During 18th to 20th century, the labor working in hat-making factories used to develop a certain set of neurological signs and symptoms. It was found out that the mercury, used to harden the leather, was the culprit. Hence, this constellation was given the name ‘Mad Hatter Disease’. Chronic mercury poisoning can manifest into Mad Hatter disease. It causes numerous neurological disorders which collectively are known as ‘erethism’. Symptoms such as headaches, fatigue, and abnormal behavior are also presented. In early cases of mercury poisoning, the following signs and symptoms are present: - Excessive salivation - Cough - Inflammation of gums - Nausea and vomiting - Diarrhea - Skin rash - Sleeping disturbances In severe cases of mercury poisoning, the individual may develop following signs and symptoms: - Memory loss - Personality changes - Muscle atrophy - Insomnia - Tremors - Irritability - Anxiety and nervousness - Shy behavior - Partial paralysis of lower limb - Muscle twitching and weakness - Altered mentation - Headaches Thanks to the regulation of mercury exposure in addition to complete removal of mercury from hat-making factories, the mad hatter disease is very rare in modern era. Reference: https://www.healthline.com/health/mad-hatter-disease#causes Image via: https://www.businessinsider.com/mad-hatter-hatmakers-mercury-poisoning-alice-wonderland-2017-6