ARSENICAL POISONING. Arsenic is now used in so many ways that accidental poisoning occurs very often. As a poison em ployed in committing suicide, and for slow poisoning with homicidal intent, it is less in favor than formerly. The forms of poisoning mostly seen are of the chronic type. These occur from the use of paints containing large quantities of either Scheele's green or Paris green: the use of spraying solutions, now widely employed as a means of protection from insect and fungus pests, and from the addition of arsenic to foodstuffs, as a preservative. Acute forms of poisoning are more often the result of attempts to commit suicide. In acute arsenical poisoning the early symptoms are those of an acute inflammation of the stomach and intestines, coming on about half an hour after taking the poison. If taken when the stomach is empty the symptoms may be ex hibited within 10 minutes; if when the stom ach is full, the effects may not appear for 10 to 12 hours. The premonitory symptoms of distress, difficulty in swallowing and a burn ing pain in the throat, are followed closely by violent cramp-like pains with nausea, vomiting and diarrhoea. The severe symptoms multiply, the diarrhoea becomes watery, arice water) and blood may appear in the vomit. A cold, damp skin of bluish hue, feeble and irregular heart action, collapse and sighing respiration may precede death, attended at times with convul sions. Death may occur within 24 hours, but it is apt to be delayed from two to four days, the patient usually dying of the secondary de generations in the organs and of exhaustion. Examination of an arsenically poisoned body after death shows arsenic in nearly every part, particularly in the liver and kidneys. It is found also in the brain and even in the spongy parts of the bones. Death by arsenic is very painful. It is, moreover, an extremely uncer tain poison, because of its insolubility, and of the vomiting reaction it induces. Many acute cases pass into the chronic stage.
Chronic arsenical poisoning may result from a single large dose, but more often results from the long-continued use of small quanti ties of the poison. In a recent outbreak of
chronic arsenical poisoning in Manchester, hun dreds of people were affected. The source of the poisoning was from arsenic in iron pyrites employed in making sulphuric acid; this cer tain sulphuric acid had been utilized in the manufacture of glucose. Several firms had purchased this glucose for the manufacture of beer, and many hundreds of the consumers of this beer suffered from various forms of ar senical poisoning. Chronic.arsenical poisoning may result from the use of wall papers and hangings colored by arsenical dyes, although such modes of poisoning may be considered ex tremely rare. The symptoms of this type of poisoning are of gradual onset : the patient is languid, weak and loses his appetite. There is discomfort in the intestines, pains similar to colic and diarrhoea or constipation may result. A sub-acute inflammation of the mucous mem brane of the nose and gums then develops, with sore gums, puffiness under the eyes with inflammation of the lids and running from the nose. Sneezing, coughing and hoarseness may occur, various skin eruptions are not uncom mon and a curious pigmentation of the skin is nearly always observed. The patient prog resses until poisoning of the ends of the nerves begins, with disturbances in sensation, anaes thesia, parmsthesia and pain. There may then develop paralysis of the extremity, frequently the toe (drop-toe); or the wrist (drop-wrist). Paralysis of sensation may also occur. The course of a chronic poisoning may not be over three or four days, but it usually requires three or four weeks, sometimes longer. Some indi viduals use arsenic throughout their lives and are never poisoned. The treatment of acute poisoning consists in the thorough and pro longed washing out of the stomach and the use of large quantities of magnesia. Support ive treatment is needed in the stage of collapse. Heat, alcohol and coffee are indicated. Brandy and ether are administered hypodermically and morphine is injected to allay the acute suffer ing. In chronic poisoning electricity and tonic treatment are required. See ARSENIC.