3. _Symptoms of the third and highest degree._ Soon after a large dose of Arsenic has been swallowed, an austere taste, and a sense of heat and constriction of the pharynx and œsophagus are perceived; in a short period excruciating pains in the stomach and bowels, accompanied with vomiting of the most violent character, the matter voided being generally of a brown colour, and not unfrequently mixed with blood; with these symptoms are conjoined an inexpressible anxiety about the præcordia, and frequent faintings; the stomach at the same time acquires such a high degree of irritability, as to reject the mildest fluids. The alvine discharges now become frequent and painful, and consist of dark and extremely fœtid matter, frequently mixed with blood. The thirst is unquenchable, and the heat of the surface becomes extreme. The pulse is small, frequent, and irregular; palpitations of the heart, violent cramps in the legs, sometimes a painful strangury and bloody micturition ensue. The powers of life begin to fail, respiration becomes laborious, cold sweats break out, hiccup occurs, the countenance assumes a singular character of anxiety and distress, a livid circle appears around the eyes, the pulse is imperceptible, the body swells and sometimes becomes covered with a species of miliary eruption, or with dark purple spots. In some cases convulsions ensue, but delirium, or loss of reason, is very rarely the consequence of this species of poisoning, and the unfortunate sufferer is conscious until a few moments before the termination of his existence. Such are the general symptoms, but it is rare to see them all united in the same case; sometimes the greater part of them are absent. _M. Chaussier_ reports the case of a robust middle aged man, who swallowed a quantity of arsenious acid in large lumps, and died without discovering any other symptom than slight syncope; other cases are related where only vomiting and purging[223] have been observed, and the symptoms have been mistaken for those of _cholera spontanea_. The practitioner is therefore not to withhold his belief in a case of poisoning, on account of the absence of several of those symptoms which are enumerated in systematic works on Toxicology. It is only by the study of individual cases, that he can learn to appreciate the just value of those pathognomonic combinations which afford the least exceptionable evidence upon such occasions. _The different modes of Poisoning by Arsenious Acid._ It has been proved by numerous experiments that the life of an animal may be destroyed with equal certainty by arsenious acid, whether it be _internally_ administered, or _externally_ applied to abraded surfaces, sores, or bleeding wounds; and it has been, moreover, shewn, that in either instance the symptoms will be analogous, except in the latter case they will often be more rapid in their course.