the consequence of its milder compounds, either given medicinally in frequent small doses, or applied continuously to the bodies of workmen who are exposed by their trade to its fumes.
The secondary and chronic effects of mercury are multifarious enough in reality; but if credit were given to all that has been written, and is still sometimes maintained on this subject, almost every disease in the nosology might be enumerated under the present head; for there is scarcely a disease of common occurrence, which has not been imputed by one author or another to the direct or indirect operation of mercury. The present remarks, however, will be confined as much as possible to what is well ascertained, and bears on the medical evidence of poisoning with mercury, or is important in regard to medical police. With this view, salivation and its concomitants, the most usual of the secondary effects of mercury, will first be treated of. Some observations will then be made on the shaking palsy, or mercurial tremor, which is caused in those who work with mercury. And in conclusion, a short view will be taken of the other diseases which are more indirectly induced by this poison, as well as some which have been ascribed to it on insufficient grounds. This being done, the mode of action of mercurial poisons will be resumed, and a description given of their relative effects when introduced by different channels and in different chemical forms.
Of Mercurial Salivation.—Mercurial salivation may be caused by any of the preparations of mercury, and either by a single dose or by frequently repeated small doses. It may be caused by corrosive sublimate as the secondary stage of a case which commenced with inflammation in the alimentary canal; or it may be the first sign of mercurial action, as in the medicinal mode of administering calomel and blue pill. Even in the latter case a single dose, and that not large, may be sufficient to induce pytalism of the most violent kind. When induced by a single dose it usually commences between the beginning of the second and end of the third day, rarely within twenty-four hours. But an extraordinary case is mentioned by Dr. Bright, where five grains, put on the tongue in apoplexy and not washed over, excited in three hours most violent salivation, with such swelling of the tongue that scarifications became necessary.[1] It commences with a brassy taste and tenderness of the mouth, swelling, redness, and subeequently ulceration of the gums; peculiar fetor of the breath; and at last an augmentation is observed in the flow of the saliva, commonly accompanied with fulness around the lower jaw. These symptoms increase more or less rapidly. Sometimes they are very mild; nay, this form of the secondary effects of mercury may consist in nothing else than brassy taste, tenderness of the mouth, redness of the gums, and fetor. On the other hand, the symptoms are often very violent, the salivation being profuse, the face swelled so as to close the eyes, and almost fill up the space between the jaw and clavicles, the tongue swollen so as to threaten
- ↑ Reports of Medical Cases, ii. 337.
