Medical Jurisprudence And Toxicology

712 MEDICAL JURISPRUDENCE

mother's milk was discontinued. Nicotine was detected in the mother's milk. Such a
result may, however, be a great rarity,

Putrefaction has no effect on nicotine, which can be detected in the body
some years after death.

A non-poisonous alkaloid resembling nicotine has been isolated from the
human body, and a ptomaine similar to nicotine has been found but is not
so poisonous.

LOBELIA INFLATA (LOBELIA, INDIAN TOBACCO)

This herb belongs to N.O. Campanulacese and grows in North America.

Lobelia nicotianse folia (Dhawal) belonging to the same natural order grows in
Southern and Western India and the mountain ranges of Ceylon. Its leaves are serrated
and hairy, and are very much like tobacco leaves.

Both these plants contain an alkaloid lobeline, and lobelic acid.

Lobeline.— This is a volatile, oily, yellow, liquid alkaloid, possessing a pungent taste
and an odour like that of tobacco. It is slightly soluble in water, but freely in ether.
It resembles nicotine very closely in action.

The non-official preparations are Lobelia (the dried flowering herb), dose, 1 to 3
grains, Tinctura lobelias cstherea (strength 1 in 5), dose, 5 to 15 minims, and Lobeline
hydrochloride, B.P.C., dose, 1/20 to 3/20 grain.

Symptoms.— Burning pain in the throat, oesophagus and stomach, vomiting, distress-
ing nausea, headache, giddiness, small, feeble and rapid pulse, pupils contracted and
insensible to light, muscular twitchings, unconsciousness, collapse, stupor, coma and
death ending the scene. Diarrhoea and dysuria are sometimes present.

Fatal Dose. — Uncertain. A drachm of the powdered leaves has caused death. One-
sixth grain of lobeline may produce poisonous symptoms.

Fatal Period.— Uncertain. Death may occur within half-an-hour or may be delayed
twenty-four to thirty-six hours.

Treatment. — Produce vomiting, if it has not already set in. Wash out the stomach.
Recumbent posture. External warmth and hypodermic stimulants, such as strychnine.

Post-mortem Appearances. — Softening and inflammation of the mucous membrane of
the stomach and intestines. Congestion of the vessels of the brain.

Chemical Analysis. — Lobeline is extracted with ether from an alkaline aqueous
solution. On evaporation of the ether, the residue gives a red colour with strong sul-
phuric acid and a violet colour with sulphomolybdic acid,

Medico-Legal Points. — The injudicious use of lobelia in medicine has given rise to
fatal accidental poisoning. It has also proved fatal when administered as an aborti-
facient.

Lobeline is excreted fcy ihe kidneys, salivary glands and skin,

PILOCARPUS MICROPHYLLUS (JABORANDI)

The leaves of Pilocarpus microphyllus and other varieties of Pilocarpus (Jabo~
randi), N.O. Rutacea, owe their toxic properties to the presence of the alkaloid, pilo-
carpine, which is a colourless, oily liquid and forms crystalline salts with acids.
Pilocarpine nitrate is a pharmacopceial preparation, the dose being 1/20 to 1/5 grain by
mouth or hypodermically.

Pilocarpine stimulates the nerve endings and produces profuse secretion of saliva
and perspiration, causes contraction of the pupils and slows the pulse rate.

Symptoms.— Flushing of the skin, salivation, lachrymation, perspiration, secretion of
mucus, contraction of the pupils, cardiac depression, thirst, nausea, vomiting, diarrhoea,
abdominal pain, difficult breathing, cyanosis, convulsions, collapse and death from para-
lysis of the respiratory centre or pulmonary oedema.

Fatal Dose and Fatal Period.— The usual fatal dose for an adult is 7* grains of pile-
carpine or its salts, although 1/6 grain of pilocarpine hydrochloride injected hypodermi-
caUy proved fatal in two cases. In one case a woman died in about 15 minutes, and in
the other case a man died in about 10 hours.11

Treatment— Empty the stomach by emetics or by washing it out with potassium
permanganate solution Inject hypodermically 1/100 grain of atropine sulphate as a
physiological antidote. Later, give stimulants.

d '071^^ Neurol°9ica> Basel> x 1949> PP. 8-21 ; Abstracts of World