THERAPEUTICS OF CALOLIEL.—As a purgative, calomel is still considerably employed, though slow in action and occasionally unreliable. The possibility of retention under such circumstances renders mercurial absorption possible when a large dose is administered, and it is always prudent to administer a saline the next morning or to give another purgative at the same time--a poor recommendation for tbe primary drug. The compound cathartic pill is based upon this principle. Recent labors have severely shaken the general belief that calomel increases the flow of bile, and tend to confirm the view that as a true purgative there are many agents, especially podophyllin, that are prefer able. Its germicidal action may render it useful, however, in the presence of infectious processes. In diphtheria, for instance, it is useful and it will some times check the disease when adminis tered, but this can hardly be credited to its merits as a purgative.
E'ffect of calomel on the secretion of bile as the result of experimental research on dogs with biliary fistulas. Oil has a negative effect on the secretion of bile, calomel a decided inhibitory effect, and salicylate of sodiurn, while it increases the quantity of bile secreted, lowers the density: the salts, etc., are reduced below the normal amount. The only ac tive cholagogue is bile itself, the ingestion of which is always followed by a consider able hypersecretion of bile. Boyon and Dufour (Presse MCA., Oct. 13, '97).
Purgative effects are obtained with more certainty and with no danger of ptyalism when very small doses, Vs to '/, grain, are administered every half hour until 3 grains are taken. All the mercury thus ingested undergoes trans formation into the purgative salt in the intestinal tract, and there is no surplus to awaken toxic symptoms later on.
Large doses of calomel have been rec ommended in the early stages of acute febrile diseases, pleurisy, pneumonia, yel low fever, and even in such affections as cholera. More clinical experience is necessary to confirm this view, but it seems to be in accord with data upon the physiological action of the remedy.
The same indications apply to the use of calomel in jaundice, or biliousness due to exposure to cold, the action being probably derivative and germicidal, to say nothing of stimulating powers which minute closes of mercury are known to possess.
In children very small doses thus be come extremely valuable when general inaptitude is associated with "heavy" breath and usually ill-smelling stools. Four doses of 1/„ grain every half hour until five (loses are taken, repeated in four or five days if needed, sometimes changes the entire aspect of the child. It is best administered thoroughly mixed with a little sugar, the powder being merely placed on the tongue. The tonic action of the remedy plays an important role here—provided only minute doses are adhered to.
i!..rafit it titarrhten this treatment is .r1.:It,21,:c. tut !zrain should be ad •ri%1- (len' three hours. As an •t may also he used with - abanta..te.
4 , et; — th S disease calomel v ,1 41 \ant age011Sly in .1s a preventive it has been v rto,minended hy Daly, of Pitts It t be administered in small 1,nt .1 77: ation upon the intestinal n by characteristic stools.
C.41, tntl is valuable in diphtheria; it is 11e best remedy we possess for prornot al surption, and is a safe and efficient ttrt*.i ide. Of thirty children treated by 11,1114.1.1 only tw o cases were fatal. G. It. l'o%%It.r .0bget. Gaz., Jan., 'SS).
l'uini:ations are also valuable, the riL,nn bein.c: volatilized under a tent f rin-.1 by sheets arranf.ted over a frame - the bed. It tends to soften the - ft meml rane to facilitate its detach n•. actina as a germicide.
Diphtheria treated by mercurial glt lens. For a child of S to 10 years 40 C-0 grains of calomel are volatilized ur,der a suitable tent or eanopy, this I kr' t over the child 20 minutes. procPdure is repeated every 2 to 3 trot-, during the. first day. The process. ntinuPd at the rate of 2 to 3 times a d y f. r a week if the cough tightens arlin. The lamp should be powerful en, ugl, to volatilize rapidly. so that the t•rnfprature under the canopy may not unTleasantly elevated. J. Corbin N V. MPd. Jour.. vol. p. 261, 'SS).