It has been proposed to use arsenious acid, on account of its caustic properties, as an application for cancerous tumours. The employment of this substance for this purpose is by no means new; but its use has been revived from time to time by the charlatan. In the year 1844, a man was tried at the Chester Winter Sessions (R. v. Port) for the murder of a woman whom he pretended to cure of a cancer by the use of an arsenical plaster. In another case, recorded by M. Flandin, where death occurred, the quack declared that he had not applied more than four or five grains to the woman‘s breast. The powder used for this purpose is generally composed of arsenious acid, realgar, and oxide of iron. The above cases, to which many more might be added, attest to the danger which attends the application of arsenic to the surface of the body; it should, therefore, never be used, especially as a more safe and potent caustic for this purpose is found in the chloride of zinc. Some years ago, in London, several cases of severe arsenical poisoning were due to the presence of arsenic in some cheap violet powder. In one case the navel and scrotum of a baby were fearfully excoriated, due to the use of this powder.
Farmers employ arsenious acid (white arsenic) for destroying vermin: for steeping corn in order to destroy any spores of fungi; and it also forms an ingredient in the wash for sheep. Injurious effects have followed the accidental use of the corn thus treated, and those employed in washing the sheep have suffered more or less severely.
By an Act of Parliament (14 Vict. cap. xiii. sec. 3), it is ordered that if sold in small quantities, it must be mixed with the sixteenth part of its weight of soot, or the thirty-second part of its weight of indigo, ten pounds being the smallest quantity allowed to be sold unmixed.
The presence of this admixture must be remembered, as a medical man may be led into an error when the vomited matters are coloured blue, black, or green, from the mixture of bile with the indigo. Arsenic is not, as a rule, a corrosive poison. One case is, however, on record where it acted as a corrosive, but the purity of the arsenic in that case has been questioned. Its action is that of an irritant, causing inflammation in the stomach and bowels of those who have taken it; and it appears that fatal effects are produced whether the poison be swallowed or introduced into the system in any other way—e.g. by injection into the rectum or vagina, or applied to the surface of the body.
Some observers hold that arsenic cannot be considered in the light of an accumulative poison, others that it is so to a certain extent, and that its elimination is not so rapid as was previously thought. Given in medicinal doses, it is eliminated in from fifteen to twenty days. Hence, in cases which have survived the immediate action of the drug, no arsenic may be found in the body fifteen days after its fatal administration. This is a fact of considerable importance. In the case of Pierre Emile L‘Angelier, for whose murder Madeline Smith was tried, Dr. Penny found 88 grains in the stomach, although the deceased survived eight or ten hours after the probable period of taking the poison, and vomited repeatedly during that time. At the above trial, the question was suddenly raised, that if such a large quantity was found after death in the stomach, it was scarcely possible to infer the administration of a much larger quantity; and thus, that the quantity must have been larger than another party could have secretly administered, or naturally would attempt to administer. Drs. Mackinlay and Wylie, of Paisley, obtained 60 grains, and Sir R. Christison 30 grains more, from the stomach of a man poisoned by arsenic administered in whisky-punch sweetened, the arsenic being kept in suspension by constant stirring.
Symptoms of Arsenical Poisoning
Acute.—The rapidity and virulence of the symptoms are more or less modified by the form (e.g. solution) and the dose taken. From half an hour to an hour is the usual time which elapses before the symptoms of poisoning present themselves. In one case, in which the poison was in solution, the symptoms came on immediately after it was swallowed; in another, after the lapse of ten hours. The patient first complains of a feeling of faintness and depression, followed by intense burning pain in the stomach, increased by the slightest pressure. Nausea and vomiting, the latter increased by the act of swallowing, now occur. The vomited matters may be dark brown, black, or bilious; or they may be greenish from the indigo mixed with the arsenic coming in contact with the yellow colouring matter of the bile. Blood may also be vomited. Purging, accompanied with straining at stool, and cramps in the calves of the legs may occur—the purging, like the vomiting, being incessant, and affording no relief to the sufferer; the stools may contain blood, or resemble those of cholera. The thirst is intense, and there may be a feeling of throat irritation, the pulse feeble and irregular, and the skin cold and clammy. The urine may or may not be suppressed. As a rule, the symptoms in this form of poisoning are continuous; but cases occur in which there are distinct remissions, and even intermissions. Coma, paralysis, or tetanic convulsions may supervene before death closes the scene.
Certain anomalies may occur.—The pain may be absent or but slight. Vomiting and purging do not occur in all cases, nor is thirst, a most common and persistent symptom, always present. In some cases the symptoms resemble those which accompany an attack of cholera. In others, signs of collapse first make their appearance, from which the patient may rally, or he may die outright. These variations in the symptoms do not appear to be due to the form or quantity of the poison taken. It should also be remembered that arsenic may produce symptoms closely resembling those the result of narcotic poisoning.
Chronic.—In whatever way the poison be exhibited in small and repeated doses, there follows a peculiar and characteristic train of symptoms, associated with (a) the general nutrition of the body, (b) the facial appearance, (c) irritative disturbance of the alimentary canal, (d) skin eruptions, and (e) implication of the nervous system.
(a) The nutrition of the body is altered, there is gradual loss of flesh with ragged growth of the finger-nails and falling out of the hair. There may be œdema and jaundice in some cases.