Mad as a hatter
Nothing personifies the cycle of treatments, craziness, and crazy-making treatments like mercury
I was probably around 11 when someone - maybe an English teacher? - shared the well-known kernel of knowledge about the Mad Hatter’s particular peculiarity. Hatters - and not, if I may be pedantic for a moment, haberdashers, which are something else - worked with chemicals in the treatment of fur and felt. One of the most notable was mercury, which, after prolonged exposure, was known to create a number of unfortunate side-effects.
According to a story published on the CDC’s website, authored by someone at NIOSH (the National Institute of Occupational Safety and Health, which I was Today Years Old when I learned was different from OSHA), “hatters or hat-makers commonly exhibited slurred speech, tremors, irritability, shyness, depression, and other neurological symptoms…The symptoms were associated with chronic occupational exposure to mercury. Hatters toiled in poorly ventilated rooms, using hot solutions of mercuric nitrate to shape wool felt hats.”
So, you know. It was unhealthy to spend your days hunching over a workbench in a subterranean studio somewhere in the coal-coated streets of London, probably smoking a cigarette and slugging rot-gut whisky while you made hats for the Bob Cratchits of the world.
But all of those compounding factors - the piss-poor diet, the piss-poor sanitary conditions, and the piss-poor air quality - made it hard to know what, exactly, about hatting was making them so…weird. And anyway, maybe weird guys were just drawn to the business? Like how only odd and slightly mentally unstable people tend to work as writers? Anyway, the result was that the mercury, itself, wasn’t blamed for the mysterious madness of hatters until much, much later.
Like 200 years later. And after a cool thousand years of people putting mercury on every inch of their skin and in every possible orifice and calling it medicine.
Disregarding the fact that there are actually other potential origins for the phrase “mad as a hatter,” it’s interesting to consider that, while there were widely acknowledged issues with mercury exposure, people kept right on using it for all sorts of things. In fact, even though it was pretty clear that mercury was not great for a person, it was deployed for centuries as a potential cure for everything ranging from worms to constipation to syphilis.
You know syphilis, right? The disease that turns your brain into a fidget spinner made of watermelon? Yeah, that’s the one. They used mercury - an element which causes symptoms often associated with mental illness - to treat a sexually-transmitted infection which also, if left untreated, causes symptoms often associated with mental illness.
It’s at times like these that I pause and marvel that any of us are alive at all and that any human civilization survived our own absolutely cuckoo-bananas selves.
Take two tabs and endless dumps and call me in the morning
Mercury was a popular medicinal treatment well before the butchering of beavers for stovepipe hats. And, as we’ve discussed before, the medical professional was pretty much fully operating on the “guess and check” model before germ theory and the ability to actually see cells up close. And if you’ll recall the whole Bad Bile school of thought, you will be wholly unsurprised that doctors liked mercury as a treatment because it was so toxic.
At the turn of the 16th century, Paracelcus found the “purging” elements of mercury treatment - i.e. the part where someone drools like a St. Bernard and also uhhhh…..evacuates the residents of Southern Hemisphere - healing. As though somehow the body would express all of the disease while leaving everything else perfectly intact. And in some ways, this did work, assuming the patient survived.
A pretty old study (1996) which looked at the history of mercury and its use in curing syphilis, found that “during 450 years mercury remained the guarantee of efficacy. The modalities of use increased, the durations of treatment lengthened without any evidence of a worsening morbidity.”
However, relying on contemporaneous history may not be a great idea; the lack of evidence of “a worsening morbidity” might have been because a.) people died from mercury poisoning but it looked like something else, b.) they died of syphilis but it looked like something else, or c.) they died from something else before the long-term effects of mercury or syphilis could get them.
And again, it’s important to note that the symptoms of mercury poisoning and the symptoms of late state syphilis are very similar.
From CDC:
Signs and symptoms of neurosyphilis can include:
severe headache;
trouble with muscle movements;
muscle weakness or paralysis (not able to move certain parts of the body);
numbness; and
changes in mental status (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, and/or making decisions).
Signs and symptoms of ocular syphilis can include:
eye pain or redness;
floating spots in the field of vision (“floaters”);
sensitivity to light; and
changes in vision (blurry vision or even blindness).
Signs and symptoms of otosyphilis may include:
hearing loss;
ringing, buzzing, roaring, or hissing in the ears (“tinnitus”);
balance difficulties; and
dizziness or vertigo.
From the Cleveland Clinic:
Organic mercury poisoning symptoms
Organic mercury causes symptoms if you inhale it (breathe it in) or touch it. Symptoms don’t occur immediately and usually arise after long periods of contact (could be years or decades) with the compound. Though not always common, being exposed to a large amount of organic mercury at one time can cause symptoms. Symptoms of organic mercury poisoning from long-term exposure include:
Feeling numb or dull pain in certain parts of your body.
Tremors (uncontrollable shaking).
Unsteady walk.
Double vision or blurry vision; blindness.
Memory loss.
That means it would have been hard to determine - in the absence of a blood test - whether someone was dying from syphilis, the mercury they treated the syphilis with, or something else that might have caused a seizure or loss of motor control.
For example, a chap who had syphilis may have gotten treated with mercury and then felt some of the symptoms much later. If he was a regular drinker - and who wasn’t? The water was full of baby poop - he might’ve written off an unsteady gait, crossed vision, or memory loss. Then one day, poof, he’s dead as he leaves the pub and everyone like “oh, it was the beer.”
But it was not the beer! Or maybe it was. We really have no way of knowing because, again, basically everything at that time could either kill you or make you crazy or both.
Salvarsan and other, safer treatments
It’s fair to ask, though, how this continued for literally hundreds of years. And the answer is that basically doctors had mercury and they did not have penicillin so they just kind of kept doing their thing. Medicine was deeply steeped in tradition, rather than innovation, for a lot of years. Probably still is. I’m not a doctor.
Plus, people kept getting sick! And if, as we have now covered, you don’t treat syphilis, it will treat you to an early and deeply undignified grave.
Once bloodletting and other “purging” treatments started to wane in popularity because they were lethal and also John Snow had figured out that stinky air wasn’t the cause of cholera (if you have not read The Ghost Map, let’s make this the year you get it together, ok?), doctors and researchers started trying to formulate cures that were less deadly.
One was developed by a Japanese man, Professor Sahachiro Hata, using a synthesized compound created by a Jewish man, Paul Ehrlich, in 1907. Hata had already figured out a pretty good treatment for the bubonic plague and was working now to find something to help the exploring syphilis epidemic. He was surveying other organic compounds that his peers were working on when he found Ehrlich’s.
Hata then came up with what was called Salvarsan on the market. Its proper name was Arsphenamine. And yes, it is arsenic-based. And yes, it was still prettttttttty toxic. But not as toxic as mercury! And it definitely helped treat soldiers in WWI before penicillin came on the scene several decades later.
This was a huge turning point, because it removed a major reason for doctors to stock and prescribe mercury. It also showed that there was, in fact, a better way to treat people that would not turn them into drooling, messy lumps.
Unsurprisingly, the white dude got a Nobel and the Asian dude did not (despite being nominated three times). Ugh.
Mercury poisoning: Not just for the fellas
The degree to which mercury was considered “safe” is sort of hard to say. Like, was it used in medicine? Absolutely. Did hatters use it all the time? You bet. Were women putting it on their faces? YES INDEED!
Was this having an effect on all of these people? We literally can’t know. Because it’s not like anyone was testing for heavy metals in the blood of regular folks. However, again, it’s a little surprising that at no point someone was like “huh, you know what the common denominator is here?”
Mercury was used in cosmetics, skin treatments, clothing, furniture, and just about everywhere else, it would have been hard to determine what the cause of anyone’s funny behavior really was. Consider 18th-century members of the court, who were often depicted as air-headed, silly, and vain. They were also covered in makeup composed of lead, arsenic, and mercury.
This continued well into the 20th century and even still does (more on that below). Mercury was especially popular in night creams which promised to reduce scars or darkness, and as a general lightener/brightener of skin. Because the last thing you would want was for the neighbors to think you did any labor out of doors like some like of….laborer.
Did the people applying mercury to their scars and scabs not care about their health? Or did they not link these products to any health issues they may have suffered? And did the expectation of women’s nature make them more likely to brush off, say, neurological symptoms? It’s hard to say. But it’s quite possible that a non-zero number of women in the Kirkbride homes were there not because they were born with an mental illness, but because they kind of contracted one.
Two policies from the FDA - the Pure Food and Drug Act (1906) and the Food, Drug, and Cosmetic Act (1938) sought to eliminate toxic ingredients in things people put, you know, on and in their faces. The updated act specifically addressed cosmetics and beauty treatments - women’s things that they couldn’t be bothered with 30 years prior - and mandated pre-market approval. It banned cosmetics that included any “filthy, putrid, or decomposed substance” or that “may have been rendered injurious to health.”
This was critical, because it meant it would be harder (but not impossible) for quack doctors to market their own special “ointments” and “tonics” directly to patients. As a result, this 1938 act took some really deadly stuff off the market. And it was part of a broader effort to find ways to help people without also hurting them.
The only 100% safe Mercury is Freddie
In 2022 (!!!), a report from the FDA found that a number of cosmetic products which promise “skin lightening” - mostly sold in East Asia and Latin America - contained potentially lethal amounts of lead. And while they aren’t *technically* allowed to be sold in the States, they very much still are.
In the year of our lord 2023, people are still using mercury cream on their faces in spite of the very, very well-known dangers. Which really drives home the fact that a lot of people will check their better instincts to get at a higher goal. And, sadly but unsurprisingly, that goal is (and has been for centuries) whiteness.
Because many, many, many of us have been conditioned to believe that it’s better to be crazy and pretty (someday I’ll write about the myth of the Hot Crazy Girl!) than to be normal-looking and able to keep your spit in your mouth.
The NIOSH (again: NOT OSHA) cautioned that mercury poisoning in the workplace is still absolutely possible within many occupations. In fact, workplace exposure to toxic chemicals like lead, which can just kind of become one with the air without a person noticing, are still a major concern for manufacturers, chemists, and crafty little Etsy shop owners who don’t use PPE when fucking around with antique jewelry.
“Metallic mercury readily vaporizes at room temperatures, and the vapor has no warning properties. At low levels, the onset of symptoms resulting from chronic exposure is insidious; fine tremors of the hand, eyelids, lips, and tongue are often the presenting complaint.
According to NIOSH, these minor-but-not-minor symptoms make it hard to gather data. So like, I guess I can cut the hatters a break for not recognizing that they were slowly poisoning themselves into insanity, especially since there were absolutely certainly zero union or other labor protections.
However, I do not give any grace to the doctors who had people pasting it onto their chancres because my god, guys.
How are any of us still alive? Again, we just can’t know.