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Full text of "Medical Jurisprudence And Toxicology"

ggg                                              MEDICAL JURISPRUDENCE

adult, and 192 grains w contained in 2 fluid ounces of camphorated oil have caused the
death of a woman, aged 30 years. Recovery has followed much larger doses both in
children and adults.

Fatal Period.—Uncertain. Death has occurred in children in from 4 to 18 hours after
swallowing the poison.                                                                            ,.,«..

Treatment—Evacuation of the stomach, warmth to the body, cold affusions to the
head, saline purgatives, inhalations of ether or dilute ammonia, stimulants, such as digi-
talin strvchnine caffeine and sodium benzoate hypodermically and artificial respiration,
^necessary. Give a short-acting barbiturate for convulsions.

Post-mortem Appearances.—The mucous membrane of the lips and mouth may be
excoriated The mucous membrane of the stomach and intestine may be congested or
inflamed with minute submucous haemorrhages and erosion or ulceration of the
stomach. The stomach contents give off the characteristic odour of. camphor and may
show a solid piece of camphor. There may be small hemorrhages in the cortex under
the capsule in both kidneys. The meninges are generally hyperoamic. The other viscera
are congested.

Detection.-Camphor may be separated by distillation from organic fluids. The
distillate is shaken out with benzene and evaporated on a warm water-bath, when
camphor remains as a residue. The residue is then purified by several recrystallizations
from 50 per cent alcohol.

There are no chemical tests for camphor, but it can be identified by its pungent,
bitter taste, characteristic odour and spontaneous volatility. It melts at 175eC.

Medico-Legal Points.—Accidental cases of camphor poisoning have occurred from
the pharmacopoeial preparations (liniment and spirit) having been drunk in mistake for
other preparations, such as castor oil, etc. Sen"* mentions a case in which a female,
aged about 18 years, swallowed about a drachm or more of camphor in water and
suffered from poisonous symptoms. Among others the chief symptoms wore twitchings
of the ringers with tingling sensation, lock-jaw and delirium. She recovered in seven
or eight days. A female child, 6 years old, swallowed about four drachms of camphor
oil at 7-30 p.m. on September 16, 1930, and immediately she felt nausea. Her throat was
tickled to make her vomit and she brought up a little of the oil. But she became
drowsy in a short time, and was removed to the King George's Hospital, Lucknow, at
8 p.m. At the time of admission she was found in a drowsy condition with the eyes
closed. The pupils were dilated. There were muscular twitching all over the body.
The pulse was rapid and feeble, and the respirations wore slow and laboured. The
stomach was first washed out with saline and then with potassium permanganate, when
the twitchings became less. The pulse became very feeble, and I ce, pituitrin was
administered hypodermically. The pulse improved and the twitchings gradually sub-
sided. Next morning the lips were found swollen and the buccal mucosa, necrosed at
places. Magnesium sulphate" was given as a purgative, and the patient was discharged
cured after 24 hours.

A case of suicide is recorded in which a European female, 39 years old, swallowed
about 2 ounces of camphor h'niment, but recovered under prompt treatment/^ A case w*
is also reported where a man took camphor with a view to committing suicide and died
soon afterwards.

Poisonous symptoms resulting in death in some cases have followed its use as art
abortifacient.

Camphor is oxidized in the tissues to camphorol which, combining with glycuronic
acid, is mostly excreted by the kidneys and traces are excreted by the lungs,

POISONOUS FUNGI  (MUSHEOOMS)

The common varieties of poisonous fungi are Amanita muscarla and Amanita phal-
loides. Amanita muscaria is known as the fly agaric, because its docoction is used for
killing flies. ^ It grows singly in sandy soil and attains a large size* It has a hollow
stalk which is solid and bulbous at the base and has gills which are always ol a pure
white colour. The pileus varies in colour from yellow to orange and red, and is covered
by warty scales.

The fungus owes its poisonous properties to an alkaloid, mtwcarine, which is a
crystalline substance, soluble in water and alcohol, but insoluble in chloroform and ether,
It is alkaline in reaction and deliquesces in the air forming a syrupy liquid. It con-
tracts the pupils when administered internally but dilates them when applied locally,

Amanita phalloides is commonly called the deadly agaric or death cap, and is white
in colour, having an unpleasant taste and giving of! a foetid odour when old, It grows

50.   Pharm. Jour., Sep. 15, 1945, p. 126.

51.   Ind. Med. Gaz., Sep. 1917, p. 336.

52.    Ind, Med. Gaz., June 1902, p. 210.

53.   Free Press Jour., Nov. 25, 1932.