Observations on the Operation and Use of Mercury in the Venereal Disease

by Andrew Duncan

It is however but too true, that mercury is frequently employed in cases where its use might readily be dispensed with. And this holds not more of its employment in other diseases, than in some venereal complaints. When, indeed, the venereal virus has actually entered the system, perhaps a cure, by means of mercury, is in every case at least to be attempted. And a cure without it, by any medicine at present in use, is seldom, if ever, to be depended on. But, where the matter occasioning the affection is still in a state of topical application only, as happens in the case of gonorrhoea, the introduction of mercury into the system is totally unnecessary. And a cure may be effected by other means, not only with greater safety and ease, but likewise with more expedition.

Mercury, in an active state, when introduced into the system, has, in every case, more or less a tendency to affect the intestines. This action, while it seldom co-operates with its other effects in curing the disease, frequently produces the most mischievous consequences in the constitution. When it occurs, therefore, it is but natural to think of checking it. This may often be successfully done, by the employment of means fitted to promote a determination to the surface. Where this method fails, it may frequently be obviated, by giving opium at the same time with the mercurial.

Another consequence which often arises from active mercury, when introduced into the system in any considerable quantity, is its exciting salivation. This discharge is attended with numberless inconveniencies, and it is at the same time no farther necessary to a cure, than as it is a proof of the quantity of active mercury which is in the system. But, where mercury in the greatest quantity is requisite to a cure, to keep the patient upon the verge of a salivation is all that is necessary. Salivation, then, on its first appearance, is always to be restrained. For this purpose, it is necessary, that the use of the medicine should for a little be intermitted. Where that is insufficient, determination to the surface, by means of diluent diaphoretics, has a tendency to restrain this discharge as well as the former, and may often, for this purpose, be used with advantage. But, in general, salivation will be most successfully checked, by increasing the determination to the intestines by means of cooling purgatives.

As well as other discharges, that by sweat may likewise, from the use of mercurials, take place in a degree not to be wished for. Although this discharge is attended with much less inconvenience than either of the two already mentioned, yet it may often be proper to restrain it. This may be done by keeping the patient more thinly clothed, and in a cooler temperature than before, and by a cautious exposure to open air.

The accidents already enumerated are the most common ones which can be considered as depending on the nature of the medicine itself. But, besides these, a variety of others, although less frequently occurring, might likewise be referred to this source. Independent of that affection of the gums and mouth, which, for the most part, is the forerunner of salivation, it sometimes happens, even where no particular exposure to cold can be blamed as a cause, that the whole head is remarkably swelled. Where this takes place, it is in general the consequence of throwing in the mercury too suddenly, and may best be avoided by a more sparing and gradual use of the medicine.

From continuing the use of mercury for a considerable time, in some cases, febrile complaints will arise. These, if they admit of a cure, while the use of the mercury is continued, will most readily be overcome by the means commonly employed for the relief of hectic fever. But it seldom happens, that these symptoms can be removed without omitting the use of the mercury. In such cases, therefore, even although from the remaining appearance of a venereal taint, the farther continuance of mercury would seem adviseable, yet, when these febrile symptoms supervene, it is for the most part necessary, to trust the cure to other means.

The action of every medicine, and consequently the circumstances claiming attention in its employment, are considerably varied by peculiarities in the habit in which it is given. What, in this respect, therefore, is chiefly to be attended to in the use of mercury, falls next to be considered.

Although it has been observed, that the accidents already mentioned may happen in any habit; yet it is certain, that in some particular habits, they will much more readily take place than in others. Where constitutions, therefore, naturally exposed to these accidents do occur, it is necessary, that the means to be employed for preventing the inconveniencies which would arise from thence, should be had recourse to, more early than in patients of a different constitution.

Mercury, when introduced into the system, has always a tendency to produce evacuation. At particular periods of life, evacuation is less easily born than at others. Hence, the long continued use of this medicine, or its employment in a considerable quantity, are always particularly to be avoided with people much advanced in life, or with infants.

During infancy, mercury may likewise produce inconvenience, from its stimulant power. On this account, the more acrid preparations are, during that period of life, to be avoided. If, however, their use should be esteemed necessary, they are to be employed only in small doses.