Introduction - Uppsala Monitoring Centre

Erythema mercuriale was described in great detail in Berenguier’s thesis in 1874.
SE of Drugs 1952 Meyler’s 1 st Edition translated from the Dutch. He also includes: various
inflammations–gastritis, colitis, rhinitis, parotitis, bronchitis, laryngitis, urethritis, endometritis, vaginitis
and more skin problems–oedema, exfoliative dermatitis, herpes zoster and erythema multiforme.
Blood disorders - leucopenia, agranulocytosis, eosinophilia and finally thrombocytopenic purpura.
‘Enemy of the nerves’- delirium, hallucinations, psychosis, polyradiculitis and meningoencephalopathy’.
SE of Drugs 2000 In addition: hypertension, hypotension, arteritis of the legs, hypochondria,
hyperacusis, polyneuropathy/ parathesia of the extremities (Enemy of the nerves), dysmenorrhoea,
hyperthyroidism, hypochromic anaemia, erythrocytosis, lymphocytosis, neutropenia, aplastic anaemia,
tylotic 174 eczema, dry skin, skin ulceration, erythroderma, corneal opacities and ulceration.
A = ‘Reactions with Drug Therapy’ by Harry L Alexander, who also includes: contact dermatitis,
urticaria, scarlatinform maculopapular eruptions, purpura, exfoliative dermatitis, and stomatitis, fever,
shock, granulocytopenia, and polyarthritis nodosa.
B Bell Benjamin. ‘A treatise on gonorrhea virulenta and lues venere’. Edinburgh. 1793, volume 2, 288.
J = Johnstone. Mercury Poisoning. Can Med Ass J. April 1931.
B = Bidstrup PL. ‘Toxicity of mercury and its compounds’. Levier publishing Company, 1964.
MB = Monamy Buckell et al. Chronic mercury poisoning. British Journal of Industrial Medicine’.
Prior to 1800 the modern terms: dysarthria, parathesia, polyneuropathy, acrodynia,
conjunctivitis and hydrargia were not known.
Acrodynia (Pink disease) = sweat, pink scaling palms and soles, pruritus, flushed
cheeks, photophobia, irritability, insomnia, wasting weakness, hypertension,
tachycardia, diminished reflexes; all due to teething powders.
Erethism = great depression of strength, anxiety about the precordium, irregular
action of the heart, frequent sighing, trembling, a small, quick and sometimes
intermitting pulse, occasional vomiting, pale shrunken countenance, and a sense of
coldness (Oke, 1856).
Vellications = twitching
Hydrargia = mercury poisoning
Erythema mercuriale = miliary rash somewhat resembling measles, whilst in
others it is considerably raised. Hot and itchy. Local application can produce a
pustular rash (Bell, 1793). Parcelsus includes leprosy and lupus vulgaris.
Mercurialentis = Greyish-brown or yellow haze on the anterior surface of the lens
(Bidstrup, 1964)
Jarisch-Herxheimer reaction = sudden release of inflammatory cytokines giving
headache, myalgia, chills, fever, worsening of pre-existing symptoms
hyperventilation, hypertension later hypotension and tachycardia. Resolves in 6–12
hours (Jarische, 1895; Herxheimer, 1902).
Excluded are: laboratory test abnormalities, effects of inhalation, and effects of
organic mercuric compounds. Some of the adverse effects were occupational and
therefore chronic.
174 Tylotic eczema = hyperkeratotic (thick skinned) eczema usually on the hands