Observation on the Use and Abuse of Mercury, and on the Precautions Necessary in Its Employment

by Alexander Philip Wilson Philip

This tendency of mercury readily accounts for the bad effects of taking cold under its influence. It is easy to conceive that the bad effects of checking perspiration will be most felt when, to use a common expression, the pores are most open, that is, when the secretion by the skin is most copious; for the greater the quantity of fluid thus discharged, the greater inconvenience is to be expected from suddenly checking its secretion. Hence also the danger of suddenly checking perspiration, when, by exercise or external warmth, it is rendered more copious than usual.

Such is the admirable constitution of our bodies, that means are provided for more or less successfully counteracting the operation of every thing which tends to injure them. If a thorn or any other extraneous body is introduced under the skin, inflammation and suppuration spontaneously arise, by which the offending cause is expelled. If a poisonous substance is received into the stomach, the action of vomiting is frequently excited, or if it passes into the bowels, nature still endeavours to carry it off by an increase of the peculiar motion of the intestines, and of the secretion from their surface; so in the case before us, the morbid fullness which would in every instance arise, when perspiration suffers a check, is generally prevented by the sympathy which subsists between the skin and several other secreting organs, in consequence of which, as soon as a check is given to the action of the former, some one of the latter, which secrete a similar fluid from the blood, is called into more vigorous action, and what should have passed by the skin is thrown off by the kidneys or bowels, sometimes by the glands of the nose, throat, and lungs, occasioning what we call a cold.

This substitution of one excretion for another, if I may use the expression, is particularly apt to occur under the use of mercury, and seems to arise from the nature of this medicine being so stimulating that we cannot retain it in the system: if one vent is denied it, it quickly finds another. Hence it is that people under the effects of mercury are so subject to an increased secretion from the kidneys and intestines, and from the glands of the mouth and throat.

It is of great consequence in most cases, in conducting a course of mercury, as much as possible to prevent its running off, and as we cannot wholly confine it, our plan is to direct it to that channel thro’ which it passes off most slowly; for it is well known that this and some other medicines, while they particularly excite any one excreting organ, are not apt to pass off at the same time in considerable quantity by any other. Now the channel by which mercury passes off most slowly is the glands of the mouth, and fauces. Our view, therefore, is generally to direct it to this channel, and the degree in which it increases the secretion from these glands is a sufficiently accurate measure of the quantity of mercury in the body, as we generally find that the effects of mercury in removing disease are proportioned to the degree in which it affects the mouth. Besides the discharge, and consequently the debility, occasioned by the same quantity of mercury, is less when it excites these glands, than when it acts on the skin and bowels.

While it increases the secretion from the glands of the mouth and fauces, it irritates and inflames them, and the inflammation it excites when the quantity which passes in this way is great, often becoming considerable and spreading to neighbouring parts, much uneasiness is sometimes occasioned.

The symptoms of salivation form the chief of the bad effects, which are peculiar to this medicine. They are indeed unpleasant, but they are unattended with danger. It is rarely proper to induce them. A physician may practice for several years without meeting with one instance in which salivation is necessary; and the extent to which the older practitioners were accustomed on every occasion to carry the use of mercury, may be regarded as one of the greatest abuses which have opposed the beneficial employment of this medicine. It has certainly more than any other tended to confirm the prejudices against it. All its good effects can in most cases be obtained by slightly affecting the mouth, and keeping up this affection for a longer or shorter time, according as the complaint proves more or less obstinate.

In certain formidable cases which, we have reason to believe, if left to themselves would prove fatal, and in which more gentle means have failed, it is proper to induce salivation. But may not a similar objection be brought against the use of most other medicines? There are few whose operation, is not attended with some inconvenience. How alarming would be the operation of an emetic were we not accustomed to see it! Violent vomiting is a symptom occasioned by some of the most fatal poisons, yet we are easily reconciled to it when assured of its beneficial tendency.

From what has been said, the reader will readily perceive, why a sudden salivation is often the effect of taking cold under the operation of mercury. We have no means of immediately checking a salivation. Discontinuing the use of the mercury, employing gentle laxatives, and avoiding every thing which tends to irritate the inflamed surface of the mouth and fauces will lessen the inflammation and discharge, and by degrees remove them.

When the mercury instead of falling on the glands of the mouth and fauces, is thrown on the bowels in consequence of taking cold, it is more in our power to regulate and restrain the discharge. For the most part this affection of the bowels is a mere diarrhœa. The griping pains which sometimes attend it seem to arise from the copious secretion from the intestines washing off the mucus which is the natural defence against the irritation of their contents. When this affection is allowed to continue, and no care is taken to defend the bowels, dysenteric symptoms sometimes shew themselves; these are most frequently the consequence of mercury taken internally, as I shall presently have occasion more particularly to observe.

This affection of the bowels may be induced in another way. It will have nearly the same effect, whether the fluid, which should pass by the skin is thrown on the bowels in consequence of the action of the skin being checked by taking cold, or in consequence of this fluid being directed to the bowels by any cause of irritation applied to their surface. Hence it is, that indigestible and irritating food will often produce such a change in the distribution of the fluids, that the increased secretion by the skin or salivary glands, occasioned by the mercury, shall be exchanged for that by the bowels.