The patient gets a metallic taste in the mouth, a disagreeable smell in the nose, a painless, audible rumbling in the bowels, an earthy complexion,
a pinched nose, blue rings round the eyes, pales leaden-coloured lips, an uninterrupted or frequently recurring shuddering (always getting stronger) that thrills deeply, even into the interior of the body. His pulse becomes small, hard and very rapid ; there is an inclination to
vomit, or at least nausea at everything, especially at animal diet, but chiefly a very violent headache of a tearing and pressive character,
which sometimes rages without intermission in the occiput or over the root of the nose.
The nose, ears, hands and feet are cold. The thirst is inconsiderable, the bowels constipated, great sleeplessness, the short dreams of a fearful character, accompanied by frequent slight perspirations. The weakness is extreme, as also the restlessness and anxious oppression which the patient thinks he never before felt anything like.
The eyes become sparkling as if full of water, the nose is as if stuffed from catarrh ; the muscles of the neck are somewhat stiff, as from
rheumatism ; the back of the tongue is whitish. At this period the patient experiences, if all goes on well, some discomfort in swallowing.
a shooting pain in the root of the tongue, on both sides of the mouth a looseness or setting on edge of the teeth (the gums recede a little
towards the root of the teeth, become somewhat spongy, red, painful, swollen) ; there is a moderate swelling of the tonsils and sub-maxillary glands, and a peculiar rancid odour from the mouth, without the occurrence, however, of a notable increase in the secretion of saliva,
and without diarrhoea or immoderate perspiration.
Four days seems to be the usual favourable period of duration of a fever of this sort, and its best crisis consists only in the permanent disappearance of every venereal symptom and the complete extirpation of the miasm.
This picture is taken from an exquisite case of very severe mercurial fever.