ARSENIC. 
§ 754 -] 
575 
inencement of the symptoms. This case is also remarkable from the 
absence of pain or tenderness of the abdomen. 
In subacute cases the urine has several times been suppressed, and 
it is generally scanty and red in colour. Irregularity of the heart's 
action and feebleness are tolerably constant phenomena. As the end 
approaches, there is excessive muscular weakness, the face is pale, the 
eyes hollow ; the mucous membranes first, and then the skin, take a 
bluish tint; the skin itself is covered with perspiration, and there has 
been noticed a peculiar odour, which has been likened to arsine (arseniu- 
retted hydrogen). The respiration is troubled, convulsive movements of 
the limbs have been observed, and cramps in the calves of the legs ; 
death follows in a variable time—from twenty-four hours to several 
days. In certain cases there is a curious remission after violent 
symptoms, the patient rallies and seems to have recovered ; but the 
appearance is deceptive, for the symptoms recur, and death follows. 
Recovery may also take place partially from the primary effects, and 
then inflammatory changes in the stomach, etc., set in, with fever and 
the ordinary symptoms which are common in all internal inflammation. 
A single dose of arsenious acid may cause a prolonged and fatal 
illness, one of the best-known examples being that of the suicide of the 
Due de Praslin, 1 who took with suicidal intent, on Wednesday, August 18, 
1847, a dose of arsenious acid. The exact time of the act could not be 
ascertained, but the first effects appeared at 10 p.m. ; there were the 
usual signs of vomiting, followed on the next day by diarrhoea, fainting, 
and extreme feebleness of the pulse. On Friday there was a remission 
of the symptoms, but great coldness of the limbs, intermittency and 
feebleness of the heart’s action, and depression. On Saturday there was 
slight fever, but no pain or tenderness in the abdomen, vomiting, or 
diarrhoea ; on this day no urine was passed. On the Sunday he com¬ 
plained of a severe constriction of the throat, and deglutition was 
extremely painful; thirst was extreme, the tongue intensely red, as well 
as the mucous membrane of the mouth and pharynx, and the patient 
had a sensation of burning from the mouth to the anus. The abdomen 
was painful and distended, the heat of the skin was pronounced, the 
pulse frequent and irregular,—sometimes strong, at other times feeble,— 
the bowels had to be relieved by injections, the urine was in very small 
quantity ; during the night there was no sleep. The duke died at 
4.35 a.m. on Tuesday the 24th, the sixth day ; intelligence was retained 
to the last. As the end approached, the respiration became embarrassed, 
the body extremely cold, and the pulse very frequent. 
§ 754. In the nervous form the ordinary vomiting and purging are 
either entirely suppressed, or present in but feeble degree ; and under 
1 Tardieu, “ Relation Medico-Legale de l’Assassinat de la Duchesse de Praslin,” 
Ann. d'Hyg. Pub. et de Med. Legale, 1847, xxxviii. 390 ; also op. cit., Obs* xi. 
