DISEASE FROM The inorganic poisons which produce diseases in man are of two classes, the solid, which are more or less soluble, and the vaporous or gaseous.
The salts of the metal arsenic, so much used in the arts, are causes of at least two kinds of disease : one directly affecting per sons who are working in arsenic, as hi the making of artificial flowers, ornamental papers, cards, paper-hangings, dresses of ladies, and candles: the other affecting those who occupy rooms, from the walls or other parts of which particles of arsenical poi son are being diffused into the air. The first may be called the acute, the second the sub-acute or chronic type of arsenical disease.
Acute arsenical disease. The acute type of arsenical disease has been described as a form of phthisis pulmonalis, or consump tion of the lungs, caused, it was believed, by the direct absorption of arsenical dust. When the disease occurred it was thought that the absorption must have taken Place through the pulmonary surface, but the death, some years since, of a girl who was engaged in making artificial flowers led to a modified view. On that occa sion Dr. Hassan showed that the local action of the poison on the skin is directly injurious. The green powder, diffused through the work-room, settles on the head, face, neck, and hands. The hands, Dr. Hassall stated, become stained of a green color, which no washing will remove. At length ugly-looking sores appear on various parts of the body, including chiefly the exposed parts, and there is constant soreness of and running from the eyes. The chest and throat are sore, and there is cough. Finally, from the irritation extending from the throat along the alimentary canal, there is irritation and pain of the stomach, diarrhoea, and absorp tion of the poison, attended with all the symptoms of acute arsen ical poisoning.
Dr. Hassall pointed out, further, that ball dresses colored with arsenical pigment are a source of danger to the wearers of the dresses as well as to the manufacturers of them, and I also col lected some cases of disease, induced by the absorption of arsenic, amongst wearers of artificial flowers colored with arsenical pig ments as well as among artificial flower-makers. My experience is to the effect that although absorption may be by the skin the danger is most frequently developed through the lungs and throat, the arsenical substance being apparently absorbed by the mucous surfaces. The more serious disease to which the workers are sub jected is commonly called consumption, but it is not a consump tion of the ordinary kind, although it is attended with wasting and sometimes ends fatally. It is accompanied by that remission of fever and flush of the face, to which the name of hectic is com monly applied, but it is rarely accompanied by spitting of blood, and it often proceeds a long time without any cough, except the throat cough which springs from irritation at the back of the throat. There is also, as Dr. Hassall describes, irritation of the membrane of the nose and of the eyes, neither of which symp toms are necessarily connected with consumption. In the end, the sufferer, if removed from the work in time, may make a fair re covery, which would not be the case if attacked with true tuber cular consumption.
In some parts of the paper-staining process, the dust of arsen ical coloring compounds is thrown off. This dust, dissolved in the mucous secretions of the mouth and throat, is swallowed into the stomach, and sets up the irritative symptoms of slow arsenical poisoning, viz., pain in the stomach, redness and soreness of the throat, and irritability of the skin. I have seen one instance of this kind, where the symptoms amounted to a modified form of gastro-enteritis. In the mildest of these irritative states of the mucous membrane there is created a persistent dyspepsia, so long as the excitant is at work.
Arsenical salts are employed for the preservation of some or ganic substances, as, for instance, for the preservation of the skins of animals, and, under some circumstances, where the preserving process is not carried out with proper skill, minute particles of the salts are thrown off, float in the air, and so become inhaled.
I have twice seen symptoms of arsenical irritation produced in this manner in a person who had the dusting and cleaning of stuffed animals, in a close and badly-ventilated museum.
Subacute arsenical disease. Some painful affections have been traced to long but less severe exposure to arsenical gases or ar senical particles. The symptoms thus excited are of a class analo gous to those above described but in a modified form. They are symptoms of chronic catarrh or cold affecting the mucous mem brane of the eyes and of the whole bronchial pulmonary tract, the nostrils, the throat, and the bronchial surface. It has been assumed that the skin may also be affected with eruption of a or scaly character from the same cause, and some ob servers have traced out a aeries of nervous affections more or less severe, and often obscure.
About twenty years ago a dispute arose in the world of science on the question whether arsenic could be distributed through the air, in minute particles, from walls covered with arsenical papers, and so become poisonous. On this important point an experi mental inquiry of a very conclusive character was conducted by Professor Abel. In the experiments which Abel carried out, a tube was filled with slips of arsenical paper-hangings and the tube was placed in a room, the temperature of which was raised to 90° Fahr. Through this tube air was constantly drawn by means of an aspirator, and was collected in test solutions. The experiments were exceedingly varied, the paper holding the arsenic being in some cases roughened and in other cases treated with paste in a state of decomposition. The air was made to pass over the arsenical surface for periods of nine days. The result of all these experiments was that not a trace of arsenic could be detected in the solutions; neither were any particles of arsenic mechanically carried over.
In a further experiment six hundred grains of finely pow dered Scheele's Green were uniformly dispersed through a quan tity of cotton wool sufficient to fill, compactly, a tall jar of a gallon capacity. A tube, charged with cotton wool and connected with a test apparatus, was passed to the bottom of the jar, and air was drawn through the apparatus continuously for one week, the jar being placed in a temperature of 90° during a portion of the time. Not a trace of arsenic was found to be volatilized at the conclusion of this experiment.
For many years these experimental facts led to the that arsenical particles can only be diffused in the air when tho surface containing the arsenic is very rough, so that the arsenical colors are loosely attached. At the same time, a great deal of evidence was collected by different observers, indicating that symptoms of arsenical poisoning were produced in persons who were exposed to arsenical surfaces of a smooth kind, and even after such surfaces had been submitted to varnish. These obser vations led Dr. Ramberg of Stockholm to suspect that the arsenic might escape in the gaseous form, that is to say, in the form of arsenide of hydrogen. To learn if this was the fact, he drew the air of a room that was papered with a light-green colored paper through refined test solutions. The color of the paper had undergone a gradual alteration : one part of the arsenious acid had been oxidized to arsenic acid, while another part had been reduced and had been combined with hydrogen, which being vola tile was passing off as a gas, and which he detected in his experiments.
We may gather, then, in considering the action of arsenic upon those who are exposed to it, the probable fact that those exposed inhale, during the exposure, the gaseous arsenic, or, speaking more correctly, arsenic in the gaseous state, in combination with hydro gen. This explanation accounts for many of the facts that have been observed, the arsenical gas being poisonous in such minute proportions, that even to work with it in the laboratory requires considerable care on the part of the worker.
M. Delpech points out various details of facts relating to the effects produced by the inhalation of arsenic derived from the dead bodies of animals that have been preserved by arsenical preparations. He finds that dead animals which have been pre served with Becceur's arsenical soap, and afterwards collected in large numbers in a Museum, charge the dust of the room with arsenic in such proportions that it can actually be removed from the air and proved by analysis. He too believes that surfaces covered with Scheele's Green may yield arsenical gases, devel oped by the reaction of the arsenious acid upon the organic com pounds with which it comes in contact, and that these gases, mingling with the air, infest it and make it a source of danger. He adds, in relation to the practical bearing of the subject, many facts demonstrating that people who live habitually in rooms in which large numbers of dead birds and mammals are preserved by arsenic, are subject to symptoms of arsenical poisoning.
In the instances of disease from inhalation of 'arsenic which have come under my own observation, the evidence of the action of the arsenic was definite enough. But the extreme organic nervous symptoms of convulsion and partial paralysis which have been sometimes described as common to poisoning from slow inhalation of arsenic, have not come so clearly under my own observation.
Dr. Leonard Sedgwick has noticed symptoms of arsenical irri tation occurring in members of a family who occupied a room decorated with blue paper, in the preparation of which arsenic had been used.