Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    78/902 page 62
    mouth; 2, by inunction; .'5, by fumigation; and 4, by subcutaneous injection. It is, as a rule, perhaps, best given by the mouth, cither in the form of a pill or mix- ture. As a pill, the green iodide in doses of a grain to 2 grains, combined with to J.- of a grain of opium to prevent purging, may be given two or three times a day, or the mercury and chalk powder in doses of from 2 to '6 grains, or calomel or blue-iiill may be substituted for it. As a mixture, the perchlorido in doses of J- to of a grain, combined with ammonia, is very useful. The green iodide possesses an advantage, in that the iodine prevents an accumulation of mercm-y in the system. Where mercury given by the mouth causes much irrita- tion of the bowels, it may be used in the form of an inunction, half a di'achm to one drachm of mercuiial ointment being rubbed into the inner part of the thigh or the axilla night and morning, the pai'fs being thoroughly washed every day to prevent the ointment accumulating in the sweat ducts, &c. This is a rapid way of bringing the patient under the influence of the drug, as is also fumigation with calomel or other preparation of mei'cury, though this latter method may be followed by violent salivation. Subcutaneous injection appears to possess no special advantages over the other methods, and is apt to cause sores or abscesses at the jioint of puncture. The effects of the mercury should bo judged by its action on the primarj' sore and secondary affections. Tnder its influence the indimxtion of the sore rapidly disap]X'ars, and the rash fades. It .should never b(; pushed beyond causing a slight soreness of the gums, the formation of a red line on their free margin, and tenderness on biting. Should salivation occiu-, the mercury should be imme- diately stopped, a gentle purgative given, the mouth rinsed with a gargle of chlorate of ]iotash, and iron taken internally. The mercury should also be int(>rmittcd for a few weeks or so at a time if symptoms of de])rossion come on. During tlio mercurial course the patit'ut should avoid chills and abstain from alcohol, frosh finiit. and food liabl(! to disturb the digestion and si^t up diarrhtva. The mercurial course may with a<lvantage be continued for a year or more, iind on its terininalion iron, tonics, and cod-liv(;r oil should be given, whilst change of air a-nd the baths of Aix-la-('lia])elle or ]Iarrogate will be found beneficial. If mercury cannot 1)0 taken oris contra-indicati'd, iodiili' of iiotassiuni with a tonic treat-
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