WEBVTT - Ep 102 Arsenic: Paris Green with Envy 0:00:03.160 --> 0:00:05.520 She turned her head from side to side with a 0:00:05.559 --> 0:00:09.920 gentle movement full of agony, while constantly opening her mouth 0:00:10.000 --> 0:00:12.960 as if something very heavy were weighing upon her tongue. 0:00:13.480 --> 0:00:18.040 At eight o'clock, the vomiting began again. Then she began 0:00:18.079 --> 0:00:22.320 to groan faintly. At first, her shoulders were shaken by 0:00:22.360 --> 0:00:25.680 a strong shuddering, and she was growing paler than the 0:00:25.680 --> 0:00:29.880 sheets in which her clenched fingers buried themselves. Her unequal 0:00:29.960 --> 0:00:35.080 pulse was now almost imperceptible. Drops of sweat oozed from 0:00:35.080 --> 0:00:38.199 her bluish face that seemed as if rigid in the 0:00:38.280 --> 0:00:42.960 exhalations of a metallic vapor. Her teeth chattered, her dilated 0:00:43.000 --> 0:00:46.279 eyes looked vaguely about her, and to all questions she 0:00:46.360 --> 0:00:49.440 replied only with a shake of the head. She even 0:00:49.479 --> 0:00:54.120 smiled once or twice. Gradually, her moaning grew louder. A 0:00:54.160 --> 0:00:57.720 hollow shriek burst from her. She pretended she was better 0:00:57.760 --> 0:01:00.800 and that she would get up. Presently, she was seized 0:01:00.840 --> 0:01:05.200 with convulsions and cried out, ah, my god, it is horrible. 0:01:06.360 --> 0:01:10.160 Then the symptom ceased for a moment. She seemed less agitated, 0:01:10.280 --> 0:01:14.120 and at every insignificant word, at every respiration a little 0:01:14.160 --> 0:01:17.880 more easy, he regained hope. His colleague was by no 0:01:18.040 --> 0:01:21.160 means of this opinion, and, as he said of himself, 0:01:21.560 --> 0:01:25.000 never beating about the bush, he prescribed an emetic in 0:01:25.080 --> 0:01:29.800 order to empty the stomach completely. She soon began vomiting blood. 0:01:30.400 --> 0:01:33.960 Her lips became drawn, her limbs were convulsed, her whole 0:01:33.959 --> 0:01:36.919 body covered with brown spots, and her pulse slipped beneath 0:01:36.920 --> 0:01:40.640 the fingers like a stretched thread, like a harpstring, nearly breaking. 0:01:41.680 --> 0:01:46.200 After this, she began to scream horribly. She cursed the poison, 0:01:46.319 --> 0:01:48.440 railed at it, and implored it to be quick, and 0:01:48.520 --> 0:01:51.760 thrust away with her stiffened arms everything that Charles in 0:01:51.880 --> 0:01:55.880 more agony than herself, tried to make her drink. Emma, 0:01:56.080 --> 0:01:59.640 her chin sunken upon her breast, had her eyes inordinately 0:01:59.760 --> 0:02:03.360 wide open, and her poor hands wandered over the sheets 0:02:03.360 --> 0:02:06.680 with that hideous and soft movement of the dying that 0:02:06.800 --> 0:02:09.440 seems as if they wanted already to cover themselves with 0:02:09.560 --> 0:02:14.200 the shroud. Her chest soon began panting rapidly. The whole 0:02:14.240 --> 0:02:17.160 of her tongue protruded from her mouth. Her eyes, as 0:02:17.200 --> 0:02:20.120 they rolled, grew paler like the two globes of a 0:02:20.200 --> 0:02:22.720 lamp that is going out, so that one might have 0:02:22.760 --> 0:02:25.760 thought her already dead, but for the fearful laboring of 0:02:25.800 --> 0:02:29.600 her ribs, shaken by violent breathing, as if the soul 0:02:29.639 --> 0:02:33.400 were struggling to free itself. Emma raised herself like a 0:02:33.440 --> 0:02:38.640 galvanized corpse, her hair undone, her eyes fixed staring. She 0:02:38.720 --> 0:02:41.880 fell back upon the mattress in a convulsion. They all 0:02:41.960 --> 0:02:43.919 drew near. She was dead. 0:03:30.120 --> 0:03:31.920 Aye, yeah, yea yi Aaron. 0:03:32.919 --> 0:03:37.160 Yeah, so that was heavily edited down from like the 0:03:37.280 --> 0:03:40.880 last chapter. Sorry for the spoilers, but the book has 0:03:40.920 --> 0:03:46.280 been out since the eighteen fifties. Madame Bovary by Gustave Flaubert. 0:03:47.200 --> 0:03:49.800 And yeah, the. 0:03:49.200 --> 0:03:54.840 Lead character dies of arsenic poisoning self inflicted. Wow. 0:03:55.800 --> 0:04:02.120 Yeah, I have a question, Okay that book. Does she 0:04:03.360 --> 0:04:06.480 take arsenic like for a long time or does she 0:04:06.560 --> 0:04:07.880 just like take a big dose of it. 0:04:08.400 --> 0:04:10.320 She takes a big dose of it from what I 0:04:10.680 --> 0:04:14.200 can tell. I attempted to read it, but I didn't 0:04:14.200 --> 0:04:16.720 start it early enough and I gave up. 0:04:17.320 --> 0:04:19.480 Yeah that's fair, but. 0:04:20.320 --> 0:04:24.880 Yeah, I'm excited to see how the description there stacks 0:04:24.960 --> 0:04:27.720 up against what we know about arsenic poisoning. From the 0:04:27.760 --> 0:04:28.680 biology section. 0:04:29.279 --> 0:04:32.440 Yeah, me too, Aaron, So. 0:04:32.480 --> 0:04:36.440 Maybe not super close cool? Maybe No, I mean, come on, 0:04:36.560 --> 0:04:40.000 it's a novel. You have to allow some literary license, right. 0:04:40.080 --> 0:04:40.880 One hundred percent? 0:04:41.040 --> 0:04:44.440 Yeah, Okay, let's let's dive in. Hi, I'm erin. 0:04:44.360 --> 0:04:48.200 Welsh and I'm erin allman updight. 0:04:48.400 --> 0:04:51.599 And this is this podcast will kill You, And. 0:04:51.640 --> 0:04:53.560 Today we're talking about arsenic. 0:04:53.720 --> 0:04:59.159 Obviously, obviously it's going to be really interesting. There's a 0:04:59.160 --> 0:05:02.800 lot of fun truvy. Yeah, I'm thrilled to learn about 0:05:02.800 --> 0:05:06.119 how it works. But first, should we is it time? 0:05:06.600 --> 0:05:08.039 It can quarantin any time? 0:05:08.360 --> 0:05:08.800 It is? 0:05:09.200 --> 0:05:10.799 What are we drinking this week? 0:05:11.400 --> 0:05:13.480 This week we're drinking the King. 0:05:13.960 --> 0:05:17.080 We're drinking the King, the actual King, the actual King. 0:05:17.520 --> 0:05:21.200 Arsenic is commonly known as the King of Poisons and 0:05:21.279 --> 0:05:22.600 also the poison. 0:05:22.160 --> 0:05:24.800 Of Kings, which I did not know and I really love. 0:05:25.560 --> 0:05:28.160 Yeah, And so we just decided to keep it simple 0:05:28.279 --> 0:05:31.279 and keep it sweet with the King. 0:05:31.640 --> 0:05:34.080 The King and what's in the King erin. 0:05:34.480 --> 0:05:40.920 What's in the King is essentially a Madori sour, because yeah, 0:05:41.080 --> 0:05:44.039 we had to have something green, because, as you'll learn, 0:05:44.680 --> 0:05:47.560 arsenic was used as a colorant for like a different 0:05:47.560 --> 0:05:53.280 shades of Green a lot during the nineteenth century, and yeah, 0:05:53.440 --> 0:05:57.960 Madori is hits, Ticks that Box and Harry Green. Yeah, 0:05:58.080 --> 0:06:03.520 and essentially Immadori Sour is Majori lemon juice, limejuice, soda water. 0:06:03.600 --> 0:06:06.960 And we'll post the full recipe for the King as 0:06:06.960 --> 0:06:10.240 well as the non alcoholic place Marita on our website 0:06:10.279 --> 0:06:12.880 This podcast will Kill You dot Com, as well as 0:06:12.920 --> 0:06:15.120 on all of our social media channels. 0:06:15.200 --> 0:06:17.920 On our website This Podcast will Kill You dot Com. 0:06:18.200 --> 0:06:21.960 The things that you can find there are numerous. They 0:06:22.000 --> 0:06:26.400 include our merch and our bookshop dot org affiliate account, 0:06:26.440 --> 0:06:29.679 and our Goodbeats list, as well as Bloodmobile, our music 0:06:30.240 --> 0:06:33.279 and transcripts for all of our episodes, and all of 0:06:33.320 --> 0:06:35.520 the sources that we use in every episode. You can 0:06:35.520 --> 0:06:39.920 find our Patreon, you can find really you name it, 0:06:39.920 --> 0:06:41.120 it's probably on our website. 0:06:41.360 --> 0:06:44.840 That's true. That's true. All right. I think that's all 0:06:44.839 --> 0:06:48.400 the business that we have. So can we get started? 0:06:48.960 --> 0:07:26.800 I would love to right after this break. So, Aaron, 0:07:27.600 --> 0:07:32.000 when I started researching for Arsenic, immediately right off the bat, 0:07:32.000 --> 0:07:36.320 I got really heavy mercury vibes, meaning I was way 0:07:36.320 --> 0:07:41.000 out of my lee. And turns out that we don't 0:07:41.040 --> 0:07:45.400 have a lot of specifics, just like with mercury. Okay, 0:07:45.920 --> 0:07:49.000 but I will tell you everything that I learned and 0:07:49.080 --> 0:07:52.000 then can't wait for your questions that I probably won't 0:07:52.000 --> 0:07:52.600 know the answer to. 0:07:52.920 --> 0:07:54.280 Okay, I can't wait to ask him. 0:07:54.480 --> 0:08:01.440 I know. My favorite part so Arsenic is a meta. 0:08:01.480 --> 0:08:04.640 What is a metaloid? You may ask, because that's certainly 0:08:04.680 --> 0:08:09.760 what I ask everyone, because chemistry really is something that 0:08:09.800 --> 0:08:12.480 makes me nervous. But I'm gonna do my best, and 0:08:12.520 --> 0:08:15.800 it means that I'll explain it as if you know nothing, 0:08:15.960 --> 0:08:19.600 because we all know nothing. Let us go. A metaloid 0:08:19.840 --> 0:08:23.800 is not quite a metal and not quite a non 0:08:24.000 --> 0:08:28.400 metal when we look at the periodic table of elements. 0:08:28.800 --> 0:08:31.160 So I feel like most people probably have a sense 0:08:31.160 --> 0:08:33.559 of what a metal is, even if you don't remember 0:08:33.559 --> 0:08:35.600 back to your high school chemistry class, like what the 0:08:35.640 --> 0:08:39.160 definition is. If you give somebody a chunk of something 0:08:39.200 --> 0:08:41.600 and say is this metal or no, they'll be like, hmm, 0:08:41.760 --> 0:08:44.760 is it shiny, is it solid? Does it look like metal? 0:08:45.000 --> 0:08:48.600 Et cetera. So those are the kinds of things that 0:08:48.640 --> 0:08:51.440 make a metal a metal, right. They're generally shiny or 0:08:51.440 --> 0:08:56.240 metallic or lustrous. Metals are generally good conductors of heat 0:08:56.280 --> 0:09:02.880 and electricity. Non metals can be anything, but in general 0:09:03.000 --> 0:09:06.120 they're not as good of conductors. They're less good than metals, 0:09:06.960 --> 0:09:11.680 and metalloids are somewhere in between. It turns out that 0:09:11.720 --> 0:09:15.679 there's no good consensus definition of what makes a metaloid 0:09:15.720 --> 0:09:18.640 a metaloid. It's not a very clear term, but it's 0:09:18.679 --> 0:09:22.000 still used in a lot of chemistry textbooks, and the 0:09:22.000 --> 0:09:25.199 most common elements on the periodic table that are considered 0:09:25.240 --> 0:09:34.360 metaloids are boron, silicon, germanium, antimony, tellurium, and of course arsenic. 0:09:35.720 --> 0:09:40.600 So Arsenic is an element like carbon, or lead or mercury. 0:09:40.840 --> 0:09:44.120 It just happens to be somewhere in between carbon and 0:09:44.360 --> 0:09:46.920 lead and mercury in that it's not a non metal 0:09:47.000 --> 0:09:52.880 and not a metal. It's a metaloid, and much like carbon, arsenic, 0:09:52.920 --> 0:09:56.200 as it turns out, exists in what are called different allotropes. 0:09:56.320 --> 0:09:59.400 I learned so many interesting facts about arsenic. 0:10:00.360 --> 0:10:03.080 I have not come across that word, but I love it. 0:10:03.400 --> 0:10:07.160 Yeah, it's a really fun word. It basically means that 0:10:07.240 --> 0:10:11.560 it can form different crystalline structures that look differently the 0:10:11.600 --> 0:10:14.080 same way if you think of carbon, atoms can form 0:10:14.280 --> 0:10:19.920 diamonds or graphite, right, same atoms, different structure, looks totally different. 0:10:20.360 --> 0:10:24.360 In the case of arsenic, there's gray arsenic, black arsenic, 0:10:24.480 --> 0:10:28.040 and yellow arsenic. Gray is the form that looks the 0:10:28.040 --> 0:10:30.960 most like a metal and tends to act the most 0:10:31.080 --> 0:10:34.800 like a metal. It can be a semiconductor, so that's 0:10:34.960 --> 0:10:37.719 very useful in a lot of industrial settings, which I'll 0:10:37.760 --> 0:10:41.880 get to, and arsenic is often used in metal alloys 0:10:41.960 --> 0:10:46.040 for that reason. And just like our friend and another 0:10:46.120 --> 0:10:50.400 element that we've talked about on this podcast, mercury, arsenic 0:10:50.480 --> 0:10:55.120 also exists across the Earth in various compounds, both organic 0:10:55.160 --> 0:10:59.880 compounds like carbon based compounds, and inorganic or no carbon 0:10:59.840 --> 0:11:05.520 involved compounds. And if you remember our mercury episode as 0:11:05.559 --> 0:11:08.200 well as our lead episode, which was a very long 0:11:08.240 --> 0:11:14.679 time ago. Now, the toxicity of elements like arsenic depends 0:11:14.720 --> 0:11:18.360 in part on what form we get exposed to, as 0:11:18.400 --> 0:11:21.240 well as of course whether we're being exposed to small 0:11:21.280 --> 0:11:24.640 amounts over long periods of time, like a chronic exposure, 0:11:25.120 --> 0:11:27.520 or a big hefty dose all at once, like an 0:11:27.520 --> 0:11:34.160 acute poisoning. And it turns out that with arsenic, this 0:11:34.360 --> 0:11:38.119 is very important. The type of arsenic that you're exposed 0:11:38.200 --> 0:11:42.840 to really determines the toxicity, and being not a chemist, 0:11:42.920 --> 0:11:45.720 I tried to not get too bogged down in oxidation 0:11:46.120 --> 0:11:49.880 states and valences, but it turns out that that's what's 0:11:49.960 --> 0:11:53.800 really important when it comes to arsenic. So the basics 0:11:53.880 --> 0:11:58.240 look like this. Arsenic is close to phosphorus on the 0:11:58.280 --> 0:12:03.640 periodic table, and so in some forms when it's oxidized 0:12:03.960 --> 0:12:07.640 in a certain way, it's called a pentavalant form. It's 0:12:07.679 --> 0:12:12.840 an inorganic form of arsenic that's called arsenate, and it 0:12:12.880 --> 0:12:18.280 really can resemble phosphate, which is a form of phosphorus, 0:12:19.320 --> 0:12:23.160 and phosphate in our bodies is a pretty integral part 0:12:23.200 --> 0:12:28.720 of human biology. It's the p in our atp adentizene triphosphate, 0:12:29.679 --> 0:12:32.920 and so much like with lead and mercury, what we 0:12:32.960 --> 0:12:37.319 see with arsenic is that the toxicity arises from its 0:12:37.360 --> 0:12:42.840 ability to mimic other compounds that our body normally uses, 0:12:43.640 --> 0:12:48.040 and or its ability to hijack various enzymes or metabolic 0:12:48.080 --> 0:12:50.400 pathways because of these similarities. 0:12:50.960 --> 0:12:54.880 It's so interesting that it does that. Because we talk 0:12:54.960 --> 0:12:59.120 about infectious diseases primarily on the podcast, although maybe not 0:12:59.160 --> 0:13:03.320 as much anymore, we think of these pathogens as striving 0:13:03.440 --> 0:13:07.720 to reproduce and survive, and that's why they cause infection, 0:13:07.800 --> 0:13:10.360 that's why they make us sick. But with arsenic, it's 0:13:10.520 --> 0:13:14.439 just like, here's this inert thing that is just happens 0:13:14.559 --> 0:13:17.480 to be extremely deadly. 0:13:17.800 --> 0:13:22.520 Right exactly. It just it just happens to have an 0:13:22.520 --> 0:13:25.680 effect in our bodies because it's similar to things that 0:13:25.720 --> 0:13:28.920 our body actually needs and uses, but not because we 0:13:29.040 --> 0:13:32.480 need it in any way, and it's just it just 0:13:32.559 --> 0:13:33.360 happens to be there. 0:13:33.480 --> 0:13:35.840 Yeah, it's oh, it's very interesting. Yeah, I know. 0:13:36.840 --> 0:13:41.839 So that's one way that arsenic can exert its toxicity 0:13:41.960 --> 0:13:46.840 when it's in its oxidized pentavalent form. Another probably even 0:13:46.920 --> 0:13:50.920 more common and more toxic form of arsenic is called arsenite, 0:13:51.640 --> 0:13:54.480 and this is the trivalent form. This is what happens 0:13:54.480 --> 0:13:58.840 when arsenic is in a reducing environment, and this, in 0:13:58.880 --> 0:14:03.360 a very similar way, disrupts a number of our biological processes, 0:14:03.480 --> 0:14:07.120 but not by mimicking phosphate in this case, but by 0:14:07.160 --> 0:14:10.440 having a high affinity for what are called thiols or 0:14:10.480 --> 0:14:14.520 self hydral groups, so sulfur and hydrogen. Turns out that 0:14:14.640 --> 0:14:18.360 our body has a lot of proteins and enzymes that 0:14:18.520 --> 0:14:22.120 have these sulfur hydrogen groups on them that are really 0:14:22.120 --> 0:14:25.680 integral to things like I don't know, ar citric acid cycle, 0:14:25.840 --> 0:14:29.640 which makes ATP to power our cells, and a whole 0:14:29.760 --> 0:14:35.800 host of other very basic and important metabolic functions. So 0:14:35.960 --> 0:14:40.560 that's kind of the most basic look at arsenic. 0:14:41.760 --> 0:14:46.520 And in terms of whether it happens to mimic thiols 0:14:46.760 --> 0:14:50.480 or phosphate, that just is in the way that it's formed. 0:14:50.800 --> 0:14:55.320 These it's basically just depends on which form of arsenic 0:14:55.360 --> 0:14:58.880 you're exposed to, okay, and which form you're exposed to 0:14:59.240 --> 0:15:02.040 will depend on on what that arsenic is doing in 0:15:02.080 --> 0:15:04.880 the environment, whether it's a high oxygen environment or a 0:15:04.920 --> 0:15:09.480 low oxygen environment, blah blah blah, And that is all. 0:15:10.120 --> 0:15:16.000 All of those are inorganic forms of arsenic. Organic arsenic 0:15:16.120 --> 0:15:19.960 organic compounds that contain arsenic can be found in really 0:15:20.000 --> 0:15:23.760 high concentrations in things like shellfish. But it turns out 0:15:24.680 --> 0:15:28.840 if we get exposed to arsenic that's already bound to 0:15:29.400 --> 0:15:32.920 organic compounds, we actually don't see a lot of effects 0:15:32.960 --> 0:15:35.520 from it. It actually is very non toxic, which is 0:15:35.640 --> 0:15:37.880 interesting and different than what we saw in mercury, which 0:15:37.920 --> 0:15:39.080 I think is just fascinating. 0:15:39.720 --> 0:15:44.440 Yeah, yeah, and these different forms of arsenic and the 0:15:44.480 --> 0:15:47.400 different things they mimic and all of that that must 0:15:47.480 --> 0:15:51.120 lead to different symptoms if it's disrupting different parts, or 0:15:51.240 --> 0:15:54.760 is it, because it's all kind of in the same pathway. 0:15:54.840 --> 0:15:57.360 So let's get into that, shall we Let's get into 0:15:57.360 --> 0:16:00.800 the symptoms and then maybe it'll kind of get at 0:16:01.000 --> 0:16:05.520 that question. Okay, So when we encounter arsenic in any 0:16:05.560 --> 0:16:08.440 of these various forms, we generally absorb it into our 0:16:08.480 --> 0:16:12.840 bloodstream and it goes to anywhere in our body, but 0:16:12.880 --> 0:16:16.160 it's often stored in places like our liver, our heart, 0:16:16.320 --> 0:16:20.320 our lungs, our kidneys are really important for excreting arsenic. 0:16:20.800 --> 0:16:24.480 It can also be found in our skin. Really, it's everywhere, 0:16:25.320 --> 0:16:29.000 and our bodies have a lot of enzymes that actually 0:16:29.040 --> 0:16:32.720 function to break down arsenic, to metabolize it into a 0:16:32.800 --> 0:16:36.160 form that we can then excrete it. But it turns 0:16:36.160 --> 0:16:38.800 out that one of these forms, which is known as 0:16:38.960 --> 0:16:44.320 methyl arsenite or monomethyl arsenite blah blah blah, this form 0:16:44.400 --> 0:16:49.000 is also very toxic. So our bodies are dealing with 0:16:49.120 --> 0:16:53.320 arsenic by quote breaking it down, methylating it really, but 0:16:53.360 --> 0:16:56.280 then that is also toxic, so it doesn't just get 0:16:56.360 --> 0:16:59.120 rid of it automatically, So then what happens to it 0:17:00.000 --> 0:17:02.120 holds up in our bodies and causes all these symptoms 0:17:02.160 --> 0:17:04.720 that I'm about to talk about. Oh oh oh, okay, yeah, 0:17:04.760 --> 0:17:08.800 so it acts just like arsenic, even though organic arsenic 0:17:09.000 --> 0:17:15.080 from a shellfish doesn't weird. I know, it's so bizarre. 0:17:16.320 --> 0:17:20.639 So we get exposed to arsenic generally via food or water, 0:17:20.960 --> 0:17:25.760 so contamination of food sources and drinking water from arsenic, 0:17:25.800 --> 0:17:30.320 which comes from honestly anywhere. Like it's found in the soil, 0:17:30.480 --> 0:17:33.600 it is ubiquitous across this earth, although as we'll see 0:17:33.920 --> 0:17:38.040 later on, it's certainly not evenly distributed across the globe. 0:17:38.960 --> 0:17:43.040 But it can be found in groundwater kind of worldwide 0:17:43.320 --> 0:17:47.680 and oral root. So ingesting it is the primary way 0:17:47.720 --> 0:17:51.200 that people get exposed. In industrial settings. You can get 0:17:51.240 --> 0:17:55.560 exposed via inhalation, and it's unclear whether you can really 0:17:55.600 --> 0:17:57.639 absorb much of it through your skin. It seems like 0:17:57.680 --> 0:18:01.000 mostly no. But if your hand it all day, all 0:18:01.040 --> 0:18:02.720 the time, and you have it on your skin, you 0:18:02.720 --> 0:18:04.160 can potentially then ingest. 0:18:04.040 --> 0:18:04.920 It from your hands. 0:18:07.080 --> 0:18:09.600 But everyone is being exposed to arsenic at at least 0:18:09.680 --> 0:18:13.280 some level, so let's talk about what we see in 0:18:13.359 --> 0:18:16.760 terms of symptoms, because as with everything we've talked about 0:18:16.800 --> 0:18:21.440 in terms of talksins on this podcast, the dose determines 0:18:21.560 --> 0:18:23.719 the poison or whatever. 0:18:23.960 --> 0:18:26.879 Right, well said, thank. 0:18:25.720 --> 0:18:32.440 You, So our first hand account perhaps described an acute 0:18:32.640 --> 0:18:37.199 arsenic poisoning episode. And I say perhaps because Aaron that 0:18:37.400 --> 0:18:40.680 firsthand didn't sound like what I'm about to describe. 0:18:41.119 --> 0:18:43.040 That's so funny because when I came across it in 0:18:43.080 --> 0:18:46.080 a book I read about arsenic for this episode, it 0:18:46.200 --> 0:18:48.719 was like yeah, and then you know, in Madame Bovriy 0:18:48.800 --> 0:18:52.880 it's actually a very excellent example of what arsenic poisoning is. 0:18:52.920 --> 0:18:57.040 Like, how fascinating. Maybe I just I will say that 0:18:57.240 --> 0:18:59.600 most of the papers that I read really did not 0:19:00.200 --> 0:19:03.320 focus on acute arsenic poisoning. It was more chronic that 0:19:03.359 --> 0:19:06.360 makes Yeah, the highlight is very much on all the chronics. 0:19:06.359 --> 0:19:09.840 So maybe I just didn't find good enough like old 0:19:09.920 --> 0:19:12.320 timey descriptions of arsenic poisoning. 0:19:12.400 --> 0:19:15.440 I mean, just pick up basically any Agatha Christie novel 0:19:15.480 --> 0:19:17.320 and your friend you'll find it in there. 0:19:18.359 --> 0:19:21.199 Well, what I found is that arsenic poisoning in some 0:19:21.240 --> 0:19:23.080 ways can look a lot like a lot of other 0:19:23.160 --> 0:19:26.440 poisonings in that within a matter of minutes to hours 0:19:26.480 --> 0:19:29.920 after ingestion, you have intense abdominal pain. You have a 0:19:29.960 --> 0:19:34.920 lot of GI symptoms, a lot of abdominal pain, vomiting, diarrhea. 0:19:35.400 --> 0:19:38.479 The diarrhea can actually be very profound. I saw it 0:19:38.520 --> 0:19:43.480 described as choleralike, remember back to that episode. So that's 0:19:43.480 --> 0:19:49.040 like a rice water, just like pure water stool, and basically, 0:19:49.160 --> 0:19:51.800 in high enough doses, this arsenic is kind of just 0:19:51.920 --> 0:19:55.000 ripping its way through your intestine eucosa. So you're losing 0:19:55.080 --> 0:19:58.600 a lot through your guts. And because of all these losses, 0:19:58.880 --> 0:20:01.840 you can end up seeing high potension, so drops in 0:20:01.880 --> 0:20:05.680 your blood pressure which can be from dehydration and volume 0:20:05.720 --> 0:20:11.000 loss from this profuse GI losses. This can then cause 0:20:11.080 --> 0:20:15.880 electrolyte abnormalities because you're losing your electrolytes through your diarrhea, 0:20:15.880 --> 0:20:19.520 through your vomiting, and that can cause your heart to 0:20:19.600 --> 0:20:23.560 stop functioning properly because without the right balance of electrolytes, 0:20:23.720 --> 0:20:26.720 your heart can't send the signals that it needs to 0:20:26.720 --> 0:20:30.440 to beat in sync. So then you can have death 0:20:30.480 --> 0:20:33.200 because of arrhythmias. If you have a high enough exposure. 0:20:34.240 --> 0:20:37.960 There also can be a lot of neurologic symptoms, but 0:20:38.080 --> 0:20:42.040 from what I read, usually, though not always, the neurologic 0:20:42.040 --> 0:20:45.520 symptoms tend to happen more like weeks days or weeks 0:20:45.560 --> 0:20:51.560 after exposure. Can cause things like numbness, tingling, muscle cramping, 0:20:51.720 --> 0:20:54.359 a lot of different neurologic effects, but these tend to 0:20:54.359 --> 0:20:58.880 not be as acute onset as the GI. 0:20:58.680 --> 0:21:03.080 Effects, and these neurological symptoms are part of the acute thing. 0:21:03.160 --> 0:21:05.800 It's just part of the recovery phase. 0:21:06.080 --> 0:21:10.720 Not necessarily recovery, but there also can be seen in 0:21:10.840 --> 0:21:13.640 more like subacute So maybe you're exposed to like kind 0:21:13.680 --> 0:21:17.119 of high doses for a number of days in a 0:21:17.200 --> 0:21:20.440 row or something like that, and you can even see 0:21:20.480 --> 0:21:24.160 them after very very long term exposures. So it's kind 0:21:24.200 --> 0:21:27.560 of just like arsenic is having its effect on your 0:21:27.560 --> 0:21:30.359 nervous system, which we'll talk about in more detail, but 0:21:30.560 --> 0:21:34.560 it's happening kind of all at once after that exposure, 0:21:34.960 --> 0:21:36.920 once it's made its way into your nervous system. 0:21:37.320 --> 0:21:42.000 Right, Okay, what's the half life of arsenic in the body? 0:21:42.440 --> 0:21:46.040 Great question. It can vary. It tends to be on 0:21:46.080 --> 0:21:49.480 the order of many hours to a few days, like 0:21:49.520 --> 0:21:53.359 two to four days. That's for the inorganic forms, But 0:21:53.440 --> 0:21:56.240 once it's methylated in our bodies, once our body tries 0:21:56.280 --> 0:21:58.280 to break it down, it can actually persist for a 0:21:58.280 --> 0:21:58.840 bit longer. 0:21:59.359 --> 0:22:04.480 Interesting. Yeah, interesting that like our bodies, Like, what is 0:22:04.480 --> 0:22:08.960 the benefit of our bodies actually breaking down arsenic Well. 0:22:08.840 --> 0:22:12.840 That's a very good question. I think it seems to 0:22:12.880 --> 0:22:17.760 make it easier to excrete via our kidneys. Okay, However, 0:22:17.800 --> 0:22:22.040 it also can have bad effects on our kidneys. Yeah, 0:22:22.640 --> 0:22:26.040 And I think it's probably in part just our body's 0:22:26.119 --> 0:22:30.399 natural reaction to stuff that gets absorbed. Right, our body 0:22:30.440 --> 0:22:32.960 methylates things, It sees something and it's like, I'm gonna 0:22:32.960 --> 0:22:35.200 methylate you. Hey, you look kind of like a phosphate. 0:22:34.720 --> 0:22:37.120 Poop poop, you know, right, Okay. 0:22:36.880 --> 0:22:40.520 So it's not necessarily Yeah, I don't know, it's a 0:22:40.600 --> 0:22:44.440 it's a good it's a good question. So that's kind 0:22:44.440 --> 0:22:49.000 of the acute phase. From what I read, Acute poisoning, 0:22:49.240 --> 0:22:54.359 especially at high enough doses to result in death, tends 0:22:54.400 --> 0:22:59.440 to happen at levels very very high. So I hate 0:22:59.600 --> 0:23:02.840 environment mental levels because it's like parts per billion and 0:23:03.200 --> 0:23:09.000 micrograms per et cetera. But sixty thousand parts per per billion, 0:23:09.040 --> 0:23:13.080 which is sixty thousand micrograms per liter. 0:23:14.080 --> 0:23:17.400 I can't, I can't imagine. It's very difficult to visualize 0:23:17.440 --> 0:23:17.880 it is. 0:23:18.160 --> 0:23:22.240 It is. That level is about ten thousand times higher 0:23:22.440 --> 0:23:25.520 than eighty percent of the drinking water in the US, 0:23:25.720 --> 0:23:29.280 for example. So it's like really really high doses, okay, 0:23:30.040 --> 0:23:33.479 but even much lower doses, like three hundred to thirty 0:23:33.600 --> 0:23:38.800 thousand parts per billion could cause pretty significant effects, right, 0:23:38.920 --> 0:23:40.320 like make you feel pretty sick. 0:23:40.800 --> 0:23:43.960 Right, But there is a level as a safe level, 0:23:44.000 --> 0:23:46.160 because our body will methylate it and kind of kick 0:23:46.160 --> 0:23:47.719 it out of our systems and excrete it. 0:23:48.040 --> 0:23:51.680 Right. The World Health Organization has the kind of provisional 0:23:51.760 --> 0:23:54.160 level of arsenic in drinking water, which is the most 0:23:54.200 --> 0:23:57.040 like ubiquitous source, and so the one that's the most 0:23:57.600 --> 0:24:01.400 has has that level attached to it is ten ten 0:24:01.440 --> 0:24:07.080 micrograms per liter or ten parts per billion. Okay, yeah, 0:24:07.280 --> 0:24:10.800 so that's the number. So we're talking about sixty thousand. 0:24:10.640 --> 0:24:12.200 Like, that's a lot, that's a lot. That's a lot. 0:24:12.359 --> 0:24:15.840 It's a lot more. But that's kind of the acute poisoning. 0:24:15.880 --> 0:24:20.399 It's pretty rare nowadays. What's much more common is that 0:24:20.440 --> 0:24:23.280 someone is exposed to levels that are higher than that 0:24:23.480 --> 0:24:27.520 ten parts per billion, but still low, like between fifty 0:24:27.560 --> 0:24:31.679 and one hundred say, for example. So people who are 0:24:31.720 --> 0:24:35.040 exposed to this lower level but still high level of 0:24:35.160 --> 0:24:38.040 arsenic over a prolonged period of time. One of the 0:24:38.080 --> 0:24:43.200 most characteristic things that we can see is pigmentation changes 0:24:43.240 --> 0:24:47.159 in the skin, which is fascinating. You get these little 0:24:47.320 --> 0:24:50.960 patches of skin that can be darker or lighter than 0:24:51.000 --> 0:24:55.960 your underlying skin tone. And these patches are hyper keratotic, 0:24:56.040 --> 0:24:59.880 which means that they are these little hard patches kind 0:24:59.880 --> 0:25:03.600 of of like a wart almost like a little stuck 0:25:03.680 --> 0:25:08.560 on patch of skin. And this is caused by your 0:25:08.600 --> 0:25:12.560 skin actually proliferating in a very abnormal way. And these 0:25:12.680 --> 0:25:15.960 lesions are precursors to various skin cancers. 0:25:16.520 --> 0:25:20.080 Oh and so the skin cancer that's associated with arsenic 0:25:20.160 --> 0:25:23.800 is not just through direct contact on your skin, but 0:25:23.880 --> 0:25:27.040 could through any way that you are exposed. 0:25:27.280 --> 0:25:31.760 Right, it's not skin contact, It is ingestion or inhalation, 0:25:32.560 --> 0:25:34.879 but it goes and is absorbed through your whole body 0:25:34.920 --> 0:25:36.720 and causes these changes in your skin. 0:25:37.080 --> 0:25:40.480 And you wouldn't expect to see this with an acute case. 0:25:40.760 --> 0:25:42.640 Not as far as I could tell, because it takes 0:25:42.680 --> 0:25:44.640 time for your skin to react to it. 0:25:44.800 --> 0:25:45.800 Gotcha right. 0:25:47.040 --> 0:25:51.520 Long term ingestion can also cause cardiovascular disease. It can 0:25:51.560 --> 0:25:55.560 cause something that is called blackfoot disease. It's a very 0:25:55.600 --> 0:25:59.359 severe form of vascular disease in the feet where the 0:25:59.440 --> 0:26:03.440 vascular system becomes so severely compromised that you basically lose 0:26:03.440 --> 0:26:06.080 circulation to your feet and then develop ganggreen. 0:26:06.600 --> 0:26:08.120 Okay, it can. 0:26:08.040 --> 0:26:11.800 Cause heart attacks, it can cause strokes, can cause a 0:26:11.800 --> 0:26:16.760 lot of different things. So I wanted to try and 0:26:16.840 --> 0:26:19.160 get a little bit more into the nitty gritty of 0:26:19.240 --> 0:26:25.800 why it's causing specifically heart attacks, specifically vascular disease. So 0:26:25.920 --> 0:26:29.600