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ELEMENTS OF MATEKIA MEDICA.

unable to open her mouth wider than half an inch. Several operations were performed,by different surgeons, to remedy this, but the relief was only temporary.

Salivation is occasionally induced by other substances (hydrocyanic, nitric, or ar-senious acids, emetic tartar, foxglove, iodine, &c.), and sometimes occurs spontaneously.The peculiar odour of the breath, the brassy or coppery taste, and the sponginess of thegums, are usually considered to be characteristic of mercurial salivation. But in somecases these symptoms are insufficient to enable us to distinguish it. I have seen abouta dozen instances of apparently spontaneous salivation, yet presenting the characters ofptyalism from mercury. They occurred in Dispensary patients, and mostly in females.The greater part of them had not (according to their own account) taken medicine ofany kind for months. Sloughing phagedena of the mouth ( stomacace gangrceuosa)cannot, in some cases, be distinguished from the sloughing produced by mercury (sto-macace mercurialis). A remarkable case, in proof, I have recorded in the LondonMedical Gazette (vol. xviii. 389).

3. Mercurial purging (diarrhoea mercurialis). —Violent purging is a very frequentconsequence of the use of mercury. It is frequently attended with griping, and some-times with sanguineous evacuations. In some cases there is fullness of the left hypo-chondrium, burning pain and tenderness of the region of the pancreas, and the evacua-tions are frothy, whitish, tough, and often greenish, at least in the commencement,from the intermixed bile. These symptoms may fairly be referred to an affection ofthe pancreas, analogous to that of the salivary glands. Dieterich (op. cit.) terms itptyalismus pancreaticus mercurialis (diarrhoea salivalis, sialorrhcea alvina, ptyalismusabdominalis).

4. Urorrhcea mercurialis. —Excessive secretion of urine, from the use of mercury, isvery rare. Two cases only are recorded, both by Schlichting (Ephemerid, A.C.L.Nuremburgse, 1748, tom. viii. Obs. viii. p. 25, quoted by Dieterich, op. cit.)

5. Hidrosis mercurialis. —Profuse sweating is another occasional effect of mercury.

6. Skin diseases. —Several forms of skin diseases, both acute and chronic, have beenregarded as part of the ill effects of mercury.

(a.) Eczema mercuriale, Pearson; (erythema mercuriale, Spens and Mullins;lepra mercurialis, Stokes and Moriarty; hydrargyria, Alley, Ilayer; erysipelas mer-curiale, Cullerier, Lagneau ; spilosis mercurialis, Schmalz).—This disease appearsoccasionally during the progress of a mercurial course. Some writers have frequentlymet with it:—thus. Alley (Ohserv. on the Hydrargyria, 1810) saw forty-three cases inten years, and of this number eight terminated fatally. Rayer confesses, that in twentyyears he never saw but three instances of it. During the ten years that I was con-nected with the General Dispensary, I saw only two cases of it. The disease consistsof innumerable, minute, and pellucid vesicles, which have been mistaken for papulse.These give the appearance of a diffused redness to the skin, and a sensation of rough-ness to the touch. Sometimes it is preceded, and attended by febrile disorder. In twoor three days the vesicles attain the size of a pin’s head, and the included serumbecomes opaque and milky. It soon extends over the body, and is accompanied bytumefaction, tenderness, and itching. It usually terminates by desquamation : but insome cases a copious discharge takes place from the excoriated and tender surface; andwhen this ceases, the epidermis comes off in large flakes : in some instances the hairand nails fall off, and the eyes and eyebrows become entirely denuded. There is usuallysome affection of the respiratory organs, indicated by dry cough and tightness of theprsecordia.

(b.) Miliaria mercurialis. —A miliary eruption has been observed by both PeterPrank and Dieterich, apparently as a consequence of the use of mercury.

(c.) Chronic skin diseases (herpes, psydracia, and impetigo). —These are doubtfulconsequences of the use of mercury. They have occurred after the employment of thismetal; but considerable doubt exists, as to whether they ought to he regarded as theeffect of the remedy, or of the disease for which they have been exhibited, or of someother condition of system. Herpes prasputialis has been ascribed, by Mr. Pearson, tothe previous use of mercury (Bateman, Pract. Synopsis of Cutaneous Diseases, 6th ed.),and his opinion has been adopted by Dieterich (op. cit.)-, but it certainly now and thenoccurs, when no mercury has been exhibited. The psydracia mercurialis and impe-tigo mercurialis of Dieterich (op. cit.) are still more doubtful effects of mercury.

7. Inflammation of the eye, fauces, and periosteum, have been ascribed by some writersto the use of mercury ; but by others the power of this ag-ent to produce these diseasesis denied. That they have follow ed the use of mercury cannot be doubted, but post hocis not ergo propter hoc. Dieterich regards the maladies referred to as states of conges-tion, not of inflammation, and therefore calls them symphoreses (from av/j.<p6o- n rj,s, an