 CHAPTER XV. PODASH, SODA, AND AMONIA. Caustic potash occurs in cylindrical sticks, is soapy to the touch, and has an acrid taste, is delicousent, fusible by heat, soluble in water. Liquor potasi is a strong solution of caustic potash, and has a similar reaction. Carbonate of potassium, also known as potash, pearlash, salt of tartar, is a white crystalline powder, alkaline and caustic in taste, and very delicousent. The bicarbonate is in cohoas prisms, which have a saline, feebly alkaline taste, and are not delicousent. Symptoms. Acrid soapy taste in mouth, burning in throat and gullet, acute pain at pit of stomach, vomiting of bloody or brown mucus, colicky pains, bloody 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 esophagus, causing starvation. Postmortem appearances. Soapy feeling, softening, inflammation, and corrosion of mucus membrane of mouth, pharynx, esophagus, 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. Permanent 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 color to the deoxidizing flame of the blowpipe. Stains on dark clothing are red or brown. Treatment. Vinegar in water, lemon juice in water, acidulated stimulant drinks, oil, linseed tea, opium to relieve pain, stimulants, and 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 and dirty crystalline masses. The latter of a pure white color. It is also found as washing soda. Symptoms. Postmortem 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 ammonia, hearts horn, as carbonate of ammonia, as cleanse cell, or as scrubs cloudy ammonia. Symptoms. Being volatile, it attacks the air passages, nose, eyes, and lungs. Being immediately affected, profuse salivation, lips and tongue swollen, red and glazed. The urgent symptoms are those of suffocation. Inhalations of the fumes of strong ammonia may lead to death from capillary bronchitis or bronchonemonia. Death may result from inflammation of the larynx and lungs. When swallowed in solution, the symptoms are similar to those of soda and potash. Both 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. Nestler's reagent is the most delicate, a reddish-brown color or precipitate being produced, but ammonia may be recognized by its pungent odor, dense fumes given off with hydrochloric acid, and strong alkaline reaction. Treatment. Vinegar and water. Other treatment according to symptoms. Fatal dose. One dracum of strong solution. Fatal period. Shortest. Four minutes. Chapter 16. Inorganic irritants. Nitrate of potassium. Niter. Saltpeter. Biotartrate of potassium. Cream of tartar. Alum. Double sulfate of alumina and potassium. Chlorides of lime, sodium, and potassium. All these are irritant drugs and give the usual symptoms. Chapter 17. Chlorate of potassium, etc. Chlorate of potassium produces irritation of stomach and bowels. Hematuria, melena, cyanosis, weakness, delirium, and coma. Postmortem. Blood is chocolate brown in color, and so are all the internal organs. Gastroenteritis, nephritis. Tests. Lip shows blood contains methemoglobin. The drug discharges the color of indigo in acid solution with sulfur dioxide. Treatment. Transfusion of blood or saline fluid. Stimulants. Sulfurate of potassium, liver of sulfur, occurs in mass or powder of a dirty green color, has a strong smell of sulfur-redded hydrogen. Symptoms. Of acute irritant poisoning, with stupor or convulsions, excreta smell of sulfur-redded hydrogen. Postmortem appearances. Stomach and duodenum reddened, with deposits of sulfur, lungs congested. Treatment. Chloride of sodium or lime in dilute solution, an ordinary treatment for irritant poisoning. Fatal period, shortest, fifteen minutes. Chapter 18. Barium salts. Chloride of barium occurs crystallized in irregular plates, like magnesium sulfate, soluble in water and bitter in taste. Carbonate of barium is found in shops as a fine powder, tasteless and colorless, insoluble in water, but effervescing with dilute acids, and readily decomposed by the free acids of the stomach. Nitrate of barium occurs in octahedral crystals, soluble in water. Method of extraction from the stomach. Dialysis as for other soluble poisons. Tess. It's emancipated from its solutions by potassium carbonate or sulfuric acid. Burnt on platinum foil, it gives a green color to the flame. Symptoms. Besides those of irritants generally, violent cramps and convulsions. Headache, debility, dimness of sight, double vision, noises in the ears, and beating at the heart. The salts of barium are also cardiac poisons. Postmortem appearances. As of irritants generally, stomach may be perforated. Treatment. Wash out stomach with a solution of sodium or magnesium sulfate, or of alum, and give stimulants by the mouth and hypodermically. Chapter 19. Iodine. Iodide of potassium. Iodine occurs in scales of a dark bluish-black color. It strikes blue with solution of starch and stains the skin and intestines yellowish-brown. Acid preparations, as the liniment or tincture, may be taken accidentally or suicidally. Symptoms. Acrid taste, tightness of throat, epigastric pain, and then symptoms of irritant poisons generally. Chronic poisoning, iodism, is characterized by cariza, salivation, and lacrimation. Frontal headache, loss of appetite, marked mental depression, acne of the face and chest, and a particular eruption on the limbs. Post-mortem appearances, those of irritant poisoning with corrosion and staining of a dark brown or yellow color. Treatment. Stomach pump and ametics, carbonate of sodium, amylaseous fluids, gruel, arrowroot, starch, etc. Analysis of organic matter containing iodine, add by sulfide of carbon and shake, the iodine may be obtained on evaporation as a sublimate. It will be recognized by the blue color which it gives with starch. Iodide of potassium, colorless, generally opaque, cubic crystals, soluble in less than their weight of cold water. Symptoms. Not an active poison, but even small doses sometimes produce the effects of a common cold, including those symptoms already mentioned as occurring with iodine. Analysis. Iodide of potassium in solution gives a bright yellow precipitate with lead salts, a bright scarlet with corrosive sublimate, and a blue color with sulfuric or nitric acid and starch. Chapter 20 Phosphorus. Phosphorus is usually found in small, waxy looking cylinders which are kept in water to prevent oxidation. It may also occur as the amorphous non-poisonous variety, a red opaque infusible substance insoluble in carbon disulfide. Ordinary phosphorus is soluble in oil, alcohol, ether, chloroform, and carbon disulfide insoluble in water. It is much used in rat poisons, made into a paste with flour, sugar, fat, and prussian blue. Yellow phosphorus is not allowed to be used in the manufacture of lucifer matches, and the importation of such is prohibited. In safety matches, the amorphous phosphorus is on the box. Symptoms. At first those of an irritant poison, but days may elapse before any characteristic symptoms appear, and these may be mistaken for those of acute yellow atrophy of the liver. The earliest signs are a garlicky taste in the mouth and pain in the throat and stomach, vomited matter luminous in the dark, bile stained or bloody with garlic like odor, great prostration diarrhea with bloody stools, harsh dry yellow skin, purpuric spots with ecomoses under the skin and mucous membranes, retention or suppression of urine, delirium, convulsions, coma, and death. Usually there are remissions for two or three days, then jaundice comes on, with enlargement of the liver, hemorrhages from the mucous surfaces and under the skin, later coma and convulsions. In chronic cases there is fatty degeneration of most of the organs and tissues of the body, the inhalation of the fumes of phosphorus, as in making vermin killers, etc., gives rise to fussy jaw. Postmortem Appearances. Losing of the stomach, hemorrhagic spots on all organs and under the skin, fatty degeneration of liver, kidneys, and heart, blood-stained urine, phosphorescent contents of alimentary canal. Treatment. Early use of stomach pump and emetics, followed by the administration of permanganate of potassium or peroxide of hydrogen to oxidize the phosphorus, oil should not be given. Sulphate and carbonate of magnesium, mucilaginous drinks. Succulate of copper is a valuable antidote, both as an emetic and as forming an insoluble compound with phosphorus. Fatal dose, one grain and a half. Fatal period, four hours, more commonly, two to four days. Detection of phosphorus and organic mixtures. Mitzchelix method is the best. Introduce the suspected material into a retort, acidulate with sulfuric acid to fix any ammonia present, distill in the dark through a glass tube kept cool by a stream of water. As the vapor passes over and condenses, a flash of light is perceived, which is the test. End of section 13. Section 14 of AIDS to Forensic Medicine and Toxicology. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. AIDS to Forensic Medicine and Toxicology by W. G. Atchison Robertson. Section 14. Chapter 21. Arsenic and its Preparations. Arsenic is the most important of all the metallic poisons. It is much used in medicine and the arts. It occurs as a metallic arsenic, which is of steel-grey color, brittle, and gives off a garlic-like odor when heated, as arsenious acid in the form of two sulfides, the red sulfide, a rialgar, and the yellow sulfide, or orpiment, and as arsenite of copper, or shield's green. It also exists as an impurity in the ores of several metals, iron, copper, silver, tin, zinc, nickel, and cobalt. Arsenic acid is frequently impregnated with arsenic from the iron pyrites used in preparing the acid. It is a constituent of many rat-pace, vermin or weed killers, complexion powders, sheep dips, etc. Arsenous acid, white arsenic, trioxide of arsenic, colorless, odorless, and almost tasteless. It occurs in commerce as a white powder or in a solid cake, which is at first translucent but afterwards becomes opaque. Simply soluble in cold water, one ounce of water dissolves about one-half grain of arsenic. Fowler's solution is the best-known medicinal preparation of arsenic, and contains one grain of arsenious anhydride in one-hundred-and-ten minims. Symptoms. Commands in from half to one hour. Faintness, nausea, incessant vomiting, epigastric pain, headache, diarrhea, tightness and heat of throat and faucies, thirst, catching in the breath, restlessness, debility, cramp in the legs, and convulsive twitchings. The skin becomes cold and clammy. In some cases the symptoms are those of collapse, but with little pain, vomiting, or diarrhea. In others the patient falls into a deep sleep, while in the fourth class the symptoms resemble closely those of English cholera. The vomited matters are often blue from indigo, or black from soot, or greenish from bile mixed with the poison. Should the patient survive some days, no trace of arsenic may be found in the body, as the poison is rapidly eliminated by the kidneys. In all suspected cases, the urine should be examined. The symptoms of chronic poisoning by arsenic are loss of appetite, silvery tongue, thirst, nausea, colicky pains, diarrhea, headache, languor, sleeplessness, cutaneous eruptions, soreness of the edges of the eyelids, emaciation, falling out of the hair, cough, hemoptysis, anemia, great tenderness on pressure over muscles of legs and arms, due to peripheral neuritis and convulsions. Pigmentation is common. The face becomes dusky red, the rest of the body a dark brown shade. This darkening is most marked in situations normally pigmented and in parts exposed to pressure of the clothes, such as the neck, axilla, and inner aspect of the arms, the extensor aspects being less marked than the flexor. The pigmentation resembles the bronzing of Addison's disease, but there are no patches on the mucous membranes and the normal rosy tint of the lips is not altered. The skin over the feet may show marked hyperkeratosis. The nervous system is notably affected. The sensory symptoms appear first, numbness and tingling of the hands and feet, pain in the soles of the feet on walking, pain on moving the joints, and erythromyalgia. Then come the motor symptoms, with drop wrist and drop foot. The patient suffers severely from neuritis, and there may be early loss of patellar reflex. The nervous symptoms come on later than the cutaneous manifestations. Postmortem Appearances Signs of acute inflammation of stomach, duodenum, small intestines, colon, and rectum. Stomach may contain dark, grumus fluid, and its mucous coat presents the appearance of crimson velvet. Ulceration is rare, and cases of perforation still less common. The patient dying before it occurs. If life has been preserved for some days, there is extensive fatty degeneration of the organs. There may be entire absence of postmortem signs. Future Faction of the Body is Retarded by Arsenic. Treatment. The stomach pump, emetics, then milk, milk and eggs, oil and lime water. Inflammatory symptoms, collapse, coma, etc., must be treated on ordinary principles. As an antidote, the best when the poison is in solution is the hydrated sesquioxide of iron formed by precipitating tinctura ferrite pericloride with excess of ammonia or carbonate of soda. This is filtered off through muslin and given in tablespoonful doses. It forms ferric arsenate which is sparingly soluble. Colloidal iron hydroxide may be used instead. Dialized iron in large quantities is efficacious. Fatal dose, smallest. Two grains. Exceptionally, recovery from very large doses if rejected by vomiting. Fatal period, shortest, twenty minutes. Exceptionally, death as late as the sixteenth day. The effects of arsenic are modified by tolerance, some persons being able to take considerable quantities. The peasants of styria are in the habit of eating it. Method of extraction from the stomach. The coats of the stomach should be examined with a lens for any white particles. These if present may be collected, mixed with a little charcoal in a test tube and heated. If arsenic is present, a metallic ring will be formed in the cooler parts of the tube. With this ring be also heated, octahedral crystals of arsenic will be deposited farther up the tube and are easily recognized by the microscope. The contents of the stomach or the solid organs minced up should be boiled with pure hydrochloric acid and water then filtered. The filtrate can then be subjected to marshes or ranches processed. Tests. In solution, arsenic may be detected by the liquid tests. 1. Ammonio nitrate of silver gives a yellow precipitate, arsenite of silver. 2. Ammonio sulfate of copper gives a green precipitate, shields green. 3. Sulfurated hydrogen water gives a yellow precipitate. Marshes process. Put pure distilled water in a marshes apparatus with metallic zinc and sulfuric acid. Hydrogen is set free and should be tested by lighting the issuing gas and depressing over it a piece of white porcelain. If no mark appears the reagents are pure and the suspected liquid may now be added. The hydrogen decomposes arsenious acid and forms arsenier-rated hydrogen. The gas carried off by a fine tube is again ignited. A piece of glass or porcelain held to the flame will have, if arsenic be present, a deposit on it having the following characters. In the center a deposit of metallic arsenic, round this a mixture of metallic arsenic and arsenious acid and outside this another ring of arsenious acid and octahedral crystals. The deposit is dissolved by a solution of chloride of lime, turned yellow by sulfide of ammonium after evaporation. On the addition of strong nitric acid evaporated and neutralized with ammonia and nitrate of silver added a brick-red color is produced, arseniate of silver. Boil distilled water with one-sixth or one-eighth of hydrochloric acid and introduce a slip of bright copper. If after a quarter of an hour's boiling there is no stain on the copper, add the suspected liquid. If arsenic be present it will form an iron-gray deposit. If this foil be dried, cut up and put in a reduction tube and heated, crystals of arsenious trioxide will be deposited on the cold part of the tube. These tests are difficult to apply but as arsenic is a ubiquitous poison and as there are many sources of fallacy it would be well when possible to obtain the services of an expert. Biological tests put the substance to be tested into a flask with some small pieces of bread sterilized for half an hour at one hundred and twenty degrees when cold inoculate with a culture of penicillium brevicale and keep at a temperature of thirty-seven degrees. If arsenic is present a garlic-like odor is noticed in twenty-four hours due to arsenirated hydrogen or an organic combination of arsenic. This test is delicate and will detect one-one-thousandth of a milligram but is not quantitative. Other preparations of arsenic. These are arsenite of potash, fowler solution, cacodilite of sodium and arsenite of copper, shield's green, the last frequently used for coloring dresses and wallpapers. Persons using these preparations may suffer from cataral symptoms, rashes on the neck, ears and face, thirst, nausea, pain in stomach, vomiting, headache, perhaps peripheral neuritis and loss of patellar reflex. The cacodilites, although formerly employed in the treatment of synthesis, should be treated with the utmost caution. The arsenites give their reactions of arsenious acid. Arsenic is eliminated not only by the kidneys and bowels but by the skin and in women by the menses. It may be detected in the sweat, the saliva, the bronchial secretion and during lactation in the milk. The sale of arsenic in its preparations to the public is properly hedged round with restrictions of all kinds. It is included in part one of the Poisons and Pharmacy Act, 8 Edward VII, C. 55. No arsenic may be sold to a person under age, nor may it be sold unless mixed with soot or indigo in the proportion of one ounce of soot or one half ounce of indigo at the least to every pound of arsenic. Arseniorated Hydrogen, our sign, arsenic trihydride, is an extremely poisonous gas and is evolved in various chemical and manufacturing processes. In damp, ferro-silicon evolves arsenic trihydride and phosphorus trihydride, both very lethal gases. Ferrochrome is used in making steel and it also evolves phosphorus trihydride and in such extreme dilution as 0.02% may cause death. Chapter 22 Antimony and its Preparations Tartar-Omedic, tartarized antimony, potassium tartrate of antimony, occurs as a white powder or in yellowish-white efflorescent crystals. Vynum antimoniali contains two grains to a fluid ounce of the wine. Symptoms. Metallic taste rapidly followed by nausea, incessant vomiting, burning heat and pain in stomach, purging, dysphagia, sense of constriction in throat, intense thirst, cramps, faintness, profound depression, in fatal cases giddiness and tetanic spasms. In chronic poisoning, nausea, vomiting and purging, weak pulse, loss of appetite, debility, cold sweats, great prostration, progressive emaciation. The symptoms in chronic poisoning may simulate gastritis or enteritis. Externally applied, it produces an eruption, not unlike that of smallpox. Postmortem appearances, inflammation, softening, and an aphid condition of the throat, gulla in stomach, the last reddened in patches. In chronic poisoning, inflammation also of cecum and colon, brain and lungs may be congested, decomposition is hindered for long. Treatment. Promote vomiting by warm greasy water or the stomach tube may be used, syncona bark or any preparation containing tannin as tea, decoction of oak bark, etc., morphine to allay pain. Fatal dose, in an adult, two grains, same as arsenic. Fatal period, death follows in 8 to 12 hours from exhaustion. Method of extraction from the stomach. The contents of the stomach or its coat should be finely cut up and boiled in water, assidulated with tartaric acid and subjected to dialysis or strained and filtered. Pass hydrogen sulfide through the filtered or dialyzed fluid until a precipitate ceases to fall. Collect the sulfide thus formed, wash and dry it. Boil the orange colored sulfide in a little hydrochloric acid. If the solution is now added to a large bulk of water, the white oxychloride is precipitated, which is soluble in tartaric acid and precipitated orange yellow with hydrogen sulfide. The chloride of bismuth is also precipitated white, but the precipitate is not soluble in tartaric acid, and the precipitate with hydrogen sulfide is black. Tess, soluble in water, but not in alcohol. Heated in substance, it crepitates and chars, and if heat be increased, the metal is deposited. Treated with sulfurated hydrogen, a characteristic orange-red sulfide is formed. A drop of the solution evaporated leaves crystals, either tetrahedric or cubes, with edges beveled off. The hydrogen passed through gives the orange-red precipitate above named. Dilute nitric acid gives a white precipitate, soluble in excess, and also in tartaric acid. Marshes and wrenches procedures are applicable for the detection of antimony, but wrenches is the better. Wrenches process gives a violet deposit instead of the black, lustrous one of arsenic. Chloride of antimony, butter of antimony, a light yellow or dark red corrosive liquid. Violet corrosion and irritation of the elementary canal, with the addition of narcotic symptoms. After death the mucous membrane of the entire canal is charred, softened, and abraded. Treatment as for tartar-o-medic, magnesia in milk. CHAPTER XXIII. MERCURY AND ITS PREPARATIONS. The most important salt of mercury, toxicologically, is corrosive sublimate. Other poisonous preparations are red precipitate, white precipitate, mercuric nitrate, the cyanide, and potassium mercuric iodide. Calamel has very little toxic action. Metallic mercury is not poisonous, but its vapor is. Corrosive sublimate, perchloride of mercury, is in heavy, colorless masses of prismatic crystals, possessing an accurate metallic taste. It is soluble in sixteen parts of cold, and two of boiling water. Soluble in alcohol and ether, the latter also separating it from its solution in water. Symptoms come on rapidly, accurate metallic taste, constriction and burning in throat and stomach, nausea, vomiting of stringy mucus tinged with blood, tenesmus, purging, feeble, quick and irregular pulse, dysuria with scanty, albuminous or bloody urine or total suppression, cramp, twitches and convulsions of limbs, occasionally paralysis. In poisoning from the medicinal use of mercury, there may be salivation, a coppery taste in the mouth, peculiar feeder of breath, tenderness and swelling of mouth, inflammation swelling and ulceration of gums, cankram oris, a blue line on the gums, and the loosening of teeth. Mercury is less quickly eliminated from the body than arsenic. In chronic cases, mercurialism, hydrigerism, patalism or salivation, including most of the symptoms enumerated above, may get eczema mercuriali and periostitis, profound anemia often a prominent symptom, neuritis not uncommon. If fumes of mercury inhaled, mercurial tremors develop. Corrosion, softening and sloughing ulceration of stomach and intestines. The mucus membrane of the esophagus and stomach is often of a bluish-gray color. The large intestine and rectum are often ulcerated and gangrenous, inflamed condition of urinary organs with contraction of the bladder. Treatment Encourage or produce vomiting, albumin as white of egg, gluten or wheat flour is the best antidote. Demulsant drinks, milk and ice, stomach tube to be used with care owing to softened state of gullet and stomach. Fatal dose, three grains in a child. Fatal period, half an hour the shortest. Method of extraction from the stomach. A trial test may be made of the contents of the stomach with copper foil. If mercury is found, the contents of the stomach may be dialyzed, the resulting clear fluid concentrated and shaken with ether which has the power of taking corrosive sublimate up and thus separating it from arsenic and other metallic poisons. The ether allowed to evaporate will leave the corrosive sublimate in white, silky-looking prisms. Suppose no mercury is found in the dialyzed fluid owing to the fact that corrosive sublimate enters into insoluble compounds with albumin, fibrin, mucus membrane, gluten, tannic acid, etc. We must dry the insoluble matter and heat it with nitrohydrochloric acid until all organic matter is destroyed and excess of nitric acid expelled, the residue dissolved in water, filtered and tested with copper foil, etc. Tess. The following table gives the action of corrosive sublimate with reagents. 1. With iodide of potassium, bright scarlet color, 2. With potash solution, bright yellow color, 3. With hydrochloric acid insulphurated hydrogen, first a yellowish and then a black color. 4. Heated in a reduction tube, melts, boils, is volatilized and forms a white crystalline sublimate. 5. With ether, freely soluble, the ethereal solution when allowed to evaporate spontaneously deposits the salt in white prismatic crystals. 6. Heated with carbonate of sodium in a reduction tube, globules of metallic mercury are produced. A very simple process for detecting corrosive sublimate is to put a drop of the suspected solution on a sovereign and touch the gold through the solution with a key when metallic mercury will be deposited on the gold. Chapter 24. Lead and its preparations. Acetate of lead, sugar of lead, a glistening white powder or crystalline mass, soluble in water with a Swedish taste. It is practically the only lead salt which gives rise to acute symptoms and only when taken in large doses. Symptoms, metallic taste, dryness and throat, intense thirst, vomiting, colicky pains, cramps, cold sweat, constipation and scanty urine, severe headache, convulsions. Chronic lead poisoning is liable to occur in those who handle lead in any form, white lead workers, paint manufacturers, plumbers, pottery workers, etc. In chronic lead poisoning the most prominent symptoms are a blue line on the gums, anemia, emaciation, pallor, quick pulse, persistent constipation, colic, cramps in limbs and paralysis of the extensor muscles, causing dropped hand. May get satyrine encephalopathies, of which intense headache, optic neuritis and epileptiform convulsions are the most common, albumin in urine, tendency to gout and in women to abortion. Postmortem appearances, inflamed mucous membrane of stomach and intestines with layers of white or whitish-yellow mucous impregnated with the salt of lead. Treatment, sulfate of sodium or magnesium or a mixture of dilute sulfuric acid, spirits of chloroform and peppermint water, milk or milken eggs. As a prophylactic among workers in lead, a drink containing sulfuric acid flavored with triacal should be given, lavatory accommodation should be provided, and scrupulous cleanliness should also be enjoined in the workshops. The dry grinding of lead salts should be prohibited. The ionization method of Sir Thomas Oliver is most useful both as regards cure and also prevention of chronic poisoning by lead. Fatal dose and fatal period, uncertain. Dry the contents of the stomach or portions of the liver, etc., and incinerate in a porcelain crucible. Treat the ash with nitric acid, dry and dissolve in water. The solution of nitrate of lead may now have the proper tests applied. Tests. Sulfurated hydrogen gives a black precipitate, liquor potasy, white precipitate, sulfuric acid, white precipitate, insoluble in nitric acid, iodide of potassium, a bright yellow precipitate. A delicate test for lead in water is to stir the water, concentrated or not, with a glass rod dipped in ammonium sulfide. A brown coloration is produced. One tenth of a grain of lead in a gallon of water may be detected. Chronic lead poisoning is an industrial disease, and being an occupation risk its victims are entitled to compensation at the hands of their employers. In case of death, compensation has been awarded even when at the autopsy the patient has been found to have suffered from acute tuberculosis of the lungs. The responsibility of apportioning the monetary value of disablement resulting from the action of the lead rests with a judge or jury who are guided by the expert medical evidence available. Diacolon or lead plaster is largely used as an abortifatient. Chapter 25 Copper and its preparations. Poisoning with copper salts is rare. The most important are the sulfate, subacetate, and arsenite. Sulfate of copper, bluestone, blue vitriol, in half-ounce doses is a powerful irritant, has been given to procure abortion. Subacetate of copper, for degree, occurs in masses or as a greenish powder, powerful astringent metallic taste, half-ounce doses have proved fatal. Symptoms. Epigastric pain, vomiting of bluish or greenish matter, diarrhea, dypsnia, depression, cold extremities, headache, purple line around the gums, jaundice is common, a chronic form of poisoning may occur, with symptoms closely resembling those of lead. Postmortem appearances, inflammation of stomach and intestines which are bluish or green in color. Encourage vomiting, give albumin or very dilute solution of ferrocyanide of potassium. Method of extraction from the stomach. Boil the contents of the stomach in water, filter, pass hydrogen sulfide, filter, collect precipitate and boil in nitric acid, filter, dilute, filtrate with water, and apply tests. In the case of the solid organs, dry, incinerate, digest ash and hydrochloric acid, evaporate nearly to dryness, dilute with water, and test. Test. Polished steel put in a solution containing a copper salt receives a coating of metallic copper. Ammonia gives a whitish-blue precipitate, soluble in excess. Ferrocyanide of potassium gives a rich red-brown precipitate. Sulfur-redded hydrogen gives a deep brown precipitate. Chapter 26. Sink, silver, bismuth, and chromium. The salts of zinc requiring notice are the sulfate and chloride. Sulfate of zinc has been taken in mistake for epsom salts. In large doses, it causes dryness of throat, thirst, vomiting, purging, and abdominal pain. Postmortem appearances. Those of inflammation of digestive tract. Treatment. Tea. Decoction of oak bark, carbonate of potassium or sodium as antidote. Light of zinc. A solution containing this substance, 230 grains to the ounce, constitutes Burnett's disinfecting fluid. It is a corrosive poison. The symptoms are burning sensation in the mouth, throat, stomach, and abdomen, followed by vomiting, diarrhea, with tenismus and distension of the abdomen. The vomited matter contains shreds of mucous membrane with blood. There is profound collapse, cold surface, clammy sweats, weak pulse, with great prostration. The treatment is to wash out the stomach with large and weak solutions of carbonate of sodium. Musilaginous drinks may be given, and hypodermic injections of morphine are useful to allay the pain. Method of extraction from the stomach. Dry and incinerate the tissues in a porcelain crucible. Digest ash and water. Apply tests. Tests. Ammonia. A white precipitate soluble in excess. Be precipitated by sulfurated hydrogen, ferrocyanide of potassium, a white precipitate. Sulfurated hydrogen, a white precipitate in pure and neutral solutions. Nitrate of burita will show the presence of sulfuric acid and nitrate of sulfur of hydrochloric acid. Silver. Nitrate of silver is a powerful irritant. Tests. Black precipitate with sulfurated hydrogen, white with hydrochloric acid. Treatment. Salt. Chronic nitrate of silver poisoning is characterized by argyria. The gums show a blue line, which is darker than that produced by lead, and the skin presents a grayish hue, which is permanent. Bismuth. The business salts are not poisonous, but may contain arsenic as an impurity, although this is far less common than it was some years ago. Chromic acid, chromate, bichromate of potassium. These act as corrosives when solid or in concentrated liquid forms, and dilute solutions they act as irritants. Used as dyes have proved fatal more than once. Those engaged in their manufacture suffer from unhealthy ulcers on the nasal septum and hands. The former may to some extent be prevented by taking snuff. Lead chromate, chrome yellow, is a powerful irritant poison. Two drachoms of the bichromate cause death in four hours. Tests. No precipitate with salts of lead, deep red with those of silver. Treatment. Ametics. Magnesia. Andiluence. Washing out of the stomach with weak solution of nitrate of silver. End of section 14. Chapter 15 of Age to Forensic Medicine and Toxicology by W.G. Acheson-Robinson. This is a LibriVox recording, or LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org, read by Aspergene, October 2009, Sydney, Australia. Gaseous Poisons. Carbon dioxide. Carbon dioxide is a product of combustion and respiration, and is generated in many ways during fermentation. It is a constituent of choke damp due to explosions in coal mines, and is given off from lime kilns, brick kilns and cement works. It is often met with in dangerous quantities in wells and in brewers vats. From 10 to 15% in the atmosphere would prove fatal, but even 2% inhaled for long would produce serious symptoms. The proportion usually present in air is 0.04%. Symptoms. Inhalation of the pure gas causes spasm of the glottis, insensibility and death from asphyxia at once. Diluted cause sense of weight in forehead and back of head, gideonus, vomiting, somnolence, loss of muscular power. Insensibility, stuctorious breathing, levidity of face and body, and death from asphyxia. Convulsions occasionally. Post-mortem appearances. Face swollen and livid, or calm and pale. Levidity is most marked in eyelids, lips, ears, etc. Limbs usually flaccid, abdomen distended, right side of heart, lungs and large veins, gorged with dark coloured blood, brain and membranes congested. Pure air, cold effusion, stimulants, artificial respiration, galvanism, inhalation of oxygen, venous section, transfusion. Carbonic oxide. This is one of the most poisonous of gases. It is evolved in the process of burning charcoal and coke in stoves or furnaces. Water gas obtained by a passing steam over heated coke contains 40% of the substance. There are main are being chiefly hydrogen. It forms the chief part of the deadly choke damp after an explosion in a mine. 2% in the atmosphere is immediately fatal. Symptoms. When in large amount, insensibility comes on at once. And in very small amounts, headache, giddiness, noises in the ears, nausea and vomiting with prostration, insensibility and coma. There may be convulsions. Even in cases which recover, permanent impairment of the brain may result. Post mortem appearances. The blood is bright red in colour due to the interaction of carbonic oxide with hemoglobin. A rosy hue of the skin surface and viscara is often noticed. Bright red patches of colour are found over the surface of the body. The spectrum of the blood is characteristic. Treatment. Ammonia to the nostrils, inhalation of oxygen, cold douche in moderation, artificial respiration, transfusion of blood. Coal gas. Coal gas contains light, carburetted hydrogen or marsh gas, olefient gas, ammonia, sulfuretted hydrogen, carbonic acid, carbonic oxide, free hydrogen and nitrogen. Coal gas has an offensive odour, burns with a yellowish white flame, yielding water and carbonic acid. Cases of poisoning often due to escape of gas into the room. Symptoms. Headache and giddiness, foaming at mouth, vomiting, convulsions, titanic spasms, statoris breathing, dilated pupil. The breath smells of gas. There is profound stupor. The patient, if alive, exhales gas from the lungs when removed into a fresh room or into the air. Smell of gas in the room and in the patient's breath. Smelt-mortem appearances, pallor of skin and internal tissues, florid colour of neck, back and muscles, if much CO present in the coal gas, fluid florid blood, infiltration of lungs. Treatment. Fresh air, artificial respiration, cold effusion, diffusable stimulants, inhalation of oxygen freely. And hydrogen is characterised by its odour, like that of rotten eggs, it is extremely poisonous. Symptoms. Giddiness, pain and depression in stomach, nausea, loss of power, delirium, tetanus and convulsions. Post-mortem appearances, fluid and black blood, sulfa hemoglobin, smell of H2S on opening the body, loss of contractility of muscles, rapid putrefaction, treatment, fresh air, stimulants, inhalation of chlorine, tests, acetate of lead throws down a brown or black precipitate according to the quantity of the gas. Sewer gas, cesspool emanations usually consist of a mixture of sulphur retid hydrogen, sulphide of ammonium and nitrogen, but sometimes it is only deoxidised air with an excess of carbonic acid gas. Symptoms. If poison concentrated, death may ensue at once. If gas diluted, or exposure only short, insensibility, levidity, hurried respiration, weak pulse, dilated pupils, elevation of temperature to 104 degrees, tonic convulsions not unlike those of tetanus, treatment, fresh air, oxygen with artificial respiration, stimulants, hypodermic of strickenin and alternate hot and cold douche. acid gases are 1. nitrous acid gas, 2. sulphurous acid gas, 3. hydrochloric acid gas, 4. chlorine, 5. bromine, 6. ammonia. They have the common property of causing irritation and inflammation of the eyes, throat and ear passages and may cause spasm of the glottis, bronchitis and pneumonia. Nitrous acid gas, one of the products of combustion of common coal. Hydrochloric acid gas, irrespirable when concentrated and very irritating when diluted, very destructive to vegetable life. Chlorine, used in bleaching and as a disinfectant, greenish-yellow colour, suffocating odour, and poisoning inhalation of sulphurated hydrogen gives relief. Vegetable irritants, the chief vegetable purgatives are aloes, colosinth, gamboge, gelap, schemony, seeds of castor oil plant, croton oil, elacterium, the heliborus and colchicum. All these have either a lone or combined proved fatal. The active principle in aloes is aloen, of jalap, jalapin, of white helibor, veratria, and of colchicum, colchicin. Morrison's pills contain aloes and colosinth. Aloes is also the chief ingredient in Holloway's pills. Vomiting, purging, tenesmus, etc., followed by cold sweats, collapse or convulsions, post-mortem appearances, inflammation of elementary canal, ulceration, softening and submucous effusion of dark blood, treatment, diluents, opium, stimulants, abdominal fomentations, etc. All parts of these irritant poisons exert a marked influence on the central nervous system as the following. Laburnum, cetaceous laburnum. All parts of the plant of poisonous, the seeds which are contained in pods are often eaten by children, contains the alkaloid citicin, which is also contained in anica. It has a bitter taste and is powerfully toxic. Vomitings are purging, vomiting, restlessness, followed by grousiness, insensibility and convulsive twitchings. Death due to respiratory paralysis. Most of the cases are in children. Treatment consists of stomach pump or ometics, stimulants freely, artificial respiration, warmth and friction to the surface of the body. U, taxus baccata, contains the alkaloid taxine. The symptoms are convulsions, insensibility, coma, dilated pupils, power, laboured breathing, collapse. Death may occur suddenly, treatment as above. Post-mortem appearance is not characteristic, but fragments of leaves or berries may be found in the stomach and intestines. Arum, arrum maculatum. This plant, commonly known as lords and ladies, is common in the woods and the berries may be eaten by children. It gives rise to symptoms of irritant poisoning, vomiting, purging, dilated pupils, convulsions followed by insensibility, coma and death. Many plants have an intensely irritating action on the skin, and when absorbed by active poisons. Rus, toxii, coden bron is the poison oak or poison ivy. Poisoning by this plant is rare in England, though not uncommon in the United States. Mere contact with the leaves or branches will in many people set up an acute dermatitis, with much edema and hyperemia of the skin. The inflammation spreads rapidly and there is formation of blibs with much itching. There is often great constitutional disturbance, nausea, vomiting, diarrhea and pains in the abdomen. The effects may last a week and the skin may deschromate. Primula obconica is another plant which, when handled, gives rise to an acute dermatitis of an erycepolatus character. The face swells and large blisters form on the cheeks and skin. Opium and morphine. Opium, the inspecated juice of the unripe capsules of the papava somniferum. As a poison it is generally taken in the form of the tincture, lordenum, which contains one grain opium in 15 minims. Opium is found in almost all so-called soothing syrups for children and in Godfrey's cordial, Dalby's carminative and Collis Brown's chlorideine. Lordenum contains 1% morphine and it, along with all other preparations, e.g. paragoric which contain 1 or more percent morphine, are included in part 1 of the schedule of poisons and come under the dangerous drugs regulations. The most important active principles of opium are the alkaloids, morphine and codeine. Symptoms usually commence in from 20 to 30 minutes, giddiness, drowsiness and stupor followed by insensibility. Pupilant seems asleep, may be roused by loud noise but quickly relapses, breathing slow and stir-torus, pulse weak, countenance livid. As coma increases, pulse becomes slower and fuller, the pupils are contracted, even to a pin's point they are insensible to the action of light. In deep natural sleep the eyes are turned upwards and the pupils contracted. Pupils confined, skin cold and livid or bathed in sweat, temperature subnormal, nausea and vomiting are sometimes present, remissions are not infrequent, the patient appearing about to recover and then relapsing, hemorrhage into the ponds may give rise to contractive pupils, young children and infants are especially susceptible to a poison. Pupilance is not always easy and one has to differentiate poisoning from cerebral apoplexy. In the latter one can seldom rouse the patient, the pupils are often unequal and hemiplegia is present. In compression of the brain fracture of the skull may be present, subconjunctival hemorrhages may be seen, the pupils are unequal and dilated and the paralysis increases. In uremic or diabetic coma the urine must be examined. The habitual use of opium is not uncommon and opium eaters are able to take enormous quantities of the drug. The opium eater may be known by his attenuated body, withered yellow countenance, stooping posture and glassy sunken eyes. Most mortem appearances, not characteristic, to a jessence of cerebral vessels there may be effusion under arachnoid, into ventricles at base of the brain and around the cord, rarely extravasation of blood. Stomach and intestines usually healthy, lungs gorged, skin livid. Fatal period, usually 9-12 hours, but in many cases if life is prolonged for 8 hours recovery takes place. Fatal dose, 4 grains of opium is the smallest fatal dose in an adult or one drachma of loudenum. Children are proportionately much more susceptible to the action of opium than adults. Stomach, tube, ometics, strong coffee or tea, ammonia, tend nostrils, give 10 grains of permanginate of potassium in a pint of water, assidulated with sulfuric acid and repeat the dose every half hour. Belladonna by mouth or atropine hypodermically, patient must be kept roused by dashing cold water over him, flagellating the wet towel, walking about etc. In conditions of collapse however, this treatment must not be continued, but everything should be done to preserve the strength. Treatment must be continued as long as life remains. Method of extraction from the stomach. Opium itself cannot be directly detected, but we test for morphine and meconic acid. These may be separated from organic mixtures thus, boil the organic matter with distilled water, spirit and acetic acid, filter and to the fluid passed through add acetate of lead to precipitate ceases, filter. Acetate of morphine passes through and meconate of lead remains. The solution of acetate or morphine may be free from excessive lead by hydrogen sulfide and filtered, excess of hydrogen sulfide driven off by heat and tests applied. Put the meconate of lead with water into a beaker and pass hydrogen sulfide. Sulfide of lead is formed and meconic acid set free. Filter. Concentrate the solution of meconic acid, allow a portion to crystallize and apply tests. Tests. Morphine and its acetate give an orange-red color with nitric acid becoming brighter on standing. We compose iodic acid setting free iodine with perchloride of iron gives a rich indigo blue with bichromate of potassium green turning to brown. When the alkaloid is heated in a watch glass with a drop of strong sulfuric acid until the acid begins to fume and is then allowed to get quite cold, a drop of nitric acid produces a brilliant red color. The iodic acid test is very delicate but requires great care and may be used in the presence of organic matter. Meconic acid gives a blood red color with perchloride of iron, not discharged by corrosive sublimate or chloride of gold. The similar color produced by sulfosionide of potassium and perchloride of iron is discharged by chloride of gold and corrosive sublimate. Morphine habit. Those who have acquired this habit take the drug usually by hypodermic injection. The victim suffers from nausea and vomiting and becomes so mentally debilitated that a silent treatment is required. Belladonna, hyocyanus and stromonium, belladonna. The root, leaves and berries of the atropa belladonna are poisonous from the presence of alkaloid atropide. Symptoms, dryness of mouth and throat, intense thirst, dysphagia and dysphonia. Quick pults, noisy delirium and stupor, stranguri and hematuria and redness of the skin especially of the face like that of scalatina have been noticed. Tiltation of the pupil occurs whether the poison be taken internally or applied locally to the eye. Just mortem appearances, congestion of cerebral vessels, dilated pupils, red patches in elementary canal. Treatment. Wash out the stomach freely, a hypodermic injection of apomorphine as an ametic followed by hypodermic injections of pylocar pine or morphine, tea, coffee or tannin to precipitate the alkaloid. Atropine may be recognized by its action on the pupil. The chloroiodide of potassium and mercury precipitates it from very dilute solutions. Hyocymus, hindbane, hyocymus nagea, stromonium thorn apple, detura, stromonium. Symptoms. Identical with those of belladonna and hyocymus, the post mortem appearances and treatment being also the same. Cannabis indica, indian hemp. When smoked produces intoxication and mania. Hashish used in the east as a narcotic may cause persons to run amok and commit murder. Cocaine. Any dose above half a grain applied to a mucus membrane or injected hypodermically may give rise to alarming symptoms. These are intense pallor, faintness, skittiness, dilation of pupils, paroxysmal, dyspnea, rapid, intermittent and weak pulse, nausea and vomiting, intense prostration, verging on collapse and convulsions. The patient may recover if allowed to remain in a recombinant position with stimulants by mouth, egemonia and the hypodermic injection of brandy or ether may be necessary with the inhalation of nitrate of amyl. For care in the prescribing of cocaine, see under the Dangerous Drugs Act 1920 page 82. The cocaine habit consists in the self-administration of the drug hypodermically. It induces excitement which is followed by prostration. In time melancholia or mania develops with great irritation of the skin. Cocaine bugs. End of Chapter 15. Section 16 of AIDS to Forensic Medicine and Toxicology. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. Reading by Leanne Howlett. AIDS to Forensic Medicine and Toxicology by W. G. Atchison-Robertson. Section 16. Chapter 32. Camphor. The liniment, oil and spirit have been poisonous in large dose. Symptoms. Fever of breath, langer, giddiness, faintness, dimness of vision, difficulty of breathing, delirium, convulsions with hot skin, flushed face and dilated pupils. Fatal dose, 30 grains. Coculus endicus. The fruit of anomertococulus contains a poisonous active principle, picrotoxin, used to adulterate beer and by poachers to stupify fish. Symptoms. Convulsions followed by stupor and complete loss of voluntary power. Chapter 33. Tetrachlorothane, etc. Tetrachlorothane, Ceylon. Acetylene tetrachloride. Fever has caused poisoning in aeroplane, dope, and cinema film works. Symptoms. Gastric symptoms and marked jaundice. This may be followed in days or weeks by stupor, coma, death. Postmortem. Fatty degeneration of internal organs, chiefly liver, trinitrotoluene, TNT, an explosive solid which stains the skin in orange color, may be absorbed through skin or be inhaled. Symptoms. Shortness of breath. Headache. Drowsiness. Later, skin irritation, gastritis, jaundice, blood degeneration. Treatment. Remove from work, rest in bed, diuretics, purgatives, alkalis. Chapter 34. Alcohol, either and chloroform. Alcohol, either and chloroform, induced general anesthesia, often preceded by delirious excitement and followed by nausea and vomiting. When they cause death, it is by inducing a state like apoplexy or by paralyzing the heart. Alcohol. Rectified alcohol is ethylhydroxide C2H5OH with not more than 1% by weight of water. Rectified spirit, spiritus rectificatus, contains 90% of alcohol. Methylated spirit consists of rectified spirit with 10% of wood spirit. Proof spirit contains a little over 49% of absolute alcohol. Body or whiskey, 53%. Port wine, 20 to 25%. Ales and stout, 4 to 6%. Symptoms. Acute poisoning, confusion, giddiness, staggering gait, headache, passing into stupor with subnormal temperature and coma. Vomiting may occur and recovery ensue, otherwise collapse sets in. Dipsomaniacs suffer from indigestion, vomiting and purging, jaundice, albuminuria, diabetes, cirrhosis of liver, degeneration of kidneys, congestion of brain, peripheral meritis, alcoholic insanity and various forms of paralysis. In the acute form, delirium trimmins is the most common manifestation. Most mortem appearances, deep red color of lining membranes of stomach, sometimes congestion of cerebral vessels and meninges, lungs congested, blood fluid, rigor mortis persistent. Fatal dose, death from one half pint of gin and from two bottles of port, but recovery from larger quantities. Fatal period, average about 24 hours, treatment, stomach tube, cold diffusion, electricity, injection of a pint of hot coffee into the rectum, give chloride of ammonium in 30-grain doses to prevent delirium, strict nine or digitaline hypodermically. Method of extraction from the stomach. Destinage the contents of the stomach, if acid, with sodium carbonate. Place them in a retort and carefully distill. Collect the distillate, mix with chloride of calcium or anhydrous sulfate of copper and again distill. Agitate distillate with dry potassium carbonate and draw off some of the supernatant fluid for testing. Tess, odor, dissolves camphor. With dilute, sulfuric acid and bichromate of potassium 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. Sexual 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, number one, marks of violence on head. Number two, stupor, sudden. Number three, face, pale, cold, pupils sluggish, sometimes dilated. Number four, remission, rare, patient recovers slowly. Number five, no odor of alcohol in breath, alcohol. Number one, no marks of violence unless person has fallen, history will be of use. Number two, excitement precedes sudden stupor. Number three, face flushed, pupils generally dilated. Number four, partial recovery may occur followed by death. Number five, odor of alcohol in breath. Opium, number one, as alcohol. Number two, symptoms slow, drowsiness, stupor, lethargy. Number three, face, pale, pupils contracted. Number four, remission, rare. Number five, odor of opium in breath. Ether is a volatile liquid prepared from ethylic alcohol by interaction with sulfuric acid. It contains 92% of ethyl oxide, C2H5O. It was formerly called sulfuric ether. It is a colorless, inflammable liquid having a strong and characteristic odor, 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 anesthesia. It has a specific gravity of 0.722 to 0.720 and its vapor is very inflammable. Symptoms, when taken as a liquid, same as alcohol. When inhaled as vapor, causes slow, prolonged and sturdorous breathing. Face becomes pale, lips bluish, surface of body cold. Pulse first quickens, then slows. Pupils dilated, eyes glassy and fixed. Muscles become flabby and relaxed, profound anesthesia. 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 effusion, artificial respiration, galvanism. Blood of extraction from the contents of the stomach. Same as for alcohol. During distillation, pass some of the vapor into concentrated solution of bichromate of potash, nitric and sulfuric acids and note reaction as for alcohol. Tests, vapor burns with smoky flame, depositing carbon, sparingly soluble in water. With bichromate of potash and sulfuric acid, same as alcohol. Chloroform. A colorless liquid, specific gravity, 1.490 to 1.495, very volatile, giving off dense vapor, sweet taste and pleasant odor. Symptoms. When swallowed, characteristics smell in breath, anxious countenance, burning pain in the throat, stomach and region of the abdomen, staggering gait, coldness of the extremities, vomiting and sensibility, deepening into coma with sturtorous 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 4 to 7 days after chloroform has been administered, especially in the case of children. The internal organs are found to be fatally degenerated and death is thought to be due to acetonuria. Postmortem Appearances. Cerebral and pulmonary congestion. Heart empty or right side distended with dark blood. Treatment, stomach tube and free lavage. Cold effusion, drawing forward tongue, artificial respiration, galvanism and suspension with head downward. Inhalation of nitrite of amyl, strict 9 hypodermically. Fatal dose. Wind swallowed from 1 to 2 ounces. Method of extraction from the stomach. By distillation at 120 degrees Fahrenheit, the vapor as it passes along a glass 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. Color. Weight. Burns with a green flame. Dissolves camphor, gutta percha and cowchick. Iodiform. Poisoning may result from its use in surgery. It produces delirium, sleepiness and coma. It may lead to mental weakness or optic neuritis. Chapter 35. Chloral hydrate. It was formerly largely used as a hypnotic and many fatal consequences ensued. It is prepared from alcohol and chlorine. Symptoms. 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 tessidous such. Treatment. Stomach tube or emetic. Take injections of strict 9. Keep patient warm and inject a pint of hot strong coffee into the rectum. Nitrite of amyl and artificial respiration. Tess. Heated with caustic potash, it yields chloroform and potassium formate. The chloroform is readily recognized by its odor and if the solution be concentrated by separating as a heavy layer at the bottom of the test tube. Chapter 36 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 color that retains its peculiar penetrating odor. Different varieties are sold under the names of Symogein, Gasoline, Naphtha, Petrol and Benzaline. Benzaline is highly inflammable and is often called mineral naphtha, petroleum naphtha and petroleum spirit. Benzaline 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 vapor 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 odor of paraffin, the face is pale and cyanotic, hot and dry and there may be vomiting. Death may result from gastroenteritis or from coma. Fatal dose. In the case of an adult one half pint should not prove lethal and patients have recovered after drinking a pint. Treatment. Emitics, purgatives and stimulants. End of section 16, recording by Leanne Howlett. Section 17 of AIDS to Forensic Medicine and Toxicology. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer please visit LibriVox.org. Recording by Jeannie Whitfield. AIDS to Forensic Medicine and Toxicology by W. G. Acheson-Robertson, Section 17, Anti-Pyrine to Hydrocyanic. Chapter 37 Anti-Pyrine, Anti-Fibrin, Finacetin and Aniline. Many of the synthetic coal tar products now so largely employed as analgesics are powerful toxic agents. Finazone, anti-Pyrine or analgesin is a complex benzene derivative prepared from aniline, acetoacetic ether and methyl iodide. It is in colorless, in odorous, scaly crystals, which have a bitter taste. It is soluble in its own weight of water. Tests can be extracted from an aniline solution of chloroform. The residue left on the evaporation of chloroform should be employed for testing. If heated with strong nitric acid and allowed to cool, a purple color is produced. Ferric chloride gives a blood-red coloration, destroyed by the addition of mineral acids. Treatment stimulants freely, inhalation of oxygen, patient to be kept in the recumbent position. Acetanilide, anti-fibrin, phenylacetamide. A constituent of daisy or headache powders is obtained by the interaction of acetic acid and aniline. It is in colorless, in odorous, laminar crystals, which have a slight pungent taste. It is insoluble in water. Tests may be extracted from acid solutions by ether or chloroform. If heated with solution of potassium hydroxide, odor of aniline is given off. If liquid when it is warmed with a few drops of chloroform, a penetrating and unpleasant odor of isocyanide. Treatment and medics, stimulants, inhalation of ether, recumbent position. Phenacetan, phenacetanamide, is produced by the interaction of glacial acetic acid and para-phenacetan. It is in white, tasteless, in odorous, glistening scaly crystals, insoluble in water. Of all the members of the group, it most rarely produces toxic symptoms. Treatment, as for the other members of this group. Exalgen, aspirin, etc. As well as above, may all act as poisons to certain persons, and even small medicinal doses may cause serious and even fatal consequences. Symptoms, more or less common to all. nausea, vomiting, hurried respiration, marked sinosis, syncope, persistent sneezing, widespread eukaryo may be present, collapse. Aniline is an oily liquid, heavier than and not soluble in water. It is colorless or reddish brown. It has a peculiar tar-like odor. It is soluble in alcohol and forms a soluble sulfate with sulfuric acid. A solution of bleaching powder gives, with the solution of sulfate, a purple color, changing to red-brown. Symptoms, nausea, vomiting, giddiness, intoxication, drowsiness, gasping for breath, feeble pulse, and marked sinosis. In its industrial use, it may act as a poison either by inhalation of the fumes or by absorption through the skin. The symptoms, then, are mainly those of peripheral neuritis with blindness. Fatal dose, about six drums. Treatment, wash out stomach, stimulants, artificial respiration, inhalation of oxygen, transfusion. Nitrobenzole, artificial oil of bitter almonds. It is used in perfumery, but is very poisonous when swallowed or inhaled or absorbed through skin. It is used in the manufacture of aniline dyes, and may act as an industrial poison. The symptoms closely resemble those of aniline poisoning, but there is perhaps greater mental confusion. Fatal dose, eight to ten drops, have caused death. Treatment, emetics, stimulants, transfusion of saline or blood, pituratin, strychnine, digital and hypodermically. Nitroglycerin gives rise to intense and persistent headache, powder headache, throbbing and pulsation of all the arteries in the body, flushing of the face, and collapse may follow. Dynitrobenzine causes symptoms resembling nitrobenzole poisoning, and when acting as a chronic poison gives rise to weakness, jaundice, and peripheral neuritis. Chapter 38 Sulfonol, Trinol, Tetronol, Verinol, Peraldehyde. These are dangerous drugs. The ordinary symptoms of the group are noises in the ears, headache, vertigo, inability to stand or to walk properly, insensibility, and cyanosis. The most interesting point is the condition of the urine. In cases of poisoning it is dark or reddish brown in color, due to the presence of hematophorein. It contains albumin and cast, but no red corpuscles. In cases of hematophorein urea, the prognosis is bad and it is said that these cases invariably infatally. Treatment. In an ordinary case, emetics, strong coffee, hypodermic injections of strychnine, saline injections, and transfusion. Cases of chronic poisoning from the ales are not uncommon and are increasing in frequency. Hypnogen is apparently identical with verinol. All the above named aniline derivatives are included in Part 1 of the scheduled Poisons. Chapter 39 Conium and Calabarabine. Conium maculatum spotted hemlock. All parts of the plant are poisonous, often mistaken for parsley. This is the poisonous principle conanine, a volatile liquid alkaloid with a mousy smell, insoluble in water, soluble in alcohol, ether, and chloroform. It also contains methyl conanine, symptoms, dryness of the throat, headache, dilated pupil, dysphagia, loss of muscular power, passing into complete paralysis, delirium, coma, and convulsions occasionally. Post-mortem appearances, congested brain and lungs, redness of the mucous membrane in the stomach. The stomach and intestines should be examined for fragments of the leaves and fruit recognized by their microscopic appearance. Treatment. Emitics. Tannic acid or Gallic acid. Diffusable stimulants. Method of extraction from the stomach. Use Stas autoprocess. Tests. The mousy odor, deepened color and dense white fumes with nitric acid, pale red deepening with hydrochloric acid. There are several umbiliferous plants which are poisonous. The water hemlock, circuitovirosa, produces symptoms not unlike those of hemlock. It has been mistaken for posh nip and celery. It contains an active principle, sicutoxin, which in some respects is allied to strychnine and picrotoxin. The fools parsley or lesser hemlock, aithusa synaptium, is another member of this group, although doubt has been expressed as to whether it is really poisonous. The water drop ward, a nasi crocata, is undoubtedly poisonous, especially to cattle. In man it produces abdominal pain with diarrhea and vomiting, dilated pupils, slow pulse and cyanosis, delirium, insensibility and convulsions. The post-mortem appearances are not characteristic, but the stomach and intestines should be examined for portions of the plant. Calabar bean or physo-stigma. The bean of physo-stigma venosum contains the alkaloid physo-stigamine, or ercine, with the antagonistic alkaloid calabarine, symptoms, vomiting, giddiness, irregular cardiac action, contraction of the pupils, paralysis of lower extremities, and death from exfixia. Treatment, emetics, hypodermic injection of one fiftieth grain sulfate of atropine, repeated if necessary. Treatment of extraction from the stomach, used stash-auto-process, test the contraction of the pupil which it causes. Chapter 40 Tobacco and Lebelia Tobacco, nicotanin tobacco, owes its poisonous properties to its alkaloid nicotine, a volatile, oily, amber-colored liquid, with an acrid taste and ethereal odor, soluble in water, alcohol, ether, and chloroform. The drug has an intense depressant action on the heart and respiratory center. Symptoms, giddiness, faintness, nausea, and vomiting, with syncope, muscular tremors, stupor, statoris, breathing, and insensible pupil. Death has occurred after 17 or 18 pipes at a sitting, post-mortem appearance. Not uniform or characteristic, general relaxed condition of muscles, engorgement of cerebral and pulmonary vessels, congestion of gastric mucous membrane. Treatment, emetics, stimulates, hypodermic injection of one fiftieth grain of stric9, warmth to the surface by hot bottles, hot blankets. Method of extraction from the stomach, digest the contents of the stomach in cold distilled water and very dilute sulfuric acid. Strain, filter, and press residue evaporates the filtrate to half its bulk, digest with alcohol, and evaporate alcohol off in a water bath. Dissolve residue, sulfate of nicotine, in water, and make solution alkaline with potash. Then shake with ether in a test tube. Remove ether and allow it to slowly evaporate, test resulting alkaloid. Test, no change of color with the mineral acids. White deposit with corrosive sublimate, sulfuric acid and bichromate of potassium Give a green color, oxide of chromium, precipitate with bichloride of platinum and with carbozoic acid. Lobelia inflata, Indian tobacco, much used in America by the coffeinite practitioners and a valuable remedy for asthma. Symptoms, nausea, vomiting, giddiness, cold sweats, prostration, headache, giddiness, tremors, insensibility, and convulsions. Hydrocyanic acid, prusic acid is the most active of poisons. The dilute hydrocyanic acid of the pharmacopeia contains 2% of hydrocyanic acid. Shields, 4%. It is a colorless liquid, feverly acid, with odor of bitter almonds. Cyanide of potassium is largely used in photography and in electroplating, and is also poisonous. It often contains undecomposed carbonate potassium, which may act as a corrosive poison and cause erosion of the mucous membranes of the lips, mouth, and stomach. Oil of bitter almonds, used as a flavoring agent, may contain, when improperly prepared, from 5% to 15% of the anhydrous acid. Symptoms, the symptoms usually come on in a few seconds and are of the shortest possible duration. There is a sudden gasp or breath, possibly a loud cry, and the patient drops down dead. If the fatal termination is prolonged for a few minutes, the symptoms are intense giddiness, pallor of the skin, dilation of the pupils, labored and irregular breathing, small and frequent pulse. Followed by insensibility, there may be convulsions or totanic spasms. With evacuation of urine and feces, death results from paralysis of the central nervous system, but artificial respiration is useless, as the drug promptly arrests the heart's action. It also kills the protoplasm of the red blood corpuscles, rendering them useless as oxygen carriers. Post-mortem appearances, skin livid, pale or violent, with bright red patches on the dependent parts. The gastrointestinal mucous membrane is bright red in color, owing to the presence of cyan methemoglobin, hands clenched, nails blue, jaws fixed, froth about the mouth. Eyes prominent and glistening, odor of acid from the body, venous system gorged. Treatment Empties the stomach by the tube at once, and washes it out with a solution of sodium thiosulfate, strong ammonia to the nostrils, stimulants freely, brandy, fluoric ether, ammonia, salvolatol, ad libitum. If a patient cannot swallow, inject hypodermically, either brandy or ether. Conjection of 150th grain atropine, douche to the face, alternately hot and cold. Desk commonly occurs so rapidly that there is no time for treatment. Fatal dose, smallest. Half a drum of BP acid, equal to 6 tenths grain of the anhydrous. Recovery from one half ounce of BP acid, these records are fallacious, for in specimens the percentage of anhydrous acid varies enormously, practically one grain of the anhydrous acid is fatal. Fatal period, from two to five minutes after a large dose, but may be less. Method of extraction from the stomach. Having previously carefully fitted a watch glass to a wide mouth bottle, nearly filled the bottle with the contents of the stomach, blood, secretions, etc. Place a few drops of solution of nitrate of silver on the concave surface of the watch glass, and cover the mouth of the bottle with it. The vapor of the hydrocyanic acid, if present, will form a white precipitate which may be tested. Other watch glasses treated with sulfide of ammonium or sulfate of iron and liquor potassium will give the reactions of the acid with appropriate tests. This method removes all objection as to foreign admixture. If the acid is not at first detected, gentle warming of the bottle in a water bath will assist the evolution of the vapor. The vapor may be obtained by distillation, but this process is open to objections, to which the other is not. In some cases it becomes changed in the body into formic acid, which should therefore be sought for. Test. With nitrate of silver, a white precipitate, insoluble in cold, but soluble and boiling nitric acid, the precipitate heated, it evolves cyanogen, having an odor of peach blossoms, and burning, when lighted, with a pink flame. Liquor potassium and sulfate of iron give a brownish-green precipitate, which turns to prussian blue with hydrochloric acid. Liquor potassium and sulfate of copper gives a greenish-white precipitate, becoming white with hydrochloric acid. Sulfide of ammonium gives sulfosynide of ammonium. This develops a blood-red color with perchloride of iron, bleached by corrosive sublimate. End of section 17, recording by Jenny Whitfield. Section 18 of Aids to Forensic Medicine and Toxicology. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. Recording by Genie Whitfield. Aids to Forensic Medicine and Toxicology by W. G. Acheson-Robertson. Section 18. Aconite to Tomains. Chapter 42 Aconite. Aconite. Aconite of Neapolis, Monkswood. Leaves and leaves. Poisonous properties depend upon an alkaloid aconite. Aconite is one of the constituents of St. Jacob's Oil. Symptoms. Numbness, tingling in the mouth, throat, and stomach. Giddiness, loss of sensation, deafness, dimness of sight, paralysis, first of the lower and then of the upper extremities, vomiting and shallow respiration. Fupils dilated, pulse small, irregular, finally imperceptible. The mind remains unaffected. Numbness often sudden, post-mortem appearances, venous congestion, engorgement of brain and membranes, treatment and medics, stimulants freely. Best antidote is sulfate of atropine, 150th grain, hypodermically, and also strychnine. Digitalis is useful, warmth to the whole body, patient to make no exertion. Fagal dose of root or tincture, one dram. Fagal period, average less than four hours, method of extraction from the stomach, etc. Extraction from contents of stomach by stash-autoprocess, it may be found in the urine, gives usual alkaloidal reactions, but no distinctive chemical tests known. Test. Chiefly physiological, tingling and numbness, when applied to the tongue or inner surface of cheek, effects on mice, etc., a cadaveric alkaloid, or tomein, has been found in the body, possessing many of the actions of ACA-19. The presence of this substance was suggested in the Lampson trial. The Indian aconite, aconitum ferrox, the bish poison, is much more active than the European variety. It contains a large portion of pseudo-aconitine, and is frequently employed in India, not only for the destruction of wild beasts, but for criminal purposes. Aconitine varies much in activity according to its mode of preparation and the source from which it is derived. The most active kind is probably made from a ferrox. CHAPTER 43 DIGITALIS All parts of the plant digitalis paparia purplepoxglove, or poisonous, contains the glucoside digitalin and other active principles, symptoms, nausea, vomiting, purging and abdominal pains, vomited matter, grass-green in color, headache, giddiness, and loss of sight, pupils dilated in sensitive pulse week, remarkably slow and irregular, cold sweat, salivation occasionally or syncope and stupor, death sometimes quite sudden, post-mortem appearances, congested condition of brain and membranes, inflammation of gastropemuscus membranes, treatment in medics freely, infusions containing tannin as coffee, tea, oak bark, galls, etc., stimulants, hypodermic injection of one one-hundred-twentieth grain of aconitine, methods of extraction from the stomach, etc., and use stash auto-process. TEST FOR DIGITALIN A white substance, sparingly soluble in water not changed by nitric acid, turns yellow, changing to green, with hydrochloric acid. The minutest trace of digitalin moistened with sulfur and treated with bromine, vapors, gives a rose-colored turning moe. This is very delicate, but in experienced hands the physiological test is more reliable. The chemist who has had no practical experience in pharmacological methods would be wiser to keep to his chemical test. CHAPTER 44 NUXVAMICA, STRICKNING AND BRUSIN Nuxvamica consists of the seeds of the strichnos nuxvamica. From these stricknine and brusine are obtained. The symptoms post-mortem appearances and treatment of poisoning by nuxvamica are the same as for stricknine. Stricknine is a powerful poison and forms the active ingredient of many vermin killers. It occurs as a white powder or as colorless crystals with a persistent bitter taste. Very slightly soluble in water, more or less soluble in benzole, ether, and alcohol. SYMPTOMS Sense of suffocation, twitchings of muscles, followed by titanic convulsions and opistotinose, each lasting half to two minutes. Mental faculties, unaffected, face congested and anxious, eyes staring, lips livid, much thirst. The period of accession of the symptoms varies with the mode of administration of the poisoning. Symptoms as a rule come on soon after the food has been taken. Patient may die within a few hours from asphyxia or from exhaustion. Intentanous there is usually history of a wound. The symptoms come on slowly, lock jaw is an early symptom, and only later complete convulsions. The intervals between the fits are never entirely free from rigidity. Death is delayed for some days. Postmortem appearance, heart empty, blood fluid, rigor mortis persistent, hands usually clenched, feet arched and inverted, congestion of the brain, spinal cord, and lungs. Treatment, emetics or stomach pump if the patient is deeply anesthetized, tannic acid and permanganate of potassium, bromide of potassium one half ounce with chloral 30 grains, repeated if necessary. Fatal dose smallest, quarter of a grain. Fatal period shortest, 10 minutes, usually two to four hours. Method of extraction from the stomach, the alkaloid may be separated by the process of stash auto. Test, strychnine has a characteristic very bitter taste. It imparts this taste even to very dilute solutions. It is unaffected by sulfuric acid but gives a purplish blue color, changing to crimson and light red when the edge of the solution is touched with dioxide of manganese, potassium by chromate, ferrocyanide of potassium or permanganate of potassium. This test is so delicate as to show the 125,000th of a grain of the alkaloid, a very minute quantity one 5,000th grain in solution placed on the skin of a frog after drying causes tannic convulsions. Brucine, this alkaloid found associated with strychnine possesses the same properties, though in less powerful degree. Nitric acid gives a blood red color changed to purple with protochloride of 10. Chapter 45, Cancerides, Cancerides Spanish fly or blistering beetle is the basis of most of the blistering preparations. It is sometimes taken as an abort a patient or given as an aphrodisiac, but whether it has any such action is open to question. It acts as an irritant to the kidneys and bladder and sometimes produces hematuria and a good deal of temporary discovery. Symptoms, burning sensation in the throat and stomach with salivation, pain and difficulty in swallowing, vomiting of mucus mixed with blood, tenisimus, diarrhea, the emotions containing blood and mucus, dysuria with passage of small amounts of albuminous and bloody urine, peritonitis, high temperature, quick pulse, headache, loss of sensibility and convulsions. Postmortem, gastrointestinal mucus membrane inflamed with gangrenous patches, genitourinary tract inflamed, acute nephritis, treatment, and a medic of epimorphine, demulsant drinks such as barley water, white of egg, and water, linseed tea and gruel, but not oils. With a hypodermic injection of morphine to a lay pain. Test, the vomited matter often contains shining particles of the powder. The urine will probably be albuminous. Chapter 46, abort a patient. Amenogogs are remedies which have the property of exciting the catamino flow. Ecobolics, or abortatives, are drugs which excite contraction of the uterus and are supposed to have the power of expelling its contents. The vegetable substances commonly reputed to be abortatives are ergot, savin, allos, hyrapycra, digitalis, colosinth, pennyroyal, and nutmeg. But there is no evidence to show that any drug possesses this property. Lead in some parts of the country is a popular abort a patient. A medicine may be an amenogog without being an embolic. Permanganate, a potassium, and benoxide of manganese are valuable remedies for amenorrhea, but will not produce abortion. The vegetable substances frequently used as abortives are savin and ergot, savin, juniperus, sabina. Leaves and tops of the plant yield an acrid oil having poisonous properties and which has even produced death. Symptoms, those of irritant poisonings, purging not always present, but tenesimus and stranguary. Postmortem appearances, acute inflammation of aluminium and terricanal, green powder found, this washed and dried and then rubbed gives odor of savin. Test, a watery solution of savin strikes deep green with perechlorite of iron, and if an infusion of the twigs has been taken the twigs may be detected with microscope. The twigs obtained from the stomach dried and rubbed between the fingers since I will give the odor of savin. Purgot, secal cornutum, a parasitic fungus attacking wheat, barley, oats and rye, which is repeated to have the power of causing contraction of unstriped muscular fiber, especially that of the uterus. Symptoms, lasatude, headache, nausea, diarrhea, anuria, convulsions, coma, small quantities frequently repeated have in the past produced gangrene of the extremities or anesthesia of fingers and toes. Lake red color with liquor potassium, this liquid filtered gives precipitate of same color with nitric acid. Chapter 47 Poisonous Fungi and Toxic Foods Fungi of the poisonous mushrooms, the aminita phylloides and the fly agaric or agarius muscarius are the most potent. The active principle of the former is phalan and of the latter muscarine. The aminita phylloides is distinguished from the common mushroom agaricus campestries by having permanent white gills and hollow stem. The agaricus muscarius is bright red with yellow spots. Phalan is a toxal human which destroys the red blood corpuscles causing the serum to become red in color and the urine bloodstained. Fibrin is liberated and thrombosis occur, especially in the liver. The symptoms may be mistaken for phosphorus poisoning or acute yellow atrophy of the liver. Muscarine affects the nervous system chiefly. Edible fungi have an agreeable taste and smell and are a firm in substance. Poisonous fungi have an offensive smell and bitter taste and are often of a bright color and soon become pulpy. Symptoms. These may be of the narcotic or irritant types. Usually, however, there is violent colic with thirst, vomiting, and diarrhea, mental excitement followed by delirium, convulsions, coma, slow pulse, statorious breathing, cyanosis, cold extremities and dilated pupils. Post-mortem. In valent poisoning, the blood remains fluid. Numerous images are present with fatty degeneration of the internal organs. Treatment. Use the stomach tube to give a solution of promanganate, a potash, emetics, followed by a hypodermic injection of 150th grain of atropine. Transfusion of saline fluid. A dose of castor oil would be useful. Foods. The kind of food which most frequently produced symptoms of poisoning are pork, veal, beef, meat pies, potted, and tin meat, sausages, and brawn. Sausage poisoning is common in Germany. It is not necessary that the food should be high to give rise to poisoning. It may arise from the use of the flesh of an animal suffering from some disease, from inoculation with microorganisms or from the presence of toxal muminosis or tomanes. Many cases such as diarrhea, enteric fever, and cholera, and perhaps tuberculosis, may be caused by eating infected food. Trichoniasis may also be mentioned. Intend fish often gives rise to symptoms of poisoning, and shellfish are not uncommonly contaminated with pathogenic microorganisms. Muscle poisoning was formerly supposed to be due to the copper in them derived from ship's bottoms, but it is more probably the result of the formation of a toxin during life and not after decomposition has set in. Milk, too, may give rise to gastrointestinal irritation from the occurrence in it of chemical changes. There have been epidemics of poisonings from eating cheese containing tyrotoxicin. Ergotism from eating bread made with ergotized wheat is now rare, but perlegra from the conception of moldy maize and lathyrism due to the mixture of flour with seeds of certain kinds of veg are still common in Southern Europe. Symptoms, the symptoms which result from the ingestion of poisonous meat are often very severe. In some cases, their appearance is delayed from 24 to 48 hours. They may resemble those of an infectious disease or those of acute enteritis. Usually, there are headache, anorexia, rigors, intestinal disturbances, pain in the back and limbs, and delirium. Sometimes, the symptoms resemble atropine poisoning, a condition due to tomatropine. Treatment, in medics, percative stimulants with hypodermic injections of stricterin and atropine along with stimulants. Chapter 48, Tomains are cadaveric alkaloids. Every medical man before presenting himself should give evidence in a case of suspected poisoning, should make himself thoroughly acquainted with recent researches on the subject. Tomains are, for the most part, alkaloids generated during the process of putrefaction, and they closely resemble many of the vegetable alkaloids, baritrine, morphine, and codeine, for example. Not only in chemical characters, but in physiological properties. They are probably allied to urine and alkaloid attain from the brain and also from the bowel. Some of them are analogous in action to muscarine, the active principle of the fly fungus. Some are proteates, abulans, and globulans. Tomains may be produced abundantly in animal substances which, after exposure under in sanitary conditions, have been excluded from the air. Tomains or toxal abulans are sometimes found in potted meats and sausages and are due to organisms, the bacillus botulinus, the bacillus enteriditis of garnare, and the B-proteus vulgaris, or the B-itridgis, which is perhaps the most common of all. The symptoms produced by the latter are usually vomiting, abdominal pains, pains in the limbs and cramps, diarrhea, vertigo, coldness, faintness, and collapse. The symptoms of botulism are dryness of the skin and mucus membranes, dilation to the pupil, paralysis of the muscles, diplopia, et cetera. Articles of food most often associated with poisoning are pork, ham, bacon, veal, baked meat, pie, milk, cheese, muscles, tinned meats. In a case of suspected poisoning, counsel for the defense, if he knows his work, will probably cross-examine the medical expert on this subject and endeavor to elicit an omission that the reactions which have been attributed to a poison may possibly be accounted for on the theory of formation of tomein. There is practically no counter-move for this form of attack. End of AIDS to Forensic Medicine and Toxicology by W. G. H. H. Robertson, recording by Ginny Whitfield.