Slow Poisoning. When arsenic is taken in small quantities, repeated at intervals, for a long time, a condition of slow poisoning is induced, which may eventuate fatally. This method has sometimes been resorted to by poisoners, in order to conceal their crime, by giving to the affection the appearance of a gradually increasing disease. Sometimes it is said that a gradual failure of the vital powers takes place, with loss of appetite, debility, and a general inert state of the faculties of mind and body, without any special or very obvious symptom. But I exceedingly doubt this method of operation. it seems to me quite incompatible with what I have seen of the action of arsenic, and with what is generally stated of its effects, that it should act fatally in this slow way, without producing obvious characteristic phenomena.* The most characteristic symptoms are nausea and vomiting, purging, and severe abdominal pains, following on each occasion the administration of the poison. Thirst, redness of the eyes, and a cutaneous eruption have been occasionally observed by Dr. Pereira, among the first symptoms. Dryness and constriction of throat, hoarseness, soreness of the fauces with painful deglutition, and ptyalism have been noticed in some instances. A chronic condition of inflammation of the alimentary canal is at length induced; furred tongue, and dryness, stricture, and burning heat in the mouth, fauces, and oesophagus are experienced; distress of stomach, with great irritability of the organ, so that everything taken into it is rejected, is not uncommon; there is usually diarrhoea, or at least looseness of the bowels, with griping pains; the pulse becomes frequent, small, and irregular; emaciation takes place; oedema of the face and limbs supervenes; and at last the nervous system becomes seriously implicated, and neuralgic pains, tremors, headache, vertigo, morbid vigilance, convulsions, and paralysis, more or less complete, indicate the slow approach of death. The fatal issue is sometimes preceded by delirium or stupor, and sometimes occurs without them, the mind remaining unclouded to the last. A curious effect, occasionally produced by arsenic, is the falling of the hair and nails.

* See the description of a case of slow poisoning from arsenic in the B. and F. Medico-chirurg. Rev., April, 1856, p. 400.

In the Medical Times and Gazette for February, 1857, Dr. Wm. Hinds called attention to cases of arsenical poisoning, which appeared to result from living in rooms, the walls of which were covered with a paper, coloured by arsenical green, or arsenite of copper. The result was ascribed to the inhalation of particles of the paper which were constantly separating, and floated in the air of the apartment. (Pharm Journ. and Trans., Oct. 1858, p 222.) There seems to be no doubt of the correctness of this statement. A portion of dust from such an apartment, which had accumulated on the tops of some books, was examined by Dr. A. S. Taylor, and found to contain arsenic. (Lancet, Jan. 1859, p. 4.) A peculiar papulous eruption, sometimes followed by ulcers, has been noticed as occurring in the workmen engaged in preparing arsenite of copper. (Arch. Gén., 5e sér., x. 683.)

Appearances after Death. in those cases in which arsenic destroys life as by an overwhelming blow, no abnormal appearance has been found after death. Generally, however, there are abundant signs of inflammation of the mucous membrane of the stomach and bowels, as redness, softening, bloody effusion, ulceration, and sometimes gangrenous patches. Marks of inflammation have been found also in the interior of the heart, the bronchial tubes, the urinary passages, etc. The blood is said to be sometimes fluid and dark; but this is not a necessary or char-acteristic effect of the poison; and M. Flandin has seen the blood of a person poisoned with arsenic perfectly healthy. (Taylor on Poisons, London, 1848, p. 31.) The same evidences of gastro-enteric inflammation have been noticed, after death from the external use of the poison.

Treatment of the Poisoning. if the patient vomit, the stomach should be well washed out by the free exhibition of demulcent liquids; if not, ipecacuanha should be given, and followed by similar drinks, which serve the purpose not only of favouring the expulsive efforts of the stomach, but of involving also the undissolved particles of the poison, especially if, as is generally the case, arsenious acid should have been taken. if the evacuation of the stomach can be effected in no other way, recourse should be had to the stomach-pump. But, along with these measures, antidotes should be employed. Two substances have been proved to possess more or less antidotal power; both, by forming with arsenious acid insoluble and inert compounds. These are hydrated sesquioxide of iron, and freshly precipitated hydrated magnesia. The former is probably most efficient; but, in its absence, the latter may be employed. Arsenious acid probably acts only as it is dissolved, which is rather slowly. The antidote combines with the dissolved portion, as fast as it is taken up by the liquids of the stomach, and before it can either act on the mucous coat, or be absorbed But, to do this effectually, it must be used largely, so as to be present in all parts of the stomach, and be ready at every point to obviate the mischief. it is said that an amount of the chalybeate should be used, not less than twelve times the supposed weight of the arsenious acid swallowed; but it would be better much to exceed this quantity. After the stomach has been thoroughly cleansed, castor oil, or other quick cathartic, also accompanied with the antidote, should be given freely, so as to neutralize and expel any of the poison which may have passed into the bowels. it is advisable to continue the use of the antidote for some time, in order to obviate mischief from any particles of the poison which may still cling to the mucous membrane, and which it is not always easy to dislodge. As the antidotes have no effect on the undissolved arsenious acid, they cannot at once neutralize the whole quantity in the stomach, no matter how largely they may be taken. Hence the necessity of continuing them, as long as there can be a suspicion, that any particle of the poison may still lurk anywhere in the primae viae Attention must also be paid to the inflammatory and irritative symptoms, which must be combated by such measures as the circumstances may seem to call for, in each particular case; bleeding, leeching, blistering, cooling drinks, ice, etc., being employed, one or all, for the relief of the inflammation; and opium, by the mouth or the rectum, for that of the irritation Often, however, the system is too prostrate to admit of free depletion, and sometimes it may be necessary to stimulate.