THE appearance of the typical Mercurius influenza is much the same as in Pyrogenium, though the patient looks a little more puffy. There may be a localised hectic flush, but it is more common to see a generalised flush in Mercurius, often with the face bright red. And there is a damp sweat-peculiarly oily- looking, so that the patient looks greasy.
In contrast to the loquacity of Pyrogenium, Mercurius patients tend to be hurried; their speech is hurried and they rather tumble over their words. There is much more anxiety and restlessness.
Pyrogenium patients, although very ill, are singularly unworried about it. Mercurius patients, however, are usually extremely distressed, restless and anxious. Very often, they are definitely depressed, in a Pulsatilla way-they weep when shown kindness. Linked with the hurried outlook is a tendency to impatience and irritability.
Their general temperature reaction is another distinguishing point. Mercurius patients feel just about as hot as Pyrogenium cases, they have the same sort of hot sweat, and are uncomfortable if covered too much and chilly if they uncover; but, there is never the same intense sensitiveness to cold as in Pyrogenium-the state is one of alternating between too hot and too cold. If a Mercurius patient is kept in a still atmosphere at a moderate temperature, he is fairly comfortable.
Mercurius patients, unlike Pyrogenium, have a very marked nightly aggravation; they are very uncomfortable all night, liable to have a marked rise of temperature and apt to sweat more, which only increases their discomfort.
It is difficult to distinguish between the headaches of Pyrogenium and Mercurius patients. Both suffer from exactly the same type of pressing headache, in just the same situations; both have the same feeling of heat in the head; both seem to get involvement of the frontal sinuses, antrum and ear; and the symptoms are very similar.
Possibly, Mercurius patients are a little more sensitive to draughts on the painful areas. More helpfully, they find rather more relief from firm pressure over the painful area than do Pyrogenium cases.
As far as thirst is concerned, there is little to distinguish between the two drugs; both are thirsty and want cold drinks. But the actual state of the mouth gives definite indications. The Mercurius mouth always shows a swollen, flabby, palish, coated tongue, with a nasty, greasy feel about it, and there is always troublesome, sticky, fairly profuse salivation. (Cf. the dry, brownish tongue of Pyrogenium.)
The Mercurius tongue is tremulous; it shows a definite fine tremor when protruded. The excessive salivation makes their tongues sticky and they find it difficult to speak and articulate.
The Mercurius throat is acutely inflamed, and there is early marked enlargement of the submaxillary glands. The throat itself is very much swollen, dusky, dark red, very tender; it feels hot and burning. The whole of the tissues round the back of the throat seem to be inflamed, and any movement hurts; swallowing is very difficult and may cause stabbing pains that spread out into the ears.
The same feeling of soreness and burning extends down the throat, involving the larynx, trachea and bronchi. Any cough is extremely painful: the whole centre of the chest feels raw and as though the mucous membrane had been stripped. The intense inflammation causes hoarseness and, very often, complete loss of voice.
Mercurius influenza patients always have an intense conjunctivitis, with profuse lachrymation of hot, burning tears which seem to excoriate the cheeks. They have severe photophobia, and are peculiarly sensitive to radiant heat-the heat of the fire-which makes their eyes smart and burn.
These patients have a profuse nasal discharge, acrid and watery, which tends to excoriate the upper lip. With it there is intense burning pain in the nose and very violent attacks of sneezing. These attacks will be induced either by going into the open air or coming into a warm room-either heat or cold will set them going-and any draught is liable to precipitate a violent bout of sneezing.
There is a tendency for the watery discharge to become thicker, and greenish in colour. It is then that the patients are liable to have intense pains radiating out into the antrum, underneath the eyes or up into the frontal sinuses.
With the intensely inflamed throat of Mercurius influenzas there is liable to be pretty acute involvement of the middle ear. It usually starts with a feeling that the ears are choked and stopped-up; and there may be a certain amount of buzzing in the ears. Very quickly the ear becomes painful. There is a feeling of increased tension and the ear throbs.
Pain tends to spread right up the side of the head and, very often, involves halt the head. There is marked tenderness of the mastoid region, very often enlargement of the post auricular glands, spreading down into the neck; extremely injected drums and early rupture.
Mercurius patients have complete loss of appetite in influenza. With their acutely inflamed throats they can hardly swallow. Moreover, there is constant accumulation of unpleasant saliva, the swallowing of which is both painful and also liable to cause a feeling of intense nausea.
These patients have generalised muscular pains. They feel stiffness in the back of the neck, down the back, in their arms and legs; and it is painful to move.
And, not only the tongue but the whole patient become tremulous in a Mercurius influenza. Hands become shaky and all fine movements tremulous.