Medical Jurisprudence And Toxicology

(594 MEDICAL JURISPRUDENCE

ernment forbids the possession of cocaine without a licence. When, owing

to the First Great War, supplies of smuggled cocaine became difficult to

procure, aneesthesin (ethylester of para-amino-benzoic acid), a synthetic

preparation of cocaine, was used instead. A solution of it was applied to

, the glans penis before intercourse. It is possible that a 5 per cent solution

\ of this drug, thus used, might be found of benefit in cases m which, owing

to excessive excitability, the sexual act cannot be properly performed.

Prostitutes sometimes inject a solution of cocaine into the vagina, by
means of a douche can. This gives the individual a sense of local con-
' striction and the general systemic effects appear immediately.46

In England, some persons are accustomed to use cocaine hypodermlcally.
In Paris certain classes of people use it in the form of snuff, and addicts use
large quantities—about a drachm a day on an average. The snuff produces
irritation of the nasal mucous membrane. The irritation causes inflammation
and ulceration which may occasionally lead to perforation of the nasal
septum.

Cocaine is rarely smoked with the cigarette or pipe tobacco. During
the smoking one observes, "a euphoric mood, and an agreeable feeling of
lightness and coolness in the head." 4T

A very small portion of cocaine is eliminated in the urine. It is largely
decomposed in the human system; hence it is difficult to be detected in the
viscera.

ARTEMISIA MARITIMA (WORM-WOOD, KIRMANI OWA)

This plant belonging to N.O. Compositse grows on the coasts of England, and yields
an active principle, santonin, chiefly from santonica or wormseed, the dried unoxpanded
flower heads. The other varieties, Artemisia brevifolia and Artemisia vulgaris, grow in
Kashmir and the hilly tracts of Uttar Pradesh.

Santonin is a glycoside and occurs as flat, glittering, prismatic crystals. It is either
tasteless or faintly bitter. It is colourless, but becomes yellow on exposure to sunlight,
It is slightly soluble in water, more soluble in hot water and is easily soluble in alcohol,
•chloroform, ether and alkalies. It is chiefly used as an anthelmintic lor intestinal round-
worms, the dose being 1 to 3 grains.

Symptoms.—Headache, giddiness, singing in the ears, pain in the stomach, nausea,
vomiting, yellow vision (xanthopsia), dilated pupils, cold skin bathed in perspiration,
feeble and slow pulse and respirations, convulsions, delirium, stupor, coma, and death
ending the scene from failure of the heart or respiration. The urine is usually increased
in quantity, and it is saffron-yellow in colour. Sometimes, strangury and hsematuria
are observed owing to irritation of the kidneys.

Fatal Dose and Fatal Period.—Two grains of santonin administered twice killed a
child, five-and-a-half years old, in twelve hours. In his annual report for the year 1924,
the Chemical Analyser, Bombay, records a case in which a girl, 4 years old, died in
about^48 hours after she was given 2\ grains of santonin. A Hindu girl, aged 16 years,
died in about an hour after taking an overdose of some " worm powder" containing
santonin.4* Recovery has taken place in the case of a child after ten grains and in the
case of an adult after an ounce taken in mistake for Epsom salts,

Treatment—Give emetics or wash out the stomach and give calomel as a purgative.
Give demulcent drinks, but avoid oils and fats. Administer stimulants to combat
collapse and potassium bromide and chloral hydrate to control convulsions. Intra-
venous short-acting barbiturate is also useful.

Post-mortem Appearances.—Not characteristic. There may be signs of gastro-
intestinal and kidney irritation.

Chemical Analysis.—Santonin may be separated from an acid aqueous solution by
shaking out with chloroform, and is identified by the following test: —

A little dilute sulphuric acid is added to some santonin, and gently heated until a
yellow colour is produced; when cold, a few drops of a very .dilute solution of ferric
chloride are added, and on again warming a blue or reddish-violet colour develops,

i£* S*-1!" P101?? ^ G* S* ch°Pra» Indian Jour, of Med. Research, Jan. 1931, p. 1013.

47. toch -Lescnke din. Toxic., Eng. Transl. by Stewart and Dorrer, 1934, p, 208.

48. Bom. Chem. Analyser's Annual Rep., 1935, p, 5.