A Case of Arsenical Poisoning with Some Unusual Features

To the Editor:—  When a 64-year-old male notices gradual onset of moderately severe, continuous, deep-seated, pressure-type substernal pain which lasts several hours and is associated with pallor, air hunger, and weakness, attention naturally centers on the heart. But, when physical examination, electrocardiogram, and other laboratory tests are negative for cardiac involvement, it may be well to inquire into the patient's gardening activities immediately preceding onset of symptoms. Such a case recently came to my attention. Onset of symptoms began about 3 hours after the patient had spread calcium arsenate (crabgrass deterrent) on his lawn. Blood arsenic level was 330 mg.%. (The normal level is variously given as from 0 to 60 mg.%.) Arsenic was also present in the urine. Approximately 32 hours after exposure to the arsenic compound, slight nausea occurred followed by 3 loose, watery stools. Malaise continued in decreasing severity for 3 days. On the fifth day after