Medical Jurisprudence And Toxicology

g90 MEDICAL JURISPRUDENCE

foodstuffs with no particular smell. The pupils were slightly dilated and the internal
organs were congested. Cocaine in marked quantity was detected in the visceral*

Synthetic substitutes such as alypin, apothesin, beta-eucaine, butyn,
novocaine, orthocaine, pantocaine, percaine, stovaine, tutocame, etc. are
frequently used in surgical practice as local or spinal anaesthetics, and have
produced poisonous symptoms followed sometimes by fatal results. Recently
two accidental cases 39 of poisoning by percaine occurred in Bombay. In one
case a Mahomedan boy, aged 8 years, who was given about 5 grains of
percaine in mistake for calcium lactate as a pre-operative treatment before
removal of tonsils, developed convulsions within two minutes. These were
followed by dilated pupils and cyanosis, and death occurred within a few
hours. In the other case of a Mahomedan boy, aged 12 years, was inadver-
tently given a similar dose of percaine, but he recovered under treatment,

Novocaine is largely added to cocaine as an adulterant or is used as a
substitute for the same. Addicts have to consume a large quantity of novo-
caine and suffer from its poisonous effects, as it does not produce the same
effects as their usual dose of cocaine. A case occurred in Patna, where a
Hindu male, aged about 30, who happened to be a cocaine eater, took a large
quantity of novocaine which was sold to him as cocaine, became unconscious
in half an hour and died in about four hours.40

Besides novocaine, boric acid, carbonate and bicarbonate of soda, lime,
chalk, aspirin, antifebrin, antipyrin, and starch are also used as adulterants
of cocaine,

Chronic Poisoning (Cog^nx&m). — This occurs among those who have
been accustomed to its use either by internal administration or by subcuta-
neous injection.

Symptoms. — Pale face ; sunken eyes ; insomnia ; digestive derangements ;
dilated pupils ; wasting ; emaciation ; tremors ; rapid pulse ; impotence ;
defective memory ; physical and moral degeneration ; derangement of the
special senses ; visual and other hallucinations ; melancholia and mania with
delusions of persecution.

The characteristic symptom, known as Magi^B's^jssanptom, and com-
plained of by the patient, is a feeling as if grains of sand were lying under
the skin, or some small insects (cocaine bugs) were creeping on the skin,
giving rise to itching sensation. The tongue and teeth of the habitual cocaine
eater in India are jet black, probably due to the chemical change brought
about by lime and saliva acting upon cocaine.41

H. Hartmann42 reports that hojmosŁŁuality is often seen among cocaine
addicts, and cites several cases of men and women who got into this habit
after they took to cocaine and the perversion disappeared after the drug was
stopped.

Treatment.— This consists in the gradual withdrawal of the drug from
cocaine addicts and in the treatment of gastric derangements, etc, with
appropriate remedies.

Detection.—!. Physiological Test.— Cocaine produces numbness and
local anaesthesia at the point of application. The condition lasts for about
half-an-hour.

38. Bengal Chem. Exam. Anual Rep. ; Ind. Med. Gaz., Aug. 1915, p. 304.

^* SS2f 'r^T*^11 datf 26*\ 2ct 1946 ^ ^e Chemical Analyser, Bombay.

40. Bengal Chem. Examiner's Annual Rep., 1936. p. 13.

41. K. C. Base, Ind. Med. Gaz,, March imt p. 85.

BerHn> Feb' 27' 1928> * »! J°ur.