1. Frequent headaches.
2. A marked general fatigue.
3. A noticeable change in disposition, disinclination for work, depression, which can nevertheless occasionally change to an exaggerated optimism.
4. Disturbance in sleep rhythm (somnolence alternating with insomnia) [difficulty to keep awake alternating with difficulty to fall asleep].
5. [Some opaque medical expressions of less relevance in this case.] A chronic case of arsenic intoxication, therefore, will feel pain in different places, mostly in the lower legs, the shoulders and in the region of the liver [a redundant quote in French].
6. The feet and lower legs become swollen.
7. The muscles of the calf [back of the lower leg] are subject to fatty degeneration, and become consequentially very weak. The victim can walk only with difficulty and can hardly rid except at walking pace.
8. Increase in weight, the body finally becoming corpulent or bloated.
9. Increase in the size of the liver, which is subject to fatty degeneration in the actual liver cells.
10. The skin tends to turn bronze [orange-like brown] in colour.
11. The entire body itches.
12. Pimples develop, often around the mouth.
13. The fine hairs of the body diminish or disappear.
14. Hair of the head grows thin.
15. The victim manifests a general lack off appetite, followed by considerable gain in appetite after the body had adapted to the continuing intake of arsenic or when it is no longer administered.
16. Impairment of hearing eventually amounting to pronounced deafness.
17. Sensitivity of the eyes to sunlight and bright artificial light. The victim may prefer a nearly darkened room.
18. Tendency to periods of emotionalism as expressed by tearfulness.
19. Difficulty in urination. Scanty urine, discharged slowly and painfully.
20. A persistent dry cough.
21. A tendency to pleurisy [inflammation of the membranes covering the lungs].
22. Sensation of fever without rise in body temperature.
23. Sweats, often heavy.
24. Icy cold legs (when dosage increased).
25. Severe hoarseness by affection of the pharynx [uppermost part of the throat] and larynx [part of the throat where the vocal cords are].
26. Tachycardia [high pulse when resting].
27. Quick and irregular pulse, or very slow pulse, according to the degree of intoxication.
28. Frequent painful cramps, especially of the muscles of the lower leg.
29. Spasms in various parts of the body.
30. Loose teeth and bleeding, swollen gums. The latter may appear mordantly [severely] pale, depending on the dosage and the body’s degree of adaptability to assimilation of the poison. The symptom of whiteness of the gums has often been wrongly attributed to scurvy [vitamin C deficiency].
31. A port-mortem will reveal as especially typical an enlarged but microscopically unchanged liver, together with swollen lymph glands in purulent decomposition, especially around the bronchi [tubes leading to the two lungs] and the mediastinum [cavity of the chest]. Considerable quantity of liquid in the pleural sacs [membranes covering the lungs]. In an earlier stage of medical knowledge this the latter condition might be diagnosed as due to tuberculosis. [Comment on the autopsy of his son Franz.]
32. Exhumation may disclose the body in a chronic arsenic intoxication case be surprisingly well preserved.
Napoléon showed at least 26 of the listed symptoms. He may have showed symptoms number 12, 18, 20, 21 and 28. In these cases I really don’t know. On the opposite I don’t think he increased in weight. There are statements about Napoléon having died fat. That I don’t get together with his other symptoms. (I think about long-lasting defiance I appetite and severe vomiting towards the end.) This holds particularly true when thinking about him being relatively modest with food earlier. Until someone can explain to me how it could have happened I think he was lean when he died. However, his belly was swollen due to his much enlarged liver. His swollen stomach also mattered but not at all as much. The later was a result of him also being poisoned with antimony. Otherwise the symptoms of antimony poisoning resemble those of sub-lethal arsenic poisoning. The symptoms that differ are:
1. Constant vomiting that can not be stopped. Small volume arsenic intoxication does not produce this reaction. Vomiting occurs when a dangerous dose has been administrated.
2. Haemorrhage [bleeding] in throat, oesophagus [the tube leading down to the stomach] and stomach, the vomit containing what resembles coffee grounds as well as small amounts of red blood.
3. Pain in the mouth and throat, due to the corrosive effect of the tartar emetic [a substance containing antimony once used as medicine]. Blisters in mouth and throat.
4. Unlike arsenic trioxide which does not corrode the stomach walls unless swallowed as such [?], antimony salt solutions corrode the mucous lining of the stomach, and in the case of a large dose, will actually perforate the stomach wall.
5. Polyuria [excess of urine] and no difficulty urinating, unlike the penuria [deficiency of urine] and painful urination characteristic of arsenic intoxication.
6. After a few weeks of intoxication, the corroding effect on the mucous lining of the stomach inhibits the vomit reflexes of the stomach. Thus the intended victim was no longer capable of vomiting preventively by natural response to danger in preparation for the second “wonder-working” remedy of those days [calomel combined with bitter almonds].
Napoléon showed all these symptoms. People regularly ingesting substances which are diuretic also feel very thirsty. This is of cause the body’s way of trying to keep its fluid balance. Consequentially he felt thirsty at very short intervals. Furthermore, he was completely blind the last six days before he died. Finally, we have the symptoms of poisoning with calomel combined with bitter almonds. In the book it is pointed out that the normal reaction is severe vomiting. Napoléon’s stomach was so overworked he could not vomit in time. The result was of cause deadly. In contrast to the symptoms of other poisonings these are described in fluent text:
It says the victim usually dies within 24 hours. (This can be found in the paragraph I replaced with “[…]”.) Napoléon died 48⅓ hours after he had swallowed his ultimate poison. Furthermore, he was conscious more than 24 hours after he had swallowed it. (He reacted noticeably to touch and was able to communicate his needs.) This does not mean he had been awake all the time. If I understand it correctly he fell asleep at least twice. He was already completely blind so there was no difference in that respect. In contrast it could very well have been noticeable that he became completely deaf. He would then not have been able to perceive the voices of the other people. During his death struggle (about 48 hours) he lay helpless and become more and more immobile. His pulse was very irregular and barely noticeable. He had very hard to breathe and at times had severe hiccups. Of cause he must have suffered from extreme pains. Finally, he lost his consciousness at least 14 hour before he died. (He lied completely motionless except for the breath.) His symptoms as such appeared more slowly than normal. I think this was due to a combination of a relatively low doses and Napoléon’s physical durability. In fact the deleted paragraph says that these factors matter. Anyway, one has to remember witch poison eventually took his life. People mixing it up with earlier poisons are far too common.