SKIN. — The long-continued use of arsenic is not infrequently followed by changes in the skin. The changes may be in the form of eruptions, pigmenta tion, etc.
Case of brown discoloration of the skin, produced by long use of arsenic, in a boy, 10 years of age, suffering from persistent fever, followed by exophtlial mos and thyroid pulsation. The patient took, in two months, 1 ounce of the liquor potassii arsenitis of the German Pharmaeopceia. lie was discharged im proved, but in fifteen days returned, ex hibiting a yellowish discoloration of the skin, face, and trunk, which gradually deepened into brown. Foerster (Berliner klin. Woch., Dec. 8, '90).
Case of a woman of 40 years, who had taken arsenic for more than a year, in whom the skin became deeply pigmented, the heels cracked and sore, and the palms and soles very dry. There were also numerous large black freckles on the face. Hutchinson (Archives of Surg., vol. v, p. 364, '94).
Case in which boils followed the con tinuous administration of the liquor potassii arsenitis (Fowler's solution) for an old and exceedingly chronic psoriasis. J. Abbott Cantrell (Med. Summary, Mar., '96).
Valuable as arsenic is as a medicine in certain ailments, if judiciously used, it occasions, if taken even in small doses for a length of time, not merely a dingi ness, but a positive pigmentation, of the skin generally. On the palms and soles it exerts its stimulant action on the sweat-glands, giving rise first to hyperi drosis of these regions, then to the for mation of warty corns around the sudor iparous orifices, and, finally, to a diffuse hyperkeratosis, associated with burning sensations. W. Allan Jamieson (Edin burgh Med. Jour., Jan., '98).
Case of arsenical melanoderma simu lating Addison's disease, including the other symptoms of the latter. The pro gressive weakness and intestinal troubles of Addison's disease are not, as a rule, present in arsenical melanoderma, and, moreover, in the latter ease there are associated dryness of the throat and con junctivitis. The pigmentation due to arsenic does not often affect the hands or feet, and the peculiar speckled appear ance of the trunk is characteristic. It is noticeable that, whereas in most cases a protracted course of arsenic is neces sary to produce pigmentation, in certain predisposed persons a few very large doses will produce the same effect. En
riquez et Lereboullet (Gaz. Hebdom. de -lied. et de Chir., July 6, '90).
Unusual poisoning symptoms in four cases of chorea which were taking ar senic. Peripheral neuritis developed in three of these cases without, the usual premonitory signs of gastric and intes tinal irritability. The paralysis affected the lower extremities, and came on grad ually for several weeks after the termina tion of the patient's stay in the hospital. All of the cases recovered after pro tracted convalescence. If grains of arsenous acid be given during three weeks, such peripheral paralysis may de velop owing to slow elimination. F. C. Railton (Hled. Chronicle, No. 2, 1900).
In snails poisoned with arsenic there was a general dilatation of the lymph vessels, increase in the quantity of pig ment, and fatty degeneration of the pro toplasm of the parenchymatous cells without any symptoms of inflammation. Plants were also poisoned, and it was found upon analysis that they absorbed very little of the poison. Stich (31iin choler sued. Wochenschrift, Mar. 12, 1901).
SECRETIONS.—In therapeutic doses it facilitates respiration, improves the cir culation, and increases the urinary, sali vary, biliary, and cutaneous secretions. (Comby.) ELIMINATION.—Arsenic is very rapidly eliminated, and chiefly by the kidneys. The mucous membranes of the alimen tary tract, the skin, tears, and saliva also assist in the process.
Administered hypodermically to the dog in such doses as to produce acute poisoning, arsenic is eliminated by the urine almost wholly unchanged; the elimination, beginning immediately after the injection, is greatest during the first few hours, and continues for three or four days at the most. Even in cases in which small doses are given daily no traces of arsenites are discoverable in the urine; in cases in which rather large doses are given daily for ten or twelve days the elimination of arsenites goes on for a somewhat longer time than stated above. (Severi.) Healthy urines of 20 persons in Berlin examined for arsenic with completely negative results. Putnam, in America, found traces of arsenic in 20 per cent. of all urines tested; this is to show that suppression of all sources of adulteration and contamination by arsenic is being satisfactorily accomplished in Prussia. R. Richter (Viertelj. ger. Med., Apr., '9S).