Other effects require the distinct co-operation of collateral causes. Many inflammatory diseases, not easily excited in ordinary circumstances, arise readily from improper exposures during salivation, for example dropsy, pneumonia, phrenitis, iritis, erysipelas, and various chronic eruptions.
Other effects again require the co-operation of disease, such as sloughing gangrene supervening on ordinary ulcers during the action of mercury,—a not uncommon accident. This appears most likely to happen when the ulcers are constitutional.
Lastly, in conjunction with other diseased morbid actions, either going on at the same time, or immediately preceding mercurial erethysm, this poison is apt to occasion some modifications of disease which are rarely otherwise witnessed. Modifications of the kind have already been traced in the instances of lues venerea and scrofula; but there is reason to believe that the same singular property may also exist in relation to other constitutional disorders.
These observations conclude the inquiry into the symptoms caused in man by mercurial poisons generally. Returning now to its mode of action, we have to examine its relative effects through the different animal textures, and in its various chemical forms.
The result of the previous remarks as to its action on animals, it will be remembered, was, that its soluble preparations cause when swallowed corrosion of the stomach, and in whatever way it enters the body irritation of the stomach and rectum, inflammation of the lungs, depressed action and perhaps inflammation of the heart, oppression of the functions of the brain, and inflammation of the salivary glands. All of these effects have likewise been mentioned in the preceding sketch, as occurring in a greater or less degree in consequence of its operation on man.
Mercury acts as a poison on man in whatever way it is introduced into the body,—whether it be swallowed, or inhaled in the form of vapour, or applied to a wound, or even simply rubbed or placed on the sound skin. But the kind of action excited differs according to the channel by which it is introduced.
The most ordinary and dangerous cases of poisoning arise from the introduction of corrosive sublimate into the stomach. The poison then kills by corroding or inflaming the alimentary canal, or by causing salivation and its concomitants.
When applied to a wound or ulcer corrosive sublimate does not often occasion dangerous symptoms. Yet it is sometimes a hazardous remedy. It is not a convenient escharotic even in a concentrated state; for its escharotic action is not incompatible with its absorption; at all events it certainly sometimes acts constitutionally through the surface of wounds and ulcers, and the symptoms brought on in this way are generally violent. They are the symptoms of mercurial salivation, accompanied at times with well-marked inflammation of the alimentary canal. When applied to sores in a diluted state it has also been known to cause dangerous effects if too long persevered in. A case of the kind has been related by Mr. Robertson, an army-surgeon. After anointing an itchy eruption of the arms for seven days with a solution of corrosive sublimate containing five grains to the ounce, his patient was attacked with fever, inflammation of the stomach and bowels, and in two days more with violent salivation.[[962]] A case of the same nature has been related by Mr. Sutleffe.[[963]] His patient, a child, in consequence of having an eruption of the head washed with a solution of corrosive sublimate, was attacked with violent salivation, which proved fatal in a few days. Pibrac has recorded three fatal cases from the free application of corrosive sublimate to ulcerated surfaces. One of these proved fatal in five days, another in twenty-four hours, and a third during the night after the poison was applied. The symptoms generally indicated violent action on the alimentary canal.[[964]] In an instance mentioned by Degner, fatal in twenty-five days, there was also violent irritation of the stomach; but the chief affection was excessive swelling of the face and throat, together with profuse ptyalism.[[965]]
One of the readiest modes of bringing the system under the poisonous action of mercury is by introducing its preparations into the lungs. It appears from some experiments by Schlöpfer that the fluid preparations act rapidly through the lining membrane of the air-passages. Six grains of corrosive sublimate in solution will thus kill a rabbit in five minutes.[[966]] But the effects of mercury through this channel are much better exemplified when its preparations are inhaled in the form of vapour. Corrosive sublimate when incautiously sublimed in chemical experiments has been known to cause serious effects. Dr. Coldstream of Leith informs me, that while subliming about twenty-four grains of it with the blowpipe when a student, he and several of his fellow-apprentices were seized with painful constriction of the throat, several had headache, and one had sickness and vomiting. The phenomena produced by the various preparations of mercury in more violent cases, are sometimes protracted tremors,[[967]] sometimes severe ptyalism and tedious dysentery,[[968]] sometimes salivation and gangrene of the mouth ending fatally.[[969]] This last form was produced remarkably in a chimney-sweeper, after cleaning a gilder’s chimney, during which operation he felt a disagreeable sense of tightness in the throat.
Several extraordinary instances have happened of poisoning from long-continued inhalation of the vapours which arise from metallic mercury. That vapours do arise from metallic mercury of the ordinary temperature of the atmosphere has been fully proved by Mr. Faraday; who found, that when a bit of gold was suspended from the top of a phial, the bottom being covered with a little mercury, the gold soon became amalgamated.[[970]] The vapours thus discharged may produce the worst species of mercurialism, if they are diffused through an apartment insufficiently ventilated. One of the most striking examples known of the baneful effects of mercury thus gradually insinuated into the system, occurred in a well-known accident which befel the ships Triumph and Phipps. These vessels were carrying home in 1810 a large quantity of quicksilver saved from the wreck of a ship near Cadiz, when by some accident several of the bags were burst and the mercury spilled. On the voyage home the whole crews of both vessels were more or less severely salivated, two died, many were dangerously ill, all the copper articles on board became amalgamated, all the rats, mice, cockroaches, and other insects, as well as a canary-bird and several fowls, and all larger animals, such as cats, dogs, goats, and sheep were destroyed.[[971]]