Medical Jurisprudence And Toxicology

464 MEDICAL JURISPRUDENCE

Medico-Legal Points.— Hydrochloric acid is chiefly used for preparing
chlorine, for dissolving metals and for medicinal purposes. It has been
sometimes used for erasing writing in attempts at forgery. Accidental and
suicidal cases of poisoning by this acid have occurred in Great Britain as
also in India. A case13 occurred in Bombay where a Parsi lady, aged 22
years, died as a result of having accidentally swallowed a quantity of hydro-
chloric acid, mistaking it for a dose of some medicine prescribed for a cold.

Homicidal cases are very rare indeed. Hydrochloric acid was intro-
duced into the vagina of a pregnant girl with a view to procuring abortion
but without success. Atresia vaginae was, however, produced to such an
extent that it was necessary to perforate the child at term.14

Hydrochloric acid was thrown in the face of a young Parsi. As a result
of this criminal assault he suffered from fulminating conjunctivitis of both
eyes. Hydrochloric acid was detected on the coat of the victim and in the
glass which was used.15 A bottle of hydrochloric acid was also thrown on
the Head Ticket Inspector at Victoria Terminus, Bombay, while he was
standing near the Crawford Market. As a result of this he received
grievous burns.10

HYDROFLUORIC ACID, HF

This is colourless gas, which becomes a fuming liquid when dissolved in water.
On account of its etching property on glass it is kept in gutta-percha bottles.

Acute Poisoning— Symptoms.— The fumes of the gas, when inhaled, produce inflam-
mation and ulceration of the conjunctivas, nostrils and gums, and severe cough due to
laryngitis and bronchitis. There may be intense vomiting and collapse.

The liquid acid produces on the skin severe and painful burns and ulcers which are
difficult to heal. When taken internally, it immediately produces retching, vomiting,
agonizing pain in the abdomen, and diarrhoea. Collapse sets in and death occurs usually
from closure of the glottis with shreds of mucous membrane.

Sodium fluoride and sodium silico-fluoride are white, crystalline powders, and are
used as wood preservatives and as insecticides. They are the constituents of most cock-
roach powders. They are also used for the etching of glass. They are general proto-
plasmic poisons and exert a strong and local irritant action on the mucous membranes.

The symptoms of poisoning by either of these salts are pain in the stomach, nausea,
vomiting, diarrhoea, muscular cramps, spasmodic contraction of the extremities and
tetany, cyanosis, dilated pupils, collapse and death from cardiac or respiratory failure.

Fatal Dose. — The fatal dose of commercial hydrofluoric acid is about 4 drachms,
though 2 drachms have caused death. The minimum fatal dose of sodium fluoride for an
adult is one drachm, but recovery has followed a dose of 50 to SO grammes of sodium
fluoride.17 Half a teaspoonful of silico-fluoride has proved fatal.18

Fatal Feriod. — The fatal period in poisoning by hydrofluoric acid is usually from a
few minutes to two hours. The fatal period in poisoning by sodium fluoride and silico-
fluoride varies from half an hour to several hours. A woman, 39 years old, took a
heaping tablespoonful of sodium fluoride in water in mistake for magnesium sulphate,
and died in seven hours.19

Treatment — Ammonia vapour is the antidote, when the fumes are inhaled. Weak
alkalies should be administered to neutralize the liquid acid, when taken internally.
Milk and demulcent drinks should be administered and castor oil should be given as
a purgative. When sodium fluoride or sodium silico-fluoride is taken, the stomach
should be washed out with liine water or a weak solution of calcium chloride and a
soluble calcium salt should be given intravenously. Oxygen and carbon dioxide should
be given for inhalation. Respiratory stimulants, such as camphor in oil and coramine,
should also be administered.

13. Times of India, Jan. 17, 1930. ;— "'

14 JJirbt. u. d, Fortschr. de Geb., 1893, 858 ; Wttthaus, Med. Jura, and Toxic., Vol. IV,
p. 279.

15. Bombay Chem. Analyser's Annual Report, 1931.

16. Times of India, Jan. 30, 1937; see also Bombay Chem. Analyser's Annual Report,

17. J. H. Peters, Amer. Jour. Med. Set., Sep. 1948, p. 278.

18L Luhrig. Chem. Zettsch*, Sep., 2£, 1925, p. 805.

19. Sharkey and Simpson, Jour. Amer. Med. Assoc., Jan. 14 1933» p. 97;