This influence of the mercurials may often be taken advantage of therapeutically with great effect. A condition of the system not unfrequently exists in febrile diseases, in which the secretions generally are deficient. The skin is dry, the mouth is dry, the urine is scanty, and the bowels, when not affected with inflammation or ulceration, are constipated from a deficiency of the intestinal secretions, including the mucous, hepatic, and probably the pancreatic. Under these circumstances, no matter what may be the special disease, a gentle mercurial influence seems to be indicated, and, according to my experience, often proves serviceable. it should be brought about by the mildest and least irritant measures. I have generally preferred for the purpose the mercurial pill or blue mass, which may be given in the dose of one grain every two hours, until the slightest sign of its action upon the mouth is observable, when the dose should be given at longer intervals, so as simply to maintain the degree of effect produced. The mercurial may often be usefully associated, in these cases, with a little ipecacuanha, say one-sixth of a grain to each pill, when it is specially desirable to promote perspiration, and a little opium also, when that medicine may happen to be indicated.

To promote the several secretions, mercury is not often given by itself, except in reference to the hepatic; but, whenever it is desirable to stimulate this function, it affords, beyond all comparison, the most efficient means. I have already treated of its use in this respect in the simple alterative doses, which, without seeming to produce much effect on the organ in health, have a remarkable power of restoring its function, when torpid or deranged from disease. But it frequently happens that a more powerful impression is required, such as may produce an obvious effect, either by purgation, through the quantity of bile secreted, or by the constitutional action of the medicine. There is a certain degree of incompatibility between these effects of the mercurials. When given in large doses so as powerfully to stimulate the liver, the medicine is apt to be carried off with the bile secreted, before it can reach the general system, so that this often escapes entirely. More will be said on this subject when we come to consider calomel as a purgative. So far as the hepatic secretion alone is concerned, this result is rather desirable than otherwise; as the end wished for is attained without the inconvenience of a sore-mouth. Hence this indication is often better met by full purgative doses of calomel, than by such an administration of it as may induce mercurialism. But not unfrequently there is a joint indication for the latter effect, and for stimulation of the hepatic function; and, in such cases, the medicine must be given in reference to both purposes, either by dividing the doses, or adding opium in order in some degree to control the purgative tendency.

Jaundice, which, as before stated, will often yield to the simple alterative influence of mercury, sometimes requires that the medicine should be carried to the point of salivation before it will yield.

Bilious colic, in which there is often great congestion of the liver, with repressed secretion, is most effectively treated with calomel and opium, which may often be advantageously carried to a slight ptyalism. Two grains of opium and from four to six grains of calomel may be given at once, to be followed, at the end of an hour, if the patient is not relieved, by half the dose, and in another hour, under the same circumstances, by another half; after which, a dose of sulphate of magnesia, or of infusion of senna with the same salt, may be given, and repeated at proper intervals until the bowels are opened.

Dysentery is another disease in which calomel may be very usefully given, with the view of promoting the biliary secretion; and the same may be said of the bilious remittent and yellow fevers; but, in these complaints, it is also employed in fulfilment of other indications to be mentioned hereafter.

In fact, in all diseases whatever, in which the liver refuses to act, whether from torpor, or excessive irritation with active congestion, the mercurials generally, and especially calomel, are strongly indicated; not only in order to restore the bilious matter to the bowels, which require it as one of their necessary stimulants, but also to eliminate from the blood effete matters, which might otherwise exercise an injurious influence on the system.

In all the cases in which the object is specially to affect the secretion of the liver, the medicine should be' given by the mouth; as, being absorbed into the portal veins, it is thus carried directly to the seat of the secretory function, and exercises its full influence on that function. if intended to affect the organization of the viscus, as in hepatitis, it would no doubt act efficiently if absorbed from the surface of the body; for it then enters the general circulation, and ultimately reaches the liver by the hepatic artery, through which it is brought into direct relation with the ultimate structure, as engaged in the process of nutrition.

On the skin and mucous membranes, it is probable that mercury operates beneficially by stimulating their secretory function, and maintaining them in that soft or moist state which is essential to their healthy condition. its usefulness in chronic cutaneous eruptions, and chronic inflamed states of the mucous membranes, may be explained in part in this way; but it probably depends more upon the revolutionizing antiphlogistic effect of mercury, which will be treated of directly.

In consequence of its general property of increasing the secretions, mercury is not unfrequently prescribed in connection with medicines addressed to the several secretory functions, in the hope that its general influence may thus receive a special direction. Thus, with the diaphoretics it is supposed to be directed specially to the skin, with the expectorants to the lungs, with the diuretics to the kidneys, and with the em-menagogues to the uterus. I am not quite sure, though I have often used mercury in such combination, that I have witnessed very decidedly the effects referred to. Nothing is more certain than that the combination often answers an excellent therapeutic purpose. Thus squill, aided by mercury, is much more efficient in curing dropsical diseases of the chest, than without such aid; and bronchitis will yield to mercury and the expectorants jointly, when it may refuse to yield to the latter medicines exclusively. But it is probable that the mercury in these, and in all other analogous cases, acts therapeutically much more by a direct alterative influence on the diseased tissue, than through any increase of secretion which it produces. Except as regards the hepatic and salivary secretions, although the medicine may produce a slight effect upon all the secretory functions as a general rule, and may occasionally excite some one of them specially, as that of the skin or kidneys, I do not think it can be depended on remedially in any one of them; and I am not therefore prepared to join in recommending it as an adjuvant to other medicines upon this ground alone. I do not think that, as a general rule, it renders Dover's powder more diaphoretic, digitalis more diuretic, or seneka more expectorant, in any sensible degree.