inflam- mations of the nose. In

SWELLING AND INFLAMMATION OF THE NOSE with congestion of the Schneiderian membrane, terminating in suppuration and ulceration ; inflammation and ulceration of the septum, formation of semis and crusts in the nostrils, bleeding from the nose, dis- charge of foul-smelling, yellowish pus, we shall find mercury a most valuable remedy, if an affection of this kind has a catarrhal origin.

Even if an acute attack of this kind is grafted upon a scrofulous condition of the organism, we may find mercury indispensable, although it may be necessary, under such circumstances, to interpose a few doses of sulphur.

SYPHILITIC OZ.ENA, with discharge of bloody, fetid ichor, and destruction of the septum and turbinated bones, mercury is indispensable.

MERCURIUS SOLUBILIS HAHNEMANN!. 395

BUCCAL GROUP.

The poisonous action of mercury upon the lymphatics of the mouth has been described. We have shown you that this action re- sults in swelling and inflammatory softening of the gums, suppuration and ulceration of the lining membrane of the cheeks, ptyalism, swelling, congestion and ulceration of the salivary glands. In view of these marked symptoms of mercurial action, we may recommend mercury for the different forms of

STOMATITIS or stomacace, or inflammation of the mucous membrane of the mouth. We find mercury indicated in

APHTHAE OF CHILDREN, also termed thrush, an inflamma- tion characterized by exudations having the appearance of curd and coalescing into irregular patches which, in severe cases, may give the whole mouth the appearance as if it were lined with flour. Mercury is particularly adapted to this affection, if it works its way down the cesophagns, involving the stomach and bowels, and giving rise to serious derangements of the digestive system, such as colicky pains, and diarrhoea. In

PSEUDO-MEMBRANOUS STOMATITIS, or the diphtheritic inflammation of Bretonneau, where the inflammatory process is of a more malignant nature, often terminating in gangrene, mercury may be found an admirable curative agent. In large hospitals where a number of children are crowded together, in foundling hos- pitals, for instance, this form of stomacace often proves a terrible scourge. Of one hundred and ninety-three cases observed by Dr. Valleix, one hundred and fifty-three terminated fatally.

This would not be the case, if the disease were treated with specific remedies, in homoeopathic rapport with the nature of this pathological process. A simple comparison of the symptoms of mercurial stomatitis with the pathognomonic signs of this disease shows that mercury must be specifically adapted to it as a curative agent. In this disease the mouth feels hot, the breath becomes fetid, and copious streams of an ichorous saliva flow from the mouth ; the flushed and swollen face and the swelling and painfulness of the submaxillary glands, all point to mercury as the material type or representative of this most dis- tressing affection.

FOLLICULAR STOMATITIS.— Another form of stomatitis is described by authors as follicular stomatitis, where the disease com- mences with the starting up of a vesicular rash which gradually terminates in the formation of innumerable little ulcers with slightly

396 MEKCURIUS SOLTJBILIS HAHNEMANN!!.

tumefied and inflamed edges and secreting a whitish lymph. The ulcers cause a good deal of stinging pain.

This affection may become very troublesome to nursing women and is often designated as

NURSING SOEE MOUTH.— The severer grades of this disease may be accompanied with frontal headache, acute pains in the stomach and bowels, diarrhoea, tympanitic distention of the abdomen and gradual supervention of typhoid symptoms.

In this affection mercury may not do much, if any, good, unless the appearance of the gums, and the flow of fetid, ichorous saliva are present. If these symptoms are either absent, or at least not prominently present, and the mouth looks generally inflamed, of a deep-red color, studded with whitish, ulcerous exudations, the patient complaining of excessive heat, dryness and soreness, we have found one or two drops of the tincture of the root of aconite in about twelve table-spoonfuls of water, to be given in table-spoonful doses at suitable intervals, an excellent remedy for this distressing trouble.

OANORUM ORIS We have finally a form of stomacace well- known as cancrum oris or gangrenous inflammation of the mouth. This sometimes terrific affection may resemble mercurial ptyalism and sloughing so closely that it is frequently mistaken for the latter condition. The sloughing may commence on the inner cheeks, whence it may spread with astonishing rapidity, sometimes involving, in the course of a few days, the cheeks, lips, nose, tongue, palate and tonsils ; or the disorganization may proceed from the periosteum of the alveolar processes when it is first seen at the edges of the gums opposite the lower incisors.

Here the gums present all the appear- ances of mercurial poisoning; they become ulcerated, the teeth fall out, the inside of the cheeks, the lips and tongue are invaded by the sloughing process; fetid ptyalism is present, and the gangrenous disorganization even shows traces of its existence on the outside of the cheeks in the shape of gangrenous blisters which break and dis- charge a dark-colored fluid, followed by the formation of sloughs.

Here we have a condition of things to which mercury is so emi- nently adapted on account of the homoeopathicity of mercurial action to the gangrenous process that even Dr. Duncan, physician to Dunn's Hospital in Dublin, has to admit the great curative virtues of mercury. In one of his articles on the subject, the Doctor attempts to show that mercury may be advantageously used in this affection, which is so exceedingly analogous to mercurial sloughing.

MERCUttlUS S0LUBIL1S HAHNEMANNI. 397

Nothing is more corroborative of the appropriateness of mercury in cancrum oris, according to the Doctor's experience, than the fact that the sloughing, so far from getting worse under the use of mercury, i? actually controlled by this agent. "If mercury," argues the Doctor, "'were inimical to this disease, the sloughing ought to be made worse even by the smallest dose of this drug unless we choose to account for such an aggravation by the same arguments that the adherents of dmilia similibus resort to."

The Doctor is no homceopath and he has evidently read something about homoeopathic aggravations. However, he has remained igno- rant of the fact that these old-fashioned aggravations, so far from beins; essential characteristics of the successful working of homoe- opathic remedial agents, are on the contrary, adventitious circum- stances frequently holding no sort of logical relation to the homoeopathic therapeutic process. In

Moreover, the mercurial ulcerative process spreads rapidly ; it con- stitutes a symptom of acute hydrargyria or mercurial poisoning; syphilitic ulcerations of the mouth are essentially chronic in their character, involving the destruction of the palatine bones and nasal cartilages, whereas mercury destroys the alveolar processes and very frequently even the maxillae.

In cases of stomatitis where the mercurial and syphilitic poisons together maintain the disorganizing process, we may have to resort to the hydriodate of potash, the muriate of gold or to some agent that shall antidote the combined forces of the enemy. Under homoe- opathic treatment, these monstrous developments need never occur.

398 MERCUKIUS SOLUBILIS HAHNEMANN!..

Mercury affects the tongue in a very remarkable manner. The symptoms of ulceration and sloughing which we have already alluded to when describing the poisonous effects of mercury, have been de- veloped more analytically, as it were, by systematic provings. Among these provings we find such records as these: "The tongue is very much swollen." "Stinging pains in the longitudinal depression or furrow of the tongue." " Burning pain in the tongue, as if it were cracked." " The edges of the tongue are soft, indented by the teeth, ulcerated." "The anterior half of the tongue is so hard that when striking against it with the knuckle, a sound is heard as when strik- ing against wood."

In siuelling and ulceration of the tongue, especially when owing to catarrhal causes, with ptyalism, we shall find mercury useful. /Swel- ling and induration of the tongue may yield to mercury. The tongue may exhibit a number of such hardened little tumors.

GLOSSITIS. — In glossitis, or inflammation of the tongue, with high fever and full, rapid and bounding pulse, we should of course give aconite; but in glossitis where the tongue is simply swollen, sore, with burning pain, and slight symptoms of fever, the pulse being simply somewhat accelerated and fuller than usual, but soft, mercury will be found an adequate remedy. A condition of this kind may sometimes be induced by wounding the tongue.

MERCUR1US SOLUBILIS HAHNEMANN].. 399

BANULA, from the Latin rana, a frog, so called from its resem- blance to the shape of a frog, mercury has been used with good effect. Eanula is a small, fluctuating, semi-transparent tumor under the tongue, arising from the accumulation of saliva in Whar- ton's duct, the excretory duct of the submaxillary gland. Of course, mercury is only applicable in cases where the swelling is primarily owing to a dynamic affection, a depression or deficient irritability of the lymphatic capillaries; if resulting from mechanical obstruction of the duct, surgical treatment will have to be instituted.

DENTAL GROUP.

EHEUMATIC PAEALYSIS OF THE JAWS— We may like- wise have to use mercury in rheumatic paralysis of the jaws, with excessive pain in the affected parts when trying to use them. The symptoms which lead us to the use of mercury in this affection, are: "Almost complete immobility of the jaws ; he is hardly able to open them without violent pain."

400 MEKCUK1US SOLUBILIS HAIINEMANNI.

PHARYNGEAL GROUP.

ANGINA FAUCIUM Here we have a group of symptoms corresponding very accurately with angina faucium, inflammation of the throat, sore throat. Angina faucium, to which mercury is homoeopathic, has the difficulty of swallowing in consequence of the aching pain ; a sensation as if a pointed body were sticking in the throat that one is anxious to get rid of by making repeated attempts at swallowing ; excessive dryness of the throat, with flow of tena- cious, ropy saliva from the mouth ; the back part of the throat seems lined with a glassy mucus ; deglutition of soft food is less painful than swallowing mere saliva.

The velum and back part of the throat looks rose-colored, and portions have a dingy yellowish and injected appearance ; the uvula is elongated, looks shining and of a pale-red color. The sensation as if a hot vapor was arising in the throat, is a symptom which we have very frequently met with in cases of angina faucium.

In common sore throat or in chronic angina faucium, where these symptoms occur more or less, mercury may prove beneficial.

ANGINA TONSILLARIS. — Mercury is eminently useful in some forms of angina tonsillaris, or quinsy sore throat, with swelling and inflammation of the tonsils, or of only one tonsil ; the patient may experience stitches in the inflamed tonsils which often dart along the Eustachian tube to the ear, sometimes attended with

MERCUKIUS SOLUBILIS HAHNEMANNI. 401

CHRONIC OESOPHAGITIS.— Mercury is likewise indicated in chronic oesophagitis, where soreness and aching pains in the poste- rior regions of the throat below the larynx are prominent symptoms. In this affection mercury is indicated by the following record : "Aching pain in the oesophagus, in the region of the larynx, aggravated by eating, and causing a sensation as if the food were gliding over an excoriated surface, with burning pains in that region."

The glands which discharge the salivary fluid into the mouth, viz., the parotid, submaxillary and sublingual glands, are subject to affections to which mercury is homojopathically adapted. They may became inflamed, swollen and indurated. Among the provings we find the following symptoms recorded : " Painful swelling of the submaxillary and parotid glands, so that it is impossible to open the jaws without suffering much pain." " Swelling of the parotid gland, with burning-aching pain in the gland, passing off in the cold and returning in warmth." Swelling and inflammation of these glands may take place in consequence of exposure to a draught of air, keen wind, dampness.

ADENITIS, under which name an inflammatory swelling of glands is described in the books, may be attended with inflamma- tory fever; in this case aconite may have to be prescribed If mercury is the homoeopathic agent, we shall find the gland of a pale rose-colored appearance, with a feeling of soreness and heat through the gland, and a mild form of erethic fever, the pulse being some- what accelerated, but soft and undulating. Ptyalism may be present. The irritation may extend along the excretory duct, causing inflammation and ulceration of the orifices of these ducts in the mouth. In neglected cases

CHRONIC INDURATIONS of the salivary glands may remain, for which mercury has to be given.

MUMPS. — We may mention one form of swelling and subacute inflammation of the parotid gland which is commonly known by the name of mumps, or, more classically speaking, parotitis, a subacute

402 MERCUKIUS SOLUBILIS HAHNEMANN!.

CHTLO-POIETIC GROUP.

In regard to appetite, we find that mercury causes a loathing of meat and a loss of appetite. The thirst is increased.

These symptoms are only important in so far as they form elements of higher groups.

PYROSIS. — Mercury causes a peculiar kind of pyrosis, character- ized by rising of an acrid, sweetish fluid from the stomach upward ; the tongue looks coated, the breath may be more or less affected, the appetite is impaired, there is no proper craving for food; the sweetish or acrid rising may even be accompanied by nausea and a sense of shivering.

WATERBRASH. — We shall find mercury indicated in water- brash, especially when the attacks come on in the night, more or less periodically. The symptom which points to mercury in this affection is the following record among Hahnemann's provings: "At one o'clock in the night, a quantity of water collects in her mouth ; this is accompanied by nausea ; it wakes her and causes vomiting; a good deal of bitter stuff is thrown off the stomach."

DYSPEPSIA AND OARDIALGIA.— Mercury causes peculiar feelings of pain and malaise in the l'egion of the stomach, which may render it a valuable agent in dyspepsia and cardialgia. Mer- cury causes a burning in the region of the stomach, and especially in the pit of the stomach ; after taking the least quantity of food, the stomach feels full and as if drawn down ; the patient complains of soreness in the pit of the stomach as if an ulcer would form in this region ; oppression as from a stone, even after the smallest quantity of food.

A dyspepsia to which mercury is homoeopathic, is generally

/

MERCURIUS SOLUBILIS HAHNEMANN!.. 403

attended with symptoms of liver complaint, constipation, offensive urine depositing a brownish sediment.

JAUNDICE. — The ulcerative and burning distress in the epi- gastric region is a symptom to which I may direct your attention, even now as a characteristic indication for mercury in jaundice.

The subject of jaundice naturally leads us to inquire into the action of mercury upon the hepatic system. We have endeavored to show that mercury exercises its deleterious action upon the tissues by breaking down the vital energies of the lymphatic system, and we shall now quote Wibmer in order to show that the lymphatics of the liver seem to be peculiarly liable to the action of this agent.

"In the bodies of those,'2 says Wibmer, "who have been treated with mercurial frictions, we discover extreme emaciation ; the mus- cles are atrophied, pale ; the lymphatic glands, especially in the region where the ointment was rubbed in, enlarged ; the pancreas hypertrophied and frequently of a reddish color ; the liver enlarged, soft, of a black-brown color ; the bile thin and copious ; the veins of the abdomen turgid with a thin, dark blood."

These toxicological post-mortem symptoms show that mercury disorganizes the parenchyma of the liver, and must therefore be an agent of great power in affections of the liver with which its jDecu- liar action is in rapport of affinity. The symptoms which we have obtained by our provings, confirm to some extent the specific rela- tion of mercury to the liver ; although it is but just to say that these symptoms are very inadequately described. One of our provers has this symptom: "Painful pressure in the right side of the abdomen, even early in the morning, in the bed." Another record reads as follows: "Pressing pain in the region of the liver, from within outward." Again we read : "He was unable to lie on his right side, for his bowels felt sore as if they were compressed."

The probability is that "right side and bowels" in these three symptoms, refer to the region of the liver. The record of symp- toms, in Hahnemann's provings, is sometimes furnished by lay- provers who were in the habit of taking extensive liberties with anatomy in describing their feelings, even as lay people do in our own couutry, when they extend the boundaries of their stomachs from the epigastric region down to the symphysis pubis. Referring these pains to the region of the liver, we judge from their peculiar character that they are traceable to engorgements of the hepatic parenchyma.

404 MEKCUBIUS SOLUBILIS HAHNEMANN!!.

We have already alluded to acute congestions of the liver where the use of mercury may become necessary. We have said that in such affections the region of the liver feels full, oppressed, sore ; the patient complains of aching and pressing pains in the region of the liver, with a feeling of uncomfortable heat, embarrassed breathing ; the liver may be swollen, and the patient is unable to lie on the right side.

We have already shown that in true hepatitis, whether the serous covering or the parenchyma of the liver is the seat of the affection, mercury is never indicated. In

CHRONIC ENLARGEMENT OF THE LIVER mercury will prove useful, provided the dynamic power of the drug harmonizes with the morbific principle of this hypertrophy. In order that it may be benefited by mercury, the hypertrophy should result from some previous congestion for which mercury was the specific remedy.

In true hepatitis, whether the serous covering or the substance of the liver is the seat of the morbid process, mercury will never reach the case. Here aconite must initiate the treatment. In inflamma- tion of the peritoneal covering of the liver, the indications for aconite are so self-evident that it is hardly possible to mistake them. The intense soreness in the right side; the stinging and lancinating pain, the burning distress, the increased temperature of the skin in the region of the liver, the utter inability to lie on the right side, the intense fever and the full, hard and rapid pulse sufficiently enlighten us concerning the necessity of using aconite in this affec- tion.

It is only when the inflammatory process is going on in the substance of the liver, that it might possibly become difficult to discriminate between aconite and mercury.

Nevertheless, whenever acute inflammation is present, we shall find aconite emphatically indicated by the character of the existing fever. If it is chronic hepatitis that you have to deal with, the totality and nature of the existing phenomena, and a history of their gradual development from the origin of the disease down to its present stage, will have to guide you in deciding either in favor of aconite or mercury. You may facilitate your choice by making particular inquiries into the nature of the paroxysms which may occur in the course of chronic hepatitis, on various occasions, during changes in the weather, or in consequence of exposure or of a cold. In these paroxysmal exacerbations of the disease the symptoms become more distinct, and their essential character reveals itself more prom-

MERCUKIUS SOLUBILIS HAHNEMANN. 405

inently and more forcibly to the observing reason. If the patient complains of great soreness in the right side, with stinging or shoot- ing pains, or spasmodic constricting pains in the substance of the liver, and more particularly if this condition of things has been superinduced by the allceopathic treatment of a previous acute in- flammation of the liver, we should not hesitate to give aconite.

But if the patient complains of dull aching pains in the right side, or of pressing, pushing pains in the liver, or seated sticking pains in certain definite and limited localities in the region of the liver, with a feeling of soreness as if ulceration might be going on in those parts, we should give the preference to mercury.

The accompanying symptoms of bilious derangement may like- wise help us in fixing our choice of a remedy. If aconite is indi- cated, we may find the edges of the tongue sore and rather inflamed, the patient may complain of flashes of heat in the face and burning- distress in the forehead or head; the alvine secretions are dry and of a dark-brown, blackish color. If mercnry is required, the tongue will look pale, and may exhibit a slimy, grayish-yellowish coating; the alvine discharges are either greenish or brown, frequently dry and without a normal admixture of the bilious pigment; or the action of the bowels may be irregular, at times very torpid and at other times resulting in the discharge of soft or even liquid bright- yellow bilious stools.

We stated that mercury causes an ulcerative and burning distress in the epigastric region, and that the presence of this symptom in an attack of jaundice affords an indication for mercury. Mercury is never indicated in an attack of acute jaundice with high fever, distressing headache, excessive vomiting of bile, dark yellow color of the face and skin, black and foul -smelling urine ; here aconite is emphatically in its place. It is in

CHRONIC JAUNDICE, with moderate vascular excitement or even with feeble and slightly accelerated pulse, yellowness of the conjunctiva, and of the face and skin generally, with slightly coated tongue, constipation, pale color and dryness of the feces, deep-yellow urine, moderate or even unimpaired appetite, that mercury will prove a specific remedy.

We are told in Grcefe's Journal that a man who was using large doses of calomel for a chancre, was attacked with jaundice. The attending physician seemed puzzled to account for the fact that calomel could produce jaundice and yec be such a great remedy for

406 MERCUEIUS SOLUBILIS HAHNEMANKL

liver complaint. The law "similia similibus" sufficiently accounts for this apparent antagonism.

FLATULENT COLIC— In such a case the attack will pass off by the emission of flatulence. Either form of colic is traceable to an abnormal action of the liver.

Mercury alters the alvine secretions in regard to frequency, com- position, color and smell. You recollect that among the poisonous effects of mercury purging was put prominently forward. Dieterich terms it "pancreatic ptyalism," because this purging seems to be induced by what superficial reasoners would term an excessive action of the pancreas, but which more careful observers, who are not carried away by a mere illusion of the senses, would consider as a weakness of this gland. The gland is too weak to retain the fluid which the lymphatics, true to their functional instinct, furnish it for the purpose of perfecting the process of chylification ; hence tbo fluid escapes in proportion as a sufficient quantity of it is elaborated, giving rise to those liquid stools which Dieterich has very aptly designated as pancreatic ptyalism and which must necessarily result in the impoverishment of the adipose and other tissues.

Nevertheless, although this species of ptyalism is a symptom of decided weakness of the pancreas, on the other hand there is a truth embodied in the statement that the secretion of the pancreatic juice goes on increasingly, but not by virtue of some primary stimulation of the functional power of the pancreas, in the sense in which old- school physiologists seem to have understood this doctrine. It is the brain, this great regulator of the functional harmonies pf the organ- ism, that taxes itself in order to repair the waste which is going on

MERCURIUS SOLUBILIS HAHNEMAtfNI. 407

BILIOUS DIARRHOEA mercury is eminently useful. The dis- charges are of the character we have described, green, dark -brown, reddish, excoriating ; they may be preceded by spasmodic pinching pains ; the bowels may feel very sore, distended.

408 MEKCUKIUS SOLUBILIS HAHNEMANN!.

of heat. In inflammatory dysentery we should never lose sight of aconite, but in bilious or congestive dysentery, consisting of frequent discbarges of small quantities of blood and mucus, or mucus without blood, without much, if any, fever, frequent shiverings, desire to be near the fire, although in other cases the skin may be hot and dry and the pulse full and bounding, we shall find mercury indicated. An additional indication for mercury is a frequent desire to urinate, with copious chalk-like sediment in the urine.

A sort of tenesmus is very apt to be present in diarrhoea to which mercury is homoeopathic ; it is an involuntary pressing, or a desire to bear down, rather than tenesmus.

Among the discharges caused by mercury, we find this record : "Whitish-gray stools." If this symptom occurs in jaundice or liver- complaint, and the existing symptoms point to mercury, this peculiar alteration of the alvine evacuations would furnish an additional indication for mercury.

CHOLERA INFANTUM — It is evident that a drug which has such a powerful effect upon the alvine secretions must be useful in cholera infantum, or the common summer complaint of children. Of course, in order that mercury should be effective in this disease, the character of the morbid action must correspond with the nature of the drug-force. At the outset of cholera infantum the symptoms frequently indicate an inflammatory type requiring aconite. If the stools are green, the bowels seem griped, the hands of the little patients feel cold, except the palms, which may feel warmer than usual, and we discover signs of chilliness, mercury will be found indispensable.

Kopp states, in his Memorabilia, that he uses calomel with the best results in the diarrhoea of nursing infants, accompanied with restlessness, sleeplessness and continual crying. If the discharges are green, if the little patients express their distress by crying, calo- mel, which is itself capable of causing green stools, acts so much

MERCURIUS SOLUBILTS HAHNEMANN!!. 409

more speedily; but even if the stools are not green and bilious, but light-colored, whitish, looking like stirred eggs, or if the stools are quite watery, calomel has never failed him. He rubs down one-sixth of a grain with three grains of sugar of milk, and divides the mass into three powders, one of which he gives three times a day, making one-eighteenth of a grain at a dose. Kopp likewise administers calomel if the diarrhoea is accompanied with vomiting.

If nursing infants are very restless, troubled with flatulence ; if they cry a good deal, and seem to suffer a good deal of pain while nursing ; if they let go of the nipple, cry hard and then resume operations ; if their sleep is restless, they wake frequently and cry ; and if they do not lose flesh, but gain rather, and the stools are not diarrhceiCj but rather hard and green, a dose of calomel, one-sixth of a grain, given at night, has a wonderfully quieting effect. Kopp knows of no remedy superior to calomel under such circumstances.

PILES mercury may prove useful ; there is no bleeding, but disr charges of mucus and serum, with swellings of the mucous mem-

410 MERCURIUS SOLUBILIS HAHNEMANNI.

brane, feeling of excoriation at the amis, stitches through the anus.

ASCAEIDES AND LUMBRIOL— Mercury is adapted to a state of the intestinal mucous lining which give rise to the formation of those annoying entozoa termed ascarides and lumbrici. In selecting mercury for this trouble, we have of course to be guided by the totality of the patient's condition, not by isolated symptoms. The formation of these parasites may be symptomatic of a general cachexia to which mercury is homoeopathic.

SYPHILITIC BUBO, the biniodide of mercury may be found preferable to any of the mercurial oxides or salts. If mercury has already been taken without affecting the swelling, the hydriodate of potash will probably be most suitable.

URINARY GROUP.

One record reads thus : " Shreds and flocks of whitish mucus are passed after urination." Another prover records this symptom : " The urine is at first clear, but afterward looks whitish as if mixed with chalk." Another record : " The urine looks as if stirred with flour, depositing a thick sediment."

DIABETES MELLITUS— These symptoms, coupled with the fact that mercury causes the secretion of increased quantities of a watery urine, far surpassing in quantity the amount of beverage drank, might lead us to employ mercury in that distressing malady diabetes mellitus and in albuminuria. It is unfortunate that no

MERCURIUS S0LUBIL1S HAHNEMANNI. 411

chemical analysis was made of these sediments, and that we are therefore left to gness whether the sediments were of a mucous or albuminous character. As far as we are able to determine from existing symptoms, we are justified in using mercury in this affection.

It is particularly indicated when we find evidences of obstruction in the portal circulation ; jaundice ; pallor, puffiness of the face ; glandular swelling in various parts of the body ; profuse secretion of pale, albuminous urine, or of urine containing fat-globules ; colic ; tenesmus.

BLENORRHCEA, or mucous discharges from the urethra, gonor rhoea, and in

CATARRH OF THE BLADDER, this burning may be present, accompanied with a rather frequent desire to urinate, and discharge of mucus from the urethra.

SEXUAL GROUP.

412 MERCURIUS SOLUBILIS HAHHEMANNI.

malignant chancre into a common sore which the disembarrassed vital force of the organism can speedily heal.

In treating these local syphilitic ulcers, you should never lose sight of the general constitution. Some organisms are exceedingly sensitive to the action of the syphilitic poison, which is readily taken up by the absorbent system and made the basis of an almost inter- minable series of most treacherous and deeply penetrating disorders. In scrofulous constitutions a combination of the syphilitic and scrofulous miasms may lead to monstrous disorganizations, unless we endeavor to protect the constitution at the outset against such a calamity. This is sometimes best accomplished by the iodides of mercury.

(EDEMA OF THE PENIS Mercury causes swelling of the

SYCOSIS. — Among the symptoms of cinnabar we .find this record : " Condylomata on the prepuce, readily bleeding when touched;" hence in sycosis or fig- warts mercury may prove indis- pensable.

MRRCURIUS SOLUBILIS HAHNEMANNI. 413

Mercury causes painful erections. This symptom may occur in- cidentally to some inflammatory or ulcerous affection of the penis for which mercury is indicated.

SPERMATORRHOEA— We also find that mercury causes invol- untary emissions ; this effect of the drug is quite prominent among the symptoms obtained by proving. We may therefore associate mercury with spermatorrhoea as one of the remedial agents which may be used in this affection.

LEUCORRHOEA. — Mercury causes a purulent and corrosive leucorrhcea. It acts curatively in leucorrhoea when the discharge is purulent, corrosive, green, is attended with much burning, itching, smartness, rawness, and is worse at night. There may be present heat and tenderness of the sexual organs, both internal and external, with ulceration of the parts; sore throat; glandular enlargements ; turbid, milky urine, depositing a sediment, which looks as if flour had been stirred into the urine ; very offensive urine, resembling in odor the urine of horses ; syphilitic taint.

CHRONIC VAGINITIS. — It also causes irritation, rawness and swelling, with itching of the vaginal mucous membrane and may be- come an important remedy in the treatment of chronic vaginitis and of

PRURITUS VULVAE, when the symptoms of the patient corre- spond with indications already given. The eruption is usually vesicular and accompanied by terrible itching, which is aggravated by warmth.

PROLAPSUS OF THE VAGINA.— Mercury causes prolapsus

414 MEKCURIUS SOLUBILIS HAHNEMANN!!.

of the vagina, in the treatment of which disease it has been em- ployed with success by Dr. Hartmann.

Mercury has produced tubercles on the lips. Hence in tubercles, blotches and condylomata of the vulva, mercury may become exceed- ingly useful, if the characteristic indications for the use of the rem- edy exist and especially if there is reason to suspect that the eruption is owing to the presence of syphilitic virus. y

ULCERATION OF THE MOUTH OR NECK OF THE UTERUS. — You may find mercurius an admirable remedy in the treatment of ulceration of the mouth or neck of the uterus. The ulcers will be deep, with ragged edges ; the womb may be covered with wart-like excrescences; there will be a tendency to frequent haemorrhages; the patient complains of great weakness and even pain in the back ; soreness in the abdomen and in the hips ; the characteristic leucorrhoea and pruritus may also be present ; syphilis ; scrofulosis.

Mercury also causes profuse menstruation, and even metrorrhagia. We have seen in previous lectures that mercury causes a tendency to haemorrhage generally ; it liquifies the blood, diminishes and finally destroys its plasticity, by which we understand the faculty of being assimilated to the organic tissues. If profuse menstruation or metrorrhagia to which mercury is specifically adapted occurs, it will occur as a symptom of general weakness and marasmus which will be found to simulate such a cachexia as mercury is capable of occa- sioning, a cachexia characterized by oedema of the extremities, coldness, disappearance of the fatty matter, paleness of the face, ex- pression of suffering in the features, shortness of breath, swelling of the abdomen. Mercury destroys the power of reproduction in the uterine sphere ; hence the foetus in the womb is apt to perish under the poisonous effects of this drug, and miscarriage is the inevitable

MERCURIUS SOLUBILIS HAHNEMANN!. 415

One of the provers of mercury has recorded the following symp- toms: " Pain in both breasts." "Excessive swelling of the mam- ma?, especially of the nipples, which were harder than usual." "Periodical pain in the mammae as if they would ulcerate."

SORE BREASTS. — In accordance with these symptoms, mercury has been employed by homoeopathic physicians in cases of sore breasts, where it is said to have effected a speedy resolution of the swelling.

CATARRHAL GROUP.

COLD IN THE HEAD, where the following symptoms prevail : sneezing, discharge of water from the nose, or discharge of a yellowish foul pus ; watering of the eyes, feeling of tightness in the head ; slight chilliness.

Mercury affects the lining membrane of the air- passages; hence it causes cough, characterized by various kinds of

416 MERCURIUS SOLUBILIS HAHNEMANNI.

paiu and expectoration. It causes a dry, hacking cough, the paroxysms of which are excited by a tickling in the upper part of the air- passages, somewhere in the region of the bifurcation of the trachea ; the cough is of a spasmodic nature, sometimes so incessant that it may cause a loss of breatli ; drinking quantities of cold water, or water and sugar, may ease the paroxysm for the time being. It also causes a cough with expectoration of sweetish or saltish mucus.

CHRONIC BRONCHITIS.— Upon looking at our provings, we find that mercury causes a burning in the air-passages ; raising of sweetish or saltish mucus and blood ; paroxysms of cough, especially at night, with coldness during the paroxysm, distress for breath ; soreness and ulcerative pain in the air-passages, especially during the cough ; the cough may give rise to nausea and actual vomiting.

Under the effects of mercury, provers have been unable to swallow liquids; the liquid would be discharged by the nose after it had reached the region of the larynx on its downward passage.

THORACIC GROUP.

MERCURIUS SOLUBILIS HAHNEMANN. 417

cough with expectoration of pus, and ulcerative pains in the chest, leads us to advise this agent in ulcerative phthisis or phthisis pul- monalis commonly termed. This affection may arise in consequence of syphilitic metastasis after the violent suppression of a chancre. In such a case mercury is eminently required both internally and externally. Internally the corrosive sublimate may prove the best adapted to the case ; beside which the mercurial ointment should be rubbed upon the chest in adequate quantities, not less than one drachm a day.

Syphilitic ulceration of the lungs is a most destructive disease ; unless the virus is counteracted by speedy and energetic treatment, of course sanctioned and dictated by reason, you cannot hope to save the patient's life.

FEVER GROUP.

Mercury develops symptoms which, in their totality, simulate various forms of fever. It distinctly simulates

CATARRHAL FEVER, the patient feels chilly, wants to be near the fire ; the palms of the hands feel warm ; the head aches, feels tight; the patient likes to stretch himself; the bowels are either consitpated, or a watery diarrhoea may exist.

RHEUMATIC FEVER with soreness of the flesh, tired feeling, coated tongue, bad taste in the mouth, loss of appetite, thirst, sallow complexion; the fever has a remittent type, with regular exacerba- tions of the symptoms at night. ■

GASTRIC FEVER, with foul, grayish, slimy coating on the tongue, sallow complexion, entire loss of appetite, nausea, bad taste in the mouth, constipation, although the bowels feel soft ; the urine deposits a reddish sediment. In

BILIOUS FEVER mercury is indicated by the yellowish, gray,

418 MERCURIUS SOLUBILIS HAHNEMANN!!.

slimy coating on the tongue ; thirst, foul taste in the mouth, nausea and vomiting of bile, constipation and distention of the bowels, dark and turbid urine having a foul smell, headache, exacerbation of the symptoms at night. The

HECTIC OR LENTESCENT FEVER mercury will be found useful, if the patient wastes away, the fever is worse at night, and toward morning a clammy perspiration breaks out, having a fetid, sour smell. In

MUCOUS FEVER mercury plays an important part. This must necessarily be so, considering the important influence which mercury exercises over the functional activity of the mucous mem- brane. In mucous fever to which mercury is homoeopathic, we shall find the tongue coated with a thick, gray or yellowish foul mucus ; the taste in the mouth is unpleasant, the mouth is sticky, dry; the patient wants to moisten his mouth quite frequently; the appetite is gone ; bowels inclining to bloat; they are either constipated or we find occasional discharges of slimy, foul mucus ; strong-smelling, dark, urine ; nightly exacerbation, with unpleasant sour sweats.

In these various fevers the pulse is rather full and accelerated, but not hard or jerking. In this respect the aconite-pulse is distin- guished from the pulse indicating mercury. The aconite-pulse is at the outset full, hard, bounding and rapid ; under the effects of aconite it is softened down and its speed is considerably' slackened, though even after this change has been effected, the general char- acter of the symptoms may still indicate aconite. The mercurial pulse, on the contrary, is never hard and jerking, even at the outset of the treatment, except in the bilious congestive fever of southern regions, where the pulse may become rather hard and resisting during the height of the fever-paroxysm.

In such cases, however, the aconite-pulse would be exceedingly jerking and bounding, and the relative degrees of intensity distinguishing the mercurial from the aconite-pulse, would still be maintained.

EXANTHEMATOUS GROUP.

In describing the poisonous effects of mercury, we have become acquainted with the several eruptions which mercury .causes, viz. : eczema, miliaria, herpes of the prepuce, impetigo, itch, ulcers, etc.

MERCURIUS SOLUBILTS HAHNEMANN!. 419

These different eruptions of the character of erythema, papula?, vesicles and pustules, enable us to use mercury with admirable effect in diseases characterized by similar appearances.

SECONDARY SYPHILIS— First and foremost we have the various eruptions incidental to secondary syphilis, pimples, blotches, spots or macula3, herpes. In nearly all cutaneous affections which can be distinctly traced to a syphilitic origin, the mercurial oxides or salts will have to be employed.

But also in non-syphilitic eruptions mercury may prove useful. We may resort to it in

FUKFUBACEOUS HERPES, with itching and burning, es- pecially at night ;

HERPES PRJEPUTIALIS, even when no syphilitic origin need be suspected ;

IMPETIGINOUS SPOTS, with inflamed base, and covered with a whitish scurfy substance, exuding from the almost imperceptible vesicles which start up on the surface of the inflamed skin ;

PSORIASIS OF THE HANDS, with bleeding, itching rhagades;

TINEA CAPITIS, with crusty ulceration of the scalp, secretion of a fetid, purulent ichor;

VESICULAR SCABIES, with formation of nasty-looking sores which cause a most distressing itching, especially at night ; the sores may not only form between the fingers, but they may likewise cover the breast, abdomen and extremities. In a case of this kind, where two fine young girls had contracted the disease in a most loathsome form by contact with other children at school, mercurius6 effected a speedy cure.

We have a perfect right to recommend mercurius for

SMALL-POX, to which the eruption which mercury excites upon* the skin, is eminently similar. In Franks Magazine a number of cases are reported, clearly showing the homosopathicity of mercury to small-pox. It is stated in these cases that the skin is swollen and inflamed ; that red stigmata break out all over the body, cover- ing the face, chest, abdomen and extremities; that, after a while, vesicles spring up, that these vesicles become gradually filled with a yellowish serum ; that this exudation is characterized by a peculiarly fetid odor, and that the patient is moreover tormented by an intol- erable stinging itching. After the eruption dries up, an universal desquamation of the epidermis takes place.

Even the preliminary symptoms correspond with the precursory

420 MEECUEIUS SOLUBILIS HAHNEMANN!!.

AFFECTIONS OF BONES, whether of a scrofulous or syph- ilitic nature, mercury is a most useful remedial agent. In chronic swellings, nodes or gummata, caries of bones, especially when symp- tomatic of tertiary syphilis, mercury may prove invaluable. Where- soever the syphilitic virus may have set up an ulcerative process, in the osseous system, in cartilaginous structures, we may depend upon the mercurial preparations as reliable antidotes, unless the syphilitic and mercurial poisons had combined in developing the existing disorganizations. In all such cases, remedies have to be chosen, that counteract both the syphilitic virus and the mercurial disease.

Even in exceedingly protracted and chronic cases mercury may

still be an efficacious means of cure. Trousseau and Pidoux furnish

two illustrations of the curative virtues of mercury in affections of

the bones, which I will briefly relate.

MERCURIUS SOLUBILIS HAHNEMANN!. 421

ASCITES or dropsy of the bowels, especially if the disease is connected with, or depending upon some affection of the liver. If this affection is organic, the dropsical affection may have to be removed by an operation ; if it is simply functional, the dropsy is curable by treatment. Ascites where mercury is specifically curative, is generally complicated with symptoms of jaundice, a sallow, greenish-yellowish hue, cold skin, feeble, slightly hurried pulse, scanty emission of a thick, foul-smelling urine, and constipation, with occasional passage of dry, light-colored feces.

BALDNESS is also caused by mercury. In scrofulosis or in dis- eases of the scalp, baldness may constitute an indication for mercury.

422 MERCURIUS SULPHURATUS RUBER.