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Full text of "Medical Jurisprudence And Toxicology"

550                                              MEDICAL JURISPRUDENCE

full    The child vomited at once.   Gastro-enterostomy was performed, when the stomach
was found shrunken, shrivelled and its walls were like leather.-

A female 29 23 years old, drank 500 ccm. of a 30 per cent solution of zinc chloride
intended for a vaginal douche. Soon afterwards she suffered from pam on swallowmg
and also to fce stomach, and vomiting, and for many days she vomited all her food
The pharynx was red but not corroded, and the stomach was pamiul on pressure A
tube could at first be passed into the stomach, but later could not pass beyond the cardiac
opening. Three weeks later, the stomach was removed and found to be only 10 cm.
long and two fingers in breadth, and was completely occluded at the cardiac and pylonc
ends with signs of necrosis and with enormous secondary cicatncial contraction. The
patient died after three days of purulent peritonitis.

The chief symptoms after the administration of zinc phosphide are a
vacant look, frequent vomiting with retching followed by respiratory
distress at death. Zinc phosphide acts as a slow poison and is decomposed
by the hydrochloric acid in the stomach with the liberation of phosphine
which acts as a respiratory poison. Being a very fine powder zinc phosphide
adheres firmly to the crypts in the mucous membrane of the stomach, and a
very small quantity only in the stomach even after vomiting is sufficient
to cause death by slow absorption.

Fatal Dose.  The smallest fatal dose of zinc sulphate is half-an-ounce, "but
recovery has occurred after a dose of two ounces. The smallest fatal dose
of solid zinc chloride that has been recorded is six grains, but recovery has
followed a dose of two hundred grains.30

In his annual report for the year 1951, the Chemical Examiner, Madras,
has determined from experiments on dogs that about 12 grains of zinc phos-
phide would be fatal to an adult weighing about 10 stone.

Fatal Period.  Death from zinc sulphate poisoning, though rare, has
occurred in 2 hours after taking 3 ounces of zinc sulphate, and on the 5th
day after taking half an ounce.

Death occurs within a few hours from primary shock and collapse
caused by zinc chloride. In some cases the primary effects may be
recovered from and the patient may die weeks or months afterwards from
inanition or perforation.

Death occurs from zinc phosphide poisoning within 24 hours. In his
annual report for the year 1951, the Chemical Examiner, Madras1, mentions
the case of a male, aged 25 years, who died in about 33 hours after taking
zinc phosphide.

Treatment.  Emetics need not be given as zinc sulphate produces vomit-
ing. If necessary, vomiting should be promoted by giving warm water or
warm milk and by tickling the fauces. Wash out the stomach with warm
water containing sodium or potassium bicarbonate except when zinc chloride
has been taken. Give freely eggs, milk and vegetable astringents1 containing
tannin, such as strong decoctions of green tea. Treat the symptoms as they
arise. For instance, give morphine to relieve pain, and warmth and stimul-
ants to combat collapse.

Post-mortem Appearances. The usual appearances of irritant poisoning,
viz. redness, congestion and inflammation of the mucous membrane of the
throat, oesophagus, stomach, and intestine, are seen, when zinc sulphate has
been taken.

When zinc chloride has been used, the mucous membrane of the mouth,
throat, oesophagus, stomach and intestines is whitened, detached and cor-
roded. There may be iilceration and even perforation of the stomach.

LI. 2*S^^                               Berlin> 1921> 95> Nos- 5~6>  339>"

'    ges' ierichtl Med" 1932>

30.   Holland, Med. Chem. and Toxic., Ed. V, p. 357.