Calomel is one of the most useful medicines we possess; but though powerful for good, it is by no means powerless for mischief, and pages might be written upon the evil effects which have resulted from its indiscriminate use in the nursery; medical men are daily and hourly witnessing this fact. It is particularly eligible in the diseases of children; but then it is quite impossible for unprofessional persons to judge when it may be appropriately exhibited. And it cannot be too generally known, that the effect of this medicine upon the evacuations is always to make them appear unnatural. From ignorance of this fact, calomel is often repeated again and again to relieve that very condition which it has itself produced, causing, but too frequently, a degree of irritation in the delicate lining membrane of the bowel, which it may be very difficult for a medical man to remove, and perhaps a source of misery to the child as long as it lives.
Its frequent exhibition has also another evil attending it, for "the immoderate use of mercury in early infancy produces more, perhaps, than any other similar cause, that universal tendency to decay, which, in many instances, destroys almost every tooth at an early age."[FN#20]
[FN#20] Bell on the Teeth.
In the diseases of childhood it is often administered by the mother or nurse with a degree of careless excess which ultimately, if not immediately, produces severe and irremediable injury. I have met with such cases; but Mr. Bell details a remarkable instance in point: "A child, about three years of age, was brought to me, having a most extensive ulceration in the gum of the lower jaw, by which the alveolar process (that portion of the jaw which forms the sockets of the teeth) was partially denuded. The account given by the mother was, that the child had some time previously been the subject of measles, for which a chemist, whom she consulted, gave her white powders, one of which was ordered to be taken every four hours. It appears by the result, that this must have been calomel; for, after taking it for two or three days, profuse salivation was produced, with swollen tongue, inflamed gums, etc., followed by ulceration of the gum, lips, and cheek. On examining the denuded alveolar process, I found that a considerable necrosis (death of the bone) had taken place, including the whole anterior arch of the jaw from the first double tooth on the left side to the eye-tooth on the right. By degrees the dead portion of bone was raised, and became loose, when I found that the mischief was not confined to the alveolar process, but comprised the whole substance of the bone within the space just mentioned," etc. Surely the knowledge of such a case as this would induce every prudent mother to exclude calomel from her list of domestic nursery medicines.
Sect. III.—OPIATES.
This class of medicine is often kept in the nursery, in the forms of laudanum, syrup of white poppies, Dalby's carminative, and Godfrey's cordial.
The object with which they are generally given is to allay pain by producing sleep; they are, therefore, remedies of great convenience to the nurse; and I am sorry to be obliged to add, that, so exhibited, they are but too often fatal to the little patient.
The fact is, that in the hands of the physician, there is no medicine the administration of which requires greater caution and judgment than opiates, both from the susceptibility of infants to their narcotic influence, and their varying capability of bearing it; the danger, therefore, with which their use is fraught in the hands of a nurse should for ever exclude them from the list of domestic nursery medicines.
Dalby's carminative and Godfrey's cordial are, perhaps, more frequently used than any other forms; and some striking cases, illustrative of the fatal results of exhibiting them indiscriminately, and without medical sanction, are on record.[FN#21] The late Dr. Clark, in his "Commentaries," mentions a case which he saw, where "forty drops of Dolly's carminative destroyed an infant." Dr. Merriman gives the following in a note in Underwood, "On the Diseases of Children:"—
[FN#21] Two or three fatal cases, and upon which coroners' inquests were held, have occurred within the last two years.