the sun, without seeing it, or even any painful sensation being produced. When he first began to see sufficiently to read, which was in the course of the first year, he could perceive but a small luminous spot upon the paper, about one inch in diameter, within which he could distinguish letters, but all without this was cloudless and confusion. During this time, the pupils were very much dilated, and he could see objects at a distance much better than those near by. His sight has continued to improve, ever since; and at the present time, although quite imperfect, is sufficiently good to enable him to read and write, although with some difficulty. The pupils are still considerably dilated, and it is with great difficulty, that he can discern objects by twilight. The direct rays of the sun upon the head, produce pain there, accompanied with a painful sensation deep in the orbit of the eye, and a disordered vision. At the present time, exercise easily produces fatigue, by which his sight is much impaired.

Case 4th. In the month of April, 1846, Dr. R. of this place took in doses of six grs. each, three drachms of quinine in 36 hours; at the expiration of which time, he became perfectly blind. His hearing was somewhat blunted, although it did not, in degree, equal the blindness. On the two succeeding days, his sight, although very imperfect was considerably restored. Had he lived, the probability is, that this imperfect sight would, as in the former cases, have continued a considerable-length of time.

Remarks. We think it clear that the blindness in the foregoing cases was the effect of the quinine; for we see it in each, coming on suddenly during its administration in large quantities, and at a time, when no other medicine was given that would be likely to produce such results. Here, cause and effect appear to be closely connected, and are so plain, as scarcely to admit of the possibility of a doubt. From the symptoms accompanying the foregoing cases, we judge that the proximate cause of the blindness, was mainly an affection of the retina or optic nerve, producing amaurosis.

I have recorded the foregoing facts, with the hope that they might be the means of causing some useful suggestions, in relation to the physiological effect and administration of this medicine.

In connection with the foregoing, we might mention the case of Mr. B. Porter, of this town, who has had for sixteen years and upwards, amaurosis of the left eye, which he supposed to have been produced by the application of a strong subacetate of copper ointment to that side of the face, for the purpose of curing Herpes circinatus. As the ringworm gave way, the blindness came on.

About one year since, he suffered with a periodical neuralgia, for which I ordered 32 grs. of quinine to be taken in divided doses of 4 grs. each, every two hours. Under its influence, the neuralgia disappeared; and on the following day, he could see objects quite distinctly with the amaurotic eye, much better than ever before, since it first became diseased, and he was much elated with the thought

of soon regaining its sight. He, however, took no more quinine, and in a few days, the benefit produced to that eye was entirely lost. Jackson, Mich.) Sept. 22, 1846.

Illinois and Indiana Med. and Surg. Jour.

On the Effects of Mercury on the Young Subject.-By JOHN B. BECK, M. D., Professor of Materia Medica and Medical Jurisprudence, in the College of Physicians and Surgeons, of New York. In some previous papers, I endeavoured to point out the peculiarities attending the operation of Opium and Emetics, on the infant subject, as distinguished from the effects of these agents on the adult. I now propose to make some remarks on another article of even still greater importance, and that is Mercury. That Mercury is an agent of immense power, either for good or evil, upon the human constitution, cannot be questioned. While in many cases it is the means of saving life, in not a few it unquestionably destroys it. If this be so, it becomes a question of the deepest practical interest, to determine whether its action is modified in any way by the age of the patient, and particularly so, when it is recollected that it is given by too many physicians, even more freely, and may I not add indiscriminately, to the young subject than to the adult.

The first and most striking peculiari'y attending the action of mercury is, that in young subjects, it does not produce salivation so readily as it does in adults. Indeed, under a certain age, it appears to be exceedingly difficult to excite salivation at all in them. On this point, besides our own experience, we have abundance of testimony. Dr. Clarke says, "under various circumstances he has prescribed mercury, in very large quantities, and in a great number of cases; and he never produced salivation, except in three instances, in any child under three years of age.' Dr. Warren, of Boston, observes, "that he has never known an infant to be salivated, notwithstanding he has given in some cases, large quantities with this view." Mr. Colles, of Dublin, says, "no man in the present day requires to be told that mercury never does produce ptyalism, or swelling and ulceration of the gums in infants." Drs. Evanson and Maunsell speak still more strongly. They say, "mercury does not seem capable of salivating an infant. We have never seen it do so. nor are we aware of any such case being on record." "We have never succeeded in salivating a child under three years of age."

The same general fact seeins to be applicable to the external use of mercury. Dr. Percival, of Manchester, remarks, that he "repeatedly observed that very large quantities of the Unguentum Cæruleum may be used in infancy and childhood, without affecting the gums, notwithstanding the predisposition to a flux of saliva, at a period of life incident to dentition."

That salivation does not take place so readily in the infant as in the adult, would seem then to be well established. That it never can or does take place, as might be inferred from some of the preceding quotations, is by no means, however, true; and the statement,

if implicitly relied on, is calculated to be the cause of much mischief. That very young subjects do sometimes become salivated, is unquestionable. One case, and only one, however, has occurred in my experience, in which a child of two years of age was salivated, and that by a very moderate quantity of calomel, viz., five grains, given in three portions, at intervals, within the space of about twelve hours. In about two days after, the gums became inflamed, the tongue swelled, several ulcers appeared in the mouth, and the flow of saliva was free; after continuing about three days in the same state, it gradually yielded, and disappeared without any further inconvenience. In this case every thing seemed favourable to the developement of mercurial action. The child had been labouring under hooping cough for several weeks, and was a good deal reduced. It vomited freely with every paroxysm of coughing, and this no doubt aided in bringing on salivation, in a constitution peculiarly sensitive and evidently scrofulous. Nor is this a solitary case. Dr. Clarke, already quoted, admits that in three cases salivation was produced in children under three years of age. And similar cases have been observ. ed by others. Dr. Blackall relates the case of a child, two years of age, who was salivated in consequence of taking two grains of calo mel for several successive nights. The child was a poor scrofulous subject, and it sunk under the effects of the mercury.

This, then, is a remarkable peculiarity in the action of this agent upon the infant subject, and the observation of it has doubtless led to the belief, too prevalent among some physicians, that it may be given to them to almost any extent with perfect impunity; an error, which, if not in its immediate, yet certainly in its remote effects, has been the prolific source of more mischief, probably, than any of us are aware of.

Although mercury so seldom salivates infants, yet, notwithstanding this, it cannot be doubted that it affects the system profoundly, and even more so proportionally than it does the adult. That it should do so appears perfectly natural, when we reflect upon the mode of its operation on the human system. On this subject, I am aware that a great difference of opinion exists. By some, mercury is looked upon as a stimulant; while others view it as a sedative. A familiar acquaintance with its effects, however, will show, I think, that it may be the one or the other, according to circumstances-according to the dose in which it is given-the length of time it is continued, and more especially, the condition of the system at the time of using it. A single large dose of calomel will cause nausea and relaxation, and sometimes unpleasant prostration, while if it be given in smaller doses and repeated frequently, it will occasion irritation of the intestines, and general disturbance of the vascular and nervous systems. In the former case acting as a profound sedative, and in the latter as a stimulant, or rather irritant. That calomel given in large doses operates as a sedative, seems to be proved, not merely by the nausea and prostration which it frequently produces, but by other considerations. In dysentery, for example, in the adult, a dose of twenty grains of calomel will sometimes allay pain and irritation,

with as much certainty as a dose of opium. For the purpose of testing the effects of calomel, some interesting experiments were made by Mr. Annesley, which would seem still further to show, that in large doses the action of this agent upon the mucous membrane of the stomach and intestines, is that of a sedative. He took three healthy dogs, and gave to one, 3j. of calomel, to a second, zij., to a third, 3iij. After this they were tied up in a room.

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"The dog which took 3j. did not appear to feel any kind of sickness, till six or seven hours afterwards, when he vomited a little. He was lively the whole time, and ate his food well; had been purged two or three times; dejections of a black grey colour.

The dog which took 3ij. was likewise lively, and ate his food well, vomiting two or three times, and was purged more than the other; he passed tape worms and the dejections were black.

The dog which took 3iij. was heavy, and apparently uncomfortable the whole day, and did not vomit at all; he was purged, and passed a very long tape worm; dejections also black."

Twenty-four hours after they had taken the calomel, the dogs were all hung, and five minutes after they were dead, they were examined, and the vascularity of the stomach was found to be in the inverse ratio of the calomel they had taken; i. e. in the dog which had taken 3iij., the vascularity was the least, and so on. For the purpose of comparing this with the condition of the stomach of a dog which had taken no calomel at all, an examination of another dog was made; and here the stomach was found to be more vascular than in any of the others. From these experiments, Mr. Annesley drew the conclusion, that "the natural and healthy state of the stomach and intestinal canal is that of high vascularity, and that the operation of calomel in large doses, is directly the reverse of inflam

mation."

The foregoing considerations would seem to show that calomel in full doses is a local sedative, and in its general effects, is debilitating to the system at large. Hence its great utility and value as a remedy in many inflammatory diseases.

When, on the other hand, it is given in small and repeated doses, it acts not unfrequently as a local, as well as a general irritant, producing immoderate action of the bowels, and general irritation of the nervous and vascular systems. Now these, we know, are the effects observed continually in the adult, and it is but reasonable to suppose that all of them must, as a matter of course, be aggravated in the more delicate and sensitive system of the infant.

What shows incontestibly that the action of mercury is actually more energetic on the infant than the adult, is the fact, that when salivation does take place in the former, as it sometimes does, its effects are most disastrous. Sloughing of the gums and cheeks, general prostration, and death are by no means uncommon occurrences. On this subject, Dr. Blackall justly remarks, "a general opinion prevails, that the constitutions of young subjects resist mercury. Its entrance into the system they certainly do resist, more than we could expect; but they are greatly overcome by salivations, and the possi

ble occurrence of such accidents may well set us constantly on our guard." Dr. Ryan, too, says, "Ptyalism of infants is often followed by sloughing of the gums and cheeks; and this I have known to occur after the use of it in Hydrocephalus."

Besides being more energetic in its action on the infant, mercury is also more uncertain. This must necessarily be the case, and for the same reasons that every other active agent is so. In the adult we know that mercury varies in its effects, according to the condition of the system, and the peculiarities of the patient's constitution. Thus some persons are salivated by the smallest quantity of this metal, while others resist the influence even of the largest quantities. In some, febrile action; in others, diarrhoea and exhaustion take place even from moderate doses. Hence it is, that every prudent physician, if unacquainted with the previous history of his patient, makes it a special subject of inquiry to ascertain whether he has ever taken mercury previously, and how it affects him. Now, in the young infant, of course, as we cannot so well have the benefit of this information, more uncertainty must neccessarily attend its operation.

These, then, are the peculiarities attending the operation of mercury on young subjects, viz: that they are salivated with great difficulty, and that notwithstanding this, the effects of it are frequently more energetic and uncertain, than they are in the adult. And it is upon these as the basis, that I propose to make a few remarks bearing upon the practical application of it in young subjects.

1. If salivation occurs so rarely in children under a certain age, then it is evident that it can never be made a criterion by which to judge of its influence on their systems. To attempt, therefore, to produce this effect, as we do in adults, is manifestly improper. In cases where it is desirable to get the system under the full influence of the remedy, other modes must be resorted to for the purpose of judging to what extent the use of the article should be carried. Now this is by no means easy. Even in adults, where we have the benefit of salivation as a test, all practical physicians are aware how difficult it is frequently, to decide when it is proper to stop the use of the remedy. How much more so must this difficulty be increased in the young infant, where we are left without this guide. The only modes of judging, of course, are the character of the evacuations from the bowels, and the general impression made upon the disease for which it is administered. Both these are evidently, however, uncertain. It is to be feared, therefore, that for the want of a more certain guide than we at present possess, the use of this remedy is, in many cases, unnecessarily protracted to the great detriment of the little patient. From all this the conclusion is obvious, that in the use of this article in the young subject much greater caution is necessary than in the adult.

2. The fact that mercury may prostrate and destroy a young child, even though it does not cause salivation, it is to be feared is not suf ficiently appreciated, at least by some. We have known calomel given without weight or measure, to a young child, and the reason