Vomiting should be encouraged by emetics or tickling the throat; the stomach pump being used if judicious. To obviate the irritation, demulcents such as arrowroot, mucilage, &c., are useful. Albumen (white of egg) has proved serviceable (Lancet, Jan. 13th, 1849). To render the arsenic insoluble, magnesia or chalk may be given. But the best chemical antidote is hydrated ferric oxide, freshly prepared by precipitating ferric chloride or tinct. ferri sesquichlor. with carbonate of soda (washing soda), or by similarly precipitating ferrous sulphate (copperas), and then shaking the mixture with air till it turns red, or by the following formula:—
| Tinct. ferr. perchlor. | 1 oz. |
| Sod. bicarb. | 1 oz. |
| Tepid water, a teacupful. |
(Hoglan, Year Book of Pharm. 1881, p. 211).
M. Lucas of Beauvais has stated, that in nine cases of arsenical poisoning, calcined magnesia arrested the symptoms and eventually removed the effects (J. Chim. Medi. 1850).
REMARKS.
Arsenic has been given in pessaries by the vagina, in ointment for skin diseases and by “cancer doctors,” also inhaled as vapour for asthma, in each case with dangerous result.
The frequent occurrence of this poison in common articles of use gives an opportunity to the defence which has led to analyses of multitudes of articles—wall-papers, clothing, cooking vessels, &c. It may be positively affirmed that if white arsenic in the solid state be found in the stomach, it could not have come from any of these sources. The trace that could be derived from wall-papers would be infinitesimal. The tests for arsenic are almost inconveniently delicate, so that the slightest impurity of the reagents will make it appear to be present. Reichardt (Archiv. der Pharm., xiv. 1-23), states that 1/1000 milligramme of As2O3 evolved as arseniuretted hydrogen will precipitate silver nitrate, and that by this means he has found it in the urine of patients suffering from arsenical wall-papers. The effect of such papers is certainly pernicious, though it may be mentioned that in Silesia mortar is made with arsenical sand, and people living in houses thus built do not suffer (Lancet, 1849, April 7th). On the whole it may be concluded that in a trial, traces of arsenic will not be sufficient, a tangible quantity found and weighed will be the only sufficient evidence of poisoning by the mouth.
To illustrate the value of a knowledge of chemistry to a medical man in such cases the following may be quoted. A child of ten was supposed to have eaten a quantity of meal mixed with arsenic for rats. An emetic of sulphate of zinc was given: the first vomit gave with ammon. sulphate of copper a bright green, with ammon. nitrate of silver, a yellow precipitate, thus establishing that the poison was arsenic. Emetics and diluents were continued, then albumen was given. Some hydrated ferric oxide was hurriedly made from common green vitriol (ferrous sulphate) and ammonia: the washed precipitate was administered in successive teaspoonfuls. Recovery on the third day. In the vomit 10 grains of white arsenic were found. (Lancet, 1849, p. 311.)
The following is a curious form of attempted poisoning. A person lately presented this prescription in Paris: “Decoct. barley, 8 oz.; hydroch. acid, 1 drachm; arsenious acid, 10 grains.” The signature of a physician was appended, but, on suspicion being aroused, was found to be a forgery.
In Ann Merritt’s case, Dr. Letheby stated that arsenic had been taken not more than two or three hours (afterwards he said four) before death, because he found undigested gruel in the stomach, containing arsenic in solution, and because the intestines contained very little arsenic. This conclusion was considered by weighty authorities to be rash, and probably wrong, because:—