Observations on antimony / Read before the Medical Society of London, and published at their request

by John Millar

Those who use it often become insensibly interested in advancing its reputation, and are not only incompetent judges, but partial in their testimony. Thus some who, with horror and remorse have applied for assistance, accusing themselves of murder, and vowing, for ever, to renounce quackery, have afterwards triumphed and assumed the credit of cures of which they had absolutely despaired, though the sick were, by other means, rescued from the danger incurred by the severe operation of this violent remedy; while others, shocked by the fatal consequences of their facility and misplaced confidence, wish to banish it for ever from their remembrance. The cases must therefore be dismissed as insufficient to justify the claim of infallibility to this antimonial preparation.

A proof of its salutary influence is attempted to be drawn from the bills of mortality. Fewer having, on an average, died in the space of thirteen years, from the year one thousand seven hundred and fifty, to the year one thousand seven hundred and sixty-three, than in the preceding thirteen years; this decrease in the funerals amounting to sixty-two thousand, two-hundred and sixty-six, is attributed to the fever-powder[81].

It might with some plausibility be objected, that the bills of mortality being collected from the reports of incompetent judges, cannot be admitted as proper evidence of the fact; but as no extraordinary skill seems necessary for the employment, and as the bills cannot be supposed to be made up with any partial intention, this argument must be admitted; and if the deaths, by fevers, shall be found to have decreased, in so great proportion, since the powder has been in general use, its reputation will be established by the most desirable evidence.

In collecting this proof, the whole circle of disorders, accidents and casualties has been calculated, though the powder was then only recommended for fevers. It has, indeed, been since extended to other diseases, but our examination shall be restricted to fevers, during the period to which the Inventor refers.

Though some of the cases which he relates happened in the year one thousand seven hundred and forty-one, yet the medicine was not much known till one thousand seven hundred and fifty, the æra from which its auspicious influence on the bills of mortality is dated. But antimonial medicines were more in fashion before the powder came into general use, than at any future time. Dr. Huxham having, in the year one thousand seven hundred and thirty-seven, recommended, in the highest strain of panegyric, the vinum benedictum, it was universally adopted, though expressly condemned by the Inventor of the fever-powder. Great numbers, says he, of those whose employment it is to attend the sick, cunningly exhibited to their patients something, which they asserted was like the fever-powder, and would do as well. I leave it to the relations of those who took the something, to judge the consequence, for I suppose few or none of them who were thus treated survive[82].

The something, it is well known, was essence of antimony or tartar emetic, medicines under the direction of prudent practitioners, similar in their operation and in their effects, not only to each other, but also to the fever-powder; and though the Inventor has perhaps too much indulged his indignation against his competitors in the antimonial trade, yet his general position, concerning the fatal consequences of the universal administration of antimonial medicines, is well supported by the evidence to which he has appealed, the bills of mortality having greatly increased during the prevalence of that practice.

The numbers of those who died of fevers from the year one thousand seven hundred and thirty-eight, to one thousand seven hundred and fifty, including a series of thirteen years, is fifty-five thousand four hundred and ninety, and those in a like series of years, immediately succeeding, is thirty-six thousand three hundred and seventy-two; consequently nineteen thousand one hundred and eighteen fewer have died in the latter than in the former period, and this has, with some appearance of justice, been urged as a proof of the efficacy of the fever-powder.

But if this decrease in the funerals were actually owing to that medicine, it should have been still more observable in the last ten years, when the powder has been more universally used. But, in that period, thirty-five thousand four hundred and ninety-four have died, and consequently, the number of deaths, by fevers, have increased eight thousand seven hundred and eighty; and if inflammation, rash, and sore-throat, which were included in the former calculations, are added, the number will amount, nearly, to ten thousand, and therefore, on an average, one thousand, or near one-third more have died, of fevers, every year, in the last ten years, while the medicine has been universally used, than in the thirteen immediately preceding. The proof, therefore, from the bills of mortality is fatal to the fame of the fever-powder, and the decrease in the funerals during the thirteen years to which the Inventor appeals for the success of his antimonial powder, must be attributed to the desertion of the antimonial practice, and not to its prevalence.

But an appeal to the sum-total of the funerals, to prove the efficacy of the fever-powder, is unfair and inconclusive, since a great number of deaths happen from disorders, accidents and casualties with which it cannot possibly have any connection. That it might have a fair trial, our calculation has been restricted to fevers; and if the other diseases, in which it is recommended, had been included, the evidence would have been still more unfavourable.