Arsenical by Design

What does arsenic have to do with dermatology? Quite a bit, actually.  As it turns out, arsenic was virtually everywhere in Europe during the 1800’s when dermatology was developing as a specialty.

arsenical issues hands
Skin ulcers and green discoloration associated with arsenic exposure

I always wondered why we spent so much time in residency studying arsenical keratoses, and had always just associated it with drinking contaminated well-water, because over 100 million people worldwide are probably still exposed to toxic levels of arsenic in their drinking water.

What I didn’t know was that arsenic was used to develop the incredible chartreuse colors that were popular in home-decorating and fashion during the Victorian era.  The color was referred to as “Scheele’s Green” because it was discovered by Carl Scheele in his chemistry experiments.  Scheele also discovered oxygen, chlorine and manganese, and died in his 40’s, probably from poor ventilation during his experiments with chlorine and arsenic.

Arsenic containing wallpaper from the book “Bitten by Witch Fever” by Lucinda Hawksley

If you were upper or middle-class in the mid-to-late 1800’s you probably had arsenic paint or wallpaper in your house, or an article of clothing like a dress, gloves, stockings or hat that was colored with arsenic dyes.   Arsenic was also used as a pigment for children’s toys and in artificial cloth and paper flowers which were also popular during that time.  Reportedly, Queen Victoria had the green wallpaper stripped from Buckingham Palace in 1879 when a visiting dignitary became very ill after spending the night in a room with arsenic-laden wallpaper.

It was also sold as rat-poison, but was colorless and tasteless.  Some people stored it in their kitchens and sometimes it would be mistaken for flour or baking soda and families would accidentally poison themselves or guests.   In 1862, a renowned London physician, Dr. Thomas Orton, was called to investigate a family who had four children, three of whom had died in rapid succession and a fourth, Amelia, who was gravely ill, and died within the month. The previous deaths were attributed to diphtheria, although the children had not responded to treatment.  Dr. Orton went to investigate the home, and noticed that the room in which the children played had bright green wallpaper, which he had tested and it contained arsenic of 3 grains per square inch, 4-5 grains being enough to kill an average adult; he subsequently determined this was the cause of mortality in these children.

Despite this, William Morris, one of the most famous wallpaper designers of the period, used arsenical dyes extensively in his papers.  Notably, the Morris family wealth came from copper mining, a byproduct of which is arsenic, and his family was one of the world’s largest arsenic suppliers to industry in the 1800’s.

The relationship of the medical profession to arsenic was dichotomous: while physicians denounced the use of arsenic in the home; doctors also prescribed arsenic to treat everything from rheumatism to impotence. Druggists compounded arsenic into soaps to promote a healthy complexion.  Charles Darwin was known to regularly ingest Fowler’s Solution to treat his skin rashes, even though cutaneous exposure to arsenic is well-documented to cause a variety of skin problems.

Other cultural references to arsenic include early uses of the phrases “if looks could kill” and “femme fatale” which were written in newspaper articles describing the use of arsenic in women and men’s clothing.  Following the gory arsenic-related death of a 19-year-old flower maker exposed through her work, the British Ladies’ Sanitary Association commissioned a chemist to test the hand-painted cloth leaves used in fashion design. His findings were publicized in a London Times article entitled “The Dance of Death” which cited that the average woman’s headdress contained enough arsenic to kill 20 people.  In Berlin, another physician concluded that the average woman’s ballgown would release up to 60 grains of arsenic in an evening. The British Medical Journal wrote that a green-clad woman “may be called a killing creature. She actually carries in her skirts poison enough to slay the whole of the admirers she may meet within half a dozen ballrooms.”

Dr. James C. Whorton, chronicles the history of criminal and environmental arsenic poisoning in his 2010 book, The Arsenic Century: How Victorian Britain was Poisoned at Home, Work and Play.   He states “Once it became evident that arsenic poisoning was increasing in the 1840s and there were cases of women being arrested and convicted, there was a hysterical AARSENCI OLD LACDEoverreaction and fear that virtually every woman in the country was trying to find a way to knock off her husband or kids.”  This idea was spun into a Broadway play, which depicts a protagonist Moritmer Brewster, whose aunts have taken to murdering lonely old men with elderberry wine laced with arsenic, strychnine and cyanide.

Popular culture references of arsenic include The Yellow Wallpaper, which is an early feminist short-story written in 1892 about a woman who is slowly going insane after being taken to a country estate by her physician husband to quiet her nerves and restore her mental health. yellow wallpaper However, she is kept in a room with wallpaper and is instructed to rest and not over-exert herself; she slowly descends into psychosis. With nothing to stimulate her, she becomes obsessed by the pattern and color of the wallpaper:  “It is the strangest yellow, that wall-paper! It makes me think of all the yellow things I ever saw – not beautiful ones like buttercups, but old foul, bad yellow things…” In the end, she imagines there are women creeping around behind the patterns of the wallpaper and comes to believe she is one of them.

Reading about arsenic in the 1800’s serves as a reminder for the need to adequately screen new chemical compounds used in health and industry.  Arsenic is just one example of a poison that was historically used in everything from fashion to home décor and healthcare products–even when it was a well-known rat poison.  Ultimately, corporations are profit-driven and most often will lobby against regulations even when there are obvious threats to the well-being of society (smoking, aldicarb, lead, etc). Congress is typically reluctant to interfere, maybe because of political challenges of passing legislation that may run counter to corporate interests.  I do believe we need enough government in our lives in order to guard public health–and that it has largely been through government intervention usually after public pressure that we have been saved from things like arsenic poisoning.

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Faculty at the Department of Dermatology at the University of Texas Southwestern. interests: cutaneous lymphomas, medical student education, the relationship between art and medicine.

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