One of the fictional characters in the children's fantasy tale Alice in Wonderland is the Hatter, the supervillain encountered by the protagonist during the Mad Tea Party. He is described as a seemingly eccentric character with impulsive behavior, making him gain the term "mad." It turns out that this character could be inspired by a neurological disorder that became prevalent centuries ago.
What is Mad Hatter Disease?
Mad hatter disease, also called mad hatter syndrome, refers to chronic mercury poisoning due to prolonged exposure to this metal. It leads to severe neurological effects called erethism. People exposed to mercury are more likely to develop mad hatter disease.
During the 18th century, workers used mercury in the felting process of making hats. The method includes steaming the caps with a substance called mercuric nitrate. Since this was done in poorly ventilated rooms, the workers frequently breathed the vapors of the compound, which were then accumulated through the years. Over time, the workers developed manifestations of excitability, psychosis, and tremors. Because these behaviors became common in hatters, the phrase "mad as a hatter" became popular.
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. 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. Signs of extended mercury exposure mark Mad Hatter disease.
The exposure method differs according to the type of mercury involved, whether elemental, organic, or inorganic. Certain factors could also increase the risk of acquiring mad hatter diseases, such as young age, workplace exposure, and high fish intake. In treating an affected individual, it is important to ensure that the concentration of mercury in the body is reduced. Some medicines can also be given to speed up the excretion of mercury through the urine or gastrointestinal tract, although the option still depends on the type of mercury involved.
Today, this neurological disorder is uncommon in the U.S. since the hat makers stopped using mercury compounds in 1941. A 2013 study reported that of 1300 single mercury exposures in the U.S., 24 showed moderate to major effects. However, higher rates of mercury exposure are reported in other countries where there is small-scale gold mining, food contamination, and mercury mining.
How Toxic is Mercury?
Mercury is a heavy metal naturally occurring in air, water, and soil. It exists in different forms, which differ in toxicity with varying effects on the digestive and immune systems and organs such as kidneys, lungs, and eyes.
Elemental mercury and compounds such as methylmercury pose health risks to a person's central and peripheral nervous systems. Meanwhile, the inorganic forms of mercury can corrode parts of the body, such as the skin and eyes, giving rise to kidney toxicity when swallowed.
Every person is exposed to some level of this toxic element. Most individuals are exposed to low levels of mercury through continuous or irregular long-term contact. However, there are instances when an individual gets exposed to high concentrations of mercury compounds for a short period. Because of this, the World Health Organization (WHO) considers mercury one of the top ten substances of significant public health concern.
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