g§8 - MEDICAL JURISPRUDENCE The resinous constituents of cannabis sativa are excreted by the kidneys, and it is, therefore, necessary to preserve urine for chemical analysis in a suspected case of poisoning by this drug. Mescal Buttons (Peyote).— These are the flowering tops of a cactus plant, Anhalonium Lewinii, growing in the deserts of Central America. They yield four alkaloids, of which mescaline is the most important. A decoction is made of mescal buttons and is used by addicts as an intoxicating drink like cannabis sativa. The symptoms are dilated pupils and prolonged visual hallucinations of various designs and colours, accompanied by confusion of thought and disorientation, particularly as to time. Three grains (0.2 gramme) of mescaline sulphate produces intoxication in about 25 minutes.01 The after-effects are insomnia, vertigo and headache. Large doses produce poisonous symptoms, the chief being nausea, vomiting, diarrhoea with bloody stools, shallow breathing and death from respiratory failure. Treatment — Empty the stomach and treat the symptoms as they arise. COCAINE (METHYL-BENZOYL-ECGONINE) , CnH^OiN -0 Cocaine is an alkaloid derived from the leaves of Erythroxylum Coca and its varieties (N.O. Lonacese) , growing in South America, but now culti- vated in the tea districts of India, Ceylon and Java. Cocaine is a colourless, odourless, crystalline substance and has a bitter taste, causing numbness of the tongue and mucous membrane of the mouth. It is soluble with great difficulty in water, but dissolves readily in alcohol, ether, chloroform and benzene, the solution being alkaline. It is a pharma- copoeia! preparation, known as Cocaina, the non-official dose being -J to J grain. The B.P.C. ointment, unguentum cocaines,, contains 4 per cent of cocaine. In the form of cocaine hydrochloride it is largely used as a local anaesthetic in ophthalmic practice, and in dental and minor operative surgery. Cocaine hydrochloride exists in colourless, acicular crystals. It is soluble in water, chloroform and glycerin. Its solution is neutral and decomposes in a short time, but keeps better if mixed with half a per cent solution of boric acid. The official dose is J to \ grain. Cocaine hydrochloride is contained in the official preparations of Oculen- turn cocaines (0.25 per cent), Lamelice cocaines (1/50 grain in each disc), Trochiscus kramerice et cocaince (each containing 1/20 grain) , and Supposi- toria cocaines (each containing \ grain) . Acute Poisoning.— This is marked by excitement with delirium of a noisy character, followed by depression, as cocaine, when absorbed into the blood, first stimulates and then paralyses the nerve centres of the brain and spinal cord. Symptoms, — In the begimiing there is excitement, restlessness, talkative- ness and the reflexes are increased. Temperature may suddenly rise with a rigor. Dryness of the mouth and throat ; dysphagia ; feeling of tingling and numbness in the tongue, hands and feet ; nausea but rarely vomiting ; cramps in the stomach ; headache ; giddiness ; f aintness ; marked cyanosis ; dilated pupils ; quick, irregular and imperceptible pulse ; shallow, gasping and con- vulsive respirations; profuse perspiration chiefly on the forehead; convulsions; paralysis. Death occurs from respiratory paralysis or from heart failure. Delirium and hallucinations may occur. nf pAfi6 °T^d*S -* ^ George's Hospital, Lucknow, where a young student of 20 years suffered from symptoms of acute poisoning within an hour after his nose 31. Macdonald Critchley, Brit JkTed. Jour., Vol. II, Oct. 25, 1930, p. 690.