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), 70.
Thoughts wandering, and impulses whimsical (elder), 56.
Intellect affected; when asked to explain any statement, he becomes confused, 55.
Weakness of intellect and memory, 37. [30.]
Intellect very weak; shows every mark of imbecility ; smiles foolishly; screams constantly without apparent cause; can speak only a few disconnected words; does not seem to understand the simplest questions, yet appears to know her sister with whom she plays, and repeats a few syllables of what the latter has said to her (younger), 56.
Loss of intellect and memory; a sort of idiocy, which in a few years becomes permanent, 43.
Loss of memory, 17, 69.
Complete loss of memory, 18.
Memory slightly affected; forgot the names of persons and places, and was frequently at a loss in endeavoring to recollect the persons to whom he had lent his tools, 16.
*Memory weak, 18.
Weakness of memory and loss of will power, 18.*
Increasing weakness of memory, 21.
Very poor memory (after thirty-eight years), 70.
Memory very much impaired, 18. [40.]
Forgetfulness, with impaired intellect, 18.
Very forgetful, 18.
Loss of consciousness, 69.
Stupor, 5, 7.
Constant disposition to lie down; inclined to sopor, coma, 17.

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, 21. [70.]
A great deal of headache, 48.
Great headache, 21.
Violent headache, 66.
Violent headache, with a sensation as though he were pulled backward, 18.
Constant and violent headache, having no fixed seat, 69.
Most violent headache, 29.
Frightful headache, 33.
Fulness, throbbing, and vertigo in head (after a few minutes), 82.
The headache was usually violent day and night, generally described as a drawing rather than a tearing pain, involving sometimes the forehead, sometimes the occiput, 18.
Throbbing headache, with vertigo, 18.
Forehead. [80.]
A good deal of pain in forehead, 50.
Pain in the left side of the forehead, aggravated by pressure upon the nodal point, 18.
Frontal headache, with fulness, soon passing to the occiput, with vertigo (after twenty minutes), 81.
Frontal bursting headache (after a few minutes), 82.
Bursting frontal headache, lasting several minutes (third day), 81.
Temples.
Subacute aching above left temple (second morning), 81.
External Head.
Falling of the hair, 18, 21, 33.
Itching of scalp (after a few minutes), 82.
Profuse falling of the hair, 18.*

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.
Flickering before the eyes, 18.
Flickering before the eyes while reading, though the accommodation seems to be unimpaired, 80.
Play of colors before the eyes, 33.

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, 18.
Chin.
Lower jaw of right side, after several years, was remarkably thin, 18.
Almost complete inability to move the lower jaw or chew, 29.*
Unable to masticate (after nine days), 59.
Mastication painful and even impossible (second day), 58.
Inflammation of the lower jaw progressing to caries, with falling out of the teeth, 11a.
Atrophy of alveolar process of the lower jaw, 18. [160.]
Periostitis of the lower jaw, 18.
In one case periostitis of the lower jaw without subsequent necrosis, 33.
Necrosis of the jaws, 18.

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, 21.*
Disagreeable sensation in the teeth, 28.
Aching in right lower molar (decayed) at 4.30 P.M. (second day), 81.
Violent pain in the teeth (after six years), 70.
Aching in left lower molar (sound), passing to upper molar (sound), at 6 P.M. (second day), 81.
Slight aching in left lower molar tooth (sound), (after two hours and a quarter), 81.
Violent toothache, 18.*
*Violent toothache, with swelling of the gum and salivary glands, 29. [190.]
Toothache (drawing) in left lower molar (sound); (not experienced for several years), (after a few minutes), 82.
Gums.
Gums much affected, 50.
Gums red, but without yellow coating on free border (eighth day), 60.*
Gums red, swollen, and covered with thin white patches, easily removed from a non-ulcerated surface ; to the left of an behind the second molar tooth, a red patch which has been covered by a white film. Gums much worn away, and coated of a dirty yellow (after ten days), 58.*
Gums red, swollen, and covered on their free border with a dirty yellowish-white substance, which extends up to the tooth-cavities. On removing this, the subjacent surface is seen to be spongy and bleeding, without ulcerations, 57.
*Gums red, and bleeding at the slightest contact, sometimes spontaneously (after six years).

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.*
The gum atrophies, especially on the roots of the lower teeth, leaving the necks of the teeth bare, 23.*
Gum atrophied and retracted below the alveolar process, 18.*
*Bleeding from the gums, 16.
*Gum bleeds easily, 18.
Gum painful, 18.
Gums and mastication painful (second day), 59. [220.]
*Gums sore, 15.
Tongue.
*Tongue black, with red edges, 31.
Tongue red, swollen, 23.
Tongue not swollen; gray patches on edges, and a thin dirty-yellow coat on upper surface (after nine days), 59.*
Tongue pale, 32.*
Tongue white, 15, 31.*
Tongue white, tremulous, 18.*
White-coated tongue, 31.*
*Coated tongue, showing the impress of the teeth upon the margin, 23.
Tongue thickly coated, 18.* [230.]
*Tongue swollen, and its movement difficult (second day), 58.
Tongue much swollen, and difficult to move (eight days), 60.*
Tongue much swollen , especially on the left side; its upper surface covered with a dirty-yellowish coating, and with gray patches on its edges; its movements are difficult, 57.
Tongue very much swollen, painful, and covered with foul ulcers, with constant oozing of blood as from a spongy tissue; these ulcers made swallowing very difficult, 44.*
Tongue so much swollen that its movements are difficult and very painful; it is very red, with a dirty-yellow coating on upper surface; shows marks of teeth, and has large gray patches on edges (after eight days), 60.*
Great swelling of the tongue, especially of the right side, which was covered with superficial ulcers; the swollen portion of the tongue and mouth were hard to touch, the tongue and palate bright-red, extremely painful, submaxillary and cervical glands swollen and sensitive to pressure, 18.
Tongue very large, especially on right side; its edges show gray patches; in front it bears the marks of the teeth its upper surface present the dirty-yellow coating characteristic of mercurial poisoning; its movements are difficult (after ten days), 58.
Trembling of the tongue, 21, 34.*
Constant trembling of tongue, 55.*
Great trembling of the tongue, 21.* [240.]
Tongue looks healthy, and is not coated; but almost as soon as it is put out it begins to vibrate like a pendulum; at first in small arcs, which rapidly enlarge if the organ is kept protruded (after thirty-eight years), 70.
Tongue difficult to move, 24.
Tongue cracked, with a dirty-white coating, 68.
Ulcers on the tongue, 18.
Long, pale ulcers on the edges of the tongue near its tip, 74, 77.
The patches on the edges of the tongue begin to disappear, and the red elevations to show themselves (after twenty days). The ulcers on the edges of the tongue, which are 4 1/2 centimetres in length, are cicatrized in their anterior third. The posterior two-thirds of the left ulceration shows a granulated surface 3 millims. in breadth. The right ulceration has a granulated surface rising above the healthy mucous membrane, and about 3 millims, in length (after twenty-two days). The ulcer on the left border of the tongue has cicatrized; a white line marks the boundary of the cicatrix. The ulcer on the right edge of the tongue is not more than 3 millims. in length; it forms a raised granulated surface, with a white border, which cuts it transversely in several places, so as to divide it, as it were, into islets. This granulated surface projects above the white border, which is a true cicatrized edge (after twenty-five days), 60.
On the right border of the tongue, instead of the gray patch, a granulated surface stands out plainly upon the healthy mucous membrane, which bleeds on the slightest touch, and has the white edging of a true cicatrix. There is a similar appearance on the left border (after sixteen days), 58.
Pain in the tongue, with blisters on the margin developing into ulcers, 18.
General Mouth.
Mucous membrane of the mouth very much affected, 21.
Mucous membrane of the palate red, with an ulcer to the left of the uvula, 21. [250.]
The mucous membrane of the palate is intensely red and œdematously swollen, 80.*
The mucous membrane assumes a bluish-red appearance in one or more places, and becomes spongy; next day these spots become whitish, and the dissolution of the mucous membrane becomes evident; in a few hours the whitish-gray substance changes to a fetid ichor, flows off, and exhibits and irregular, shaggy, flat ulcer, with an almost spongy base, and sharply indented edges; the ichor is discharged in profuse quantity, the ulcer spreads rapidly in extend, without penetrating into the flesh, and is very painful ; if the use of the metal be continued, and the ulcers left to themselves, they assume a dirty, foul appearance, and become rapidly phagedenic; blood is now discharged from the ulcers, not actively, but oozing out as from a sponge, and evincing a state of great debility; the bottoms of these ulcers often present unequal elevations and depressions, as if it had been corroded by insects; the breaking out of these sores is often accompanied by irregular and quick pulse, sleeplessness, restlessness, profuse night-sweats, great nervousness, and impatience from the slightest cause, 14.*
Copper-colored redness and swelling of the gum and mucous membrane of the mouth, followed by excoriations of the inner surface of the lips and gums, and moderate salivation (after working fourteen days), 20.
Mucous membrane of the mouth livid, with moderate salivation, especially in the morning; gum red, elevated, with a grayish-red margin, 21.
Mucous membrane of the mouth pale, with numerous erosions, 18.*
The mucous membrane of the lower lip, especially on the left side, is covered with large yellowish patches, which cannot be detached by the finger-nail. Buccal mucous membrane swollen, red, thickened, and covered on the cheeks, gums, and palate, with white patches are easily detached from a non-ulcerated surface. The gray patches on the lower lip and inside the cheeks, and on the edge of the tongue, were bordered by a red line (after four days). On removing with a cloth the patches which extended from the lower lip over the inside of the cheeks, the mucous membrane was laid bare, and was seen to be rough and uneven, staining the cloth with a good deal of blood. Severe pain was thus caused (after six days). The gray patches have disappeared, leaving red spots. On the right cheek, near the labial commissure, is a reddish-gray surface, as large as a half a dollar, raised above the healthy mucous membrane. The red spots are true granulations , indicating ulceration of the mucous membrane; the gray places are remnants of the previous white patches (after thirteen days), 57.
Buccal mucous membrane swollen and painful (second day). Mucous membrane of inside cheeks swollen, especially on right side, where is a red patch which has been covered by a white film. The palate also shows some of these films. The mucous membrane of the lower lip presents thinnish white patches, bordered with red (after ten days). The white patches on the lower lip are replaced by a surface covered with small red elevations, having a thin gray coating between them. This granulated surface stands out in bold relief upon the healthy mucous membrane, and leaves blood on the cloth when touched; contact is very painful (after eleven days), 58.
Buccal mucous membrane lining the upper lip presents, near the right commissure, a thick white patch, bordered with red; the inside of lower lip is entirely covered with moderately thick, gray patches, also bordered with red. Mucous lining of cheeks swollen, especially on right side; it, as wheel as the palate, shows thin white films (after nine days), 59.
Palate almost entirely covered by a thin false membrane, which can be removed from a non-ulcerated surface. Buccal mucous membrane partly covered with thin white patches, but in some places there are thick layers which cannot be wholly removed by the nail (after eight days). Patches on inside cheek, bordered with red (after ten days). Patch on right cheek has gone off, and is replaced by a prominent grayish-red surface; the red points are evidently granulations; the gray points are remains of the false membrane (after eleven days). Granulations on the above places in left cheek; more apparent in right cheek (after twelve days). In right cheek a granulated surface, 1 millimetre in breadth and 5 millimetres in length; around it the mucous membrane is red to the extent of 6 millimetres (after twenty-five days), 60.
*Bad odor from the mouth, 23, 75.
Mouth extremely offensive, 44.* [260.]
Fetor from the mouth, 80.
*Fetid odor from mouth, 74.
Mercurial odor very strong (after eight days), 60.
Odor from the mouth disagreeable, sweetish, 68.*
Swelling of the gum, lips, and cheeks, 2a.
Mucous membrane of the mouth swollen, elevated, 21.
Spongy swelling of the mucous membrane of the lower lip, with numerous pustules looking like swollen mucous glands; also the mucous membrane of the cheek and upper lip has a peculiar spongy appearance, 80.
Stomatitis in two-thirds of all the cases, sometimes with swelling of the cervical and submaxillary glands; in about one-half of the cases there were mercurial ulcers in the mouth; in one case, inflammation of the tongue; in another case, inflammation of the tonsils, and formation of an abscess, 33.
Acute stomatitis, 73.*
*Violent stomatitis and salivation, 18. [270.]
Violent stomatitis; deep mercurial ulcers on the inner surface of the right cheek descending as far as the tonsil; as the mouth healed she was attacked with fearful tremor, so that she could not leave her bed nor speak a word, 18.
Frightful stomatitis, 18.
Soreness and sense of swelling in mouth, 13.
Pimples and swelling in mouth (second day), 60.
A breaking out, similar to the ulcers in diphtheritis, upon the right side of the mucous membrane of the mouth and tongue; swelling of the right submaxillary glands, and profuse secretion of fetid saliva, 73.
Ulcers in the mouth, 18.*
In 1821, Mm. F. and B., then students in the Hospital de la Pitié, and attending to the treatment of prostitutes, were both attacked with inflammation of the gums, which could only have arisen from the discharge of their duties in the venereal wards. In M. B.'s case, there were even ulcers in the back of the mouth; they did not seem to him to be important, and he paid little attention to them until he perceived them to grow worse. He then consulted a distinguished practitioner, who pronounced the disease venereal, and prescribed a course of Mercury. As M. B. had never had syphilis, and had never been even exposed to the contagion , he declined to follow this advice. His complaint lasted several months, and disappeared finally after he had left off treating venereal patients. In the same year, M. P., another élève externe at the same hospital, was likewise affected with a swelling of the gums, and also had ulcers on the mouth and back of the mouth, which, as fast as they were cured in one place, reappeared in another. Her was finally relieved only by staying at home for some time, 47.
Numerous ulcers in mouth, 10.
Ulcers on left margin of tongue and on right cheek, 18.
Ulcers on the mucous membrane of the cheek, 18. [280.]
Superficial ulcers in the angle in front of the arch of the palate, sometimes left, sometimes right, 18.
Deep ulcers developed on the inner surface of the lips and cheeks, with elevated, eroded margins, with swelling of the tonsils and cervical glands (after working fourteen days), 20.
Inner surface of the cheeks deeply ulcerated and inflamed, 31.
On the mucous membrane of the lips were small whitish, deep, easily bleeding ulcers, with somewhat elevated margins, and of a livid color, 68.
Foul ulcers in mouth, from which a copious and most offensive sanious discharge was constantly dropping, 5.
Small pigmented scar on the right side, between the hard and soft palate, with a mercurial ulcer, 18.
Saliva.
Saliva increased, 23, 68.
Salivation, 21, 24, 28 , etc.; (third day), 58, 59, 60.*
Slight salivation (after nine days), 59.
Long-continued slight degree of salivation, 49. [290.]
Moderate degree of salivation, 51.
Frequent salivation, 16.
An alarming illness broke out among the crews, all of whom were more or less salivated. The surgeons, pursers, and three petty officers, who were nearest the place where it was stowed, felt its effects the most, their heads and tongues having swelled to the most alarming degree. Every rat, mouse, and cockroach on board has been destroyed, and the symptoms of general salivation have appeared in a strong degree, 46.
Great salivation, 21.
Abundant salivation, 57.
Salivation very abundant; almost at its height (after eight days), 60.
Profuse salivation, 18, 31, 63.
Very violent salivation, 21.
Salivation, which caused the loss of all his teeth, 65.
Thirty-nine out of the forty-three patients were attacked with mercurial salivation; in some cases it assumed a severe from, 62. [300.]
Very offensive salivation, 31.*
Ptyalism; has to spit a great deal (after thirty-eight years), 70.*
Ptyalism, which wasted her to a skeleton, 11.
Smoking caused unusual profuse salivation, 18.
Bloody saliva, 44.*
Taste.
Bad taste, 78.
Bitter taste, 31.
Metallic taste, 5, 21, 29.
Strong metallic taste (after thirty-eight years), 70.*
Unable to take soup, on account of a very salt taste which it seemed to have, 78.
Speech. [310.]
Speech tremulous, 21 ; for years, 18.*
Speech slow, 18.
Speech impeded, 69 ; (second day), 58.
Speech greatly impeded, 15.
Speech difficult, 31 ; (after eight days), 60.
Difficulty in speaking and masticating, 73.*
*Speech difficult on account of the trembling of the mouth and tongue, 23.
The masseter muscles became contracted, so that speech was at times very difficult and almost impossible, 79.*
Inability to speak plainly, 64, 74.
Speech only partially intelligible, 1. [320.]
Speech scarcely intelligible, 1.
Could scarcely speak intelligibly, from the constant state of agitation into which they were thrown the moment they were addressed, or attempted to articulate, 49.
*Speech stammering, 2a, 18, 21 , etc.
Stammering (since the tremor began), (after thirty-eight years), 70.
Speech stammering and usually very difficult, 79.
Speech stammering; at last unintelligible, 30.
Stammering, speech slow, difficult; entirely unable to speak on any excitement, 18.
Stammering like a child, 1.
Stammered badly, 1.
Dreadful stammering, 10. [330.]
Articulation somewhat indistinct (one), 51.
Difficult articulation, amounting to stammering; he could hardly be understood, 1.*
Utterance embarrassed, indistinct, and hurried, 55.
Psellismus (Paresis tremens of the organs of speech), 18.*
Loss of speech, 7.

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.
Great pain from swallowing or speaking, 10.
External Throat.
Loud bruit de souffle in the veins of the neck, especially in the left side, 18.
Lymphatic glands of the throat hard and rather large, but those on the nape, elbows, and inguinal region not enlarged, 18.* [360.]
Submaxillary glands swollen, 18.*
In some cases the submaxillary glands were swollen without salivation, 25.
Submaxillary glands slightly swollen (after nine days), 59 ; (after ten days), 58.
Submaxillary glands much swollen, especially left (after eight days), 60.
Submaxillary glands slightly engorged, 57.
Cervical glands swollen, 21.*
Cervical glands swollen, soft, 21.
Cervical gland very much swollen, 21.*
Cervical glands large, hard, 21.*
Hard swelling of the cervical and parotid glands, 29. [370.]
Right side of the thyroid gland very much enlarged, 21.
Great hardness of the parotid gland, behind the ramus of the jaw, 21.
*The right sublingual glands were as large as hazel nuts, and very hard, 18.
Trembling of the sublingual glands, 11a.

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), 81.
Very short of breath, 5.
Dyspnœa, 18, 28.
Dyspnœa and cough, 73. [470.]
Asthma, 5.
Finally, became asthmatic; the paroxysms at first occurring with long intermissions, but gradually becoming more frequent; there was a constant rattling, but no cough or expectoration; towards the close of the disease, which lasted eighteen years, she could not walk or bend over, for fear of suffocation; the symptoms becoming worse, she was confined to her arm-chair for more than a year before death came to her relief, 11.
Asphyxia, 9.

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, 64.
The principal affection under which he labored was not, as has sometimes been described in these cases, a constant tremor of the limbs and seesaw of the head, such as occur in old paralytic persons, but a sort of rapid convulsive agitation of the limbs (whenever the act of volition was exerted upon the muscles), which moved the extremities quickly in all directions except that which the will prompted. Thus, he could sit on his chair still and nearly unmoved, but the moment he got up and attempted to walk, his legs began to dance, as it were, in spite of himself, and performed very rapid and irregular motions, with so much violence as to compel him to drop on his chair again, or to throw him down. Somewhat similar motions were performed by his arms, if he attempted to use them; so that he was unable to carry anything to his mouth, and the smallest quantity of liquid was immediately dashed out of any vessel from which he made an attempt to drink. He was under the necessity, therefore, of being fed like a child. These spasmodic tremors were greatly increased by any circumstance that agitated his mind, or occasioned any anxiety (one), 51.
They thought they were cured, when in about fifteen days after leaving off treatment, they were seized with jactitation of the muscles of the limbs, 47a.
Sudden jerking of the extremities, so that he could scarcely walk or eat; the fear of falling induced him to keep his bed, 18.
Paralysis of the extremities except of the left arm; afterwards motion returned in the arm but not in the lower extremities, 37.
Weakness of the limbs, 18.*
Painful prostration in all the limbs (second day), 58, 59, 60.
Subjective.
Frequent falling asleep of the arms and legs, especially at night, 21.
Sensation of fuzziness and paralysis in the limbs, 18.
Unusual heaviness of the limbs, 28.* [550.]
Feeling of heaviness and fuzziness in the limbs, 21.
Feeling of heaviness in the extremities, especially feeling very sleepy, especially at night, 21.
Pain in the extremities, 17, 18.
Pains in the arms and legs, 21.
Pains in the forearms and legs, 18.
Slight pain in the joints, especially of the wrists, elbows, knees, and ankles, 43.
Great pain and tremor in the limbs, 66.
Obstinate and intense pain in the limbs for a month, 73.
Dull pains in the joints, 28.
Returns of aching pains in limbs (second day), 81. [560.]
Tearing in the limbs, especially in the arms, 18.
Tearing pains in the extremities, 18, 21.
Painful tearings in the hands and feet, worse at night, 28.
Violent tearing pains, like rheumatism, in the arms and legs; increased in bed, so that she was often obliged to leave it, 18.

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.
Constant repeated, prolonged convulsive movement of both forearms on the radial side, causing flexion of the thumb and forefinger, 55. [580.]
First symptom was weakness of the forearm and pain of the elbows, 53.
Wrist.
Wrists permanently flexed at a right angle with the forearm, but are easily straightened out, 55.
Acute aching in left wrist and dorsum of hand, succeeded by subacute aching over hepatic region (second day), 81.
Hand.
As soon as they were desired to do anything with their hands, it was evident that they had no power of directing them with decision to the performance of voluntary motion; thus, instead of taking hold of a book or paper presented to them, they caught at it with sudden spasmodic jerks; and whenever at last the paper was seized it was crumpled in the hand, 49.
*Tremor of hands, 1, 18.
Trembling of the hands, so that it became impossible to hold anything, with great weakness, 34.*
Trembling of the hands, at first lasting about a quarter of an hour, and passing off, afterwards becoming more and more frequent, and lasting a longer time, 79.
Hands trembled so that he could scarcely work, 1.*
Constant trembling of the hands, so that the patient cannot hold them still for a moment, and every movement is impeded thereby, 80.*
Involuntary trembling of the hands, 80.* [590.]
He could neither feed nor dress himself, 77.*
One could not carry a glass of water to the mouth without spilling it; could take neither food nor drink, but had to be fed like a child, 2a.*
So paralytic that he could not, with both his hands, carry a glass half full of wine to his mouth without spilling it, 2.*
Frequent involuntary jerking of the hands and fingers; the convulsions are greatly aggravated by every exertion, 79.*
A slight loss of power in the hands, which came on at various times, and was generally relieved by the use of ardent spirits, 16.
He was in the habit of intoxication; and noticed that when in this state he could hold his glass without spilling, which he could not do when sober, 10.
Fingers.
Finger nails blue, 28.
Trembling of the fingers, 18.
The fingers of the left hand became permanently contracted, 79.
Sensation of coldness and deadness of the fingers, 80.

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, 18.
Chlorosis and amenorrhœa, palpitation, weakness, loss of appetite, 18.
Chlorosis; skin of the face and mucous membrane pale, white like a corpse, eyes watery, pulse small, rapid, great thirst, palpitation, dyspnœa, pains in the head and stomach, œdema of the lower extremities, general weakness, depressed mood, blowing sounds in the carotids, 35. [640.]
Exostoses, especially on the tibia, seldom on the upper arm or head; these were accompanied by swelling and sensitiveness of the periosteum, especially aggravated at night, and by the warmth of the bed and in cold damp weather, thunderstorms, etc., 20.
Periostitis and subsequent necrosis, 19.
Among five hundred patients suffering from caries, necrosis, or exostosis of the bones, there is no case known of it occurring among the workers in Mercury, 18.
Syphilis was extremely rare among the workers, 20.
Syphilis was extremely rare among the workers in Mercury, especially remarkable since the sexual desire is usually excited; several physicians who practiced in Fourth, where the factories are, and who had a large practice among syphilitics, could not remember a single case of syphilis among the workers, 39.
Syphilis is exceedingly rare; but one case was treated by Prof. Thiery, in Brussels; a man, suffering from mercurial poisoning, tremors, salivation, etc., had an indurated chancre with swelling of the inguinal glands, but developed no other symptoms of constitutional syphilis so long as he was under observation, within thirty years, more than two hundred persons in Erlangen, and four or five times as many in Fourth, have been treated for constitutional mercurial poison; and though these cases have increased sexual desire in consequence of Mercury, and, without doubt, are not particular about their associations, since among them the belief is universal that Mercury protects them from syphilis, no case has been known to occur. Cazenave has never seen secondary symptoms among the workers, 18.
No case of syphilis was ever known to occur among the workers, though they were no more continent than other people, 25.
The caries affects the bones and joints that are never or rarely affected by syphilis; among five hundred and sixty workers in Mercury, there was not a single case of caries of the scalp, tibia, clavicle, or sternum, which parts are especially affected by syphilis, 19.
When the system begins to evince that it is under the control of the medicine, various symptoms are exhibited; sometimes they are of a mild nature, at others very violent; the mouth sometimes first displays the constitutional affection, but it is most generally preceded by some degree of acceleration of the pulse, a degree of feverish excitement, and various nervous affections. If the ptyalism be suddenly established without much previous admonition, the excitability of the system is very commonly much greater, and general constitutional disorder is evinced, and the soreness of the mouth causes an irritability of the whole frame; considerable absorption of the fatty matter, attended by a great attenuation of the body, is quickly visible, and the stoutest person generally becomes thin and emaciated; the excretions from the various organs are altered in appearance, and, oftentimes, in odor; the alvine evacuations become of a brighter yellow, the urine is higher colored; a peculiar state of the skin, evinced by a very singular fetor, which is quite diagnostic of the mercurialization, and of which it is impossible to convey any impression by language. It materially differs from the smell that issues from the body after sweating has been produced by Dover's powder, or that which occurs after some eruptive fevers, or upon mental derangement; it is a peculiar characteristic which occasionally lasts after ptyalism ceases. When the action is very severe upon the mouth, the misery which taking any food produces is enough to prevent the indulgence of the appetite, which is sometimes not at all diminished; but when the ptyalism has completely ceased, the appetite is of the most ravenous character, which nothing appears to satisfy; then nutrition recommences, the depositions of the well-digested secretions in the various parts of the body, which have lately lost their usual quantity of fatty matter, is very rapid, and the frame speedily acquires even a greater bulk than it previously had, and oftentimes the standard of health is more firmly fixed than it was before; but this is not always the case; some individuals are left in a state of great feebleness, and liable to every shock that would, under ordinary circumstance, be light. Sometimes local disease has lasted for some time, and even run to a very outrageous extent; ulcerations of the tongue, exfoliations of the alveolar process, 41.
The first symptom was persistent diarrhœa, which lasted profusely eight days, and ceased after she stopped work; after a year and a half there appeared tremors with loss of appetite and diarrhœa, followed by falling out of the hair; on stopping work and using baths the tremors disappeared in four weeks, and the hair grew again; after returning to work the teeth began to be gray, though she daily scoured them with charcoal; afterwards she was attacked with weakness, vertigo, uneasy sleep with heavy dreams, loss of memory, affections of the mouth, which she treated with alum, and increased decay of the teeth; after a time the tremors reappeared and gradually became worse, as also did the headache and sleepiness; afterwards she had palpitation of the heart and hiccough, at times so violent that she had to be held by several people; after leaving the work she became better, but the tremors did not entirely leave her, and were especially aggravated by any vexation or other emotional excitement; the gums were somewhat atrophied and retracted from the teeth; teeth of a grayish-brown color; copper color of the roof of the palate and uvula; slight tremors of the extremities and of the tongue, especially noticeable in speech; the right posterior cervical gland swollen; rheumatic pains in both upper arms; profuse perspiration at night and easily becoming chilly; the patient had two children, the first four weeks too early; the child was weak, and died when a year and a half old, 22. [650.]
One day when he was getting better I met him suddenly became very much affected, staggered, could scarcely, could scarcely speak, and nearly fell down; pulse 120, small; respiration rapid, with violent trembling; after keeping quiet for half an hour the trembling disappeared and he was able to speak; pulse 80; complained of great weakness of the limbs and oppression of breath, especially at night, 18.
Breath and whole body smelled foul, 17.*
Peculiar hastiness of all motions, 18.*
Involuntary motions of the head and hands, 80.*
The arms and especially the hands, when kept in a horizontal position, are soon thrown into a constant jerking movement. This is independent of the will, and the patient is not only unable to stop it, but it even becomes more frequent when she tries to restrain it; and slight emotional disturbance has the same effect. All manual labor, all prehensile movements of any delicacy, are nearly impossible; she can hardly pick up a needle lying on a table. The lower extremities are similarly affected; she can scarcely stand; walking is difficult and staggering; she has to support herself every moment (after thirty-eight years), 70.
*Trembling, 21, 75.
General tremors, 18.
Involuntary tremors, 2a, 31.*
General involuntary tremor, 47a.*
Mercurial tremors affect the muscles which are usually under the control of the will, so that one is never master of his own motions ; the affected muscles exhibit normal electrical irritability, but are not able to respond to the will; on attempting to respond the muscles begin to tremble and twitch excessively; they frequently make all sorts of motions, as in chorea, before the desired motion is effected, or are sometimes affected with violent convulsive motions, which also involve neighboring groups of muscles; these muscles are better able to hold heavy objects than light ones, as for example, a knife or fork cannot be used because they are jerked out of the hand, while a heavy object may be held firmly for a long time; the hands and arms are first affected, the lower extremities next, while the head becomes affected later and only in violent cases; the general trembling of the body seems to alternate with the stammering of speech; sometimes the speech is very stammering and unintelligible, while the rest of the body is not affected; at other times the whole body trembles, twitches immoderately, while the speech though tremulous and interrupted is yet intelligible; sometimes one-half of the body is more affected than the other; sometimes the patients are unable to walk, drink, eat, dress, undress, speak intelligibly, or indeed to utter an articulate sound; sometimes patients are able to ascend and descend steps, though with difficulty, like patients with tabes dorsalis, but are not able to eat or drink, while in others these conditions are reversed; some are no longer able to drink without assistance because the water is spilled before it reaches the mouth, while they are still able to carry food to the mouth by supporting the arm; one patient was obliged to be held by several people whenever he attempted to drink; sometimes chewing is absolutely impossible; in the convulsive form patients are obliged to be tied in bed to prevent their being thrown out by the convulsions. At times tremors occur in paroxysms of varying severity and duration; these paroxysms are brought on by emotional excitement, physical exertion, and sometimes occur without assignable cause. At times the paroxysms resemble the violent shaking of ague. One case presented the following remarkable symptoms: the whole body was tossed to and fro, while every muscle and each group of muscles seemed to be in incessant activity; the head rolled about on the shoulders, jerking backward and forward and from side to side, the eyelids opened and closed, the eyeballs rolled from side to side, the wings of the nose and the corners of the mouth twitched, grimaces distorted the face, the jaw moved backward and forward, the upper a and lower extremities jerked as a whole and each muscle by itself; the convulsions were even so violent that several strong men were unable to hold the patient; it tossed him to and fro or threw him out of bed. In another case the patient suffered from general tremors with stammering, at times amounting to most violent convulsions, in which she screamed loud, and had to be bound, consciousness, however, was not completely lost; the paroxysms seemed to be worse in the evening, and only in very violent cases did the trembling continue during sleep; the tremors usually prevent sleep, or as soon as the patient falls asleep a convulsive shock wakes him, and the tremor begins anew (tetanic spasms have never been observed), 18.* [660.]
Altogether disabled from work by paralytic tremor and debility, 51.
Trembling not only of the limbs but of the whole body, of the tongue when protruded; speech was stammering, 33.
General convulsive tremors; his arms and head trembled even while sitting; speech was tremulous; the tongue trembled when protruded; all the muscles of the body gradually became affected, and all in constant motion; the head, arms, etc., were never quiet for a moment; the eyelids twitched as if affected by chorea; constant twitching of the muscles of the face; sometimes for a moment there were more violent tremors of the right half of the body, amounting to clonic convulsions affecting one or several groups of muscles and certain fibres, as for example, of the pectoralis major, were at times affected by violent shaking; speech difficult, stammering; he spoke only short syllables; it was frequently impossible to pronounce these; the patient was so weak and dizzy that he could not leave the bed, 18.
The limbs tottered, and the man, though young, moved like one advanced in years.

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, 47a.
When laboring under one of his numerous attacks of convulsive trembling, he was liable to break whatever he touched, and the movements of his legs were so irregular that in going downstairs he was sometimes obliged to jump over two or three steps at once; to avoid this, he was in the habit of crawling backwards, and on his hands; he drank out of a dish, in order to bring the liquid more readily to his mouth, and because a glass would be crushed by the spasmodic clenching of his jaws, 43.
Tremors, always commencing in the fingers , gradually increasing in violent and extending until the whole body was involved, 34.
Trembling of the corners of the mouth, tongue, and hands, 23.
Tremor of neck and hands, 6.
Tremors beginning in the hands, especially when attempting to hold anything, gradually increasing, attacking the knees, and rarely the neck, 30.
Trembling of the extremities and head, 43.
Tremors first attack the fingers, arms, and then the knees, extremities, and tongue, 31.
*Trembling of the hands and tongue, 18. [680.]
Tremor of the hands, so that could not lift anything, eat, or write; marked tremor of the neck and lower extremities, 69.*
Trembling, which disabled him from writing, drawing, or working, and even from eating or drinking without assistance, 1.
Had to be assisted in everything like a child, 1.
Tremors so that she could not drink without assistance, 18.
Trembled so badly that he could do no work, and could not go upstairs without great danger of falling; had to be fed, dressed, and assisted in every other way like a child; could not go out of doors for three months; and, when the weather became warmer, began to creep rather than walk about the streets, 1.
Sudden tremors, 18.
Tremors occurred suddenly and unexpectedly, amounting to frightful convulsions, which throw her out of bed if she did not have tight hold of something; was obliged to be fed; speech entirely lost, 18.
The attack is sometimes sudden, at others gradual; with unsteadiness and shaking of the arms and limbs, which prevent walking, speaking, or masticating; for the tremors become frequent, may, almost constant; every action is performed by starts; if the occupation be continued, sleeplessness, loss of memory, and death terminate the scene; a peculiar brownish hue of the whole body and dry skin generally accompany the disease. In its first attack it may be taken for St. Vitus's dance, in its later stages for delirium tremens, 52.
Very great tremors, 21.
Violent tremors, so that she was obliged to lie down, 18. [690.]
Violent tremors, with jerking of the hands, feet, and head (rats and mice inhabiting the mines became affected with tremors and convulsions, like men), 27.
Violent tremor, which at times made it impossible for her to take food or work, 18.
Violent trembling, first of the hands, afterwards of the whole body. Shaken by continual spasm; he could not speak, nor could he carry his hand to his mouth without striking himself; he was obliged to be fed, 10.
Tremor very violent; especially on any excitement, preventing speech, 18.
Such violent general trembling that she was confined to her bed for nine months, when she was frightened out of it by an alarm of fire, which endowed her with momentary strength, 1.
A sudden violent attack of tremor, without vertigo, so violent that speech was difficult and he was obliged to keep his bed, 18.
Frightful tremors, with inability to speak, take food, etc., accompanied by sleepiness, with stupefaction, vertigo, starting up, violent headache, great weakness of memory, great anxiety, tightness of the chest, roaring in the ears, flickering before the eyes, constant motion of the eyeballs, and bends of the limbs, 18.
Frightful convulsive tremors, with unintelligible speech, inability to walk, violent attacks of vertigo; the tremors prevented sleep, 18.
Trembling at first came on at long intervals; but finally, after a feverish attack that lasted five days, it became continuous, and so bad that he could neither talk, work, nor eat, 1.
Tremors in paroxysms almost daily, often several times a day, generally worse in the morning than in the evening; these paroxysms interfered with his work; they often occurred spontaneously without known cause, but were especially violent after emotional excitement; the whole body and head trembled violently; he could scarcely stand upon his limbs; it was difficult to speak; he was like a man shaking with the most violent chill, only there was no cyanosis, 18. [700.]
Tremors aggravated by emotional excitement, 37.
Tremors recurred for years from any emotional excitement, 18.
During rest the patient did not tremble, but on the slightest emotional excitement, even when spoken to, there was trembling of the arms, legs, and head, so that she was obliged to sit down, and the pulse became accelerated, 18.
When the women were asked why they did not speak they, almost without exception, answered that the visit frightened them, excitement seemed to cause trembling, 23.
Tremor, not constant, but especially noticed when under the influence of surprise or fear, 4.
Every attempt at voluntary motion in creased the tremors, 37.
On every attempt to exercise the voluntary muscles, the tremors take place, 53.
In general, so long as he does not attempt the performance of an act of volition, the muscles are not agitated, but on attempting any motion the tremors and jactitation occur, 54.
Trembling after standing or walking a long time, disappearing during rest, 18.
Tremors, not during rest, but on attempting to make any muscular exertion, except of the neck and face; the tremors lasted as long as the muscles were exercised, when they also extended to the groups of muscles not in motion; so the outstretched hand trembled; especially on stretching out the fingers and on repeated pronation and supination of the arm the whole body trembled; the protruded tongue trembled very violently. All the muscles reacted completely to the galvanic current, 38. [710.]
While walking and standing, the trembling is not so marked, but as soon as the patient closes the eyes the trembling becomes much worse, when it is noticed even in the feet, 80.
Trembling of the muscles of the head and spine, so that on account of the general tremors can neither stand nor sit on a chair without danger of falling; the tremors ceased only while asleep in bed, 28.
Those suffering from salivation rarely had tremors, 2a.
Tremors alternating with violent general convulsions, 37.
Shaking palsy, which lasted all his life, 65.
General clonic spasms of all muscles of the body, ushered in by violent spasmodic pains; the paroxysm was so violent and accompanied with so much raving that the patient was placed in the delirious ward; after a year, a second similar attack occurred; the consciousness was never lost, the tongue never bitten; the attacks were preceded by vertigo and confusion of the head, 79.
Violent spasmodic affection. The head, arms, and fingers, particularly on the left side, presented a succession of quick, convulsive, jerking motions. The angles of the mouth were retracted, the eyebrows twitching, the head constantly thrown back, but the agitation scarcely raised the arms. The nostrils were spasmodically dilated. The sterno-mastoid, trapezius, scaleni, diaphragm, and the abdominal muscles were similarly affected. Their contractions were short, rapid, and painful. From the constant hiccough with which the spasms of the diaphragm were attended, and the jerking motion of the tongue, his speech was interrupted and indistinct. He was occasionally free from spasms altogether, but whenever he transmitted volition to any part of the muscular system, it became instantly affected. When he endeavored to raise his foot from the ground it quivered and fell quite powerless and useless. Whenever he attempted to carry a vessel to his lips he generally overshot the mark, carrying the vessel towards his ear, nose, or forehead, and spilling its contents on his face or neck, so that it was a common saying among the patients in the ward, that he did not know the way to his mouth. But if a vessel was applied to his lips by another person, he could swallow easily. A sudden blast of cold air, the application of a cold hand to the skin, or the abrupt entrance of any person into the ward brought on an attack of spasms. The muscles of the left hand and left side were affected much more than those of the right. After a few days, the spasms of the left side continued, though much less severe. Those of the purely voluntary muscles of the right ceased, while the spasms continued in the respiratory muscles on the side, 16.
Irregular and gradually increasing spasmodic action, affecting more particularly the hands, which were in almost constant motion; the left was most convulsed, and the moment he was spoken to the convulsive action increased. If he attempted to make any voluntary exertion, as taking hold of anything, the hand was thrown in every direction with short but violent convulsive catches. When lying quite undisturbed, the motion was often for a time suspended; he had also a hurried, convulsive, and indistinct mode of articulation, 50.
Frightful convulsive spasms; inability to speak or leave the bed, with great anxiety and roaring in the ears, 18.
Paralysis, 5, 8. [720.]
All, sooner or later, became paralytic and die hectic, 2.
Died with symptoms of apoplexy , one side and the tongue being paralyzed, 7.
Decay of the bodily and mental powers went on unceasingly, 17.
*Weakness, 18, 28, 31 , etc.
A child born during the mercurial disease was weak, had to be fed because the mother had no milk, and died after seven weeks, this woman afterwards had eleven confinements but only five living children, 18.
Great weakness, 21.*
General weakness, approaching to palsy, 66.*
General weakness, at first affecting the left and afterwards the right arm, weariness, with general tremors increasing very rapidly, so that she was obliged to keep her bed; this was followed by violent pains and cramps in the right arm that lasted three days, followed by complete paralysis; for this weakness the patient was kept in bed; this was associated with great mental weakness, hallucinations, delirium, aphonia, and almost complete blindness and loss of hair; her mind returned slowly and gradually, and her right arm regained a portion of its former power, but was never strong; after some years the arm was emaciated and at times affected by violent tremors; sensibility was perfectly acute; the slightest touch or the prick of a pin was instantly felt, and followed by reflex motion, and the muscles reacted perfectly to electrical stimulus, 18.
Sudden attacks of weakness and trembling, 2a.
Progressive weakness, until the patient is no longer able to walk, 30. [730.]
Weakness that increased so that he was unable to walk about the room alone; was constantly obliged to keep his bed, 18.
Debility, at first of the lower limbs, afterwards affecting the arms and hands, then becoming general, and soon succeeded by visible tremor (after eighteen years), 70.
Much debility, 13.
Enfeebled, 49.
General exhaustion, 18.
Collapse; with swelling of the gum, fetid breath, hiccough, agrypnia, retention of urine, 78.
Some were obliged to sit or lie the whole day, and on attempting to stand they fell to the ground, 2a.
Attacks of faintness, during which she did not entirely lose consciousness, accompanied by a peculiar distressing sensation in the right hypochondriac region (after some years), 18.
Three attacks of faintness in one day; the first was caused by starting at something falling to the floor, 18.
Restless, nosy (younger), 56. [740.]
A universal uneasiness of body, so that he could not remain one moment in the same posture, 42.*
Subjective.
General bodily torpor, 5.
General anæsthesia, with a sensation of numbness and fuzziness, especially of the fingers, 18.
Cutaneous sensibility more obtuse in the limbs than in the trunk, and in the right lower extremity than in the left, 55.
Diminution of the sense of touch, 18.
The sense of touch became blunted, 24.
General state of troublesome excitement, 43.
Very easily startled, 18.
Startled and flurried by slight causes (one), 51.
General sense of great debility (one), 51. [750.]
Painfulness of the affected parts, 57.
All affected parts painful (after nine days), 59.
All affected parts very painful (after eight days), 60.
*Bone-pains, 19, 29.
Pain in the head and bowels, 42.
Much pain in limbs and loins (one), 51.
Severe pain all over, worse at night, 47a.
Wandering pains, 75.
Rheumatic troubles, 18.
Rheumatic pains, especially in shoulders and forearms, 18.
Drawing in the bones, 45. [760.]
Nightly drawing pains in the head and extremities, 20.
Shooting pains and a sense of formication in various parts of the body, 16.
Tearing pains in the face, head and neck sometimes accompanied the stomatitis, 33.
Young people are more easily affected than old, 18.

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), 71.*
Groins and thighs very itchy and painful, with eruption on thighs (after ten days). Very copious red eruption and general erythema all over the thighs, Eruption slightly elevated above skin and somewhat rough to touch. It extended pretty generally over lower extremities, and had also appeared on arms and hands. In some places, small vesicles (after twelve days). Erythema has extended over arms, and the eruption over greater part of body. An exudation of a serous, yellowish fluid has also taken place, particularly from the inside of his thighs, groins, and contiguous parts, which, when dry, stiffens his linen (after fourteen days). In a few days, the erythema had extended over the whole skin, which was everywhere very painful, somewhat swelled, and most distressingly itchy, attended with a considerable desquamation of the cuticle. The exudation became more general, frequent, and copious; the smell which issued from him was peculiar and very offensive. Cuticle begins to come off in large portions. The discharge is attended with a most unpleasant and peculiar odor. Trunk of body and extremities, particularly feet, considerably swelled (after twenty-two days), Exudation more general and copious than it has yet been, attended with much itching. Smell from discharge still more offensive (after twenty-three days). Swelling of face so considerable this morning when he awoke, as nearly to close his eyes. The cuticle is falling off in portions of very considerable side, especially from his hands. Feet still more swelled, and of a deeper red color (after twenty-four days). Erythema continues almost general, the pain and itching very distressing, the exudation very profuse, and the fetor exceedingly offensive. Lips and eyelids more swelled; tarsi and eyes considerable inflamed (after twenty-five days). The exudation which had taken place on the forepart of the breast, belly, and extremities, in also coming from his face to-day, which is more swelled, and there is considerable desquamation from his shoulders and back (after twenty-six days). Copious exudation from the breast. Considerable desquamation from the face (after twenty-seven days). Exudation very general. Desquamation begins to extend to hairy scalp (after twenty-eight days). Back very itchy, as usual before the exudations, which, however, have been rather less frequent for several days; but his skin continues very painful, the fetor very strong, and large portions of the cuticle are falling off (after thirty days). Some swelling in many place where the cuticle had peeled off. The newly formed cuticle cracked during the night, and a considerable exudation succeeded (after thirty-two days). Exudation diminished; but skin still very painful, and feet and hands much swelled (after thirty-four days). Exudation again more profuse (after thirty-six days). Exudation very profuse (after thirty-eight days). Swelling of hands nearly gone; that of feet continues, and the newly formed cuticle is coming off lower extremities in pretty large portions (after thirty-nine days).
Exudation much diminished (after forty-four days). Exudation nearly gone except from back of head; but skin still itching, and very painful, especially when he moves; feels as if his flesh was cracking in pieces (after forty-seven days). Skin more painful (after forty-eight days). Some exudation for last two days, with restless night (after fifty days). Less pain and itchiness of skin to-day, but some exudation (after fifty-one days). Some flushing of face, and increased redness of trunk and extremities. Some exudation from different parts (after fifty-two days). Redness of trunk and extremities; pain and itchiness diminished. Exudation more general, and there is a discharge of purulent matter from his hands (after fifty-four days). Exudation chiefly from back (after fifty-six days). State of skin still occasions considerable uneasiness; some exudation from back of head, from which the hair is falling off (after fifty-seven days). Two small tumors, one on left breast towards sternum, the other on lumbar region of same side, which seem to contain a fluid, and are of a darker color than the rest of skin, but are very little painful (after fifty-nine days). Skin much better, itchiness much less troublesome, and smell much less offensive (after sixty days). Feet very tender (after eighty-three days). The soles of the feet continued so tender for many weeks, that he could hardly put a considerable time after he was quite well in every other respect, 13. [780.]
Whole surface of body hot and itching, with swelling and inflammation of the integuments, most considerable on face and eyelids. These symptoms were preceded and accompanied with alternate cold and hot fits, languor, prostration of strength, loss of appetite, thirst, and watchfulness. She continued in this state for fourteen days, when a scarlet eruption appeared over the whole cuticle, particularly on inside of arms, thighs, and legs; attended with an exudation, which was greatest from the groins and thighs, and with a disagreeable smell. In a few days, the eruption became dry and white; and afterwards the cuticle peeling off, and leaving the cutis very itching and tender, the new cutis became affected in the same way as the former, 12.
Eruption of many large sudamina on abdomen, chest, and upper limbs. The first appeared as round, transparent vesicles, varying in diameter from half a line to two lines, and with a red areola. These were filled with a clear liquid, excepting on the abdomen, where it was slightly turbid. Under the lower jaw were shreds of epidermis, caused by the desquamation of some of these vesicles. On the third day, several of the sudamina had dried up, and new one had appeared; on some portions of the chest and abdomen the desquamation took place in patches, owing to the coalescence of the swellings. On the sixth day, there were more new sudamina; and on the eighth day, thirty-six hours after death, many were still to be seen, containing a transparent liquid, and in all respects similar to the preceding, 55.
Erysipelas of the forearm; of the legs, 18.
Eczema on the back, appearing in the form of vesicles as large as the head of a pin, with violent itching, 18.
Eczema on the back of the foot, 18.
Herpes oris, 18.
Mercurial sore are not necessarily circular or oval in shape, neither are their regularly defined; on the contrary they vary in these particulars, and assume different forms as they spread; their edges are often quite ragged, loose, and undermined, and their borders are often marked with a thin, transparent cuticle, like that of a newly formed cicatrix, extending quite around them, and giving them a silvery-white appearance; their base are not hard, neither are their surfaces covered with the tenaciously adherent lymph so characteristic of venereal; on the contrary the surface of the mercurial ulcer may present every variety of shape and appearance, sloughy at one spot, deeply excavated and rapidly ulcerating at another, with exuberant granulations at a third, and exhibiting a tendency to heal at a fourth. But the most striking characteristic of the mercurial ulcer is its tendency to spread, and the manner in which it enlarges itself; it generally spreads quickly, and there seems to be no limit to the size it may possibly attain. I have seen one as large as my hand in each groin of the same individual; they are easily distinguished from the venereal, when they assume a herpetic character, and heal in one par whilst spreading in another, which the latter never do. The mercurial ulceration often attacks the cicatrix of a recently healed chancre, and a fresh sore is thus formed, 61.
Several ulcers with whitish-gray bases, bleeding easily, and exuding thin matter, 75.*
Serpiginous ulcers in the skin (after working several years), 20.*
On the face, eruption consisting of a tetter about the mouth and on the cheeks, with hard and very superficial ulcers, 18. [790.]
Erysipelas and gangrene of the lips, with violent fever, thickly coated tongue; the gangrene extended and destroyed also a portion of the right cheek; there developed also on the right temple a gangrenous spot, which on opening discharged offensive gas and pus (the patient died after three weeks with hepatization of the upper portion of the left lung), 63.
Ulcer on the foot, 19.
Small easily bleeding ulcers, of a dirty-white color, with livid borders, on the lips, 37.
Varicose ulcers on the extremities were frequent; indeed it was an exception to find a worker free from them, 18.
Sensations.
Formication, 37.
Fuzzy feeling in the arms and hands, 37.

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.
Very copious perspiration, 34.
Profuse perspiration, at night, 18.*
Profuse offensive perspiration, 18.* [840.]
Skin dry; easily desquamating, 21.

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.

Mercurius