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Full text of "Medical Jurisprudence And Toxicology"

486                                               MEDICAL JURISPRUDENCE

luminous in the dark, and has no taste or odour. It does not oxidize in the
air at the ordinary temperature, and is not, therefore, preserved under water.
Unlike the white variety, it is not poisonous, but the commercial red
phosphorus may be poisonous, as it sometimes contains as much as 0.6 per
cent of the white variety. It is used in the manufacture of " safety " matches
but the matches do not contain phosphorus, being tipped with a mixture of
potassium chlorate and antimony sulphide. They are ignited by being
rubbed upon the side of the containing box, which is covered with a thin layer
of red phosphorus and powdered glass.

Symptoms.—In acute poisoning the symptoms may appear in a few
minutes after swallowing a poisonous dose, but usually they are delayed
from one to six hours. The symptoms complained of by the patient are a
garlic-like taste ,in the mouth, and burning pain in the throat, gullet and
stomach followed by intense thirst, nausea, eructations and vomiting. The
ejected matter has a garlicky odour, is luminous in the dark, and is coloured
with bile, but later contains almost pure blood. The breath is also garlicky
in odour and may be luminous in the dark. Diarrhoea is not a constant
symptom but, when present, the motions are dark, offensive and sometimes
phosphorescent just like the vomited matter. In rapidly fatal cases these
symptoms become severe, collapse sets in, and the patient passes into a state
of delirium or convulsions and coma.

In most cases, however, the symptoms abate, and there is a semblance
of recovery. After a period of intermission lasting from two to six days
jaundice makes its appearance, and becomes well-marked. The pain in the
stomach increases in severity, and the abdomen becomes distended. The
liver is greatly enlarged and tender to touch, and so is the spleen. Vomiting
is much more distressing. Diarrhoea is more severe. Both the vomited
matters and motions contain blood. There are also haemorrhages from the
nose and other mucous membranes, such as the urethra, vagina and uterus.
Abortion occurs in a pregnant woman with alarming flooding. "Subcutaneous
haemorrhages or purpuric spots may be present. The urine becomes very
scanty, highly coloured and strongly acid in reaction, containing albumin,
blood, bile-pigments and tube casts, and occasionally leucin, tyrosin and
cystin. HypoglycEemia is often present.

The nervous symptoms develop; viz. frontal pains, restlessness, insom-
nia, ringing in the ears, deafness, impaired vision, formication, cramps,
tremors and paralysis. There is frequently priapism. The pulse becomes
feeble, quick and irregular. Fever sets in, and a condition of stupor or coma
supervenes ending in death. Sometimes, delirium or convulsions precede
death.

The symptoms1 of acute poisoning by organic phosphorus compounds
are giddiness, headache, anorexia, nausea, wheezing, tightness of the chest
and a sensation of pricking of the eyes accompanied by suffused conjunctivas,
f contracted pupils and difficulty in raising the upper eyelids. These are
followed later by vomting, abdominal cramps, diarrhoea, perspiration, sali-
vation, pale face, cramps in the muscles of the legs, muscular weakness,
diminished tendon reflexes, delirium, coma and death.

In poisoning by Mipafox general weakness" of almost all the voluntary
muscles of the trunk and upper extremities and complete flaccid paralysis
of the lower limbs are observed in addition to the usual symptoms of
poisoning,2

1,    Keith Simpson, Modern Trends fy Forensic Hfet&cme, 1953, pp. 310-314.

2.    Lesley Bidstrup, Bonnell arf ^Garclon Beckett, Brit Med. J<wr., May 16, 1953f
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