Metallic arsenic is not poisonous, as it is not absorbed from the alimentary canal.
Poisonous compounds:
1. Arsenious oxide or Aresenic trioxide (Sankhya or Somalkar): it is known as white arsenic. It has been found to be useful in treatment of Acute Promylocytic Leukemia (APL)*
2. Copper acetoarsenate (paris green): It combines with sulphydryl enzymes and interferes with cell metabolism.
3. Copper Arsenate (Schcele’s green).
– Signs and Symptoms:
1. The Fulminant type: Large doses of arsenic can cause death in one to 3 hrs from shock.
2. The Gastro enteric type: This is acute poisoning, resembling bacterial food poisoning or cholera.
– This is the most common form.
– The stools are expelled frequently and involuntarily, are dark coloured, stinking and bloody, but later becomes colorless, odourless and water resembling rice water stools of cholera.**
– Sequence of symptoms:
• Throat pain
• Vomitting (Bile, Blood and Mucous)
• Purging (Tenesmus present)
3. Narcotic form: Tenderness of the muscle, delirium, coma and death.
• Arsenic poisoning resembles
– Pre malignant condition
– Cholera
– Fading measles
– Addison’s disease.
– Treatment
1. Freshly prepared precipitated hydrated ferric oxide (arsenic antidote)* is given. Dialysed Iron is substitute.
2. In arsenic poisoning BAL is an antidote. (BAL is contraindicated in cadmium and iron poisoning).
3. Calcium disodium versenate
4. Alkali is contra indicated.
– Postmortem appearance
• Red Velvety* appearance of the stomach mucosa.
• Subendocardial haemorrhage of heart.*
– Chronic poisoning:
1. CNS—Polyneuritic, optic neuritis
2. Skin—finely mottled brown change mostly on the temples, eyelids and neck (RAIN Drop pigmentation)
• There may be a rash resembling fading measles rash*
• Hyperkeratosis and Hyperpigmentation of the palms and soles with irregular thickening of the nails is seen.
• Nails show ALDRICH MEE’s line (Leukoparonychia).{Confuser*
Beau’s Lines
® Chronic Systemic Disease, also Muehrcke’s Line® hypo proteinemia}
• Nails show ALDRICH MEE’s line (Leukoparonychia).
– Arsenophagists are people who take arsenic daily as tonic or as an aphrodisiac and they acquire a tolerance of up to 0.3gm or more in one dose.
Medicolegal Importance
• Arsenic is the most popular homicidal poison.
• Napoleon was killed using Arsenic poison (c.f. Socrates was killed using Hemlock poisoning).
• It delays putrefaction.
• It can be detected in completely decomposed body.
• It can be found in bones, hair and nails for a long time.
• It can be detected in charred bone and ashes.
• It is sometimes used in abortion sticks.
• Arsenic causes Black foot disease.*
• Marsh test and Reinsch test are important Chemical tests*.
Early stages greatest quantity in liver Later keratin tissues: BONE, HAIR & NAILS.
Test for Arsenic®
I. Reinsch Test
II. Marsh Test (mARSenich)
III. Gutzeit Test.
