Arsenic poisoning in humans: signs, consequences, first aid

Arsenic is one of the elements of the periodic table, with the atomic number 33 and in Latin designated as As (arsenicum). The substance is a fragile semi-metal and has a color reminiscent of steel with a greenish tint. In nature, it can exist both in free form and as part of many compounds, posing a certain danger to living beings, since it is poisonous. Arsenic can be found in many minerals, and in particular lead, copper, cobalt, zinc, silver and tin ores, from where it easily passes into the soil or water, so arsenic poisoning can even be obtained accidentally, for example, by drinking from a metal vessel containing particles of a poisonous substance. By the way, such cases were reflected in the annals of the Chinese people.

A bit of history

Arsenic is considered one of the poisons, references to which have ancient roots. It is not known for certain who was the first to isolate this chemical element from natural compounds. Some historians attribute the primacy to the German scientist and alchemist Albert the Great (13th century), but there is no strict documentary evidence of this. However, in the works of the Swiss doctor and alchemist Paracelsus (16th century), one can find a detailed description of the production of free arsenic by reaction with eggshells.

In fact, obtaining arsenic in its free form was not particularly difficult. For example, arsenic sulfide, which is part of mineral ores, is similar in appearance and properties to mercury minerals, and extracting mercury from these materials was considered a very easy matter. This was used not only by European alchemists (the Renaissance in Italy, Spain, England, and France was marked by a huge number of deaths due to deliberate arsenic poisoning, the culprits of which were even the highest-ranking persons of these rather developed countries), but also by Russian healers, of whom there were more than enough in Rus' at that time.

In the Middle Ages, arsenic poisoning in Rus' was considered one of the most popular ways to resolve political issues, deal with those who were inconvenient and rivals. For example, the same Ivan the Terrible used the services of an astrologer and false doctor from Westphalia, Elisha Bomelius, as a result of which all the courtiers who somehow displeased the ruler and the tsar himself were subjected to poisoning with mercury, arsenic, lead. These metals in small quantities do not act immediately, forcing the victim to suffer. This gave Ivan the Terrible considerable pleasure. However, it later turned out that the tsar himself received "treatment" with the same drugs thanks to Bomelius.

In the 17th-18th centuries, a wave of poisonings swept across Italy. The culprit of most of them is considered to be Teofania di Adamo, who personally made poisonous water that had neither a taste difference from ordinary water nor a specific smell. This water was called "aqua Tofanu", and it contained arsenic and belladonna extract. The poisonous water killed its victims slowly, causing symptoms similar to various serious diseases (for example, typhoid fever). It is clear that medicine at that time was still at a low level, so it was practically impossible to accurately diagnose poisoning or illness, which allowed the criminal to act for a long time with impunity, bringing more than 600 people to the grave.

Arsenic poisoning is not such a common occurrence these days, people have become more civilized and the times when important state (and not only!) issues were resolved with the help of this chemical element have sunk into oblivion. The reasons causing such severe poisoning, which threatens a person with a terrible death, have also changed.

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Causes arsenic poisoning

As already mentioned, arsenic poisoning can be acquired without even suspecting it, because arsenic can be found in different environments: soil, water, air. In nature, it exists in two forms: as inorganic compounds with oxygen (oxides), chlorine (chlorides) and sulfur (sulfides) or as an organic compound with hydrogen or carbon. Inorganic forms of arsenic are the most dangerous, although inhaling its organic forms can also cause significant harm to the body.

The danger of this brittle semi-metal is that people widely use it in various areas of their lives: in agronomy, in manufacturing, in dentistry, in the pharmaceutical industry, and to control rodents.

The Russian name of the poisonous substance itself has simple ancient roots, because for centuries arsenic has been used to kill mice, rats and other rodents that harm the national economy. As we can see, in the Middle Ages, not only many people died from arsenic, but also hordes of rodents that settled in grain storage facilities and storerooms. Such use of arsenic is known even today, which carries a certain risk for both animals and people.

The mouse poison itself is indistinguishable from flour in appearance and due to the lack of a specific smell, so its storage and use should be very careful.

In agronomy, arsenic is considered a fairly strong pesticide that helps in the fight against plant pests. However, the plants themselves used for food and their fruits can also absorb particles of this poison with water and nutrients from the soil, which then enter our body. In connection with this, the use of arsenic in agronomy when growing fruit plants and root crops had to be limited.

However, arsenic is used quite widely in industry and without any special restrictions. Compounds of As with silicon are used in the manufacture of semiconductor elements, which are actively used in electronics.

Metallurgy has found application for arsenic, adding it to various non-ferrous metals (most often copper and lead), which makes them stronger. By the way, the combination of arsenic and lead is found in shot for hunting rifles, which is designed not only to injure, but also to kill. Arsenic compounds with metals are popular in the manufacture of bearings. Adding arsenic makes such compounds more susceptible to high temperatures and corrosion, makes them stronger and more durable.

A chemical compound of arsenic with oxygen (arsenic oxide) is used in the production of glass, for impregnating wood products, which makes them more resistant to the aggressive effects of various environmental factors (soaking and corrosion in liquid, damage by insects, etc.), as an antiseptic solution in the tanning of animal skins.

But as we already know, arsenic compounds are considered to be quite unstable, which means that both during the production process and when using products containing particles of this toxic substance, arsenic can penetrate into the air and water, which subsequently reach a person who is in close contact with the product.

Previously, arsenic was actively added to some decorative building materials (wallpaper paints, plaster, etc.). At high air humidity, arsenic formed organic volatile compounds, which in large quantities can also cause poisoning when inhaled with air.

Arsenic is also widely used in medicine. Despite the fact that this microelement is poisonous, in some cases it can save a person's life rather than destroy it. Thus, arsenic is widely used as part of inorganic compounds in the treatment of leukemia, because this substance can suppress the pathological synthesis of leukocytes and stimulate the production of red blood cells. Similar drugs are also used in the treatment of anemia.

Inorganic arsenic-based preparations are also used in the treatment of chronic skin diseases (lichen rosacea, psoriasis, etc.). They are also used for exhaustion, neuroses, and neurasthenia.

Organic arsenic compounds are contained in drugs that are used in the treatment of pathologies caused by protozoan parasites (Aminarson, Novarsenol, etc.).

Despite the fact that arsenic is contained in the human body in limited quantities and performs many useful functions (stimulates metabolism and production of red blood cells, promotes the absorption of nitrogen and phosphorus, inhibits oxidation processes, etc.), an increase in its content in the blood and tissues can lead to the appearance of toxic phenomena. Therefore, the use of drugs containing arsenic compounds should be carried out strictly under the supervision of a doctor, and the dosages should be minimally effective.

It is no secret that arsenic is still used in dentistry. In this regard, many are concerned about the question of whether arsenic poisoning is possible during dental treatment?

Yes, a drug called "Arsenic anhydride" was previously actively used as a temporary filling for necrosis of the dental nerve. True, now such treatment is carried out less and less often, despite the fact that the dose of arsenic in the filling is unlikely to cause poisoning, unless several teeth are filled one after another. It turns out that theoretically this is quite possible, but in practice, if all precautions and time frames are observed, such cases have practically never occurred.

Firstly, arsenic is placed in the tooth as a bottom layer and covered with a filling, preventing it from getting into the gastrointestinal tract. Secondly, the filling is placed for a limited time, during which intoxication does not occur. It is another matter if you do not come to the dentist in time to remove the "poisonous" filling. In this case, you can observe local symptoms, such as inflammation of the gum near the tooth, destruction of the bone under it, which in the future is fraught with the loss of one or more teeth. A metallic taste in the mouth will indicate mild intoxication.

In principle, if there are certain concerns, you can ask your doctor to use other materials to treat your tooth or simply change your dental clinic that adheres to conservative, outdated methods and means.

As we can see, arsenic compounds are quite actively exploited by humanity. Does it mean that people use arsenic to their own detriment, despite its toxic properties? This is not entirely true. In fact, arsenic poisoning in most cases occurs either through carelessness or due to non-compliance with safety standards. We should not exclude episodes when a person voluntarily harms his health, wanting to commit suicide. However, arsenic poisoning is far from the most attractive method of suicide.

So, you can become poisoned with arsenic by consuming water and food containing this chemical element (and it doesn’t matter how it got there), by inhaling poisoned air containing arsenic particles, by accidentally swallowing mouse poison, mistaking it for flour, or by attempting suicide.

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Risk factors

Risk factors for arsenic poisoning include:

• living in a region where there are high levels of arsenic in the soil, water or air,
• work in mines where As is found in the composition of minerals,
• participation in the treatment of wood with arsenic compounds,
• work in non-ferrous metallurgy processing plants,
• work in glass production, where arsenic trioxide is used as a brightening agent,
• manufacturing of semiconductor products in the electronics industry,
• the use of arsenic in rodent control,
• working with pesticides containing arsenicum,
• tanning of skins using arsenic,
• severe depression, suicidal thoughts.

Let's say right away that in production facilities where arsenic is used, all measures must be taken to ensure the safety of workers. It's a different matter if safety requirements were ignored by the management of the enterprise or by the workers themselves.

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Pathogenesis

For arsenic poisoning to occur, the poison must enter the human body. There it reacts with the so-called thiol groups in the molecules of enzyme cells, which are responsible for their functional properties. As a result of this reaction, cyclic compounds are formed that have toxic properties and disable thiol enzymes. A deficiency of such enzymes in turn entails the disruption of many vital functions.

The mechanism of action of most arsenic compounds is similar. The nature of the effect of arsenic hydrogen is slightly different; you can get poisoned by inhaling it from the air at work. This arsenic compound is a hemolytic poison, since it participates in the destruction of red blood cells, as a result of which oxygen starvation and disruption of various oxidative processes involving oxygen develop in the body.

In case of poisoning with arsenic hydrogen, local damage to the mucous membranes of the respiratory system does not occur, but the kidneys suffer greatly, the tubules of which become clogged with the decay products of red blood cells.

The danger of this compound is that it is a by-product of many industrial and domestic processes (for example, filling balloons and aerostats with hydrogen).

Other arsenic compounds provoke a disruption of the vascular patency of various organs, causing their paresis or paralysis. This leads to a sharp drop in blood pressure (collapse), which predetermines further symptoms of poisoning.

Most often, arsenic poisoning occurs when particles of the substance enter the esophagus or respiratory organs, less often the penetration of the poison into the body is noted through the skin. According to statistics, the proportion of arsenic poisoning is relatively small, especially if we compare the number of deaths from this poison today and in the Middle Ages. Among the victims are mainly workers of enterprises where arsenic is used, and suicides who decided on this unsightly way to part with life. Arsenic poisoning occurs quite rarely as a result of accidents. However, among other poisons, arsenic stands out for its high fatality rate (about 30%).

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Symptoms arsenic poisoning

In principle, the clinical picture of arsenic poisoning largely depends on the route by which the poison entered the body. The oral route primarily involves damage to the mucous membrane of the stomach and intestines, since arsenic has an irritating and cauterizing effect on delicate tissues. When inhaling arsenic particles (except for arsenic hydrogen), the first signs of poisoning indicate damage to the mucous membrane of the respiratory tract and eyes: tears flow, sneezing, coughing with mucus, and chest pain.

The first signs of acute arsenic poisoning can be expected within half an hour after the poison has entered the body (depending on the form of arsenic, the initial symptoms may appear a little later, in 2-6 hours). However, if a dose of the poisonous substance is consumed on an empty stomach, the symptoms will appear much earlier and will most likely lead to death. A similar situation is observed if a person inhales arsenic vapors with a high concentration of the poisonous substance.

By consuming arsenic with food, a person does not prevent poisoning of the body, but only delays the appearance of symptoms of intoxication.

What symptoms are we talking about? Let's list all possible manifestations of the toxic effects of arsenic and its compounds on the body:

• sudden appearance of a metallic taste and smell of garlic in the mouth,
• a feeling as if the throat is scratched by something sharp,
• attacks of nausea and frequently repeated debilitating vomiting (especially when taken orally), which lead to the appearance of intense thirst, hoarseness of the voice and decreased skin turgor due to dehydration of the body,
• severe diarrhea resembling cholera, with the stool beginning to resemble rice flakes (the symptom appears after several hours), painful false urge to defecate due to a disruption in the digestive system,
• severe squeezing pain in the stomach in the form of regular spasms,
• burning sensation in the esophagus, gastric bleeding due to burns of the gastrointestinal mucosa,
• headaches and dizziness,
• an incomprehensible runny nose appears, if arsenic gets into the eyes, conjunctivitis may develop,
• deterioration of general condition, incomprehensible weakness, hypodynamia, feeling of fear, stupor,
• a drop in blood pressure, increased heart rate, deterioration of myocardial nerve conduction, and weakening of the pulse associated with disorders of the cardiovascular system are observed.
• clouding of consciousness, hallucinations, delirium, psychomotor agitation due to damage to the nervous system (occurs when large doses of arsenic enter the body),
• difficulty breathing due to laryngeal spasm, pulmonary edema, development of respiratory failure (disruption of the respiratory system),
• changes in blood composition, decrease in the number of red blood cells, anemia,
• development of acute renal failure due to renal tubules, decrease in the amount of urine and its retention in the body, uric acid poisoning, the appearance of blood particles in the urine,
• the liver increases in size and begins to hurt, jaundice develops,
• convulsive syndrome, pain and twitching of the calf muscles appear,
• loss of consciousness, comatose state.

In case of poisoning with organic forms of arsenic, which are used in medical preparations, other symptoms may also appear:

• allergic and anaphylactic reactions accompanied by hyperemia of the skin of the face, shortness of breath, swelling of the larynx and tongue, cough, frequent but weak pulse, collapse,
• Several hours after the condition has stabilized, the symptoms resume and are supplemented by chills, fever, skin rashes, vomiting, convulsions similar to epileptic ones, and loss of consciousness.

The rate of development of acute symptoms depends on the dose of arsenic that has entered the patient's body. The higher the dose, the more severe the disease and the less likely it is to save a person's life. High doses of arsenic cause almost instant death, small doses make one suffer for 1-2 days, after which a fatal outcome is again quite likely.

If a person works in production and is in constant contact with the poison, he may well develop chronic intoxication. Chronic arsenic poisoning does not manifest itself immediately. The first symptoms can be expected after 2 weeks of regular contact with the poison, or after 2 months.

The whole point is that the dose of arsenic entering the body in this case is very small, and it is excreted from the body with urine and feces within 24 hours, without having time to thoroughly disrupt the functioning of organs and systems. But since arsenic must enter the body regularly in chronic poisoning, more and more new disorders of the physiological functions of various structures gradually emerge.

So, the first signs of chronic intoxication are:

• increased fatigue and general weakness of the body, loss of strength,
• increased pigmentation of the skin, hyperemia of the skin in the eyelids, armpits, temples, neck, testicles in men, mammary glands,
• thickening and hardening of the skin (hyperkeratosis),
• the appearance of peeling on the body, the development of dermatitis,
• edematous syndrome, the eyelids swell especially strongly, the eyes and eyelids acquire a reddish, inflamed hue,
• redness and dryness of the mucous membranes of the nose and mouth,
• the appearance of small growths (calluses, warts) on the palms of the hands and feet,
• formation of white transverse lines on the nail plate,
• alopecia,
• decrease in red blood cells, pale skin, anemia,
• muscle weakness,
• inflammation and bleeding of the gums,
• deterioration of dental condition, progressive caries.

At the next stage of intoxication (subacute arsenic poisoning), diagnostic tests may show:

• damage to the cerebral cortex (encephalopathy),
• disruption of the nervous system responsible for the lower part of the body (neuropathy of the lower extremities, which manifests itself in the form of pain and weakness in the legs, paresthesia),
• inflammatory processes in the heart and pericardium (myocarditis, pericarditis),
• inflammatory processes in the bronchopulmonary system (laryngitis, tracheitis, bronchitis).
• increasing the lumen of small capillaries,
• hearing impairment (bilateral sensorineural hearing loss),
• development of skin cancer and other oncological pathologies.

The clinical picture of intoxication may vary depending on the dose and type of toxic compound, the time of exposure, and the measures taken to remove the poison from the body. However, in any case, even mild arsenic poisoning is fraught with serious, sometimes irreversible, health problems.

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Complications and consequences

As we can see, the picture is not pleasant. However, people with suicidal tendencies have something to think about. In case of arsenic poisoning, death does not always occur instantly, a person can be saved by timely application of effective treatment, the emotional state can also be restored, but it is not possible to restore health in all cases.

Whatever the cause of arsenic poisoning, its consequences are disruptions in the functioning of many organs and systems. When taken orally, the gastrointestinal tract suffers greatly, and when arsenic enters the body by inhalation, serious pathologies of the respiratory system are observed. But then the arsenic molecules still enter the blood and spread throughout the body, causing more and more complications.

Changes in the blood composition indicate anemia, which means that the body's organs and systems are not receiving enough oxygen and nutrients. As a result of hypoxia, the heart, brain, and nervous system suffer first and foremost, and their recovery is problematic.

As a result of any intoxication, a strong blow falls on the liver and kidneys, and if we take into account that arsenic itself is excreted through the kidneys, then it is not always possible to avoid the development of renal failure.

Even if the treatment succeeds in completely deactivating and removing the arsenic molecules from the body, the consequences of the poison remaining in the body will have to be treated for a long time.

But the most dangerous consequence of arsenic poisoning is still considered to be the death of the patient, which is considered to be far from a rare occurrence. Sometimes a person dies, although he could have been saved. The reason for this phenomenon is the untimely provision of first aid, ignoring the symptoms that arise, late treatment at a medical facility.

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Diagnostics arsenic poisoning

In case of arsenic poisoning, it is not so much the external symptoms that the doctor learns about from the patient or his relatives that are indicative, but the results of laboratory tests. After all, as we already know, the presence of arsenic in the body cannot but affect the composition of the blood and urine. It is the tests that allow us to determine the presence of arsenic compounds in physiological fluids, as well as calculate its concentration. And this moment makes it possible to make certain prognoses for the patient's life and develop the most effective treatment plan.

The main materials for laboratory tests are blood and urine. Blood and urine tests for acute arsenic poisoning will show an increased concentration of the toxic substance, which can be used to judge the severity of the victim's condition. However, it should be understood that the test results may not be entirely accurate if the poison entered the body with food or accumulated in it due to existing chronic renal failure (in the latter case, we are talking about organic arsenic compounds).

In critical conditions, the As content in a single portion of urine is indicative. High concentrations clearly indicate acute arsenic poisoning, but low concentrations do not refute the diagnosis. Arsenic in non-toxic concentrations (less than 20 mg) is present in the body of every person, but its presence in daily urine in a concentration exceeding 50 μg/l indicates intoxication of the body with this poison. We are not talking about a single portion of urine, but about its daily amount, because the rate of As excretion with urine is not a constant value.

If a slight increase in the concentration of arsenic in the urine is noted, the clinical picture of poisoning needs to be clarified. The fact is that ordinary seafood can increase the level of arsenic in the body. Sometimes this indicator can be quite high - about 1.7 mg / l. In this case, the nature of the arsenic compound found in the urine is clarified, or a repeat analysis is carried out several days (usually about a week) after eating seafood.

So far we have been talking about acute arsenic poisoning. But what about subacute and chronic forms? Will blood and urine tests be relevant, since they do not provide reliable information about the amount of arsenic initially in the body?

In fact, a comprehensive blood test, liver enzyme activity and kidney function tests, general urine analysis and the current concentration of arsenic in urine collected over a 24-hour period remain as relevant as in acute conditions. After all, they allow us to identify not only the presence of poison in the body, but also the pathological processes caused by it. The blood may show a low platelet count, changes in the structure and activity of red blood cells, a decrease in hemoglobin concentration, etc. Protein and blood may appear in the urine, and the level of leukocytes will be elevated due to purulent-inflammatory processes in the kidneys.

In addition to laboratory diagnostics, instrumental diagnostics can also provide certain information to the doctor. Arsenic as a chemical element belongs to the group of semi-metals, which means that it remains impermeable to X-rays. After oral administration of arsenic, its accumulations are clearly visible on an abdominal X-ray using contrast materials. Unfortunately, this method of research is far from always indicative, because there are other ways for the poison to enter the body, and scattered particles are practically invisible on an X-ray.

By the way, the presence of arsenic in nails and hair can be detected on an X-ray even several months after the episode of poisoning.

Diagnosis of arsenic poisoning includes not only measures to detect the poison in the body and measure its concentration, but also procedures that allow recording various disorders of human organs and systems caused by toxic arsenic compounds. Heart disorders due to the negative effects of arsenic are clearly visible on an electrocardiogram. Heart rate and blood pressure measurements can also provide some information. Disruptions in the nervous system are examined using electroneurography. In case of serious damage to the gastrointestinal mucosa, gastroscopy and colonoscopy may be required. In case of liver and kidney damage, in addition to laboratory tests, an ultrasound procedure may be prescribed.

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Differential diagnosis

Since the symptoms of arsenic poisoning are mostly non-specific and a similar clinical picture can be observed in other health pathologies, differential diagnostics plays a major role. If laboratory tests show high levels of arsenic in physiological fluids, the preliminary diagnosis does not require revision. But in the case of low levels of the poison against the background of a clear clinical picture, doubts may arise that can only be dispelled by differential diagnostics, which may require repeated tests and additional studies.

Treatment arsenic poisoning

Treatment for arsenic poisoning always begins with gastric lavage (in the case of oral ingestion of toxic compounds) and the administration of an antidote - a drug that can bind the poison into non-toxic compounds and remove it from the body.

Fortunately, there is a specific antidote for poisoning, and it is called “Unitol”.

"Unitol" can be used both to cleanse the stomach of poisons (rinsing is done with warm water, to which an antidote is added), and to disinfect the entire body. The drug is administered intramuscularly up to 4 times a day in a daily dose of no more than 150 ml, on the second day the frequency of administration does not exceed 3 times a day, then during the week no more than 1-2 times.

The drug should not be taken in case of severe liver damage and arterial hypertension. The drug is well tolerated by most patients. Only in rare cases may there be increased heart rate, nausea, pale skin, dizziness, which do not require discontinuation of the drug.

In case of hypertension, instead of Unitol, you can administer Tetatsin calcium. It is administered as a dropper. Take 20 mg of a 10% solution and mix it with a solution of NaCl or glucose. The frequency of administration is 1 or 2 times a day. The course of treatment is 1 month. The scheme of administration is 3 or 4 days in a row, then a break of also 3-4 days.

"Calcium Tetacin" is not used for kidney diseases and liver dysfunction. Side effects of the antidote include: gastrointestinal and kidney disorders, decreased hemoglobin levels.

In case of arsenic poisoning, an antidote used for poisoning with salts of heavy metals can be administered as an effective antidote. First, the patient is given a glass of water, then half a glass (100 ml) of antidote. After half an hour, the stomach must be washed.

Acute arsenic poisoning can be treated with another specific antidote prepared from 50 ml of iron sulfate solution and 150 ml of clean boiled water. The antidote should be given many times during the day (6 times per hour) until vomiting caused by intoxication of the body stops.

"2,3-dimercaptopropanol-1" is an antidote to lewisite, a chemical used in combat that contains arsenic.

In homeopathy, an antidote to metals called Antidotum metallorum is used for arsenic poisoning. It can be taken undiluted ¼ - ½ cup in 200 ml (drink the medicine as soon as possible) or mix a cup of antidote and 1.5 cups of water and use the mixture to wash out the stomach.

Since arsenic poisoning is accompanied by vomiting and diarrhea, which cause the body to lose precious fluid, the victim is recommended to drink plenty of fluids and undergo dehydration therapy. As part of the therapy for dehydration, subcutaneous administration of sodium chloride and glucose, intravenous infusions of sodium chloride and calcium chloride are performed. Oral administration of the drugs "Regidron", "Hydrovit", "Trigidron" is indicated when vomiting subsides.

In parallel, symptomatic treatment is carried out for pain along the gastrointestinal tract (morphine, promedol, novocaine blockade).

During the first day of arsenic intoxication, peritoneal and hemodialysis procedures are performed, which will prevent the development of renal failure or help improve the patient's condition in the presence of acute renal dysfunction.

In case of liver damage the following will be relevant:

• intravenous injections of glucose with insulin,
• oral administration of Methionine tablets (2 tablets 3 times a day, not prescribed for severe liver diseases with impaired functionality),
• internal administration of a solution of "Choline chloride" 5 ml 3 to 5 times a day for 14-21 days (may cause digestive disorders).

In case of symptoms such as circulatory and respiratory disorders, blood transfusion procedures are performed, vasoconstrictors are administered, and artificial respiration is used. In case of allergic manifestations, antihistamines are indicated.

After vomiting has stopped, vitamins are actively given orally; before that, they can be administered parenterally in the form of solutions.

As a physiotherapeutic treatment to relieve unpleasant symptoms, warm baths are used, heating pads are applied, and oxygen cocktails are given to drink. Other physiotherapy methods can be prescribed in connection with metabolic disorders and disorders of functions of various organs (electrotherapy, ultrasound, magnetic therapy, therapeutic baths, etc.) after the patient's condition has stabilized after acute poisoning.

In severe cases, when there is no breathing or heartbeat, active resuscitation measures are carried out.

Folk remedies

Arsenic poisoning is a great danger to human life. Without effective medical care, victims in most cases face a quick or slow death. Traditional medicine can somewhat reduce the toxic effect of poisons on the body, but it cannot completely deactivate them. Traditional medicine recipes can be used as a supplement to the main treatment, but not instead of it. Therefore, we provide this information purely for informational purposes.

The recipes and methods listed below are more or less effective for mild poisoning, as well as supportive therapy during the recovery period.

• Sea salt. Washing the stomach with an aqueous solution of sea salt will not only effectively cleanse it of poison particles, but also saturate the body with important microelements that are lost during diarrhea and vomiting (1 teaspoon per 200 ml of warm water). This same solution can be used for enemas, cleansing the intestines.
• Milk and egg white. A good remedy for poisoning with metallic poisons, which can be used to maintain vomiting, even if the poison is not exactly known. To prepare the "medicine", milk is mixed with egg white whipped to a foamy state.
• Potato juice. Potato juice is indicated for reducing oxidative reactions (acidosis) stimulated by arsenic and for healing burns on the gastrointestinal mucosa caused by the poison.
• Dill and honey. One of the oldest remedies used for various poisonings. Mix honey in a glass of water and add 1 tbsp. of dry dill powder or ½ tsp. of crushed seeds of a well-known spice (you can also use fresh raw materials in the same amount).

A few words about treating poisoning with herbs. A useful composition that is used for various intoxications: golden root extract in alcohol (5-10 drops) is added to water. Take the composition 2 to 3 times a day, sweetened with honey.

Herbs useful for poisoning include licorice root, horsetail, green fruits and leaves of walnut, dandelion grass, root and flowers, elecampane root (especially useful for liver damage). Herbs are used in the form of infusions and decoctions.

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First Aid for Arsenic Poisoning

Regardless of the dose of arsenic compounds that entered the body, first aid to the victim of poisoning is provided according to the standard scheme. And the sooner measures are taken to remove the poison from the body, the better the prognosis for life.

In domestic conditions, arsenic poisoning occurs mainly orally. There is no need to wait for the first symptoms to appear and calculate the dose if it suddenly becomes known that a person has swallowed arsenic. It is impossible for an uninformed person to determine by eye whether the poisoning is mild or severe, so in any case, you need to urgently seek help from specialists. Ideally, you need to call an ambulance or quickly deliver the victim to the hospital in another way.

While the ambulance is on its way, all measures must be taken to remove the poison from the body. These measures include:

• stimulation of vomiting by irritating the root of the tongue (carried out in the absence of the urge to vomit), clearing the mouth of vomit containing particles of arsenic compounds with clean water,
• gastric lavage (use a large amount of warm water, to which you can add a little salt),
• To effectively wash out the stomach and inactivate arsenic molecules, it is recommended to add one of the following components to the water:
• unitol solution (20-30 ml of a five percent solution per 2 liters of warm water),
• magnesium oxide suspension used to reduce the acidity of gastric juice (40 g per 2 liters of slightly warmed water).
• drinking plenty of fluids (the procedure not only helps to remove the poison faster with urine, but also combats dehydration caused by vomiting and diarrhea); in no case should you fight vomiting and diarrhea, on the contrary, you need to promote the natural cleansing of the body by drinking warm milk,
• taking adsorbents (not a very effective procedure, but in the absence of other means it helps to reduce the dose of poison in the body); you can use regular "Activated carbon", which is available in almost every home medicine cabinet,
• vinegar and citric acid help to speed up the removal of arsenic from the body and reduce its toxicity; take a spoonful of vinegar or 3 g of citric acid per glass of warm water,
• Taking a saline laxative is possible, but many sources recommend against it,
• siphon enemas,
• If arsenic gets on your skin, it is enough to wash the body with warm water and soap, preventing the poison from being absorbed into the blood.

A person can take all of the above measures themselves if they know that the poison has entered the body and there is no one to help. If the victim is at home alone and their condition is rapidly deteriorating, when calling an ambulance, you need to leave the doors to the apartment open so that the medical staff can freely and quickly provide the necessary assistance even if the patient is unconscious.

The main thing is not to panic and not to limit yourself to first aid, which does not guarantee 100% removal of the poison from the body. In addition, even after a short period of action, arsenic can cause serious disruptions in the functioning of the body, which can only be corrected with the help of professional doctors.

The appearance of critical symptoms requires the first aid provider to be collected and calm. This is not the time to panic. You need to act quickly and confidently.

• If the victim is unconscious, before the ambulance arrives, he should be laid on a flat surface on his side to prevent asphyxia due to the tongue sinking and mucus entering the bronchi. Before the ambulance arrives, if possible, a 5% solution of Unitol should be administered intramuscularly (the dose is calculated based on the ratio of 1 ml of the drug for every 10 kg of the patient's body weight). It is imperative to constantly monitor the pulse, breathing, and blood pressure in order to proceed to available resuscitation measures if necessary.
• If there are no signs of breathing and no heartbeat is heard, urgent resuscitation measures are needed, including indirect cardiac massage and parallel artificial respiration.

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Prevention

Personal hygiene plays a major role in preventing poisoning with arsenic and its compounds. Sometimes the poison enters the body through carelessness, if arsenic particles get on the skin of the hands after working with insecticides, mouse poison, or materials treated with arsenic. Unwashed hands in this case become the main source of infection.

After working with such materials, you must thoroughly wash exposed parts of the body with water and soap. Moreover, you cannot eat food while spraying plants with pesticides and working with arsenic compounds.

In production, in order to prevent chronic arsenic poisoning of employees, high-quality ventilation and means of protecting the skin and respiratory tract from contact with arsenic must be provided.

If a person lives in an area where the level of arsenic in the soil and water is elevated, they should try to have less contact with the soil, not swim in contaminated water bodies, and drink only purified water that is brought in.

When working with mouse poison, you need to be especially careful, placing the poison in places inaccessible to children. Under no circumstances should you store the remains of the poison in the kitchen or pantry near food. The poison should be stored in a tightly sealed container in a secret place that only a limited number of people know about. It is not recommended to use flour that raises doubts during cooking until you are sure of its safety.

When treating teeth in dentistry, insist on using safer materials than arsenic anhydride. Fortunately, there is no shortage of such materials these days.

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Forecast

The prognosis for arsenic poisoning depends entirely on the dose taken and the timeliness of measures to neutralize and remove the poison from the body. The most favorable prognosis is for chronic poisoning, since a single dose in this case is small. The main thing is to pay attention to unusual symptoms as early as possible. In acute poisoning with large doses of arsenic compounds, the probability of a fatal outcome is high. However, effective and prompt assistance to the victim in many cases made it possible to save a person's life even in critical conditions.

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