Aids To Forensic Medicine And Toxicology Part 13

_Method of Extraction from the Stomach._--Mince up the coats of the stomach and boil them in water, or boil the contents of the stomach and subject them to dialysis. Concentrate the distilled water outside the tube containing the vomited matters, etc., and apply tests.

_Tests._--White precipitate with nitrate of silver, soluble in nitric acid and ammonia. When the precipitate is dried and heated on platinum-foil, it disperses as white vapour with slight detonation.

Sulphate of lime in excess gives a white precipitate, soluble in nitric or hydrochloric acid, but insoluble in oxalic, tartaric, acetic, or any vegetable acid.

=Oxalate or Binoxalate of Potash= (salts of sorrel or salts of lemon) is almost as poisonous as the acid itself.

XIV.--CARBOLIC ACID

=Carbolic Acid, Phenic Acid, or Phenol=, is largely employed as a disinfectant, and is often supplied in ordinary beer-bottles without labels.

_Symptoms._--An intense burning pain extending from the mouth to the stomach and intestines. Indications of collapse soon supervene. The skin is cold and clammy, and the lips, eyelids, and ears, are livid. This is followed by insensibility, coma, stertorous breathing, abolition of reflex movements, hurried and shallowed respiration, and death. The pupils are usually contracted, and the urine, if not suppressed, is dark in colour, or even black. Patients often improve for a time, and then die suddenly from collapse. When the poison has been absorbed through the skin or mucous membranes, a mild form of delirium, with great weakness and lividity, are the first signs.

_Post-Mortem._--If strong acid has been swallowed, the lips and mucous membranes are hardened, whitened, and corrugated. In the stomach the tops of the folds are whitened and eroded, while the furrows are intensely inflamed.

_Treatment._--Soluble sulphates which form harmless sulpho-carbolates in the blood should be administered at once. An ounce of Epsom salts or of Glauber's salts dissolved in a pint of water will answer the purpose admirably. After this an emetic of sulphate of zinc may be given. White of egg and water or olive-oil may prove useful. Warmth should be applied to the body.

_Fatal Dose._--One drachm, but recovery has taken place after much larger quant.i.ties, if well diluted or taken after a meal.

_Tests_ are not necessary, as the smell of carbolic acid is characteristic.

_Local action_ of carbolic acid produces anaesthesia and necrosis.

Accidents sometimes happen from too strong lotions applied as surgical dressings.

=Lysol= is a compound of cresol and linseed-oil soap, and is much less toxic than carbolic acid.

XV.--POTASH, SODA, AND AMMONIA

=Caustic Potash= occurs in cylindrical sticks, is soapy to the touch, has an acrid taste, is deliquescent, fusible by heat, soluble in water.

=Liquor Pota.s.sae= is a strong solution of caustic potash, and has a similar reaction. =Carbonate of Pota.s.sium=, also known as potash, pearlash, salt of tartar, is a white crystalline powder, alkaline and caustic in taste, and very deliquescent. The bicarbonate is in colourless prisms, which have a saline, feebly alkaline taste, and are not deliquescent.

_Symptoms._--Acrid soapy taste in mouth, burning in throat and gullet, acute pain at pit of stomach, vomiting of b.l.o.o.d.y or brown mucus, colicky pains, b.l.o.o.d.y stools, surface cold, pulse weak. These preparations are not volatile, so that there is not much fear of lung trouble. In chronic cases death occurs from stricture of the oesophagus causing starvation.

_Post-Mortem Appearances._--Soapy feeling, softening, inflammation, and corrosion of mucous membrane of mouth, pharynx, oesophagus, stomach, and intestines. Inflammation may have extended to larynx.

_Method of Extraction from the Stomach._--If the contents of the stomach have a strong alkaline action, dilute with water, filter, and apply tests.

_Tests._--The carbonates effervesce with an acid. The salts give a yellow precipitate with platinum chloride, and a white precipitate with tartaric acid. They are not dissipated by heat, and give a violet colour to the deoxidizing flame of the blowpipe. Stains on dark clothing are red or brown.

_Treatment._--Vinegar and water, lemon-juice and water, acidulated stimulant drinks, oil, linseed-tea, opium to relieve pain, stimulants in collapse. Do not use the stomach-tube. The glottis may be inflamed, and if there is danger of asphyxia, tracheotomy may have to be performed.

=Carbonate of Sodium= occurs as _soda_ and _best soda_, the former in dirty crystalline ma.s.ses, the latter of a purer white colour. It is also found as 'washing soda.'

_Symptoms, Post-Mortem Appearances, Treatment, and Extraction from the Stomach._--As for potash.

_Tests._--Alkaline reaction, effervesces and evolves carbonic acid when treated with an acid; crystallizes, gives yellow tinge to blowpipe flame. No precipitate with tartaric acid, nor with bichloride of platinum.

=Ammonia= may be taken as _liquor ammoniae_ (harts-horn), as carbonate of ammonium, as 'Cleansel,' or as 'Scrubb's Cloudy Ammonia.'

_Symptoms._--Being volatile, it attacks the air-pa.s.sages, nose, eyes and lungs, being immediately affected; profuse salivation; lips and tongue swollen, red, and glazed. The urgent symptoms are those of suffocation.

Inhalation of the fumes of strong ammonia may lead to death from capillary bronchitis or broncho-pneumonia. Death may result from inflammation of the larynx and lungs. When swallowed in solution, the symptoms are similar to those of soda and potash.

_Post-Mortem Appearances._--Similar to other corrosives.

_Method of Extraction from the Stomach._--The contents of the stomach, etc., must be first distilled, the gas being conveyed into water free from ammonia.

_Tests._--Nessler's reagent is the most delicate, a reddish-brown colour or precipitate being produced, but ammonia may be recognized by its pungent odour, dense fumes given off with hydrochloric acid, and strong alkaline reaction.

_Treatment._--Vinegar and water. Other treatment according to symptoms.

_Fatal Dose._--One drachm of strong solution.

_Fatal Period (Shortest)._--Four minutes.

XVI.--INORGANIC IRRITANTS

=Nitrate of Pota.s.sium (Nitre, Saltpetre)--Bitartrate of Pota.s.sium (Cream of Tartar)--Alum (Double Sulphate of Alumina and Pota.s.sium)--Chlorides of Lime, Sodium, and Pota.s.sium.=--All these are irritant drugs, and give the usual symptoms.

XVII.--CHLORATE OF POTa.s.sIUM, ETC.

=Chlorate of Pota.s.sium= produces irritation of stomach and bowels; haematuria; melaena; cyanosis, weakness, delirium, and coma.

_Post-Mortem._--Blood is chocolate-brown in colour, and so are all the internal organs; gastro-enteritis; nephritis.

_Tests._--Spectroscope shows blood contains methaemoglobin; the drug discharges the colour of indigo in acid solution with SO_{2}.

_Treatment._--Transfusion of blood or saline fluid; stimulants.

=Sulphuret of Pota.s.sium= (liver of sulphur) occurs in ma.s.s or powder of a dirty green colour; has a strong smell of sulphuretted hydrogen.

_Symptoms._--Of acute irritant poisoning, with stupor or convulsions.

Excreta smell of sulphuretted hydrogen.