MERCURIUS SOLUBILIS [Merc]:

- Douglas M.Borland.

THERE are two types of conditions which indicate Mercurius. The first is an acute gastritis; the second is an acute enteritis, either a simple enteritis or one going on to a definite dysentery. In either case there are very definite Mercurius indications. The patients always look ill; they have a very suggestive pale, earthy, puffy appearance, with a moist, sweaty skin. Quite early in the disease, whether it is a gastritis or an enteritis, these Mercurius patients become very restless, and very tremulous. Often they have distressing jerking, twitching sensations. They suffer from troublesome alternations of heat and cold- either becoming intensely hot and unable to bear being covered up, or else pushing off the covers and becoming cold and shivery. But, whether hot or cold, they are sweaty all the time. With the digestive disturbances, these patients tend to develop troublesome rheumatic pains, which are mostly complained of as bone pains. These become much more troublesome as the patient gets warm, and they are extremely painful as night advances. They are one of the causes of the patient's intense restlessness. In their attacks of acute gastritis, the patients tend to become definitely apprehensive and worried about themselves. And often rapid in their speech. On the other hand, their mouths become unpleasantly foul, causing difficulty in articulation and they may actually stammer. In their more serious enteric conditions, Mercurius patients may become very depressed, wretched and miserable. They are rather apt to be distrustful, they feel they are not being properly looked after and are not going to get better. In their wretchedness, when talking about their complaints, they may break down and weep. The appearance of the Mercurius tongue is always very suggestive. The first impression is that it is swollen and toneless, and it has a strange appearance of being somewhat oedematous-it looks watery. With this swollen-looking appearance you may find the imprint to the teeth along the sides. The tongue is usually palish in colour, but it may have a definite coat, either white or a dirty yellow. A constant characteristic is the peculiar tremulousness of the tongue when it is extruded. These patients often complain of a very foul or a sweetish taste in the mouth, which is very distressing to them; and always, in all their complaints, they suffer from acute salivation. In acute gastritis, the patients suffer from extreme burning pain in the pit of the stomach. This is very much aggravated by any food, and is accompanied by extreme heartburn. Although the pain is aggravated by food, the patients often have a feeling of extreme hunger, frequently accompanied by a craving for stimulants, especially brandy or wine. In these acute gastric upsets, the Mercurius patient is always thirsty, and the desire is for cold drinks. In acute gastritis, Mercurius patients may develop acute inflammatory gall-bladder attacks, accompanied by extreme soreness in the region of the liver which is very much aggravated if the patient turns on to the right side. During these attacks, they frequently have a marked nightly aggravation, with rise of temperature, increased discomfort, waves of heat and cold, profuse sweats-a typical septic appearance. Where there is this type of liver disturbance Mercurius patients usually develop an acute aversion to anything fatty or greasy. They also develop an acute aversion to meat of any kind. Associated with the unpleasant sweet taste in the mouth, Mercurius patients normally have marked aversion to sweets. The enteritis of Mercurius is a very violent attack with acute griping in the intestine. All the contents of the abdomen feel sore and raw. It is accompanied by a good deal of abdominal distention and very violent tenesmus. The tenesmus is often quite ineffectual and nothing is passed at all. Or there is extremely violent tenesmus and the passage of a very small, bloody mucous stool, accompanied by extreme burning in the rectum. Not infrequently, with the persistent tenesmus, the patients develop a tendency to very painful rectal prolapse. I recall a number of these acute dysenteries in World War I. It was a bacillary dysentery with severe and almost incessant tenesmus and straining. As a rule the upset was more marked during the night than during the day. Many of these cases cleared up entirely in a very short time on Mercurius. Depending on the degree of tenesmus and the state of bloodiness of the stools, one prescribed either straight Mercurius sol. or else Mercurius cor. When the stools contained more blood and less faecal material, the tenesmus was more violent, and the tendency to prolapse more marked, Mercurius cor. gave better results.