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Full text of "Medical Jurisprudence And Toxicology"

492                                              MEDICAL JURISPRUDENCE

a girl, aged ten years, in 12 hours. A dose of one hundred grammes of sodium bromide
caused death in. six days from a bilateral pneumonia of the inferior lobe,14 but about
thirty grammes of sodium or potassium bromide may produce alarming symptoms.

Treatment.—Adrninister apomorphine hypodermically or other emetics, and give
starch or albumen. Give ammonia vapour and steam for inhalation when bromine fumes
are inhaled. Adrninister by the mouth 15 grains of sodium chloride thrice a day or
physiological saline solution intravenously once a day to hasten the elimination of bromides
from the system. Inject hypodermically caffeine, sodium benzoate and strychnine to
combat respiratory failure.

Post-mortem Appearances.—When liquid bromine is administered, there is inflam-
mation of the cesophagus and stomach with dark brown stains on the mucous membrane,
which presents a leathery, parchment-like appearance. Occasionally there is perfora-
tion of the stomach, or the stomach wall is destroyed altogether.

When bromine fumes are inhaled, there is inflammation of the respiratory tract.

Chemical Analysis.—Free bromine may be separated from organic mixtures by
distillation. If combined, the mixture should be saturated with potassium bichromate
and acidulated with sulphuric acid, before it is distilled.

Tests.—Bromine can be recognized by its colour and odour, as well as by its
colouring starch paper yellow. It forms an orange or yellow coloured solution in chloro-
form or carbon bisulphide, and with phenol forms a white, crystalline precipitate due
to the formation of tribromophenol, insoluble in water. A filter paper impregnated with
a dilute solution of fluorescein and moistened with 35 per cent acetic acid, when exposed
to the vapours of bromine, will become pink. Compounds of bromine give a whitish-
yellow precipitate with silver nitrate, which is not readily soluble in ammonium hydrate,
but soluble in potassium cyanide.

Medico-Legal Points.—Poisoning by bromine, though rare, has occurred when it
was swallowed in the liquid form or when its fumes were inhaled. A case 15 is recorded
where a saturated solution of potassium bromide was administered by a man to his
wife with intention to cause harm.

During the First Great War, the Germans used certain organic compounds of bro-
mine in asphyxiating and lachrymating shells. The vapours of these substances in
concentration as little as one part in several millions of air are said to cause watering of
the eyes and inability to open them, so specifically irritating are they to the conjunctivas.
In greater concentrations they are said to cause irritation of the mucous membrane of
the respiratory tract.

Bromine and bromides are eliminated in the urine, saliva, sweat and milk. An
infant, six months old, got a painful pustular eruption due to bromine excreted in the
milk of the mother, who had been addicted to the use of a proprietary remedy, " Miles
restorative nervine", a solution of bromides in syrup.16 An infant 10 days after its
birth got cutaneous eruptions due to bromide derived from the mother's milk.17

IODINE

This is a solid, having bluish-black, soft and scaly crystals with a metallic lustre
and an unpleasant taste. At all temperatures iodine gives off a violet coloured vapour,
possessing a characteristic odour. It is only slightly soluble in water, but is freely
soluble in alcohol, ether, chloroform, glycerin, carbon bisulphide or aqueous solutions
of iodides. The following are the pharmacopoeia! preparations of iodine : —

1.    Liquor Iodi Aquosus (Aqueous solution of iodine).—It is also known as Lugol's
solution or liquor iodi cornpositus, and contains 5 per cent of iodine with 10 per cent,
of potassium iodide in water.   Dose, 5 to 15 minims.

2.   Liquor  Iodi Fortis   (Tinctura  Iodi Fortis  or Liniment  Iodine).—It  contains 10
per cent of iodine by weight and 6 per cent of potassium iodide by weight.

3.    Liquor lodi Mitis (Tinctura Iodi Mitis or Tincture of Iodine) .—It contains 2.5 per
cent of iodine and 2.5 per cent of potassium iodide.   Dose, 5 to 30 minims.

Iodine, when swallowed in the solid form, acts as a corrosive poison, while its,
vapours are strongly irritant to the respiratory passages.

Symptoms.—Acute Poisoning,—Soon after swallowing a large dose of iodine, there
is a burning pain in the mouth, oesophagus and stomach, followed by intense thirst,

14.    VHen, Quoted by Erich Leschke in his Clinical Toxicology, Eng. Transl. by Stewart
and Dorrer, 1934, pp. 95? 96.

15.    Beng. Chem. Examiner's Annual Report, 1934, p. 13.

16.    Jour. Amer. Med. Assoc., April 9, 1921, p. 1012; Amer. Jour. Z>is. Child.. 1921, Vol.
21, p. 167.

17.    Geo. T. C. Young, Brit. Med. Jour^ April 1, 1950, p. 769.