Arsenic - symptoms of poisoning, treatment. Could this be a cure?

Trivalent arsenic (As+3) binds to the thiol groups of enzymes and other proteins in tissues. When taken orally, it causes enterotoxic, neurotoxic, hemolytic effects and associated kidney and liver damage. In chronic poisoning, arsenic usually accumulates in hair and nails.

Arsenic and its compounds (arsenic anhydride, arsenous acid and its salts, arsenous hydrogen, salvarsan, osarsol, herbicides, “Paris greens”, pesticides) are used to treat seeds, leather, fur, and destroy garden pests.

Arsenic, entering the body through inhalation, being absorbed from the gastrointestinal tract and from the surface of the skin, causes acute or chronic poisoning. Chronic forms of intoxication are more often observed, usually in the form of sensory or mixed forms of polyneuropathy.

What is arsenic and where is it used?

Arsenic, also known as Arsenicum in Latin, is an element of the periodic table, a semimetal. Despite the fact that it is a strong poison for the human body, arsenic also has beneficial properties, which makes it indispensable in various fields:

• agriculture (pesticides),
• deratization and disinfestation (the element is included in many pest control products),
• production of semiconductors and electronics,
• glass industry,
• metallurgy (to impart strength to alloys and increase their anti-corrosion resistance),
• woodworking (for impregnation of wooden products),
• leather and fur industry (as an antiseptic for products),
• medicine (in particular dentistry).

In nature, Arsenicum is present in certain quantities in ore deposits, mountain and earth layers, from where it can be washed out with rain into nearby bodies of water. And when using such water, poisoning is very likely. But this is not the only situation in which arsenic can cause poisoning.

What it is? Description of the element and its physical properties

The periodic table element has an official name (Arsenicum) or arsenic, which means yellow orpiment, and the Russian name most likely refers to the fact that its compounds are used to kill mice and rodents. In the periodic table, the chemical element is located under serial number 33 and is designated As.

The content of the article

1. What it is? Description of the element and its physical properties
2. The role of arsenic for the human body
3. Sources of entry of a chemical element into the body
4. Signs of arsenic deficiency in the body and signs of excess
5. Symptoms of poisoning

Arsenic is conventionally classified as a chemical element of the group of semimetals, but many scientists believe that it is still rather a non-metal. One of the features that distinguishes this element from similar ones is its extreme density, which significantly affects the physical and chemical properties. Its atom has 3 empty electrons and a valence of 3, which determines its chemical properties.

The semimetal is characterized by a steel color, with a greenish tint, but it can also be yellowish, some varieties are black, although it is rarely found in its pure form, being an accompanying component in lead, copper or silver ores.

The largest deposits where this element is mined are located in Georgia, Central Asia, Kazakhstan, Great Britain, the USA, Canada and other countries of Europe and Asia, in some regions of Russia.

Despite its high level of toxicity, arsenic has many important properties used in both medicine and industry. In its pure form, As is used in the synthesis of semiconductors. Another important method of use in the manufacture of paints: sulfides of this substance are used in the creation of paints both for painting and for leather production. The chemical industry uses arsenic acid, which is formed as a result of the oxidation of the starting material.

Interesting historical data

In the 19th century, rumors spread from the States and some European countries about a miraculous cosmetic medicine called Arsenic; all the ladies were sure that it gave the skin a noble paleness and a lively shine to the eyes.

The dosage of the medication was strictly regulated, starting with small doses and gradually increasing….

The moments of using this substance as a means for losing weight are also described. It was added in tiny doses to weight loss pills. What this ultimately led to, history is silent.

On the Internet I came across a photo of a New York newspaper clipping that gives a recipe for delicious waffles with arsenic.

Ways and methods of poisoning

There are only 3 routes of intoxication: inhalation, ingestion and skin contact. This can happen in different ways:

• in cases of murder or suicide attempts, industrial accidents,
• when living in arsenic-contaminated areas,
• inhalation of poisoned air,
• after eating seafood from contaminated waters,
• from the use of pesticides, preservatives (food), herbicides and products against insects, rodents and fungi,
• after drinking raw water,
• in direct contact with semi-metal in production,
• violation of safety regulations when working with arsenic.

In other words, you can encounter arsenic almost everywhere. But whether a person becomes poisoned or not will depend on the concentration of the poison that enters the body.

Signs of arsenic deficiency in the body and signs of excess

The content of any chemical element in the body of a living creature must comply with existing standards. With deficiency or excess, pathologies of varying levels of complexity can develop. This rule also applies to this element. And since it is very toxic, it is important to know the norms regarding its content in the body and the symptoms that indicate the presence of an imbalance.

Deficiency: causes and consequences

The issue of As element deficiency in the human body has not been studied actively; it is assumed that when the chemical is consumed in a dosage of 1 mcg/day or less, deficiency develops.

With a deficiency of the element in the body, blood composition indicators change (the number of triglycerides in the blood and serum decreases), anemia and dermatitis develop.

In animals, a deficiency of this element causes miscarriage and cubs with its deficiency do not grow well.

What are the dangers of excess?

One of the most important aspects of the negative effect of As on human health is a decrease in the absorption of zinc, selenium, and certain vitamins and amino acids. In a minimal amount, this property is not dangerous, but accumulating in the body, this element can cause serious health problems.

Scientists believe that the acceptable rate of intake of As compounds into the body may be 50-100 mcg/day, and the toxicity threshold leading to signs of poisoning is 20 mg.

There may be several reasons for excess arsenicum in the body:

• poisoning by pesticides or insecticides that contain a large dose of this substance;
• work in a manufacturing plant that involves contact with toxic substances. These types of activities include the production of pesticides, the production of various alloys and others;
• smoking, excessive consumption of alcoholic beverages, especially wine;
• disruptions in the regulation of the metabolism of arsenic and other substances in the body.

It is believed that a constant overdose of orpiment, which is a strong carcinogen, can lead to the development of oncology.

Arsenic in dentistry - is it dangerous?

Not so long ago, arsenic paste was used to successfully kill the dental nerve by placing it in the cavity of an exposed diseased tooth. It was assumed that over the next 2 days the poison would reduce sensitivity to zero, the nerve would be removed, and the tooth would be healed.

It would seem that everything is very simple. But there are some nuances here: you can carry arsenic in your mouth for no longer than 2 days. After this time, a visit to the dentist must be made again to remove the paste. Because of this, the question often arises: is it possible to get poisoned by carrying arsenic paste in your mouth?

Oddly enough, many people, afraid to feel pain again, walk with arsenic in their mouth for more days than they should, in order to be sure to “finish off” the nerve. The result here can be one: the poison begins to have a destructive effect on the tooth and soft tissues, which leads to inflammation and rapid destruction of the tooth itself.

Contrary to the existing myth that a filling with arsenic can poison the body, I would like to say that this is not at all the dose of poison that could really lead to intoxication. With arsenic, dental treatment will not lead to poisoning, even if:

Read also: Milk during and after poisoning

• a dental filling containing arsenic fell out and was accidentally swallowed,
• the patient is a child,
• There was an overexposure of the arsenic filling in the mouth.

The minimum amount of arsenic in the composition of the medicinal paste is unable to poison the entire body. But since it can harm the tooth, this substance is rarely used in dentistry. Basically, unless the patient is allergic to modern local anesthetics.

And although arsenic poisoning during dental treatment is impossible, dentists themselves increasingly refuse to use the outdated method of killing the nerve in order to preserve the tooth and its soft tissues. This has been replaced by strong anesthetics that can reduce discomfort to zero, which allows you to painlessly treat the tooth and preserve it for a long time.

Arsenic poisoning. Treatment[edit | edit code]

Arsenic was used as a medicine and poison in Greece and Rome more than 2,400 years ago. Information about it, gleaned from documentary and folklore sources, prompted the first pharmacologists to actively study this substance. Many modern drug treatments are based on Ehrlich's early work with organic arsenic compounds. Once such drugs were used very widely. Currently, arsenic compounds are used only for the treatment of certain tropical diseases, such as sleeping sickness (Chapter 41). In the United States, exposure to arsenic is possible both at work and at home (Winship, 1984; Hindmarshand McCurdy, 1986; NRC, 1999).

Arsenic is widely distributed in nature. It is found in soil, water and air. In some areas of Argentina, Chile and Taiwan, the concentration of arsenic in groundwater is greatly increased, which leads to numerous poisonings. In West Bengal (India), the concentration of arsenic in drinking water is also very high. A similar situation has developed in many western states of the United States. Arsenic is not mined separately, but is obtained as a by-product during the processing of copper, lead, zinc and other ores. In this case, it can enter the environment. Mineral spring waters and effluents from geothermal power plants leach arsenic from soils and rocks rich in this substance. In addition, arsenic is contained in coal, released during its combustion. Another source of arsenic is pesticides and herbicides; the production of these substances is associated with most cases of occupational arsenic poisoning (Landrigan, 1981). Poisoning can be caused by fruits and vegetables treated with arsenic compounds; in addition, arsenic can accumulate in the body of various types of fish and shellfish. Arsenic is sometimes added to the feed of poultry and other domestic animals to speed up their growth. The average person receives approximately 10 mcg of arsenic per day, primarily through food and water.

Arsenic hydrogen (arsine) and arsenous anhydride are used in the production of silicon microcircuits, gallium arsenic and metallic arsenic are used in the production of complex semiconductors containing elements of groups III and V of the periodic table of Mendeleev (such semiconductors are needed for the manufacture of LEDs, lasers and solar cells). Both industries can be a source of metallic arsenic, which is used in technological processes or formed as a by-product.

Chemical state[edit | edit code]

Arsenic exists in several states (metallic, trivalent and pentavalent). The toxicity of a particular arsenic compound depends on the degree of its accumulation in tissues, which is determined by the rate of excretion of the substance. In general, arsenic compounds are arranged in order of increasing toxicity as follows: organic arsenic compounds < As5+ < As3+ < AsH3 (arsenous hydrogen).

In organic compounds, the arsenic atom is bonded to the carbon atom by a covalent bond, and arsenic can be in either a trivalent or pentavalent state. Salvarsan, or arsphenamine (arsenobenzene derivative), contains trivalent arsenic, sodium arsanilate - pentavalent.

Organic arsenic compounds are usually eliminated faster than inorganic arsenic compounds.

Structural formulas of salvarsan and sodium arsanilate.

In the pentavalent state, arsenic is present in arsenates—salts of arsenic acid, H3As04 (for example, lead hydroarsenate, PbHAs04). Pentavalent arsenic compounds have a much lower affinity for sulfhydryl groups and are therefore significantly less toxic than trivalent arsenic compounds. Arsenites are salts of arsenous acids (for example, potassium arsenite, KAsOj), containing trivalent arsenic. Arsenic hydrogen (AsH3), a gaseous compound of trivalent arsenic, differs in toxic effects from other arsenic compounds. Mechanism of action. Arsenates cause uncoupling of oxidation and phosphorylation in mitochondria by competing with inorganic phosphate in the process of ATP synthesis. The resulting arsenic acid ester is unstable and hydrolyzes quickly.

Trivalent arsenic compounds, including inorganic arsenites, primarily react with sulfhydryl groups and, therefore, inhibit many enzymes. The pyruvate dehydrogenase complex is especially sensitive to trivalent arsenic compounds: as a result of the interaction of these compounds with two sulfhydryl groups of lipoic acid, a stable six-membered ring is formed:

Absorption, distribution and excretion[edit | edit code]

The absorption of poorly soluble arsenic compounds, such as arsenic anhydride (As2O3), largely depends on their physical state. In the form of large particles, such substances are less toxic, since they are excreted in the feces without having time to be absorbed. Arsenic acid salts are more soluble in water than arsenic anhydride and are more easily absorbed. According to experimental data, the degree of absorption of arsenic compounds (both tri- and pentavalent) is quite high - 80-90%.

The distribution of arsenic depends on which of its compounds enters the body and how much time has passed since contact with arsenic. Arsenic accumulates mainly in the liver, kidneys, heart and lungs. It is found in much smaller quantities in muscles and nervous tissue. Keratin contains many sulfhydryl groups, so most arsenic is present in hair and nails. Arsenic begins to be deposited in the hair within 2 weeks after entering the body and is found in it for several years. Due to its chemical similarity to phosphorus, arsenic accumulates in bones and teeth, remaining there for a long time. Arsenic easily passes through the placenta and affects the fetus. The concentration of arsenic in cord blood is the same as in the mother's blood.

Arsenic compounds quickly undergo biotransformation in both laboratory animals and humans (Fig. 67.5). Arsenates (pentavalent arsenic compounds) are converted to arsenites (trivalent arsenic compounds) to form oxidized glutathione. Arsenites are methylated to form methylarsenite and dimethylarsenite, which are easily excreted from the body. Arsenic is eliminated in different ways (with feces, urine, sweat, milk, hair, through the lungs and skin). In humans, the main route of elimination is through the kidneys; T )/2 is 3-5 days, which is significantly less than for heavy metals. Methylated arsenic derivatives react less vigorously with endogenous compounds, have less cytotoxic effects, and are more readily excreted in urine than inorganic compounds (NRC, 1999). Among arsenic compounds that are excreted in the urine, 10-30% are inorganic compounds, another 10-20% are methyl arsenites, and 55-75% are dimethyl arsenites.

Impact on the body

So, it is impossible to be poisoned by this semi-metal during dental treatment. However, if the poison enters the body in other ways and in large quantities, serious harm is caused to health.

A lethal dose of arsenic for an adult can be 0.1 - 0.2 g of poison. Sometimes a negligible dose of 0.05 g is enough for a child.

Under the influence of arsenic (after its rapid absorption into the blood), all organs and their systems are affected. The liver, heart, lungs and kidneys are especially affected, and this happens in just a day. After 2 weeks, the substance is found in bones, nails, hair and skin. Wherein:

• biochemical processes are disrupted,
• the nervous system is affected,
• oxygen exchange in cells is disrupted,
• the substance quickly binds to hemoglobin, etc.

Removal of poison from the body during arsenic poisoning occurs with feces and urine, and with urine much faster. The remnants of the received dose are stored in tissues and organs, continuing to have a detrimental effect.

Chronic arsenic poisoning[edit | edit code]

The most common early signs of chronic arsenic poisoning are muscle weakness and muscle pain, hyperpigmentation of the skin (especially the neck, eyelids, nipples and armpits), hyperkeratosis and swelling. Gastrointestinal disorders are less pronounced than in acute poisoning. Other symptoms that may suggest arsenic poisoning include garlicky breath and sweat, increased salivation and sweating, stomatitis, generalized itching, sore throat, runny nose, lacrimation, numbness, burning and tingling in the extremities, dermatitis, hypopigmentation and alopecia. The disease may develop gradually; First, weakness, lethargy, loss of appetite appear, and sometimes nausea and vomiting, as well as diarrhea or constipation. Subsequently, symptoms resembling acute rhinitis occur. Dermatitis and hyperkeratosis of the palms and soles are typical. Another characteristic sign is the deposition of arsenic in the nails in the form of transverse white stripes (Mie lines), which usually appear 6 weeks after contact with arsenic. Since nails grow at a rate of 0.1 mm/day, the Mie lines can be used to approximately determine when poisoning occurred. Peeling of the skin is observed; epithelial desquamation can also occur in other organs. The liver enlarges; With obstruction of the biliary tract, jaundice appears. As a result, cirrhosis of the liver may occur.

Possible kidney failure. With severe intoxication, encephalopathy develops. Neuropathy leads to paralysis and loss of sensation in the limbs; Unlike lead poisoning, the legs are more affected, not the arms. The bone marrow is severely affected. In severe poisoning, all the formed elements of the blood are affected. Treatment. In case of acute poisoning, it is necessary to stabilize the patient's condition and prevent further absorption of arsenic. It is important to maintain blood volume as gastrointestinal disturbances can cause hypovolemic shock, which can be fatal. To eliminate arterial hypotension, in addition to infusion therapy, vasopressor agents are used.

Kammex-forming agents

. In acute poisoning, dimercaprol is usually prescribed first (3-4 mg/kg IM every 4-12 hours). The drug is administered until the symptoms of gastrointestinal damage disappear and activated charcoal appears in the stool (if it was used). After this, instead of dimercaprol, penicillamine is prescribed at a dose of no more than 2 g/day in 4 divided doses for 4 days. If symptoms return after treatment, a second course of penicillamine will be given. Promising results have been obtained using succimer, a derivative of dimercaprol (Graziano et al., 1978; Lenzetal., 1981; Fournier et al., 1988). However, succimer is currently only approved by the FDA for the treatment of lead poisoning in children.

For chronic poisoning, dimercaprol can also be used in combination with penicillamine, but penicillamine alone is usually sufficient. During treatment, the concentration of arsenic in the urine is periodically measured. The duration of treatment depends on the results of these measurements and the patient's condition. Side effects of complexing agents (see below) limit their use. Severe arsenic nephropathy may require hemodialysis. Successful removal of arsenic using this method has been reported (Vaziri et al. 1980).

Arsenic hydrogen

. This gas, formed during electrolytic or metallothermal processing of arsenic-containing polymetallic ores, occasionally causes industrial poisoning. In case of poisoning with arsenic hydrogen, in contrast to poisoning with other arsenic compounds, severe hemolysis quickly develops, which often leads to death. Apparently, hemolysis is caused by the interaction of arsenous hydrogen with hemoglobin and the subsequent reaction of the resulting complex with oxygen. A few hours after poisoning, headache, loss of appetite, vomiting, paresthesia, abdominal pain, chills, hemoglobinuria, increased levels of bilirubin in the blood and anuria occur. Hemolysis, abdominal pain and hematuria constitute the classic triad of symptoms of arsenic hydrogen poisoning. Jaundice develops within 24 hours. Due to methemoglobinemia and jaundice, the skin often acquires a bronze tint. In the kidneys, hemoglobin casts are usually found, as well as swelling and necrosis of proximal tubular cells. If the patient does not die from severe hemolysis, the cause of death is often renal failure. Since the complex of hemoglobin with arsenous hydrogen is not removed by dialysis, in severe cases an exchange transfusion is indicated. Forced alkaline diuresis can also be used. Dimercaprol is not recommended because it does not reverse hemolysis or improve renal function.

It is important to note that many metals (such as lead) contain arsenic or antimony. When such metals interact with acids, arsenic hydrogen and antimonous hydrogen can be formed, respectively.

Symptoms

Signs of arsenic poisoning in acute form are quite characteristic. This specificity helps to identify the problem in time:

• temperature increase,
• thirst, dehydration,
• vomiting with nausea,
• sharp pain of varying intensity in the stomach,
• decreased diuresis,
• weakness,
• loose stools that look like rice water,
• numbness of hands and feet,
• metallic taste in the mouth,
• convulsions,
• partial loss of vision,
• the characteristic smell of garlic from the mouth of a poisoned person,
• heart failure, tachycardia, decreased blood pressure.

Read also: Poisoning in humans with Domestos

These symptoms of arsenic poisoning indicate an acute form. But with constant contact with this poison (for example, when working in production where Arsenicum is used), the intoxication takes on a chronic form.

Chronic arsenic poisoning will not be immediately noticeable, but it will eventually result in very serious problems due to the growing amount of poison that gradually accumulates in the body:

• the upper layers of the skin grow and become scab-like (hyperkeratosis),
• whitish stripes appear on the nail plates of the hands and feet,
• the skin peels and flakes off even in those parts of the body that have always been protected from contact with poison,
• red spots appear on the head, chest, armpits and scrotum,
• encephalopathy and neuropathy develop,
• convulsions,
• destruction of red blood cells - hemolysis,
• toxic hepatitis,
• burns of the larynx, ulcers of the esophagus, bleeding in the gastrointestinal tract,
• renal failure with blood in urine darkened due to hemolysis,
• coma.

If acute arsenic poisoning is accompanied by symptoms that develop half an hour after taking a dose of poison, then in the chronic form, signs of intoxication can be noticed only after 0.5 - 2 months.

Toxic effect of arsenic[edit | edit code]

The effects of arsenic compounds are varied and affect many organs and systems (see below). The cardiovascular system. In acute and subacute poisoning, small doses of inorganic arsenic compounds have a mild vasodilator effect. Increased capillary permeability leads to hidden swelling (especially on the face) and weight gain, which was previously mistakenly regarded as a tonic effect. The permeability of the capillaries of internal organs increases to the greatest extent. When exposed to higher doses, a significant decrease in blood volume is possible due to the release of plasma from the vascular bed. As a result, arterial hypotension, heart failure and arrhythmias develop. In chronic arsenic poisoning, peripheral arteries are affected (Engel et al., 1994), up to gangrene of the extremities, most often the feet.

Figure 67.5. Metabolism of arsenic compounds in humans.

Prolonged exposure to arsenic may be accompanied by myocardial damage and arterial hypotension.

Gastrointestinal tract[edit | edit code]

Acute and subacute arsenic poisoning is manifested by a variety of gastrointestinal disorders, from mild cramping abdominal pain and diarrhea to severe hemorrhagic gastroenteritis accompanied by shock. In case of chronic poisoning, there are usually no symptoms of gastrointestinal damage. In small doses, inorganic arsenic compounds, especially trivalent arsenic, cause slight congestion of internal organs. In case of poisoning with higher doses, plasma escapes from the capillaries and the formation of vesicles under the gastrointestinal mucosa. The vesicles subsequently rupture, the epithelium sloughs off, and plasma enters the intestinal lumen, increasing the volume of intestinal contents. Tissue damage and an increase in the volume of intestinal contents leads to increased peristalsis and the appearance of characteristic large, watery stools, reminiscent of rice water. Due to the suppression of epithelial proliferation, tissue damage increases. Soon blood appears in the stool. Upper gastrointestinal involvement usually manifests as bloody vomiting. Possible stomatitis. Sometimes the symptoms grow so imperceptibly that arsenic poisoning remains unrecognized for a long time.

Kidneys[edit | edit code]

Severe kidney damage is possible due to the toxic effect of arsenic on renal capillaries, tubules and glomeruli. First, the glomeruli are affected and proteinuria appears. Later, dystrophy and necrosis of the tubular epithelium occur. Oliguria with proteinuria, hematuria and cylindruria is often observed.

Leather[edit | edit code]

When arsenic poisoning occurs, the skin is the first to suffer. Hyperpigmentation of the skin of the trunk and extremities (diffuse or in the form of small spots) is often the first manifestation of chronic arsenic poisoning. The time to onset of hyperpigmentation is dose dependent; it can be detected as early as 6 months after contact with arsenic. Over the years, hyperkeratosis occurs, mainly in the area of ​​the palms and soles. With long-term intake of inorganic arsenic compounds in low doses, dilation of the blood vessels of the skin occurs, as a result of which it acquires a characteristic color (“blood and milk”). Over time, arsenic can cause skin cancer.

Nervous system[edit | edit code]

Acute or subacute poisoning with high doses of arsenic can be accompanied by encephalopathy, but most often arsenic causes polyneuropathy with “socks” and “gloves” dysesthesia, similar to Guillain-Barré syndrome (Donofrio et al., 1987). Subsequently, weakness of the limb muscles occurs; with prolonged contact with arsenic, tendon reflexes decrease and muscles atrophy. Changes in the brain are caused mainly by vascular damage and are observed in both gray and white matter. A characteristic feature is multiple symmetrical foci of hemorrhagic necrosis.

Blood[edit | edit code]

Inorganic arsenic compounds affect the bone marrow and cause changes in the cellular composition of the blood.

Blood tests usually reveal anemia with mild to moderate leukopenia, and sometimes eosinophilia. With longer contact with arsenic, anisocytosis occurs. Bone marrow vascularization increases. Some late hematological disorders may be a consequence of folic acid malabsorption. In case of poisoning with organic arsenic compounds, severe irreversible changes in the blood and bone marrow are rarely observed.

Liver[edit | edit code]

Inorganic and some now obsolete organic arsenic compounds have a strong toxic effect on the liver, causing fatty degeneration, centrilobular necrosis and cirrhosis. The severity of the injury can vary from mild to extremely severe and fatal. Usually the liver parenchyma is damaged, but in some cases the clinical picture resembles obstruction of the common bile duct, and pericholangitis and bile casts in the bile capillaries are found in the liver.

Malignant neoplasms[edit | edit code]

More than 100 years ago, it was noted that the use of drugs containing arsenic could cause skin cancer (Hutchinson, 1887). In 1980, the International Agency for Research on Cancer concluded that inorganic arsenic compounds are carcinogenic to both the skin and the lungs (if inhaled). It was later shown that the increased incidence of lung cancer and bladder cancer in Taiwan, Argentina and Chile is due to high (on the order of several milligrams per liter or higher) concentrations of arsenic in drinking water. An increased risk of other malignancies, such as kidney and liver cancer, has also been reported, although the link between these diseases and arsenic is less clear. At the same time, arsenic was recently found to be effective in acute promyelocytic leukemia (Chen et al., 1996).

How to help the victim

Although mild poisoning does not require hospital treatment, only a doctor can determine the severity of the problem. Therefore, first of all, you need to call an ambulance, and during its journey, independently help the victim:

• provide fresh air,
• give 1 glass or 1 liter of acidified water to drink (with 1 liter of vinegar or 3 g of citric acid) to cleanse the stomach,
• if there is hydrogen sulfide water in the house, give it a solution (100 ml) to neutralize the poison and transform it into a safe substance - arsenic sulfide,
• give sorbents (any except activated carbon, which is useless in this situation),
• in case of dehydration, unsolder the victim little by little, but often,
• If a toxic substance gets on your skin, wash it off with soapy water.

It is unlikely that in any home there will be drugs for every occasion, much less antidotes against arsenic. Therefore, all other actions will be carried out by doctors.

"Military arsenic."

After the use of chlorine and other poisonous gases during the First World War, chemists in different countries began to develop even more deadly chemical weapons. They, of course, paid a lot of attention to arsenic. In 1918, the American chemist W. J. Lewis, in search of new components for chemical weapons, reacted acetylene with arsenic chloride in the presence of aluminum chloride. As a result, it formed a dark brown liquid with the smell of geranium, which contained b-chlorovinyldichloroarsine as the main component: AsCl3 + C2H2 ® ClCH=CHAsCl2, as well as b,b'-dichlorodivinyldichlorarsine (ClCH=CH)2AsCl2 and b,b' ,b"-trichlorotrivinylarsine (ClCH=CH)3As. This pleasant-smelling mixture, named lewisite after the chemist, had a terrible blister, generally poisonous and irritating effect. Already at a concentration of 0.3 mg/m3, lewisite vapor causes irritation of the upper respiratory tract, and with increasing concentrations it causes damage to the eyes, skin and death. When droplets of lewisite come into contact with the skin, it is quickly absorbed into it, disrupting the course of many biochemical processes and causing severe damage to the body, especially the vascular system. This circumstance at one time gave rise to the Americans calling lewisite “the dew of death.”

Soon other arsenic poisonous substances were synthesized. Among them was a group of irritating substances, its typical representatives being diphenylchloroarsine (C6H5)2AsCl, diphenylcyanoarsine (C6H5)2AsCN, adamsite:

Substances of this group selectively act on the nerve endings of the mucous membranes - mainly the membranes of the upper respiratory tract. This causes the body to reflexively release the irritant by sneezing or coughing. Unlike tear poisonous substances, these substances, even in mild poisoning, act even after the affected person has escaped from the poisoned atmosphere. Within several hours, a person is shaken by a painful cough, pain appears in the chest and head, and tears begin to flow involuntarily. Vomiting, shortness of breath, and a feeling of fear occur; all this leads to complete exhaustion. And in addition, these substances cause general poisoning of the body.

Fortunately, lewisite and other arsenic toxic substances did not have time to be used in the war, but in all countries, including the USSR, lewisite was accumulated in huge quantities - tens of thousands of tons. It is not easy to neutralize it in a safe way. One of the methods is oxidation to low-toxic arsenic acids:

ClCH=CHAsCl2 + H2O2 ® CHAs(O)(OH)2 + 2HCl;

another way is chlorination with the formation of AsCl3, which is used in industry (see ARSENIC).

Treatment in hospital

If the poisoning is determined to be severe, the patient will be transported to the department. There, under medical supervision, he will receive the necessary treatment:

Read also: Body poisoning from exhaust gases

1. Antidotes. The introduction of an antidote is a necessary step in the treatment of poisoning. In case of acute arsenic intoxication, Unithiol will play this role as the main antidote. It neutralizes the poison, turning it into a safe compound, and removes it from the body along with urine. It is administered intravenously (injection or dropper) or intramuscularly. In the chronic form, D-penicillamine is used as an antidote - one gram orally 4 times a day.
2. Oxygen. Inhalations with it are indicated for arsenic vapor poisoning.
3. Atropine + morphine. They are administered by injection if pain in the stomach persists.
4. Hemodialysis, blood transfusion, increased diuresis. They are carried out selectively depending on how badly the kidneys are damaged.
5. Novocaine + glucose in the presence of blood in the urine.
6. Calcium chloride (or saline + glucose + adrenaline) to maintain blood pressure and maintain fluid volume in the body.

Treatment after severe poisoning can last up to 2 years. Therefore, after an inpatient course, it is necessary to adhere to rehabilitation standards: do not violate the drinking regime, take baths with alkalis, follow the prescribed diet, and continue vitamin therapy.

First aid for poisoning

In case of arsenic poisoning at home, it is necessary to call an ambulance, and before it arrives, try to provide first aid to the victim.

First aid steps:

• Gastric lavage. The patient should drink a large amount of water and forcefully induce vomiting. It is recommended to do the procedure several times to prevent absorption of the poison by the gastrointestinal tract.
• Give the patient any sorbent - it can be activated carbon, Smecta or Enterosgel.
• Do not leave the victim unattended until the medical team arrives.

We recommend: Ammonia poisoning

If poisoning occurs in a child, gastric lavage is carried out only by medical workers through a special tube.

Consequences

Severe poisoning often affects the body quite seriously, leaving behind additional health problems. After a strong (or long-term) toxic effect of arsenic (even after high-quality treatment), the following may appear:

• polyneuritis,
• decreased immunity with subsequent manifestation of existing chronic diseases,
• failure of the liver, lungs, kidneys, heart,
• headaches after exposure to the central nervous system (mainly felt in the back of the head, forehead and temples).

The consequences of poisoning in children are especially severe: they experience disturbances in speech, hearing and coordination of movements.

Arsenic is a strong carcinogen that, after poisoning, can cause cancer of the prostate, lung, kidney, bladder or liver.

Symptoms of poisoning

It is not difficult to determine the acute form of arsenic poisoning by external signs. The most obvious symptoms include:

• presence of a metallic taste in the mouth,
• the stomach often hurts,
• Vomiting and diarrhea are observed.

In the most severe cases, it can lead to: acute renal and liver failure and even paralysis with a fatal outcome. If the poisoning is chronic, symptoms include:

• frequent headaches,
• damage to the blood vessels and respiratory system,
• allergic skin reactions,
• constant fatigue and irritability.

The consequences of arsenic poisoning are sad, these may be signs:

1. damage to the lungs and kidneys, fatty hepatosis,
2. decreased hearing acuity in children, appearance of skin ulcers,
3. development of psychoses and impaired motor coordination,
4. violations of muscle trophism, development of endemic goiter,
5. manifestations of diseases of the nervous system (encephalopathy, seizures, speech disorders),
6. development of polyneuritis and immunodeficiency,
7. lesions of the gastrointestinal tract and bone marrow,
8. development of oncological diseases of the blood, skin, eyes

How to provide first aid for poisoning

A toxic substance can enter the body in several ways:

• by mouth when ingested;
• when inhaling vapors of this substance;
• through skin pores.

Once inside, arsenicum, through the movement of blood, moves to the internal organs - liver, heart, lungs and spleen, affecting the digestive organs and nervous system. Entering cells in large quantities, it inhibits their work, including interfering with the implementation of the most important biochemical processes and disrupting cellular respiration. At a dosage of 0.05 g or more, this substance can become deadly.

If the victim exhibits characteristic symptoms of poisoning, a set of first aid measures must be taken:

1. Call an ambulance;
2. If the victim has lost consciousness, turn him on his side, and if breathing stops, carry out resuscitation;
3. If the victim is conscious, cleanse the body of the toxin. To do this, do a gastric lavage by adding 2 tablespoons of salt per liter of water. If this toxic substance gets on the skin, it is removed from its surface using a large amount of soap and water and a washcloth;
4. Elimination of the consequences of intoxication and prevention of dehydration - the victim is given frequent, light drinks. Sometimes it is recommended to take activated carbon, but it is quite weak to neutralize the poison.

Depending on the condition of the victim, he will be subject to hospitalization (in severe cases) or may be treated at home when the dose of toxin is insignificant and there is no danger to life.

Therapeutic measures for poisoning, their intensity and nature will depend primarily on the degree of damage by the toxin. If poisoning with toxic vapors has occurred, inhalation is used.

To cleanse the blood of toxic components, infusion therapy is carried out; if renal failure develops, appropriate therapeutic actions are carried out, and in case of damage to the cardiovascular system, special supportive therapy is used.

In a medical hospital, to eliminate the toxic effect of As, they resort to its most effective antidote “Unitiol”, which is administered intravenously or intramuscularly.

Application in medicine

The powerful effect of this semi-metal has long been appreciated by doctors, and for many centuries it has been used for anesthesia, as well as for dental purposes. The main effects of this substance, which have long been valued in medicine, can be considered a cauterizing, irritating and necrotizing effect. The latter feature is still partially used in the field of dentistry today.

Due to the strong toxicity of this substance, with the development of new technologies in medicine, it began to be used much less frequently, but in some areas it is still used. These areas include dentistry and oncology.

Arsenic for dental treatment

Dentistry is one of the few areas in which this substance is still used. True, today it is not arsenic itself that is used for dental treatment, but a special compound called arsenic anhydride.

It is not used in its pure form, but as part of a special paste, the purpose of which is to devitalize the dental pulp. In simple words, it kills the nerve, which is required in case of damage to the hard parts of the teeth by caries, usually accompanied by severe pain.

This effect is ensured due to the presence of protoplasmic poison in the composition of this element, which, by reacting with sulfhydride groups, helps block enzyme systems. The consequence of this effect will be hypoxia of cells and their subsequent death, which is actually required from the action of a paste with arsenic anhydride in its composition.

Many patients are interested in how safe it is to use arsenic pastes in dental treatment and whether it is possible to find equally effective and less toxic analogues.

In this aspect, experts argue that such pastes can cause harm in one way or another only if you do not follow the procedure technology or violate the rules and terms of use of this product.

Contraindications. There are also some contraindications to dental treatment with arsenic paste. They apply primarily to patients with a tendency to allergies, children under 1.5 - 2 years old, those who suffer from diseases of the genitourinary system, increased intraocular pressure.

This method of treatment is also contraindicated in the presence of incompletely formed or absorbable roots or in the case of the formation of through holes in the root, as well as some other contraindications.

As for poisoning, which many patients in dental clinics fear, such a consequence is only possible if the doctor has significantly exceeded the dosage or duration of the drug. Therefore, the doctor gives precise instructions on how long to keep arsenic in the tooth.

Another risk group is patients who drink alcohol after applying the paste. Alcohol can enhance the effect of arsenic compounds, thereby increasing their toxicity. In other cases, poisoning as a result of using the paste is unlikely.

Arsenic in the fight against leukemia

The ability of arsenicum to stop cell viability is also useful in the treatment of cancer, especially leukemia. This disease, called leukemia or leukemia, refers to blood pathologies.

The main essence of leukemia is the formation of a tumor as a result of multiple replication of immature bone marrow cells. If there is no proper and timely treatment, tumor tissue grows, then the appearance and growth of metastases begins in the main organs and organ systems.

The As element effectively suppresses the excessive formation of leukocytes and promotes more active formation of red blood cells, which has an additional therapeutic effect.

When treating leukemia, the degree of the disease should be taken into account - arsenicum-based remedies are most effective in the primary stage, immediately after the diagnosis is made, until a significant enlargement of the lymph nodes and spleen begins. If the disease reaches a more serious level, the effectiveness decreases sharply.

It is believed that arsenic is an essential, immunotoxic poison, which tends not only to harm health, but which the body cannot do without.

When studying the issue of the chemical and therapeutic properties of arsenicum, the features of its use in medicine and other fields, it should be taken into account that the effect of the semi-metal on health depends on the methods of application, dosage and individual characteristics of the person.

Prevention

Since arsenic is a poison that can cause not only disability, but also death, compliance with preventive measures is extremely important.

To protect yourself and others from the harmful effects of arsenic, it is enough to follow simple rules:

• in production, observe all necessary safety measures (protective uniform, neatness, etc.),
• do not shy away from undergoing medical examinations,
• do not drink raw water,
• do not buy products secondhand from strangers,
• Do not store substances containing arsenic in the house.

But if, nevertheless, it was not possible to avoid poisoning for some reason, the main thing is to remember the need to immediately call a doctor. You will not be able to determine the severity of intoxication on your own or completely remove the poison from the body.

When is medical help needed?

For any type of arsenic poisoning, treatment should be carried out by toxicologists. Victims are prescribed dithiol antidotes (Unithiol, lipoic acid). The dosage is determined by the doctor based on the severity of the poisoning, the weight and age of the patient, general health and other factors. To improve metabolic processes, vitamin therapy (Ascorbic acid, B vitamins) is indicated. If the functions of the cardiovascular system are impaired, they are corrected. Oxygen therapy is provided if necessary.

Treatment of inhalation arsenic poisoning includes local anti-inflammatory therapy and the mandatory use of dithiol antidotes.

For inflammatory processes in the conjunctiva and cornea, a 5% solution of Unithiol is instilled into the eyes.

Chronic arsenic poisoning is treated with the administration of D-penicillamine. Symptomatic therapy is also carried out, aimed at eliminating the symptoms of poisoning and removing the poison from the body as quickly as possible.