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Introduction
PROLOGUE
I am an evil, poisonous smoke . . .
But when from poison I am freed,
Through art and sleight of hand,
Then can I cure both man and beast,
From dire disease ofttimes direct them;
But prepare me correctly, and take great care
That you faithfully keep watchful guard over me;
For else I am poison, and poison remain,
That pierces the heart of many a one.
(Valentini, 1694845)
The alchemists' symbol for arsenic, a menacing coiled serpent, proba-
bly symbolizes very well the element's prevailing evil reputation.
Anxiety about arsenic is not difficult to comprehend, inasmuch as
arsenic compounds were the preferred homicidal and suicidal agents
during the Middle Ages and arsenicals have been regarded largely in
terms of their poisonous characteristics in the nonscientific literature.
For example, an almost clinical description of acute arsenic poisoning
appears in the novel Madame Bova~y.255 Flaubert's extensive account
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ARSENIC
of Emma Bovary's prolonged death throes must have made a vivid
impression on many a reader. Arsenic has also been referred to in more
recent literature, such as Kesselring's drama, Arsenic and Old Lace. 423
Although arsenic was only one of three poisons used by the Brewster
sisters to dispatch their guests, "Strychnine and Old Lace" or
"Cyanide and Old Lace" would not have had as great an impact on the
public.
A famous case of hypothetical arsenic poisoning was the alleged
attempt to do away with Napoleon Bonaparte on several occasions
during his exile on St. Helena. After analyzing compilations of Napo-
leon's signs and symptoms during his later years, Forshufvud et al. 259
concluded that the Emperor had suffered intermittently from chronic
and acute arsenic poisoning. Neutron-activation analysis of hair repu-
tedly taken from Napoleon's head showed considerably more arsenic
than samples from unexposed people. An editorial concerning
this controversial hypothesis577 set on a large measure of de-
bate ~05 ~32 337 370 666 667 s65 The original hypothesizers later analyzed ad
ditional hair samples attributed to Napoleon and found a distribution of
arsenic along the length of the hair shaft that indicated a periodicity of
exposure that coincided relatively well with the course of his dis-
ease.260 744 However, the evidence of chronic arsenic poisoning of the
Emperor was described as "unsatisfactory, irritating, and tortuous."~04
Another viewpoint was that Napoleon may indeed have received
arsenic, but "only in an honest endeavour to help him."836
The possibility that arsenic compounds were prescribed for Napo-
leon reveals another side of arsenic- its widespread use in eighteenth-
and nineteenth-century medicine as a tonic, or "alterative." At about
the same time that Flaubert was writing Madame Bovary, there were a
half-dozen "official" arsenicals listed in the U.S. Dispensatory.870 The
prevailing professional opinion at that time concerning the medicinal
use of arsenic was summarized as follows :29 "Arsenic is a safe
medicine; none of the respondents having found it permanently detri-
mental. When given in a judicious manner, it did not even induce
serious temporary effects. In the few cases apparently leading to a
contrary inference, there was sufficient evidence of ignorant adminis-
tration, or injudicious perseverance on the part of the patient." The
heyday of arsenical chemotherapeutics occurred in the early part of the
twentieth century, when Ehrlich discovered Salvarsan (arsphenamine),
which was effective in treating human venereal diseases; but the use of
these compounds declined after World War II, with the advent of the
more specific antibiotics.
The complex folklore surrounding arsenic might provide us with an
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Introduction
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example of man's supposed ability to tolerate the element, inasmuch as
peasants in the Styrian Alps of Austria during the nineteenth century
were said to consume arsenic habitually as a means of promoting
physical stamina.30 The origins of this custom are difficult to trace. One
of the best early accounts was that of Roscoe,673 who concluded: "I.
That arsenious acid is well known to and widely distributed amongst
the peasants of Styria. II. That arsenious acid is taken regularly into the
system, by certain persons in Styria, in quantities usually supposed
sufficient to produce immediate death." Maclagan507 had reached
similar conclusions. The nineteenth-century medical establishment,
however, especially in the English-speaking world, remained highly
skeptical of the phenomenon: "Upon the whole, it is not improbable
that the accounts received of the habitual use of arsenic by the peasants
of Styria are either untrue or greatly exaggerated."870 Maclagan508 later
claimed that two habitual arsenic-eaters took their dose in the presence
of a scientific meeting on the Continent, thereby providing "public
testimony to the accuracy of the observations previously made."
Unfortunately, this is one aspect of the biochemistry of arsenic that
will probably never be totally resolved.
Although the earlier medicinal uses and criminal abuses of arsenicals
provide a helpful background of information about these compounds,
the primary purpose of this report is not to determine the human hazards
of such large direct exposures. Rather, this report is concerned
primarily with assessing a more indirect hazard the possibility of
man's harming himself by contaminating his environment with arseni-
cals. There are potential ecologic dangers, in that large quantities of
arsenicals are injected into the environment as a result of industrial and
especially agricultural activities. Paris green (copper acetoarsenite)
was the first pesticide widely used in modern agriculture (see Whor-
ton856 for an account of early agricultural experience with this and other
arsenicals), and several arsenic compounds continue to be used today
(see Chapter 31. Moreover, recent studies have again raised the
question of the carcinogenicity of inorganic arsenic compounds (see
Chapter 61. For some applications, there appear to be no suitable
substitutes for the arsenicals. Therefore, we must learn to manage
carefully the toxic yet useful compounds of arsenic.