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The membranes of the brain are hypersemic, and the ventricles are
of serum.

In poisoning by arseniuretted hydrogen post-
mortem examination shows a dirty yellow-
colour of the skin. The mucous membrane of
the stomach and small intestine is yellow in
colour and may show signs of infLammation.
The liver is normal in size or somewhat en-
larged, and may show some fatty degeneration.
The spleen shows the evidence of blood destruc-
tion in the deposits of blood pigment throughout
the organ. The kidneys are enlarged and
congested, and may be inflamed. The lungs
may be cedematous. .

Chronic Poisoning.—Chronic arsenical poison-
ing occurs among persons engaged in works
and factories where arsenic compounds are
used, among persons inhabiting rooms, the walls
of which have been painted with arsenical
pigments, or prepared with coloured papers, or
among persons who have been taking arsenic

fig.    168.—Heart    showing
ecchymoses    in    the    left
ventricle  in  acute poison-
ing by arsenic.

as a medicine for a prolonged period or in too large a quantity. It must be
remembered that chronic poisoning may follow acute arsenical poisoning,
especially when recovery has occurred from a large dose of arsenic.

Symptoms. — The symptoms of chronic poisoning are exhibited in four

First Stage. — The symptoms in the first stage are those of gastric troubles,
viz. malaise, loss of appetite, salivation, c^iaky^pa^nr constipation,- or some-
times diarrhosa and vomiting or glairy mucus tinged with bile. The gums
are red and soft, and the tongue is coated with a thin, white, silvery fur.
The temperature is raised to 102° or 103°F. with a frequent pulse.

Second Stage. — This is marked by cutaneous eruptions and catarrh of
J^^                    There is rtSSKng "of dryness and itching in


the fauces and larynx. Hence the voice becomes hoarse and husky. The
eyes are suffused and the conjunctivas are greatly congested. There is run-
ning from the nose with intense coryza. The patient gets spasmodic cough
with expectoration tinged with blood on account of inflammation of the
bronchial tubes.

Erythematous,   eczematous,   urticarial   or   pustular   eruptions   manifest!
themselves on the skin, chiefly on the folds of the armpits and groins, as well
as on the scrotum.    After a certain time the skin becomes pigmented, and
the epidermis comes off in desquamations.   The nails become brittle and
loose.   The hair becomes dry and may fall off.

Third Stage. — In this the sensory troubles jarejrnore prominent. They
resemble those met with in alcotiD&r*g^sbning more than in lead poisoning.

The first symptom, which appears from a week to three or four weeks,
is headache, followed by numbness, tingling, formication and cutaneous
anaesthesia. Perspiration is well-marked. There is extensive tenderness of
the muscles of the extremities on pressure and the knee jerk is usually lost
The loss of sgytial power%is a constant symptom, but the special senses are

A not deranged.

Fourth Stage.—This is the stage^ofp^ralsgis.   In this stage Hje
become weak and feeble, so that "ffif^S^SF^&ts easily fatigued wMIe
ing or ascending a stairMSase.   He also adopts an ataxic gait wbm he