Medical Jurisprudence And Toxicology

TETRACHLORETHANE 647

Post-mortem Appearances.—Acute yellow atrophy of the liver is often seen in death
from inhalation of the vapours. There may also be fatty degenerative changes in the
kidneys.

Medico-Legal Points.—Tetrachlorethane is a powerful poison and causes acute and
chronic poisoning. Acute poisoning occurs from swallowing large quantities of liquid
tetrachlorethane, which has a narcotic action. Chronic poisoning is caused by the
inhalation of the vapours of tetrachlorethane and occurs mostly among workers in fac-
tories, where it is used. In this type of poisoning, tetrachlorethane acts chiefly on the
liver causing death from necrosis of the liver.

Acute poisoning by tetrachlorethane is generally suicidal and rarely accidental.
This drug is not known to have been used as a homicidal poison.

Gilbert Forbes41 records the case of a labourer, aged 33 years, who died about six
hours after drinking the liquid. Keish Mant 42 also reports two suicidal cases of acute
poisoning by this drug. In one case a gardener, 57 years old, died rapidly within a few
hours after the ingestion of a large quantity of tetrachlorethane taken on an empty
stomach. In the second case a carpenter, 20 years old, died in about fifteen hours after
he had ingested about 1 to 2 ounces of the poison.

Trichlorethylene (Chlorylen or Trilene), CJICla.—This is a colourless, volatile liquid,
having a pleasant, sweetish odour and boiling at 87 °C. It is used as a solvent for fat,
tar, rubber and in the extraction of oils and fats, degreasing metals, painting, enamelling,
dry cleaning, and cleaning photographic plates. It is used as a general ansesthetic, and
is also employed in the treatment of trigeminal neuralgia and migraine in doses of 10 to
20 minims to be inhaled from cotton wool.

Locally applied, trichlorethylene causes blisters of the skin after an interval of
about twenty-four hours. Prolonged exposure to the fumes has an acute narcotic effect,
and causes headache, giddiness, confusion, fainting, jaundice, paralysis of the sensory
fibres of the fifth nerve, retrobulbar neuritis, optic atrophy, cardialgia, albuminuria, coma
and death.

The treatment consists in the administration of oxygen and 5 to 7 per cent of carbon
dioxide by inhalation. Oxygen may also be administered if pulmonary cedema is present.

The post-mortem appearances are congestion of the liver and fatty degenerative
changes in the kidneys with haemorrhages. There may be congestion and acute cedema
of the lungs with subpleural petechial haemorrhages. The brain and its membranes are
congested.

Trichlorethylene is likely to give rise to addiction, and may sometimes induce a
state of drunkenness with complete loss of control. A man, 26 years old, had been
addicted to the drug by soaking his handkerchief in it and sniffing it regularly. One
night he murdered his mother to whom, he was devoted very much. The prosecution,
finding no evidence of motive, accepted the accused's plea of not guilty of murder but
guilty of manslaughter. He was sentenced to five years' imprisonment.43

The drug is likely to be decomposed into dichloracetylene, a toxic product, which
can probably cause nerve palsies, when mixed with soda lime.

Jensenius44 reports the case of a widow, 72 years old, who took 15 cc. of trichlo-
rethylene in mistake for castor oil. She spat a little of the trichlorethylene, but most
of it was retained. She drank two glasses of milk, but ate nothing. A few hours later,
she became giddy, with cardialgia, drowsiness and coma. The temperature was sub-
normal, with pulse 92 per minute, rigidity of the muscles of the extremities and increased
tendon reflexes. She became conscious, but paraesthesia of the limbs set in, which
gradually passed off.

D.D.T. OR DICOPHANE [DICHLORO-DIPHENYL-TRICHLOROBTHANE,
l-TRICHLORO-2, 2-BIS (P-CHLOROPHENYL) ETHANE, P, P-D. D. T.]

Pure D.D.T. is a white, crystalline, solid substance, insoluble in water, but soluble
in hot alcohol, ethyl acetate, chloroform, benzene, kerosene and many other organic
solvents. It is used for destroying flies, mosquitoes, lice, fleas, bed-bugs, etc. A 5 per
cent solution of this substance in kerosene oil is used as a spray for destroying bed-
bugs and lice. A 2 per cent solution may act as a poison to human beings and its solu-
tion in fatty acids is stated to increase its toxicity.

D.D.T. is taken accidentally and suicidally. When swallowed, an oily solution of
D.D.T, acts locally as an irritant and remotely as a nerve poison. In pure solid form

41. Brit. Med. Journal, March 20, 1943, p. 348.

42. Brit. Med. Journal, March 21, 1953, p. 655.

43. Lancet, Dec. 24, 1949, p. 1205.

44. Med.-Leg. and Crim. Rev., Vol. VII, Part II, 1938, p. 202; vide also Stephens, Brit.
Med. Jour., Aug. 18, 1945, p. 218.