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.