YANDULL on Spamodic Cholera.



ultimately die. In other cases, where cramps and rice water
passages were also present, I gave the calomel in doses of 60
grains, and in every instance with a different result. With
this experience, I was inclined to the use of this remedy in
large doses, and thefirst case which I saw in June confirmed
me inthe proprietyofthe course. Thepatient wasahealthylad,
in a factory, aged about 18 years. He was seized with diar-
rhoea at 4 o'clock on the morning of the 4th, but continued
at his work until 10, at which time he Was in advance of
his task. I saw him at 12, when his owner had given him
20 grains of calomel. He was sitting up dressed, and com-
plained of nothing but the looseness of his bowels. Never-
theless, he looked ill, and his pulse was much below the
healthy standard in force and fulness. In about three hours,
and of course, before the calomel had operated, he was taken
with spasms, and died before 6 in the evening.
  From the repugnance of many persons to large doses of
calomel, I was obliged, in a few cases afterwards, to com-
mence with small doses. And, as stated, this course very
often succeeded; but now and then the case proving obsti-
nate, it was found necessary to increase the quantity in the
manner above referred to. In nearly every instance where
60 or 100 grains were given at first, the effect was that of an
opiate upon the bowels-arresting all dischargesuntil bilious
matter began to pass off.
  In using this article thus liberally I had but one fear-
that of salivating the patient, and when it had acted favora-
bly, aloes freely given kept up the secretion of the liver, and
obviated this difficulty. Calomel, it is well known, is one
of the most insoluble of substances, and though administer-
ed in large quantities can enter, in any reasonable time, but
sparingly into the circulation. Hence the danger of ptya-
lism is not in proportion to the quantity taken, while I have
experienced that the certainty of its operation is. Such
being the case, and since hypercatharsis is not one of the
consequences to be dreaded from it, it appeared to me but
reasonable to employ the remedy, in which I had most cdn-



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