'J70 PRACTICAL OBSERVATIONS ON THE 



endeavour to point out, front a successful practice in the 

 West Indies, as well as in this country. 



In fevers where there are but slight signs of inflammatory 

 diathesis, mild antimonials, as James\s powder, the antimonial 

 powder of the shops, or antimonial wine, in small and re- 

 peated doses, with occasional opiates, are generally sufficient 

 to open the pores of the skin, and occasion a gentle perspira- 

 tion. But where these or the like mild means are of no avail, 

 there is every probability to suppose that topical inflammation, 

 internally, has taken place. 



In cases of this sort I have immediate recourse to calomel, 

 either by itself, or joined with antimonials or opiates. The 

 quantity of calomel I employ is proportioned to the violence 

 of the disorder, and the danger the patient is in. In this 

 country I have seldom exceeded five or six grains of calomel 

 a day ; but in the West Indies I have given twenty grains in 

 twenty-four hours with the most marked success. 



In 1771, Dr Lysons published his Essay on the good ef- 

 fects of Camphor and Calomel in continual fevers. In such 

 cases I have found no occasion for the first of these ; and Dr 

 Ly'sous 1 success with the latter must have been in cases 

 where there was a morbid and topical affection of the viscera 

 and alimentary canal. 



About fourteen years ago, I communicated my method of 

 treating obstinate and acute diseases, in the West Indies, to 

 an eminent physician who had the care of a large hospital in 

 England. He gave calomel, in large and frequent doses, in 

 fevers that resisted the common methods of cure, and found 

 it to answer far beyond his expectations. It sometimes had 

 no other effect than occasioning a copious stool at times ; but 

 for the most part it acted as a mild diaphoretic and sedative : 

 a crisis, or favourable turn of the fever was soon brought 

 about, and the patient speedily recovered. 



It seems hardly necessary to mention to you, that in all 

 cases of typhus there can be but little hope of success, unless 



