Introduction - Uppsala Monitoring Centre

The loss of hair has only been reported with mercury as a consequence of
eczema mercuriale and then only after repeated desquamation. It is much more
likely to be due to secondary syphilis. Matthias said ‘alopecia, or falling of the hair is
not a symptom of mercurial disease, but due to debility’ he went on to say ‘I am
convinced that in Europe there is no other remedy (other than calomel) which has
the least effect in subduing the venereal irritation...it (calomel) has the power of
suppressing, but not of curing the venereal action’ ... It is, perhaps, capable of curing
syphilis in every form.’ (Mathias, 1810).
Discussion
The lack of early references is probably due to the main use of mercury being
delayed until syphilis arrived in Europe in December 1494 and perhaps partially to
fact that it would not have been described in a ‘Herbal’ being a mineral. There is a
gap in the reports of toxicity of 1200 years between 78 to 1298 despite several
mentions of its usage.
If we examine the ADRs discovered in the centuries after 1500 we can see a
pattern:
1500s: hypersalivation, gingivitis, fetid breath, ulceration of the gums, loose
teeth, dysarthria, thirst, tremors, deafness, epilepsy, madness,
anorexia and death
1600s: enemy of the nerves, palsy, abdominal cramp, sweating,
strangulation and coma
1700s: metallic taste, fever, emaciation, erethism, vertigo, twitching,
intellectual deterioration, hallucinations, diarrhoea, constipation,
nausea and vomiting, insomnia, headache, increased pulse, swollen
ankles, lassitude, increased urine, erythema mercuriale, joint pains,
swollen glands, and rheumatic swellings of the face
1800s: cough, parathesia, renal damage and hair loss (the latter is probably
not an ADR, but due to syphilis).
1900s: polyneuropathy, liver damage, conjunctivitis and acrodynia
The commonest ADRs were published before 1600 and during the next century
few new ADRs were discovered. There seems to have been a general concern
about the early 1700s as to the dangers of mercury and many new ADRs were
mentioned. This great surge in the 1700s may be partly due to the advent of medical
journals in 1665. It is surprising that nausea and vomiting, and constipation were not
mentioned earlier and I can think of no easy explanation. Diarrhoea may not have
been considered as adverse, but rather as a treatment for constipation and
‘increased urine’ similarly as it was used as a diuretic. For some ADRs their
absence was possibly due to medical terms not coming into frequent use until later
or that with increase in knowledge a more suitable term was devised covering