beau hilton

layout: post title: “On the logo and its color” categories: - medicine tags: - arsenic - cancer - iconography - color

- medicine


One of several alchemical symbols for arsenic

On my first day in leukemia clinic in 2015, with a certain young fellow from Syria and a certain attending physician who is rather fond of a good story, I was told the story of how arsenic made its way back into medicine as a treatment (and often cure) for one of the worst types of blood cancer, “Acute Promyelocytic Leukemia” (APL).

Arsenic has been used for thousands of years for everything from medicine to candy to wallpaper to rat/king poison. It was used widely for this last purpose, because it is odorless, tasteless, dissolves instantly in liquid, and is among the more deadly poisons known to man. In low doses it is a mild stimulant (and, apparently, aphrodisiac), and in higher doses bad things happen, even if not ingested.

In the 1800s in the West arsenic was found to be helpful in certain blood cancers if ingested and in certain skin and breast cancers if applied to the skin. A string of studies from China in the 1990s using arsenic trioxide for patients with APL had remarkable results, which led to studies in the U.S and a remarkably swift change in standard medical practice. APL was a disease that would almost invariably bring you into the hospital in critical condition and send you out in a bag to. Now, last time I was with a patient with APL, that young Syrian fellow (who is now an attending) kept repeating:

↵ Sun HD, Ma L, Hu X-C et al. Ai-Lin 1 treated 32 cases of acute promyelocytic leukemia. Chin J Integrat Chin Western Med 1992;12:170-172. Google Scholar Zhang P, Wang SY, Hu XH. Arsenic trioxide treated 72 cases of acute promyelocytic leukemia. Chin J Hematol 1996;17:58-62. Google Scholar ↵ Shen Z-X, Chen G-Q, Ni J-H et al. Use of arsenic trioxide (As2O3) in the treatment of acute promyelocytic leukemia (APL): II. Clinical efficacy and pharmacokinetics in relapsed patients. Blood 1997;89:3354-3360. Abstract/FREE Full Text ↵ Soignet SL, Maslak P, Wang Z-G et al. Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide. N Engl J Med 1998;339:1341-1348. CrossRefMedlineGoogle Scholar ↵ Soignet S, Frankel S, Tallman M et al. U.S. multicenter trial of arsenic trioxide (AT) in acute promyelocytic leukemia (APL) [abstract 3084]. Blood 1999;94(suppl 10):698a. Google Scholar

'Bottle of iron, arsenic and digitalin tablets, London, 1916-' by Science Museum, London. Credit: Science Museum, London. CC BY