BARIUM 565 A family in Hisar District ate chapatis made with atta (wheat flour) mixed with pills of barium carbonate used for destroying rats. Soon afterwards all of them began to vomit and purge, exhibiting the symptoms of an irritant poison.76 Morton77 describes two outbreaks of food poisoning affecting 85 British soldiers of the Persian Iraq Com- mand. The poisoning was caused by barium carbonate contaminating by mistake the flour used in preparing marmalade tart and treacle tart. All of them suffered from symptoms of gastro-enteritis with tingling of the face and neck followed by loss of tendon reflexes, disordered action of the heart and muscle paralysis. Recovery was rapid and there was no death. Dean78 reports seven cases of accidental poisoning by barium carbonate dispensed in mistake for barium sulphate used in preparing barium meals for X-ray examinations. Of these one person who had swallowed 1.7 oz. of barium carbonate died. It is there- fore suggested that barium carbonate be coloured with a distinctive hue to avoid it being mistaken for barium sulphate. An accidental fatal case79 of poisoning by barium sulphide occurred under tragic circumstances in the Sassoon Hospital at Poona on April 3, 1923. His Highness the Rajasahib of Akalkot had some stomach trouble and went to the hospital by appoint- ment to consult the X-ray specialist. It was arranged to X-ray the stomach and in order to note the process of food digestion a meal of barium sulphate mixed with porridge had to be given. There being no barium sulphate in the hospital, an order for the drug was sent to the Poona Drug Stores which unfortunately supplied barium sulphide instead of barium sulphate. About two tablespoonfuls of this were mixed up with a bowlful of porridge and about two or three mouthfuls of the mixture of barium sulphide were taken which probably contained about a teaspoonful of the salt. The Raja could not take any more on account of the offensive odour of the mixture and started vomiting immediately afterwards. He then complained of a burning pain at the pit of the stomach. In spite of prompt treatment the patient collapsed and died within two hours after having taken the drug. There was no post-mortem examination. The chemist who dis- pensed the drug and the X-ray specialist who administered it were both convicted by the Assistant Collector for causing death by a rash and negligent act. A Hindu male,so aged 55 years, took about 1J drachms of a depilatory powder con- taining 1 part of barium sulphide and 8 parts washing earth or botni mitti in mistake for a laxative powder at 4 a.m. on April 14, 1929. Vomiting commenced soon afterwards and was persistent; he had 3 motions in the course of the next four hours. At 10 a.m. he noticed difficulty in lifting the arms and extending the legs and could not close the fist • tightly. At 5 p.m. his tongue was found coated and dry, and the pulse slow, full and intermittent. The heart sounds were booming, the second aortic sound being markedly accentuated and intermittent with a beat missing after every five or six beats. There was paresis of the arms and legs, and the grip was very weak. The deep reflexes were absent. There was no sensory disturbance. The brain was absolutely clear. He was given one drachm of magnesium sulphate in solution every two hours, and he recovered after he had taken altogether six doses. He had 5 thin watery motions in the night. A Mahomedan woman, aged 25 years, took a quantity of a depilatory powder con- taining barium sulphide with intent to commit suicide at 7 p.m. on the 18th July 1931. Soon afterwards she had vomiting which contained blood and emitted the odour of hydrogen sulphide. She could not swallow anything, as there was excoriation of the throat. She was at once removed in a collapsed condition to the King George's Hospital, Lucknow, where she died at 10-40 p.m. In his annual report for the year 1941 the Chemical Examiner, Bengal reports a case in which a Hindu woman (colliery employee), aged about 40 years, committed suicide by taking barium sulphide. Barium is eliminated chiefly in the faeces, though slightly in the urine. SODIUM Sodium Chloride (Common Salt or Table Salt), NaCl.—This is called Named* in the vernacular. It occurs in colourless, cubical crystals or in a small, white, crystalline powder, and is largely used in the alkali industry. It is a necessary article of food for men and other animals. It is soluble in 3 parts of cold water. It occurs in official prepa- rations of Injectio sodii chloridi or Liquor sodii chloridi physiologicus (Physiological or normal saline solution) and Injectio sodii chloridi composite, (Ringer's solution for injection). Symptoms.—In large doses it causes irritant symptoms, followed by paralysis. Fatal Dose.—Half a pound. 76. Punjab Chemical Examiner's Annual Report, 1928, p. 9. 77. Lancet, 1945, Vol. II, p. 738. 78. Brit. Med. J., Oct. 7, 1950, Vol. II, p. 817. 79. Med.-Leq. Jour., July and August 1923, Vol. XI, p. 106. 80. Bhupal Sing, Ind. Med. Gazette, Sep. 1929, p. 506.