The mystery of the poisonous neckerchief

poisonous scarfIn 1873 The Medical Times and Register published an unusual case report from one  Joseph G. Richardson, a doctor from Philadelphia:

J. B., a farmer, 74 years old, residing near Darby, in the vicinity of Philadelphia, came under my care in the out-patient department of the Pennsylvania Hospital, January 27, 1873. His neck, face, and head were much swollen, and displayed an erysipelatous redness…

‘Erysipelatous’ describes an inflammation of the skin. At this date it was a non-specific term, though today it generally refers to infection by a particular type of streptococcus bacteria.

…which was accompanied with intense smarting and burning pain, so severe that for more than a month he had been unable (according to his own account) to sleep at night. On investigation I found that the attack had first made its appearance about seven weeks before, in the form of an eruption of “little water blisters” upon the sides of the neck and on the chin below the angles of the mouth, from whence it had spread to the extent above mentioned.

Soon after the inflammation appeared, the patient had consulted a local doctor, whose response was to ask when he had been in the woods – assuming that the rash was caused by poison ivy. The usual remedies for this complaint, however, had no effect.

Finding the patient had never been subject to poisoning from Rhus toxicodendron [poison ivy] before, and deeming the starting-point of this disease an unusual one for such a malady, I was led to doubt the accuracy of his medical adviser’s diagnosis, and on further questioning I learned that two weeks before the affection first appeared he had commenced wearing a silk neck-handkerchief, newly dyed of a crimson color, which I at once requested that he would bring down to the hospital and show me on his next visit. On examining the handkerchief I immediately recognized the brilliant hue of red aniline with which most microscopists are so familiar.

Red aniline is an organic compound, one of several dyes derived from aniline in the nineteenth century. This particular dye may be either fuchsine or safranin, both of which were used in the laboratory to stain structures which would otherwise remain invisible through the microscope. Dr Richardson performed chemical tests, which proved to his satisfaction that aniline was present in the dyes used to colour the scarf. The patient was given a lotion of slippery elm mucilage – a topical remedy long favoured by Native Americans – which seemed to clear the symptoms, and he soon pronounced himself cured.

This was not an isolated incident. Four years earlier The Lancet had printed the following letter:

Captain George Montagu, of Seend, bought some coloured socks in London. The pattern was formed by alternate broad bands of white and dark red, separated by very narrow lines of yellow. He wore the socks next day, and walked some distance. At night he found his feet considerably inflamed. The following day I saw him. He complained of great irritation of the skin, and had had very little sleep the preceding night. Both feet and ankles were encircled with bands of inflamed skin, which were swollen, and surmounted with scattered vesicles. Between the inflamed ridges the skin was pale and healthy. On comparing the feet with the socks, it appeared that the inflamed parts corresponded to the red bands of the socks, while the intermediate skin had been in contact with the white bands. In two or three days the vesicles had greatly increased in size and number, and were running together. Ultimately the sole of each foot rose in great bladders, just as if blisters had been applied; the skin came off, and left raw surfaces to heal. From the time of wearing the socks to the present time the Captain has been confined to the house.

The facts of the case inevitably lead to the conclusion that this painful complaint was caused by wearing the socks. First: The feet were healthy up to the time of wearing the socks. Secondly: The eruption immediately followed wearing the socks, and was confined to the parts covered by them. Thirdly: The pattern of the socks was distinctly marked on the feet.

The unfortunate Captain Montagu was one of many; there was a veritable epidemic of poisonous socks. Shortly afterwards the Medical Times and Gazette published an update, under the remarkable headline ‘Poisonous Socks Again’:

This very obscure matter is at length, we believe, to be investigated under the direction of the Medical Department of the Privy Council. The facts known about it are few and striking, but by no means clear. There is no doubt but that some persons who have worn silk socks, dyed with sundry brilliant colours, have suffered from most severe irritation of the skin, peculiar redness, vesication, intense pain, and general illness. The affected patches of skin have corresponded exactly with the coloured portions of the socks; and of all the colours red and scarlet have proved the most severe in their effects. The socks have been washed, and the colour has been washed out, but still, we are assured, the irritating qualities have remained. Eminent chemists have thrown little light on the matter, but they agree that coal-tar furnishes the substratum of the colour, and it is certain that arsenic is an occasional, if not a constant, ingredient.

That does seem a regrettable state of affairs.

This last is the opinion of the indefatigable Mr. Webber, who has forced this subject on the attention of the public. Why it is that so few persons have suffered from such articles of common wear, or should not have made their sufferings public, is a mystery; but whether or no poisonous colours are used, as we are told, to colour sweetmeats, wines, and soaps, the matter seems one which a competent commission would soon solve.

Subsequent inquiries established that arsenic, which had previously been used in the production of clothes dyes, was no longer employed in the process. Isolated instances of sock-poisoning were reported for a few more years, but after the adoption of better and less toxic dyes in the 1870s the problem was finally eliminated.

Further reading: After writing the above I discovered that this intriguing episode is dealt with in more detail in a recent book of essays about the history of chemistry, The Case of the Poisonous Socks: Tales from Chemistry by William H. Brock.

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