A manual of legal medicine : for the use of practitioners and students of medicine and law / by Justin Herold.

Date:
1902
Catalogue details

Licence: In copyright

Credit: A manual of legal medicine : for the use of practitioners and students of medicine and law / by Justin Herold. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    (Among the different classes of corrosives are the mineral acids, the caustic alkalies, their carbonates, and corrosive sublimate. Carbolic acid, strong solutions of oxalic acid, etc., belong to the organic class of cor- rosives.) The irritant poisons cause burning and constriction in the oesophagus and throat, pain in the stomach and intestines, nausea, vomiting, thirst, purging, bloody stools, dysuria, and an irregular and feeble pulse. (Irritants may be of two kinds,—viz., local irritation, such as is produced by the principal vegetable irritants, the less active metallic poisons, and irri- tant gases, and specific remote effects, such as are the result of poisoning by arsenic, antimony, lead, copper, cantharides, etc.) Poisons which act on the brain are divided into three classes,—viz., the opium group, producing sleep ; the belladonna group, producing illusions and delirium ; and the alcohol group, producing exhilaration, followed by sleep or delirium. The symptoms arising from the first, or opium group, are giddiness, headache, tinnitus aurium, dimness of vision, contraction of the pupils, con- fusion of the intellect, and drowsiness, merging into insensibility. Breathing is stertorous, and the skin is cold and clammy. The second, or belladoyina groiip, causes dilatation of the pupil, spectral illusions, thirst, dryness of the throat and mouth, and delirium. There may be paralysis and tetanoid convulsions. The third, or alcohol group, exhibits the loss of power of co-ordination and of muscular movement, excitement of the cerebral functions and of the circulatory apparatus, diplopia, profound sleep, and deep coma. Delirium tremens is characteristic of the chronic form of alcohoHsm. Of the poisons acting on the spinal cord (strychnine, brucine, etc.), the leading symptom is the tetanic spasm, which lasts from one to five minutes, with intervals of perfect relaxation. Other poisons than strychnine, etc., may produce tetanic convulsions, and it is well to recollect this, although the diagnosis is usually not very obscure nor difficult, as the tetanus in this instance will be generally complicated with other symptoms, whereas in strychnine-poisoning the one great and prominent sign is the tetanic spasm. Poisons affecting the heart, among which are oxalic acid and the oxalates, digitalis, aconite, prussic acid, and tobacco, cause death by sudden shock, syncope, or collapse. Those acting on the lungs, such as carbonic acid gas, etc., produce asphyxiation. Poisoning is frequently feigned, and at other times imputed. A poison- ous draught is sometimes substituted for a harmless medicine. Diseases simulating Poisoning.—The differential diagnosis between strychnine-poisoning tetanus and that arising idiopathically is as follows : In the tetanus of the former the development of the symptoms is accomplished in a few minutes; the trismus may be ab.sent, or it is imperfect. The opis- thotonos is very violent, and appears early in the convulsion. The spasms are clonic and intermittent, and deglutition is peculiar, but perfect. In the