GIGANTIC DOSES OF MEDICINE.
Although I was opposed to the frequent and free use of medicine, I early
fell into one habit which was as diametrically opposed to my general
theory as could possibly have been. I refer to the habit of giving my
patients, at least occasionally, most enormous doses of those more
active preparations which should seldom, if ever, be administered in
this way. As nearly as I can now recollect, I fell into this habit in
the following manner:
Among my standing patients, before mentioned, were several drunkards.
Occasionally, however, they were more than standing or standard
patients; they had attacks of mania, or as it is usually called in the
case of drunkards, delirium tremens. In these circumstances, among these
patients, I often had the most severe trials. Sometimes I could relieve
them; but sometimes, too, I failed.
One night, while endeavoring to relieve the sufferings of one of these
patients in delirium tremens, almost to no purpose, the thought struck
me, "What effect would a prodigious dose of calomel have on the poor
creature? Can it kill him? I doubt it. I will venture on the trial."
So, without communicating the slightest hint to any one around me of
what I was about to do, I contrived to insinuate a hundred grains or
more of this substance into the man's stomach, that like a chemical
receiver took what was poured into it. Having succeeded in the
administration of the dose, I waited patiently the issue.
The medicine had, in due time, its full ordinary effect; but the degree
of its cathartic effect was not in proportion to the largeness of the
dose. Its activity hardly amounted to violence. It seemed, however, to
quiet the brain and nerves as if by magic; nor am I aware that any
injurious effects, either local or general, ever followed its
exhibition. I had the full credit of a speedy and wonderful cure.
Another fact. I was frequently called to prescribe for children who were
threatened with the croup. One night, on being called to a child of some
eight or ten months, I thought of large doses of calomel. Was there any
great risk in trying one? I ventured. I gave the child almost a
teaspoonful of this active cathartic. It was indeed a gigantic dose, and
the treatment was bold if not heroic.
For a couple of hours the patient breathed badly enough. There was
evidently much oppression, not only of the lungs but of the nervous
system. The parents and friends of the child grew uneasy. They were not,
however, more uneasy than their physician. But I consoled myself by
laboring to compose them. I preached to them long and loud, and to some
extent with success.
At the end of about two hours, the latter part of which had been marked
by a degree of stupor which almost discouraged me, a gentle vomiting
came on, followed by moderately cathartic effects; and the child
immediately recovered its mental activity, and in a few days was well.
Empirical as this practice was, I ventured on it again and again, and
with similar success. At length the practice of giving giant doses in
this disease became quite habitual with me, and I even extended it to
other diseases. Not only calomel, but several other active medicines
were used in the same bold and fearless manner. I do not know that I
ever did any direct or immediate mischief in this way. On the contrary,
I was regarded as eminently successful.
And yet I should not now dare to repeat the treatment, however urgent
might seem to be the demand, or recommend it to others. It might,
perhaps, be successful; but what if it should prove otherwise? I could
make no appeal to principle or precedent in justification of my conduct.
It is true, I have met with one or two practitioners whose experience
has been similar; but what are a few isolated cases, of even honest
practice, in comparison with the deductions of wise men for centuries?
There may be after consequences, in these cases, which are not foreseen.
Sentence against an evil work, as Solomon says, is not always executed
speedily.