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Full text of "Medical Jurisprudence And Toxicology"

608                                               MEDICAL JURISPRUDENCE

According to Frayer15 snake poison is excreted by the kidneys and
mammary glands, and probably also by the salivary glands as well as the
gastric mucous membrane. An infant died in two hours after it had sucked
its mother who had been bitten by a venomous snake. This case also serves
as an illustration that snake venom may be absorbed by the stomach of an
infant in a sufficient quantity to cause death.

POISONOUS INSECTS

Ants.—These produce pain, irritation and swelling at the seat of the bite owing to
the action of formic acid secreted by certain glands situated in the tail.

Wasps, Bees and Hornets.—These secrete a poisonous fluid containing formic acid,
when they sting. The bee venom probably contains histamine, Single stings produce
local irritation, burning pain and swelling, but multiple stings sometimes produce
symptoms very much resembling heat apoplexy. These are unconsciousness, lividity
of the face, jerky breathing, cold and clammy skin, and involuntary passage of urine
and fauces. Death may occur from shock. Dyke 1G reports two fatal cases from a Wasp-
sting. In one, a man aged 44 years, was stung by a wasp on the right temple. Soon
afterwards his face became suffused and he fell down, and died in less than twenty
minutes. Autopsy revealed a minute puncture surrounded by an area of inflammation
on the right temple. The thymus appeared to be enlarged, the pericardial sac contained
excess of clear fluid and the lungs were congested. In. the other case, a woman, about
60 years old, was stung by a wasp. Ammonia was immediately applied to the site of
the sting, but the woman became unconscious and died shortly afterwards. It must be
remembered that personal idiosyncrasy is responsible to some extent for the degree of
the severity of a bee-sting.

A case17 is also recorded in which a lady stung by a bee on the ring finger suffered
from severe symptoms. A few minutes after the sting the pulse was rapid and small,
the face and neck were swollen and cyanosed, and breathing was obstructed by a similar
swelling of the glottis and bronchioles.

Treatment.—The sting should be removed by lifting or scraping it out with the
blade of a knife or the edge of a long finger nail, and the part should then be dabbed on
with a solution of ammonia. Hot fomentations should be applied to relieve the pain of
severe stings.

The wasp-sting is alkaline in reaction, and should be treated with dilute vinegar,

Pungat is recommends the early local application of a 20 per cent solution of
powdered aloes in 60 per cent ethyl alcohol for the treatment of the stings of bees,
wasps and hornets. The pain is checked almost immediately, and the swelling cither
does not appear or is greatly reduced.

Scorpions.—These possess a hollow sting in the last joint of their tail, communicating
by means of a duct with the poisonous glands, which secrete poison on stinging. The
poison consists of (1) neurotoxin which acts on the respiratory and vaaomotor centres,
nerve terminals and endplates of both striped and unstriped muscles and (2) lisemolysins,
agglutmins, hsemorrhagins, leucocytolysin, coagulins, ferments, lecithin and cholesterin.

Symptoms.—The symptoms produced by the sting are severe local irritation and
burning pain radiating from the site. Sometimes, there may be giddiness, faintness,
muscular weakness, vomiting, diarrhoea, convulsions and mental disturbances, A girl,
about 17 years old, was stung by a scorpion on the tip of her right ring finger,, which
became dry and gangrenous.19 Rarely death may occur, especially in children and in
old and feeble persons. Sundaram2^ reports the case of a boy, 18 years old, who was
stung by a scorpion on the left index finger on March 2, 1930, and died of acute pulmo-
nary oedema on March 14, 1930. Dey also records a case in which a girl, aged 11 years,
was stung by a black scorpion on the upper part of the left nipple and on the chin and
died in a few hours.21

Treatment—Apply a ligature above the site of the sting and incise it. Wash the
wound with a weak solution of ammonia, borax or potassium permanganate or apply
5 to 10 minims of a 5 per cent solution of cocaine around the site of the wound. In cases
of shock give hypodermic injections of caffeine and atropine sulphate, and administer
subcutaneously or intravenously normal saline.

15.    Thanatophidia of India,, p. 43.

16.   Lancet, Sep. 13, 1941, Vol. II, p. 307; see also Lancet, 1872, II p. 135,

17.   F. W. L., Brit. Med. Jour., Aug. 16, 1924, p. 303.

18.   Revue Medicate de la Suisse Romande, Lausanne, March 25, 1929, p, 205: Jour.
Amer. Med. Assoc., June 1, 1929, p. 1897.

19.   Ansari, Brit. Med, Jour., Aug. 21, 1948, p. 388.

20.   Ind. Med. Gazette, Sep. 1931, p. 510.

21.   Ind. Med. Gazette, July 1^36, p. 402.