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ARSENIUS—ARSES

twelve or more hours if the drug be taken in solid form and the stomach be full of food. The usual period, however, is from half an hour to an hour. In a typical case a sensation of heat developing into a burning pain is felt in the throat and stomach. This is soon followed by uncontrollable vomiting, and a little later by severe purging, the stools being first of all faecal but later assuming a rice water appearance and often containing blood. The patient suffers from intense thirst, which cannot be relieved, as drinking is immediately followed by rejection of the swallowed fluid. There is profound collapse, the features are sunken, the skin moist and cyanosed. The pulse is feeble and irregular, and respiration is difficult. The pain in the stomach is persistent, and cramps in the calves of the legs add to the torture. Death may be preceded by coma, but consciousness is often maintained to the end. The similarity of the symptoms to those of cholera is very marked, but if the suspicion arises it can soon be cleared up by examining any of the secretions for arsenic. More rarely the poison seems to centre itself on the nerve centres, and gastro-intestinal symptoms may be almost or quite absent. In such cases the acute collapse occurs in company with both superficial and deep anaesthesia of the limbs, and is soon followed by coma terminating in death. In criminal poisoning repeated doses are usually given, so that such cases may not be typical, but will present some of the aspects of acute and some of chronic arsenical poisoning. As regards treatment, the stomach must be washed out with warm water by means of a soft rubber tube, an emetic being also administered. Then, if available, freshly precipitated ferric hydrate must be given, which can be prepared by adding a solution of ammonia to one of iron perchloride. The precipitate is strained off, and the patient can swallow it suspended in water. While this is being obtained, magnesia, castor oil or olive oil can be given; or failing all these, copious draughts of water. The collapse must be treated with hot blankets and bottles, and subcutaneous injections of brandy, ether or strychnine. The pain can be lessened by injections of morphia.

Arsenic may be gradually absorbed into the system in very small quantities over a prolonged period, the symptoms of chronic poisoning resulting. The commonest sources used to be wall-papers, fabrics, artificial flowers and toys: also certain trades, as in the manufacture of arsenical sheep-dipping. But at the present time cases arising from these causes occur very rarely. In 1900 an outbreak of “peripheral neuritis” with various skin affections occurred in Lancashire, which was traced to beer made from glucose and invert sugar, in the preparation of which sulphuric acid contaminated with arsenic was said to have been used. But the nature of the disease in this case was decidedly obscure. The symptoms so closely resembled those of beri-beri that it has also been suggested that the illness was the same, and was caused by the manufacture of the glucose from mouldy rice (see Beri-Beri), though no proof of this was possible. The earliest symptoms are slight gastric disorders, loss of appetite and general malaise, followed later by colicky pains, irritation of eyelids and skin eruptions. But sooner or later peripheral neuritis develops, usually beginning with sensory disturbances, tingling, numbness, formication and occasionally cutaneous anaesthesia. Later the affected muscles become exquisitely tender, and then atrophy, while the knee-jerk or other reflex is lost. Pigmentation of the skin may occur in the later stages. Recovery is very slow, and in fatal cases death usually results from heart failure.

After acute poisoning, the stomach at a post-mortem presents signs of intense inflammation, parts or the whole of its mucous membrane being of a colour varying from dark red to bright vermilion and often corrugated. Submucous haemorrhages are usually present, but perforation is rare. The rest of the alimentary canal exhibits inflammatory changes in a somewhat lesser degree. After chronic poisoning a widely spread fatty degeneration is present. Arsenic is found in almost every part of the body, but is retained in largest amount by the liver, secondly by the kidneys. After death from chronic poisoning it is found present even in the brain and spongy bone. The detection of arsenic in criminal cases is effected either by Reinsch’s test or by Marsh’s test, the urine being the secretion analysed when available. But Reinsch’s test cannot be used satisfactorily for a quantitative determination, nor can it be used in the presence of chlorates or nitrates. And Marsh’s test is very unmanageable with organic liquids on account of the uncontrollable frothing that takes place. But in such cases the organic matter can be first destroyed by one of the various methods, usually the moist method devised by Fresenius being chosen.

ARSENIUS (c. 354–450), an anchorite, said to have been born of a noble Roman family, who achieved a high reputation for his knowledge of Greek and Roman literature. He was appointed by Theodosius the Great, tutor of the young princes Arcadius and Honorius, but at the age of forty he retired to Egypt, where for forty years he lived in monastic seclusion at Scetis in the Thebais, under the spiritual guidance of St John the Dwarf. He is said to have gained the admiration of his fellows by the extreme rigour of his asceticism. The remainder of his life he spent at Canopus, and Troë near Memphis, where he died at the age of ninety-five. Of his writings two collections of admonitory maxims are extant: the first, Διδασκαλία καὶ παραίνεσις, containing instructions for monks, is published with a Latin version by Fr. Combefis in Auctarium biblioth. patr. novissim. (Paris, 1672), pp. 301 f.; the second is a collection of forty-four wise sayings put together by his friends under the title of Ἀποφθέγματα (see Cotelerius, Eccl. graec. monum., 1677, i. pp. 353-372). In the Roman Catholic Church his festival is on the 19th of July, in the Orthodox Eastern Church on the 8th of May. His biography by Simeon Metaphrastes is largely fiction.

ARSENIUS AUTORIANUS (13th century), patriarch of Constantinople, lived about the middle of the 13th century. He received his education in Nicaea at a monastery of which he later became the abbot, though not in orders. Subsequently he gave himself up to a life of solitary asceticism in a Bithynian monastery, and is said, probably wrongly, to have remained some time in a monastery on Mount Athos. From this seclusion he was in A.D. 1255 called by Theodore II. Lascaris to the position of patriarch at Nicaea, and four years later, on that emperor’s death, became joint guardian of his son John. His fellow-guardian Georgios Mouzalon was immediately murdered by Michael Palaeologus, who assumed the position of tutor. Arsenius then took refuge in the monastery of Paschasius, retaining his office of patriarch but refusing to discharge its duties. Nicephorus of Ephesus was appointed in his stead. In 1261 Michael, having recovered Constantinople, induced Arsenius again to undertake the office of patriarch, but soon incurred his severe censure by ordering the young prince John to be blinded. Arsenius went so far as to excommunicate the emperor, who, having vainly sought for pardon, took refuge in false accusations against Arsenius and caused him to be banished to Proconnesus, where some years afterwards (according to Fabricius in 1264; others say in 1273) he died. Throughout these years he declined to remove the sentence of excommunication which he had passed upon Michael, and after his death, when the new patriarch Josephus gave absolution to the emperor, the quarrel was carried on between the “Arsenites” and the “Josephists.” The “Arsenian schism” lasted till 1315, when reconciliation was effected by the patriarch Niphon (see Gibbon, Decline and Fall of the Roman Empire, ed. J. B. Bury, 1898, vol. vi. 467 foll.). Arsenius is said to have prepared from the decisions of the councils and the works of the Fathers a summary of divine laws under the title Synopsis Canonum. This was published (Greek original and Latin version) by G. Voël and H. Justel in Bibliotheca Jur. Canon. Vet. (Paris, 1661), 749 foll. Some hold that the Synopsis was the work of another Arsenius, a monk of Athos (see L. Petit in Vacant’s Dict. théol. cathol. i. col. 1994); the ascription depends on whether the patriarch Arsenius did or did not sojourn at Mount Athos.

See Georgius Pachymeres ii. 15, iii. passim, iv. 1-16; Nicephorus Gregoras iii. 1, iv. 1; for the will of Arsenius see Cotelerius, Monumenta, ii. 168.

ARSES, Persian king, youngest son of Artaxerxes III., was raised to the throne in 338 B.C. by Bagoas (q.v.), who had