Medical Jurisprudence And Toxicology

638 MEDIQAL JURISPRUDENCE

Formaldeh'ydi, commercially known as formalin or formol. It is used as a disinfectant
for the fumigation of rooms, as a preservative for pathological specimens, and in the
preparation of artificial ivory, celluloid, and horn. It is also frequently used as a pre-
servative for food, especially milk.

Symptoms.—The vapour, when inhaled, irritates the eyes and air-passages and
causes painful irritation when it comes in contact with the skin. The liquid solution,
when swallowed, produces a burning pain in the mouth, throat and abdomen, nausea,
vomiting containing blood and mucus, contracted pupils, flushed face, and painful stools.
The vomited matter and stools have the strong odour of formaldehyde. There may be
suppression of urine. If urine is passed, it contains formic acid. Death may occur from
dyspncea and heart failure. In some cases the narcotic symptoms, viz. giddiness, uncon-
sciousness and stertorous breathing, are more prominent and supervene soon after the
solution is swallowed. In a case reported by Moorhead unconsciousness supervened in
three minutes after about 3 ounces of 4 per cent formaldehyde were taken,'20

March2! reports a case in which a boy, aged 7 years, drank half-an-ounce of
commercial formalin in mistake for lemonade. In about 15 minutes he was somewhat
collapsed, though quite sensible. He complained of a burning pain in his throat and
epigastrium. His pulse was rapid and weak. He had vomited once, bringing up a
quantity of clear, greenish fluid, and he was gasping for breath. He improved under the
usual treatment, and on the following day he was in his usual health, except that he
complained of slight pain in the throat, and made an uneventful recovery since then.

Fatal Dose,—Half-an-ounce of formalin may be regarded as a dangerous dose, while
one to three ounces have proved fatal. On the other hand, recovery has occurred from
a dose of four fluid ounces of formaldehyde.22

Fatal Period.—This usually varies from a few hours to one or two days. The
shortest period is 20 minutes in a case, where a man, aged 69 years, died after taking
two to three ounces of commercial formalin.23

Treatment—Wash out the stomach and administer a dilute solution of ammonia or
liquor ammonii acetatis as a direct antidote. These unite with formaldehyde, and form
a non-poisonous compound, hexamethylenetetramine, popularly known as methenamine,
urotropine or hexamine. Inject hypodermically strychnine. It may be necessary to
resort to artificial respiration.

Post-mortem Appearances.—The eyes may be red and congested. The smell of
formalin may be noticed on opening the body. The mucous membrane of the stomach
may be red, inflamed and eroded with extravasations of blood, or may be hard and
tough like leather. The duodenum may present the same appearances as those of the
stomach. The intestines are congested. The liver may show fatty degeneration. The
kidneys may present inflammatory changes. The lungs are congested or may show
patches of broncho-pneumonia. The membranes of the brain are congested,

Chemical Analysis.—Formaldehyde may be recovered by distillation. The distillate,
when treated with an ammoniacal solution of silver nitrate and gently heated, will
produce a beautiful mirror of metallic silver on the inner side of the test tube.

.If 10 drops of a 5 per cent aqueous solution of phenylhydrazine hydrochloride, 1 or
2 drops of a i per cent solution of sodium nitroprusside and 10 drops of a 10 per cent
solution of sodium hydroxide be added to 2 cc. of the distillate, a blue colour develops
in the presence of formaldehyde. The blue colour changes to green and lastly to
yellowish-red.

Medico-Legal Points.—Accidental and suicidal cases of poisoning by formaldehyde
have been reported, and a few of them have also been fatal. A case 24 is recorded in
which formaldehyde was used externally with criminal intent. A young wife of 15 years
of age was severely beaten by her husband and father-in-law, and some quantity of
about a 31 per cent solution of formaldehyde was poured over her head* The solution
caused her great pain and some hours later her hair was found to be falling off in locks
and the skin of her scalp to be peeling off.

ETHER (AETHER, SULPHURIC ETHER, ETHYLIC ETHER OR
ETHYL OXIDE), C2H5.O.C2H5

This is diethyl ether and is prepared" from ethyl alcohol by interaction
with concentrated sulphuric acid. It is a colourless, mobile liquid, having ,a

20. Brit. Med. Jour., Nov. 23, 1912, p. 1470

2L Ibid, Oct. 15, 1927, p. 687.

22. Hale, Jour. Amor. Med. Assac., Feb. 12, 1922, p. 452

23. Levison, Jour, Amer. Med. Assoc., 1904, Vol. XLIL p 1492

24. Madras Ghem. Examiner's Annual Rep., 1931, p. -4 , '