ARSENIC. 
§ 755 - 757 -] 
*577 
towards the end, as a specially marked symptom, there was noted 
hyperesthesia of the inferior extremities, so that the least touch was 
painful. 
§ 755. Absence of Symptoms. —In a few cases there has been a 
remarkable absence of symptoms, and this both in man and animals. 
Seven horses were fed with oats accidentally mixed with arseniate of 
soda. The first succumbed three hours after taking the poison, without 
having presented any symptom whatever ; he fell suddenly, and in a 
short time expired. 1 It is related by Orfila 2 that a woman, aged 27, 
expired in about twelve hours from a large dose of arsenious acid ; there 
were the usual post-mortem appearances, but in life no sign of pain, no 
vomiting, and but little thirst. Symptoms are sometimes delayed, as 
in a case reported by Ryan ( Lancet , 1851). A man took 15-6 grms. 
of arsenious acid, and there were no symptoms for nine hours. 
§ 756. Slow Poisoning. —Slow poisoning has been caused accidentally 
by arsenical wall-paper, in the manufacture of arsenical pigments, by the 
admixture of small quantities of arsenic with salt or other condiments, 
and repeated small doses have been used for criminally producing a fatal 
illness intended to simulate disease from natural causes. The illness 
produced by small intermittent doses may closely resemble in miniature, 
as it were, that produced by large amounts ; but, on the other hand, 
it may be different and scarcely to be described otherwise than as a 
general condition of ill-health and malaise. In such cases there are loss 
of appetite, feebleness, and not infrequently a slight yellowness of the 
skin. A fairly constant effect, seen when a solution of arsenious acid 
is given continuously for a long time, is an inflammation of the con¬ 
junctive, as well as of the nasal mucous membrane—the patient com¬ 
plains of “ always having a cold.” This inflammatory action also affects 
the pharynx, and may extend to the air-passages, and even to the lung- 
tissue. At the same time there is often seen an exanthem, which has 
received a specific name—“ eczema arsenicale .” Salivation is present, the 
gums are sore, at times lacerated. In chronic poisoning by arsenic, 
nervous symptoms are almost constant, and exhibit great variety ; there 
may be numbness, or the opposite condition, hyperesthesia, in the ex¬ 
tremities. In certain cases fainting, paresis, paralysis, and sometimes 
convulsions occur ; towards the end a sort of hectic fever supervenes, 
and the patient dies of exhaustion. 
§ 757. The Maybrick Case . 3 —The Maybrick case may be considered an example 
of poisoning extending over a considerable period of time. Mr James Maybrick, a 
Liverpool cotton-broker, aged 49, married Florence Elizabeth, an American lady, 
aged 21. They had two children. The marriage proved an unhappy one. Some 
1 Bouley (Jeune), Ann. d'Hyg. et de Medico-Leg., 1834, xii. 393. 
2 Tome i., Obs. iv. p. 314. 
3 “ The Maybrick Trial and Arsenical Poisoning,” by Thos. Stevenson, M.D., 
Guy's Hosp. Rep., 1889. 
37 
