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ELEMENTS OF MATERIA MEDICA.

The nature or quality of the inflammation also influences the effects,and thereby the uses, of mercury. Thus, in syphilitic inflammation,mercurials are of the greatest utility; less so in rheumatic inflammation;still less in scrofulous ; and most decidedly objectionable in cancerous orscorbutic diseases. The treatment of rheumatism by calomel and opiumwas proposed by Dr. Hamilton {op. cit.), and has found many supporters(vide Dr. Hope, Lond. Med. Gaz. xix. 815); and, undoubtedly, when thefebrile action does not ran too high, or when the pericardium becomesaffected, calomel and opium, preceded by blood-letting, will be foundserviceable. It appears to be best adapted to the fibrous or diffuse formof the disease, and to fail in the synovial (Dr. Macleod, Lond. Med. Gaz.xxi. 361). The scrofulous habit is, for the most part, unfavourable to theuse of mercury given as a sialogogue, but there are cases in which it isnot only admissible but serviceable—as scrofulous ophthalmia, when ofan acute kind. In all maladies of a malignant character (as cancer,fungoid disease, &c.) mercurials are highly objectionable.

(c.) Venereal diseases. —It was formerly the opinion of surgeons thatthe symptoms of venereal diseases were progressive, and never disap-peared until mercury was administered; but it has, of late years, beenclearly proved that this notion is erroneous : and we are indebted to someof our army surgeons—namely, to Messrs. Ferguson, Rose, Guthrie,{Med. Chirurg. Trans, vols. iv. and viii.), Hennen {Military Surgery ),and Bacot {On Syphilis, 1821), and to Dr. Thomson (Ed. Med. and Surg.Journ. xiv.)—for showing that the venereal disease, in all its forms, maybe cured without an atom of mercury. Moreover, it is fully establishedby the experience of almost every surgeon, that while in some instancesmercury exercises a beneficial influence hardly to be observed with re-spect to any other disease or any other remedy, yet, that in some cases itacts most injuriously ; and it is generally supposed that many of the badvenereal cases formerly met with, arose, in great part, from the improperuse of mercury. It is a point, therefore, of considerable importance, todetermine what cases are best adapted for a mercurial, and what for anon-mercurial, method of treatment; for in admitting the possibility of acure without this agent, it is not to be inferred that the method is eithereligible or expedient; nay, the very persons who have proved this pos-sibility, admit that in some cases this mineral, given so as to excitemoderate salivation, is advisable. One fact is, I think, now tolerablywell established—viz. that the cure of venereal diseases without theaid of mercury is much slower and less secure against relapses thanby a mercurial treatment (vide Colles, Tract. Observ. on the Vener. Dis-ease, p. 318). It is not easy to lay down rules to guide us in the selec-tion of the one or the other of these methods of treatment. Mr.Carmichael (On Venereal Diseases, 2d ed. 1825) relies principally on theeruption, and, next to this, on the appearance of the primary ulcer; andof the four forms of the venereal disease which he has described, namely,the papular, the pustular, the phagedenic, and the scaly, full courses ofmercury are required, he says, in one only—namely, the scaly ; in whichthe primary sore is the Hunterian chancre or callous ulcer, and the erup-tion partakes of the characters of lepra or psoriasis. But it has beensatisfactorily proved by experiments made in the military hospitals, thateven thig scaly form of the disease may get well without mercury ; and,on the other hand, in the pustular and papular forms, mercury is often a