MERCURIUS.

Hydrargyrum, and elementary body. (Mercurius vivus, Quicksilver.)

Preparation for use , Triturations.

Authorities. [These are "pure;" the utmost care has been taken to avoid any complication with disease; especially have the effects of Mercury in syphilitic cases been omitted.]

1 , A. De Haen, effects on a gilder, Ratio Medendi, p. 229 (Leyden, 1661); 2 , Walter Pope, effects on laborers in quicksilver mines in Italy. Philos. Trans., 1665, 1, p. 21; 2 a , Scopoli, effects on workers in the mines in Idria, Venice, 1671; 3 , John Paterson Hain, effects on self of handling or being in the same room with the metal or any of its compounds, Bonetus, Med. Septendri. Coll., Geneva, 1686, 2, 386; 4 , Jussieu, effects on workers in quicksilver mines of Almada, Spain, Mem. de l'Acad. Roy. des Sciences, 1719, p. 358; 5 , Ramazzini, effects on gilders, Op. Med. et Phys. (de morb. artificium), 1719, p. 486; 6 , Junchen, general effects in gilders, from Ramazzini; 7 , Fernelius, effects in a gilder, from Ramazzini; 8 , Forestus, effects in a gilder, from Ramazzini; 9 , Borichius, effects in a gilder, from Ramazzini; 10 , Fourcroy, effects in a gilder, not to a translation of Ramazzini (from Swediaur, Traité des Mal. Syphil.); 11 , same effects on wife of preceding, who also slept in the workroom; 11 a , Trew, effects in a woman, aged sixty, from silvering mirrors, Act. Phys. Med. 1737; 12 , Spens, effect in a woman, aged thirty-six, of rubbing ointment of Merc. into groins and upon some hæmorrhoids, Edin. Med. and S. J., 1805; 13 , same, effect in a man, of mercurial pill and ointment continued six weeks for bubo; 14 , Dietrich, "Mercurial Diseases," general effects (from Hempel, Mat. Med.); 15 , Thackrah, effects in gilders, ibid.; 16 , Wm. Stokes, effects from silvering mirrors, Ryan's Med. J., 5, 520; 17 , Kopp, from Hempel, effects in a gilder; 18 , Kussmaul, Unters, ueb. d. Constitutionellen Mercurialismus, 1861, detailed effects in over one hundred workers in Erlangen; 19 , Hermann, effects in workers, from Kussmaul; 20 , Keller, effects on workers in Bohemia, from Kussmaul; 21 , Bæumler, effects on workers, from Kussmaul; 22 , same, effect in a woman aged twenty-eight; 23 , Kussmaul, op. cit., effects on workers in Fourth; 24 , Fronmuller, effects on workers, from Kussmaul; 25 , Goetz, effects on workers, from kussmaul; 26 , Ascherson, effect on a man, from Kussmaul; 27 , Keyssler, Journeys, Hanover, 1740, effects in workers in mines, from Kussmaul; 28 , Weerbeeck du Chateau, effects on workers in Prague, 1814, from Kussmaul; 29 , Bayer, Horn's Archiv, 1820, effects in workers from Kussmaul; 30 , Sundelin, effects on workers, from Kussmaul; 31 , Mitchell, effects on workers, Lond. Med. and Phys. Jour., 1831, from Kussmaul; 32 , Rayer, effects on workers, annal. de Thérap, 1846, from Kussmaul; 33 , Canstatt, effects in thirty-four cases among workers, Clin, Ruck. Blatt, 1848, from Kussmaul; 34 , Van Berger, Deutsch. Clin., 1850, effects on workers; 35 , Passot, effects on workers, Gaz. Méd. de Lyon, 1852, from Kussmaul; 36 , Koch, effects on workers, Canstatt's Jahrb., 1855; 37 , Pleischl, effects on workers, Oest. Zeit. f. Prak. Heilk., 1856; 38 , Petters, effects on workers, Prague, Vjhrt., 1856; 39 , Aldinger, Inaug. Diss., Würtsburg, 1861, effects in workers; 40 , omitted; 41 , Sigmund general effects, Bost. M. and S. J., 18, 362; 42 , same, effect in a man, of 22 ounces of crude metal, taken in five days; 43 , Burdin, effects on silverers of mirrors, Dict. des Sciences Méd., 54, 276; 44 , Schron, effects of carrying Merc. in a leather bag about the neck, Hygea, 11, 514; 45 , Abeille Med., 1853, effects in a "silverer;" 46 , Edin. M. and S. J., 6, 513, effects of a large quantity (30 tons) stowed on shipboard; 47 , Colson, effects on physicians and students from inhaling mercurialized atmosphere in a syphilitic hospital. Arch. Gén. de Méd., 1826, p. 71; 47 a , same, effects of mercurial inunction for itch, in two women; 48 , R. Bright, effects on a workman exposed to vapor of mercury, Rep. of Med. Cases, London, 1831; 49 , same effects in a man and woman from fine particles of triturated Mercury; 50 , same, effects in a gilder; 51 , Bateman, effects in two "silverers," Edin. Med. and Surg. J., 8, 376; 52 , same, Bost. M. and S. J., 18, 138; 53 , Arrowsmith, effects on a "water gilder," Lond. Med. Gaz., Apr. 1834; 54 , same, another case; 55 , Peyrot, effects on a "silverer," Arch. Gén. de Méd., 1834; 56 , Ollivier and Roger, effects of vapor of distilling Merc. on two girls aged seven and ten, Ann. d'Hyg., 1841; 57 , Grapin, effects in a man of sleeping in a room in which a wooden bowl that had held Mercury had been burnt in a leaky stove, Arch. Gén. de Méd., 1845, p. 328; 58 , same, effects on wife, aged fifty-six; 59 , same, effects on daughter, aged twenty-one; 60 , same, effects on daughter, aged sixteen; 61 , Porter, general effects, Am. J. Med. Sc., 1847, p. 245; 62 , effects of fumigating with Merc. a hospital ward infested with bugs, Journ. de Chim. Méd., 1849; 63 , Lange, effects of ointment in children with lice, Med. Zeit., 1851; 64 , Barlow, effects in a gilder, Med. Times and Gaz., 1853; 65 , Christison, effects in workmen; 66 , Falconer, effects of a girdle containing Mercury worn about the waist for the cure of itch, Bost. M. and S. J., 18, 138; 67 , Earle, effects in a gilder, Bost. M. and S. J., 7, 274; 68 , Oppolzer, effects in a woman employed in making barometers, Oest. Zeit. f. Pr. Heilk., 1857; 69 , Bricheteau effects in a gilder, Bull. Gén. de Thérap., 1866; 70 , Leroy, effects in a woman working in skins that had been treated with Mercury, l'Union Méd., 1867; 71 , Tilbury Fox, effect of inunction, Lancet, 1867; 72 , Ramskill, effects in a silverer, Lancet, 1868; 73 , Ferrand, effects in a woman of sleeping in a room where Merc. had been volatilized, l'Union Méd., 1868; 74 , Gueneau de Mussy, effects on a man, aged thirty-seven, of "silvering" for two years, Gaz des Hôp., 1868; 75 , Vallon, effects in two workers, Schm. Jahrb., 86, 239; 76 , Gailleton, general effects, l'Union Méd., 1867; 77 , same as 74; 78 , Concato, effects on workers, Revista Clin., 1868. S. J., 145, 144; 79 , Schmitz Inaug. Diss. 1869, effects of silvering; 80, same, another case exposed to vapor of Merc.; 81 , Morrison, effects of strongly inhaling from an old vial containing the 4th dec., Month. Hom. Rev., 1875, p. 33; 82 , same, effect on Dr. J. B.; 83 , Sharp, Essays on Med., p. 725, effects of 1/2 gr. of first or second trit., taken night and morning. [Dr buchmann's "emanation provings," from holding a sealed vial of Mercury in the hand, Hom. Vierteljahrsschrift, 15, 301, are omitted

. -T. F. A.] MIND

• Emotional.
• Mind easily agitated, 54.
• Occasionally his mind seemed to wander, 17.
• Frightful images at night, 18.
• Hallucinations day and night, 45.
• Hallucination of mind, especially at night, with desire to escape, 75.
• Delirium; his speech was disconnected, and he would not answer questions; this delirium increased to a violent rage, so that the patient was obliged to be confined in a strait-jacket, with rolling of the eyeballs, clonic spasms, discharge of yellow, frothy liquid from the mouth and nose, and rattling in the trachea, followed by trismus and tetanus, 78.
• Delirium, 18, 37.
• Delirium, like delirium tremens, 33.*
• Nightly delirium, 18, 34. [10.]
• Muttering delirium, 17.*
• Constant weeping (elder), 56.
• Sadness, 2a.
• Low-spirited, 17.
• Spirits depressed, 15, 17.
• Anxious, 18.
• Attacks of frightful anxiety, 18.
• Great excitability; easily frightened, 18.
• Great irritability, 18.
• Very irritable disposition, 31, 37. [20.]
• When in the state of tremor, his temper became more irritable, and anger, in turn, so increased the trembling, that he was obliged to sit down to save himself from falling, 45.
• Ill-humor, 18.
• Ill-humored; the patient was very fretful and peevish; easily excited, 18.
• Ill-humor and great irritability, 37, 68.
• Fretful mood, 18.
• Very fretful mood, 18.
• Intellectual.
• *Slow in answering questions (after thirsty-six years), .

HEAD

• Confusion and Vertigo.
• Confusion of the head, 18.
• Confusion and heaviness of the head, 28.
• Vertigo, 5, 18, 21.
• Vertigo, even to falling down, 18.
• Vertigo only in the evening, 33. [50.]
• Vertigo on ascending or descending steps, 28.
• Vertigo, with raging headaches, 18.
• Attacks of vertigo, worse in the evening; if he was not lying in bed he would suddenly fall down, with flickering before the eyes, sometimes with complete loss of consciousness lasting several minutes; during these attacks he looked very pale, and sometimes had nausea and vomiting; vertigo occurred even in bed, and once in the morning he became unconscious and fell out of bed, 18.
• Almost incessant vertigo, 69.
• Great vertigo, 9.
• Violent vertigo, so that sometimes he fell down like one intoxication, 18.
• Vertigo, frequently very violent, 33.
• Giddiness, 43.
• Occasional giddiness, 64.
• General Head.
• Such trembling of the head as almost entirely prevented her from falling asleep, 1. [60.]
• Constant rotary motion of head, even when lying on the pillow, 55.*
• Congestion of the brain, 18.
• Fatal apoplexy, 43.
• Heaviness of the head, 18.
• Slight pain and heat about head, 67.
• Headache, 18, 21, 31 , etc.
• Rose with a headache evening morning, 17.
• Itching, which keeps him awake, with twitching pain in the belly and back, 64.
• Headache and vertigo, especially violent after a glass of beer, 18.
• Frequent headache and vertigo, . [70.]

EYE

• Objective.
• Staring eye, with watery obscuration, 45. [90.]
• Eyes swollen, 5.
• Eyes sunken, surrounded by blue rings, 28.
• Eyes sunken, surrounded by brown rings, 37, 69.
• Eyes inflamed, with swollen inverted tarsi, and very sensitive to light, 13.*
• Blennorrhœa of both eyes, 68.
• Soft cataract of the left eye (after some years), 18.
• Keratitis and sclerotitis, 18.
• Eyes weak, 2a.
• Eyes weak, bleared, 30.
• Lids.
• Eyelids jerked when the lids were closed, 24.
• Conjunctiva. [100.]
• Chronic conjunctivitis, with a fine, rosy red injection around the cornea, 18.*
• Blennorrhœa of both conjunctivæ, 37.
• Pupil.
• Pupils dilated, 55.
• Pupils greatly contracted, scarcely reacting at all to the light, 79.
• (No case of syphilitic iritis, and no case of iritis of any form , has been noticed among the workers), 18.
• Vision.
• Diminution of vision, 37.
• Dimness of vision, 18, 28, 69.
• Vision weak ; examination with an ophthalmoscope showed an atheroma of the left arteria centralis retinæ, 18.
• Weakness of vision, so that he could with difficulty read No. 7 of the test type, 18.
• Mist before the eyes; inability to read, 18. [110.]
• Sight of left eye considerably impaired, 16.

EAR

• Burning in right ear (after a few minutes), 82.
• Paraplegia of the left ear, 19.
• Hearing.
• Remarkable exaggeration of sensibility; the noise of a horse or carriage made him start to such a degree that several times he would have been run over had he not kept close to the walls or shop-fronts. He was then obliged to stop for fear of falling; he could not express the disagreeable sensation which the noise occasioned, 10.
• Diminished hearing, 37.
• Difficulty of hearing, 2a, 45.
• Difficulty of hearing, with roaring in the right ear, 18. [120.]
• Deafness, 7.
• Roaring in the ears, 18, 28, 33.
• Violent roaring in the ears, 18.

NOSE

• Objective.
• Nasal catarrh, with thin discharge; frequently with loss of smell and with hoarseness (after working fourteen days), 20.
• Constant nasal catarrh, 21.
• Complete nasal obstruction, right side, soon passing off, at 8 A.M. (second day), 82.
• Subjective.
• Congestive fulness and stuffiness in nostrils, especially right side (after a few minutes), 82.
• Pinching sensation in right ala nasi (after a few minutes), 82.
• Irritation of nasal mucous membrane, as from catarrh (after twenty minutes), 81.

FACE

• Objective.
• Dull-looking countenance (after thirty-eight years), 70. [130.]
• Stupid expression of face (younger), 56.
• Cadaverous appearance, 5.
• Cadaverous countenance, 9.
• Yellow, cadaverous face, 5.
• Cachectic complexion, 74.
• *Face earthy-colored, puffy, 44.
• Color of the face dirty-greenish, 30.
• Pale-yellow color of the face, 28.
• Sallow, 49.*
• Countenance sallow, 48. [140.]
• Face pale, 18, 78 ; with a look of intoxication, 43.
• Face pale and bloated (after thirty-eight years), 70.*
• Looked pale, 17.
• Sickly, pale look, 21.*
• Face swollen, 31.
• Wrinkled face, with a prematurely aged look, 74.
• Twitching of the facial muscles, 34.
• Face distorted by twitching of the muscles, 37.
• Facial muscles slightly affected, 55.
• Subjective.
• Pain, especially in the lower jaw, 18. [150.]
• Tearing pains in the face, 18.
• Cheeks.
• In one case the cheeks became thick, 33.
• Lips.
• Deep fissures in the corners of the mouth, 31.*
• Trembling about the corners of the mouth, especially when talking, .

MOUTH

• Teeth.
• *Teeth black, loose, 45.
• Teeth turn yellow and become loose, 28.
• Thick gray coating on the teeth (after working fourteen days), 20.
• Teeth dirty-gray, loose, 68.
• Teeth foul, 55.
• Teeth thickly covered with tartar, 21.
• *Carious teeth, 18. [170.]
• *Decay of the teeth; they become loose in succession, and at the age of thirty she had lost six; they fell out at the slightest shock (after six years); most of the teeth, especially the molars, were gone; those that remained were blackened, laid bare, loose and carious (after thirty-eight years), 70.
• After a time, the teeth decay, become lose, of a grayish color, and fall out, 23.*
• Since going into the works, he been obliged to have several teeth removed, 18.
• All the teeth were loose, 18.
• Teeth loose, discolored, 75.*
• Teeth loose; at last drop out, 49.*
• The teeth especially the anterior back ones, are loose, and would fall out, 20.
• Looseness of the teeth, especially of the molars; they become denuded of the gum and turn black, with nightly pains in the teeth, jaws, and head, 2a.*
• Teeth very loose (after ten days), 58.
• Falling out of teeth, 6, 21. [180.]
• Falling out of the teeth, 21.
• Loss of nearly all the teeth; gum-boils formed close to their roots, and they soon after dropped out, 16.
• All the teeth except the incisors have been lost, at least the crowns of the teeth, leaving only the roots, with very red gums, which are very soft, .*

Of a deeper red, and slightly swollen (after eighteen years).

Red, bleeding in spots, but do not seem swollen; small ulcers on them at intervals (after thirty-eight years), 70.

• *The gum has a bright-red margin, 79.
• The margin of the gum shows a bluish-gray color and seems inflamed, 80.
• Gingival line, 76.
• Gums swollen and of a livid-red color, 18.* [200.]
• Gum swollen, with a light violet margin, 18.
• Gums swollen, separated from the teeth, 28.*
• Gums swollen painful, 45.
• In 1822, two "élèves externes," at the Venereal Hospital, were affected with a considerable swelling of the gums, which lasted all the time they were employed there. Merely with drawing from the hospital sufficed to cure the complaint. I myself was troubled in the same way, while serving in the same capacity at the institution. After residing there for about six weeks, my gums swelled so badly that they were very sore, and bled at the least touch. I could not eat bread without pain, and my food was bloody when chewed . Nothing gave entire relief until I left the hospital, 47.
• *Gums frequently become soft and bleeding, 69.
• *Gums spongy and bleeding, 29.
• Gums spongy, and covered with pultaceous exudation, 74, 77.*
• Gum very spongy, and partly destroyed, 75.*
• Gums ulcerated, 49.*
• Gum ulcerated, loose, spongy, offensive, 31.* [210.]
• Suppuration between the teeth and gum, 18.*
• Gums somewhat worn away, red, swollen, covered with white films; free edges entirely coated of a yellowish-gray (after nine days), 59.
• His gums, without much sponginess, had been gradually absorbed, and most of his teeth had fallen out; ptyalism had never occurred, 64.
• Atrophy of the gum, especially of the lower anterior portion, 18.*
• , .*

THROAT

• Chronic angina of the root of the palate, uvula, tonsils, and fauces, 23.
• Sensation as of a foreign body sticking in the throat, seeming to be dependent upon involuntary contraction of the muscles of the pharynx, 79.
• Uvula and Tonsils.
• Soft palate, and especially the uvula, of a coppery-red color; on the left side, a long superficial ulcer, 21.*
• Ulcers on the right side of the soft palate, 21.
• Great swelling of the uvula, 18.* [340.]
• Uvula elongated and enlarged, 18.*
• Tonsils red, 80.
• Left tonsil greatly swollen, 18.
• Tonsils much swollen and red, without patches (after nine days), 39.
• Tonsils much enlarged (after eight days), 60.*
• One of the men who escaped the salivation suffered from acute tonsillitis, 62.
• Fauces and Pharynx.
• Mucous membrane of the fauces red, streaked with mucus, 21.
• Angina faucium dark red, 18.
• Angina of the fauces of a coppery red color, 18.*
• Chronic angina of the fauces, 18. [350.]
• Chronic angina of the fauces without ulceration, 18.
• All the workers not salivated were affected with ulcers of the fauces, 20.
• Constriction and dryness of fauces (after twenty minutes), 81.
• Circumscribed swelling of the pharyngeal mucous membrane, 18.
• Mucous membrane of the pharynx swollen in spots, 18.*
• Ulcers developed upon the posterior wall of the pharynx (after working a few weeks), 20.
• Swallowing.
• Swallowing was convulsive, and often nearly caused suffocation, 10.

STOMACH

• Appetite.
• Loss of appetite, 2a, 17, 18 , etc.
• Want of appetite, 73.
• His appetite fell off, 15.
• No appetite, 74.
• During the salivation, there was little appetite; when she had no salivation, she had ravenous hunger, 18.
• Thirst.
• Thirst, 2a. [380.]
• Much thirst, 13.
• Great thirst, 18, 78.
• Urgent thirst, 74.
• Eructations and Hiccough.
• Eructations, especially after eating, 18.
• Violent eructations, 18.
• Hiccough, that could not be quieted, aggravated by eating, with general weakness, 18.
• Nausea and Vomiting.
• Nausea, 78.
• Distressing nausea, 13.
• Vomiting, 18, 45, 73.
• Vomiting of bile and food, with constipation, coated tongue, and great vertigo, 18. [390.]
• Frequent vomiting of saliva and bile after eating, 18.
• Stomach.
• Digestion disturbed, 45.
• Difficult digestion, 74.
• Pain and sensation of constriction in the epigastric region, 31.
• Sensation of tightness and pain in the epigastrium, 31.
• A contraction of the epigastrium, which increased during a sleepless night, with dyspnœa and hiccough, accompanied by cough, and followed by vomiting, 73.
• Pressure in the stomach, 21.
• Pressure in the stomach and eructations, especially after eating, 18.

ABDOMEN

• Hypochondria.
• Twitching in muscles of right hypochondrium (after a few minutes, 82.
• Chronic atrophy of the liver, with emaciation and desiccation of the body, 19.* [400.]
• One of the men who escaped the salivation suffered from chronic hepatitis, 62.
• Subacute aching over hepatic region, preceded by acute aching in left wrist and dorsum of hand (second day), 81.
• General Abdomen.
• Abdomen greatly distended by gas, 18.*
• Abdomen tympanitic, 2a.*
• Parietes of the abdomen tense, 79.
• Abdominal muscles tense, 34.
• Abdomen somewhat retracted, 34.
• Pains in the abdominal muscles, 17.
• Twitching pain in belly, 64.
• Tearing pains in the abdominal muscles, 18. [410.]
• Much colic, 18.
• Flatulent colic, with constipation, 18.
• Hypogastrium and Iliac Regions.
• Griping in the lower part of abdomen (after a few minutes), 82.
• Aching in right inguinal region (after two hours and a quarter), 91.

ANUS

• Prolapsus ani, 18.

STOOL

• Diarrhœa.
• Diarrhœa, 37, 45, 79 ; in a few cases, 33.
• Diarrhœa occurred to some simultaneously with the appearance of salivation, 62.
• Diarrhœa alternating with constipation, 18.
• Exhausting diarrhœa, 28.
• Offensive diarrhœa, 37. [420.]
• Diarrhœa thin, very offensive; at times involuntary, 68.
• Involuntary stools, 17, 34.
• Stools at first thin and green, but afterwards constipated, 25.
• Flatulent motion, with softened, orange-yellow fæces (second morning), 81.
• Bloody stools, 78.
• Indolent stools (after two years), 18.
• Constipation.
• Stool constipated, 80.
• Constipation, 18, 31, 33 , etc.
• Constipation, with occasional gripings; bowels opened every alternate day, 64.
• Obstinate constipation, 18. [430.]
• Bowels inclined to be costive, 16.
• Bowels rather costive, 67.
• Bowels would not act, nor could the costiveness in any way be relieved, and on the second day he died, 42.

URINARY ORGANS

• Incontinence of urine, 45.
• Urine scanty; specific gravity 1022, 79.
• Urine scanty, dark-yellow, albuminous, 18.
• Urine thin, frequently passed, 30.
• Albuminuria with dropsical symptoms; during pregnancy, 18.

SEXUAL ORGANS

• Male.
• Total loss of sexual power, 74.*
• Female.
• Women frequently aborted, 20. [440.]
• Profuse hæmorrhage from the female genitals, 37.
• Sudden, profuse hæmorrhage from the genital organs, 68.
• Very profuse metrorrhagia; once there was menstrual flow for ten weeks, 18.
• Menstruation irregular and scanty, 18.
• Menstruation irregular, sometimes omitting, sometimes too copious, and too late, 18.
• Menses scanty, 18.
• Menstruation scanty, pale, lasting only a few hours, 18.
• Suppression of menses, 47a.

RESPIRATORY ORGANS

• Larynx and Bronchi.
• Complete picture of laryngeal phthisis, with erosions and ulcers on the posterior wall of the pharynx, 19.
• One of men who escaped the salivation suffered from chronic bronchitis, 62.
• Voice. [450.]
• Tone of voice altered (after eight days), 60.
• Voice tremulous, pretty much like that of a person during rigor, 54.
• Cough.
• Cough and tightness of the chest, 15, 31.
• Cough, with tightness of the chest, 31.
• Cough, with pain in the left side and left shoulder, 18.
• Cough, with profuse perspiration and great prostration, so that she kept her bed for a year, 18.
• Cough at first dry, afterwards with white frothy expectoration, with emaciation and weakness, 18.
• Loose cough, which finally was accompanied by such acute pain in the chest that leeches were applied in order to relieve it; the leech bites bled upwards of twenty-four hours, and the blood seemed very thin, 17.
• Cough, with expectoration, and so great emaciation that she was thought to have consumption, 18.
• Respiration.
• *Fetid breath, 10, 54, 74 , etc.; (after thirty-eight years), 70. [460.]
• Mercurial odor of breath (after nine days), 59.
• Strong mercurial odor of the breath, 57.
• While breathing quietly, respiration perfectly normal; but on attempting to take a deep breath, neither inspiration nor expiration was performed in one act, but in three or four jerks, 18.
• Respiration rapid, accompanied by a sensation of constriction and by cough, 31.
• Respiration very rapid, 64, 78.
• Respiration was frequently very weak, with dyspnœa, and even asthmatic attacks, 18.
• Oppression of respiration, upward from diaphragm (after twenty minutes), .

CHEST

• Objective.
• It was remarkable that in deep inspiration the diaphragm seemed scarcely moved, 18.
• Tremors; after lasting six weeks they were followed by profuse hæmorrhage from the lungs at intervals for nearly three months; this disappeared after leaving off work, but reappeared on returning to it, 36.
• The women who work in quicksilver are much more affected than the men, and a much larger proportion of them die; of the disease with which the workers die, tuberculosis greatly preponderates, so that it seems settled that mercurialismus frequently passes into tuberculosis of the lungs, and there is no doubt that working in quicksilver produces pulmonary consumption, 18.
• (One case developed tuberculosis of the right side of the chest, which progressed while the immediate symptoms of mercurial poisoning passed off), 18.
• Emphysema of the lungs, 37.*
• Chronic emphysema of the lungs, 18.
• Subjective.
• Pains in various parts of the chest, especially on deep inspiration, 18. [480.]
• Tightness of the chest, and cough, 15.
• Great tightness of the chest, 18.
• Constriction of chest; lower lobes (diaphragm?), (after one hour and a half), 82.
• Severe constriction of the chest, 9.*
• Constriction pains in various parts of the chest, 18.
• Sensation of pressure upon the chest, 31.
• Pressure upon the chest, without cough, 18.
• Oppression of the chest, 18.
• Lungs dreadfully oppressed, 13.
• Pain in the left side, aggravated by inspiration, 18.

HEART AND PULSE

• Præcordium. [490.]
• Aching pain at apex of heart, extending upwards towards the base (pericardial), 81.
• Cardiac oppression (after one hour and a half), 82.
• Heart's Action.
• Palpitation, 18.
• Palpitation on the slightest exertion, 18.*
• Palpitation of the heart, with pulse that could not be counted, 78.
• Frequent palpitation, 18.
• Palpitation violent, irregular, 18.
• Pulse.
• Pulse full, tremulous, frequent, 17.
• On retiring to bed quickened pulse (first night), 81.
• Pulse quick, weak, and small, 16. [500.]
• Pulse quick and small, but difficult to be felt, on account of the constant tremor, 15.
• Pulse small and rapid, 31.
• Pulse slow, 32.
• Pulse weak and slow, 54.
• Pulse slow, 53 and 54, 24.
• Pulse only 52 and 56; heart's impulse very weak, 24.
• Pulse weak, frequently slow, sometimes rapid and frequent, 30.
• The pulse was slow, in many cases 50 to 56; in one 60, but showing great and rapid changes, running up to 80 or 100 on the slightest excitement, 18.
• Pulse very slow in one case of ptyalism and weakness, but without tremors; and very small and slow in a case of tremors without ptyalism; in other cases, the pulse was increased in frequency, 33.
• Pulse rather weak, 53. [510.]
• Pulse small, soft, anæmic, 45.
• Pulse very soft, 64.

NECK AND BACK

• Neck.
• Indurated lymphatics in the nape of the neck, 18.*
• Boring sensation in right side of neck (after a few minutes), 82.
• Back.
• Softening and curvature of the spine, 19.
• Periosteal aching down spine (after twenty minutes), 81.
• Twitching pain in back, 64.
• Dorsal.
• Sensation of heat and hyperæsthesia in upper half of back (after a few minutes), 82.
• Aching in mid-dorsal region to right of spine (after twenty minutes), 81.
• Right subscapular aching, becoming also interscapular, lasting two hours, at 11 A.M. (second day), 81. [520.]
• Right subscapular aching, extending over hepatic region, on waking (third day), 81.
• Continuous achings beneath lower angles of scapulæ, severe, continuing three-quarters of an hour (after one hour and a half), 81.
• Continuous aching beneath right scapula (after twenty minutes), 81.
• Long-continued severe interscapular aching (after twenty minutes), 81.
• Slight tenderness on pressure over the fourth and fifth dorsal vertebræ, but the rest of the spine exhibited no increase of sensibility, 16.
• Throbbing over left acromion (after a few minutes), 82.

EXTREMITIES IN GENERAL

• Objective.
• Loss of power in the limbs was accompanied by a certain hastiness of motion, 33.
• Tremor of the limbs, 1, 9, 11a , etc.*
• Trembling of the extremities, especially of the hands, so that the patient cannot hold them still for a moment, indeed, can carry nothing to the mouth, 28.* [530.]
• Tremor of the upper and lower limbs, which became worse when they were spoken to at all severely, 56.
• Electric irritability was good, but the muscles of both the upper and lower extremities did not contract in a tonic manner but tremulously, so that the fingers upon the electrode felt a kind of whirring, 80.
• *Trembling of the hands and feet, so that the patient was unable to write, 17.
• Trembling of the hands, sometimes also of the feet, 20.*
• Periodic trembling of the extremities, 24.
• Great trembling of the limbs, 18.*
• Trembling of the limbs so great that she could no more use her hands and could not ascend a height alone; she could only talk with difficult, and sometimes could not at all carry the food to her mouth, and was even disturbed in bed by trembling, though it never amounted to convulsions; she could not hold light things in her hands, for the violent trembling would throw them away; but she was able to carry heavy articles, 18.
• Excessive trembling in all the limbs, especially the upper; progressively increasing, until he was unable to work, or to eat, drink, or perform the offices of nature, without assistance, 1.
• A woman had violent tremor of the extremities, 24.
• Legs trembled moderately; arms violently; had to be assisted in everything, like a child. So much difficulty in walking, that he often fell to the ground on his back, as if from some external force, even while striving to keep himself up by bending forwards, 1. [540.]
• Quite unable to hold either hand steady for a moment; the muscles are wasted and thin, and always in a state of spasmodic activity; it is with the greatest difficulty that he can manage to feed himself; the affection is not so severe in the legs; he walks very slowly, and with a tottering gait; he continued, however, to come upstairs without assistance, holding on by the banister all the way; in bed his movements are often sufficient to shake the bed, .

SUPERIOR EXTREMITIES

• Objective.
• Trembling of the arms, 78.
• Suddenly seized, after a day of unusually laborious work, with cramps in the fingers, which were shortly followed by a shaking and tremulous motion of both upper extremities. They were slight at first, but gradually increased, so as to become very distressing. This agitation of the muscles continued even during sleep, and was accompanied with a gnawing pain, as he expressed it (after two weeks). The symptoms have become still more general, the lower extremities having been affected the previous evening, so that, in fact, the whole body appeared in constant motion. Towards the latter part of the day, the tremulous motion of the muscles of the right arm subsided, but the limbs remained almost paralyzed (after three weeks), 67.
• Entire loss of control of the left upper extremity; all the limbs were more or less affected, 79.
• The left arm cannot be raised; the forearm is moved with difficulty, the hand more easily, while the fingers are perfectly flexible; right arm similarly affected, but in a less degree; the right hand can be lifted to the chin, 55.
• Paresis of the right upper extremity, with trembling, 21.
• Subjective.
• At times, a disturbance of sensibility in the left arm, 79. [570.]
• Rheumatic pains in the arms, 18.
• Rheumatic pains in the left arm, 18.
• Drawing pains in the arms and hands, 37.
• Tearing pains in the left arm, 21.
• Much soreness in the muscles of the arms, 64.
• Periosteal aching in outer side of left arm, changing to left wrist and forearm, on waking and subsequently (second morning), 81.
• Forearm.
• Patients are subject to cramps and paralysis of the extensor muscles of the forearm, 76 . [An important point in the differential diagnosis between this and lead poisoning, since in this latter the flexor muscles are the ones particularly affected.]
• Achings in flexor muscles of left forearm (after two hours and a quarter), 81.
• Periosteal aching down left forearm; then down right forearm; then in right elbow; then down spine; with varying intensities, (after twenty minutes), 81.

INFERIOR EXTREMITIES. [600.]

• Considerable œdema of lower extremities (while the eruption was going off), 12.
• Veins of the lower extremities dilated, 21.
• Varicose veins in the legs, 18, 21.
• Varicose veins of the legs, without ulcers, 18.
• Saphena vein as large as the thumb, 21.
• Trembling of the legs, so that he could scarcely stand or walk, with trembling of the hands, so that he could carry nothing to his mouth, and trembling of the tongue, 31.
• Movements of the lower limbs were performed naturally, but slowly; those of the hip-joint were difficult, 55.
• Gait in walking uneven and hesitating (younger), 56.
• His walk was hesitating and difficult, 77.
• Remarkable heaviness of the lower extremities, so that the gait was unsteady, followed by tremors of the hands, and gradually of the whole body, 37. [610.]
• Staggering gait, 6.
• Patients suffering from mercurial tremors had a gait very similar to those suffering from tabes dorsalis, 33.
• Unable to stand steadily, 49.
• Great weakness of the legs, so that he could scarcely stand, 18.*
• Confined to his chair; unable to walk a step, 10.
• Bursting sensation in right leg, followed by periosteal tingling (after a few minutes), 82.
• Although every muscle of their legs was trembling, they were frequently obliged to stretch them out upon chairs, in order to relieve the severe cramps in those parts, 47a.
• Periosteal aching in anterior surface of left tibia (second morning), 81.
• Pains in the knees at times, 18.
• Soles of both feet turned inwards and upwards; the tendon of the tibialis anticus is rigid and prominent; this contraction is permanent and painless, 55. [620.]
• Tingling of toes (left foot), (after a few minutes), 82.

GENERAL SYMPTOMS

• Objective.
• Emaciation, 18, 31, 33.
• He was emaciated and cachectic, and looked prematurely old, 7, 4.
• Considerable emaciation (after thirty-eight years), 70.
• Great emaciation, 18, 21.
• Excessive emaciation, 18.
• Body wasted, 15.
• Cachectic condition, 5.
• It is certain that the children of the workers are affected with the mercurial poisoning; although it may be from the poison carried in the clothing, 23.
• One child of a woman-worker was badly nourished, and when a year old had no teeth, 23. [630.]
• The children of the workers were pale, cachectic, and scrofulous; while, in the same locality, the workers were pale, cachectic, and scrofulous; while, in the same locality, the children of those who did not work at silvering mirrors were usually healthy, 20.
• The children of the workers are very commonly affected by scrofula, rachitis, and tuberculosis, 39.
• Her child had the rickets, 21.
• A daughter, born during her mercurialismus, was very small, only learned to walk when there years old, and never grew to be more than four feet in height; there was kyphoskoliotic curvature of the spine, the head was drawn to the chest and somewhat to the left side; there was very imperfect development of the muscle and bone, 18.
• This worker had four children by his first wife, who was also employed in the factory; all were sickly; one son died of gangrene of booth feet; the three other children and the wife died of consumption; the second wife and her children also died of consumption; the children of the third wife were healthy, except the one born after she was employed in the works; all three wives died in consumption; of the first wife's children one was thirty-one years old, the second twelve, and the third three or four years, 21.
• A child of one of the workers, a year old, had trembling of the arms moderate stomatitis, and ptyalism; the child was pale, but well nourished, even fat, and intelligent, 23.
• Fatal consumption, 43.
• One woman, who had been healthy and had three healthy children, died of tuberculosis, .

He could not convey any liquid to his mouth in consequence of the severity and constancy of the tremors . So great was the violent of the trembling of his whole frame that he was nearly thrown out of a bath by it; much of the water was driven over the side of the tub, and it required the force of two men to prevent him from being actually ejected, 15.

• Tremor, beginning in the hands, and soon becoming general, 43.
• Trembling of the hands, afterwards of the extremities, and gradually of the whole body, 37.
• This was his third attack of tremor, the first having occurred seven years ago. Now affected with general tremor, the head being involved as well as the limbs, and the arms so much agitated that he could not cut up his dinner. At first he used to shake most at night. His spirits were greatly depressed by the attack. Felt dreadfully nervous at times, especially during change of weather, 72.
• The symptoms first experienced were unusual nervousness and trembling of the hands , as well as tremor when standing; and this rapidly increased, so that he was unable to feed himself. At the time I first saw him, he stated that he was infinitely more steady than he had been a few months before, but still he had tremor of every part, and difficulty of speaking; and the more he was questioned about his ailments, the more agitated he became, till he was quite unable to stand, to assist himself, or to speak, 48.*
• General tremors, with stammering of speech , most violent convulsions at times, during which the patient scarcely ever completely lost consciousness; relieved by tightly binding the body and limbs, 37.*
• Formication, drawing pain, and a fuzzy feeling in the upper extremities, followed by trembling, first in the upper, then also in the lower extremities, and at last of all the voluntary muscles, so that she could neither stand, walk, speak, nor chew; this trembling was aggravated on every attempt at voluntary motion and by emotional excitement, 68. [670.]
• General tremor. Almost the whole locomotive apparatus was shaken by regular and spasmodic vibrations, apparently caused by alternate muscular relaxation and contraction. The tremor was more marked in the upper than the lower limbs, and on the left than on the right side. It became worse when the patient attempted certain movements, especially if of a tonic character; and these became more disordered in proportion as they required precision and voluntary effort. Walking was difficult and hesitating. Eating and dressing without assistance, and, a fortiori , legible writing, were impossible. The abnormal muscular action extended to the organs of speech, causing a precipitate and indistinct mode of utterance, which did not, however, amount to stammering, 74.
• The tremor chiefly affected the limbs, especially the thighs, legs and forearms. The dorsal and gluteal muscles, and those of the pelvis and shoulder were less affected-those of the upper abdomen, anterior chest and face, not at all, .

SKIN

• Early color of skin (after thirty-eight years), 70.
• Skin, pale soft, 30.
• Skin pale, dry, 21.
• The skin on the back of the hands was thin and glistening, 21.
• So full of Mercury, that putting a piece of brass in his mouth, or rubbing it in his fingers, it immediately became white like silver, as if he had rubbed Mercury upon it, 2.
• Very great desquamation of the thickened epidermis of both legs; the scales are rather red; under them the skin has a dark-red pigmented look; formerly there had been numerous small ulcers on the legs, followed by this desquamation, 21. [770.]
• Fresh wounds healed very slowly, 20.
• Eruptions, Dry.
• Papular eruption, 76.
• Feverish, eruptive exanthem resembling roseola, which began first in the throat and face, and from these parts spread all over the body (five or six days after appearance of other symptoms); in six days it disappeared without leaving any trace, 73.
• Papulous exanthema over the whole body, with nightly bone-pains, 19.
• Maculous, papulous, or even squamous eruptions; the latter especially in old people (on the chest, back, and scalp); the eruptions often appeared suddenly, lasted a few weeks and then disappeared, and then again returned, 20.
• Psoriasis in spots over the whole body, 18 . [This was ineffectually treated with gray ointment until salivation occurred; the palms of the hands and soles of the feet were free from the eruption.]
• Urticaria on the genitals and thighs, and in spots on the chest and abdomen, lasting two days, 26.
• An itching and redness between the fingers, also a swelling of the face, and especially of the inner side of the elbow; with a somewhat altered state of bodily feeling, and a sense of loathing. On one occasion, a letter was brought to me by a countryman, who had carried it in his bosom, next to an undergarment which he had besmeared with mercurial ointment for the destruction of lice. Scarcely had he produced it, before a swelling bigger than a hen's egg appeared on my hand, and my face puffed up and became red and itching, 3.
• Eruptions, Moist.
• It is an erythema, upon which vesicles form, and pour out a thinnish, clear fluid. The vesicles are quickly broken, then contents desiccate, and the redness remains for a week or ten days. (It is clearly a local disease, and not a true eczema), .*

SLEEP AND DREAMS

• Sleepiness.
• Sleepiness, for eight weeks, 18.
• Sleepiness, with great anxiety, 18.
• Great sleepiness, but sleep very much interrupted and disturbed by bad dreams, 18.
• Drowsiness, 54. [800.]
• Sleep but half awake, with heavy dreams and fantasies, 18.
• Sleeplessness.
• Sleep very imperfect; frequently awoke starting and frightened, and was troubled with incessant unpleasant dreams (one), 51.
• Sleep bad, with frightful dreams, 18.
• Disturbed sleep, 54.
• Sleep greatly disturbed, 15.
• Restless sleep, with frightful dreams, 33.
• Loss of sleep, 47a.
• Very little sleep, which is disturbed by dreams and nightmares (after thirty-eight years), 70.
• Sleeplessness, 33, 34, 37 , etc.; for months, 18.*
• Sleeplessness, with hallucinations, heavy dreams, nightmare, 18. [810.]
• Sleeplessness; or the sleep was frequently interrupted by jerkings, and disturbed by heavy dreams, 18.
• Sleeplessness; on falling asleep he fancied that some one called him, started up in fright and became chilly, 18.
• Obstinate sleeplessness; nights disturbed by nightmare and half-waking dreams, 69.
• Sleepless night, 73.
• Night sleepless, especially after midnight, 36.
• The patient had no rest at night would stand up, wanted to walk about, saw ghosts, animals which were jumping at her, thought men were on the bed, thought living things were creeping into her mouth and vagina, 33.
• Starting up in sleep, 21.
• Dreams.
• Heavy dreams, 18.
• Frightful dreams at night, 18.

FEVER

• Chilliness.
• Skin cold and dry, 16, 30. [820.]
• Whole body cold, 78.
• Constant chilliness, even in a heated room and in bed, 18.
• Frequent chill and heat, 18.
• Those suffering from tremor frequently complained of a sensation of coldness, though without diminished temperature; one person wore a heavy overcoat, even in the hot summer, 25.*
• Heat.
• Increased temperature, 31.
• Heat of the skin above the natural standard, 15.
• Skin hot and dry, 31.
• Feverish and very uneasy (after twelve days), 13.
• Fever, 17, 31.
• The common erethic fever, or fever of salivation, characterized by quick pulse, hot and dry skin, red gums, swollen tongue, salivation, loss of appetite, restlessness, headache, etc.; this may continue as long as the poisonous effects of Mercury continue in the system, for weeks and even months. Another kind of fever is the dynamic mercurial fever, characterized by depression of strength, præcordial anxiety, frequent sighing, partial or universal trembling, a small quick pulse, a pinched and cadaverous countenance, a sense of coldness; the tongue is seldom furred; a sudden and violent exertion may sometimes prove fatal, 14. [830.]
• Hectic fever, 44.
• Hectic fever and phthisis pulmonalis, 30.
• (Intermittent fever seems very prevalent among the workers in nearly all the mines and factories, as reported by nearly all observers, but whether due to Mercury or local causes is uncertain. T. F. A.), 2a.
• One of the men who escaped the salivation suffered from quotidian ague, 62.
• Sweat.
• *Sweat, 17.
• Profuse sweats at night, 21.*
• Constantly bathed in sweat, though in a state of collapse, 78.

CONDITIONS

• Aggravation.
• ( Morning ), On rising, headache; aching in left arm; tremors.
• ( Evening ), Vertigo; tremor.
• ( Night ), Hallucinations, etc.; falling asleep of arms, etc.; heaviness in extremities, etc.; tearings in hands, etc.; oppression of breath; sweats.
• ( In bed ), Tearing in limbs.
• ( Beer ), Headache, etc.
• ( Closing eyes ), Tremors.
• ( Eating ), Eructations; hiccough; vomiting; pressure in stomach.
• ( Emotional disturbance ), All symptoms, 49; tremor.
• ( Exertion ), Jerking of hands.
• ( Change of weather ), nervous feelings.
• Amelioration.
• ( Intoxication of wine ), Tremor.
• ( Rest ), Tremor.
• ( Ardent spirits ), Loss of power in hands.

SUPPLEMENT: MERCURIUS. Authorities.

84 , Dr. Goolden, Lancet, 1853 (2), p. 231, effects on a silvever; 85 , H. J. Franks, ibid. p. 317, same; 86 , Dr. H. Jackson, Med. Times and Gaz., 1877 (1), p. 641, effects on a man employed in amalgamating zinc plates with Mercury; 87 , T. Pratt, M.D., Hahn. Month., vol. xiii, 1878, p. 472, prescribed a powder 3 1/10th trit., every three hours, for a severe cold in the head, in the second stage.

• After he had taken the fourth powder I was summoned to see him, when he informed me that the catarrhal symptoms were much improved, but he was then having a most violent facial neuralgia on the right side, originating in the dental nerve, and radiating upwards over the side of the face. This he first felt after taking the second dose, and immediately after each of the two last the aggravation was marked and intense, so much so, that he felt that he could not take another dose. I discontinued the remedy and the difficulty soon subsided, 87.
• His teeth, which are carious, are becoming loose; there is a white line, from undue epithelial secretions, at the margin of the gums; there are great tremors, approaching to paralysis, and an indecision in speaking, resembling stammering. He has lost two stone weight during the last two years. The tongue is wavy from nervous debility, and he suffers from nocturnal perspirations; memory is rather failing, and appetite is bad, 85.
• Pale, weak, and anxious-looking, with a slow but regular pulse; tongue furred; teeth mostly greenish black and carious; skin generally dry and cold. He could not walk at all, hardly speak, and when he attempted to move, or was asked a question, his whole frame was thrown into the most immoderate convulsive actions, 84.
• Old-looking for his age; thin and pale; sallow, but not to an extreme degree. Has slight blue line along lower gums. Teeth, lower incisors; pegged flattened at the top, the centre brown, the enamel everywhere deficient. All of them chipped and decayed. Mental condition defectivee. He cannot give a history of his illness. To every question about it, answer only, "Mercury." When pressed about it, says, "Too much is expected of him," and he begins to sob and cry. Cries with the least excitement. He cannot remember his age to within ten years. Speech very thick; the words are drawled out, but he often fails to complete them. After he has been talking a little time, articulation becomes less and less distinct, apparently from defective control over the muscles. Tremors; when he is not talking the face is tranquil, but directly he begins to speak all the face muscles become tremulous. When told to open his mouth he gets marked tremor of muscles of mastication. Tongue very tremulous when protruded; no nystagmus. Coarse tremor of whole right upper limb elicited on movement. Lower limbs: Able to walk a mile fairly well, but no more. No trembling of legs when he stands or walks. Staggers when eyes are closed; would fall unless prevented. When sitting in a chair, and told to raise the right leg off the ground, there is coarse tremor in the whole limb, 86.