Introduction - Uppsala Monitoring Centre

Figure 8 Arsenic © Wellcome Images
'This is my appearance after a good dose of ARSENIC taken medicinally'
Thomas Fowler (1736-1801) of ‘Fowler’s Solution’ wrote a
monograph on Arsenic (1786) and described its adverse effects:
nausea, and rarely vomiting, slight griping, increased number of
stools, certain swellings especially of the face, loss of appetite,
uneasiness and pain in the stomach, diuretic, slight eruption like
nettle-rash, sweat, headache and slight tremor. He reported on 320
cases and said that one third had nausea, one third ‘open body’
(increased stools) and one third griping. This is one of the first papers
giving rough incidences to ADRs. He also gave numbers cured with
(27) and without relapse (144), suspended by solution (51), relieved
by solution (20) and not relieved by solution (5) out of a total of 247
patients. He referred to his ‘mineral solution’ which contained
arsenious anhydride in powder form, plus potassium carbonate, 10
grammes of each, plus 30 ml of compound tincture of lavender and
distilled water to one litre [Fowler’s solution]. (Fowler, 1786). This
produced a 1% solution of potassium arsenate (KH 2 AsO 3 ). The ADR
he mentions fall short of the ADRs mentioned by Lewin in 1881 who
gives much more emphasis to the skin eruptions and also mentions
salivation, thirst, the mucous membrane of the mouth, cough,
bronchitis and hoarseness, tinnitus, dizziness and anaphrodisia.
Twentieth century reports also include cirrhosis of the liver and
various cancers. Fowler’s ADRs will have been limited by the
numbers that he treated, the dosages that he used and the lack of
knowledge of his period. He also wrote medical reports on tobacco,
bloodletting, sudorifics and blisterings in defined diseases. He
emphasized the need to distinguish between the adverse effects and
the curative effects of a medicine in these words: ‘It becomes highly
requisite that the Public should speedily be made acquainted with
such effects as far as they are known; together with such Precepts,
Cautions and Restrictions, as may tend to unite the greatest Degree
of Safety with its Efficacy. Nothing of this sort has yet been done.’
(Tröhler, 1978).
1787 ‘An essay, on the operation of mercury, in the human body; in which,
the manner how salivation is produced, by that medicine, is
attempted to be explained: interspersed with observations on the
treatment of the venereal disease’ by Robert Maywood, M. D.
London: Printed for the author, at the Literary-Press, No. 14, Red-