Trimers (sometimes called Danbury trimers) occur first in the hands, then progress to lips and tongue and finally involve arms and legs. The trimer is moderately coarse and is interspersed by jerky movements. The advanced condition is called hatter’s shake or glass bower’s shake, because the are common in persons working in glass-blowing and hat industries.

• The patient then becomes unable to dress himself.
• Write legibly or walk properly.
• The most severe form is known as concussion mercularis, in which no activity is possible.
• Mercurial Erethism is seen in persons working with mercury in mirror manufacturing firms. This term is used to refer the physiological effects of Mercury toxicity. These include anxiety, depression, shyness, timidity,irritability, loss of confidence, mental depression, delusion and hallucinations, emotional instability, loss of memory and insomnia
• Mercurial Entis is a peculiar eye change due to exposure to the vapour of mercury. It is due to the brownish deposits of mercury through the cornea and anterior lens capsule.
• Renal damage results in membranous glomerulonephritis with hyaline casts and fatty casts in the urine
• Kidney is the primary target

Page no: 486 Chapter 27 Metallic Poisoning In:The essentials of forensic medicine and toxicology by Narayan Reddy/29e.