What are the symptoms of poisoning after drinking realgar water?

Realgar water is harmful to human health if people drink it improperly. Generally speaking, people will show the following symptoms after being poisoned by drinking realgar water.

(1) Symptoms of acute gastroenteritis

Burning sensation in the throat and esophagus, nausea, vomiting, abdominal pain, diarrhea, "rice-water"-like stool (sometimes with blood), which can lead to dehydration and circulatory failure, prerenal renal insufficiency, etc.

(2) Neurological manifestations

There are headaches, dizziness, fatigue, numbness around the mouth, and body aches. Severely ill patients suffer from restlessness, delirium, delusions, muscle spasms in the limbs, confusion, and even coma, paralysis of the respiratory center and death. Delayed multiple peripheral neuritis occurs 3 to 3 weeks after acute poisoning; it manifests as muscle pain, numbness of the limbs, pins-and-needles-like paresthesias, and weakness of the upper and lower limbs. Symptoms develop symmetrically between the distal and proximal ends of the limbs, and then the sensation decreases or disappears. Severe patients have foot drop, wrist drop, accompanied by muscle atrophy, and disappearance of the Achilles tendon reflex.

(3) Damage to other organs

The main symptoms of acute inhalation of arsenic compounds include coughing, sneezing, chest pain, difficulty breathing, and even swelling of the throat and larynx, leading to suffocation. Gastrointestinal symptoms occur later and are milder. There may be local itching and rash at the skin contact site, and after one week, there will be bran-like desquamation, followed by local pigmentation and hyperkeratosis. 40 to 60 days after acute poisoning, almost all patients will have white horizontal lines (Mess lines) on their fingernails and toenails, which will move to the toes as they grow and disappear after about 5 months. Toxic hepatitis (hepatomegaly, abnormal liver function or jaundice, etc.), myocarditis, kidney damage, anemia, leukopenia or leukocytosis, etc. may occur.