course of the night. During the next fifteen days he had a paroxysm every evening about the same hour; which returned after an intermission of eight days, and frequently for several months afterwards.
In the following set of cases the nervous symptoms exhibited a singular combination of delirium, convulsions, tetanus, and coma, such as is frequently met with in paroxysms of hysteria; but the cases are probably not pure examples of poisoning with arsenic, for liver of sulphur was administered as a remedy to a considerable amount. Three servant girls in one of the Hebrides ate a mixture of lard, sugar, and arsenic, which had been laid for destroying rats. The ordinary signs of irritation in the stomach ensued, but on the following morning were greatly mitigated. They were then ordered twelve grains of liver of sulphur every other hour. Soon afterwards the inflammatory symptoms became more severe, the root of the tongue swelled and inflamed, and in the afternoon two of them lost the power of speech and swallowing, and were attacked with locked-jaw and general convulsions. The third had not locked-jaw, but was otherwise similarly, affected. On the morning of the third day one of the two former was found comatose, with continuance of the locked-jaw and occasional return of convulsions; and on being roused by venesection and the cold affusion, she complained of headache and heat in the throat. The sulphuret of potass, which had been discontinued on account of the locked-jaw, was then resumed. On the evening of the fourth day the headache increased, and the patient became delirious and unmanageable. The cold affusion, however, soon restored her again to her senses, and from that time her recovery was progressive. In the other patients the symptoms were similar, but less violent. In these instances the evidence of an injury of the nervous system was decisive; but it may be doubted whether the symptoms were not, in part at least, owing to the sulphuret of potass, which has been already described as an active poison, capable of inducing convulsions and tetanus. Its properties were not generally known in this country at the time the cases in question happened.[1]
Sometimes the convulsions caused by arsenic assume the form of pure tetanus. At least a case of this affection is noticed by Portal.[2] He has given only a mere announcement of it; and I have not hitherto met with a parallel instance in authors.
A common nervous affection in the advanced stage of the more tedious cases of poisoning with arsenic is partial palsy. Palsy in the form of incomplete paraplegia is a very common symptom even of the early stage in animals, and has been also sometimes observed during that stage in man. The paralytic affection, however, is more frequent in the advanced stage; and in those persons who recover, an incomplete paralysis of one or more of the extremities, resembling lead-palsy, is often the last symptom which continues.
