92 MATER i A MEDIC A AND THERAPEUTICS. 



that they may be recognised and arrested. The principal 

 application of the drug is as an " alterative " in syphilis, a 

 disease attended by the growth of cells around the small 

 vessels, and the development of these into nodes, gummata, 

 various eruptions, etc. Mercury has a powerful influence in 

 controlling the severity of this disease. Its employment may 

 be commenced with various local applications to the primary 

 sore, and regular internal doses of the solution of the per- 

 chloride, calomel, grey powder, or some of the other prepara- 

 tions, until salivation threatens. It is generally (not 

 universally) believed that the secondary stage is rendered less 

 severe, or is even entirely prevented by this means. The drug 

 must be continued during the appearance of secondary symp- 

 toms ; but, as a rule, it is better omitted in the tertiary stage. 

 The particular preparation employed varies with the experience 

 of the practitioner. Quinine and opium are useful means of 

 support to be combined with mercury in a course of the metal, 

 and we must repeat that, unless the appetite and digestion 

 continue good, its use must be interrupted. 



The other use of mercurials as alterative remedies is in 

 internal inflammations, especially inflammation of serous 

 membranes, such as peritonitis, pericarditis, pleurisy, menin- 

 gitis, and orchitis. This line of treatment, once universal in 

 England, is now almost obsolete, excepting, perhaps, in peri- 

 tonitis of a subacute or chronic kind, in which, as in most 

 instances where it is used as an antiphlogistic, mercury is 

 combined with opium. Possibly some of the benefit thus 

 attending mercurialisation in inflammation, and which was 

 formerly referred to a " resolvent " action on the fibrin of exu- 

 dations, is due to its purgative and indirect cholagogue effects. 



5. REMOTE LOCAL ACTION AND USES. 



Mercury passes out of the system in all the secretions the 

 saliva, sweat, milk, urine, and bile, probably as an albuminate, 

 and stimulates many of the glands en route. It is in this way, 

 as we have seen, a powerful sialagogue, causing swelling of 

 the salivary glands and a profuse flow of the secretions of the 



v mouth. This effect is important only because it is to be 

 avoided. The diaphoretic effect of mercury is comparatively 

 insignificant. Whilst it does not increase of itself the volume 



\oi urine, it assists to a marked degree such diuretics as 

 digitalis and scilla ; but it must not be given in kidney disease, as 

 it acts injuriously on the diseased tubules, and readily produces 

 its debilitating effects when the renal function is impaired. In 

 the faeces mercury leaves the body as the sulphide, being de- 

 rived, first, from that considerable portion of the dose which is 



