mercurial inunction form a well-known and satisfactory proof of this. Even without the aid of infriction, the soluble preparations of mercury will excite mercurial action by being put simply in contact with the skin. Thus it has been shown by a German physician, Dr. Guerard, that pytalism may be induced by a warm-bath of corrosive sublimate in the proportion of an ounce to 48 quarts of water, and that the effect commonly begins after the third bath with an interval of three days between them.[1] It is not so generally known that the more active preparations, such as corrosive sublimate or nitrate of mercury, may, like arsenic, cause through the sound skin effects almost as violent as through the alimentary canal. The following pointed illustration is related by Dr. Anderson. A gentleman affected with rheumatism, was persuaded by a friend to use a nostrum, which was nothing else than a solution of half a drachm of corrosive sublimate in an ounce of rum. This was rubbed on the affected part for several minutes before going to bed. Ere the friction was ended, he felt a sensation of heat in the part, to which, however, he paid little attention. But during the night he was attacked with pain in the stomach, sickness, and vomiting, and soon after with purging and tenesmus. In the morning Dr. Anderson found him very weak and vomiting incessantly. The arm up to the shoulder was prodigiously swelled, red, and blistered. Next day he complained of brassy taste and tenderness of the gums, and regular salivation soon succeeded.[2] Another case of much interest has been described by my colleague, Professor Syme, where a solution of the nitrate was rubbed by mistake upon the hip and thigh instead of camphorated oil. Intense pain immediately followed, and afterwards shivering; the urine was suppressed for five days, without any insensibility, and during its suppression urea was detected in the blood; pytalism appeared on the third day, became very profuse, and was followed by exfoliation of the alveolar portion of the lower jaw, but recovery nevertheless slowly took place.[3]
The mere carrying of mercurial preparations for a length of time near the skin, though not in direct contact with it, may be sufficient to induce the peculiar effects of the poison, as the following example will show. A man applied to a German physician, Dr. Scheel, affected with violent salivation evidently mercurial which proved fatal, but which it was impossible to trace to its real cause till after death, when a little leathern bag containing a few drachms of mercury was found hanging at his breast; and it was then discovered that he had been in the practice of carrying this bag for six years as a protection against itch and vermin, and during that period had frequent occasion to renew the mercury.[4]
The effects of mercury as a poison differ with the chemical form in which it is introduced into the system.
In its metallic state it is probably inactive. This fact is a material
