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The toxic effect of arsenic on the living cell probably follows the combination of the arsenic with certain vital components of the cell (1 to 5, 8). This combination has been observed to be reversible in vitro (5 to 9). With the development of 2,3-dimercaptopropanol (BAL) by Peters, Stocken, and Thompson (8), the detoxification of arsenic by dissociation of the arsenic-cell complex seemed feasible in man, since BAL has the requisite affinity for arsenic without undue toxicity (8 to 10). BAL was therefore administered in ointment, and later by injection, in the treatment of arsenical intoxication (11, 12). An increased elimination of arsenic from the body during BAL treatment would probably reflect the release of a significant amount of arsenic from the cells (8, 10). To test this point, the urinary excretion of arsenic has been followed before and during treatment with BAL in 18 patients in this clinic. Sixteen were suffering from a complication of arsenical therapy. The effect of BAL on these patients' course is described in another report (11). The other 2 patients, who had received mapharsen without untoward reaction, were studied to determine the effect of BAL administered 2 and 3 days after an injection of the arsenical drug. The effect of BAL on the fecal excretion of arsenic was not followed, since the brief control period and the illness of the patients prevented the collection of accurately timed speciments.

CLINICAL USES OF 2,3-DIMERCAPTOPROPANOL (BAL). VIII. THE EFFECT OF BAL ON THE EXCRETION OF ARSENIC IN ARSENICAL INTOXICATION 1