Mercurius Vivus - General symptoms

GENERAL

General

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,.

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,.

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),.

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,.

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),.

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),.

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),.

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),.

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.

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,.

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,.

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,.

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.

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,.

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),.

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,.

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.

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,.

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,.

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),.

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,.

GENERAL SYMPTOMS.

Objective.

Emaciation, ,

He was emaciated and cachectic, and looked prematurely old,

Considerable emaciation (after thirty-eight years),

Great emaciation,

Excessive emaciation,

Body wasted,

Cachectic condition,

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,

One child of a woman-worker was badly nourished, and when a year old had no teeth,

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,

The children of the workers are very commonly affected by scrofula, rachitis, and tuberculosis,

Her child had the rickets,

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,

Mercurius Vivus 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,.

but one case was treated by Prof. Thiery, in Brussels.

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,.

The first symptom was persistent diarrhoea, 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 diarrhoea, 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 Carbo Veg ^charcoal.

afterwards she was attacked with weakness, vertigo, uneasy sleep with heavy dreams, loss of memory, affections of the mouth, which she treated with Alumina ^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.

Cuprum Metallicum ^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,.

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,.

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),.

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),.

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,.

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 Tuberculinum ^tub, and it required the force of two men to prevent him from being actually ejected,.

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,.

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,.

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,.

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,.

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.

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,.

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,.

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,.

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,.

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,.

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,.

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, praecordial 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,.

($56$) MERCURIUS OXYDULATUS NIGER. Mercurius Solubilis ^{Mercurius solubilis Hahnemanni}. Dimercuros ammonium nitrate. 2(NH2Hg2) NO3H2O. Trituration. ($5.6$) MERCURIUS VIVUS. Hydrargyrum. Argentum vivum. Chamaeleon minerale, &c. Metallic Mercury. Quicksilver. Hg (A. W. 199.8). Trituration.

Abscess (s). Anaemia. Aphthae. Appendicitis. Balanitis (s). Bone, disease of (s). Brain, inflammation of. Breath, offensive (s). Bronchitis (s). Bubo (s). Cancrum oris. Catarrh (s). Chancre. Chicken-pox (s). Cold (s). Condylomata. Cough (s). Dentition, abnormal (s). Diarrhoea (s). Dysentery. Dyspepsia (s). Ecthyma (s). Eczema. Emaciation. Excoriation (s). Eyes, affections of (s).

gouty inflammation of. Fainting. Fevers. Fissures. Glandular swellings (s). Gout (s). Gum-boil (s). Gums, unhealthy (s). Heart, affections of (s). Herpes (s). Hydrophobia. Jaundice (s). Joints, affections of (s). Leucorrhoea.

mapped (v). Toothache (s). Tremors (s). Typhus fever (v). Ulcers (s). Vaccination (s). Vomiting (s).

many having been severely affected by absorbing it through their hands. There is no difference between these effects and the symptoms of the proving so far as the general characteristics are concerned. In the finer characteristics there must be differences. The symptoms of the proving are in general more particularly characterised than the effects of Merc. viv. For instance, "At night severe toothache, and when that went off great chilliness through the whole body," belongs to the Merc. sol. proving.

and so do these "Vertigo when sitting at his desk there was whirling in the head, as if he were drunk, he rises up and walks about the room staggering, then anxious heat breaks out over him, with nausea but not to the length of vomiting.

at the same time some headache." "From occiput a strong, tearing, continued pain, which went into the forehead and there pressed." The symptoms of nose-bleed and the more finely characterised throat symptoms ("stitches on tonsils"; "stitches into ear on swallowing"; "something hot rises into throat.,"), were produced by Merc. sol., so were the majority of the symptoms in the male and female sexual organs. But this is not to say that Merc. viv. will not answer equally well, or even better, for curing them. The only bit of comparative experience I have in the action of the two is this in a case of cold in which Merc. seemed indicated, Merc. sol. 30 was given and failed, and Merc. viv. 30 promptly cured.

agg. by heat and agg. by cold.

Especially is this noticeable in the bone pains.

No. 3 is Profuse sweat accompanying nearly all complaints and which does not relieve; it may even aggravate.

Guided chiefly by these two indications "Profuse sweat with no relief" and "agg. at night," I have cured many cases of rheumatic fever with Merc. viv. 12, without any other remedy.

Keynote No. 4 is The mercurial odour.

The mercurial patient is offensive; breath excessively fetid; sweat offensive, mawkish, sweetish.

Keynote No. 5 is tremor.

Mercurius Vivus symptom is so pronounced and universal that it renders Merc. the best general remedy in paralysis agitans.

There is tremor of head, of hands, of tongue.

Tremors commencing in the fingers.

Short of this there is great tendency to fainting; extreme exhaustion after a stool.

The tremors may become jerkings and even convulsions.

Extreme restlessness. The mind is as weak and tremulous as the body; everything is done hastily.

Hurried and rapid talking.

On the other hand slow in answering questions; loss of memory; of will power.

Embarrassment. Absent-minded.

Imbecility. Time seems to pass slowly.

Desire to flee. Homesick.

Suicidal. Murderous. Merc. is Hahnemann's typical antisyphilitic remedy, as Sulphur ^Sul. is the typical antipsoric, and Thuja ^Thuja the typical antisycotic.

Bones, glands, and skin are affected.

Inflammation leads to induration, induration to ulceration.

Merc, corresponds accurately to the true Hunterian chancre.

Merc. ulcers have a grey, lardy, ashy, or cheesy base.

There are burning or stinging pains in them.

Another great feature of Merc., almost constituting a keynote, is the tendency to the formation of pus.

In the suppurative stage of small-pox it is specific.

Flow of pus, and particularly bloody pus, from any orifice calls for Merc.

Pus forms in cavities in abscesses, which burn and sting.

Discharges are yellow-green in colour.

Gonorrhoea. Fetid ear discharge.

Merc. is a great solvent it dissolves metals out of their ores and it dissolves living tissues, inducing excessive emaciation.

Lowly organised tissues as indurations, exostoses, and some tumours are melted first.

OEdema and dropsies are absorbed; rheumatic swellings.

If the doses of Merc. are large and dropsies disappear rapidly under them, the tissues themselves may disappear also in offensive rapidly decomposing ulcers.

The bones soften so that they will bend.

Whilst Merc. intensifies the action of the absorbents, it may also paralyse them, hence enlargement of glands, with pricking pains, inflammation, suppuration.

The liver is congested, enlarged, inflamed, stitches in the liver, sensitiveness in the liver and inability to lie on right side.

Mercurius Vivus "agg. lying on r. side" is a very characteristic condition of Merc., and when present Merc. should always be considered.

Along with the liver the stomach is disordered.

Sweets disagree; aversion to meat, wine, brandy, beer, coffee, greasy food, butter.

There is the characteristic flabby, coated, teeth-indented tongue, foul breath, and intense thirst.

Throat dry and forepart of tongue moist.

Merc. is rarely indicated when the tongue is dry.

Sliminess is a general characteristic.

Slimy stools; stools acrid, knotty, containing pus, viscid.

Just before stool a sick, painful, faint feeling comes on.

During stool there is tenesmus, or tenesmus and no stool.

Dysentery with much straining; never-get-done feeling when there is no more to come.

Diarrhoea with slime. "Merc. is rarely indicated in these troubles where there is no slime" (Guernsey).

Merc. affects profoundly the generative organs of both sexes.

It has stinging, cutting pains in ovaries; cutting pains from l. to r. in lower abdomen. "Stinging" is very frequent in mercurial pains, and "stinging pain in ovaries is just as likely to need Merc. as Apis Mel ^Apis" (Kent).

Almost all kinds of eruptions are produced by Merc.

Scurfy, syphilitic, pustular, moist, oozing, offensive eczema.

Shingles. Small-pox. They are all agg. by warmth and at night and agg. by cold.

In olden times it was recognised that a patient under a "course" of Mercury must be very careful not to catch cold.

Mercurius Vivus gives one indication for Merc. in abnormal tendency to catch cold.

But for this condition it must not be too frequently repeated, as it will aggravate it.

The patient needing Merc. is sensitive to every draught and yet agg. by warmth the nasal secretion is acrid, and the nose red and excoriated; dirty-nosed children" (Guernsey).

Old catarrhal smell in the nose inside nostrils smarting and burning.

Aching, tearing, and out-pressing in the bones. "Kali Iodatum ^{Kali iod}. is better for the same bursting in the face, running coryza, and agg. from heat and warmth of the bed" (Kent).

The eyes are very markedly influenced by Merc.; also the bones round the eye "Whenever cold settles in the eye in gouty and rheumatic patients" (Kent).

Every degree and kind of inflammation and ulceration is produced by Merc. and its salts.

J. J. Hirsch, of Prague (H. R., vii. 220), relates some striking experiences with a preparation of Merc. viv. which he learned from an old allopath.

Quicksilver is boiled in water for half an hour, two teaspoonfuls being given every two hours.

Hirsch's cases were those of acute inflammation of the brain, in which Belladonna ^Bell. was indicated, and in one of which Merc. (in the ordinary homoeopathic preparation) had already been administered in vain.

Mercurius Vivus is the case A black-haired girl, 9, had malignant scarlatina, which commenced six days before Hirsch (who came as consultant) saw the case, signs of brain inflammation having set in on the third day.

Hirsch found her unconscious, sharply defined redness of cheeks, pulse 120, hot skin.

Piercing screams were emitted from time to time; boring head in pillows; chewing motion of jaws; gnashing teeth.

Lips brown and dry; not much thirst; water not accepted readily; but milk seemed to be relished.

Reddened patches here and there, especially along neck.

Under the "decoction," which was given to the girl on Hirsch's suggestion, she slowly but steadily improved, and in a week was convalescent.

Among the Sensations of Merc. are Vibration in forehead. Head as if in a vice.

as if growing larger. As of sparks being emitted from eyes.

as of a body underneath lids.

as if feathers came from corners of eyes. As if a wedge driven in ear.

as if ice in it. as if cold water running out of it. Cracklings in head as from metal plates. As if weight on forehead.

as if weight hanging on to nose. As if teeth were loose.

were fixed in a mass of pap. As if hot vapours rising into throat.

of worm rising into throat, must swallow it down.

of apple core sticking in throat. As if mammae would ulcerate. As if everything in chest was dry.

Stabbing pains and stitches, burning, boring, digging, stinging, and dragging pains. Soreness and sensitiveness. Itching.

voluptuous itching. Merc. is more particularly suited to Light-haired persons with lax skin and muscle.

before falling asleep. agg. Blowing nose. agg. During a catarrh. agg. From cold air. agg. From taking cold. agg. From lamplight.

firelight. agg. During perspiration.

on getting warm in bed. agg. Before stool. agg. During urination and after. agg. Lying on right side. agg. Motion.

walking. slightest exertion. agg. Evening. Rest amel. Coitus amel. Weeping amel. agg. Touching anything cold (= pain in abdomen). agg. Bending forward (digestion immediately disordered). agg. After eating (if he eats ever so little it causes a dragging down in stomach).

Quicksilver. Hahnemann. The Element.

Violent. racking. worse at night, as if the head and chest would burst, sometimes with vomiturition.

in two paroxysms, from tickling in the larynx and upper part of the chest.

only at night or only by day.

with acrid, yellowish mucus, at times mixed with coagulated blood and tasting putrid or saltish.

with shortness of breath and salivation.

but allowing him to utter an audible word.

worse at night, in the night air, when lying on either side.

Mercury is used in testing the temperature, and a Merc constitution is just as changeable and sensitive to heat and cold The patient is worse from the extremes of temperature, worse from both heat and cold. Both the symptoms and the patient are worse in a warm atmosphere, worse in the open air, and worse in the cold.

The complaints of Mercury when sufficiently acute to send him to bed are worse from the warmth of the bed, so that he is forced to uncover.

but after he uncovers and cools off he gets worse again, so that he has difficulty in keeping comfortable. This applies to the pains, the fever, ulcers and eruptions and the patient himself.

He is an offensive patient. We speak of mercurial odors. The breath especially is very foetid, and it can be detected on entering the room.

it permeates the whole room. The perspiration is offensive.

it has a strong, sweetish, penetrating odor. Offensiveness runs all through.

offensive urine, stool and sweat.

the odors from the nose and mouth are offensive. When Merc is used in large doses and the patient is salivated he gives off these odors.

One who has once smelt a salivated patient will remember the mercurial odor. I remember when I was a student, almost every room had the mercurial odor. Mercury was given till the gums were touched and salivation was produced. That odor is often an index to the use of Merc

He is worse at night The bone pains, joint affections and inflammatory conditions are all worse at night and somewhat relieved during the day. Bone pains are universal, but especially where the flesh is thin over the bones. Periosteal pains, boring pains, worse at night and from warmth of the bed.

The glands are inflamed, and swollen.

the parotids, sub-linguals, lymphatic glands of the neck, groin and axilla are all affected.

the mammae swell and there is inflammation and swelling of the liver. It is pre-eminently a glandular remedy. Induration is also a general.

inflamed parts indurate If the skin is inflamed it is hard. Inflamed glands are hard.

There is induration with ulceration. A tendency to ulcerate runs through the remedy. Ulcers are found everywhere, in the throat, nose, mouth, and on the lower limbs. Ulcers sting and burn and have a lardaceous base, an ashy-white appearance looking as if spread over with a coating of lard. It looks like a diphtheritic exudate, and Merc has diphtheritic exudations on inflamed surfaces.

Ulcers in the throat have this appearance. The mucous membrane sometimes inflames without ulceration, but with exudation, and hence it is useful in diphtheria It has the same condition in ulcers.

Another marked feature is the tendency to the formation of pus With inflammation there is burning and stinging and the rapid formation of pus and the part is aggravated by both warmth and cold. Abscesses burn and sting.

inflammation of joints is attended with pus formation.

Rheumatic inflammation of joints and catarrhal inflammation of mucous membrane are features running through the remedy, and these are attended with sweat, and an astonishing feature is that the sweat does not relieve, and there is even an aggravation while sweating

After a prover has taken Merc a long time he emaciates. This is seen in old mercury takers and in syphilitics who have been mercurialized. It is a great remedy in this condition-steady emaciation with trembling, worse at night and from the warmth of the bed, great restlessness, can't find peace in any position. These miserable wretches, who are breaking down, are great sufferers, whether psoric, syphilitic or sycotic.

A strange feature is repeated swelling and abscess formation without any heat. An abscess or swelling in a joint forms, and he sweats from head to foot, is worse at night, loses flesh, trembles and is weak, but there is no heat while the abscess goes on. Abscesses form when the life force is so low that there is no tendency to repair.

a slow and prolonged pus formation, no irritability in the abscess, no tendency to granulate, it opens and keeps on discharging and seems dead. Merc will warm it up, stop the sweat and favor granulation.

The superficial ulceration is inclined to spread and become phagedenic.

it is not deep but grows larger. These open ulcers are especially seen in old syphilitics.

lardaceous base. not much irritability, they are even numb, and if pus is discharged it is greenish-yellow.

false granulations appear. Mercurius Corrosivus ^{Merc. cor} is a greater remedy for the superficial, eating, phagedenic ulcer.

At times Merc takes on a gangrenous condition. This may be seen anywhere, but especially on the lips, cheeks and gums. Cancrum oris. Gangrenous chancre, foetid and black; a sphacelus forms in the chancre and the part sloughs off. All these conditions are aggravated by beat.

A patient with a typical Merc abscess rebels at times against the poultice, for it makes the trouble worse.

Trembling runs through the remedy, quivering all over. It has been used with benefit in paralysis agitans. Tremor of the hands so that he cannot lift anything or eat or write. Merc is a great remedy in children with epileptiform fits, twitching and disorderly motions. It will help children to grow out of these in coordinate angular movements of the hands and feet.

Jerking, twitching and trembling. The motions of the tongue are disorderly and the child cannot talk. Convulsions. Involuntary motions which can be momentarily controlled by volition. The restlessness is extreme.

The trembling, weakness, sweat, foetor, suppuration and ulceration, the aggravation at night and from heat and cold, give the earlier impressions of the remedy.

A marked feature running all through is hastiness.

a hurried, restless, anxious, impulsive disposition. Coming in spells, in cold cloudy weather, or damp weather, the mind will not work, it is slow and sluggish and he is forgetful. This is noticed in persons who are tending toward imbecility. He cannot answer questions right off, looks and thinks, and finally grasps it. Imbecility and softening of the brain are strong features.

He becomes foolish. Delirium in acute complaints. From his feelings he thinks he must be losing his reason. Desire to kill persons contradicting her. Impulse to kill or commit suicide.

sudden anger with impulse to do violence. She has the impulse to commit suicide or violent things, and she is fearful that she will lose her reason and carry the impulses out. Impulsive insanity, then, is a feature, but imbecility is more common than insanity.

These impulses are leading features. The patient will not tell you about his impulses, but they relate to deep evils of the will, they fairly drive him to do something. Given a Merc patient, and he has impulses that he tries to control, no matter what, Merc will do something for him. During menses, great anxiety, great sadness. Anxious and restless as if some evil impended, worse at night, with sweat.

Al these symptoms are common in old syphilitics, broken down after mercurial treatment and Sulphur ^sulphur baths, at the springs, with their bone pains, glandular troubles, sweating, catarrhs and ulcerations everywhere.

It began as an otitis media with discharge which was suppressed. Two or three doctors were called and could do nothing. In the night I went to the bedside and got the history and symptoms of Merc Merc re-established the discharge in twenty-four hours, the torticolis passed away, the fever subsided and the child made an excellent recovery. I can recall many such cases.

There is a tension about the scalp as if it were bandaged. Nervous girls have headache over the nose and around the eyes as if tied with a tape, or as if a tight hat were pressing on the head. Pressing, tearing pain in the eyes. Burning pains in the temples ameliorated by sitting up and moving about, worse at night.

Periosteal pains worse in cold, damp weather, in rheumatic and gouty constitutions, with sensitiveness in the eyes and ears, sore throat and glandular swellings. Headaches in old mercurialized syphilitics.

they become barometers.

sensitive to the weather. The catarrhal headaches are very troublesome.

headache in those suffering from chronic catarrh with thick discharge.

The thick discharge becomes watery and the pain in the forehead, face and ears very distressing. These headaches are violent. Chronic rheumatic headache from the suppression of a discharge from any part, or from foot sweat suppressed.

alternation of foot sweat and headache. When the foot sweat is gone he has pain and stiffness in the joints.

Silicea ^Silicea has that also. Silicea ^Sil. and Merc do not follow each other well, when well selected.

but if crude Mercury has been taken for a long time, Silicea ^Silica, like Nitric Acid ^{Nitric acid}, is a good remedy to eliminate it when the symptoms agree.

With all headaches there is much heat in the head. Bursting headaches, fullness of the brain, and. constriction like a band. Vise-like pressure. He is sensitive to the air when he has headache. This is true of Merc all through. He is relieved in the room, but worse in a warm or cold room, and violently worse from a draught. He wants to be covered but is worse from heat. The hoop-like sensation is worse at night.

Merc is a wonderful remedy to ward off acute hydrocephalus after measles and scarlatina; the child rolls the head and moans, and the head sweats. It is closely related to Apis Mel ^Apis, which is also a great remedy after scarlet fever to ward off or cure hydrocephalus. Exostoses in old syphilitics.

Lacerating, tearing pains in the pericranium.

The whole external head is painful to touch The scalp is tense and sore. Foetid, oily sweat on the head. Children have moist eczema, an excoriating, offensive eruption.

Every cold settles in the eye in gouty and rheumatic patients. Catarrh of the eyes worse from looking into the fire or rather from sitting close to the fire; the radiated heat causes smarting. Eyelids forcibly drawn together as if long deprived of sleep. Fog or mist before the eye. Merc. cures iritis in syphilitics.

The rule now-a-days is to use a mydriatic in iritis to prevent adhesions. I have treated many cases and I have no desire to dilate the pupil. I believe it is unnecessary. The homoeopathic remedy will stop the iritis speedily so that no adhesions will form, and if they have begun the remedy will remove them. Pains tearing and burning around the eyes, in temples, etc. Tension of the scalp as if it were a tight fitting cap, or tension as from a tape.

Ulceration and inflammation of the cornea. Vascular appearance of the cornea.

inflammation, especially confined to the cornea, sometimes pustular, sometimes diffused. There is copious lachrymation with all eye symptoms, and the tears excoriate, causing a red line down the cheeks. Greenish yellow, or a green discharge. Lids spasmodically closed. Great photophobia. In inflammatory conditions of all the tissues of the eye lids, conjunctiva and deeper structures. Colds settle in the eye like Dulcamara ^Dulc.

Sometimes you will see a little fine growth on the Iris Versicolor ^iris, growing across the pupil and attached by a pedicle. It is really a syphilitic condylomata. Merc cures it in a few days. Inflammation of the retina and choroid and of the optic nerve. All sorts of disturbed vision. It is useful in purulent ophthalmia, with swollen lids. Two kinds of constitution need it, the syphilitic and the rheumatic or gouty. He can not open the eyes.

they are spasmodically closed, and there is great tumefaction.

Merc has stinging pain like Apis Mel ^Apis. All routinists will give Apis Mel ^Apis for stinging pains, and yet it often is Merc that the patient needs. Purulent, offensive otorrhoea. Enlargement of the parotids and cervical glands with all inflammations of the ears. Parotids sore and enlarged, neck stiff, and head sometimes drawn back., Furuncles in external canal. Fungous excrescences and polypi.

The nose troubles would take a long time to describe.

Old syphilitics, with nasal bones affected, thick, greenish, yellow, acrid, stinking discharge. Nosebleed and bloody discharge from the nose. Coryza acrid, watery, with pressure through the bones of the face, worse from heat or cold, worse at night.

sensitive to every draught.

must get up and walk the floor. It has coryza with much sneezing with an opposite state, ameliorated lying, not at all during the night while lying in bed, only in the daytime while up and about.

The inhalation of hot air feels good to the nose, but the heat aggravates the body. Incessant sneezing. Bleeding, scurfy, red nostrils. Old catarrhal smell in the nose. Rawness, burning and swelling. Inside of the nostrils smarting and burning. Aching, tearing and pressure in the bones. Bones of the face painful, feel as if pressed outward, and be wants to press, but it is painful.

Merc is not deep enough to cure the whole constitution in psoric cases that are constantly taking cold. It cures the cold at once, but implants its own nature and the patient catches cold oftener. It should not be given often, not oftener than twice in a winter. Kali Iodatum ^{Kali iod}, is better for the same burning in the face, running coryza, and aggravation from heat and warmth of the bed, and it will cure the coryza in a night when apparently Merc is indicated. it is also an antidote to Merc Don't give many doses of Merc in psoric cases.

look for a deeper medicine.

Scorbutic gums in those who have been salivated. Rigg's disease.

purulent discharge from around the teeth. Toothache.

every tooth aches, especially in old gouty and mercurialized patients. Looseness of the teeth. Red, soft gums. Teeth black and dirty. Black teeth and early decay of the teeth in syphilitic children, like Staphysagria ^Staph. Copious salivation.

Gums painful to touch. Pulsation in the gums and roots. Gums have a blue red margin, or purple color, and are spongy and, bleed easily. Gums settle away, and the teeth feel long, and are elongated. Teeth sore and painful so that he cannot masticate. Abscesses of the gums and roots of the teeth.

The taste, tongue and mouth furnish important and distinctive symptoms. As the tongue is projected it is seen to be flabby, has a mealy surface, and is often pale. The imprint of the teeth is observed all round the edge of the tongue. The tongue is swollen as if spongy, and presses in around the teeth and thus gets the imprint of the teeth. Inflammation, ulceration and swelling of the tongue are strong features.

Old gouty constitutions have swollen tongue.

the tongue will swell in the night and he will waken up with a mouthful. The taste is perverted, nothing tastes right. The tongue is coated yellow or white as chalk in a layer. Offensive mouth.

putrid odors from the mouth especially the mercurial odor of the salivated patient. The tongue becomes clumsy.

difficulty in talking.

his speech is hardly intelligible. Awkwardness of the tongue as in persons intoxicated. Ulcers flat.

eating ulcers. holes are eaten through the cheek. Eating away of the soft palate and the bone of the bard palate is often eaten away.

Purulent formation in the antrum of Highmore and fistulae from the mouth to the antrum. Fluoric acid and Silicea ^Silicea are more frequently indicated in these fistulae, especially if the bone is involved. Copious flow of foetid saliva Sore mouth of children and nursing mothers.

little aphthous patches with the mercurial odor and flabby, spongy appearance of the mucous membrane and tongue. General diffused inflammation of the mouth. The whole mucous membrane is sensitive and painful, burning, stinging and smarting.

dryness with or without aphthous patches. Thrush of children. Scorbutic gums.

Swallowing is attended with difficulty, pain and paralytic weakness, and the effort to swallow forces the bolus up into the nose, and liquids come out through the nostrils. The mercurial odor is a strong feature, but Merc. often cures when that odor is not perceptible.

it has such an affinity for the throat. it has chronic throat troubles and syphilitic ulcers and patches.

The inflammation extends upwards and downwards, red and pale patches, the red looking as if they would suppurate or ulcerate. The red spots become quite purple, but the more purple they are the more they are like Lachesis ^Lach Tonsils dark red with stinging pains. Quinsy, after pus has formed. It is useful in diphtheria, and most cases are diffused, extensive patches or patches here and there, with spongy appearance, but no ulceration. Tumefaction.

and the exudations are upon a tumefied base. Stiff neck. Erysipelatous inflammation of the throat. Dark, sloughing, eating, corroding ulcers in the throat.

Milk disagrees, and comes up sour. Sweets disagree. He is turned against his beer. The stomach is chronically disordered.

eructations, regurgitations, heartburn, etc. Sour stomach.

it is foul. He has nausea with vomiting and regurgitation of food. In such a stomach food is like a load. Bad taste.

bitter mouth. be tastes the food.

it comes up sour.

With all this the saliva constantly runs from the mouth. It does not improve as digestion goes on. The half-digested substances are vomited. It is like the state in persons who have destroyed their stomach from crossing liquors, beer, wine and whisky.

Liver The liver furnishes much trouble.

Our forefathers for years took blue mass every Spring to regulate the liver. They physicked themselves with it and tapped their liver every Spring with it, and as a result they had worse livers than they would have had if the doctors had stayed at home. Constipation, bilious habits and disordered stomach.

The fullness in the region of the stomach, coming in spells, worse in cold, damp weather and warm, damp weather, worse in the Spring, jaundiced condition, disordered stomach, the aggravation at night and from the warmth of the bed, nightly feverishness and foul mouth, will give you the Merc. state.

Stitches in the liver. Liver symptoms worse lying on the right side. Many complaints of Merc are aggravated by lying on the right side. The lung symptoms and cough, liver, stomach and bowel symptoms are all worse while lying on the right side.

It has a great variety of stools, of diarrhoea and constipation. It has a well-defined dysenteric condition. Slimy, bloody stools with much straining, he feels as if he could never finish, even when no more is passing, a "never-get-done" feeling

Mercurius Vivus is the very opposite of Nux Vomica ^Nux and Rhus Tox ^Rhus in dysentery. These are relieved if a little stool is passed, but Merc. and Sulphur ^Sulph will sit and strain, and all the salts of Merc. have the same state. Mercurius Corrosivus ^{Merc. cor} has a more violent attack, with violent urging to stool and to urinate, and intense suffering, with burning in the parts and the passage of pure blood.

Merc., Ipecacuanha ^Ipec. and Aconite ^Acon. are frequently indicated in epidemic dysentery that comes in hot weather, and Ipecacuanha ^Ipec., Dulcamara ^Dulc. and Merc. are frequently indicated in the dysentery of cold weather

You should go to the bedside of a case of dysentery with the repertory or go home and send medicine. Your first prescription should cure in epidemic dysentery, and if you work cautiously you will cure every case. It is a very simple condition to cure, but a very bad thing to get mixed up. Do not give Arsenicum Album ^Arsenic just because it conforms to the dysenteric condition, for if it does not cure it will mix up the case. Hesitate about giving Arsenicum Album ^Ars in dysentery until you are perfectly sure it is indicated.

A few days ago I saw a patient who could not lie down because, of pain in both hypochondria.

he had incessant vomiting, inflammatory rheumatism of the ankles, hands, arms and shoulders, he had purpuric spots on the arms and legs, he had inflammation of the stomach, and was a perfect museum of diseases. He had had Phosphorus ^Phos. and Arsenicum Album ^Ars. and many remedies very high, all supposed to be well selected but Cadmium Sulphur ^sulph. put him to sleep in fifteen minutes.

The point was that he wanted to keep perfectly still, and hence it was unlike Arsenicum Album ^Ars, although all the other symptoms were like Arsenicum Album ^Ars

That is a strong feature of Cadmium Sulphur ^sulph.

Frequent urging to urinate, dribbling a little; bloody urine, great burning. Haemorrhage from the urethra. Itching worse from the presence of urine. Gonorrhoea which has existed for some time; discharge thick, greenish-yellow, and offensive. Smarting and burning in the urethra when urinating. Loss of sexual power.

Ulcers on the prepuce and glans, making it suitable in chancre and chancroid. Flat ulcers.

The woman has much tribulation. Burning, stinging in ovaries. Screaming from pain. Stinging, tearing, cutting pains in the ovaries, patient covered with sweat. Copious, excoriating leucorrhoea, parts raw, sore, inflamed and itching.

Stinging, itching and boring pains in the uterus. Pains in the uterus and ovaries at the menstrual period. Milk in the breast of the non-pregnant woman at the menstrual period. Milk in the breasts instead of the menstrual flow. I once had a freak in a sixteen-year-old boy, who had milk in his breasts. I cured him with Merc

Menstrual flow light red, pale, acrid, clotted, and profuse or scanty. The menses are sometimes suppressed. Women who have been in the habit of taking mercury for biliousness remain sterile. (Coffee drinkers often remain sterile also and you must stop their coffee.)

Amenorrhoea with ebullitions. Chancres on the female genitals. Aged women have denuded genitals, rawness, soreness and false granulations, which are always bleeding. Burning, throbbing and itching in the vagina. Itching of the genitals from the contact of the urine; it must be washed off.

In children, boys or girls, the urine burns after urinating and they are always carrying the hands to the genitals. Little girls have acrid leucorrhoea causing burning and itching and much trouble. Phlegmonous inflammation of the genitals. Boils and abscesses at the menstrual period.

little elongated abscesses along tho margin of the mucous membrane and skin, painful, aggravated by walking, forming during the flow and breaking after the period. This with itching, causes great suffering.

Symphoricarpus Racemosus ^{Morning sickness}. A woman, while pregnant, has oedematous swelling of the genitals. Diffused inflammation, soreness and fullness of the genitals and pelvis, causing difficulty in walking, and she must take to bed.

In pelvic cellulitis in the early months of pregnancy Merc is an important remedy. Repeated miscarriages from sheer weakness Merc is a wonderful strengthener when properly used. Prolonged lochia. Milk scanty and spoiled.

The stooth attenuation, given as often as the pains were very severe, took it away and she remained well. The effect observed on the nose is not all of the Merc coryza.

Respiratory Most Merc cases begin in the nose and travel down the throat, creating rawness and scraping of the larynx, and rawness and soreness in the chest; laryngitis, tracheitis and bronchitis.

Loss of voice, complete aphonia. The course of the Merc cold is downwards, even going on to pneumonia, with sweat, restlessness and aggravation from the warmth of the bed. Of course many of the colds remain in the nose.

There are various conditions in the chest Coughs.

colds that remain in the chest, lack of reaction and tardy recovery. The colds finally settle in the bronchial tubes.

the chest feels as if it would burst and the cough is worse lying on the right side I look back over many cases of patients who took cold from exposure and now look sickly and sallow, with a dreadful cough and rattling on the chest.

every change of the weather gives them a new cold, and they cannot lie on the right side.

their tendency is to go into mucous phthisis or quick consumption.

The cough is worse in the night air. There are many pains in the chest. He has a rheumatic constitution, is always sweating, worse while sweating and from the extremes of heat and cold. Stitching stabbing, rheumatic pains in the chest with night sweats. Bloody, thick green expectoration. Suppuration of the lung, great quantities of pus form.

Tremendous orgasms, bubbling and flushes of heat in the chest. With many complaints there is sore throat and rheumatism and stiffness of the neck.

stiff neck with swollen glands and goitre. Stiff neck with every cold.

stiffness of the side and back of the neck. Induration and soreness of the cervical glands along with other complaints.

Limbs Merc especially affects the joints; inflammatory rheumatism with much swelling, aggravated from the heat of the bed and from uncovering.

It is difficult to get just the right weight of clothing. Rheumatic affection with sweat, aggravation at night, from the warmth of the bed and while sweating, with sickly countenance. It especially attacks the upper limbs, but is also found in the lower.

Tremulous condition of the extremities, like paralysis agitans. Trembling of the hands with great weakness. Paralysis of the lower limbs, and twitching, jerking and quivering of the paralyzed parts. Argentum Metallicum ^Arg. n., Phosphorus ^Phos., Stramonium ^Stram., Secale Cornutum ^Secale and Merc have twitching of the muscles of the paralyzed limb.

Soreness between the thighs and genitals. Ulcers on the legs; abscesses. Oedematous swelling of the feet. Cold perspiration. Copious sweat during sleep. Pain and sweat come on when comfortable in bed; bone pains. He covers up because he feels cold, but when he becomes warm the pains are aggravated.

The Merc patient about to go into a chill is chilly even when the chill has not yet come on; sensitive to the moving air in a warm room; violently sensitive to a draught. Cold hands and feet. The sweat is profuse and offensive.

The complaints in general are worse while he sweats, and the more he sweats the worse he is. He sweats copiously and his greatest sufferings are in the sweat. Merc does not have a clear intermittent.

Between the paroxysms be has liver disturbances, diarrhoea, fever. In surgical fevers, bilious fevers, worm fever in children, and remittent fevers there is much aching in the bones, great sensitiveness to the air, aggravation at night in bed when the fever runs highest, mercurial breath and sallow skin. The fever does not go so high. and the skin is not so hot as in Belladonna ^Bell The loaded tongue and the bilious fevers fade out after Merc

Ulcers on parts where the skin and flesh are thin over the bones. Offensive forms of eczema. Most eruptions are moist with copious oozing. It cures shingles.

The skin is sallow. Excoriating wherever two parts come together. Rawness between the thighs and between the scrotum and thighs. Eruptions in such places. it has fissures at commissures, at the corners of the mouth and eyes; rawness and bleeding of the perineum rendering walking difficult.

Mercurius Vivus furnishes a basis for the Salts of Mercury.

The salts of mercury After studying Merc., corrosive mercury, the proto-iodide and the bin-iodide, we may from some specific symptoms in the case say that we prefer one of the salts of Mercury

When we go to rheumatic and gouty cases with the aggravation from sweat, aggravation from the warmth of the bed, the mercurial odor, etc., we can commonly say that one of the Mercurius will cure this case.

s Ear troubles Horribly stinking greenish discharge. Green, thick, acrid pus from the ears like the discharge from the nose and other parts. Stinking otorrhoea. In otitis media with ruptured drum, Merc is a frequently required remedy. In Spring after a long, cold Winter, the cold, damp weather causes many cases of otorrhoea.

it is almost endemic in large cities. The ear drum heals like any other place if the patient is put in good condition by the remedy. It not well treated a hole will be left. Ears inflamed, with cramp-like pains.

Sore throat It is a remedy for inflammation of the throat, with spongy appearance, general diffused tumefaction swelling of the parotids, fullness and stiffness of the neck. Lardaceous base in ulcers.

flat ulcers, spreading ulcers. Great dryness in the throat. The swelling impairs the motion of all the ' muscles that take part in swallowing.

Swollen, flabby tongue, taking imprint of the teeth; gums also swollen, spongy or bleeding; breath very offensive.

Sweats day and night without relief in many complaints.

Creeping chilliness in the beginning of a cold, or threatened suppuration.

Sliminess of mucous membranes.

Moist tongue, with intense thirst.

Glandular swellings, cold, inclined to suppurate; ulcers with lardaceous base.

Modalities worse at night in warmth of bed, while sweating, lying on right side.

Bone diseases; pains worse at night.

Dysentery stools slimy, bloody, colic, fainting; great tenesmus during and after, followed by chilliness, and a "cannot finish sensation." The more blood and pain the better indicated.

Affects lower lobe of right lung; stitches through to back (Chelidonium Majus ^Chel., Kali Carb ^{Kali c}.).

Intense thirst, although the tongue looks moist and the saliva is profuse.

In low potencies, hastens suppuration; in high, aborts suppuration, as in quinsy.

As in Antimonium Crudum ^{Antimonium crudum}, so in Mercurius, the leading characteristic is found in the mouth, or, I might rather say, characteristics, for the gums are swollen, spongy, sometimes bleeding; the tongue is also swollen, flabby, taking the imprint of the teeth (Arsenicum Album ^Arsenicum, Chelidonium Majus ^Chelidonium, Podophyllum Peltatum ^Podophyllum, Rhus Tox ^{Rhus tox}. and Stramonium ^Stramonium), generally moist, yet with intense thirst.

The fever symptoms of Mercurius are notable, especially in the sweats. The chill also is peculiar as I have observed it. It is not a shaking chill, but is simply creeping chilliness. Often when this creeping chilliness is felt it is the first symptom of a cold that has been taken, and, if left alone, the coryza, sore throat, bronchitis of even pneumonia may follow; but, if taken early, a dose of Mercurius may prevent all such troubles. The chilliness is felt most generally in the evening and increases into the night if not removed by Mercury. It also alternates with flashes of heat.

Now the sweats. They are very profuse and do not relieve like the sweats of inflammatory diseases generally do, but no the contrary the complaints increase with the sweat. (Tilia Europoea ^Tilia.). In what diseases is this condition found? It may be found in almost every disease In sore throat, bronchitis, pneumonia, pleuritis, peritonitis, abscesses, rheumatism, etc., to the end of a long list. In short in any disease in which this profuse and persistent sweating without relief is present Mercurius is the first remedy to be thought of. Worse at night, and especially in the warmth of the bed, is another strong characteristic of Mercurius. (Ledum Palustre ^Ledum pal.) There is a long list of remedies that have aggravations at night, but not so many from warmth of the bed. I have cured many skin diseases of various names guided by this modality.

The glands and bones also come strongly under the influence of Mercurius Vivus. The glandular swellings are cold, inclined to suppurate, having these chilly creepings aforementioned. These with the bone-pains in the exostoses and caries are all aggravated at night in the warmth of the bed.

The mucous membranes are everywhere affected; the discharges from them are at first thin and excoriating, even from the catarrh of the nose to the diarrhoeic, or dysenteric, discharges. Afterwards they become thicker or more bland, like the Pulsatilla ^Pulsatilla discharges. Where are worse at night also, even the leucorrhoea.

Characteristics

No pains have been taken to keep distinct Merc. sol. and Merc. viv., and I do not find it practicable to attempt to separate them. Though Merc. sol. was the preparation Hahnemann proved, he recommended Merc. viv. as a superior preparation for homoeopathic prescribing in his preface to the proving. Mercurius Solubilis ^{Mercurius solubilis Hahnemanni} was invented by him in his pre-homoeopathic days in response to a general desire for a mercurial preparation which should be at once soluble and non-corrosive, and it at once took its place in pharmacy, a place it has never lost. The method of developing the medicinal power of metallic mercury by graduated trituration was a later discovery, though there was a suggestion of it in the well-known Hydrargyrum cum cretâ. To the symptoms of Hahnemann's pathogenesis of Merc. sol. are added observed effects of Mercury in those engaged in working with the metal, in patients taking Mercury, and effects in those applying mercurial inunctions to patients

Sensations

Formication,

Fuzzy feeling in the arms and hands,

Preparation

features The pathogenesis of Mercury is found in the provings of Merc. viv. and Merc. sol, two slightly different preparations, but not different enough to make any distinction in practice.