Medical Jurisprudence And Toxicology

668 MEDICAL JURISPRUDENCE

TabeZfce glycerylis trinitratis is an official preparation, each tablet containing 1/130
grain of ntooglycerin. A non-official preparation of Liquor glycerylis tnmtratis is a 1
per cent alcoholic solution of nitroglycerin, the dose being £ to 2 minims.

The vapours of nitroglycerin are highly poisonous. f _

Symptoms.-A burning sensation in the throat, nausea, vomiting colicky pain m
the abdomen, sometimes diarrhoea, painful throbbing of the arteries all over the body
severe headache, giddiness, flushing of the face and skin, perspiration, oppression m the
heart, hurried ar,d difficult breathing, marked cyanosis complete paralysis and uncon-
sciousness. Death occurs from respiratory paralysis. Muscular twitchmgs and delirium
may sometimes be observed.

Fatal Dose.—This is uncertain. A few drops of the undiluted drug would probably
cause death.

Fatal Period.—Death may occur from two to six hours.

Treatment.—Emetics or stomach tube; the patient to be kept lying down ; ergotin,
adrenaline chloride or atropine hypodermically; cold water or ice to the head and
black coffee to relieve headache. Fresh air and artificial respiration in poisoning by
vapour inhalation.

Post-mortem Appearances.—Ecchymosis and congestion in the stomach and intes-
tines. The lungs are cedematous, and the other organs are congested. The blood may
be of a chocolate colour due to the formation of methsemoglobin.

Chemical Analysis.—Nitroglycerin may be isolated by ^digesting the suspected organic
material with methyl alcohol for about twenty-four hours. The mixture is filtered and
the filtrate is evaporated to a thick syrupy consistence, and extracted with ether or chloro-
form. On evaporating the solvent, the residue will contain nitroglycerin, after it is
extracted with cold alcohol.

Tests.—1. When treated with aniline and a drop of strong sulphuric acid, nitro-
glycerin produces a red colour. The same reaction is obtained when treated with
brucine and strong sulphuric acid.

2. Nitroglycerin explodes violently when struck with a hammer,
Medico-Legal Points.—Accidental poisoning "may result from an overdose of nitro-
glycerin administered as a remedy for angina pectoris, cardiac dyspnoea, etc. but most
of the cases of poisoning occur especially among new workmen engaged in the manu-
facture of nitroglycerin, dynamite "or other high explosives. After a few days of constant
exposure the workmen acquire an immunity, which is lessened by alcoholic indulgence,
It must be remembered that the combination of nitroglycerin and alcohol produces a
violent and serious form of intoxication and such intoxication may occur in a person
who can usually tolerate large quantities of alcohol without ill-effect. A case1J) is
recorded in which a man who had worked all day with explosives developed a headache
and took a very little whisky. Within a few hours he developed an acute homicidal
mania, shooting and wounding one man and killing another.

Cases of homicide have been described, nitroglycerin having been administered in
alcoholic drinks.

Nitroglycerin is absorbed from the skin and produces ulcers on the fingers of the
workers who handle the drug during its manufacture.

Nitroglycerin. has been used by malingerers to stimulate heart disease.
/ ^ ^ Nitroglycerin is absorbed unchanged from the stomach and, on reaching the blood,
it is rapidly decomposed; hence the vomit or stomach contents are the most important
for chemical analysis in a suspected case of poisoning by this compound.

PETROLEUM (ROCK OIL) 0

This is an oily liqmd found under the ground in several parts of the earth, and
consists of a mixture of hydrocarbons of the paraffin series. This crude oil contains
^arnmable and ^plosive products, which are removed by distillation and purification
™%Jf render it fit for household use. The refined oil is called kerosene, During the
££™ ™™ v^°n SeT^ other P^ucts ^ separated which cannot be used in
lamps. Those which are lighter and boil at a lower temperature than kerosene are
known as gasoline petrol, naphtha, benzene, etc. From the heavier portions or those
paraffin £e made temperatures *»* kerosene the lubricating oils, vwelSe, and

Symptoms.—The symptoms produced by inhaling the fumes are dizziness headache

19. I. M. Rabinowitch, Canad. Med. Assoc. Jour., March 1944 Vol «tt r, IQQ .
Leg. and Criminal. Rev., Vol. Xn, Part in, 1944, p 167 ' P' '