[Reprinted from the Boston Medical and Surgical Journal, 
November 17, 1887.] 
A CASE OF POISONING FROM ARSENICAL 
WALL-PAPER.1 
BY W. EVEBETT SMITH,Stt.D., BOSTON, MASS. 
About the middle of September, 1886, my patient, 
Mrs. S., changed her residence from the country to 
the city. She very soon discovered that some ferns 
in her parlors were withering, but not from neglect or 
improper care, since although ultimately dying, they 
revived for a brief season upon being removed to an- 
other part of the house. In the early part of Novem- 
ber, she suffered from an attack of nausea and a dizzi- 
ness so intense, especially when she attempted to 
stoop, that for several days she was obliged to keep 
the bed. These symptoms persisted in their intensity 
about a fortnight, and were followed by a sharp at- 
tack of facial neuralgia which lasted about a week. 
In the latter part of December, the dizziness re-ap- 
peared, but in a far milder form than it had been the 
month before. At about the same time she began to 
complain of extreme lassitude and a loss of" pleasure 
in pursuits that formerly gave enjoyment. The quiet 
of her own room was the one thing that she eagerly 
sought. 
Although she suffered from a continual slight nau- 
sea, her appetite was unusually good; there was, as 
she expressed it, an almost constant "gnawing in the 
stomach." After the eating of food the nausea would 
increase, and she would complain of a feeling of heav- 
iness and uneasiness throughout the bowels, especi- 
1 Read before the Section for Clinical Medicine, Pathology, and 
Hygiene, of the Suffolk District Medical Society, October 10,1887. 2 
ally in the umbilical region. Her increase of adipose 
tissue began to be distressing to her. Although she 
had always before drank very little water, she now 
was thirsty all the time. The menstrual functions 
continued to be regular so that the symptoms pre- 
sented were considered to be indicative of over-work 
and loss of nervous energy rather than of any physio- 
logical disturbance. The patient herself was disposed 
to consider her symptoms malarial in their nature, al- 
though, contrary to her expectations, quinine gave 
her no relief. Occasionally, she would speak of her 
eyes smarting and watering if she tried to use them. 
Suddenly, on March 16, 1887, she was taken with- 
out any apparent cause with headache, extreme nau- 
sea, and uncontrollable vomiting. The usual anti- 
emetic remedies, internal and external, dietary and 
medicinal, were tried in turn, but all without relief. 
On the contrary, they seemed rather to increase her 
distress. The only expedient that gave the slightest 
semblance of relief was the holding of pieces of ice in 
the mouth. The vomiting yvas almost incessant and 
was increased by assuming the recumbent position. 
The vomitus consisted at first of mucus, on the third 
day of free blood, and later of thick yellow bile. Ten- 
derness in the epigastric and right hypochondriac re- 
gions speedily developed itself. The temperature and 
pulse remained nearly normal. discharge 
was uniformly bloody. The menstrual functions still 
remained normal so that the symptoms seemed to 
indicate clearly an acute exacerbation of the same 
trouble that had existed all winter in a mild and chronic 
form. 
Although I could not absolutely exclude either a 
primary gastro-duodenal ulceration or some of the 
freaks of pregnancy, I remembered the withering of 
the ferns and began strongly to suspect some form of 3 
irritant poisoning to be the cause of sickness. I ac- 
cordingly sent samples of all the wall-papers in the 
house (except, of course, plain "cartridge" papers 
which I knew to be practically free from suspicion), 
to Dr. Edward S. Wood for examination. Upon 
analysis, he pronounced only one paper arsenical, but 
found such an amount of arsenic therein, that he ad- 
vised its immediate removal. 
To settle decisively the question of poisoning, the 
urine also was examined for arsenic. Six ounces col- 
lected on March 23d, the eighth day of the incessant 
vomiting, yielded numerous crystals of arsenic after 
re-sublimation in the tube, while a quart of urine col- 
lected three days later yielded a very dark deposit 
upon the tube, but after re-sublimation, scarcely a 
trace of arsenic crystals. This seemed to indicate 
not only that there had been a very large amount of 
arsenic in the system of my patient, but also that a 
rapid elimination of the poison was taking place. 
But the vomiting and prostration continued una- 
bated. For twenty days the patient could retain ab- 
solutely nothing upon the stomach. Enemata, both 
of beef tea and of Murdock's Food were attempted, 
but could not be retained. Finally, brandy was sub- 
stituted for them and with better results. The tem- 
perature had never risen above 100°, nor the pulse 
much above 96. At midnight of the twentieth day 
the nausea and vomiting ceased as suddenly as it had 
begun. The following morning the patient expressed 
her first desire for food. We began with Horlick's 
Food, and although during the next week we changed 
at her request to Mellen's, Hard's, and to Wells & 
Richardson's Lactated Food, we returned to Horlick's 
and found it the best suited to the case. The recovery 
was rapid and complete in less than a fortnight. 
There was only one relapse that could be traced di- 
rectly to arsenic. 4 
It had seemed at first improbable not only to my- 
self, but to Drs. Wood and Whittier, whom I consulted 
in the case, that the wall-paper already found to con- 
tain arsenic could be the sole cause of all this arseni- 
cal poisoning. The paper was upon the walls of a 
small room on the entrance floor of the house where 
the patient had been very little, the parlors were on 
the floor above, and her chamber on the floor above 
the parlors. In hopes, therefore, of finding some 
other source of arsenic, dress goods and window drap- 
eries were analyzed, but with negative results, so far 
as finding arsenic were concerned. Chromium was, 
however, found in large amounts in one pattern of 
dark green dress goods. I had early seen to it that 
all cretonnes and turkey-red material were removed 
from the chamber, since they are well-known to be 
highly charged with arsenic. 
The almost conclusive proof, however, that the sole 
cause of my patient's sickness existed in this room is 
as follows : The dangerous wall-paper was removed 
while the patient was convalescent. She insisted that 
she was not yet strong enough to venture from home 
and so remained in the house, confined strictly to her 
room, while the work went on. After the walls had 
been scraped and washed, and the room thoroughly 
cleaned preparatory to the laying of the new paper, 
she ventured to look into the room but remained there 
scarcely ten minutes. She very soon had a return of 
nausea and vomiting, which lasted nearly twenty-four 
hours. I thereupon insisted that she go into the 
country and that in her absence the entire house be 
thoroughly cleaned and dusted. This was done, and 
since her return she has presented no further symp- 
toms of arsenic poisoning. 
Another member of the family was affected by the 
removal of the paper, his symptoms taking the form 5 
of a sharp diarrhoea. The other two members did not 
at any time present marked symptoms of arsenical 
poisoning, except a noticeably sallow complexion and 
a pretty constant feeling of lassitude all winter. They 
had, however, had more exercise in the open air than 
my patient. 
I trust the record of this case may stimulate physi- 
cians to investigate more thoroughly than they other- 
wise might, cases that they hastily assume to be the 
results of malaria, nervous prostration or other indef- 
inite or undetermined causes. Many of these cases I 
believe to be simply chronic poisoning from some 
material source near at hand. The profession has 
learned that wall-paper and some kitchen utensils are 
often arsenical, and it is slowly realizing that articles 
of clothing and of household decoration may likewise 
be injurious to health, although the subject has not 
yet received the attention that it deserves. It seems 
to me that it is our duty as physicians interested in 
public health and preventive medicine to make renewed 
and concerted efforts to secure such laws as shall 
make it a criminal offence for a manufacturer to allow 
any deadly poison to be in fabrics or materials that 
are used or that are sold upon the market. 
DISCUSSION. 
A specimen of the paper was shown to the Society, 
but the amount of arsenic it contained was not known. 
Dr. B. F. Davenport said : It may be of interest 
to the Society to know, in connection with this case, 
that the German government has, during the past 
summer, passed a new law, to go into effect next 
spring, in which the presence of two-and-one-half 
grains of arsenic per square yard is allowed in woven 
goods, provided it is in an insoluble (?) condition. 6 
The presence of arsenic in any arsenical color is for- 
bidden if the poison is present as a constituent part of 
the color; but if it is present simply as an impure 
material the law forbidding its presence does not 
apply. What the grounds for these limits of the new 
German law are, I do not know, but presumably they 
are based on some competent experiment. 
Dr. F. I. Knight asked if that would modify the 
law in relation to the manufacture of colors also. 
Dr. Davenport: Yes. The old German law, which 
is at present upon the statute books, forbids the pres- 
ence of arsenic in toys and wall-papers, but its enforce- 
ment has been suspended, and they allow the presence 
of arsenic in other things, provided they are to be ex- 
ported. They are not so particular about other 
nations as about their own. That reminds one of the 
oleomargarine law in one of the Western cities. The 
dairy commissioner, reporting on the subject, said it 
was immediately gotten rid of by shipping into the 
neighboring States. 
Dr. Albert N. Blodgett said: I would like to 
ask Dr. Smith what degree of reliability is to be 
placed on the testimony of paper manufacturers or 
paper dealers, as to the presence or absence of arsenic 
in their manufactured fabrics. A short time ago in a 
discussion before this Section the statement was made 
that the certificates of chemists were often utterly 
valueless ; that paper which was pronounced by com- 
petent chemists free from arsenic was found to con- 
tain large and dangerous amounts of it. I would like 
to ask if Dr. Smith has had any experience in the 
proving of certificates of the chemists of manufacturers 
in regard to the compounds of arsenic in paper, and 
what value he places upon them. 
Dr. Smith : When I was re-papering my rooms, I 
was in some doubt as to what dealer to go to, Bum- 7 
stead, or Gregory & Brown. I went to the latter, and 
picked out papers that I thought I would like, and 
saw the analyses. The papers were said to be free 
from arsenic. I did not engage them to hang the 
paper, but engaged a wall decorator; he traded for 
the most part with another firm, the Boston Wall- 
Paper Company. They had a chemist of whom Dr. 
Wood and Dr. Harrington had never heard. They 
had specimens which were said to be free from poison. 
I finally purchased of Gregory & Brown. Dr. Har- 
rington had marked one specimen " Practically free 
from arsenic." I went to Dr. Harrington myself, be- 
cause I wanted to know how much it contained. I 
should place very little reliance upon the statements 
of any dealer in wall-paper, because he is in one sense 
an interested, and in another sense an uninterested 
party. He may sell arsenical wall-paper in perfectly 
good faith. He receives it from the producer, and 
takes the word of the chemist. If it proves to be full 
of arsenic, of course if there were a law, he would be 
subject to penalty. 
When I was getting the paper, Dr. Wood told me 
an experience that he passed through. He changed 
the paper in his house while he was at the sea-shore. 
Dr. Hills one day asked him what paper he was putting 
on the dining-room. He replied that it was from a 
lot which had been examined, as the dealer said, by 
Dr. Hills himself. Dr. Hills was sure he had not seen 
it before, and on analyzing it, it was found to be a 
typical arsenical paper. Mr. Bumstead had the paper 
taken off at his own expense, and Dr. Wood said the 
paper-hanger had the most typical case of inflamma- 
tion about the nails that he ever saw. I think Bum- 
stead, although he has made some mistakes that were 
reported here last winter, has always acted fairly 
when he has found any paper that contained arsenic. 8 
I am sure that Gregory & Brown are very care- 
ful. 
Dr. Davenport said: It is well to remember that 
the certificate of the chemist applies only to the par- 
ticular sample examined. It does not apply to an- 
other roll, whether of the same pattern or not. Two 
rolls of the same pattern may be quite different. One 
may be free ; the other may contain a considerable 
amount of arsenic. 
Dr. Smith: The reason why I spoke as I did about 
the law, was because Dr. Wood said he had been at 
the State House, in relation to the matter, but has 
been rebuffed every time. Testimony is brought for- 
ward to controvert his own. If the law were passed, 
he would be cutting his own fingers, for he gets some 
income from analyzing the papers. He has been one 
of the most strenuous in pushing the law at the State 
House. I would like to ask Dr. Davenport whether 
arsenic in wall-paper does not exist for the main part 
as an impurity. 
Dr. Davenport : I presume it does. Most wall- 
paper in this vicinity is manufactured by the American 
Wall-Paper Company. They claim, and with reason- 
able evidence in favor of it, that they do not now use 
arsenical colors at all and do not intend to have arsenic 
in their paper. I have understood that they had last 
year a thousand samples of paper, just as it came from 
the factory, analyzed, and found it contained arsenic on 
the average in some 66 per cent, of samples. 
The stock from which the paper is made is largely 
clay, and this, as well as the ochre, may contain arse- 
nic. All papers with gilt contain arsenic, that is, 
practically all, because commercial copper is very sel- 
dom free from arsenic. Of course the bronze contains 
copper and zinc. Gilt from the American ore is gen- 
erally free, but imported ore generally contains arsenic. 9 
Then as all chemicals are made more or less directly 
with the use of sulphuric acid, which is made from 
pyrites, it may come in that way. And so, well nigh 
everything, unless it has been specially freed from it, 
would contain a trace of arsenic. 
Dr. Smith said : It seemed to me that the amount 
of arsenic which would thereby creep into the color 
would be very small, but I supposed that the arsenic 
was used as a mordant, and was not washed out. 
Dr. Davenport : As a mordant, quite a number 
of large cotton print mills use twenty tons of arsenic 
a month. A common piece of print cloth may con- 
tain three, four or five grains of arsenic per yard. 
Dr. Smith had been told last June that Mr. Binney, 
employed by the Walpole company, made the strong 
assertion that arsenic had no business in the chemistry 
of coloring material at the present time ; that it was 
the lazy greediness of the manufacturers, who allow 
it to remain in their colors ; that they do not take 
time to wash it out thoroughly. 
Dr. Buck said: There is one element of danger 
in papering rooms which does not often come up here. 
We may have a paper perfectly free from arsenic and 
still get arsenic poisoning. A certain number of 
paper-hangers put arsenic in their paste, and that 
gradually gets through the paper. 1 would like to 
know if any one has seen differences in the number of 
cases reported in different seasons of the year. In my 
experience I have seen more cases in the summer than 
at any other time. I have seen paper-box 
workers during the summer, and although I have had 
the Dispensary work to do at other seasons of the year. 
I have not seen these patients during the winter or 
fall months. They have presented themselves chiefly 
during the early summer. I have thought that possi- 
bly it might have something to do with the heat, there 10 
being a greater degree of volatility at that season of 
the year. 
Dr. Vickery: Would paper containing two-thirds 
of a grain to the yard, be poisonous ? 
Dr. Davenport: Whether it would be poisonous 
is a question of dispute. Some say yes, and some no. 
Nobody knows. 
Dr. Blodgett: I would like to observe that the 
chemist of the Roxbury Carpet Works, in which 
nearly all the various colors are employed, informed 
me that he never used arsenic, and that it was en- 
tirely unnecessary and out of place in the production 
of any color, and that it was perfectly possible to get 
all the advantages, found in arsenic, from other and 
safe means. He expressed himself very strongly, and 
said that the presence of arsenic even as an impurity 
was unnecessary if proper care was employed in the 
selection of colors. 
Dr. Smith added that a former occupant of the 
house where this patient lived, had died from some 
obscure trouble, having had stomach and head symp- 
toms. She supposed it was the drainage, and the 
plumbers had been over the house again and again, 
but they pronounced everything in good order. Per- 
haps the present case may give us some hint as to the 
cause of that sickness and death. 
Dr. Pengra: In what form is the arsenic set free 
from the wall-papers ? Is it in the form of gas or 
solid ? 
Dr. Davenport: I believe it is now commonly 
considered that the danger is from the dust which is 
removed from the surface and inhaled. It was claimed 
at one time that there was danger of arseniuretted hy- 
drogen being formed and exhaled as a gas. I believe 
the latest experiments have shown that this gas is not 
formed except there is free arsenic present in the 11 
color. In the case of Scheele's green or Paris green, 
each coinmonly contains a certain per cent, of free 
arsenic, so that in the presence of moisture and fer- 
mentation, arseniuretted hydrogen may be formed. In 
connection with those hearings which were carried on 
before the legislature, one of the gentlemen papered 
a large room with a heavy arsenical paper, and drew 
the air from the room through a solution which would 
take out the gas which would be formed. I think it 
was carried on for some weeks without any 
result. 
Dr. Pengra. I would like to know whether the 
finish would not have something to do with it. 
Dr. Davenport. As I understand it, the danger 
is of the color being mechanically removed. Of course 
if the finish is such as to prevent that, the danger is 
prevented. A rough finish I presume is more likely 
to be loosely attached than the smooth polished sur- 
face. There are a great many interesting questions 
arising from this. Take a paper which contains a 
grain of arsenic per square yard. Suppose that it 
covers a room larger than the average, so that we 
have sixteen rolls of paper. Such a room would have 
something like sixty grains of arsenic on the wall. 
It would take a good many years for the paper to fall 
off, and if one were in the room and inhaled all of it, 
it would be a very minute quantity. It seems as if 
people were more affected by very minute doses than 
we are accustomed to see when we give it medicinally. 
One writer says that it has a greater effect, but 1 do 
not know why. 
Dr. Pengra said, I would agree with Dr. Daven- 
port's statements that the arsenic would not become 
arseniuretted hydrogen, but the process of fermenta- 
tion may produce that gas. During the past four 
vears I have seen students to the number of from one 12 
hundred to two hundred, working in a laboratory 
where the gas was generated every day, each student 
probably generating from six to ten volumes in a 
moderate-sized room. They did this during six to 
nine months of the year. I have never seen a student 
suffering from anything like arsenic poisoning. I 
have seen students suffering from the fumes of amyl 
alcohol, and from sulphuretted hydrogen ; but never 
has there been a case of arsenic poisoning among stu- 
dents who have been there two years.