Arsenic may be gradually absorbed into the system in very small
quantities over a prolonged period, the symptoms of chronic poisoning
resulting. The commonest sources used to be wall-papers, fabrics,
artificial flowers and toys: also certain trades, as in the manufacture
of arsenical sheep-dipping. But at the present time cases arising from
these causes occur very rarely. In 1900 an outbreak of "peripheral
neuritis" with various skin affections occurred in Lancashire, which was
traced to beer made from glucose and invert sugar, in the preparation of
which sulphuric acid contaminated with arsenic was said to have been
used. But the nature of the disease in this case was decidedly obscure.
The symptoms so closely resembled those of _beri-beri_ that it has also
been suggested that the illness was the same, and was caused by the
manufacture of the glucose from mouldy rice (see BERI-BERI), though no
proof of this was possible. The earliest symptoms are slight gastric
disorders, loss of appetite and general malaise, followed later by
colicky pains, irritation of eyelids and skin eruptions. But sooner or
later peripheral neuritis develops, usually beginning with sensory
disturbances, tingling, numbness, formication and occasionally cutaneous
anaesthesia. Later the affected muscles become exquisitely tender, and
then atrophy, while the knee-jerk or other reflex is lost. Pigmentation
of the skin may occur in the later stages. Recovery is very slow, and in
fatal cases death usually results from heart failure.
After acute poisoning, the stomach at a _post-mortem_ presents signs of
intense inflammation, parts or the whole of its mucous membrane being of
a colour varying from dark red to bright vermilion and often corrugated.
Submucous haemorrhages are usually present, but perforation is rare. The
rest of the alimentary canal exhibits inflammatory changes in a somewhat
lesser degree. After chronic poisoning a widely spread fatty
degeneration is present. Arsenic is found in almost every part of the
body, but is retained in largest amount by the liver, secondly by the
kidneys. After death from chronic poisoning it is found present even in
the brain and spongy bone. The detection of arsenic in criminal cases is
effected either by Reinsch's test or by Marsh's test, the urine being
the secretion analysed when available. But Reinsch's test cannot be used
satisfactorily for a quantitative determination, nor can it be used in
the presence of chlorates or nitrates. And Marsh's test is very
unmanageable with organic liquids on account of the uncontrollable
frothing that takes place. But in such cases the organic matter can be
first destroyed by one of the various methods, usually the moist method
devised by Fresenius being chosen.
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