Aids To Forensic Medicine And Toxicology Part 19

_Fatal Period._--Average about twenty-four hours.

_Treatment._--Stomach-tube, cold affusion, electricity, injection of a pint of hot coffee into the r.e.c.t.u.m. Give chloride of ammonium in 30 grain doses to prevent delirium; strychnine or digitalin hypodermically.

_Method of Extraction from the Stomach._--Neutralize the contents of the stomach, if acid, with sodium carbonate; place them in a retort and carefully distil. Collect the distillate, mix with chloride of calcium or anhydrous sulphate of copper, and again distil. Agitate distillate with dry pota.s.sium carbonate, and draw off some of the supernatant fluid for testing.

_Tests._--Odour. Dissolves camphor. With dilute sulphuric acid and bichromate of pota.s.sium turns green, and evolves aldehyde. Product of combustion makes lime-water white and turbid.

=Methyl Alcohol: Wood Naphtha.=--Used to produce intoxication by painters, furniture-polishers, etc.

_Symptoms_ are those of alcoholic poisoning, but vomiting and delirium are more persistent. Total or partial blindness may follow as a sequel of optic atrophy. A fatal result not infrequently follows.

The following table gives the points of distinction between concussion of brain, alcoholic poisoning, and opium poisoning:

CONCUSSION OF BRAIN. ALCOHOL. OPIUM.

1. Marks of violence 1. No marks of violence, 1. As alcohol.

on head. unless person has fallen. History will be of use.

2. Stupor, sudden. 2. Excitement precedes 2. Symptoms slow.

sudden stupor. Drowsiness, stupor, lethargy.

3. Face pale, cold; 3. Face flushed; pupils 3. Face pale; pupils pupils sluggish, generally dilated. contracted.

sometimes dilated.

4. Remission rare. 4. Partial recovery may 4. Remission rare.

Patient recovers occur, followed by slowly. death.

5. No odour of alcohol 5. Odour of alcohol 5. Odour of opium in in breath. in breath. breath.

=Ether= is a volatile liquid prepared from ethylic alcohol by interaction with sulphuric acid. It contains 92 per cent. of ethyl oxide (C_{2}H_{5})O. It was formerly called 'sulphuric ether.' It is a colourless, inflammable liquid, having a strong and characteristic odour, specific gravity 0.735. =Purified ether= from which the ethylic alcohol has been removed by washing with distilled water, and most of the water by subsequent distillation in the presence of calcium chloride and lime. It is this preparation which is used for the production of general anaesthesia. It has a specific gravity of 0.722 to 0.720, and its vapour is very inflammable.

_Symptoms._--When taken as a liquid, same as alcohol. When inhaled as vapour, causes slow, prolonged, and stertorous breathing; face becomes pale, lips bluish, surface of body cold. Pulse first quickens, then slows. Pupils dilated, eyes gla.s.sy and fixed, muscles become flabby and relaxed, profound anaesthesia. Then pulse sinks and coma ensues, sensation being entirely suspended. Nausea and vomiting not uncommon.

_Post-Mortem Appearances._--Brain and lungs congested. Cavities of heart full of dark, liquid blood. Vessels at upper part of spinal cord congested.

_Treatment._--Exposure to pure air, cold affusion, artificial respiration, galvanism.

_Method of Extraction from the Contents of the Stomach._--Same as for alcohol. During distillation pa.s.s some of the vapour into concentrated solution of bichromate of potash, nitric and sulphuric acids, and note reaction as for alcohol.

_Tests._--Vapour burns with smoky flame, depositing carbon. Sparingly soluble in water. With bichromate of potash and sulphuric acid same as alcohol.

=Chloroform.=--A colourless liquid, specific gravity 1.490 to 1.495, very volatile, giving off dense vapour. Sweet taste and pleasant odour.

_Symptoms._--When swallowed, characteristic smell in breath, anxious countenance, burning pain in the throat, stomach, and region of the abdomen, staggering gait, coldness of the extremities, vomiting, insensibility, deepening into coma, with stertorous breathing, dilated pupils, and imperceptible pulse. When inhaled, much the same as ether, but produces insensibility and muscular relaxation more rapidly. It would be impossible to instantly render a person insensible by holding a pocket-handkerchief saturated with chloroform over the face. Statements such as this, which are often made in cases of robbery from the person and in cases of rape, are incredible.

_Delayed Chloroform-Poisoning._--Death may take place in from four to seven days after chloroform has been administered, especially in the case of children. The internal organs are found to be fattily degenerated, and death is thought to be due to acetonuria.

_Post-Mortem Appearances._--Cerebral and pulmonary congestion. Heart empty, or right side distended with dark blood.

_Treatment._--Stomach-tube and free lavage; cold affusion; drawing forward tongue; artificial respiration; galvanism and suspension with head downward. Inhalation of nitrite of amyl; strychnine hypodermically.

_Fatal Dose._--When swallowed, from 1 to 2 ounces.

_Method of Extraction from the Stomach._--By distillation at 120 F. The vapour, as it pa.s.ses along a gla.s.s tube, may be decomposed by heat into chlorine, hydrochloric acid, and carbon--the first shown by setting free iodine in iodide of starch, the second by reddening blue litmus-paper, and the last by its deposit.

_Tests._--Taste, colour, weight; burns with a green flame; dissolves camphor, guttapercha, and caoutchouc.

=Iodoform.=--Poisoning may result from its use in surgery. It produces delirium, sleepiness, and coma. It may lead to mental weakness or optic neuritis.

x.x.xV.--CHLORAL HYDRATE

It was formerly largely used as a hypnotic, and many fatal consequences ensued. It is prepared from alcohol and chlorine.

_Symptoms._--Deep sleep, loss of muscular power, diminished or abolished reflex action and sensibility, followed by loss of consciousness and marked fall of temperature. Pulse may become quick, and face flushed or livid and bloated. Prolonged use of this drug may produce a peculiar eruption on the skin. Supposed to act in the blood by being decomposed into chloroform and sodium formate. Its effects are due chiefly to depression of the central nervous system, the medulla being the last part of the nervous system to be attacked.

_Method of Extraction from the Stomach._--By distillation in strongly alkaline solutions, when it may be obtained as chloroform and tested as such.

_Treatment._--Stomach-tube or emetic. Hypodermic injections of strychnine. Keep patient warm, and inject a pint of hot strong coffee into the r.e.c.t.u.m. Nitrite of amyl and artificial respiration.

_Tests._--Heated with caustic potash, it yields chloroform and pota.s.sium formate. The chloroform is readily recognized by its odour, and, if the solution be concentrated, by separating as a heavy layer at the bottom of the test-tube.

x.x.xVI.--PETROLEUM AND PARAFFIN-OIL

Cases of poisoning by petroleum and paraffin are common, and occur chiefly in children.

=Petroleum= is a natural product, and is a mixture of the higher saturated hydrocarbons. The crude petroleum is purified by distillation, and is then free from colour, but retains its peculiar penetrating odour. Different varieties are sold under the names of cymogene, gasolene, naphtha, petrol, and benzoline. Benzoline is highly inflammable, and is often called mineral naphtha, petroleum naphtha, and petroleum spirit. Benzoline is not the same as benzene or benzol, which is one of the products of the dry distillation of coal.

From its very general use as a fuel in motor-cars many accidents have happened from inhaling the vapour of petrol. It gives rise to coldness, shallow respiration, syncope, and insensibility, but seldom death.

=Paraffin=, also known as kerosene and mineral oil, is a mixture of saturated hydrocarbons obtained by the distillation of shale.

By the retailer the terms 'petroleum' and 'paraffin' oil are used indifferently, and each is sold for the other without prejudice.

_Symptoms._--These substances are not very active poisons, and, as a rule, even children recover. The breath has the odour of paraffin, the face is pale and cyanotic, hot and dry, and there may be vomiting. Death may result from gastro-enteritis or from coma.

_Fatal Dose._--In the case of an adult, 1/2 pint should not prove lethal, and patients have recovered after drinking a pint.

_Treatment._--Emetics, purgatives, and stimulants.