It can often be observed that people who habitually take arsenic, either for medicinal or other purposes, look better and younger; and we have, ourselves, noted in some of them a disappearance of wrinkles. Wrinkles are caused by the loss of the fatty tissue from under the skin, and as arsenic causes an increase of fat in the tissues it may improve such a condition.
As is well known in some parts of Europe, notably in Styria, the habit of eating arsenic is very prevalent among the peasants; and it is strange to note that most of these people live to a great age, and at the same time are extremely immune to all kinds of bodily fatigue—for instance, they can climb the highest peaks in their native mountainous country without great exertion. They take arsenic because it enables them to undertake harder work, such as climbing, with greater ease, and also improves their appearance.
We have known several ladies, famous actresses among them, who have indulged in this habit from vanity. A very interesting case was tried, about ten years ago, before an Austrian court of justice, in which a servant girl tried to poison her mistress by arsenic in small quantities. To the dismay of the servant, however, the lady continued to become more beautiful; so the murderess determined to give a larger dose, which induced grave symptoms of intoxication, and caused the discovery of the plot.
It is equally well known that animals obtain a glossy and sleek coat through the administration of arsenic in small quantities.
There can be no doubt that when arsenic is taken in small quantities it may prove of therapeutic value against old age; but as very aged people are often antagonistic to its use, it would seem to offer better results if used as a preventive against premature old age rather than as a cure after old age had much advanced.
As arsenic can give good results, especially in combination with iron, in anæmia, and also in neurasthenia and hysteria, we think that its use would be particularly beneficial in women near the forties, and especially during the years before and after the climacteric until about the sixtieth year. According to Grawitz, arsenic acts better than iron in the anæmia of the aged.
Arsenical treatment has given us excellent results also in nervous troubles of women at a much earlier age. It has often produced an increase in the weight and an improvement in the personal appearance of our patients.
As, according to Gauthier[345] and Bertrand, the thyroid gland contains arsenic, we are thus administering an important element of this gland. The observation of Dr. Sajous[346] is of great importance, that arsenic dilates the arterioles. Indeed, we have also made similar observations; thus we found after the use of arsenic in several cases a higher vascular pressure and irregularities of the pulse similar to those occurring after tobacco smoking, which, as shown before, has also a stimulating action upon the adrenals. In a few cases there was also pigmentation of the skin. By using arsenic while taking thyroid extracts we stimulate the antagonists of the thyroid, the adrenals; and thus the symptoms of hyperthyroidia can be avoided by simultaneously giving arsenic in small doses. As we shall, in the next chapter, recommend the use of thyroid extracts in the prevention of premature old age, and in the treatment of old age, this simultaneous use of arsenic can increase the benefit of such treatment; but for the purpose in question arsenic should be given in the smallest possible doses, as Fowler’s solution, beginning with 3 drops and increasing to not more than 5 or 6 drops per day, by slow and gradual degrees, and then decreasing slowly again, but not for longer than for three or four weeks altogether. In women something more could be given. Far better than Fowler’s solution would be the various mineral waters that contain the most useful form of arsenic, as such waters usually contain also iron, which still further increases their value. Such mineral waters can be found in various countries, viz.: in Austria, in the Tyrol: Levico, very rich in arsenic and iron, and Roncegno, rich in arsenic; in Bosnia: Guberquelle, very rich in iron; in Switzerland: Val Sinistra; in France: Royat, Bourboule, etc. They are absolutely innocuous if taken under medical care. We must begin by taking one tablespoonful of these arsenical waters, and gradually increase to five or six tablespoonfuls a day, when we must then again gradually diminish the amount.
By taking such waters, increasing slowly and gradually and then decreasing in a similar way, the most efficacious arsenic and iron treatment can be obtained, and a simultaneous thyroid treatment better endured. It is better to take such remedies after meals, and the patient must be kept under constant medical supervision, just as they are during iodine or thyroid treatment.
We have often observed that women, especially in the forties or fifties, looked much younger after a treatment by iron preparations, particularly when in combination with iron and arsenic; mineral mud baths, containing much iron, have been used; and we are quite emphatic in asserting that such treatment, possibly more in women than in men, though in these we have not infrequently noted the same results, is able to improve the symptoms of old age; for we have had opportunities of observing this in many cases, sometimes even in women at the beginning of the sixties.
The best results can be observed in women between 30 and 60, even though they sometimes have no previous anæmia, who look much healthier after such a combined iron, arsenic, mineral water, and mud-bath treatment. In men similar results have been noted; but in the case of women it must be regarded as a specific.
In the same way as iodides act on the thyroid, we are inclined to think that arsenic and iron are specifics to promote a better action of the sexual glands, especially the ovaries, and probably also of the adrenals.
According to Professor von Noorden[347] and other authors, chlorosis is due to a degenerated condition of the ovaries. But the adrenals also may be altered, causing the great muscular weakness of chlorotic girls. Thus Dr. Sajous[348] has attributed chlorosis to adrenal degeneration. If, as observed for centuries, arsenic and iron are specifics in augmenting hæmoglobin in the blood, it is a question whether this effect is obtained by the action of these preparations upon the ovaries, or upon the adrenals, as advocated by Dr. Sajous.[349] The probability is that they act upon both glands. Mud baths which are rich in iron are especially potent and successful against chlorosis and anæmic conditions, and at the same time against ailments of the ovaries and uterus, as is well known to gynæcologists. Iron seems also to exercise beneficent action on the male sexual glands. Impotency, as we have also seen, can often be improved by iron preparations, or by mineral waters containing iron and arsenic. Hysteria, as ancient physicians supposed it to be, and as we have tried to show,[350] is due, in great probability, very frequently to alterations in the female sexual organs, and iron treatment, especially arsenic and iron mineral waters, improves many cases.
As well known to urologists, the general condition in cases of chronic posterior gonorrhœa, and in prostate troubles from such a cause, is often improved through iron treatment; as also is neurasthenia, even though some cases are not in etiological relation with such a cause.
We must thus consider iron, especially when in combination with arsenic, as one means of improving the condition of the sexual organs judging from the foregoing reported clinical observations. The fact that iron of itself is no longer regarded as being useful in senility—i.e., when the sexual glands are more or less degenerated—points to the value of its combination with arsenic. We consider iron, especially in the form of the easily absorbed iron mineral waters, and in the form of the iron contained in mud baths, as a valuable means for the prevention of premature old age, and for the treatment of old age. Iron, and especially inorganic iron, is indicated as a preventive of old age for the reason that it stimulates to greater activity the blood forming organs, as has been shown by Harnack and von Noorden. It is a fact, upon which we have already insisted, that the organs which control the condition of the bone marrow, the seat of the blood forming mechanism—i.e., the thyroid and the ovaries,—are degenerated in old age. Iron acts upon the bone marrow through the intermediate agency of these glandular structures.
It can be administered in the form of the perchloride or of other inorganic preparations. According to Bunge, organic iron preparations and iron contained in food have the advantage of being more readily absorbed and assimilated. (See chapter on the blood as an article of iron-containing food.) But Grawitz still prefers to prescribe inorganic iron, such as reduced iron or perchloride of iron. An old iron preparation of great efficacy is the Blaud pills.
A very successful method of iron treatment is by mineral waters which are rich in iron—in Austria, Franzersbad; in Germany, Langenswalbach. We prefer such waters as contain arsenic besides iron, as already mentioned.
When mud baths are used simultaneously, it will be advisable not to take thyroid extracts also; but to await doing so till after the course of baths is finished.
Increase of fat and of connective tissue are the most typical and anatomo-pathological changes in the tissues produced by old age. It is evident that drugs which can combat these changes are also able to treat and improve the condition of old age. There is no inorganic drug which can give such good results in these conditions, according to our present knowledge, as the iodides. It is generally believed that through the use of potassium iodide we are able to diminish fat in many cases. The increase of connective tissue in different organs, that takes place in the cirrhosis of these organs, has also been treated by iodides with success, according to some authorities, and, according to others, without any. At any rate, in arteriosclerosis there can be no doubt that iodides do give good results as they facilitate the circulation of the blood by diminishing its viscosity. According to Heinz,[351] iodides can combat connective tissue hypertrophy by rendering the vessel walls more permeable. They also increase the activity of the leucocytes.
When we administer iodides we give in them the main element of the thyroid gland—iodine, so that iodide treatment acts on these glands and increases their iodine contents. Iodine is a rational remedy for preventing old age, for the reason that, as Baumann and Jollin have found, the thyroid gland of aged persons contains but little iodine. We know, through the researches of Blum, Baumann, Kocher, Aeschbacher, etc., that by administering iodide we increase not only the iodine content of the thyroid, but also, as the experiments of Garnier show, its colloid substance. Iodides are best taken in the form of a saturated solution of sodium iodide, or other preparations containing this salt. They act best when taken in small quantities (not over 15 grains of the iodide a day), such amounts stimulating thyroid activity; larger doses, by overstimulating, may cause a subsequent exhaustion of the thyroid.
That iodide treatment is able to increase thyroid activity is best shown by the fact that it may be followed by iodism, which presents most of the symptoms that follow large doses of thyroid extracts. It is very probable that many benefits obtained by iodide treatment can be explained through its action in increasing thyroid activity.
Instead of using inorganic iodine, it would seem more logical to use organic iodine, as contained in the thyroid gland. We could thereby, to a certain extent, replace iodides successfully by thyroid extracts; the drawback, however, is that some thyroid preparations contain only a minimum quantity of iodine, while others contain more. It would, therefore, be advisable, when thyroid extracts are used, which contain only a very little iodine, to use in combination therewith, very small quantities of iodide of potassium; say, one day one or two thyroid tablets, and the next day the iodide. It is best, when we are trying to treat the symptoms of senility by combined iodide and thyroid preparations, to feel our way very cautiously, every third day examining the heart and pulse (see following chapter).
Such treatment should be undertaken only when a thorough knowledge is possessed of the physiology and pathology of the thyroid gland.
The fact that iodides improve the circulation of the blood makes them, in old age, especially useful, as arteriosclerosis is then very frequent and the iodides become of special value. Similar remedies are also indicated in all conditions arising from tertiary syphilis, which is very often a cause of premature senility. For all the reasons given above we think that iodide treatment, in small doses, especially in combination with thyroid treatment, can give good results in our struggles against old age, and in its treatment when it has advanced on us.
We have often observed that old people taking iodides for arteriosclerosis, present a much more youthful appearance after such treatment; and Dr. G. W. Gibson, physician of the Royal Infirmary in Edinburgh, tells us that he has observed the same thing. We might especially mention the case of an English gentleman 58 years of age, who had six years ago a hemorrhage in the right eye; since that time he has been taking iodides, and in spite of his age is looking quite fresh and youthful—indeed, he recently married a young lady of 18 years.