113 
PATHOLOGY. 
(Doftrina de Morb. Pentium, p. 52.) How far, however, 
this fubltance may indireftly hurt the teeth, by derang¬ 
ing the gaftric funftions, may admit of fome difcuffion. 
Genus II. Ptyalifmus , [from wlow, to fpit.] Diforders 
affecting the Salivary Glands. This genus contains three 
fpecies. 
1. Ptyalifmus acutus, or Salivation, has three varieties : 
et, hydrargyratus; ( 3 , fympatheticus ; 7, mellitus. 
a. Ptyalifmus hydrargyratus. This confifts in an in¬ 
creased Secretion of faliva from an extreme action of the 
Salivary glands. As an idiopathic diSeaSe, it is Seldom 
Seen, and even then not until it hasaffumed the chronic 
'form. It more ufually makes its appearance in confe- 
quence of irritation from mercury. Other fubftances, 
however, will produce it ; but this is the molt common, 
and the only one we are acquainted with which increafes 
this Secretion with certainty and precifion. Formerly the 
uSe of mercury for the purpofes of Salivation was carried 
to So great an extent, that frequent floughings and ul¬ 
cerations of the mouth were the confequence. But, 
llnce it has been known that the degree of violence with 
which mercury is puflied is far from increaling its curative 
effefts, we have not to record So many of thofe frightful 
appearances. 
The production of this difeafe is generally the work of 
the phyfician. With refpeft to the quantity of mercury 
neceflary to produce it, the greateft variation is obferv- 
able. While, on the one hand, it is carried into the 
conftitution without vifible effeft for very long periods, 
or is carried off by Sweat, purging, &c. on the other, the 
moll trifling doSes in different conftitutions produce vio¬ 
lent and alarming effefts in a few days. The inftances in 
which the patients have been infenflble for long periods 
to large and frequently-repeated dofes of this medicine, 
will be familiar to mod of our readers. The oppofite ftate 
of conftitution is not perhaps So frequently met with ; 
but even that is Sufficiently common. The uSual quan¬ 
tity of mercury required is about five grains of the blue 
pill, which contain a grain of mercury, to be repeated 
three times a-day ; or, if calomel is employed, a grain 
night and morning at firft, or two grains at night, guarded 
with a grain of opium, left it Ihould irritate the bowels, 
will be a proper dofe. If the ointment is preferred, half 
a dram of the ftrong mercurial ointment may be rubbed 
in night and morning. In about a week or ten days, by 
either plan, the mouth will be Slightly fore in the majo¬ 
rity of cafes; while, on the contrary, as we have before 
mentioned, cafes are not uncommon in which two or 
three Small dofes of mercury have produced copious fa¬ 
livation. In debilitated habits, three grains of calomel 
given in the dofe, or one grain on three Succeeding nights, 
has been found to induce the discharge. It has been 
brought on by Sprinkling precipitate on a wound (Hil¬ 
da n u s) ; by a mercurial injeftion in a fiftula ; by a mer¬ 
curial girdle; or by the mercurial ointment employed to 
kill lice. In thefe cafes, the idiofyncracy of the patient 
Seems to influence the effeft ; and, therefore, this ftiouid 
be, if poffible, ascertained before mercury is exhibited in 
any considerable quantity. 
It is uSual at prefent to produce this discharge in a 
very moderate degree; but Some aftion on the gums is 
neceflary, to (how that the medicine has been introduced 
into the fyftem. This is particularly the cafe in lues and 
chronic inflammations of the liver. In other complaints 
it is lefs effential if the Symptoms disappear. The effec¬ 
tual relief of thefe is the only certain criterion by which 
we are taught to leave off’ the medicine; and it will be 
prudent to continue it for fome time after thefe have dis¬ 
appeared. 
Of courfe this is not the proper place to difcufs the ef¬ 
fefts of mercury, or, generally Speaking, its adminiftra- 
tion ; but, as far as regards the bringing on of ptyalifm, 
we cannot help remarking, that, as its continuance is al¬ 
ways unpleafant, and Sometimes difficult of cure, a 
greater degree of care is required in its inftitution than 
the generality of praftitioners think proper to adopt. 
Under this impreffion, we cannot do better than urge the 
rules of Dr. Hamilton on this fubjeft ; wliofe advice, 
however it may be thought by Some to favour of unne- 
ceffary minutenefs, is nevertheless highly ufeful in many 
cafes, and has the advantage of erring on the right fide 
in all. 
“ The firft precaution to be adopted in this climate du¬ 
ring a courfe of mercury, is confinement within doors, 
with a regulated temperature of the apartment. The 
utility and the neceflity of this precaution muft be So ob¬ 
vious, that it is unneceffary to expatiate upon the fub¬ 
jeft. Not that it is meant that the patient fliould be con¬ 
fined to an ill-ventilated room 5 for, on the contrary, a 
plentiful Supply of freflr air is of effential utility. While 
the boldnels with which Mr. Pearfon expoles Such pa¬ 
tients to cool dry open air may be well Suited to perfons 
who have been immured in a crowded hofpital with a 
mercurial atmofphere, it certainly would be moft preju¬ 
dicial to the better ranks of Society in private practice. 
“ zdly. The diet ought to confilt of the mildeft poffi¬ 
ble food, Such as preparations of milk and farinaceous 
matter, with weak animal mucilages. In ffiort, all (Simu¬ 
lant food or drink of every description, ought to be molt 
fcrupuloufly refrained from. 
“ 3dly. IS the individual be robuft. Sixteen or twenty 
ounces of blood Should be drawn from the arm before 
any preparation of mercury be exhibited. Where, from 
the delicacy of the patient, blood-letting cannot be ad- 
vifed, confinement within doors a week previous to be¬ 
ginning the mercury, and during that time one or more 
dofes of cooling phyfic ought to be taken. 
“ 4thiy. The mercury mult not be given in Such quan¬ 
tity, or with Such aftivity, as to produce a Sudden effeft 
upon the fyftem. This is certainly one of the moft im¬ 
portant practical improvements, fuggefted by Mr. Aber- 
nethy and others, and confirmed by the late experiments; 
for irreparable mifchief was often committed by the 
hurry with which the fyftem was loaded with mercury. 
If the other precautions be implicitly adopted, the more 
(lowly the mercury is adminiltered, the more certainly, 
and perhaps Speedily, will the primary Sores heal. 
“ 5thly. Although, in particular cafes, (ome of the 
more aftive mercurial oxydes may be ufeful, the blue 
pill or the blue ointment furnilh in general tliefafeft and 
mildeft preparations of mercury. 
“ 6thly. Salivation is to be guarded againft by leffening 
the dole, or fulpending the medicine, whenever the brally 
tafte in the mouth is perceived. The Same meafures are 
to be purfued if any irritation of the bowels threatens. 
“ 7thly. Some vegetable diluent ought to be drunk in 
large quantities, for thepurpofe principally of preventing 
the peculiar ftate of the blood, which mercury is So apt 
to produce. The decoftions of farfaparilla, guaiacum, 
faffafras, &c.'anlwer this purpofe; and perhaps they are 
all equally efficacious, if drank tepid, and in Sufficient 
quantity. 
“ Stilly. It is extremely difficult to eftablifli any gene¬ 
ral rule tor the duration of a mercurial courfe, as that 
muft be regulated very much by the circumftances of each 
particular cale. From two to three months may perhaps 
be Sufficient in the majority of cafes. 
“ 9thly. The daily ufe of the warm bath, where that 
can be conveniently commanded, is found particularly 
beneficial. 
“ xothly. If any irritable feelings occur wdiile under 
the influence of mercury, the ufe of the medicine fliould 
be inftantly fufpended, and the moft aftive mealures for 
checking the progrefs of Such complaints ought to be 
carefully adopted. Preparations of camphor, of the fpi- 
ritus ammonite aromaticus, of opium, of cicuta, &c. are Se¬ 
verally ufeful, accprding to the circumftances of each 
cafe. 
“ uthly. After the mercurial courfe is finilhed, the 
patient ought to remain within doors for at lealt a fort¬ 
night, improving the diet, (though ftill abftaining from 
wine 
