SANGER. — CHRONIC ARSENICAL POISONING. 169 



Case 20. This case was also reported to me by Dr. Clarke. Mrs. 

 D., aged GG, had lived in her tenement for nine years. During 

 this time the rooms were papered in different years with papers 

 which, in eight cases, were arsenical (not sent to me for analysis). 

 " General weakness and nervous prostration have been pronounced 

 symptoms of her case. The mouth and throat have been sore. The 

 parts smart and sting, and the sensations extend into the trachea and 

 oesophagus. The tongue is red, especially at the tip, the follicles are 

 large, red, and protrude, and are very sensitive." On leaving the 

 house for a short time, relief was immediate, but the symptoms reap- 

 peared on return to the house. July 2, 1886, the urine contained 

 0.005 mgr. per litre. 



Discussion. 



In all these cases the amount of arsenic eliminated by the kidneys 

 is extraordinarily small, varying from 0.002 mgr. to 0.068 mgr. per 

 litre. In the cases quoted in the historical sketch, the amounts could 

 not have been much in excess of this, and in the analyses of Worcester 

 given in Putnam's paper below, the quantity varied from 0.005 to 0.1 

 mgr. per litre. 



I have been able to find but one quantitative determination of the 

 rate at which small amounts of arsenic are eliminated. ( Hubbard,* in 

 1882, gives the following experiments. -^ grain (3.87 mgr.) of arse- 

 nious oxide was given to a man, in pill form, for five days, and the 

 urine of the last three days collected. On the third day no arsenic 

 was found, on the fourth, 0.01 grain (0.65 mgr.), and on the fifth, 

 " traces." Continuing, fa grain (7.74 mgr.) was given for two days, 

 then 3^ grain (5.16 mgr.) for two days. On the eighth day, -fa 

 grain (1.12 mgr.), and on the ninth, -g\ grain (0.78 mgr.), was 

 recovered. During this time the man was indoors and took no exer- 

 cise. In the second case s % grain (6.45 mgr.) was given for six 

 days to a man who took sufficient exercise each day to induce fatigue. 

 On the fifth day T \^ grain (0.59 mgr.), and on the sixth day T | T 

 grain (0.35 mgr.), was recovered, the urine of the first four days 

 not being examined. In the third case, the person was in feeble 

 health and suffered from indigestion due to gastric catarrh. -fa grain 

 (3.24 mgr.) was given for six days, and on the sixth day no arsenic 



* Physician and Surgeon, Ann Arbor, IV. 348 ; also, Contrib. Chem. Lab. 

 Univ. Mich., I., Part 1. 



