742 MEDICAL JURISPRUDENCE Fatal Dose and Fatal Period.—About a drachm of liquid carbon disulphide, when taken internally, will cause serious symptoms, and about half an ounce will prove fatal. Death may occur within a few hours or may be delayed for several days. It has been ascertained that a concentration of about 600 partis per million produces serious symp- toms if inhaled for one hour, whilst double this concentration is dangerous in thirty minutes.15 Treatment.—Wash out the stomach. Warmth, stimulants and artificial respiration. Kemove the victim at once into the fresh air and administer oxygen by inhalation, if carbon bisulphide has been inhaled. Post-mortem Appearances.—The odour of carbon disulphide on opening the body cavities. The blood is dark and fluid. Congestion and punctiform haemorrhages in the stomach. Chemical Analysis.—Carbon bisulphide may be separated from an organic mixture by distillation, and recognized by the following test:—On heating with lead acetate and caustic potash, it produces a black precipitate. Chronic Poisoning.—This form, of poisoning occurs among workmen from constant exposure to its fumes in ill-ventilated India-rubber and caoutchouc factories, and in artificial silk factories. Symptoms.—Nausea; anorexia and sometimes vomiting with abdominal pain; head- ache ; noises in the ears; insomnia; tremors ; muscular' weakness ; ataxia; tingling, numbness and burning sensation in the hands and feet (peripheral neuritis); paralysis of the extensor muscles; delirium ; mania and even dementia. Amblyopia with optic atrophy occurs in some cases. Death may occur from inanition and hepatic insufficiency* Treatment—A nutritive diet rich in vitamin content should be allowed to the patients. Vitamin B complex and liver extract should be administered. Hygienic measures should be adopted. There should be sufficient arrangements for ventilation in the factories, and the workmen should be medically examined at least every month. Post-mortem Appearances.—There may be degenerative changes in the ganglion cells of the cerebral cortex. There may also be degenerative changes in the heart and in the liver. Medico-Legal Points.—Carbon bisulphide is an industrial poison, and is absorbed from the alimentary canal, from the lungs and from the skin. Carbon bisulphide is some- times taken as a suicidal poison, when it causes symptoms of acute poisoning. Carbon bisulphide is excreted unchanged in the breath and in the urine, HYDROGEN SULPHIDE (SULPHURETTED HYDROGEN), H.S This is a colourless, transparent gas, having a somewhat sickly sweetish taste and an odour of rotten eggs. It dissolves in water, forming an acid solution, which is some- times called sulphhydriq acid. It burns in air with a pale blue flame, forming sulphur dioxide and water. Hydrogen sulphide is formed during the decomposing process of organic substances containing sulphate, and may be" formed as a bi-product in some of the sulphur industries* It is often found in large quantities in sewers, cesspools, privy vaults and tannery vats. It is also found in many chemical industries, such as artificial silk works, sulphur dye works, gas works, tar distillation works, efc. It is a highly poisonous gas, acting as a local irritant and affecting the central nervous system. It causes death from asphyxia due to paralysis of the respiratory centre. Hydrogen sulphide is not a cumulative poison. When inhaled, it passes into solu« tion in the blood, where it is rapidly oxidized by the oxygen qf the haemoglobin to harmless or relatively non-toxic substances. It does not combine with oxyhsemoglobin, but combines with methaemoglobin and changes it to sulphmethaBmoglobin, especially after death. Symptoms.—When inhaled in its pure state, this gas is almost immediately fatal, causing unconsciousness at once and stoppage of respiration after a few seconds. When diluted with air, it produces irritation of the eyes, nose, throat and air-passages, followed by dizziness, headache, nausea, vomiting, abdominal pain, cyanosis, dilated pupils, cold extremities, muscular prostration, laboured breathing, irregular pulse, tetanic convulsions, delirium, stupor, coma and death. In some cases there may be pneumonia or oedema 2f* i e -S^l m?* ?argfry diluted, it gives rise to languor and sleepiness, and proves fatal without sensibility being restored. When very largely diluted, it may sometimes produce febrile symptoms somewhat resembling typhoid fever. 15. Brit. Med. Jour., June 2, 1934, p. 998.