![]() It is heavy metal and bright silvery in appearance It is liquid and is non poisonous if swallowed. Signs of extended mercury exposure mark Mad Hatter disease. Dr Kaleem Khan Assistant Professor Forensic Medicine JNMCH,AMU. Early symptoms include diarrhea, cough, and skin rash, while later symptoms include more severe manifestations such as muscle atrophy, poor mental function, and mood swings. The symptoms of chronic mercury poisoning depend on a person's level of mercury exposure and the kinds of mercury a person is exposed to. Because these behaviors became common in hatters, the phrase "mad as a hatter" became popular. Chronic mercury toxicity leads to multi-system disorders, predominantly neurological (tremor, neurasthenia, erethism, emotional lability, insomnia, delirium, mixed sensorimotor neuropathy, ataxia and anosmia), gastrointestinal (metallic taste, burning pain in the mouth, loose teeth, gingivostomatitis and hypersalivation), renal dysfunction. The well-known idiom mad as a hatter is a story of mercury poisoning, derived from 18th- and 19th-century hat workers who developed psychosis and dementia after chronic exposure to mercury, which was used to stiffen felt (). Over time, the workers developed manifestations of excitability, psychosis, and tremors. Mercury Poisoning: Background, Definition, Physiopathology, and Treatment. ![]() Since this was done in poorly ventilated rooms, the workers frequently breathed the vapors of the compound, which were then accumulated through the years. Several days after the initial exposure, symptoms are more similar to those that develop following inorganic mercury poisoning, including ptyalism (heavy salivation), enteritis, and renal damage there can also be chronic CNS effects, which develop as a result of the ability of absorbed elemental mercury to cross the blood-brain barrier. Intentional subcutaneous or intravenous injection of elemental mercury results in toxicity similar to chronic inorganic mercury exposure, but can also result in severe tissue damage that may require extensive surgical debridement. The method includes steaming the caps with a substance called mercuric nitrate. Of note, mercury vapor is heavier than air which increases the risk of exposure to pediatric patients. People exposed to mercury are more likely to develop mad hatter disease.ĭuring the 18 th century, workers used mercury in the felting process of making hats. It leads to severe neurological effects called erethism. Mild, subclinical signs of central nervous system toxicity can be seen in workers exposed to an elemental mercury level in the air of 20 g/m3 or more for several years. These cells penetrate into the sub-endothelial space. The first visible lesion of atherosclerosis in arterial wall is the fatty streak or the foam cell. Mad hatter disease, also called mad hatter syndrome, refers to chronic mercury poisoning due to prolonged exposure to this metal. Symptoms include tremors, insomnia, memory loss, neuromuscular effects, headaches and cognitive and motor dysfunction. The medicinal use of mercury, and recognition of its toxicity, go back to China in the third century BC. The predominant manifestations of sub-acute or chronic mercury intoxication include GI symptoms, neurologic abnormalities and renal dysfunction 15,28,39. ![]() (Photo: Wikimedia Commons/ USEPA Environmental-Protection-Agency) What is Mad Hatter Disease?
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