680 MEDICAL JURISPRUDENCE 3. Lamelloe Atropiuce. Each disc contains 1/5,000 grain of atropine sulphate. 4. Oculentum Atropince. It contains 0.25 per cent of atropine sulphate. 5. Oculentum AtropTiince cum Hydrargyri Oxido.-lt contains 0.125 per cent of atropine sulphate and 1 per cent of yellow mercuric oxide. 6 Tabellce Atropinos Sulphatis.Dose, 1/240 to 1/60 grain. If the quantity is not mentioned, each tablet must contain at least 1/100 grain of atropine sulphate. Symptoms. These closely resemble those of poisoning by datura. Diagnosis. In doubtful cases of belladonna alkaloid poisoning 10 to 30 mgm. of methacholine chloride subcutaneously injected confirms the diag- nosis if the characteristic flush, sweating, lacrimation, rhinorrhea, saliva- tion and enhanced peristalsis does not appear. This diagnostic application of the parasympathomimetic actions of methacholine has been suggested by Dameshek and Feinsilver.9 Fatal Dose. This is variable. A decoction of 80 grains of belladonna root used as an enema caused the death of an adult woman. Three berries proved fatal to a child, 9 months old, and 14 berries caused the death of an old man. On the other hand, recovery has occurred after eating 50 berries. A teaspoonful of belladonna liniment, a drachm of the tincture and the same quantity of the extract have respectively caused death. Recoveries have, however, followed the ingestion of larger doses of these pharmacopoeial pre- parations. I saw a case where a man recovered under the treatment of prostigmrn after he had taken by mistake one and a half ounces of the tincture of belladonna. One and a half to two grains of atropine taken ; internally may be considered a fatal dose, although half a grain of atropine has proved fatal, but recoveries have taken place after the administration of much larger doses, even as much as 7.5 grains of atropine sulphate.10 One-twentieth grain of atropine injected hypodermically has killed an adult. Three grains of an ointment containing 1.6 mg. of atropine applied to the eyes twice a day for two consecutive days killed a boy, aged 2 years and 9 months, on the third day.11 An ointment containing three grains of atro- pine applied to the abraded skin has caused death.12 Fatal Period. In rapidly fatal cases death occurs in 3 to 6 hours. Usually death occurs within 24 hours, although it may be delayed for days. Treatment. The same as for datura poisoning. Post-mortem Appearances. Berries, seeds or fragments of leaves may be found in the alimentary canaL The other appearances are similar to those found in poisoning by datura. Chemical Analysis. Atropine may be extracted by the Stas-Otto process from organic mixtures, which are slightly acidified by tartaric acid or ren- dered alkaline by a small quantity of sodium carbonate. Atropine is very prone to undergo hydrolysis. The extraction should, therefore, be conducted at a low temperature to prevent this action. Chloroform is the best solvent for the final extraction of atropine. Tests. 1. Vitati's Test. The extracted residue is treated with a few drops of fuming nitric acid, heated to boiling, and evaporated to dryness on a water bath. After cooling, the residue is moistened with a few drops of freshly prepared alcoholic potassium hydroxide solution, when a violet colour is produced which soon changes to red and finally disappears. The colour 9nQU(2£? bry ^°Fdl^an ^Oilman in The Pharmacological basis of therapeutics, Ed. II, p. 473 ; Jour, of Am. Med. Assoc., 1937, pp. 561-64. 10. Comroe, Jour. Amer. Med. Assoc., Aug. 5, 1933, p 446 1L Morton, J., Pediatrics, 14, 1939, p. 755; W. E. Heath, Brit Med. Jour., Sep. 9, 1950, p. oUo» 12. Glaister, Med. Juris, and Toxic., Ed. IX, p. 651.