DOI: 10.7925/drs1.ucdlib_280399
title: Ulceration of intestine from arsenic

description: Watercolour medical illustration depicting ulceration of the intestine from arsenic. It has the alternative reference number 1376, 122 and P4A on the front. The Richmond Hospital Museum reference is B.c.79. The entry for this in P263/1 pg. 14 reads 'Ulceration of intestine from arsenic. Mr Carmichael'. The artist's name is in the bottom right corner 'J. Connolly Del.t' and 'Case of M.l Kenny aet 60' in the bottom left corner. There are three illustrations. The typescript note on the back begins 'Ulceration of the Intestines produced by Arsenic'.
description: Scope and content: The full typescript note on the back reads 'Ulceration of the Intestines produced by Arsenic. Mr Robert W. Smith laid before the Society a drawing exhibiting the post mortem appearances met with in a case where the absorption of arsenic, used externally for the removal of a cancerous growth on the face, led to a fatal issue. The patient, a man aet 60, had a small cancerous ulcer not larger than a shilling on one of his cheeks; it had existed for some years, gave him little or no trouble, and was attended with scarcely any pain. However, as he was anxious to have it cured, an attempt was made to remove it by the application of a powder composed of sixty grains of calomel and one of arsenic. This powder was applied every second day during a fortnight, when it was changed for the arseniate of iron, which was employed for another fortnight, at the end of which period, and shortly after the last application, the patient, who had previously been in the possession of excellent health, was suddenly attacked in the middle of the night with a violent diarrhoea, which rapidly merged into dysentery of the most severe character. No medicine could control the discharge from the bowels; they recurred hourly, and were attended with tenesmus and mixed with blood. At the same time there was ardent and unquenchable thirst, which no description or quantity of drink could appease, together with a sense of heat and constriction in the fauces and oesophagus, and tenderness of the epigastrium. The patient died upon the third day of the attack, the dysenteric symptoms persisting in all their violence to the last. Autopsy – The thoracic viscera were healthy, the stomach presented but little worthy of notice, its mucous membrane was softer than natural, that of the small intestines was extremely vascular, but in the caecum, especially near the valve and appendix, were found numerous large patches of ulceration, by which the muscular fibres were exposed; the mucous membrane around the ulcers was intensely vascular; the colon presented similar appearances; and the rectum throughout its entire extent was highly inflamed and of a bright vermillion colour. Mr Smith expressed his opinion that the morbid state of the intestines which he had described was due to the absorption of arsenic. He grounded this opinion upon the suddenness with which the attack of dysentery occurred, the violence with which it began, the sensation of heat and constriction in the oesophagus, the previously healthy condition of the intestines, the rapidity of the fatal termination, the post mortem appearances, and the circumstance of dysentery not having been prevalent at the time'.
description: Numbering/sequence: Original reference number: 1376.
description: Date details: This illustration is undated, approximate dates are given based on dates for the entire collection.