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Full text of "Medical Jurisprudence And Toxicology"

666                                               MEDICAL JURISPRUDENCE

Medico-Legal Points.-Symptoms of acute poisoning, followed by death in some
cases occSrel among workers in the factories, where high explosives were manufac-
toed duriS theFirft Great War. Accidental cases of poisoning have also occurred
™£™e of dmitrophenol for slimming purposes. Suicidal cases of poisonmg by
SStrophenol have been reported. A girl, aged 18 years took 24 capsules of this drug
with suicidal intent, but she recovered under prompt treatment."

Poisoning by dmitrophenol rarely occurs  in  India,   although  it  is  used  for  the

Fields,  fallowed  dmitrophenol mixed with water  with  the   intention  of
suicide and died in five hours.

After absorption into the system dmitrophenol is excreted in the urine.

Dinitrocresol (4 : 6-Dinitro-Ortho-Cresol).-This is commonly known *s DNOC. It
forms long, yellow crystals and melts at 86°-87°C Heated with ammonia at 180 C it
yields dinitrotolouidine. Jt produces a considerable rise in the metabolic rate and is
used under the trade name of "Dekrysil" for reducing body weight and obesity the
dose being 0.5 to 1 milligramme per kilogramme of body weight or between 50 and 100
milligrammes per day for a normal adult person It acts as a violent poison, and is
absorbed by ingestion, by inhalation of dust or by the skin. The patient must be watched
carefully, when he is advised to take this drug.

Dinitrocresol is used nowadays as a weed killer and insecticide and is applied as
a spray in aqueous solutions in varying proportions of 5 to 8 Ibs. in 100 gallons of water
per acre in the fields of cereal crops.13. It produces poisonous effects on farmers, espe-
cially when they are careless in handling the spray.

Symptoms.— Severe headache, vertigo, loss of appetite, nausea, vomiting, unusual
thirst, anxiety, restlessness, lethargy, marked sweating, fever, yellow pigmentation of the
skin and conjunctive, shortness of breath, tachycardia, loss of weight, scanty urine,
cramps, convulsions, coma or collapse and death.

Fatal Dose and Fatal Period.— The fatal dose for an adult may be regarded as 350
to 500 mlgs. of dinitrocresol.14 Death may occur after an illness of one to four days.
A case is is reported in which death occurred after an illness of sixty hours.

Treatment.— Stop the treatment if the patient is administered the drug for obesity.
Remove the farmer from environments if he is poisoned by the spray. Allow complete
rest and give barbiturates. Administer large quantities of fluids and give oxygen, if
necessary.

Post-mortem Appearances. — Marked yellow staining of the skin, mucous membrane
and hair. Haemorrhagic erosions in the mucous membrane of the stomach. The liver
is congested. The kidneys show cloudy swelling. Punctiform haemorrhages in the
brain.

Medico-Legal Points.— Dinitrocresol is a cumulative poison, as it is excreted slowly
by the kidneys. The poisonous symptoms appear after it is absorbed in the system for
many days, and are aggravated particularly in hot weather.

TRINITROTOLUENE (TROTYL), C«Ha (CH3) (NO.) «

This is a high explosive, commonly called T.N.T., and obtained by nitrating toluene,
a product of coal-tar distillation. It is a fine crystalline, yellow powder, sometimes used
by shell fillers in the form of fused yellowish-brown lumps. It melts at about 80 °C.
It is soluble in oils and greases as well as in acetone, ether, benzene and xylol It stains
the skin and hair a characteristic yellow or tawny orange colour which is not removed
by ordinary washing. It is actively toxic, and may produce poisonous ejects by absorp-
tion through, the skin, gastro -intestinal tract, or lungs. Poisoning, sometimes attended
with fatal results, occurred among workers who were engaged ia the manufacture of
this substance during the First World War and among those who handled it in filling
shells, mines and grenades.

Symptoms.— These 1& may be considered under the following heads : —•

(1) Dermatitis.    (2) Toxic Gastritis.    (3) Blood Changes.    (4)  Toxic Jaundice.

11.   Geiger, Jour. Amer. Med. Assoc., March 16, 1935, p, 915,

12.   Jour. Ind. Med. Assoc., Sep. 1953, Vol. XXII, p. 504.

13.   P. Lesley. Bidstrup and D. J. H. Payne, Brit. Wed. Jour,, July 7, 1951, p, 16,

IQ«       ;o°' Harvey> p- Lesley Bidstrup and J. A. L. Boimell, Brit Med Joun, July 7,
1951, p. 13.

^Ac ^J^^ Ml} Arch' Gewerbepath., 1939, 8, p, 441 ; Dent Z. ger, Med, De< 1938,
p. 305 ; Medico-Leg, and Criminal Rev., April 1939, Vol. VII, p» 201,
ic 16-   k^fstone-Learmonth and Cunningham, Lancet, Aug. 12, 1916, p, 261 ; Ibid,, Pec.
ID, lyio, p. 1026.