The Cholera in Paris
1832
Boston Medical and Surgical Journal
well, and I learned from her sister, who two years afterwards was placed under my care, that she remained so. It is not difficult to perceive the principle on which the minute doses are so powerful. From their little aperient tendency, they readily enter the system, and, from the little irritation and excitement they occasion, they are not apt to be thrown off by it. Such cases as the preceding, and I could mention many, in which a certain affection of the mouth arose from even smaller
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... s, which, had they been continued, would soon have produced the same effect as in tho preceding case, prove that the peculiar effects of mercury may be obtained in any degree we please, by small doses. What, then, can be the motive for employing larger ones, unless, either from the nature of the symptoms, or the urgency of the case, the more active effects of the medicine, or the more rapid impregnation of the system, bo required ; or, as happens in certain diseases, the powers of the absorbing vessels arc so impaired, that minute doses arc no longer capable of exciting them, and therefore cannot enter the system ? The cause of minute doses sometimes producing an effect on the gums, when larger doses fail, arises from the latter being so much moro powerful in exciting the excretorios, by which, in certain constitutions, they are often thrown off as fast as they are taken, and thus little impression is made, either on the mouth or the disease. It is to the thorough manner in which the minute doses are received into, and retained in, the system, and the general, steady, and gentle impression they make, that they owe an efficacy which surprises those who have not been accustomed to see their effects. Such doses, of course, have little effect in suddenly emulging the biliary ducts, and thus discharging collections of vitiated bile ; and, until they succeed in restoring the due action of the liver, which in general requires some time, the collections are in many cases more or less apt to form under their use, and occasionally to require the operation of a more active mercurial, the necessity for which is different in different cases, according to the tendency to such accumulations. Where there is no tendency of this kind, the active dose is unnecessary, and its frequent repetition is seldom proper. Calomel, we have seen, generally answers the purpose of the larger dose better than the blue pill, although, in the more obstinate cases, I have sometimes found a combination of the plan I am now describing, and that of Mr. Abernethy, the most successful. THE CHOLERA IN PARIS The following account, which is, no doubt, a correct one, is from tho pen of Mr. N. P. Willis, of this city, now in Paris. It composes the latest of those epistles published and publishing in the New York Mirror, under the head of "First Impressions of Europe ;" and, as it was written by an intelligent, although not a medical, observer ofthe epidemic lately so rife in the French metropolis, it is recommended to the attention and implicit credit of the reader.
doi:10.1056/nejm183206130061802
fatcat:7yovbaf7s5hwfbns75j4dbz5qa