Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
History
Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
The following fact, communicated to me by Dr. Stewart, will show the
safety of large doses of calomel in this fever. Mrs. M'Phail took 60
grains of calomel, by mistake, at a dose, after having taken three or
four doses, of 20 grains each, on the same day. She took, in all, 356
grains in six days, and yet, says the doctor, "such was the state of her
stomach and intestines, that that large quantity was retained without
producing the least griping, or more stools than she had when she took
three grains every two hours."
I observed the mercury to affect the mouth and throat in the following
ways. 1. It sometimes produced a swelling only in the throat, resembling
a common inflammatory angina. 2. It sometimes produced ulcers upon the
lips, cheeks, and tongue, without any discharge from the salivary glands.
3. It sometimes produced swellings and ulcers in the gums, and loosened
the teeth without inducing a salivation. 4. There were instances in which
the mercury induced a rigidity in the masseter muscles of the jaw, by
which means the mouth was kept constantly open, or so much closed, as to
render it difficult for the patient to take food, and impossible for him
to masticate it. 5. It sometimes affected the salivary glands only,
producing from them a copious secretion and excretion of saliva. But, 6.
It more frequently acted upon all the above parts, and it was then it
produced most speedily its salutary effects. 7. The discharge of the
saliva frequently took place only during the remission or intermission of
the fever, and ceased with each return of its paroxysms. 8. The
salivation did not take place, in some cases, until the solution of the
fever. This was more especially the case in those forms of the fever in
which there were no remissions or intermissions. 9. It ceased in most
cases with the fever, but it sometimes continued for six weeks or two
months after the complete recovery of the patient. 10. The mercury rarely
dislodged the teeth. Not a single instance occurred of a patient losing a
tooth in the city hospital, where the physicians, Dr. J. Duffield
informed me, relied chiefly upon a salivation for a cure of the fever.
11. Sometimes the mercury produced a discharge of blood with the saliva.
Dr. Coulter, of Baltimore, gave me an account, in a letter dated the 17th
of September, 1797, of a boy in whom a hæmorrhage from the salivary
glands, excited by calomel, was succeeded by a plentiful flow of saliva,
which saved his patient. I saw no inconvenience from the mixture of blood
with saliva in any of my patients. It occurred in Dr. Caldwell, Mr.
Bradford, Mr. Brown, and several others.
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