AIDS

TO
FORENSIC MEDICINE AND TOXICOLOGY
BY
W.G. AITCHISON ROBERTSON
M.D., D.Sc., F.R.C.P.E.
LECTURER ON FORENSIC MEDICINE, SCHOOL OF MEDICINE, EDINBURGH; LATE
EXAMINER IN THE UNIVERSITIES OF EDINBURGH AND ST. ANDREWS; FOR THE
TRIPLE BOARD; DIPLOMA IN PUBLIC HEALTH, ETC.
NINTH EDITION
TWENTIETH THOUSAND
LONDON
BAILLIÈRE, TINDALL AND COX
8, HENRIETTA STREET, COVENT GARDEN
1922
PREFACE TO NINTH EDITION
I trust that, having thoroughly revised the "Aids to Forensic Medicine,"
it may prove as useful to students preparing for examination in the
future as it has been in the past.
W.G. AITCHISON ROBERTSON.
SURGEONS' HALL,
EDINBURGH,

_November_, 1921.
PREFACE TO EIGHTH EDITION
This work of the late Dr. William Murrell having met with such a large
measure of success, the publishers thought it would be well to bring out
a new edition, and invited me to revise the last impression.
This I have done, and while retaining Dr. Murrell's text closely, I have
made large additions, in order to bring the "Aids" up to present
requirements. I have also rearranged the matter with the object of
making the various sections more consecutive than they were previously.
W.G. AITCHISON ROBERTSON.
SURGEONS' HALL,
EDINBURGH,
_June_, 1914.

CONTENTS
PART I

FORENSIC MEDICINE

PAGE
I. Crimes 1
II. Medical Evidence
2
III. Personal Identity
10
IV. Examination of Persons found Dead
12
V. Modes of Sudden Death
13
VI. Signs of Death 16
VII. Death from Anæsthetics, etc.
19
VIII. Presumption of Death; Survivorship
20
IX. Assaults, Murder, Manslaughter, etc.
21
X. Wounds and Mechanical Injuries
21
XI. Contused Wounds, etc.
22
XII. Incised Wounds
23
XIII. Gunshot Wounds
24
XIV. Wounds of Various Parts of the Body
26
XV. Detection of Blood-Stains, etc.
30
XVI. Death by Suffocation
34
XVII. Death by Hanging 35
XVIII. Death by Strangulation
35
XIX. Death by Drowning 36
XX. Death from Starvation
38
XXI. Death from Lightning and Electricity
38
XXII. Death from Cold or Heat
39
XXIII. Pregnancy 40
XXIV. Delivery
41
XXV. Foeticide or Criminal Abortion
42

Feigned Diseases 63 XL. Superfoetation 53 XXXIII. Inheritance 54 XXXIV. Responsibility. Classification of Poisons 83 IV. Infanticide 44 XXVII. etc. Undue Influence. Viability of Children 51 XXXI.XXVI. Symptoms and Post-Mortem Appearances of Different Classes of Poisons 86 . Evidences of Live-Birth 46 XXVIII. Idiocy. Marriage and Divorce 60 XXXIX. Evidence of Poisoning 85 V. Mental Unsoundness 67 XLI. Imbecility. Cretinism 68 XLII. Impotence and Sterility 54 XXXV. Lucid Intervals. Legitimacy 52 XXXII. Scheduled Poisons 80 III. Rape 55 XXXVI. Dementia 70 XLIII. Blackmailing 60 XXXVIII. 71 XLIV. Duration of Pregnancy 50 XXX. Examination of Persons of Unsound Mind 76 XLV. Unnatural Offences 59 XXXVII. Inebriates Acts 78 PART II TOXICOLOGY I. Mania. Cause of Death in the Foetus 50 XXIX. Definition of a Poison 80 II.

Zinc. and Ammonia 101 XVI. The Mineral Acids 94 X. Lead and its Preparations 116 XXV. Sulphuric Acid 95 XI. 103 XVII. etc. and Chromium 118 XXVII. Arsenic and its Preparations 107 XXII. Belladonna. Hydrochloric Acid 98 XIII. Copper and its Preparations 117 XXVI. Soda. Potash. Iodine--Iodide of Potassium 104 XX. Treatment of Poisoning 90 VIII. Antimony and its Preparations 112 XXIII. Barium Salts 104 XIX. Cocaine 128 XXXII. Detection of Poison 91 IX. Vegetable Irritants 123 XXIX. Bismuth. Nitrate of Potassium. Mercury and its Preparations 113 XXIV. Hyoscyamus. Carbolic Acid 100 XV. and Stramonium 127 XXXI. Tetrachlorethane 129 . Nitric Acid 97 XII. 103 XVIII. Camphor 129 XXXIII. etc. Gaseous Poisons 120 XXVIII. Duty of Practitioner in Supposed Case of Poisoning 89 VII. Opium and Morphine 124 XXX. Phosphorus 105 XXI. Potassium Salts.VI. Oxalic Acid 98 XIV. Silver.

Chloral Hydrate 134 XXXVI. Phenacetin. and Aniline 135 XXXVIII. and Brucine 145 XLV. Antipyrine. Trional.XXXIV. Alcohol. Veronal. Tetronal. Paraldehyde 137 XXXIX. Antefebrin. Abortifacients 147 XLVII. and Chloroform 130 XXXV. Ptomaines or Cadaveric Alkaloids 150 Index 152 . Strychnine. Conium and Calabar Bean 138 XL. Cantharides 146 XLVI. Nux Vomica. Aconite 143 XLIII. Sulphonal. Poisonous Fungi and Toxic Foods 148 XLVIII. Petroleum and Paraffin Oil 134 XXXVII. Hydrocyanic Acid 140 XLII. Tobacco and Lobelia 139 XLI. Digitalis 144 XLIV. Ether.

The distinction is not very definite. therefore. and includes all questions which bring medical matters into relation with the law. with (1) crimes and (2) civil injuries. 2. rape. is insane. which involve the capital sentence or long terms of imprisonment. generally under two years. No act is a crime unless it is plainly forbidden by law.--CRIMES Forensic medicine is also called Medical Jurisprudence or Legal Medicine. as a rule. or has been made to commit it under compulsion. as murder. Crimes are divided into _misdemeanours_ and _felonies_. and are punishable with a term of imprisonment. and is punishable on summary conviction before a magistrate or justices only. It deals. two circumstances are necessary to be proved--(a) that the act has been committed. unless he is under the age of seven years. manslaughter. but. the former are less serious forms of crime. Every person who commits a crime may be punished. AIDS TO FORENSIC MEDICINE AND TOXICOLOGY PART I FORENSIC MEDICINE I. while felonies comprise the more serious charges. while the more serious crimes (_indictable offences_) must be tried before a jury. A _crime_ is the voluntary act of a person of sound mind harmful to others and also unjust. whether injured or . while the latter are punished. 1. any person. An _offence_ is a trivial breach of the criminal law. _Civil injuries_ differ from crimes in that the former are compensated by damages awarded. To constitute a crime. (b) that a guilty mind or malice was present. The act may be one of omission or of commission.

The medical man then gives evidence of a skilled or expert nature. and to explain to the judge before taking the oath that his memory has not been sufficiently 'refreshed. he may be asked whether he concurs with opinions held by other medical authorities. may prosecute for a crime. This evidence is what any lay observer might be asked. If summoned by the side on which he thinks the medical testimony is correct. while only the sufferer can sue for a civil injury._. will probably see that the fee is forthcoming. if a certain wound would be immediately fatal.' and in which he affords the basis for the next examination or 'cross-examination' by . This is very generally done by uplifting the right hand and repeating the oath (Scottish form). and. then he ought to refuse to appear and give evidence. he is of opinion that the medical evidence is clearly and correctly on the opposite side. II. the nerve specialist. previous to the trial. In this way only can he decide as to whether in his opinion the plaintiff or defendant is right as regards the medical evidence. but they are not usually allowed to hear the evidence of other expert witnesses. In civil cases the medical witness should.--MEDICAL EVIDENCE On being called. He may be called to give _ordinary evidence_ as a _common witness_. He may be asked his opinion on certain facts narrated-- _e. 2. Skilled witnesses may hear the evidence of ordinary witnesses in regard to the case in which they are to give evidence. carry greater weight with the jury than would the evidence of an ordinary practitioner. _Expert Witness. but not for a civil injury. better that they should understand the case thoroughly. indeed. Thus he may be asked to detail the facts of an accident which he has observed. and of the inferences he has deduced. It would be safer for him to do so. Whether an expert witness who has no personal knowledge of the facts is bound to attend on a subpoena is a moot point. by the party on whose side he is engaged. or by making a solemn affirmation. Again.' The solicitor. make an agreement with the solicitor who has called him with reference to the fee he is to receive. the lawyer would not desire his presence in the witness-box unless he could uphold the case. If. or the mental consultant may be served with a subpoena to appear at court on a certain date to give evidence. Before consenting to appear as a witness the practitioner should insist on having all the facts of the case put before him in writing. The evidence of such skilled observers will. if he desires his evidence. 1. then it is his duty to consent to appear. which is called the 'examination in chief. or by kissing the Bible. he may be examined on matters of a technical or professional character. however.not._--On the other hand.g. the medical witness enters the witness-box and takes the oath.In important cases specialists are often called to give evidence of a skilled nature. and it is. The Crown may remit punishment for a crime. Thus the hospital surgeon. it is supposed. A witness may be subjected to _three_ examinations: first. indeed.

In charges of murder. If any witness disobeys the summons to attend the inquest.. the coroner has the power of holding a court without a jury if. In the third he is allowed to clear up any discrepancies in the cross- examination. In the next his testimony is subjected to rigid examination in order to weaken his previous statements. he must summon a jury. if not present. are examined on oath by the coroner. either unanimously or by a majority. in his discretion. and this forms his _deposition_. or of infants in nursing homes. but only if the notes were taken by him at the time when the observations were made. This is then read over to each witness. it appears to be unnecessary. deaths of prisoners in prison. =The Coroner's Court. in suspected cases of poisoning is usually done by a special analyst named by the coroner. and that there is reasonable cause to suspect that such person died either a violent or unnatural death. manslaughter. he is committed by the coroner to prison to await trial. and the jury return their verdict or _inquisition_. take down the evidence in writing.the opposite side. and should not quote authorities in support of his opinions. He should make his statements in plain and simple language. he must summon a jury of not less than twelve men to investigate the matter--in other words. and may dispense with an inquest and grant a burial certificate.=--When a coroner is informed that the dead body of a person is lying within his jurisdiction. any medical practitioner. inmates of asylums or inebriates' homes. but he must not introduce any new matter which would render him liable to another cross-examination. There are various _courts_ in which a medical witness may be called on to give evidence: 1. or as soon after as practicable. or died a sudden death of which the cause is unknown. or. who signs it. A chemical analysis of the contents of the stomach. or by any private individual. avoiding as much as possible technical terms and figurative expressions. The coroner may be satisfied with the evidence as to the cause of a person's death. parish officer. the coroner may summon the medical attendant to give evidence. At the end of each case the coroner sums up. who must. hold an inquest--and if the deceased had received medical treatment. By the Juries Act of 1918. Witnesses. Cases are notified to the coroner by the police. An expert witness when giving evidence may refer to notes for the purpose of refreshing his memory. having been cited to appear. The third is the 're-examination' by his own side. If this charges any person with murder or manslaughter. registrar of deaths. The medical witness should answer questions put to him as clearly and as concisely as possible. the coroner may issue a warrant for his arrest. By the Coroners (Emergency Provisions) Act of 1917. in criminal cases at least. In the first he merely gives a clear statement of facts or of his opinions. the number of the jury has been cut down to a minimum of seven and a maximum of eleven men. he . etc.

and capital charges must be dealt with by the High Court of Justiciary. In Scotland the Procurator Fiscal fulfils many of the duties of the coroner. and the Juries Act of 1918. retract. =The Magistrate's Court or Petty Sessions= is also a court of preliminary inquiry. in cases of assault. in cases of homicide or suicide. The coroner may give an order for the exhumation of a body if he thinks the evidence warrants a post-mortem examination. where the attendants on the deceased have been culpably negligent. c. with an extra guinea for making a post-mortem examination and report (in the metropolitan area these fees are doubled). by subsequent Acts--_e. however. where the cause of death is not clear. the medical witness is not paid any fee. The fee payable to a medical witness for giving evidence at an inquest is one guinea. an inquest may not be held in any premises licensed for the sale of intoxicating liquor if other suitable premises have been provided. and are also defined by statute. and should an inquest be adjourned to a later day. but he cannot hold a public inquiry. the Coroners (Emergency Provisions) Act. or. Even though the inquest be held in a coach-house or barn. and you will make a bad impression on judge and jury if you modify. In Scotland the verdicts of the jury may be 'guilty. in minor assault cases.' 'not guilty. He interrogates the witnesses privately. but in addition the coroner may commit him to prison for contempt of court. no further fee is payable. or lunatic asylum.' or 'not proven. If the deceased died in a hospital. Any misstatements or discrepancies in your evidence will be carefully inquired into.' 2. Should a medical witness neglect to make the post-mortem examination after receiving the order to do so. By the Licensing Act of 1902. 71). your deposition made to the coroner forms the basis of your examination.g.. 1917. if the case is of sufficient . They have been modified. as. and these questions with the answers form the _precognition_. or in certain cases of uncertified deaths._. principally by the Coroners Act of 1887 (50 and 51 Vict.renders himself liable to a fine not exceeding £2 2s. In criminal cases the witnesses are bound over to appear at the assizes to give evidence there. The medical witness should be very careful in giving evidence before a coroner. where the medical attendant refuses to give a certificate of death. infirmary. he is liable to a fine of £5. You had your opportunity of making any amendments on your evidence when the coroner read over to you your deposition before you signed it as true. The duties of the coroner are based partly on Common Law. where death has taken place immediately or some time afterwards. Coroners' inquests are held in all cases of sudden or violent death. If the case goes on for trial before a superior court. or explain away your evidence as given to the coroner. for example. yet it has to be remembered it is a court of law. The prisoner may be dealt with summarily. More serious cases are dealt with by the Sheriff of each county. the Act of 1892. The coroner must sign the order authorizing the payment.

with his second-class railway fare. At the Court of Assize the prisoner is tried by a jury of twelve. If a witness is summoned to appear before two courts at the same time. If they find a 'true bill. In the City of London is the Mansion House Justice-Room. In bringing in the verdict the jury must be unanimous. The fee for a medical witness who resides within three miles of the court is ten shillings and sixpence. =Court of Criminal Appeal.=--These are held every quarter by Justices of the Peace. he is entitled to threepence a mile for refreshments both ways. A right of appeal may be based (1) solely on a question of law. There is the _Crown Court_. in a civil case. and there is the _Civil Court_. where civil cases are heard. The prisoner may ultimately be sent for trial to the Central Criminal Court. known as the Old Bailey. If they cannot agree. A medical man has no right to claim privilege as an excuse for not divulging professional secrets in a court of law. If there is no railway. Still.' the case goes on. and the evidence justifies such a course. if he . but if they 'throw it out. may be committed for trial. or elsewhere. 3. 5. and he has to walk. if at a greater distance. The medical witness also receives a reasonable allowance for hotel and travelling expenses. if there is a second class on the railway by which he travels. At the Assize Court the medical witness gets a guinea a day. =Quarter Sessions.=--This was established in 1908.gravity. In Borough Sessions a barrister known as the _Recorder_ is appointed as sole judge. 4.' who is one of the great unpaid. (3) on mitigation of sentence.' the accused is at liberty to take his departure. with two shillings extra to pay for his bed and board for every night he is away from home. the case must be retried before a new jury. which is composed of superior individuals. In the Metropolis the prisoner in the first instance is brought before a magistrate. this to include everything except travelling expenses. presided over by the Lord Mayor or one of the Aldermen. and thus occupies a superior position to the ordinary 'J. Criminal cases take precedence of civil. In London this court is known as the Central Criminal Court. All cases can be tried before the sessions except felonies or cases which involve difficult legal questions. =The Assizes= deal with both criminal and civil cases. technically known as the 'beak. and consists of three judges. in addition to being a person of great acumen. in the Superior Courts the fees which may be claimed by medical men called on to give evidence are a guinea a day if resident in the town in which the case is tried.' who. and it also acts as the Assize Court. one guinea.P. and the less he talks about professional etiquette the better. it is investigated by the _grand jury_. Before a case sent up by a lower court can be tried by the judge and petty jury. is a stipendiary. (2) on certificate from the judge who tried the prisoner. he must obey the summons of the higher court. where criminal cases are tried.. Speaking generally. and from two to three guineas a day if resident at a distance from the place of trial.

' which occur in the English form. 46. or to put any question. in using the expression 'I have no hope of recovery. with the bare right hand uplifted above the head. though not altogether to supply its place. There is no kissing of the book. A witness engaged to give expert evidence should demand his fee before going into court. are not employed. without any suggestions or comments of his own. § 5) declares. and nothing but the truth. In a criminal case he would promptly be reminded of the nature of his oath. c. that 'if any person to whom an oath is administered desires to swear with uplifted hand. and see them signed and witnessed. It will be noted that the Scotch form constitutes an oath. But the person must believe that he is _actually_ on the point of death. It must be made clear to the court that at the time of making his statement the witness was under the full conviction of approaching or impending death. he shall be permitted to do so. In one case only is hearsay evidence admissible. but all testimony is not evidence.' The presiding judge should say the words. but if he is not available. If possible. or. If after making the statement the patient were to say. and the witness should repeat them after him. and no technical terms should be employed.were to make an emphatic protest. . A statement was rejected because the dying person. and may be used by the witness in court as a refresher to the memory. It may be the history of a fatal illness or the result of a post-mortem examination. should write down the statements made by the dying person. This is a statement made by a dying person as to how his injuries were inflicted. death must ensue. on the spot. The judge has no right to ask if you object on religious grounds. these should be made at the time. To make the declaration admissible as evidence. No witness on being sworn can be compelled to 'kiss the book.' requested that the words 'at present' should be added. but to every oath which may be lawfully administered either in Great Britain or Ireland. and the words 'So help me. A medical man may be required to furnish a _formal written report_. All evidence is made up of testimony. the medical man. He is bound by the provisions of the Act.' The Oaths Act (51 and 52 Vict. or before coroners. With regard to notes.' it would invalidate the declaration. at all events. God.' The witness takes the oath standing. whether in civil or criminal courts. The witness must not introduce hearsay testimony.. and the oath shall be administered to him in such form and manner without further question. These declarations are accepted because the law presumes that a dying man is anxious to speak the truth. before being sworn. the formula being: 'I swear by Almighty God that I will speak the truth. 'I hope now I shall get better. and is not an affirmation. a magistrate should take the dying declaration. in the form and manner in which an oath is usually administered in Scotland. and that is in the case of a _dying declaration_. the matter in all probability would not be pressed. These reports must be drawn up very carefully. and the enactment applies not only to all forms of the witness oath. with _absolutely_ no hope of recovery. the whole truth. without any qualification.

the general development of the body. marks on the body. as Indian ink. the coccyx movable and turned back. With regard to the identification of the dead in cases of death by accident or violence. scars and tattoo marks.III. or cupping instruments. may be judged from the bones of the female generally being smaller and more slender than those of the male. The scars of leech-bites. or by steeping some of it in dilute nitric acid. the costal cartilages longer. and cannot be changed. though it may sometimes be so. the brighter colours. linear being chiefly found between the fingers and toes. The cicatrix resulting from a wound depends upon its situation. inquiry should be made as to menstrual or vicarious discharges. to give any certain or positive opinion as to the age of a scar. By way of disguise the hair may be dyed black with lead acetate or nitrate of silver. if that only be found. the form of the prepuce. Tattoo marks may disappear during life. or with regard to the organs of generation in cases of doubtful sex. It is difficult. The arrangement of these lines is special to each person. The impression reveals the fine lines which exist at the tips of the fingers. nævi materni. it will be remembered that scars occasioned by actual loss of substance. Openings must be carefully sounded as to their communication with bladder or uterus. With regard to scars and their permanence.--PERSONAL IDENTITY It is but seldom that medical evidence is required with regard to the identification of the living. detected by letting the hair grow and by its unnatural feeling and the irregularity of the bleaching. But of all these signs the only one of any real value is the roundness of . the following points should be noticed: the size of the penis or clitoris. the medical man's assistance may be called. and testing with iodide of potassium for lead. the pubes shallow. and the whole pelvis shallower and with larger outlets. After puberty. lancet-wounds. never disappear. as vermilion. or by wounds healed by granulation. if not impossible. the presence or absence of nymphæ and of testicles or ovaries. the ilia more expanded. the growth of hair. Finger-print impressions are the most trustworthy of all means of identification. the tone of voice. the tuberosities of the ischia wider apart. as a rule. and the behaviour of the individual towards either sex. The sex of the skeleton. In the determination of cases of doubtful sex in the living. The hair may be bleached with chlorine or peroxide of hydrogen. and hydrochloric acid for silver. If the tattooing is superficial (merely underneath the cuticle) the marks may possibly be removed by acetic acid or cantharides. The medical man may in such cases be consulted as to family resemblance. by the female thorax being deeper. Such a print is obtained by rubbing the pulp of the finger in lampblack. may disappear after a lapse of time. and whether perforate or not. and then impressing it on a glazed card. more readily than those made with carbon. Of incised wounds an elliptical cicatrix is typical. the sacrum flatter and broader. detected by allowing the hair to grow. Hence this method is employed by the police in the identification of prisoners. recent scars are pink in colour. or even by picking out the colouring-matter with a fine needle. as in the celebrated Tichborne case. old scars are white and glistening. after death the colouring-matter may be found in the proximal glands.

--EXAMINATION OF PERSONS FOUND DEAD When a medical man is called to a case of sudden death. such as occurs in injuries. from the cartilages of the ribs. Age may be calculated from the presence. the seat of injury being inspected first. such as phthisis.the pubic arch in the female. or other internal organs. (2) _Asthenia_. giddiness.--MODES OF SUDDEN DEATH There are three modes in which death may occur: (1) Syncope. if there has been foaming at the mouth. and in some cases of poisoning--for example. every cavity and important organ of the body must be carefully and minutely examined. met with in starvation. aconite. (2) asphyxia. nature and number of the erupted teeth. and convulsions. and irregular pulse. sighing respiration. (3) coma. cancer. When. and in the young from the condition of the epiphyses with regard to their attachment to their respective shafts. slow. or failure of the heart's action. Before puberty the sex cannot be determined from an examination of the bones. =Syncope= is death beginning at the heart--in other words. if the face is distorted. Urine may be drawn off with a catheter and tested for albumin and sugar. there is sudden stoppage of the heart. from the angle formed by the ramus of the lower jaw with its body (obtuse in infancy. He should also notice if there are any signs of a struggle having taken place. dilated pupils. The symptoms of syncope are faintness. V. however. and the condition of the clothes. If required to make a post-mortem examination. 1. pallor. . the right and left cavities contain blood in the normal quantities. and if urine or fæces have been passed involuntarily. he should carefully note anything likely to throw any light on the cause of death. pernicious anæmia. and Bright's disease. as compared with the pointed arch in the male. To determine stature. IV. if the hands are clenched. a right angle in the adult. weak. 1-1/2 to 2 inches being allowed for the soft parts. and blood is found in the venæ cavæ and in the arterial trunks. It may arise from— (1) _Anæmia_. the position and attitude of the body. which gradually ossify as age advances. the position of surrounding objects. insensibility. failure of circulation. or deficiency of blood due to hæmorrhage. in exhausting diseases. the whole skeleton should be laid out and measured. He should notice the place where the body was found. or from bleeding from the lungs. uterus. the soil or surface on which the body lies. stomach. There is no engorgement of either lungs or brain. and again obtuse in the aged from loss of the teeth). Post mortem the heart is found empty and contracted.

embolism of the pulmonary artery. or abdominal aneurism. Cerebral hæmorrhage or embolism. Rupture of heart. 3. are either empty or contain but little blood. strangling. or death beginning at the lungs. dietetic and uræmic conditions. The post-mortem signs are congestion of the substance of the brain and its membranes. and from opium and other narcotic poisons. with accumulation of the blood in the cavities of the heart. compression. blocking of a cerebral artery from embolism. Much bloody froth escapes on cutting into the lungs. may arise from concussion. 7. cerebral pressure from hæmorrhage and other forms of apoplexy. The symptoms of this condition are fighting for breath. or death beginning at the brain. suffocation. Rupture of aortic aneurism. spleen. the left cavities of the heart. . In all cases of sudden death think of angina pectoris and the rupture of an aneurism. there is no line of demarcation between the various modes of death. especially in nose. loss of consciousness.2. and hanging. 3. etc. and the lining of the air-tubes is bright red in colour. Embolism of coronary artery. 2. giddiness. and convulsions. 4. The following is a list of some of the commoner causes of sudden death: (a) =Instantaneously Sudden Death=-- 1. Rupture of a gastric or duodenal ulcer. and stertorous breathing. The pulmonary veins. The symptoms of this condition are stupor. owing to the interdependence of all the vital functions. Aortic incompetence. relaxation of the sphincters. and from spasmodic contraction of the thoracic and abdominal muscles in strychnine-poisoning. rupture of liver. Post mortem. Angina pectoris. =Coma=. Rupture of a valve. effusion into the pleuræ. Syncope (by far the commonest cause). 2. =Asphyxia=. The lungs are dark and engorged with blood. with consequent pressure on the lungs. 5. Mitral and tricuspid valvular lesions if the patient exerts himself. as well as in the skin of the neck and face. Numerous small hæmorrhages (Tardieu's spots) are found on the surface and in the substance of the internal organs. drowning. may be due to obstruction of the air-passages from foreign bodies in the larynx.. lips. or extra-uterine gestation. It must be remembered that. ears. more on the right side than on the left. from injury to the cervical cord. the right cavities of the heart and the venæ cavæ are found gorged with dark fluid blood. 6. and the aorta. (b) =Less Sudden but Unexpected Death=-- 1. 3. cadaveric lividity is well marked.

spleen. collapse from cholera. In addition. fundus yellow in colour. 6. vomited matter or other material drawn into the trachea or air-passages. livid. Poisoning. 7. Diabetic coma. (d) the dulling of a steel needle when thrust into the living body. VI. Still. oedema of glottis following inhalation of ammonia. It is a frequent cause of death during chloroform anæsthesia for slight operations in young people. Cessation of the circulation may be determined by (a) placing a ligature round the base of a finger (Magnus' test). hypertrophy of the thymus. and the stillness or otherwise of the air about the body. may be said to be _quite cold_ in about _twelve hours_. even when the autopsy has been made by skilled observers. as well as of Peyer's patches and mesenteric glands. ashy white colour. iris insensible to light. pale. as by hydrocyanic acid. or aneurism. do: =Cooling of the Body. croup. embolism. with loss of elasticity. inhalation of carbonic acid or coal gas. 4. . Exertion while the stomach is overloaded. 11. no sound being heard by the stethoscope. Arterio-sclerosis may lead to thrombosis. Mental or physical shock.=--The average internal temperature of the body is from 98° to 100° F._ This is a general hyperplastic condition of the lymphatic structures in the body. shocks of electricity of high tension. the surrounding temperature. and is seen in enlargement of tonsils. the tension is at once lost. other things being equal. (4) The state of the skin. (e) the clear outline of the dead heart when viewed in the fluorescent screen. (3) The state of the eye. 10. Rapid onset of some acute specific disease. (c) looking through the web of the fingers at a bright light (diaphanous test). the presence or absence of clothing on the body. Suffocation during an epileptic fit. thymus. (2) Cessation of the circulation and respiration. 9.--SIGNS OF DEATH (1) Cadaveric appearance. and the brain and cord have been submitted to microscopical examination. cyanide of potassium. uræmia. the age of the person. 8. (b) injecting a solution of fluorescin (Icard's test). lightning. and in Addison's disease. The above signs afford no means of determining how long life has been extinct. In some cases of sudden death nothing has been found post mortem. Heat-stroke. The following. the body. (5) Extinction of muscular irritability. cornea dull and sunken. 5. _Status lymphaticus. it may be as well to remember that death sometimes occurs suddenly in exophthalmic goitre. 12. but it may be modified by the kind of death. such as pneumonia or diphtheria. The time taken in cooling is from fifteen to twenty hours. however.

the body may pass at once into rigor mortis. the hypostasis is bright red also. The organ first showing the putrefactive change is the trachea. In lingering diseases. chest. in the case of ecchymosis the subcutaneous tissues are infiltrated with blood-clot. in the drowned. and lastly to the lower extremities. even in that due to hæmorrhage. It is a sure sign of death. and then passes into the muscles of the face. After death from convulsions or strychnine-poisoning. It commences in the muscles of the back of the neck and lower jaw. as a greenish- blue discoloration of the abdomen. semi- fluid mass. If the intestine is pulled straight. =Putrefaction= appears in from one to three days after death. becomes darker and more general. Rigor mortis must be distinguished from _cadaveric spasm_ or the _death clutch_. not so in rigor mortis. It is caused by the coagulation of the muscle plasma. In tetanic spasm the limbs when bent return to their former position. it may not come on until from ten to twenty-four hours. front of the neck. the period. in the former. When the blood is of a bright red colour after death (as happens in poisoning by CO or HCN. It lasts from sixteen to twenty hours or more. and its position on the body will help to determine the length of time the body has lain in the position in which it was found.=Hypostasis= or =post-mortem staining= is due to the settling down of the blood in the most dependent parts of the body while the body is cooling. and occurs in all forms of death. and disappears in two or three hours. Internally. in the case of hypostasis a few small bloody points of divided arteries will be seen. after violent exertion. inflammatory redness is continuous. It has been noticed in the new-born infant. These putrefactive changes are modified by the fat or lean condition of the body.=--For some time after death the muscles continue to contract under stimuli. hypostasis is disconnected. although not so marked in degree. It must be distinguished from ecchymosis the result of a bruise. and in _all_ cases precedes putrefaction. the whole body at length becoming changed into a soft. When this irritability ceases--and it seldom exceeds two hours--rigidity and hardening sets in. by making an incision into the part. the temperature (putrefaction taking place more rapidly in summer than in winter). a strong putrefactive odour is developed. . the thorax and abdomen become distended with gas. articles in the hands are readily removable. This increases. The muscles then become pulpy. and in warm climates. in those who are in perfect health and die from accident or asphyxia. as well as in the foetus. and assume a dark greenish colour. About the neck hypostasis must not be mistaken for the mark of a cord or other ligature. in the latter this is not the case. and the epidermis peels off. hypostasis must not be mistaken for congestion of the brain or lungs. Post-mortem staining (_cadaveric lividity_) begins to appear in from eight to twelve hours after death. that which resists putrefaction longest is the uterus. upper extremities. or the results of inflammation of the intestines. and may last three or four days. The staining is of a dull red or slaty blue colour. or in death from cold). access of air. it sets in quickly. over the head and face. =Cadaveric Rigidity--Rigor Mortis.

Examine external surface of body and take accurate measurements of wounds. first have the body identified. etc. fiscal. and transmit these personally to the analyst. This consists of a margarate or stearate of ammonium with lime. The anæsthetist has to appear at the inquest. VII. In cases of suspected poisoning have several clean jars into which you place the stomach with contents. mode of interment. then photographed if it has not been identified. and a yellowish odorous matter. if an interval of twenty years has elapsed. and contained organs. piece of liver. tattooings. Clothing should be examined for blood-stains. and so as to furnish yourself with a proper defence in the event of death occurring. Should a fatal result follow. age. and saw off calvarium. marks. =Exhumation.--DEATH FROM ANÆSTHETICS. =Post-Mortem Examination. Examine brain by making incision from ear to ear across vertex. but only by consent of the Crown authorities or of the Sheriff. Before. the fat uniting with the ammonia given off by the decomposition to form _adipocere_. potash. =Saponification.=--In bodies which are very fat and have lain in water or moist soil for from one to three years this process takes place. oxide of iron. The coroner in England and Wales and Ireland must inquire into every case of death during the administration of an anæsthetic. unctuous feel. you ought to examine the heart. intestines with contents. attaching label with name of deceased. date. deformities. that the one employed was the most suitable.. therefore. It has a fatty. cuts. or from the Home Secretary. ETC.=--A body which has been buried cannot be exhumed without an order from a coroner. and seal each up carefully. in Scotland. etc. spleen. an accused person cannot be prosecuted (_prescription of crime_). There is no legal limit in England as to when a body may be exhumed. with an odour of decayed cheese. is either pure white or pale yellow. and kidneys of the patient to see if they are healthy. the anæsthetist will require to prove that it was necessary to give the anæsthetic. etc. reflect scalp forwards and backwards.place. reflecting tissues from chest wall and cutting through costal cartilages.=--Never make an autopsy in criminal cases without a written order from the coroner or Procurator Fiscal. A medical man representing the accused may be present. etc. that the patient was in a fit state of health to have it administered. note degree and distribution of post-mortem staining. that he had the usual remedies at . however. Examine brain carefully externally and on section. certain fatty acids. Examine organs of chest and abdomen through an incision made from symphysis menti to pubis. and must answer a long series of questions relative to the administration of the drug. Small portions of the body may show signs of this change in six weeks. however. that it was given skilfully and in moderate amount. giving an anæsthetic. If authorized. Bodies which remain in water putrefy more slowly than those in air. kidney. lungs. rigidity.

--WOUNDS AND MECHANICAL INJURIES A wound may be defined as a 'breach of continuity in the structures of . and so collide with another in front. =Assault. etc. If. MANSLAUGHTER. Before a major operation is performed. This means that a human being has been killed by another maliciously and deliberately or with reckless disregard of consequences. it is well to get a written agreement.--PRESUMPTION OF DEATH. skill. as in defence of one's family or property. it can be shown that in all probability death had occurred in a certain accident or shipwreck. or judgment. =Presumption of Survivorship. ETC. This applies especially to dentists who give gas to females.hand in case of failure of the heart or lungs.=--When two or more related persons perish in a common accident.--ASSAULT. or _excusable_. in order to decide questions of succession. the court may.=--If a person be unheard of for seven years. The condition of the lungs is of more importance than the state of the heart. =Malpractice. and that he employed every means in his power to resuscitate the patient. IX. It is most frequently alleged in connection with surgical affections-- _e. that the law expects of him. it may be necessary. An anæsthetic should never be administered except in the presence of a _third person_. X. but evil intention must be proved. The assault may be aggravated by the use of weapons. When a corporal hurt has been sustained.g. on application by the nearest relative. _Felonious homicide_ is murder. knowledge. the decree may be made much earlier. =Homicide= may be _justifiable_. If he does not. overlooking a fracture or dislocation. it is not necessary that actual injury has been done. signalman who allows a train to pass. VIII. The chloroformist ought always to use the best chloroform.=--In every case where a medical man attends a patient. SURVIVORSHIP =Presumption of Death. then _assault and battery_ has been committed. MURDER. then the charge of malpractice may be brought against him. It is generally accepted that the stronger and more vigorous will survive longest. =Manslaughter= or =Culpable Homicide= (Scotland) is the unlawful killing of a human being without malice--as homicide after great provocation. presume death to have taken place. to determine which of them died first. however.=--This is an attempt or offer to do violence to another person._. as in the case of judicial execution. he must give him that amount of care.

(2) formation of vesicles. as solid carbonic acid. =Burns= are caused by flames. if sustained after death. seen after removing the cuticle. (5) deep parts charred. Burns may cause death from shock. contains but little fluid. the edges of this blister are bright red. coma. and from _malum regimen_ on the part of the patient or surgeon. from the supervention of crysipelas or pyæmia. (6) carbonization of bones. There are six degrees of burns: (1) Superficial inflammation.' The law does not define 'a wound. and there are no signs of vital reaction. suffocation. by steam or hot fluids. (3) destruction of superficial layer of skin. oedema glottidis.' but the _true skin must be broken_. _Is the wound dangerous to life?_ This question can only be answered by a full consideration of all the circumstances of the case. suddenly occasioned by mechanical violence. and the base.the body. Wounds are dangerous from shock. A burn of the skin inflicted during life is followed by a bleb containing serum. is red and inflamed. bronchitis. a bleb. (4) destruction of cellular tissue. . duodenal ulcer. pneumonia. scalds. or exhaustion. hæmorrhage. if present. whether external or internal. inflammation of serous surfaces. a guarded prognosis is wise in all cases. highly heated solids. or very cold solids.

The larger the area of skin burnt. In the case of a post-mortem stain the edges are sharply defined. In a recent incised wound inflicted during life there is copious hæmorrhage. on section. but acting as mechanical irritants. XII. the more grave is the prognosis. Lacerated wounds combine the characters of incised and contused wounds. XI. Young children are specially liable to die after burns. there is produced a bruise. A bruise may be distinguished from a post-mortem stain by the cuticle in the former often being abraded and raised. . They cause little hæmorrhage externally. The wounds heal by suppuration.--CONTUSED WOUNDS AND INJURIES UNACCOMPANIED BY SOLUTION OF CONTINUITY If a blow be inflicted with a blunt instrument. Burns of the abdomen and genital organs are especially dangerous. being ridden over. the whole of the subcutaneous tissues are found to be infiltrated with blood-clot. machinery crushes. the cellular tissue is filled with blood.--INCISED WOUNDS AND THOSE ACCOMPANIED BY SOLUTION OF CONTINUITY These comprise incised. or _ecchymosis_. bites. the edges of the wound gape and are everted. They are greater in depth than in length. They are caused by falls. but death may be due to internal hæmorrhage. When an incision is made into the bruise. not only carrying in septic matter. and. mere bloody points are seen which are the cut ends of the divided blood vessels. and lacerated wounds. which may at the time be difficult to detect. and the cavity of the wound is filled with coagula. of which it is unnecessary here to describe the appearance and progress. blows from blunt weapons. (2) the entrance of foreign bodies which lodge in the wound. not raised. punctured. (3) injury to deeper parts. They may be complicated by (1) the introduction of septic material adhering to the instrument. and there is no clear margin. being caused by sword or rapier thrusts. etc. _Punctured wounds_ come intermediate between incised and lacerated.

g. The Lee-Metford . The distinction between incised wounds inflicted during life and after death is found in the fact that a wound inflicted during life presents the appearances already described. while at distances greater than 3 feet the shot scatter and there is no central opening. shin or cranium. _Lacerated wounds_ as a rule bleed less freely than those which are incised. If the wound is seen soon after it is inflicted. Small shot fired at a short distance make one large ragged opening. or in order to bring accusation against another. A heavy blow with a stick may at once cause fatal effusion of blood. It is often difficult to distinguish between a wound of the scalp inflicted with a knife and one made by a blow with a stick. inelastic. or lacerated. Such wounds are always in front. contused. Again.--GUNSHOT WOUNDS These may be punctured. and there are no signs of vital reaction. or it might present a jagged. the edges are close.An apparently _incised wound_ may be produced by a hard. with much contusion of the surrounding tissues. it is often difficult to decide whether the injury which caused death was the result of a blow or a fall. examination with a lens may disclose irregularities of the margins. pointed knife leaves a fusiform or spindle-shaped wound. or little bridges of connective tissue or vessels running across the wound. A wound from a blow with a stick might be of this character. or sand. not over vital organs. XIII. dirt. the blood is not effused into the cellular tissue. but this might equally result from fracture of the skull resulting from a fall. Note the condition of the clothes in such cases. and so be inconsistent with its production by a cutting instrument. probably two or three days. _Self-inflicted wounds_ are made by the person himself in order to divert suspicion. A puncture with a sharp-edged. yielding. and superficial in character. whereas in a post-mortem incised wound only a small quantity of liquid venous blood is effused. The wound should be carefully examined for foreign bodies. swollen appearance at the margin. blunt weapon over a bone--_e. Round balls make a larger opening than those which are conical. The presence of inflammatory reaction or pus shows that the wound must have been inflicted some time before death. Symptoms of concussion would favour the theory of the injury having been inflicted by a heavy instrument. such as grit._.

and the wound heals by first intention. whilst blackening of the hand points to suicide. If a revolver is found tightly grasped in the hand it is probably a case of suicide. The former is the larger. unlike a punctured wound. Smokeless powder does not blacken the skin. and that of exit larger. singeing of the hair. Even when the weapon is fired quite close there may be no blackening of the skin. as they may be useful in evidence. In the case of high-velocity bullets from smooth-bore rifles. with inverted edges. less regular than that of entrance. Blackening of the wound. Speaking generally. Wounds inflicted by firearms may be due to accident. A pocket revolver. The contents of all gunshot wounds should be preserved. if reasonable precautions be taken.000 yards may act as an explosive. and from such complications as pleurisy. A wound in the back may be met with in a sportsman who indulges in the careless habit of dragging a loaded gun after him. the Lee-Metford 215. show that the weapon was fired at close quarters. the aperture of entrance is round. a gunshot wound. pericarditis. and with everted edges. A bullet penetrating the skull even from a distance of 3. but there is also risk from secondary hæmorrhage. for it may have been thrown into a river or pond. it is not conclusive proof that it is not suicide. If no weapon is found near the body. but the difference in size is not great. scattering the contents in all directions. the aperture of entry is small. or suicide. or to some distance and picked up by a passer-by. Death may result from shock. homicide. becomes larger as it increases in depth. The Martini-Henry bullet weighs 480 grains. and the hand is not always blackened in cases of suicide. The external cicatrices finally look very similar to those produced by bad acne pustules. and the Mauser 173. leaves the bullet in the body. injury to brain or important nervous . and tends to be more slit-like. whilst if it lies lightly in the hand it may be suicide or homicide.bullet is more destructive than the Mauser. There is but little tendency to carry in portions of clothing or septic material. the aperture of exit is slightly larger. and peritonitis. Wounds on the back of the body are not usually self-inflicted. clean. hæmorrhage. The prognosis depends partly on the extent of the injury and the parts involved. as a rule. scorching of the skin and clothing. including the Mauser and Lee-Metford. but a suicide may elect to blow off the back of his head. but the bullet from a revolver will usually be found in the cranium.

Concussion is a common effect of blows or violent shocks. and inflammation. but after variable periods. When the injury is below the fourth. very slight wounds producing severe symptoms. or wounds. and _vice versâ_. but power is retained in the arms and the upper intercostal muscles act. The cord and nerves may be injured (1) by the puncture. A severe blow on the vertex may cause fracture of the base of the skull. the diaphragm continues forcibly in action.=--Wounds of the scalp are likely to be followed by (1) erysipelatous inflammation. Inflammation does not usually come on at once. wounds. and the symptoms follow immediately on the accident. The symptoms may come on suddenly or gradually. When the injury is in the dorsal region. Injuries of the brain include concussion. as the orbit and ear. That the wound has penetrated the meninges is shown by the escape of cerebro-spinal fluid. In injuries to the lumbar region the legs may be partly paralysed. and (3) by subsequent septic inflammation. (2) inflammation of the tendinous structures.structures. or on the occurrence of any excitement. compression (fracture-dislocation). Division or complete compression of the cord at or above the level of the fourth cervical vertebra is immediately fatal (as happens in judicial hanging). Compression may be caused by depressed bone or effused blood (rupture of middle meningeal artery) and serum. (2) by extravasation of blood and the formation of a clot. but the lungs are imperfectly expanded. 2. =Of the Head. there is paralysis of the legs and of the sphincters of the bladder and rectum. death sometimes taking place without reaction. recover from the first effects. and then die with all the symptoms of compression from internal hæmorrhage. the extent of paralysis depending on the level of the lesion. and life will not be maintained for more than a day or two.--WOUNDS OF VARIOUS PARTS OF THE BODY 1. compression. XIV. =Injuries to the Spinal Cord= may be due to concussion. contusion. Inflammation of the meninges or brain may follow injuries. Wounds of the brain present very great difficulties. but to the scalp and adjacent parts. A person may receive an injury to the head. with or without suppuration. This is due to the fact that the primary syncope arrests the hæmorrhage. which returns during the subsequent reaction. not only to the brain itself. and the rectal and bladder sphincters . and vary greatly in their effect.

Passengers after railway accidents. or traumatic neurasthenia. and there may be separation of the iris from its ciliary border. Partial dislocations of the lens as the result of severe blows generally terminate in cataract.=--These produce great disfigurement and inconvenience. involving the hyoid bone and the thyroid and cricoid cartilages. the wound being shallower as it reaches its termination. the incision being slightly inclined from above downwards. Wounds of the throat inflicted by suicides are commonly situated at the upper part. but septic pneumonia is very apt to follow. the lens appears like a large drop of oil lying at the back of the cornea.=--Incised wounds of the walls are not of necessity . as from the cork of a soda-water bottle. giving rise to facial paralysis.may be involved. and of the internal jugular vein very dangerous on account of entrance of air. Wounds of the larynx and trachea are not necessarily or immediately dangerous. _Railway spine_.=--Very frequently inflicted by suicides. the margin exhibiting a brilliant yellow reflex. may be set up by concussion of the cord as a result of blows or falls. 3. or miners. =Of the Throat. often suffer from this affection. The seventh nerve may be involved. Wounds apparently confined to the external parts often conceal deep-seated mischief. =Of the Eye. Wounds at the edge of the cornea are often followed by prolapse of the iris. Inquiry should be made as to whether the patient is right or left handed. At the termination of a suicidal cut-throat the skin is the last structure divided. 4. The lens is frequently wounded in addition to the cornea and iris. The weapon is often firmly grasped in the hand.=--The iris may be injured by sharp blows. In dislocation of the lens into the anterior chamber as the result of a blow. Punctured wounds of the orbit are especially dangerous. and there is a risk of injury to the brain. The larynx is opened. 5. 6. the wounds often show parallelism. or ambidextrous. Acute traumatic iritis or irido-cyclitis may supervene four or five days after the injury. In most suicidal wounds of the throat the direction is from left to right. =Of the Chest. Division of the carotid artery is fatal. It is usually followed by hæmorrhage into the anterior chamber. =Of the Face. but the large vessels often escape. Homicidal cut throat is usually very severe and situated low down in the neck or far to the side.

of the base more speedily than of the apex. 13. Wounds of the gall-bladder cause effusion of bile and peritoneal inflammation.=--May be fatal from shock.=--Fatal hæmorrhage may result from penetrating wounds or from rupture due to kicks. from hæmorrhage. ventral hernia may follow. when the ends are driven outwards.=--Generally fatal. are often fatal. either dry or with effusion. or to indirect violence. may be dangerous from division of the epigastric artery. Laceration of the liver may result from external violence without leaving any outward sign of the injury. Fracture of the ribs may be due to direct violence. it is commonly fatal.=--These usually cause hæmorrhage. =Of the Diaphragm. Venous blood flows profusely from a punctured wound of the liver. =Of the Stomach. Rupture from disease usually occurs in the left ventricle. There is rapid and acute anæmia from the pouring out of blood into the abdominal cavity. =Of the Abdomen. 9. hernia of the organs may result. etc. 8. This may also occur with injuries of other organs in the abdomen. especially if the spleen be enlarged. as from a blow.=--Of the walls. internal hæmorrhage. =Of the Spleen. rupture from a crush is usually towards the base and on the right side. crushes. Injury to the right ventricle is the most fatal injury and the most frequent. =Of the Heart. 7.=--May divide the large vessels. but severe blows. The symptoms of penetrating wounds of the chest are--(1) The passage of blood and air through the wound. =Of the Liver. and by pneumonia. as from a squeeze in a crowd. =Of the Aorta and Pulmonary Artery.=--Penetrating wounds are fatal from hæmorrhage. If the diaphragm be ruptured. 11. owing to the severe injury of the other abdominal organs. (3) pneumothorax. and are frequently followed by pleurisy. 12. from . blows. but life may be prolonged for some time even after a severe wound to the heart. when the ends are driven inwards. Blows on the abdomen are prone to cause death from cardiac inhibition. (2) hæmoptysis.dangerous. 14. and (4) protrusion of the lung forming a tumour covered with pleura.=--Fatal. by causing fracture of the bones and internal injuries. 10. =Of the Lungs.

the latter becoming brighter on exposure to the air. Removal of testicles may prove fatal from shock to nervous system. 16. The danger is materially lessened by prompt surgical intervention. such as the vapours of sulphurous.=--May be fatal in the same way as those of the stomach. XV. on floors and furniture. a cinnabar-red streak is seen on drawing a needle across the stain. a jelly-like material may be seen by the aid of a magnifying-glass lying between the fibres. More dangerous in the small than in the large intestines. =Of the Kidneys. 15. extravasation of urine.--DETECTION OF BLOOD-STAINS. etc. After a few hours blood-stains assume a reddish-brown or chocolate tint. If old. The colour is determined. If recent.=--Dangerous from extravasation of urine. . =Of Genital Organs. ETC.=--Blood-stains on dark-coloured materials. Wounds of the spermatic cord may be dangerous from hæmorrhage. or from inflammation. The following are the distinctive characters of blood-stains: (a) =Ocular Inspection. =Of the Intestines. Wounds to the vulva are dangerous. In fracture of the pelvis the bladder is often injured. This change is due to the conversion of hæmoglobin into methæmoglobin. and extraperitoneal infiltration of urine occurs. sulphuric. with frequently a fatal issue. may be readily detected by the use of artificial light. on cutting instruments. but is influenced by the presence or absence of impurities in the air.=--May prove fatal from hæmorrhage. or inflammation. Stains may require detection on clothing. which they maintain for years. and hydrochloric acids. as that of a candle. owing to hæmorrhage from the large plexus of veins without valves. of a purple hue if venous. Blood-spots when recent are of a bright red colour if arterial. =Of the Bladder.extravasation of contents. The change of colour in warm weather usually occurs in less than twenty-four hours. and finally into hæmatin. which in daylight might be easily overlooked. 17. 18. not entirely by the age of the stain.=--Incised wounds of penis may produce fatal hæmorrhage. brought near the cloth.

reptiles. but the size of a corpuscle is affected by various circumstances. or of an ethereal solution of the same substance (known as _ozonic ether_). when a coagulum is formed soluble in hot caustic potash.=--Water has a solvent action on blood. The corpuscles of most mammals are smaller than those of man. when the blood will peel off. the colour entirely destroyed. which are oval. blood may be detected by the presence of the characteristic blood-corpuscles. The solution obtained in water is coagulated by heat. and amphibians. fishes. fresh stains rapidly dissolving when the material on which they occur is placed in cold distilled water. and pus. (g) =Action of Guaiacum. so employ a weak solution of ammonia. This test is delicate. saliva. such as drying or moisture. having a diameter of about 1/3500 of an inch. forming a bright red solution. the solution formed being greenish by transmitted and red by reflected light. rust may be mixed with the blood. All mammalian red corpuscles have the same shape. except those of the camel. Unfortunately. It is not absolutely indicative of the presence of blood. and a flocculent muddy-brown precipitate formed.=--Blood-stains on knives may be removed by heating the metal. the corpuscles are usually so dried that little information regarding their size can be given. and succeeds best in dilute solutions.=--Tincture of guaiacum produces in the watery solution a reddish-white precipitate of the resin. The corpuscles of birds. The hæmatin of old stains dissolves very slowly. (c) =Action of Water. (e) =Action of Caustic Potash. but on addition of an aqueous solution of peroxide of hydrogen.=--Nitric acid added to a watery solution produces a whitish-grey precipitate. and this will give a solution of alkaline hæmatin. at once distinguishing it from rust. Should the blood-stain on the metal be long exposed to the air. The human blood-corpuscle is a non-nucleated. when the test will fail. (d) =Action of Heat. . are oval and nucleated. Rust is not soluble in water. (f) =Action of Nitric Acid.=--With the aid of the microscope.=--The solution of blood obtained in water is boiled. so that the medical witness is rarely justified in going farther than stating whether the stain is that of the blood of a mammal or not. a blue or bluish-green colour is developed. for tincture of guaiacum is coloured blue by milk. biconcave disc.(b) =Microscopic Demonstration.

If ammonia be added to the original solution. (j) =Precipitin Test. _Hæmochromogen_ gives a very characteristic spectrum. until from three to five injections have been given. By shaking the solution.=--If a solution of a recent stain be examined by the spectroscope. _Methæmoglobin_ is formed in stains which have been exposed to the air for a few days.' or Uhlenhuth's test. These bands indicate _oxyhæmoglobin_. and is obtained by reducing alkaline hæmatin by ammonium sulphide. =Rust Stains. on slowly evaporating it. _alkaline hæmatin_ is produced. It is again heated until bubbles appear. _acid hæmatin_ is produced. (i) =Spectroscopic Appearances.c. but it is not reduced by ammonium sulphide. we get two absorption bands situated between the lines D and E. and _hæmatin_ is found in old stains. but with the blood of no other animal. A cover-glass is placed over this.=--These are produced by heating a drop of blood. They are dark brown or yellow rhombic prisms. The serum of this animal's blood will then give a white precipitate only when brought into contact with dilute solutions of human blood.(h) =Hæmin Crystals (Teichman's Crystals). and each gives its appropriate absorption bands. An improvement on this test is the use of formic acid alone. oxyhæmoglobin is again reproduced. _Carbon monoxide hæmoglobin_ gives a spectrum which resembles that of oxyhæmoglobin. and gives its special absorption bands. numerous very small dark crystals are visible if hæmoglobin has been present (Whitney's test). which is a single broad absorption band situated in the interval between the preceding oxyhæmoglobin bands. and do not stiffen . or if acetic acid be chosen. or a watery solution of it.=--These are yellowish-red in colour. of human blood is injected into its peritoneal cavity at intervals. Crystals of hæmin may now be detected by the microscope. we get the spectrum of _reduced hæmoglobin_. and a drop of glacial acetic acid allowed to run in.=--This allows us to tell whether the blood is from a human being or not. A specific serum must be obtained from a rabbit which is sensitized as follows: 10 c. the one nearer E being doubly as broad as the other. This is known also as the 'biologic. If we now add a little ammonium sulphide to this solution. with a minute crystal of sodium chloride on a glass slide and evaporating to dryness.

with small root-like filaments. convulsions. =Fruit Stains= are seldom so dark as blood-stains. ears. continuous.=--Human hairs must be identified and distinguished from those of the lower mammals. convulsions of stretching character. or that the root is encased in a fatty sheath. XVI._--Cadaveric lividity well marked. heart continues to beat for three to four minutes after breathing ceases. nose. when. with much bloody mucus escaping from mouth and nose. anxiety. If the hair has been pulled out from the root. and soon cease. ammonia changes the colour to blue or green. relaxation of sphincters. Respirations feeble and gasping. appearance may be placid or. Loss of consciousness. the tongue may be protruded and eyeballs prominent. silk fibres are solid. and striated transversely._--The blood is dark and remains fluid. air hunger. linen fibres are round. and highly glistening. on adding ferrocyanide of potassium. _Internal. the microscope will show that the bulbous root has a concave surface which fitted over the hair papilla.the cloth. great engorgement of .=--Microscopically. 2. ringing in ears. 3._--There are usually three stages: 1. if asphyxia has been sudden. congested appearance of face. lips. curly. Solutions of these do not change colour or coagulate on boiling. acid brightens the original colour. jointed at frequent intervals.--DEATH BY SUFFOCATION _Signs and Symptoms. finger-tips almost black in colour. cotton fibres appear as flattened bands twisted into spirals. The iron may be dissolved by placing the stain in a dilute solution of hydrochloric acid. =Fibres of Clothing. _Post-Mortem Appearances--External. Prussian blue is produced. wool fibres are coarse. while chlorine bleaches it. Exaggerated respiratory activity. =Hairs.

much bloody froth escapes on squeezing them. XVIII. right side of heart. The mark on the neck. owing to . and may be produced some hours after death. etc. with an almost entire absence of the signs just given. XVII. The mark of the cord is not a sign of hanging. and the hands are clenched. is a purely cadaveric phenomenon. It may be effected by a ligature round the neck. death occurs by asphyxia.venous system. or torn. When homicidal. and death takes place in four or five minutes. tongue swollen and livid. great veins of thorax and abdomen. spleen. bruised. air-cells distended or ruptured. which may be more or less interrupted by the beard. much injury is done to the neck. In ordinary suicidal hanging there may be entire absence of injury to the soft parts about the neck.--DEATH BY STRANGULATION This differs from hanging in that the body is not suspended. and the inner coats of the carotid arteries are sometimes found divided. many small hæmorrhages on surface of lungs and other organs. which in hanging is obliquely round the neck following the line of the jaw. mucous lining of trachea and bronchi congested and bright red in colour. In judicial hanging. and the spinal cord injured so high up that almost instant death takes place. or by direct pressure on the windpipe with the hand. shows the course of the cord. liver. Lungs dark purple in colour. On dissection the muscles and ligaments of the windpipe may be found stretched. Sensibility is soon lost. the cervical vertebræ are dislocated.--DEATH BY HANGING In hanging. as well as in their substance (_Tardieu's spots_). Strangulation is frequently suicidal. due to rupture of venous capillaries from increased vascular pressure. the length of the drop modifying these appearances. In other cases the countenance is placid. owing to the long drop. but may be accidental. but. but straight round in strangulation. blood or bloody froth is found about the mouth and nostrils. in which case death is said to be caused by _throttling_. The eyes in some cases are brilliant and staring. death is not due to asphyxiation. as in drowning.

the lungs are found to be increased in size ('ballooned'). sand. . Do this every five seconds. and shows that the person fell into the water alive). water mud. XIX. The presence of this fine (often blood-stained) froth is the most characteristic sign of drowning. _Schäfer's. Tardieu's spots are not so frequently met with in cases of drowning as in other forms of asphyxia. The post-mortem appearances include those usually present in death by asphyxia. etc.the force with which the ligature is drawn. with sand or mud under the nails. on section. retraction of penis and scrotum. injuries from passing vessels. together with the following. Kneel over him athwart or on one side facing his head. peculiar to death by drowning: Excoriations of the fingers. etc. The fluid acts mechanically by entering the air-cells of the lung and preventing the due oxidation of the blood. cutis anserina. Get back into position at once. In throttling. The other signs of death by asphyxia are present. with a folded coat under the lower part of the chest. Place your hands flat over the lower part of his back. the marks of the finger-nails are found on the neck.--DEATH BY DROWNING Death by drowning occurs when breathing is arrested by watery or semi-fluid substances--blood. and make pressure on his ribs on both sides. Froth like that of soap-suds in the trachea is an indication of a vital act. and throw the weight of your body on to them so as to squeeze out the air from his chest. in air-tubes. The blood collects in the venous system. water in the stomach (this is a vital act. fine froth at the mouth and nostrils. The presence of vomited matters in the trachea and bronchi is a valuable sign of drowning._--Place the patient on his face. Go to work at once. Wounds may be present on the body. urine. and must not be mistaken for the tenacious mucus of bronchitis. due to falling on stakes. and get someone to time you with a watch. On post-mortem examination. fragments of plants grasped in the hand. and is dark and fluid. Keep this going for half an hour. and when you are tired get someone to relieve you. but leave your hands as they were. Unfasten the collar and neckband. froth. The methods of performing artificial respiration in the case of the apparently drowned are the following (the best and most easily performed is Schäfer's prone pressure method): 1.

and internal organs are shrivelled and bloodless. bad-smelling excretion. and froth from the air-passages. _Marshall Hall's. 5. on relaxing the pressure the chest again fills with air. Hypodermic injections of 1/50 grain of atropine. lungs. with a folded coat under the chest._--This consists in placing the patient in the prone position. in . and rolling the body alternately into the lateral and prone positions. and covered with a brown. The heart. and this method may be employed along with any of the other methods. The patient is in the supine position--but first the water must have been drained from the mouth and nose by keeping the body in the prone position. _Laborde's Method. and not only blocks the entrance of air. _Howard's. may be found useful.--DEATH FROM STARVATION The post-mortem appearances in death from starvation are as follows: There is marked general emaciation. but the gall-bladder is distended with bile. The objections to the supine position are that the tongue falls back. and thus dragging upon and elevating the ribs. suprarenal or pituitary extracts._--This consists in holding the tongue by means of a handkerchief. the skin is dry. XX. shrivelled.Other people may apply hot flannels to the limbs and hot water to the feet. 3. The stomach is sometimes quite healthy. and free from fat. _Silvester's. the muscles soft. the liver is small._--This consists in emptying the thorax by forcibly compressing the lower part of the chest. The tongue must be kept forward by transfixing with a pin. Here the patient is placed in the supine position. and rhythmically drawing it out fully at the rate of fifteen times per minute. mucus. the chest being emptied by lowering the arms against the sides of the chest and exerting lateral pressure on the thorax. atrophied. This excites the respiratory centre. holding them by the elbows. but prevents the escape of water. 2._--In this method the capacity of the chest is increased by raising the arms above the head. 4.

The hair may be singed or burnt and the clothing damaged. and ulcerated. arborescent markings are not uncommon. then the probability is great (provided there be no actual disease present) that the child has been starved.g. but what is supplied is insufficient in quantity or of improper quality. lacerated. bruises or skin eruptions. In America. Rigor mortis is very rapid in its onset and transient. in others the body may be most curiously marked. stricture of oesophagus. In some cases there are no signs. Wounds of various characters--contused._. The alternating current is supposed to be more fatal than the continuous. presence of vermin. where electricity is adopted as the official means of destroying criminals. There may be burns. Post mortem there are no characteristic signs.g. dirtiness of skin and hair. tuberculosis. one must examine the body for signs of neglect--_e. If the disproportion be great and signs of neglect present. In the case of children there is not always absolute deprivation of food. and ecchymoses. empty. The defence commonly set up is that the child died either of marasmus or of tuberculosis. In the absence of any disease productive of extreme emaciation (_e. Addison's disease). 1. The presence or absence of a storm may assist the diagnosis.000 volts will kill. XXI.500 volts is regarded as the lethal dose.other cases it may be collapsed. Much depends on whether the contact is good (perspiring . In cases where it is alleged that a child has been starved and ill-used. but the blood may be dark in colour and fluid. Injuries by electrical currents of high pressure are not uncommon.--DEATH FROM LIGHTNING AND ELECTRICITY The signs of death from lightning vary greatly. empty.000 to 2. but there are many instances of persons having been exposed to higher voltages without bad effects. Compare its weight with a normal child of the same age and sex. The intestines are also contracted. such a state of body will furnish a strong presumption of death by starvation. and punctured--may be produced. vesications. speaking generally. and translucent. 1._. diabetes.

hands or damp clothes). Death has been attributed in these cases to
respiratory arrest or sudden cessation of the heart's action. The best
treatment is artificial respiration, but the inhalation of nitrite of
amyl may prove useful. Rescuers must be careful that they, also, do not
receive a shock. The patient should be handled with india-rubber gloves
or through a blanket thrown over him.
XXII.--DEATH FROM COLD OR HEAT
=Cold.=--The weak, aged, or infants, readily succumb to low
temperatures. The symptoms are increasing lassitude, drowsiness, coma,
with sometimes illusions of sight. Post mortem, bright red patches are
found on the skin surface, and the blood remains fluid for long.
=Heat.=--Death may result from syncope, the result of exposure to great
heat.
=Sunstroke.=--The person loses consciousness and falls down insensible;
the body temperature may be 112° F., the pulse is full, and a peculiar
pungent odour is given off from the skin. Coma, convulsions with
(rarely) delirium, may precede death. _Treatment_ consists in lowering
the body temperature by application of cold cloths, stimulants,
strychnine or digitalin hypodermically.
XXIII.--PREGNANCY
The signs of the existence of pregnancy are of two kinds, uncertain and
certain, or maternal and foetal. Amongst the former class are
included--Cessation of menstruation (which may occur without pregnancy);
morning vomiting; salivation; enlargement of the breasts and of the
abdomen; quickening. It must be borne in mind that every woman with a
big abdomen is not necessarily pregnant. The tests which afford
conclusive evidence of the existence of a foetus in the uterus
are--Ballottement, the uterine souffle, intermittent uterine
contractions, foetal movements, and, above all, the pulsation of the
foetal heart. The uterine souffle is synchronous with the maternal

pulse; the foetal heart is not, being about 120 beats per minute.
Evidence of pregnancy may also be afforded by the discharge from the
uterus of an early ovum, of moles, hydatids, etc. Disease of the uterus
and ovarian dropsy may be mistaken for pregnancy. Careful examination is
necessary to determine the nature of the condition present. Pregnancy
may be pleaded in bar of immediate capital punishment, in which case the
woman must be shown to be 'quick with child.' A woman may also plead
pregnancy to delay her trial in Scotland, and both in England and
Scotland, in civil cases, to produce a successor to estates, to increase
damages for seduction, in compensation cases where a husband has been
killed, to obtain increased damages, etc. A woman may become pregnant
within a month of her last delivery.
In cases of rape and suspected pregnancy, it must be borne in mind that
a medical man who examines a woman under any circumstances against her
will renders himself liable to heavy damages, and that the law will not
support him in so doing. If, on being requested to permit an
examination, the woman refuse, such refusal may go against her, but of
this she is the best judge. The duty of the medical man ends on making
the suggestion.
XXIV.--DELIVERY
The signs of recent delivery are as follows: The face is pale, with dark
circles round the eyes; the pulse quickened; the skin soft, warm, and
covered with a peculiar sweat; the breasts full, tense, and knotty; the
abdomen distended, its integuments relaxed, with irregular light pink
streaks on the lower part. The labia and vagina show signs of distension
and injury. For the first three or four days there is a discharge from
the uterus more or less sanguineous in character, consisting of blood,
mucus, epithelium, and shreds of membrane. During the next four or five
days it becomes of a dirty green colour, and in a few days more of a
yellowish, milky, mucous character, continuing for two to three weeks.
The change in character of the lochial discharge is due to the quantity
of blood decreasing and its place being taken by fatty granules and
leucocytes. The os uteri is soft, patulous, and its edges are torn. The
uterus may be felt for two or three hours above the pubis as a hard
round ball, regaining its normal size in about eight weeks after
delivery. Most of these signs disappear about the tenth day, after which

it becomes impossible to fix the date of delivery.
In the dead the external parts have the same appearance as given above.
The uterus will vary in appearance according to the time elapsed since
delivery. If death occurred immediately after delivery, the uterus will
be wide open, about 9 or 10 inches long, with clots of blood inside, and
the inner surface lined by decidua.
The signs of a previous delivery consist in silvery streaks in the skin
of the abdomen, which, however, may be due to distension from other
causes; similar marks on the breast; circular and jagged condition of
the os uteri (the virgin os being oval and smooth); marks of rupture of
the perineum or fourchette; absence of the vaginal rugæ; dark-coloured
areola round the nipples, etc. The difference between the virgin _corpus
luteum_ and that of recent pregnancy is not so marked as to justify a
confident use of it for medico-legal purposes.
XXV.--FOETICIDE, OR CRIMINAL ABORTION
This consists in giving to any woman, or causing to be taken by her,
with intent to procure her miscarriage, any poison or other noxious
thing, or using for the same purpose any instruments or other means
whatsoever. It is a felony to procure or attempt to procure the
miscarriage of a woman, whether she be pregnant or not, and it is a
felony for the woman, if pregnant, to attempt to procure her own
miscarriage. It is a misdemeanour for any person or persons to procure
drugs or instruments for a like purpose. It is not necessary that the
woman be _quick_ with child. The offence is the intent to procure the
miscarriage of any woman, _whether she be or be not with child_. When
from any causes it is necessary to procure abortion, a medical man
should do so only after consultation with a brother practitioner. Even
in these cases there is no exemption legally. Any medical man who gives
even the most harmless medicine where he suspects the possibility of
pregnancy may render himself liable to grave suspicion should the woman
abort.
In medicine, an _abortion_ is said to occur when the foetus is expelled
before the sixth month; after that it is _premature birth_. In law,
however, any expulsion of the contents of the uterus before the full
time is an _abortion_ or _miscarriage_.

the examination of the substances expelled must be carefully made. by falls. etc. In the hands of ignorant persons the use of instruments (sounds. should all be carefully examined. and especially in those who have borne children. or any other drug administered internally.--INFANTICIDE Infanticide. with inflammation of the contents of the true pelvis. Perforation of the vaginal walls. the presence or absence of constipation. for in the former case no criminal intent may exist. pennyroyal. etc. or soon after. The term is applied technically to those cases in which the mother kills her child at. bitter-apple. Septic pelvic peritonitis may ensue. although pregnancy be present. and abortion may follow. and the os uteri. and therefore the result of conception. It is usually committed with the object of concealing delivery. or the coat of the uterus. An examination of the woman will be necessary. and unconnected with pregnancy. but is tried by the same rules as in cases of felonious homicide. Moles are blighted foetuses. in popular language. The state of the breasts. though it is not easy during the early months of pregnancy. except when taken in such large doses that actual poisoning results. She is often in such a condition of mental anxiety as not to be responsible for her actions. violent exercise. blows on the abdomen. Diachylon pills are largely employed to induce abortion. will cause a woman to abort. the hymen. and very often the woman taking them suffers severely from lead-poisoning. its birth. bladder. cervix. Abortion may be procured by the introduction of instruments.In deciding whether any substance expelled from the uterus is really a foetus or a mole. and the woman may lose her life. Putting a few apparently unimportant questions as to the frequent use of purgatives. XXVI. The history must be inquired into. to say whether abortion has taken place or not. savin. is not treated as a specific crime. 'strayed . and to hide the fact that the girl has. will often assist the diagnosis as showing that the woman has acted in an unusual manner. the regular or exceptional use of drugs to promote menstruation is important. skewers. In such cases reflex uterine contractions may be set up. may follow their use. bougies. or the murder of a new-born child. or uterus. The person who has employed such means for inducing abortion is liable to be charged with the crime of murder.) is attended with great danger. There is no evidence to show that ergot.

clitoris covered by the labia. Killing a child in the act of birth and before it is fully born is not infanticide. Every child is held in law to be born dead until it has been shown to have been born alive._. length of child 10 to 14 inches--that is. umbilicus midway between the ensiform cartilage and pubis. (3) Blows on the head. membrana pupillaris disappearing.' The child must have had a separate existence. Medical evidence will be called to show that the child was born alive. the woman may in England be tried for _concealment of birth_. meconium at upper part of large intestine.from the paths of virtue. dusky red. allowing it to lie under the bed-clothes and be suffocated. weight. and in Scotland for _concealment of pregnancy_. points of ossification in centre of cartilage at lower end of femur.' the child must have been alive after its body was entirely born--that is. nails not reaching to ends of fingers. 7 to 8 pounds. skin rosy. (2) Strangulation with the hands. testes past inguinal ring. meconium at termination of large intestine. With regard to the question of the maturity of a child. sebaceous matter on the body. (4) Drowning by putting it in the privy or in a bucket of water. skin. not separating the cord. about 1-1/2 to 2-1/2 lines in diameter. membrana pupillaris disappeared. testes near kidneys. length of child 18 to 22 inches. though this does not imply the severance of the umbilical cord. To constitute 'live birth.g. At nine months. by a tape or ribbon. the differences between a child of six or seven months and one at full term may be stated as follows: Between the sixth and seventh month. or dashing the child against the wall. nails reach to ends of fingers. Owing to the difficulty of proving that the crime of infanticide has been committed. (5) Omission: by neglecting to do what is absolutely necessary for the newly-born child--_e. the length of the child after the fifth month is about double the lunar months--weight 1 to 3 pounds. no appearance of convolutions in brain. if she conceal . but if before birth injuries are inflicted which result in death after birth. hair on head about an inch long. The methods of death usually employed are--(1) Suffocation by the hand or a cloth. or by the umbilical cord itself. lanugo only about shoulders. points of ossification in four divisions of sternum. it is murder. covered with downy hair (lanugo) and sebaceous matter. entirely outside the maternal passages--and it must have had an independent circulation.

Under an anæsthetic the uterus acts as energetically as if the patient were in the full possession of her senses. The charge of concealment is very often alternative to infanticide. and it is a mere travesty of justice to pass on her the death sentence. for the contractile power of the womb is independent of volition. In this case the body will be flaccid and flattened. the skin of a red or brownish-red colour. and so should have talked about it or have made clothes. and accompanied by laceration of the scalp. usually depressed. the head soft and yielding. A negative opinion may be formed when evidence is found of the child having undergone intra-uterine maceration. the cavities filled with abundant bloody serum. and are attended with such hæmorrhage as could only have occurred while the blood was circulating. the umbilical cord straight and flaccid. the ilia prominent. the cuticle more or less detached. and are situated on the vertex or in the parietal protuberance. etc.--EVIDENCES OF LIVE BIRTH The signs of live birth prior to respiration are negative and positive. To substantiate the charge. XXVII. It is expected that every pregnant woman should make provision for the child about to be born. and raised into large bullæ. Fractures of the cranium from accidental falls (precipitate labour) are as a rule stellate.. well knowing that it will never be executed. it must be proved that there had been a _secret disposition of the dead body_ of the infant. Either of these charges would only be brought against a woman who had obviously been pregnant.her pregnancy during the whole time and fail to call for assistance in the birth. for it. as well as an endeavour to conceal its birth. A woman may be delivered of a child unconsciously. The punishment for concealment is imprisonment for any term not exceeding two years. and now the child is missing or its dead body has been found. The fractures from violence are more extensive. A positive opinion is justified when such injuries are found on the body as could not have been inflicted during birth. however. The evidences of live birth after respiration has taken place are . Nowadays a woman is rarely hanged for infanticide.

in a putrefied child. when the hydrostatic test. After respiration they expand and occupy the whole thorax. there is an absence of any of the signs of suffocation. but this test is of little value. (2) This objection is too refined for practical use. To take these objections in detail. The lungs decompose late. Few of these objections apply. As originally performed. The test is now modified by squeezing. the question of live birth is answered. without mottling. The objections to the test as originally performed are--(1) That the lungs may sink as the result of disease--_e. and rises higher in the thorax in the former case than in the latter. those in which it has not. and do not fill that cavity. The lung test simply shows that the child has breathed. owing to large portions of lung tissue remaining unexpanded (_atelectasis_). and can be expelled by pressure. (4) The lungs may have been inflated artificially. in water. The lungs are mottled from the presence of islands of aerated tissue. about 1 to 70. modified by pressure. with or without the heart. (3) Putrefaction may cause the lungs to float when respiration has not taken place.g. The so-called _emphysema pulmonum neonatorum_ is simply incipient putrefaction. 1 to 35. is. Lungs in which respiration has taken place float in water. and closely surround the heart and thymus gland. red-brown colour and of the consistence of liver. which is also unreliable._. and crepitate under the finger. (3) Gas due to putrefaction collects under the pleural membrane. is employed. The weight of the lungs before respiration is about 550 grains. and the matter ends. (2) That respiration may have been so limited in extent that the lungs may sink. and is not found in the air cells. double pneumonia. however. before respiration. but affords no . after an hour's respiration 900 grains. The lungs sink. and noticing whether they sank or floated. though indications are also found in other organs. after. The diaphragm is more arched before than after respiration. this test consisted merely in placing the lungs. hence in a fresh body putrefaction of the lungs is absent. it may be stated: (1) If the lungs sink from disease. There are exceptions to this rule.usually deduced from the condition of the lungs. and is not required to indulge in conjectures as to the amount of respiration which may or may not have taken place. if the lungs sink. it must have been stillborn. The lungs before respiration are situated in the back of the thorax. The ratio of the weight of the lungs to that of the body (Ploucquet's test). The portions containing air are of a light brick-red colour. however. they are of a dark. on which. The examiner has only to describe the conditions which he finds. is founded the _hydrostatic test_. sink. surrounded by arteries and veins. and by cutting the lungs up into pieces.

The child may have breathed as soon as its head protruded. this is known as Breslau's second life test. recognized by the microscope and by Trommer's test for sugar. firm. and there is a distinct inflammatory circle round its insertion. and the extent to which these changes have advanced will give an idea of how long the child has lived: The _ductus arteriosus_ begins to contract within a few seconds of birth. The _foramen ovale_ becomes obliterated at extremely variable periods. It is seldom that a child bleeds to death from an untied or cut umbilical cord. although it is not necessary that the umbilical cord should have been cut. and falls off about the fifth day. then flattened and shrivelled. If the stomach and duodenum contain air. and the chances in a torn cord are still more remote. live birth may be suspected from the following conditions: The _stomach_ may contain milk or food. then ensues about the . The third stage. and may continue open even in the adult. the _large intestines_ in stillborn children are filled with meconium. and is rarely delayed beyond thirty hours. the cord becomes reddish-brown. this change may begin early. Importance of late has been attached to the _stomach-bowel test_. The next change is that of desiccation or mummification. The umbilical cord in a new-born child is fresh. The _umbilical arteries and vein_: the arteries are remarkably diminished in calibre at the end of twenty-four hours. The changes in the cord are as follows: First it shrinks from the ligature towards the navel. the cord becomes flabby. and consequently float in water. that of cicatrization. and bluish in colour. the umbilical vein and the ductus venosus are generally completely contracted by the fifth day. the _skin_ is in a condition of exfoliation soon after birth. the chances are that the child did not die immediately after birth. In addition to these tests. the rest of the body being in the maternal passages. The _organs of circulation_ undergo the following changes after birth. then translucent and of the colour of parchment.proof that the child has been born alive. at the end of a week it is about the size of a crow quill. in those born alive they are usually empty. the _bladder_ is generally emptied soon after birth. and about the tenth day is obliterated. and the ruptured parts present ragged ends. The cord may be ruptured by the child falling from the maternal parts in a precipitate labour. round. The child is not born alive until it has been completely expelled. and obliterated almost up to the iliacs in three days. and the lower the air in the intestinal canal. the greater is the probability that the child survived birth. blood is contained in its vessels.

--CAUSE OF DEATH IN THE FOETUS The death of the foetus may be due to--(1) Immaturity or intra-uterine malnutrition. and the stage at which the separation of the cord by ulcerative process has arrived will point to the probable duration of time the child has existed after birth. with inflammatory thickening and slight purulent secretion. allowing it to be suffocated by discharges in the bed. fracture of the bones of the head and face. heart. asphyxiation from the funis being twisted tightly round the neck or limbs. There are many fallacies in the application of any of these tests. and warmth. clothes. Under the head of infanticide by _commission_. In the latter category come such accidents as the pressure of tumours in the pelvic passages.--DURATION OF PREGNANCY . (2) complications occurring during or immediately after birth. The medical witness would do well to exhibit a cautious reserve. under infanticide by _omission_. Where the death of the foetus has been induced with criminal intent. for the new-born child. or simply from deficient vitality. XXIX. we have injuries of all kinds. or from injuries due to falls on the floor in sudden labours. strangulation. for if the child dies immediately after birth it is almost impossible to prove that it was born alive. neglect to provide food. may be considered as evidence of live birth. or from being thrown into water. or disease of the bones in the mother. neglecting to tie the cord. and the whole subject bristles with difficulties. or may be induced with criminal intent. dislocation of the neck.tenth to the twelfth day. it may be due to punctured wounds of the fontanelles. suffocation. or spinal marrow. which may either be unavoidable or inherent in the process of parturition. orbits. drowning in the closet pan or privy. The bright red rim round the insertion of the cord. or pressure on the cord from malposition of the child during labour. XXVIII. separation of the head from the body.

which are not sufficiently defined to be recognized by those conceiving for the first time. and. the Lord Chancellor accepted a case where it was alleged pregnancy had extended to 331 days. at one monthly period. It may be mentioned that 300 days is the extreme limit fixed by the French and Scottish law.The natural period of gestation is considered as forty weeks.._ This does not. In Scotland a child born six months after marriage is legitimate. cause this. however. The data from which it is calculated are the following: (1) _Peculiar sensations attending conception_. and the woman become pregnant before the next. (4) _A single coitus. etc. have been recorded in which children born at six months have been reared. In a recent case decided. however. on the other hand. for the menses may be arrested by cold. and if this time were not very materially exceeded it would be well to give the woman the benefit of the doubt._ Other causes may. XXX. A medical witness would have to admit the possibility of gestation being prolonged to 300 days. (2) _Cessation of the catamenia. Many cases. Several days may elapse before the spermatozoa meet with an ovum and fertilize it. also occurs at variable periods from the tenth to the twenty-sixth week. for a short time at all events.--VIABILITY OF CHILDREN A child may be born alive. There is considerable difficulty in many cases in fixing the date of conception. No fixed period is assigned in English or American law to the duration of pregnancy. The signs of immaturity and maturity may be thus tabulated: . when perceived (which is not always the case). or 280 days. 180 days represents the lowest limit at which a child is viable. Speaking generally. ten lunar months. but may not be viable. correspond to the time of fertilization. but prolonged survival under these circumstances is the exception. however. This datum also gives a variable period. which is allowing an ample margin. (3) _The period of quickening. A child only five months old may live. a woman may menstruate during the whole period of her pregnancy. though it is allowed that utero-gestation may be greatly prolonged. by which is meant that it is not endowed with a capacity of maintaining its life._ This. and may involve an error of several days or a month.

In the last case. The offspring of voidable or invalid marriages may be made legitimate by application to the courts.--LEGITIMACY A child born in wedlock is presumed to have the mother's husband for its father. head Strong movements and cries as soon disproportionate in size. pupillaris present. nails not nails. This may. impotence or disease in the husband preventing matrimonial intercourse. and downy covering. and ears. hair. mouth. testicles descended. eyebrows. membrana as born. intense red skull somewhat firm. the child at the age of twenty-one is at liberty to select its father from the possible pair. deep red colour of nostrils. indicated by seizure on the sleep. formed. A child born of parents before marriage is in Scotland rendered legitimate by their subsequent marriage. necessity for of urine and meconium. almost unbroken suction. feeble movements. closed state of mouth. XXXI. want of access. but if the parents were married only a week previously it could not have been lawfully begotten.IMMATURITY. free discharge inability to suck. rare and imperfect nipple or a finger placed in the discharges of urine and meconium. open. MATURITY. parts of generation. and fontanelles colour. The Acts and rulings relating to Marriage and Legitimacy are extremely . undescended. be open to question upon the following grounds: Absence or death of the reputed father. and not far apart. testicles coated with sebaceous matter. however. and the marriage of the woman again immediately on the death of her husband. A child born in wedlock is legitimate. red colour. eyelids. mottled appearance. of skin. There is a difference between being legitimate and lawfully begotten. premature delivery in a newly-married woman. body clear. where either husband might have been the father. but in England the offspring remains illegitimate whether the parents marry or not after its birth. Centre of body high. and nostrils. power of artificial heat. perfectly developed. eyelids. mouth.

and it . must be born during the lifetime of the mother. XXXIII. monsters are incapable of inheriting.' When a man marries a woman possessed of an estate or inheritance. on the other hand. It has been shown that the os uteri is not closed. or the fact of it having been heard to cry by witnesses. Should an ovum escape into the uterus.--SUPERFOETATION By superfoetation is meant the conception. The most probable explanation is that the case has been one of twins. the uterus may have been double. of a second embryo. as was once supposed. in this case he shall. In Civil law any motion of the child's body. however slight. immediately _on conception_.complicated. or. issue born alive in her lifetime capable of inheriting her estate. by a woman already pregnant. XXXII. and that thousands of children who have not the slightest doubt as to their legitimacy are in the eyes of the law bastards.--INHERITANCE In order to inherit. and must be born capable of inheriting--that is to say. the child must be born alive. but there are well-authenticated cases which countenance the theory of a double conception. by her. on the death of his wife. The meaning of the words 'born alive' in this instance is not the same as in cases of infanticide. or in two separate births. It may die immediately afterwards. The possibility of the occurrence of superfoetation has been doubted. is held to be sufficient proof of the child having been born alive. and conception may have taken place in one cornu at a later period than in the other cornu. differing much in their degree of maturity. It is not putting it too strongly to say that a very large number of people in this country who believe themselves to be legally married are not married at all. hold the lands for his life as tenant by the courtesy of England. and has. it may become impregnated a month or so after a previous conception. one being born prematurely. with a considerable interval between. There is a mode of inheritance called 'tenancy by courtesy. resulting in the birth of two children at the same time.

whilst the male sopranos. malformation of the genital organs. timidity. XXXIV. impotence may arise from physical or mental causes. The mental causes include--passion.is not necessary that the child be viable. imperforate hymen. marriage. or _castrati_. . In the case of the Earl of Essex the defendant admitted the charge as regards the Countess. The physical causes may be--too great or too tender an age. as far as the law goes. When a man becomes impotent _after_ marriage. before marriage--and should be of a permanent or incurable nature. and tumours of the vagina. impotence may be caused by the narrowness of the vagina. or debility from acute disease. are often utilized for that purpose. Eunuchs are capable of affording illicit pleasure. and disgust. although it deprives him of his procreative power. A man may be _sterile_ without being impotent. adhesion of the vulva. but pleaded that he was not impotent with others. defect or disease in the testicles. aversion. the marriage may be set aside on the ground that it had never been consummated. and early and excessive sexual indulgence. The wife may be practically impotent. but the law will not take cognizance of that. but this custom is no longer regarded with favour by the judges. He must continue to do his best under difficult circumstances. his wife must accept the situation. as many of her waiting-maids could testify. but the law will not assist the husband. etc. are also causes. apprehension. If a man is impotent when he marries. Masturbation. absence of vagina. In the female. In former times in case of doubt a husband was permitted to demonstrate his competency in open court. The case will be remembered of the man who was impotent unless the lady were attired in a black silk dress and high-heeled French kid boots.--IMPOTENCE AND STERILITY In the male. The law requires that the impotency should have existed _ab initio_--that is. _crypsorchides_. being regarded as a contract in which it is presupposed that both the contracting parties are capable of fulfilling all the objects of marriage.). and has no redress. neurasthenia. as mumps. The removal of the testicles does not of necessity render a man impotent. constitutional disease (diabetes.

let us say. Intercourse with a girl between thirteen and sixteen. she not resisting. since she is not of an age to become a consenting party. The perpetrator must be above the age of fourteen years. has connection with her.' and it is not 'against her will. the case of a woman who goes to bed expecting her husband to return at a certain hour. dysmenorrhoea.' as she has not been fully informed as to all the circumstances of the case. takes advantage of this fact. and even the solicitation of the act on the part of the child will not exonerate the accused. and. 49. The consent of the girl makes no difference. threats. but her statements may be impugned on the ground of her previous bad character. The woman is a competent witness.. c. together with absence of the uterus and ovaries. XXXV. In all cases of rape in which there is no actual resistance or objection.g. The child is sent out to . constant amenorrhoea.--RAPE Rape is the carnal knowledge of a woman by force and against her will. This Act is a favourite with the blackmailer. It is not essential that the woman should state in so many words that she does not object. and evidence may be called to substantiate the charge. syncope. By 48 and 49 Vict. syphilis. The lodger. Her consent makes no difference. fear. horror. assuming all the while that it is her husband. or menorrhagia. The force used may be moral and not physical--_e. the carnal knowledge of a girl under thirteen is technically rape. even with her consent._. or from great debility. consent may be assumed.' but it is 'without her consent. getting into bed. The resistance of the woman _must be_ to the utmost of her power.Sterility in women may occur from the above-named causes of impotence. is a misdemeanour. An attempt at carnal knowledge of a girl under thirteen is a misdemeanour. for example. Take. but it is not 'by force. but if she yield through fear or duress it is still rape. This is rape. The definition of rape which we have given is not altogether satisfactory.

C. sister. To constitute rape there must be _penetration_. False charges of rape are very often made. Consent and even solicitation no defence.) or its attempt may be summed up as follows: Under thirteen C. consent immaterial. The motive may be to extort . for obtained by fraud. Subject to civil action for loss of girl's services by father. Idiot or imbecile C. Charge must be brought within three months.K.K. dressed like a woman. From thirteen to sixteen Attempt Misdemeanour. Felony. Married woman C. Misdemeanour. Under thirteen Attempt Misdemeanour. Mother. From thirteen to sixteen C.K.K. with consent Nil. Reasonable cause to believe the girl over sixteen is a good defence. It is a misdemeanour to give to a woman any drug so as to stupefy her. There may be a sufficient degree of penetration to constitute rape without rupturing the hymen. and so enable any person to have unlawful connection with her. with violence Rape. Idiot or imbecile C.K. grand-daughter born in wedlock or not Females Indecent assaults Misdemeanour.solicit. Consent no defence. but appears in the witness-box in a much more juvenile costume. Incest. Over sixteen C.K. Personation of husband Rape. daughter. without violence Misdemeanour. The subject of carnal knowledge (C.K. but this may be of the slightest. with consent Adultery.K. Tacit consent no defence. Proof of actual emission is now unnecessary.

The patient will have difficulty in walking. brownish-red pointed crystals resembling hæmin crystals are obtained. Pregnancy may follow rape. On examining such cases bruises are seldom found.blackmail. 30) in a watch-glass. but scratches which the woman has made on the front of her body may be discovered. and many innocent people have been exposed to danger from false charges of rape on children. Semen may be found on the linen of the woman and man. if present at all. distilled water. with swelling of the external genitals. at least--all signs of rape disappear in three or four days. the laceration in some cases extending into the rectum. In the child there may be no hæmorrhage. may follow the rape of a young child. but as a rule--in the adult. for these bodies are not always present in the semen of even healthy adult young men._--If a drop of the fluid obtained by wetting a supposed spermatic stain be mixed with a drop of the following solution (KI. and blood found on the parts._--In the adult the hymen may be ruptured. Severe hæmorrhage. Spermatozoa must not be mistaken for the _Trichomonas vaginæ_ found in the vaginæ of some women. the fourchette lacerated. and a sticky greenish-yellow discharge is present. with probably considerable laceration of the hymen. A knowledge of these facts suggests the necessity of giving a guarded opinion when children are brought for examination in suspected cases. revenge. 2. _Physical Signs. After some hours the parts are very tender and swollen. together with scratches and other marks and signs of a struggle. On being moistened they give the characteristic seminal odour. . or mere delusion. minute filamentary bodies with a pear-shaped head. parts 1. but there will be indications of bruising on the external organs. These signs last longer in children than in adults. Infantile leucorrhoea is common. simulating an attempt at rape. pure iodine. with translucent edges. and the local injuries to the generative organs are slight. and even death. _Seminal stains_ render the clothing stiff and greyish-yellow in colour. and will be recognized under the microscope by the presence in it of spermatozoa. but it must not be forgotten that the non-detection of spermatozoa is no proof of absence of sexual intercourse.65. _Florence's Micro-Chemical Test for Spermatic Fluid. The latter have cilia surrounding the head. Young and delicate children may suffer from a vaginal discharge.54. and in passing water and fæces. instituted as a means of levying blackmail. which is globular.

and penetration. _Gonorrhoeal Stains. XXXVI. 45). but psychically a woman. with or without hard labour.. Sodomy is a crime both in the active and passive agent. they fail to attract attention. The tendency nowadays is not to charge these people with the more serious offence.--UNNATURAL OFFENCES Trials for =sodomy= and =bestiality= are common at the assizes. It is equally an offence whether the relationship can or cannot be traced through lawful wedlock._--Mix a drop of the spermatic stain with a drop of a saturated solution of picric acid. 1908 (8 Edward VII. provided the relationship is known. unless the latter is a non-consenting party. emission is not essential. A woman may be charged under the Act if she. but. shall be guilty of a misdemeanour. is a misdemeanour. There can be no doubt that in the majority of these cases there exists a congenitally abnormal condition of the sexual instinct. Consent is no defence._Barberio's Test.. c. when needle-shaped yellow rhombic crystals are formed. As in cases of rape. however slight. answers all practical purposes. =Incest. 1885 (48 and 49 Vict. daughter. 69). but to deal with them under Section 11 of the Criminal Law Amendment Act. runs as follows: 'Any male person who in public or private commits or is a party to the commission. c. which is sufficiently comprehensive. sister. or grand-daughter. The man is physically a man. of any act of gross indecency with another male person.' The penalty is imprisonment for two years. being above the age of sixteen._--A cover-glass preparation stained with methylene blue reveals the gonococci lying in pairs within the leucocytes. and _vice versâ_. It also applies to the half-brother and half-sister. If the crime is committed on a boy under fourteen. This section.=--This crime is dealt with under the Punishment of Incest Act. or attempts to procure the commission by any male person. Carnal knowledge with mother. it is a felony in the active agent only. The evidence of either associated may be received as against his colleague. . It is provided by Section 4 of the same Act that a boy under sixteen may be whipped. these individuals from their childhood manifesting a perverted sexual instinct. as they are rarely reported.

which is the essence of the contract. There is the breach-of-promise blackmailer. which he threatens to reveal to your friends or colleagues unless you buy him off.' Put the matter into the hands of a good sharp criminal solicitor. but it is essential that the expressions of consent must be for a matrimonial intent. The introduction of corridor carriages on many of our railways has done much to stamp out one particular form of blackmailing. 'Habit and repute' . for persons having a domicile in Scotland. There is the man who knows something about your past life. It is of no use attempting to deal with these cases single-handed. It is the worst possible policy to temporize with a blackmailer. It is as well to remember that it is just as criminal to attempt to extract money from a guilty as from an innocent person. The consent of the parties. or son. there is the marriage by repute. (4) by the Superintendent-Registrar's licence.with consent permits her grandfather. but public urinals are still a source of danger. you are his for life. You must not only deny the allegation. may be expressed before witnesses. and instruct him to rid you of the nuisance by taking criminal proceedings.--BLACKMAILING There are in London and every large city scores of men and women who live by blackmailing or chantage. XXXVIII. and it is not requisite that a clergyman should assist. father. Medical men from their position are often selected as victims. brother.--MARRIAGE AND DIVORCE Marriage may be accomplished in many ways: (1) By the publication of banns. but 'spurn the allegator. (5) by a special licence granted by the Archbishop of Canterbury in consideration of the payment of the sum of £25. who threatens to charge you with improper conduct or indecent assault. and there is the female patient. Then. If you give him a single penny. XXXVII. There are many different forms of this industry. (3) by a special licence. (2) by an ordinary licence. to have carnal knowledge of her.

but such marriage is strictly speaking inoperative. and is recognized in most foreign countries. and does not of necessity mean physical violence.). She must prove adultery plus cruelty. A woman cannot obtain a divorce from her husband for adultery alone. In a case in which a marriage was solemnized in a building near the church at a time when the church was undergoing repairs. Practically. for when people live together and say they are married. it is difficult in the majority of cases to establish by ocular demonstration that adultery has been committed. she may be able to prove either bigamy or incestuous adultery. it was held that the ceremony was good. If the husband as the result of his infidelity were to give his wife a contagious disease. they are accepted at their own estimate. If the person who officiated were a bogus clergyman. A marriage with a deceased wife's sister is now legal in Great Britain and the Colonies. The cohabitation must be in Scotland. it is a matter of no importance. Failing this. A man can obtain a divorce from his wife if he can prove that she has been guilty of adultery since her marriage. Any irregularity in the marriage ceremony or the non-observance of any formality will not invalidate the marriage. that would probably be held to constitute cruelty. W. But given evidence of familiarity and affection with opportunity and suspicious conduct. if a husband were to have connection in her house with his wife's maid.constitute good evidence. A common device with people within the prohibited degrees is to get married abroad. All marriages between persons within the prohibited degrees of consanguinity or affinity are null and void. that would constitute cruelty. however. or adultery plus desertion without reasonable cause.R. This may be established by inference. If a man were married in a wrong name the contract would still be valid if the wife were unacquainted with the deception at the time. as it would tend to lower her in . and unvarying belief of friends and neighbours. and where during such alterations Divine service had been performed. and the law looks to the _intention_ rather than to the actual details. Legal cruelty is a very comprehensive term. This prohibition extends both to the illegitimate as well as the legitimate children of the late wife's or husband's parents. the marriage would hold good if the contracting parties supposed him to be a properly ordained priest. Bart.. and the children of such union are illegitimate. To all intents and purposes marriage comes under the 'Law of Contract' (see Anson. a jury will commonly infer it. Taking a more extreme case. constant. but the repute must be the general. Obviously. unless it were known to both the contracting parties.

(7) concealment of pregnancy at the time of marriage. as. =Voidable Marriages. but that Mr. and by many is regarded as a disease in itself. but for a divorce she requires more than one. (2) if one of the parties were insane at the time of marriage.the eyes of her servants. to escape punishment or avoid public service--and .=--If a man and woman go through the marriage ceremony. (6) when drunkenness had been induced so as to obtain consent. however. (3) where the plaintiff is under sixteen years of age. that a wife's confession is evidence against herself. that would have come to him or her on the death of the losing party. no decree absolute. or (3) desertion without reasonable cause for two years.. Instead there is a single and final judgment. In Scotland there is no decree nisi. has committed adultery with Mr. A wife can obtain a judicial separation if she can prove (1) adultery. The jury may find that Mrs. has not committed adultery with Mrs.--FEIGNED DISEASES Malingering in its various forms is by no means uncommon. and such not known by the other at the time). the wife in such circumstances may claim her right to one-third of his real estate. (4) when the marriage has not been consummated or followed by cohabitation. but not another's. B. for example. that is not desertion. and if there are children. to distinguish between those cases in which it is feigned for some definite purpose--for example. The explanation is. The Divorce Law of Scotland differs materially from that of England. and to one-half if there are none. it is sufficient if she can prove one variety of matrimonial offence. XXXIX. If the husband is the offender. B. but not against another person. the case of an officer ordered abroad. If a husband is away on his business. It is necessary. and no intervention by the King's Proctor. A. (5) when one of the parties was incapable of performing the marital act (impotent. For a woman to get a judicial separation. (2) cruelty. and when a decree of divorce is pronounced the successful litigant at once succeeds to all rights. A. such a contract is null and void under the following circumstances: (1) Where bigamy has been committed. legal and conventional. You can confess your own sins. to one-third of his personal property.

those in which there is adequate motive, and the patient shams simply
with the view of exciting sympathy, or from the mere delight of giving
trouble. It is not uncommon for individuals summoned on a jury, or to
give evidence in the law courts, to apply to their doctor for a
certificate, assigning as a cause of exemption neuralgia, or some
similar complaint unattended with objective symptoms. In such cases it
is well to remind the patient that in most courts such certificates are
received with suspicion, and are often rejected, and that the personal
attendance of the medical man is required to endorse his certificate on
oath.
Malingering has become much more common since the National Health
Insurance Act has been passed. The possibility of obtaining a fair sum
each week without the necessity of working for it induces many persons
either to feign disease or to make recovery from actual disease or
accident much more tedious than it ought really to be.
The feasibility of successfully malingering is greatly enhanced by the
possession of some chronic organic disease. An old mitral regurgitant
murmur is useful for this purpose.
It is not flattering to one's vanity to overlook a case of malingering,
but should this occur little harm is done. It is a much more serious
matter to accuse a person of malingering when in reality he may be
suffering from an organic disease.
Here are some of the diseases which are most frequently feigned:
=Nervous Diseases=, as headache, vertigo, paralysis of limbs, vomiting,
sciatica, or incontinence or suppression of urine, spitting of blood;
others, again, simulate hysteria, epilepsy, or insanity.
On the other hand, the malingerer may actually produce injuries on his
person either to excite commiseration or to escape from work. Thus, the
beggar produces ulcers on his legs by binding a penny-piece tightly on
for some days; the hospital patient, in order to escape discharge,
produces factitious skin diseases by the application of irritants or
caustics.
It is much more difficult to decide whether certain symptoms are due to
a real disease which is present, or whether they are merely
exaggerations of slight symptoms or simulations of past ones. The miner,
after an injury to his back, recovers very slowly, if at all. He is
suffering from 'traumatic neurasthenia'--a condition only too often

simulated, and a disease very difficult to diagnose accurately. The
miner takes advantage of our ignorance, and continues to draw his
compensation. A workman during his work receives a fracture; instead of
being able to resume work in six weeks, he asserts that the pain and
stiffness prevent him, and this disability may persist for months. Such
cases as these frequently come before the courts when the employer has
discontinued to pay the weekly compensation for the injury. Medical men
are called to give evidence for or against the injured workman.
=Epilepsy= is often simulated. The foaming at the mouth is produced by a
piece of soap between the gums and the cheek. The true epileptic,
especially if he suspects that a fit is imminent, takes his walks abroad
in some secluded spot, whilst the impostor selects a crowded locality
for his exertions. The epileptic often injures himself in falling, his
imitator never; one bites his tongue, but the other carefully refrains
from doing so. The skin of an epileptic during an attack is cold and
pallid, but that of the exhibitor is covered with sweat as the result of
his exertions. In epilepsy the urine and fæces are passed involuntarily,
but his colleague rarely considers it necessary to carry his deception
to this extent. In true epilepsy the eyes are partly open, with the
eyeballs rolling and distorted, whilst the pupils are dilated and do not
contract to light; the impostor keeps his eyes closed, and he cannot
prevent the iris from contracting when a bicycle-lamp is flashed across
his face. A useful test is to give the impostor a pinch of snuff, which
promptly brings the entertainment to an end.
=Lumbago= is often feigned, and the imposture should be suspected when
there is a motive, and when physical signs, such as nodes and tender
spots, are absent. A simple test is to inadvertently drop a shilling in
front of him, when he will promptly stoop and pick it up. The same
principles apply to spurious sciatica.
=Hæmorrhages= purporting to come from the lungs, stomach, or bowels,
rarely present much difficulty. The microscope is of use in all cases of
bleeding. Possibly the gums or the inside of the cheeks may have been
scratched or abraded with a pin.
=Skin Diseases= are excited artificially, especially those which may be
produced by mechanical and chemical irritants. The most commonly
employed are vinegar, acetic acid, carbolic acid, nitric acid, and
carbonate of sodium; but tramps frequently use sorrel and various
species of ranunculus. The lesions simulated are usually inflammatory in
character, such as erythema, vesicular and bullous eruptions, and
ulceration of the skin. They may be complicated by the presence of

pediculi and other animal and vegetable parasites. Chromidrosis of the
lower eyelids in young women often owes its origin to a box of paints.
Factitious skin diseases are seen most commonly on the face and
extremities, especially on the left side--in other words, on the most
accessible parts of the body.
Feigned menstruation, pregnancy, abortion, and recent delivery are
common, and should give rise to no difficulty. The same may be said of
feigned insanity, aphonia, deaf-mutism, and loss of memory.
The following hints may be useful to a medical man when called to a
supposed case of malingering: Do not be satisfied with one visit, but go
again and unexpectedly; see that the patient is watched between the
visits; make an objective examination, compare the indications with the
statements of the patient, noting especially any discrepancies between
his account of his symptoms and the real symptoms of disease; ask
questions the reverse of the patient's statements, or take them for
granted, and he will often be found to contradict himself; have all
dressings and bandages removed; suggest, in the hearing of the patient,
some heroic methods of treatment--the actual cautery, or severe surgical
operation, for example; finally, chloroform will be found of great use
in the detection of many sham diseases.
XL.--MENTAL UNSOUNDNESS
The presumption in law is in favour of a person's sanity, even though he
may be deaf, dumb, or blind.
The terms 'insanity,' 'lunacy,' 'unsoundness of mind,' 'mental
derangement,' 'madness,' and 'mental alienation or aberration,' are
indifferently applied to those states of disordered mind in which the
person loses the power of regulating his actions and conduct according
to the ordinary rules of society. The reasoning power is lost or
perverted, and he is no longer fitted to discharge those duties which
his social position demands. In some cases of insanity, as in confirmed
idiocy, there is no evidence of the exercise of the intellectual
faculties. It is probable that no standard of sanity as fixed by nature
can be said to exist. The medical witness should decline to commit
himself to any definition of insanity. There is no practical advantage
in attempting to classify the different forms of insanity.

With regard to the care of lunatics. examines the lunatic tendered as a witness as to his knowledge of the nature and obligation of an oath. If a person receives another not of unsound mind into his house.--IDIOCY. if suffering from such a state of mental unsoundness as to be unable to take care of his property. XLI. A person. One patient may be taken without the house being licensed. if satisfied. CRETINISM =Idiocy= is not a disease. The judge.According to English law. and otherwise allows him entire freedom of action. and that he did not know at the time of committing the crime that the offence was against the laws of _God_ and _nature_. if they understand the nature of an oath and the character of the proceedings in which they are engaged. IMBECILITY. and such person becomes subsequently insane. as in relation to crime. he allows him to be sworn. At common law it appears that a lunatic cannot be placed in an asylum unless dangerous to himself or to others. may be placed under the care of the Court of Chancery. as in the case of children. but in order to excuse from punishment on this ground it must be proved that the individual was not capable of distinguishing right from wrong in relation to the particular act of which he is accused. no person is allowed to receive more than one lunatic into his house unless such house is licensed and the proper certificates have been signed. but under the Lunacy Acts the placing of a madman in an asylum is considered as a part of the treatment with a view to the cure of the patient. madness absolves from all guilt. Lunatics are competent witnesses in relation to testimony. The Court then administers his property. and the Lunacy Commissioners communicated with. the person so keeping him renders himself liable to heavy penalties. and. but a congenital condition in which the intellectual faculties are either never manifested or have not been sufficiently developed to enable the idiot to acquire an amount of . unless the legal certificates are at once procured and the Commissioners of Lunacy communicated with. but the usual certificates must in all cases be signed.

The characteristics of this form of idiocy are an enlarged thyroid gland constituting a goitre or bronchocele. and moral imbeciles. small legs. shambling. but in regard to crime. =Imbecility= is a form of mental defect not usually congenital. =Cretinism= is a form of amentia. =Feeble-Minded.knowledge equal to that acquired by other persons of his own age and in similar circumstances with himself. and France. and their features ill-formed and distorted. obscene. or as a witness. or general. Feeble-mindedness may affect the moral nature only. etc. but commencing in infancy or in early life. which is endemic in certain districts. sallow complexion. a high-arched palate. Savoy. =Mental Deficiency and Lunacy Act. moral. but are incapable. The parents or guardians of such children between the ages of five and sixteen years must provide for them education and proper care. see remarks made above. squinting eyes. The complexion is sallow and unhealthy. In his legal relations an absolute idiot is civilly disabled and irresponsible. or as to their ability to manage their own affairs. The Act of 1899 controls feeble-minded children. from mental defect which has existed from birth or from an early age. dwarfed stature. large mouth. the School Boards or Parish Councils must do so. Idiots. but its symptoms usually appear within a few months of birth. or unemployable. of (a) competing on equal terms with their normal fellows. The teeth are few in number and very irregular. Questions frequently arise as to their responsibility for actions done by them. in distinction from the mere parrot-like utterance of a few words which can be taught the idiot. Their heads are generally small and badly-shaped. and the gait is awkward. 1913. and indistinct speech.=--These are persons who are capable of earning a living under favourable circumstances. If they are unable to do so. The hard palate has a very deep arch. rendering the person selfish. especially in some of the valleys of Switzerland. and unsteady. the limbs imperfectly developed. conical head. criminals. Imbecility may be intellectual. The line of demarcation between the imbecile and the idiot may be found in the possession by the former of the faculty of speech.=--Those included under this Act are idiots. or (b) of managing themselves and their affairs with ordinary prudence. are deformed in body as well as deficient in mind. . as a rule. The malady is not congenital. or may even be cleft. prostitutes. feeble-minded persons. imbeciles. many such become paupers. untruthful.

apoplexy.XLII. Later on the reasoning powers begin to fail. dulness of perception. Its most prominent and characteristic symptom consists in delusions of great power. AND PARALYTIC In dementia the mental aberration does not occur until the mind has become fully developed. the mind being. =Senile Dementia= is a form which is incidental to aged persons. locomotor ataxy. arrested and fixed in abstraction on the event. Women are comparatively rarely affected by it. the muscular power and force remaining intact. exalted position. or repeated attacks of epilepsy. It is commonly parasyphilitic in origin. mania. which is congenital or comes on very early in life. and the like. In the last stage there is simply bare physical existence. and face. bigamous marriages. there may be maniacal paroxysms or epileptic fits. =General Paralysis of the Insane. by severe pain. that he is the Prince of Wales. and its duration is from a few months to three years. and power of attention.=--This is a most interesting form of dementia. =Chronic Dementia= is generally caused by the gradual action on the mind of grief or anxiety. and the patient may maintain at one and the same time that he is running a theatrical company. the sphincters refuse to act. memory. SENILE. and the patient is often guilty of criminal assaults. It is closely allied to. and inability to fix the attention. The delusions remain the same throughout. as it were. Paralytic symptoms first appear in the tongue. =Acute Dementia. Paralytic Dementia. The exaltation is universal. which arises from sudden mental shock. and commences gradually with such symptoms as loss of memory for recent events. paralysis. and his last words will . It is accompanied with progressive bodily and mental decay. during the earlier stages especially. and unlimited wealth--megalomania. lips. the speech becomes thick and hesitating. CHRONIC. The paralytic symptoms gradually go on increasing. indecent exposures. reason. thus differing from amentia. Sometimes. Moral perversion is a common symptom. the patient always expresses himself as being happy. and it generally commences in men about middle age. are quite lost.--DEMENTIA: ACUTE. and death may occur from suffocation and choking.=--This is a condition of profound melancholy or stupor. and that he is the Almighty. if not identical with. and finally.

He may be suffering from either mental or physical disease. or love of gain. a chimerical thought. an incorrect impression of the senses. When a person of hitherto blameless life is charged with an act of indecency. or =Monomania=. or both (see p. also called =Melancholia=. It is divided into general. =General Intellectual Mania=. Mania is usually preceded by an incubative period in which the patient's general health is affected. and sustains immense muscular exertion without apparent fatigue. an _illusion_. An _hallucination_ is a sensation which is supposed by the patient to be produced by external impressions. counterfeit appearances. as pride. and each of the two latter classes again into general and partial. vanity. A _delusion_ may be defined as a perversion of the judgment. and fill the mind with intellectual delusions. and moral. although no material object acts upon his senses at the time. there is pain.I. he should be examined for G. with restlessness. the eye wild and sparkling. the patient has paroxysms of violence directed against himself as well as others. is a form of the disease in which the patient becomes possessed of some . The condition of his prostate should also be investigated. but some one emotion or passion. intellectual. When the disease is established.--MANIA Under the term 'mania' are included all those forms of mental unsoundness in which there is undue excitement. =Partial Intellectual Mania=. is rare. 59). attacking the intellect alone. He tears his clothes to pieces.P. =General Mania= affects the intellect as well as the passions and emotions. an illusion of the senses. either abstains from food and drink or eats voraciously. weight. may obtain ascendancy. The duration of this period may vary from a few days to fifteen or twenty years.probably have reference to money and other absurd delusions. and giddiness in the head. hence we speak of a delusion of the mind. The face becomes flushed. Lawyers lay great stress on the presence of delusions as indicative of insanity. XLIII.

temper. a propensity to murder. _Pyromania_. or amorous madness. and very frequently are those of persecution. contradictory alike to common-sense and his own experience. the patient in the interval being in his right mind.=--In this form one or two only of the moral powers are perverted. and natural impulses. The patient's conduct is dominated by his delusion. _Homicidal mania_. _Suicidal mania_. In these cases the law. =Partial Moral Mania--Paranoia--Delusional Insanity. moral dispositions. common in women in easy circumstances. an insatiable desire for drink. =Insanity of Pregnancy. a craving for morphine or its preparations. =Mania with Lucid Intervals.=--This is a morbid perversion of the natural feelings. =Insanity of Lactation= comes on four to eight months after parturition. There are several forms: _Kleptomania_. The question of the presence or absence of a lucid interval frequently occurs where attempts are made to set aside wills made by persons having property.=--This may show itself after the third month of pregnancy in the form of melancholia.single notion. inclinations. Some consider suicide as always a manifestation of insanity. thus murder and suicide may be committed. _Morphinomania_.=--In many cases mania is intermittent or recurrent in its nature. =Puerperal Mania. _Erotomania_. It is not recovered from until after delivery. There is in many cases a strong homicidal tendency against the child. Delusions are always present. an insane impulse to set fire to everything. without any remarkable disorder or defect of the intellect.=--This form of mania attacks women soon after childbirth. The mother may repeatedly attempt suicide. a propensity to theft. It consists in an uncontrollable desire for sexual intercourse. from the reasonableness . or _Oinomania_. and particularly without any insane illusion or hallucination. When occurring in women this is also called _Nymphomania_. =General Moral Mania. affections. either as mania or melancholia. a propensity to self-destruction. and in men _Satyriasis_. _Dipsomania_. or knowing and reasoning faculties. It is often difficult to distinguish this form of mania from the moral depravity which we associate with the criminal classes. habits.

and (4) sufficient physical and mental power to resist undue influence. ask if it be to his wife or some other likely person. (3) freedom from delusions affecting his property and his friends. ascertain his intention by definite questions.000 to leave. will constitute a valid document. and may be able to indicate his wishes by nods and shakes of the head. and yet be sufficiently sound mentally to make a valid will. and his knowledge of the home-life of the patient will either confirm or set aside the idea of influence. when the provisions of the will of a lunatic are attempted to be upheld. In certain forms of neurasthenia. the medical man should satisfy himself that the testator is of a 'sound disposing mind. then if he has £100. may assume the existence of the lucid interval.' This he will do by questioning. then inquire if he has £10. the 'phobias' are common.of the provisions of the will. That being settled. having ascertained his views. A person who is aphasic may be competent to make a will. . a mark which he acknowledges in the presence of two witnesses. the plaintiff must show that the will was made during a lucid interval. 'pathophobia' is the fear of disease. He may not be able to speak. commit them to writing. and in this way arrive approximately at the sum. Before witnessing the will made by such a person. preferably men of standing. (2) memory sufficient to recognize his proper relations to those about him. A testator is capable of making a valid will when he has (1) a knowledge of his property and of his kindred. If he nods assent. When an attempt is made to set aside the provisions of a will on the ground of insanity in a person not previously judged insane. but may understand what is said to him.=--Persons of weak mind or those suffering from senile dementia are often said to have been unduly influenced in making their wills. but must not be regarded as evidence of insanity. the plaintiff must show that the testator was mad. A will made during a lucid interval is valid. and subsequently their dispositions are disputed in court. The fact of a man being subject to delusions may not affect his testamentary capacity. 'siderophobia' is the fear of thunder and lightning. 'batophobia' is the fear that high things will fall. If he wishes to divide it. Then ask him if he wishes to leave it all to one person. Ask him if he wishes to make a will. =Undue Influence. whilst 'pantophobia' is the fear of everything and everybody. He may believe himself to be a tea-kettle. 'Agoraphobia' is the fear of crossing an open space. and ask if it expresses his intentions. read the document over to him. and.

which may lead him to attack people or commit suicide. 2. Thus the patient may urinate or undress in a public place. and may commit crimes such as rape or murder. as a rule. The plea of insanity is brought forward. illusions. _Chronic Alcoholic Insanity. ferocious. _psychic form of epilepsy_). _Delirium Tremens_. it must be proved that the prisoner at the time when the crime was committed did not know the nature and quality of the act he was committing. At the present time. and did not know that it was wrong. Such insanity differs from ordinary insanity in its sudden onset. _Acute Alcoholic Delirium_ (_mania a potu_). The patient suffers from horrible dreams. and often very immoral.=--To establish a defence on the ground of insanity. intensity of symptoms. but insane. If proved 'guilty. and that the crime was committed at a period having a definite relation to the epileptic seizure. hallucinations and delusions of persecution. =Responsibility for Criminal Acts. if found guilty. (3) After the fit the patient may perform various automatic actions (_post-epileptic automatism_) of which he has no subsequent recollection. with paralysis of motion. the intellect deteriorates and chronic dementia or delusional insanity may supervene. =Alcoholic Insanity. _epileptic equivalent_. 3. only in capital charges. will escape hanging. the patient may have a violent maniacal attack (_masked epilepsy_. To establish a plea of epilepsy in cases of crime. their conduct is sometimes brutal.' the person is sentenced to be kept in a ._ Loss of memory is the chief symptom. the _power of controlling his actions_ is usually made the test. (1) Before a fit the patient may develop paroxysms of rage with brutal impulses (_preparoxysmal insanity_). and may be arrested for indecent exposure.=Epilepsy in Relation to Insanity. (2) Instead of the usual epileptic fit. As the fits increase in number. one must show that the individual really did suffer from true epilepsy. so that the prisoner.=--This may occur in three forms: 1. Epileptics who suffer from both petit and grand mal attacks are specially liable to maniacal attacks. however. and suspicions.=--The subjects of this disease are often subject to sudden fits of uncontrollable passion. due to long-continued over-drinking. short duration and abrupt ending. due to excessive amount of alcohol consumed.

and in women the state of the menstrual function should be ascertained. such as the day of week. should be inquired into. and pulse. In order to ascertain the capacity of the mind. has squandered his money. The medical men must not be in partnership or in any way interested in the patient. and speech. birthplace. In very urgent non-pauper cases the signature of one medical man is sufficient. month. bowels. The opinion of a supposed lunatic that his examiner's feet _were large_ was not considered by the Commissioners among the facts indicating insanity. should be noted. movements. appetite.--EXAMINATION OF PERSONS OF UNSOUND MIND The following hints with regard to the examination of patients supposed to be insane will be useful: The general appearance and shape of head. profession. has absurd delusions. number of family. questions should be asked with regard to age.' XLIV. or does not know about things with which his questioner is well acquainted. but such certificate (_Emergency Certificate_ or _Urgency Order_) is only valid . and the personal history taken with care. except in the case of a pauper patient. a man is not necessarily mad because he cannot perform simple arithmetical operations. Some well-marked delusion should be recorded. yet statements quite as absurd are made by medical men as 'facts of insanity' observed by themselves. and common events. and write on the proper forms the facts observed by themselves and those observed by others. It may be necessary to pay more than one visit. the state of the general health. and year. Ascertain whether it is a first attack. they must make separate visits at different times. skin. tongue. giving the name of the informer. The power of performing simple arithmetical operations may be tested. 'Reads his Bible and is anxious about the salvation of his soul' is another example of a bad certificate. The examiner should be careful to ask questions adapted to the station of life of the supposed lunatic. and expression of countenance. For a lunacy certificate (_Reception Order on Petition_ or _Judicial Reception Order_).criminal lunatic asylum 'during His Majesty's pleasure. etc. whether the patient has suffered from epilepsy. gait. grown restless. A certificate is valid only for seven days. there are required the signatures of two independent medical men and of a relation or friend. complexion. The family history must be traced out. especially as to whether the unsoundness came on late in life or followed any physical cause.

for two days. and will ultimately. who must state that he understands the effect of his application. XLV. it must be supplemented by another signed as above directed. His signature must also be attested by two justices. He must make an application to the owner of a licensed retreat. is--(a) dangerous to himself or others. Under the provisions of the Habitual Drunkards Acts (42 and 43 Vict. 19). 19. c. or of ordinary proper conduct. it is not expedient to resort to such urgency orders. or (b) a cause of harm or serious annoyance to his family or others. There must be no reasonable ground for alleging want of 'good faith' or 'reasonable care. and while under the influence of such thing or things. c.. stating the time during which he undertakes to remain. or (c) incapable of managing himself or his affairs. in all probability. after which he must resume his . and that it has been explained to him. where an expert opinion is readily obtainable. or in consequence of the effects thereof. The limit to the term of restraint is twelve months. any habitual drunkard may voluntarily place himself under restraint. Medical men should be careful how they sign certificates of insanity. Without this testimony as to moral character his application cannot be entertained.. No medical man is bound to certify. and 51 and 52 Vict. be officially adopted: An inebriate is a person who habitually takes or uses any intoxicating thing or things. but for the moment the following will suffice. and. In London and other large towns.--THE INEBRIATES ACTS It is somewhat difficult to define an inebriate.' The practitioner must exercise that amount of care and skill which he may reasonably be expected to possess. with reasons for making such statement. but if he does so he must be prepared to take the responsibility of his acts. His application must be accompanied by a statutory declaration of two persons stating that they knew the applicant to be a confirmed drunkard. as the patient can only be detained in the asylum under this order for seven days in England or three in Scotland. The medical certificate must contain a statement that it is expedient for the alleged lunatic to be placed forthwith under care. The certifying medical practitioner must have personally examined the patient not more than two clear days before his reception.

=Inebriates Act= (1898-1900). and should he succeed in effecting his escape he may be arrested on a warrant. it lays stress on the _malicious intention_ in giving a drug or other substance to an individual. when it has been set for a certain time. He is held answerable both for being under the influence of alcohol or of any other drug. and that the penalty is a fine of £20 or three months' imprisonment. and the licensee incurs distinct obligation in return for the powers entrusted to him. The Inebriates' Retreat must be duly licensed. and.--If an habitual drunkard be sentenced to imprisonment or penal servitude for an offence committed during drunkenness. The Act works automatically. A drunkard who does not obey orders and conform to the rules of the establishment may be sent to prison for seven days. or cause to be administered. and for the acts such influence induces.--DEFINITION OF A POISON Though the law does not define in definite terms what a poison really is. It may be as well to mention that it is an offence to supply any drunkard under the Act with any intoxicating drink or sedative or stimulant drug without authority. the court may order him to be detained for a term not exceeding three years in an inebriate reformatory. any poison or other destructive thing with intent to murder. the patient cannot release himself until the period has expired. PART II TOXICOLOGY I. It is a _felony_ to administer. The Act is a good one. but might be carried farther with advantage. and if he takes away his senses by drink it is no excuse.former habits if he wishes to qualify for another period. or if he has been convicted four times in one year. or with the intention of stupefying or overpowering an . A person is supposed to know the effect of drink. It is an offence against the Act to assist any habitual drunkard to escape from his retreat. It has been ruled that a crime committed during drunkenness is as much a crime as if committed during sobriety.

contains a list of those which are considered very active poisons--_e. tartar emetic. it causes illness or even death. injure. =Scheduled Poisons. savin. cantharides. picrotoxin. Only registered medical practitioners and legally qualified druggists are permitted to dispense and sell scheduled poisons. The practitioner who carelessly prescribes a drug in a poisonous dose is not held responsible. It is a _misdemeanour_ to administer any poison. diachylon. They are responsible for any errors which may be committed in the sale of poisons. is capable of injuring health or destroying life. A great responsibility rests on the medical man who does his own dispensing. nux vomica. or annoy an individual.individual so that any indictable offence may be committed. If a doctor prescribes a drug with the intention of curing or preventing a disease. It has to be proved that actual injury has been sustained by the complainant before an action for damages can be commenced. SCHEDULED POISONS The sale of poisons is regulated by various Acts.=--By the Pharmacy Act of 1868 two groups of poisons are scheduled. and by the Poisons and Pharmacy Act. 1868. and that the plaintiff was free from all contributory negligence. or introduced into any orifice of the body. belladonna. laudanum. alkaloids. no responsibility can rest with the prescriber. arsenic. coca (if containing more than 1 per cent. he may refuse to dispense it. For a working _definition_ we may state that a poison is a substance which. 1908. veronal and all poisonous . but that. applied to the skin. injected into the tissues. When a dispenser finds an error in a prescription._. contrary to expectation and general experience. If a druggist knows that a drug in a prescription is to be used for an improper purpose. cyanides. merely to aggrieve. alkaloids). but chiefly by the Pharmacy Act. but the dispenser would be if he dispensed it and harmful or fatal consequences followed on its being swallowed.g. or destructive or noxious thing.--SALE OF POISONS. Part I. A poison may therefore be swallowed. ergot. when introduced into or applied to the body. as there is no one to check his work. corrosive sublimate. II. opium. it is his duty to communicate with the prescriber privately pointing out the mistake.

The entry must be signed by the purchaser and by the introducer. and date of sale. The word 'Poison' must be affixed to the bottle or package. Part II. anthrax. the latter must enter into the 'Poison Register' the name of the poison. A register of proprietary medicines.=--Every case of poisoning which occurs in any industry (lead. the dispenser retains the prescription. CLASSIFICATION OF POISONS . contains a list of poisons supposed to be less active. is established. Preparations containing less than 1/5 per cent.urethanes. It is not necessary to enter the transaction in a register. If sold. and it must not be dispensed more than once. and also the name and address of the seller. Prescriptions containing the above drugs must be dated and signed with the full name and address of the prescriber. and likely soon to become law). arsenic. the quantity and purpose for which it is to be used. III. etc. the word 'Poison. prussic acid. =Proprietary Medicines Bill= (introduced in 1920. of the first two or less than 1/10 per cent. morphine.) must be notified by the medical attendant to the Chief Inspector of Factories (Factory and Workshops Act. Chemists are required to keep poisons in specially distinguishable bottles. etc. Such poisons must not be sold to strangers.. 1920. 1895).--ACTION OF POISONS. and these in a special room or locked cupboard. but only to persons known to or introduced by someone known to the druggist.=--The regulations restrict the manufacture and sale of opium. etc. vermin killers. of the last two are excluded. The object is to protect the public against quack remedies. or package there is affixed a label with the name of the article. and heroin so as to prevent their abuse.--The sale of any unregistered proprietary medicine purporting to cure certain diseases or produce abortion is made an offence. cocaine.' and the name and address of the seller. =Dangerous Drugs Act. box. Special books must be kept recording the purchase and sale of these drugs. These may only be sold if on the bottle. the name of the person to whom it is sold. and must have also those of the patient. =Notification of Poisoning. The total amount of the drug to be supplied must be stated.

=Action of Poisons.=--They may act either locally or only after
absorption into the system.
1. _Local Action_, as seen in (a) corrosive poisons; (b) irritant
poisons, causing congestion and inflammation of the mucous
membranes--_e.g._, metallic and vegetable irritants; (c) stimulants or
sedatives to the nerve endings, as aconite, conium, cocaine.
2. _Remote Action._--This may be of reflex character, as seen in the
shock produced by the pain caused by corrosive poisons, or the poison
may exert a special action on certain structures, as belladonna on the
cells of the brain, strychnine on the motor nerve cells of the spinal
cord.
3. _In Both Ways._--Certain poisons, as carbolic or oxalic acids, act in
this way.
Age, idiosyncrasy, tolerance, and disease, all exert modifying
influences on the action of a poison. The form in which the poison is
swallowed and the quantity also determine its action. In the gaseous
form, poisons act most rapidly and fatally. When in solution and
injected hypodermically, they also act very rapidly. In the solid form
they act as a rule slowly, and may even set up vomiting, and so may be
entirely ejected by vomiting. Poisons act most energetically when the
stomach is empty. If taken when the stomach already contains food,
solution and absorption may be greatly delayed.
Some poisons are cumulative in their action, and thus, even if
infinitesimal doses be swallowed each day, there is a certain amount of
storage in the tissues (though a certain percentage of the poison is
being constantly eliminated), and at last symptoms of poisoning show
themselves.
=Classification of Poisons.=--As an aid to memory, the following
classification is perhaps the best:
I. _Inorganic._
1. Corrosive acids and alkalies, and caustic salts (carbolic and
oxalic acids also).
2. Irritant--practically all the metals and the metalloids (I. Cl.

Br. P.).
II. _Organic._
{ Animal--venomous bites, food poisoning, cantharides.
1. Irritant { Vegetable--all strong purgatives, hellebores, savin,
{ yew, ergot, hemlock, laburnum, bryony, etc.
2. Neuronic.
(a) Somniferous--opium and its alkaloids.
(b) Deliriant--belladonna, hyoscyamus, stramonium, cannabis,
cocaine, cocculus, camphor, fungi.
(c) Inebriants--alcohol, ether, chloral, carbolic acid (weak),
benzol, aniline, nitro-glycerine.
3. Sedative or depressant.
(a) Neural--conium, lobelia, tobacco, physostigma.
(b) Cerebral--hydrocyanic acid.
(c) Cardiac--aconite, digitalis, colchicum, veratrum.
4. Excito-motory or convulsives--nux vomica, strychnine.
5. Vulnerants--powdered glass.
III. _Asphyxiants._
Poisonous and irrespirable gases.
IV.--EVIDENCE OF POISONING
It may be inferred that poison has been taken from consideration of the
following factors: Symptoms and post-mortem appearances, experiments on
animals, chemical analysis, and the conduct of suspected persons.
1. _Symptoms_ in poisoning usually come on suddenly, when the patient is
in good health, and soon after taking a meal, drink, or medicine. Many
diseases, however, come on suddenly, and in cases of slow poisoning the

invasion of the symptoms may be gradual.
2. _Post-Mortem Appearances._--These in many poisons and classes of
poisons are characteristic and unmistakable. The post-mortem appearances
peculiar to the various poisons will be described in due course.
3. _Experiments on Animals._--These may be of value, but are not always
conclusive.
4. _Chemical Analysis._--This is one of the most important forms of
evidence, as a demonstration of the actual presence of a poison in the
body carries immense weight. The poison may be discovered in the living
person by testing the urine, the blood abstracted by bleeding, or the
serum of a blister. In the dead body it may be found in the blood,
muscles, viscera--especially the liver--and secretions. Its discovery in
these cases must be taken as conclusive evidence of administration. If,
however, it be found only in substances rejected or voided from the
body, the evidence is not so conclusive, as it may be contended that the
poison was introduced into or formed in the material examined after its
rejection from the body, or if the quantity be very minute it will be
argued that it is not sufficient to cause death. A poison may not be
detected in the body, owing to defective methods, smallness of the dose
required to cause death, or to its ejection by vomiting or its
elimination by the excretions.
5. _Conduct of Suspected Persons._--A prisoner may be proved to have
purchased poison, to have made a study of the properties and effects of
poison, to have concocted medicines or prepared food for the deceased,
to have made himself the sole attendant of the deceased, to have placed
obstacles in the way of obtaining proper medical assistance, or to have
removed substances which might have been examined.
V.--SYMPTOMS AND POST-MORTEM APPEARANCES OF DIFFERENT CLASSES OF
POISONS
Whilst recognizing the fact that toxic agents cannot be accurately
classified, the following grouping may for descriptive purposes be
admitted with the view of saving needless repetition:
1. =Corrosives.=--Characterized by their destructive action on tissues
with which they come in contact. The principal inorganic corrosives are

dysuria. Death may result from shock. or brown. and the lining membrane of the passages._--Burning pain in mouth. purging and tenesmus. and later dark coffee-grounds in appearance. destruction of the parts--_e. anxious expression. intense thirst. some alkaline salts. cold skin. or black gelatinous liquid or black blood._. or pylorus._--Burning pain and constriction in throat and gullet. The vomit consists at first of the food. suffocation. due to extravasation of blood from the over-distended vessels in the gastric mucous membrane. and feeble and irregular pulse. Irritants may be divided into two groups: (1) Those which destroy life by the irritation they set up in the parts to which they are applied. and contains a larger number of poisons than all the other classes together. _Post-Mortem Appearances. Inside of mouth corroded. with bloody stools. The stomach is filled with a yellow. metallic or alkaline taste. shrivelled and corroded. perforation of stomach or duodenum. and acetic acid. shock. and vegetable substances. convulsions. pain and tenderness of stomach and bowels. vomiting.the mineral acids. Sometimes considerable portions of the lining membrane of the gullet or stomach may be discharged by vomiting or by stool. stomach. collapse. and may in rare cases be perforated. There are also dysphagia. etc. Death may occur from shock._--Those of corrosion. retching and vomiting. and stomach. and followed by inflammation and its consequences. _Symptoms. blood. the discharged matters containing shreds of mucus. and the second comprises the metallic irritants. The class includes mineral. or some weeks subsequently death may be due to cicatricial contraction of the gullet. =Irritants. exhaustion. or from starvation on account of chronic inflammation of the . and their carbonates. gullet. yellow. and one animal substance. nausea.. strong solutions of oxalic acid.=--These are substances which inflame parts to which they are applied. 2. and in some cases the intestines. some metallic poisons. thirst. brown. and gullet. The corrosions may be small. small and frequent pulse. The first group includes the principal vegetable irritants.g. may be white. Beyond the corroded parts the textures are acutely inflamed. strong acid. _Symptoms. animal. then it becomes bile-stained. dyspnoea. The mouth. (2) those which add to local irritation peculiar or specific remote effects. or may extend over a very large surface. with corrugation from strong contraction of muscular fibres. the organic are carbolic acid. the caustic alkalies. throat. cantharides. the metalloids (phosphorus and iodine).

may be thickened.=--Three classes: The opium group. In the alcohol group._--In the opium group. nil. The rectum is frequently the seat of marked ulceration. and tobacco. thebaïne. ulcerated. dilated pupils. illusions of sight. =Poisons Acting on the Brain. dry mouth. =Poisons Acting on the Lungs. or collapse. drowsiness and confusion. fluidity of blood. double vision. mania. gullet. want of power of co-ordination and of muscular movement. and the alcohol group. delirium. dimness of sight. In the chronic form. 6. 3. causing exhilaration. thirst. producing sleep. fauces. giddiness. convallaria. dilute solution of oxalic acid and oxalates. 4._--Of the opium group. followed by profound sleep and coma. redness of skin. _Symptoms. Of the alcohol group. The leading symptom is tetanic spasm. syncope. =Poisons Affecting the Heart. They comprise prussic acid. or sloughing. Coats of stomach. In the belladonna group. fulness of the sinuses and veins of the brain. 120)._--Those of inflammation and its consequences. congestion of brain and membranes. _Post-Mortem Appearances. strophanthus. and tightness in the lower part of the throat. Vessels filled with dark blood ramify over the surface. Acute inflammation is often found in the small intestines. and duodenum. with effusion of serum into the ventricles and beneath the membranes. 5. =Poisons Acting on the Spinal Cord. aconite. long-continued rigor mortis. headache.=--Strychnine. The fumes of ammonia are intensely irritating.=--These have for their type carbonic acid gas and coal gas. . Nitric acid fumes sometimes produce no serious symptoms for an hour or more. _Post-Mortem Appearances. followed by capillary bronchitis (see p. producing delirium and illusions.=--These kill by sudden shock. delirium tremens. black. with ulceration and softening of mucous membrane. noises in the ears. the belladonna group. Of the belladonna group. and even pneumonia. and may give rise to laryngitis. difficulty of breathing. followed by delirium or sleep. signs of inflammation. passing into insensibility. but there may then be coughing. gangrenous. contraction of the pupils. bronchitis. digitalis. excitement of circulation and of cerebral functions. brucine. coma.gastro-intestinal mucous membrane.

The gut and the gullet being cut across between these ligatures.--TREATMENT OF POISONING The modes of treatment may be ranged under three heads: (1) To eliminate the poison.VI. his duty is a simple one. vomited matter. A double ligature should be passed round the oesophagus. If life is extinct. and to place himself in a position to give evidence if called on to do so. He should notice the position and temperature of the body. He had much better stick to his own business. appearance of lips and mouth. and time at which food or medicine was last taken. He should take possession of any food. the stomach may be removed entire without spilling its contents. marks of violence. urine. (2) to antagonize its action. the condition of rigor mortis. and initialled. These should all be put in separate jars without any preservative fluid. In making a post-mortem examination. VII. labelled. The intestines may be removed in a similar way. the medical man has two duties to perform: To save the patient's life. If the medical practitioner is in doubt on any point. and not act as an amateur detective. and also round the duodenum a few inches below the pylorus. or they will not be admitted by the court for the purpose of refreshing the memory whilst giving evidence. in the room. (3) to avert the tendency to . the alimentary canal should be removed and preserved for further investigation. All observations should be at once committed to writing. He should not make a post-mortem examination without an order in writing from the coroner. he should obtain technical assistance from someone who has paid attention to the subject. medicine. In a case of attempted suicide by poisoning. tied up. is it the duty of the doctor to inform the police? He would be unwise to do so. sealed. or fæces. and the whole or a portion of the liver should be preserved. and should seal them up in clean vessels for examination.--DUTY OF PRACTITIONER IN SUPPOSED CASE OF POISONING If called to a case supposed or suspected to be one of poisoning. He should make inquiries as to symptoms.

We should endeavour to promote the elimination of the poison from the body by stimulating the secretions. If there is a choice. 3. or. It may be given in the form of the injection of the Pharmacopoeia. stimulants to overcome collapse. In the selection of the appropriate antidote. The various antidotes will be mentioned under their respective poisons. or preferably as a tablet dissolved in water. The bowels and kidneys must also be stimulated to activity. 1. and cold affusions. give apomorphine hypodermically. and mustard. The first indication is met by the administration of emetics. In using the elastic stomach-tube. if by mouth. as accidents have happened from neglecting this precaution. The tube should be examined to see that it is not broken or cracked. Every doctor should provide himself with an antidote case. some fluid should be introduced into the stomach before attempting to empty it. or a portion of the mucous membrane may be sucked into the aperture. Apomorphine is not allied in physiological action to morphine. stimulants. Sulphate of zinc. To avert the tendency to death. by forming harmless compounds. In the case of narcotics and depressing agents. (2) physiologically. as charcoal. In the absence of a hypodermic syringe. Pain must be relieved by the use of morphine. as lime in oxalic acid poisoning. we must endeavour to palliate the symptoms and neutralize the effects of the poison. to help in the elimination of the poison. saline infusions in shock. etc. The best emetic is that which is at hand. the remedy may be given by the rectum. 2. starch. or by the application of the stomach-tube. may be found useful. Tickling the fauces with a feather may excite vomiting. inflamed mucous membrane soothed by such _demulcents_ as oils. salt-and-water. milk. a knowledge of pharmacology is required. the drug which is administered neutralizing more or less completely the poison which has been absorbed.death. . especially of the physiological antagonism of drugs. and may be given in cases of narcotic poisoning. electricity. Antidotes are usually given hypodermically. in the form of tablets. (3) physically. are all useful as emetics. Antidotes may act (1) chemically. ipecacuanha. The second indication is met by the administration of the appropriate antidote. The dose for an adult is 10 minims. to produce vomiting.

and general appearance. Make a solution of the contents of the stomach or solid organs minced very fine by digesting them with acidulated alcohol or water and filtering. in order that crystalloid substances may be separated from colloid bodies. after distillation for the volatile substances just mentioned. the watery solution neutralized with soda. etc. are _soluble_ in ether. opium. This process is based upon the principle that the salts of the alkaloids are _soluble in alcohol and water_. and mix the filtrates. The filtrate is shaken with ether to remove fat. nitro-benzol. In the case of phosphorus the condenser should be of glass. hydrocyanic acid. the following is the process of Stas-Otto. free from fusel oil. cantharides. In the case of volatile substances distillation will be required. The poisons thus sought for are alcohol. the contents of the alimentary canal. (2) Cool the mixture and filter. and _insoluble in ether_. The pure alkaloids. The flask is heated in a water-bath. carbolic acid. The colour may indicate salts of copper. and anilin. chloral. This examination having been made. or phosphorus. and any other substances to be examined. phosphorus. the ether separated. _The residue may be set aside for the detection of the metallic poisons. colour. and acidulated with tartaric acid. alcohol. in other cases dialysis will be necessary. Simple filtration will sometimes suffice to separate the required substance. must be submitted to chemical processes. The odour may show the presence of prussic acid. and the process of distillation conducted in the dark. etc. and subject to a gentle heat._ Expel the alcohol . ether. with twice its weight of absolute alcohol.. and the vapours condensed by a Liebig's condenser. if suspected. which removes the alkaloid in a more or less impure condition. The organic matters are placed in a flask. with the exception of morphine in its crystalline form. of the matter submitted for examination. diluted with distilled water if necessary. so that the luminosity of the phosphorus may be noted. The knowledge of these facts will help to explain the following details. which may be modified to suit individual cases: (1) Treat the organic matter. and then shaken with ether. For the separation of an alkaloid.VIII.--DETECTION OF POISONS Notice the smell. chloroform. Seeds of plants may be found. iodine. to which from 10 to 30 grains of tartaric or oxalic acid have been added. wash the residue with strong alcohol.

_digitalin_. add a saturated solution of carbonate of potash or soda. (3) phospho-molybdic acid gives a yellow precipitate. Boil the finely divided substance with about one-eighth its bulk of pure hydrochloric acid. but not cantharidin. The ether floats on the surface. conine and nicotine. Filter through a filter moistened with alcohol. in solution. Filter through a filter moistened with water. add a few pieces of calcium chloride to ethereal solution to absorb the water. Evaporate filtrate to dryness. allow it to evaporate. Evaporate the filtrate to a syrup. (4) platinic chloride. (5) tannic acid. and test the residue for the alkaloids. when the solid alkaloid will be left in an impure state. On the evaporation of the alcohol the resinous and fatty matters separate. Hot water will now dissolve out _picrotoxin_. Separate the ethereal solution and evaporate. _colchicin_. briskly shaken. add from time to time potassic chlorate until the solids are reduced to a straw-yellow fluid. and extract with successive portions of absolute alcohol. (3) Ether from the acid solution dissolves out _colchicin_. holding the alkaloids. and traces of _veratrine_ and _atropine_. (2) Mayer's reagent (potassio-mercuric iodide) gives a yellowish-white precipitate. Fresenius's method is adopted. and. add a small quantity of dilute sulphuric acid. If a volatile alkaloid. and dissolve residue in water. oily streaks appear on the glass. mixed with four or five times its bulk of ether. etc. (5) A part of this ethereal solution is poured into a watch-glass and allowed to evaporate. or benzole. holding the other alkaloids in solution or suspension. chloroform. Now shake watery solution with ether. If a fixed alkaloid. except morphine. and left to rest.by careful evaporation. _cantharidin_. In order to isolate an inorganic substance from organic matter. treat the acid solution with soda or potash and ether. a brown precipitate._--(1) Wagner's reagent (iodine dissolved in a solution of potassium iodide) yields a reddish-brown precipitate. if not volatile. the solution being made distinctly acid. . and _digitalin_. To purify it. then saturate with sulphuretted hydrogen until metals are thrown down as sulphides. If the alkaloid is volatile. and leave it on evaporation in a crystalline form. and _picrotoxin_. Treat this with excess of bisulphate of sodium. is made strongly alkaline with soda. crystalline traces will be visible. Absolute alcohol will then dissolve out the alkaloid. _General Reactions for Alkaloids. draw off the ethereal solution with a pipette. (4) The remaining acid watery liquid. after evaporating to three-quarters of its bulk. evaporate ethereal solution after separation.

and tin. chin.--THE MINERAL ACIDS These are sulphuric. are shrivelled and corroded. the patient may ultimately die from starvation. or portions of the lining membrane of the gullet and stomach. The vomited matters are strongly acid in reaction. _Post-Mortem Appearances Common to the Mineral Acids. tongue. and the vessels are injected._--Stains and corrosions about the mouth. and oesophagus. _pink_. For the detection of minute quantities. or suffocated. The blood in the . and commencing immediately on the poison being swallowed. _white_. and barium. and vomiting of brown. and hydrochloric acids. Exhaustion succeeds. and surrounded by inflammation and black extravasation. After recovering from the acute form of poisoning. Epiglottis contracted or swollen. or black glutinous liquid. Stomach filled with brown. stomach.These may be collected and tested. _green_. is white and corroded. with violent burning pain extending into the oesophagus and stomach. manganese. tenesmus. arsenic. the microscope must be used. Crystalline poisons may be recognized by their characteristic forms. There is intense thirst and constipation. lead. coagulated mucus. the intellect remaining clear to the last. nitric. etc. _black_. epithelium. yellow or dark brown. and shrivelled. and Guy's and Helwig's method of sublimation will be found advantageous. constant retching. _dark_._--Acid taste in the mouth. _Symptoms of Poisoning by the Mineral Acids. is on the posterior aspect. The residue of the material after digestion with hydrochloric acid and potassium chlorate may have to be examined for silver. when it takes place. and stain articles of clothing on which they may fall. the lips. zinc. and inside of the mouth. its lining membrane is charred or inflamed. antimony. Perforation. iron. black. add ammonia and ammonium sulphide. the apertures are circular. due to stricture of the oesophagus. hydrogen sulphide precipitates copper. with scanty or suppressed urine. fauces. Pylorus contracted. _yellowish_. If no precipitate. and fingers. eructations. From the acid solution. chromium. and mercury. and small and frequent pulse. convulsed. or wherever the acid has come in contact. lead. yellow. IX. and the patient dies either collapsed. The inside of the mouth. or yellow matter containing blood.

Take a portion of the liquid. Vomited matters and contents of stomach should not be mixed. and then dark brown or black. boiled in water. Avoid mistaking gastric or duodenal ulcer. The presence of corrosion of the mouth is as important as the chemical tests._--The contents of the stomach or vomited matter should. but each _separately_ examined. first white. A sulphate may be present. It is frequently thrown over the person to disfigure the features or destroy the clothes._--Calcined magnesia or the carbonate or bicarbonate of sodium. evaporate to dryness. is now ready for testing. owing to the hygroscopic property of the acid. for the effects of a corrosive poison. . a sulphate. In all cases every organ should be examined. or survival for several days.large vessels may be coagulated. and may be tested. Black woollen cloths are turned to a dirty brown. If the breathing is impeded. mixed with milk or some mucilaginous liquid.--SULPHURIC ACID =Sulphuric Acid=. and incinerate. if present.. filtered and concentrated. the solution filtered. may be concentrated or diluted. In the absence of these. and the fluid so obtained tested. tracheotomy may be necessary. etc. _Method of Extraction from the Stomach._--Sulphuric acid may not be found even after large doses. Parts of the body touched by it are stained. or oil of vitriol. be diluted with pure distilled water and filtered. whiting. On _cloth_ the stain may be cut out. due to treatment. Blood. This rule holds good for all poisons. _Caution. and tested with blue litmus and other tests. etc. X. The stomach-pump should not be used. Injuries of external parts by the acid must be treated as burns. vomiting. will be found of service. milk. if necessary. with or without perforation. _Treatment. The stomach should be cut up into small pieces and boiled for some time in water. the stains remain damp for long. will be obtained. The solution.. soap-suds. oil. the edges of the spots becoming red in a few days. chalk. due to the dilution of the acid from the absorption of moisture. are the best antidotes. milk. may be separated by dialysis.

_Fatal Dose. _Fatal Period. dialyzed. Dilute acid chars paper when the paper is heated._Post-Mortem Appearances. eighteen to twenty-four hours. is less frequently used as a poison than sulphuric acid. the fluid concentrated and allowed to crystallize. The fumes from nitric acid have caused death from pneumonia in ten or twelve hours. the contents are black or brown._--Where the acid has come in contact with the mucous membranes there are dark brown or black patches. It gives a red colour with brucine._--Concentrated acid gives off irritating orange-coloured fumes of nitric acid gas. evolves heat when added to water. three-quarters of an hour. and with hydrochloric acid dissolves gold._--Shortest._--The mucous membranes are rendered yellow or greenish if bile be present. is to dissolve in the suspected fluid some crystals of ferrous sulphate. _Post-Mortem Appearance. it gives off red fumes and leaves a green solution of nitrate of copper. copper cuttings. XI. A delicate test for the acid._--Concentrated acid chars organic matter. In beer. Dilute solutions give a white precipitate with barium nitrate. The stomach is greatly contracted. free or in combination. insoluble in hydrochloric acid even on boiling. or mercury. _Tests. or aqua fortis. When poured on copper.--NITRIC ACID =Nitric Acid=. _Method of Extraction from the Stomach.. _Tests._--In an adult. turns the green sulphate of iron black. the summits of the mucous membrane ridges being charred and the furrows greatly inflamed. they are also thickened and hardened. the mixture may be neutralized with carbonate of potassium. 1 drachm. etc. and sulphurous fumes when boiled with chips of wood. when crystals of nitrate of potassium may be recognized. and then to gently pour down the test-tube some strong . average period from onset of primary effects. gives a white precipitate with nitrate or chloride of barium._--The same as for sulphuric acid. and is entirely volatilized by heat.

in infants in a few minutes. which is insoluble in nitric acid and in caustic potash.--HYDROCHLORIC ACID =Hydrochloric Acid=. is not uncommonly used for suicidal purposes. _Fatal Dose. or spirit of salt. from the formation of _picric_ acid. and often eroded. _Fatal Period._--The mucous membranes are dry. _Fatal Period. It turns the skin bright yellow. _Tests._--The same as for sulphuric acid. As hydrochloric acid is a constituent of the gastric juice. and does the same with woollen clothes. _Post-Mortem Appearances._--The concentrated acid yields dense white fumes with ammonia. Stains on clothing are reddish-brown in colour. and shrivelled. Death may occur after an interval of some weeks from destruction of the gastric glands and inability to digest food._--Shortest. When warmed with black oxide of manganese and strong sulphuric acid it gives off chlorine.--OXALIC ACID . muriatic acid. the signs of the acid must be looked for. from suffocation. if nitric acid be present. but is soluble in ammonia. a reddish-brown ring will be formed. a white precipitate.sulphuric acid._--Half an ounce. _Method of Extraction from the Stomach. twenty-four hours. recognized by its smell and bleaching properties. Where the two liquids meet. XII._--Shortest._--Two drachms. average. one hour and three-quarters in an adult. white. XIII. and when dried and heated melts. being fifth in the list. and forms a horny mass. two hours. Diluted it gives with nitrate of silver. _Fatal Dose.

which comes on immediately. it disperses as white vapour with slight detonation. cyanosis and pallor of the skin. then chalk. but half an ounce is usually fatal. Not alkalies. there are often black or brown streaks in it. It is in common use for cleansing brass. etc. as if they had been boiled._--If a concentrated solution be taken. or boil the contents of the stomach and subject them to dialysis. tartaric. and brittle. and gullet. and especially for bleaching straw hats. pain in head and back. Stomach contains dark. _Tests. or lime-water. and is soft._--Mucous membrane of mouth._--White precipitate with nitrate of silver. grumous matter. _Symptoms. white and softened. oxalic acid has been taken in mistake for the former. soluble in nitric or hydrochloric acid. causing a burning acid. or any vegetable acid. purging and tenesmus. it acts as a corrosive. but not stomach-pump. acetic. _Fatal Dose. freely. and may resemble narcotic poisoning. great pain and tenderness and burning at pit of stomach.=Oxalic Acid= is used by suicides. followed by collapse. Sometimes almost instant death. Emetics. also swelling of tongue. as the oxalates of the alkalies are soluble and poisonous. with dysphagia. Concentrate the distilled water outside the tube containing the vomited matters. in laundry work. for dyeing purposes.. but insoluble in oxalic. When the precipitate is dried and heated on platinum-foil. Sulphate of lime in excess gives a white precipitate. May be tetanus or coma. intensely sour taste. though not often by murderers. The crystals closely resemble those of Epsom salts or sulphate of zinc. the nervous symptoms predominate. _Method of Extraction from the Stomach. In some cases cramps and numbness in limbs. _Treatment. soluble in nitric acid and ammonia._--Warm water. _Post-Mortem Appearances._--Mince up the coats of the stomach and boil them in water. feeble pulse. pain and tightness in throat. carbonate of magnesium. stomach sometimes quite healthy. throat. If taken freely diluted. Castor-oil._--One drachm is the smallest. bloody or dark coffee-ground matters. Vomiting of mucus. pale. =Oxalate or Binoxalate of Potash= (salts of sorrel or salts of lemon) is . delirium and convulsions. and apply tests. Intestines slightly inflamed.

if well diluted or taken after a meal. and is often supplied in ordinary beer-bottles without labels. with great weakness and lividity. An ounce of Epsom salts or of Glauber's salts dissolved in a pint of water will answer the purpose admirably. Patients often improve for a time._--If strong acid has been swallowed. This is followed by insensibility. Phenic Acid. The skin is cold and clammy._--Soluble sulphates which form harmless sulpho-carbolates in the blood should be administered at once. _Tests_ are not necessary. _Symptoms. and the urine. whitened.--CARBOLIC ACID =Carbolic Acid. Indications of collapse soon supervene. The pupils are usually contracted. _Treatment. as the smell of carbolic acid is characteristic. is dark in colour. the lips and mucous membranes are hardened. When the poison has been absorbed through the skin or mucous membranes._--One drachm. and death. or Phenol=. are livid. eyelids. abolition of reflex movements. . but recovery has taken place after much larger quantities. is largely employed as a disinfectant. _Local action_ of carbolic acid produces anæsthesia and necrosis. and then die suddenly from collapse. are the first signs. hurried and shallowed respiration. stertorous breathing.almost as poisonous as the acid itself. or even black. if not suppressed. White of egg and water or olive-oil may prove useful. In the stomach the tops of the folds are whitened and eroded. _Post-Mortem. coma. XIV. while the furrows are intensely inflamed. and the lips. and corrugated. and ears. After this an emetic of sulphate of zinc may be given. Accidents sometimes happen from too strong lotions applied as surgical dressings. Warmth should be applied to the body._--An intense burning pain extending from the mouth to the stomach and intestines. _Fatal Dose. a mild form of delirium.

and are not deliquescent. _Method of Extraction from the Stomach. Inflammation may have extended to larynx. filter. _Tests. AND AMMONIA =Caustic Potash= occurs in cylindrical sticks. acidulated stimulant drinks. is deliquescent._--Acrid soapy taste in mouth.=Lysol= is a compound of cresol and linseed-oil soap. pharynx. Do not use the stomach-tube. soluble in water. acute pain at pit of stomach._--If the contents of the stomach have a strong alkaline action. Stains on dark clothing are red or brown. and if there is danger of asphyxia. stimulants in collapse._--The carbonates effervesce with an acid. and intestines. lemon-juice and water. softening. and corrosion of mucous membrane of mouth. surface cold. The bicarbonate is in colourless prisms. . oesophagus. In chronic cases death occurs from stricture of the oesophagus causing starvation. fusible by heat. oil. =Liquor Potassæ= is a strong solution of caustic potash.--POTASH. feebly alkaline taste. so that there is not much fear of lung trouble. They are not dissipated by heat. which have a saline. linseed-tea. and give a violet colour to the deoxidizing flame of the blowpipe. bloody stools. pulse weak. and has a similar reaction. pearlash. The glottis may be inflamed. _Symptoms. alkaline and caustic in taste. and very deliquescent. _Treatment. and a white precipitate with tartaric acid. SODA. and apply tests. tracheotomy may have to be performed. vomiting of bloody or brown mucus. opium to relieve pain. also known as potash. is soapy to the touch. XV._--Soapy feeling. =Carbonate of Potassium=. has an acrid taste. and is much less toxic than carbolic acid. inflammation. is a white crystalline powder. stomach. _Post-Mortem Appearances. These preparations are not volatile. salt of tartar. colicky pains._--Vinegar and water. dilute with water. The salts give a yellow precipitate with platinum chloride. burning in throat and gullet.

and Extraction from the Stomach. lips and tongue swollen.' _Symptoms. Death may result from inflammation of the larynx and lungs. red. the latter of a purer white colour._--Alkaline reaction. _Tests. but ammonia may be recognized by its pungent odour. effervesces and evolves carbonic acid when treated with an acid._--Vinegar and water. as 'Cleansel. _Method of Extraction from the Stomach. No precipitate with tartaric acid._--Nessler's reagent is the most delicate. being immediately affected. _Post-Mortem Appearances. profuse salivation. must be first distilled. gives yellow tinge to blowpipe flame. The urgent symptoms are those of suffocation. and strong alkaline reaction. =Ammonia= may be taken as _liquor ammoniæ_ (harts-horn)._--Being volatile. Post-Mortem Appearances. _Fatal Period (Shortest). When swallowed in solution. as carbonate of ammonium. . eyes and lungs._--As for potash._--Four minutes. and glazed._--One drachm of strong solution._--Similar to other corrosives. the gas being conveyed into water free from ammonia. etc. the former in dirty crystalline masses.' _Symptoms.. Inhalation of the fumes of strong ammonia may lead to death from capillary bronchitis or broncho-pneumonia. _Treatment. Other treatment according to symptoms. crystallizes.' or as 'Scrubb's Cloudy Ammonia. _Tests.=Carbonate of Sodium= occurs as _soda_ and _best soda_._--The contents of the stomach. nose. _Fatal Dose. the symptoms are similar to those of soda and potash. nor with bichloride of platinum. a reddish-brown colour or precipitate being produced. It is also found as 'washing soda. dense fumes given off with hydrochloric acid. it attacks the air-passages. Treatment.

stimulants. and ordinary treatment for irritant poisoning. with stupor or convulsions. Excreta smell of sulphuretted hydrogen. has a strong smell of sulphuretted hydrogen. _Fatal Period (Shortest).=--All these are irritant drugs. nephritis._--Fifteen minutes. cyanosis._--Blood is chocolate-brown in colour. _Post-Mortem.XVI._--Of acute irritant poisoning.--INORGANIC IRRITANTS =Nitrate of Potassium (Nitre._--Transfusion of blood or saline fluid.--BARIUM SALTS . Lungs congested. XVII. _Treatment. the drug discharges the colour of indigo in acid solution with SO_{2}. _Tests._--Chloride of sodium or lime in dilute solution. =Sulphuret of Potassium= (liver of sulphur) occurs in mass or powder of a dirty green colour. and Potassium. XVIII. and coma.--CHLORATE OF POTASSIUM. delirium. melæna._--Spectroscope shows blood contains methæmoglobin. _Post-Mortem Appearances. =Chlorate of Potassium= produces irritation of stomach and bowels. Saltpetre)--Bitartrate of Potassium (Cream of Tartar)--Alum (Double Sulphate of Alumina and Potassium)--Chlorides of Lime. with deposits of sulphur. and so are all the internal organs. ETC. Sodium. weakness. _Symptoms._--Stomach and duodenum reddened. gastro-enteritis. hæmaturia. _Treatment. and give the usual symptoms.

frontal headache.=Chloride of Barium= occurs crystallized in irregular plates. Liquid preparations. but effervescing with dilute acids. _Method of Extraction from the Stomach. XIX. _Treatment. soluble in water. tasteless and colourless. and lachrymation._--Acrid taste. and readily decomposed by the free acids of the stomach. debility.--IODINE--IODIDE OF POTASSIUM =Iodine= occurs in scales of a dark bluish-black colour. _Tests. may be taken accidentally or suicidally. like magnesium sulphate. _Symptoms. It strikes blue with solution of starch. Chronic poisoning (iodism) is characterized by coryza. ._--Besides those of irritants generally. double vision. acne of the face and chest. =Carbonate of Barium= is found in shops as a fine powder. Stomach may be perforated. violent cramps and convulsions._--Dialysis as for other soluble poisons. insoluble in water. =Nitrate of Barium= occurs in octahedral crystals. and a petechial eruption on the limbs. and give stimulants by the mouth and hypodermically. epigastric pain. tightness of throat. it gives a green colour to the flame. salivation._--As of irritants generally. The salts of barium are also cardiac poisons. _Post-Mortem Appearances. headache. loss of appetite. and stains the skin and intestines yellowish-brown. or of alum. and beating at the heart. _Symptoms. and then symptoms of irritant poisons generally. noises in the ears. as the liniment or tincture._--Precipitated from its solutions by potassium carbonate or sulphuric acid. soluble in water and bitter in taste._--Wash out stomach with a solution of sodium or magnesium sulphate. dimness of sight. marked mental depression. Burnt on platinum-foil.

and a blue colour with sulphuric or nitric acid and starch. arrowroot. XX. diarrhoea. cubic crystals. alcohol. with garlic-like odour. Great prostration.--PHOSPHORUS =Phosphorus= is usually found in small. ether. Yellow phosphorus is not allowed to be used in the manufacture of lucifer matches. but days may elapse before any characteristic symptoms appear. bile-stained or bloody. Harsh. soluble in less than their weight of cold water. and staining of a dark brown or yellow colour. It is much used in rat poisons. _Symptoms. insoluble in water. carbonate of sodium. _Analysis._--Add bisulphide of carbon. made into a paste with flour. In 'safety' matches the amorphous phosphorus is on the box. chloroform. and carbon disulphide. _Symptoms. It will be recognized by the blue colour which it gives with starch. Vomited matter luminous in the dark. a red opaque infusible substance. starch. gruel._Post-Mortem Appearances. generally opaque. and the importation of such is prohibited._--Those of irritant poisoning with corrosion._--Iodide of potassium in solution gives a bright yellow precipitate with lead salts. The iodine may be obtained on evaporation as a sublimate. sugar. amylaceous fluids. _Treatment. but even small doses sometimes produce the effects of a common cold. including those symptoms already mentioned as occurring with iodine. The earliest signs are a garlicky taste in the mouth and pain in the throat and stomach. insoluble in carbon disulphide. waxy-looking cylinders._--Stomach-pump and emetics. and these may be mistaken for those of acute yellow atrophy of the liver. Ordinary phosphorus is soluble in oil. with bloody stools._--At first those of an irritant poison. . which are kept in water to prevent oxidation. dry. _Analysis of Organic Mixture containing Iodine. and Prussian blue. =Iodide of Potassium. a bright scarlet with corrosive sublimate. etc. fat._--Not an active poison. and shake. It may also occur as the amorphous non-poisonous variety.=--Colourless.

XXI._--Mitscherlich's method is the best. copper. hæmorrhages from the mucous surfaces and under the skin. silver. Distil in the dark.. nickel. coma. which is of a steel-grey colour. Usually there are remissions for two to three days. through a glass tube kept cool by a stream of water. _Fatal Period. purpuric spots with ecchymoses under the skin and mucous membranes. In chronic cases there is fatty degeneration of most of the organs and tissues of the body. _Detection of Phosphorus in Organic Mixtures. followed by the administration of permanganate of potassium or peroxide of hydrogen to oxidize the phosphorus. in the form of two sulphides--the red sulphide. brittle. which is the test. and death. _Treatment.--ARSENIC AND ITS PREPARATIONS =Arsenic= is the most important of all the metallic poisons. blood-stained urine. and . and heart. The inhalation of the fumes of phosphorus. kidneys. both as an emetic and as forming an insoluble compound with phosphorus. then jaundice comes on. It also exists as an impurity in the ores of several metals--iron. Sulphate of copper is a valuable antidote. Introduce the suspected material into a retort. gives rise to 'phossy-jaw._--One grain and a half. tin._--Early use of stomach-pump and emetics. zinc. convulsions._--Four hours. later. or realgar.' _Post-Mortem Appearances. etc. or orpiment. with enlargement of the liver. delirium. and gives off a garlic-like odour when heated. mucilaginous drinks. as arsenious acid. and the yellow sulphide. more commonly two to four days. phosphorescent contents of alimentary canal. coma and convulsions. Sulphate and carbonate of magnesium. retention or suppression of urine. or Scheele's green. It is much used in medicine and the arts.yellow skin. It occurs as metallic arsenic. hæmorrhagic spots on all organs and under the skin._--Softening of the stomach. _Fatal Dose. Oil should not be given. and as arsenite of copper. a flash of light is perceived. fatty degeneration of liver. as in making vermin-killers. As the vapour passes over and condenses. Acidulate with sulphuric acid to fix any ammonia present.

cutaneous eruptions. Sulphuric acid is frequently impregnated with arsenic from the iron pyrites used in preparing the acid. debility. as the poison is rapidly eliminated by the kidneys. The skin becomes cold and clammy. diarrhoea.cobalt. . or diarrhoea. axilla. =Arsenious Acid= (White Arsenic. falling out of the hair. great tenderness on pressure over muscles of legs and arms. It occurs in commerce as a white powder or in a solid cake. vermin or weed killers. restlessness. soreness of the edges of the eyelids. The symptoms of _chronic_ poisoning by arsenic are loss of appetite. languor. pain on moving the joints. and convulsions. cramp in the legs. the rest of the body a dark brown shade. Faintness. due to peripheral neuritis. pain in the soles of the feet on walking. and almost tasteless. mixed with the poison. It is a constituent of many rat pastes. 1 ounce of water dissolves about 1/2 grain of arsenic. In all suspected cases the urine should be examined. The pigmentation resembles the bronzing of Addison's disease. odourless. thirst. and erythromelalgia. thirst. complexion powders. and the normal rosy tint of the lips is not altered. headache. while in the fourth class the symptoms resemble closely those of English cholera. such as the neck. The skin over the feet may show marked hyperkeratosis. diarrhoea.--Colourless. In some cases the symptoms are those of collapse. emaciation. The nervous system is notably affected. _Symptoms. but afterwards becomes opaque. or black from soot. hæmoptysis. Should the patient survive some days. but there are no patches on the mucous membranes. which is at first translucent. the extensor aspects being less marked than the flexor. The vomited matters are often blue from indigo. headache. vomiting. no trace of arsenic may be found in the body. incessant vomiting. sleeplessness. nausea. anæmia. etc. the face becomes dusky red. Fowler's solution is the best-known medicinal preparation of arsenic. Pigmentation is common. or greenish from bile. and contains 1 grain of arsenious anhydride in 110 minims. epigastric pain. Trioxide of Arsenic). silvery tongue. cough. This darkening is most marked in situations normally pigmented and in parts exposed to pressure of the clothes. colicky pains. The sensory symptoms appear first: numbness and tingling of the hands and feet. Slightly soluble in cold water. catching in the breath. In others the patient falls into a deep sleep. with but little pain. sheep dips. and convulsive twitchings. nausea. tightness and heat of throat and fauces._--Commence in from half to one hour. and inner aspect of the arms.

and its mucous coat presents the appearance of crimson velvet. _Fatal Dose (Smallest). If this ring be also heated. and rectum. some persons being able to take considerable quantities. coma. must be treated on ordinary principles. arsenic may be detected by the liquid tests._--In _solution_. This is filtered off through muslin and given in tablespoonful doses. The peasants of Styria are in the habit of eating it. milk and eggs. which is sparingly soluble. should be boiled with pure hydrochloric acid and water. and are easily recognized by the microscope.. _Method of Extraction from the Stomach. The nervous symptoms come on later than the cutaneous manifestations. The effects of arsenic are modified by tolerance. collapse. Putrefaction of the body is retarded by arsenic._--Twenty minutes. recovery from very large doses if rejected by vomiting. Exceptionally. then milk. the best when the poison is in solution is the hydrated sesquioxide of iron. Exceptionally. or the solid organs minced up. Dialyzed iron in large quantities is efficacious. As an antidote. then filtered. Ulceration is rare. Colloidal iron hydroxide may be used instead._--Two grains. colon. death as late as the sixteenth day. with drop-wrist and drop-foot. _Fatal Period (Shortest). oil and lime-water. there is extensive fatty degeneration of the organs._--Signs of acute inflammation of stomach. may be collected. the patient dying before it occurs. small intestines._--The stomach-pump. if present. or carbonate of soda. It forms ferric arsenate. If arsenic is present. The filtrate can then be subjected to Marsh's or Reinsch's process. mixed with a little charcoal in a test-tube. etc. and cases of perforation still less common.Then come the motor symptoms. _Tests. Inflammatory symptoms. The contents of the stomach. and there may be early loss of patellar reflex. and heated. duodenum. The patient suffers severely from neuritis. There may be entire absence of _post-mortem_ signs. emetics._--The coats of the stomach should be examined with a lens for any white particles. formed by precipitating tinctura ferri perchloridi with excess of ammonia. If life has been preserved for some days. octahedral crystals of arsenic will be deposited farther up the tube. . _Post-Mortem Appearances. _Treatment. Stomach may contain dark grumous fluid. a metallic ring will be formed in the cooler parts of the tube. These.

The deposit is dissolved by a solution of chloride of lime. and forms arseniuretted hydrogen. on the addition of strong nitric acid._--Put pure distilled water into a Marsh's apparatus with metallic zinc and sulphuric acid. after a quarter of an hour's boiling. the last frequently used for colouring dresses and wall-papers. This test is delicate. crystals of arsenious trioxide will be deposited on the cold part of the tube. and as there are many sources of fallacy. turned yellow by sulphide of ammonium after evaporation. If arsenic is present. and should be tested by lighting the issuing gas and depressing over it a piece of white porcelain._--Boil distilled water with one-sixth or one-eighth of hydrochloric acid. but it is not quantitative._--Put the substance to be tested into a flask with some small pieces of bread. =Other Preparations of Arsenic. the reagents are pure. If no mark appears. _Reinsch's Process. round this a mixture of metallic arsenic and arsenious acid. _Marsh's Process. The gas carried off by a fine tube is again ignited. These tests are difficult to apply. A piece of glass or porcelain held to the flame will have. The hydrogen decomposes arsenious acid. cut up.=--These are arsenite of potash (Fowler's solution). put in a reduction-tube. it would be well. and keep at a temperature of 37° C. Hydrogen is set free. and introduce a slip of bright copper. a deposit on it having the following characters: In the centre a deposit of metallic arsenic. when possible. a brick-red colour is produced--arseniate of silver. If. due to arseniuretted hydrogen or an organic combination of arsenic. and heated. If this foil be dried. When cold. but as arsenic is a ubiquitous poison. inoculate with a culture of _Penicillium brevicaule_. evaporated and neutralized with ammonia and nitrate of silver added. (3) Sulphuretted hydrogen water gives a yellow precipitate.(1) Ammonio-nitrate of silver gives a yellow precipitate (arsenite of silver). a garlic-like odour is noticed in twenty four hours. add the suspected liquid. If arsenic be present. there is no stain on the copper. to obtain the services of an expert. and outside this another ring of arsenious acid in octahedral crystals. if arsenic be present. and the suspected liquid may now be added. _Biological Test. sterilize for half an hour at 120° C. cacodylate of sodium. . (2) Ammonio-sulphate of copper gives a green precipitate (Scheele's green). and arsenite of copper (Scheele's green). and will detect 1/1000 of a milligramme. it will form an iron-grey deposit.

nausea. purging. although formerly employed in the treatment of phthisis. faintness. should be used with the utmost caution. nausea. The symptoms in chronic poisoning may simulate gastritis or enteritis. of the Poisons and Pharmacy Act (8 Edward VII. and an aphthous .Persons using these preparations may suffer from catarrhal symptoms. sense of constriction in throat. and it also evolves PH_{3}. vomiting and purging. debility. =Arseniuretted Hydrogen= (arsine. incessant vomiting. _Post-Mortem Appearances. it produces an eruption not unlike that of smallpox. perhaps peripheral neuritis and loss of patellar reflex. intense thirst. c. and is evolved in various chemical and manufacturing processes. ears. loss of appetite. but by the skin. The arsenites give the reactions of arsenious acid. It is included in Part I. The cacodylates. and in women by the menses. may cause death. The sale of arsenic and its preparations to the public is properly hedged round with restrictions of all kinds. rashes on the neck. in the milk. nor may it be sold unless mixed with soot or indigo in the proportion of 1 ounce of soot or 1/2 ounce of indigo at the least to every pound of arsenic. _Ferro-silicon_ evolves AsH_{3} and PH_{3}. When damp. _Ferrochrome_ is used in making steel. burning heat and pain in stomach. pain in stomach. during lactation. giddiness and tetanic spasms. thirst.. or in yellowish-white efflorescent crystals. rapidly followed by nausea._--Metallic taste. weak pulse. and._--Inflammation. progressive emaciation. _Symptoms.--ANTIMONY AND ITS PREPARATIONS =Tartar Emetic= (tartarized antimony. vomiting. XXII.02 per cent. softening. Vinum antimoniale contains 2 grains to a fluid ounce of the wine. In _chronic poisoning_. both very lethal gases. 55). the bronchial secretion. AsH_{3}) is an extremely poisonous gas. the saliva. potassio-tartrate of antimony) occurs as a white powder. cramps. headache. cold sweats. profound depression. and face. great prostration. in fatal cases. Dysphagia. Arsenic is eliminated not only by the kidneys and bowels. No arsenic may be sold to a person under age. and in such extreme dilution as 0. Externally applied. It may be detected in the sweat.

which is soluble in tartaric acid and precipitated orange yellow with hydrogen sulphide. lustrous one of arsenic. collect the sulphide thus formed. Brain and lungs may be congested._--In an adult 2 grains (same as arsenic). _Symptoms. or strained and filtered. wash and dry it. the last reddened in patches. and the precipitate with hydrogen sulphide is black._--Violet corrosion and irritation of the alimentary canal. but Reinsch's is the better. from exhaustion. or cubes with edges bevelled off. If the solution be now added to a large bulk of water. After death the mucous membrane . etc. soluble in excess. =Chloride of Antimony= (Butter of Antimony). Sulphuretted hydrogen passed through gives the orange-red precipitate above named. _Treatment. In chronic poisoning. The chloride of bismuth is also precipitated white. _Fatal Period._--Soluble in water. a characteristic orange-red sulphide is formed. Morphine to allay pain._--Death follows in eight to twelve hours. or the stomach-tube may be used. Pass hydrogen sulphide through the filtered or dialyzed fluid until a precipitate ceases to fall. as tea. A drop of the solution evaporated leaves crystals._--Promote vomiting by warm greasy water. it crepitates and chars. the white oxychloride is precipitated. Reinsch's process gives a violet deposit instead of the black._--The contents of the stomach or its coats should be finely cut up and boiled in water. Marsh's and Reinsch's processes are applicable for the detection of antimony. either tetrahedric. Heated in substance. and if heat be increased. but not in alcohol. inflammation also of cæcum and colon. Boil the orange-coloured sulphide in a little hydrochloric acid. and stomach. Cinchona bark or any preparation containing tannin. _Fatal Dose. Decomposition is hindered for long. decoction of oak bark. gullet. _Method of Extraction from the Stomach.condition of the throat. and also in tartaric acid. Treated with sulphuretted hydrogen. with the addition of narcotic symptoms. _Tests. the metal is deposited. acidulated with tartaric acid and subjected to dialysis.--A light yellow or dark red corrosive liquid. Dilute nitric acid gives a white precipitate. but the precipitate is not soluble in tartaric acid.

Profound anæmia often a prominent symptom.' 'hydrargyrism._--Corrosion. mercuric nitrate. The mucous membrane of the oesophagus and stomach is often of a bluish-grey colour.' or 'salivation. and the loosening of teeth. constriction and burning in throat and stomach.of the entire canal is charred. tenderness and swelling of mouth. May get _eczema mercuriale_ and periostitis. peculiar foetor of breath. Cramp. softened. and sloughing ulceration of stomach and intestines. vomiting of stringy mucus tinged with blood. and irregular pulse. is corrosive sublimate. a blue line on the gums.' 'ptyalism. the latter also separating it from its solution in water. _Post-Mortem Appearances. white precipitate. Feeble. In chronic cases 'mercurialism. Metallic mercury is not poisonous. XXIII. Inflamed condition of urinary organs. tenesmus. _Symptoms_ come on rapidly. purging. the cyanide and potassio-mercuric iodide. softening. occasionally paralysis. . toxicologically. nausea. metallic taste.' including most of the symptoms enumerated above. The large intestine and rectum are often ulcerated and gangrenous. quick. mercurial tremors develop. and abraded. there may be salivation. Calomel has very little toxic action. Acrid. In poisoning from the medicinal use of mercury. If fumes of mercury inhaled. with contraction of the bladder. but its vapour is. _Treatment. albuminous or bloody urine or total suppression. inflammation. neuritis not uncommon. possessing an acrid. Other poisonous preparations are red precipitate. swelling and ulceration of gums (cancrum oris). a coppery taste in the mouth. =Corrosive Sublimate= (perchloride of mercury) is in heavy colourless masses of prismatic crystals. magnesia in milk. Mercury is less quickly eliminated from the body than arsenic. It is soluble in sixteen parts of cold and two of boiling water. twitches and convulsions of limbs. metallic taste. dysuria with scanty.--MERCURY AND ITS PREPARATIONS The most important salt of mercury._--As for tartar emetic. Soluble in alcohol and ether.

Suppose no mercury is found in the dialyzed fluid. 4. With iodide of potassium Bright scarlet colour._--The following table gives the action of corrosive sublimate with reagents: 1. _Tests._--Half an hour the shortest._--Three grains in a child. is volatilized. the ethereal solution. gluten._Treatment. tannic acid. etc. and tested with copper-foil. 3. 2. filtered._--A trial test may be made of the contents of the stomach with copper-foil. .. we must dry the insoluble matter. With hydrochloric acid and First a yellowish and then a black sulphuretted hydrogen colour. and heat it with nitro-hydrochloric acid until all organic matter is destroyed and excess of nitric acid expelled. 6. boils. owing to the fact that corrosive sublimate enters into insoluble compounds with albumin. _Method of Extraction from the Stomach. Stomach-tube to be used with care. when metallic mercury will be deposited on the gold. is the best antidote. _Fatal Period. _Fatal Dose. A very simple process for detecting corrosive sublimate is to put a drop of the suspected solution on a sovereign and touch the gold through the solution with a key. Demulcent drinks. which has the power of taking corrosive sublimate up. 5. With potash solution Bright yellow colour. The ether allowed to evaporate will leave the corrosive sublimate in white silky-looking prisms. as white of egg. deposits the salt in white prismatic crystals. With ether Freely soluble. and thus separating it from arsenic and other metallic poisons. etc. and forms a white crystalline sublimate. or wheat flour. If mercury is found. Heated with carbonate of Globules of metallic mercury are sodium in a reduction-tube produced. gluten. when allowed to evaporate spontaneously. and ice. The residue dissolved in water. milk._--Encourage or produce vomiting. the contents of the stomach may be dialyzed. mucous membrane. Albumin. owing to softened state of gullet and stomach. fibrin. the resulting clear fluid concentrated and shaken with ether. Heated in a reduction-tube Melts.

tendency to gout.' May get _saturnine encephalopathies_. and in women to abortion._--Inflamed mucous membrane of stomach and intestines.XXIV._--Metallic taste. paint manufacturers. impregnated with the salt of lead._--Dry the contents of the . convulsions. etc. _Fatal Dose and Fatal Period. intense thirst. emaciation. and only when taken in large doses.--A glistening white powder or crystalline mass. In chronic lead-poisoning the most prominent symptoms are a blue line on the gums. severe headache. or milk and eggs. and scrupulous cleanliness should also be enjoined in the workshops. _Chronic lead-poisoning_ is liable to occur in those who handle lead in any form--white-lead workers. colicky pains. pottery workers. cramps in limbs. with layers of white or whitish-yellow mucus. spirits of chloroform. The ionization method of Sir Thomas Oliver is most useful both as regards cure and also prevention of chronic poisoning by lead. _Symptoms. and epileptiform convulsions.--LEAD AND ITS PREPARATIONS =Acetate of Lead= (Sugar of Lead). _Post-Mortem Appearances. cramps. and peppermint-water. of which intense headache. anæmia._--Uncertain. Milk. with a sweetish taste. _constipation_ and scanty urine. persistent constipation. optic neuritis. are the most common. pallor. As a prophylactic among workers in lead. Albumin in urine. dryness in throat._--Sulphate of sodium or magnesium. Soluble in water. _Method of Extraction from the Stomach. vomiting. _Treatment. a drink containing sulphuric acid flavoured with treacle should be given. plumbers. causing 'dropped hand. Lavatory accommodation should be provided. colic. quick pulse. cold sweat. The dry grinding of lead salts should be prohibited. or a mixture of dilute sulphuric acid. and paralysis of the extensor muscles. It is practically the only lead salt which gives rise to acute symptoms.

a bright yellow precipitate. Diachylon. white precipitate. Jaundice is common. its victims are entitled to compensation at the hands of their employers. XXV. being an occupation risk. =Subacetate of Copper= (verdegris) occurs in masses. dry. In case of death. astringent. blue vitriol) in half-ounce doses is a powerful irritant. iodide of potassium. The most important are the sulphate. Has been given to procure abortion. and dissolve in water. diarrhoea. Half-ounce doses have proved fatal. subacetate. The solution of nitrate of lead may now have the proper tests applied.. or as a greenish powder._--Sulphuretted hydrogen gives a black precipitate. cold extremities. vomiting of bluish or greenish matter. with a glass rod dipped in ammonium sulphide: a brown coloration is produced. One-tenth of a grain of lead in a gallon of water may be detected. purple line round the gums.' and. with symptoms closely resembling those of lead. or lead-plaster. liquor potassæ. =Sulphate of Copper= (bluestone. is largely used as an abortifacient. insoluble in nitric acid. A _chronic_ form of poisoning may occur. and incinerate in a porcelain crucible. metallic taste. etc.stomach or portions of the liver. _Tests. Treat the ash with nitric acid. A delicate test for lead in water is to stir the water. ._--Epigastric pain. depression. white precipitate. who are guided by the expert medical evidence available. and arsenite. Dyspnoea.--COPPER AND ITS PREPARATIONS Poisoning with copper salts is rare. concentrated or not. headache. The responsibility of apportioning the monetary value of disablement resulting from the action of the lead rests with a judge or jury. compensation has been awarded even when at the autopsy the patient has been found to have suffered from acute tuberculosis of the lungs. _Symptoms. Chronic lead-poisoning is an 'industrial disease. sulphuric acid. Powerful.

XXVI. _Method of Extraction from the Stomach. Give albumin or very dilute solution of ferrocyanide of potassium. decoction of oak-bark. =Chloride of Zinc. vomiting. clammy sweats. Ferrocyanide of potassium gives a rich red-brown precipitate. In the case of the solid organs. BISMUTH. Ammonia gives a whitish-blue precipitate. The vomited matter contains shreds of mucous membrane with blood. _Post-Mortem Appearances. digest ash in hydrochloric acid. pass hydrogen sulphide. _Treatment. There is profound collapse. carbonate of potassium or sodium as antidote.--ZINC._--Boil the contents of the stomach in water. stomach. incinerate. _Treatment. followed by vomiting. AND CHROMIUM The salts of zinc requiring notice are the sulphate and chloride. and abdominal pain. SILVER. filter. filter.' It is a corrosive poison. and abdomen._--Tea.=--A solution containing this substance (230 grains to the ounce) constitutes 'Burnett's disinfecting fluid._--Inflammation of stomach and intestines. which are bluish or green in colour. thirst. soluble in excess._--Encourage vomiting._Post-Mortem Appearances. . purging. dilute with water. evaporate nearly to dryness. and test. dry. cold surface. with tenesmus and distension of the abdomen._--Those of inflammation of digestive tract. throat. dilute filtrate with water and apply tests._--Polished steel put into a solution containing a copper salt receives a coating of metallic copper. diarrhoea. collect precipitate and boil in nitric acid. The symptoms are burning sensation in the mouth. filter. _Tests. In large doses it causes dryness of throat. Sulphuretted hydrogen gives a deep brown precipitate. =Sulphate of Zinc= has been taken in mistake for Epsom salts.

and nitrate of silver of hydrochloric acid. a white precipitate in pure and neutral solutions. which is permanent. digest ash in water. _Treatment. Used as dyes. The gums show a blue line. The _treatment_ is to wash out the stomach with large and weak solutions of carbonate of sodium. _Method of Extraction from the Stomach. magnesia. with great prostration. Chromate.=--Nitrate of silver is a powerful irritant.=--The bismuth salts are not poisonous. In dilute solutions they act as irritants. but may contain arsenic as an impurity. Mucilaginous drinks may be given. apply tests. _Tests._--Black precipitate with sulphuretted hydrogen._--Yellow precipitate with salts of lead. which is darker than that produced by lead. Chronic nitrate of silver poisoning is characterized by _argyria_. sulphuretted hydrogen. _Treatment. The former may to some extent be prevented by taking snuff. reprecipitated by sulphuretted hydrogen. ferrocyanide of potassium. _Tests. Bichromate of Potassium. =Chromic Acid. and hypodermic injections of morphine are useful to allay the pain. Two drachms of the bichromate caused death in four hours._--Dry and incinerate the tissues in a porcelain crucible. and diluents. Nitrate of baryta will show the presence of sulphuric acid. Washing out of the stomach with weak solution of nitrate of silver. white with hydrochloric acid._--Common salt. and the skin presents a greyish hue. a white precipitate. although this is far less common than it was some years ago. =Bismuth.weak pulse. deep red with those of silver. Those engaged in their manufacture suffer from unhealthy ulcers on the nasal septum and hands. Lead chromate (chrome yellow) is a powerful irritant poison. _Tests. =Silver. ._--Ammonia.=--These act as corrosives when solid or in concentrated liquid forms. have proved fatal more than once. a white precipitate soluble in excess._--Emetics.

_Post-Mortem Appearances. It forms the chief part of the deadly 'choke damp' after an explosion in a mine. or calm and pale. lips. gorged with dark-coloured blood. galvanism. The proportion usually present in air is 0. when in _very small amounts_.XXVII. insensibility. at once. obtained by passing steam over heated coke. giddiness. _Symptoms. From 10 to 15 per cent. Brain and membranes congested. somnolence. and is generated in many ways during fermentation. transfusion. headache. _Treatment. Even in cases which recover. loss of muscular power. with prostration.04 per cent.=--Carbon dioxide is a product of combustion and respiration. etc. Water-gas. stimulants. _Post-Mortem Appearances. limbs usually flaccid. in the atmosphere is immediately fatal. inhalation of oxygen. =Carbonic Oxide. brick-kilns. It is evolved in the process of burning charcoal and coke in stoves or furnaces. insensibility comes on at once. nausea. and coma. _Symptoms. Insensibility. and is given off from lime-kilns. artificial respiration. ears. venesection._--The blood is bright red in colour. vomiting.=--This is one of the most poisonous of gases. abdomen distended. cold affusion. causes sense of weight in forehead and back of head. giddiness._--When in _large amount_. permanent impairment of the brain may result. There may be convulsions. stertorous breathing. It is a constituent of _choke damp_ due to explosions in coal-mines. and large veins. lividity is most marked in eyelids. lungs. It is often met with in dangerous quantities in wells and in brewers' vats. Convulsions occasionally. contains 40 per cent. _diluted_._--Inhalation of the _pure_ gas causes spasm of the glottis. but even 2 per cent. in the atmosphere would prove fatal. right side of heart._--Pure air._--Face swollen and livid. of the substance. and death from asphyxia. inhaled for long would produce serious symptoms.--GASEOUS POISONS =Carbon Dioxide. insensibility. and cement-works. lividity of face and body. and death from asphyxia. and vomiting. noises in the ears. Two per cent.. the remainder being chiefly hydrogen. due to .

yielding water and carbonic acid. foaming at mouth. exhales gas from the lungs when removed into a fresh room or into the air. sulphide of ammonium. artificial respiration._--Fresh air. and nitrogen. cold affusion. It is extremely poisonous. and nitrogen. =Sulphuretted Hydrogen= is characterized by its odour. diffusible stimulants. if alive. tetanic spasms. The breath smells of gas.the interaction of carbonic oxide with hæmoglobin. loss of power. back. stertorous breathing. and muscles. the patient. Bright red patches of colour are found over the surface of the body._--Acetate of lead throws down a brown or black precipitate according to the quantity of the gas. if much CO present in the coal gas. The spectrum of the blood is characteristic. cold douche in moderation. artificial respiration. inhalation of oxygen freely._--Fluid and black blood (sulph-hæmoglobin). _Treatment. and convulsions._--Headache and giddiness. olefiant gas. =Coal Gas. _Tests. Coal gas has an offensive odour. rapid putrefaction._--Giddiness. tetanus. smell of H_{2}S on opening the body. florid colour of neck. transfusion of blood. =Sewer Gas. sulphuretted hydrogen. infiltration of lungs. _Treatment. free hydrogen. ammonia. burns with a yellowish-white flame. convulsions. fluid florid blood. _Symptoms. like that of rotten eggs. inhalation of oxygen. there is profound stupor. carbonic acid._--Ammonia to the nostrils. delirium. Cases of poisoning often due to escape of gas into the room. loss of contractility of muscles._--Pallor of skin and internal tissues._--Fresh air. _Post-Mortem Appearances. carbonic oxide. nausea. pain and oppression in stomach. stimulants. but sometimes . _Treatment. inhalation of chlorine. dilated pupil. A rosy hue of the skin-surface and viscera is often noticed. vomiting. _Symptoms. _Post-Mortem Appearances. Smell of gas in the room and in patient's breath.=--Cesspool emanations usually consist of a mixture of sulphuretted hydrogen.=--Coal gas contains light carburetted hydrogen or marsh gas.

gamboge. _Symptoms. and alternate hot and cold douche. collapse. Very destructive to vegetable life. purging. weak pulse. aloes is also the chief ingredient in Holloway's pills. and air-passages.=--Used in bleaching. _Post-Mortem Appearances. followed by cold sweats. elaterium. elevation of temperature to 104°. (6) ammonia. _Symptoms. etc. They have the common property of causing irritation and inflammation of the eyes. =Chlorine.. and pneumonia. =Hydrochloric Acid Gas. tenesmus. =Sulphurous Acid Gas. colocynth. and may cause spasm of the glottis.=--One of the products of combustion of common coal. (5) bromine._--Vomiting. In poisoning. _Treatment. lividity. or exposure only short. and of colchicum. and colchicum. jalap._--Fresh air. hypodermic of strychnine. XXVIII. of white hellebore. Stimulants. and very irritating when diluted._--If poison concentrated. (2) sulphurous acid gas. (4) chlorine. (3) hydrochloric acid gas. suffocating odour. All these have. dilated pupils. either alone or combined. Morrison's pills contain aloes and colocynth. if gas diluted.it is only deoxidized air with an excess of carbonic acid gas. proved fatal.=--Irrespirable when concentrated. insensibility. or convulsions. throat. death may ensue at once. and as a disinfectant. scammony. The active principle in aloes is aloin. hurried respiration. Greenish-yellow colour. bronchitis. with artificial respiration. . tonic convulsions not unlike those of tetanus. jalapin. croton-oil. inhalation of sulphuretted hydrogen gives relief. seeds of castor-oil plant. the hellebores.--VEGETABLE IRRITANTS The chief vegetable purgatives are aloes. colchicin. of jalap. oxygen. veratria. =Irritant Gases= are--(1) Nitrous acid gas._--Inflammation of alimentary canal.

--This plant. Death due to respiratory paralysis. commonly known as 'lords and ladies. diarrhoea. Mere contact with the leaves or branches will in many people set up an acute dermatitis. and is powerfully toxic. =Rhus toxicodendron= is the poison oak or poison ivy. _Treatment. Certain of these irritant poisons exert a marked influence on the central nervous system. and large blisters form on the cheeks and chin. and the skin may desquamate. Treatment as above. vomiting. coma. and convulsive twitchings. Symptoms are purging.' is common in the woods. There is often great constitutional disturbance. Many plants have an intensely irritating action on the skin. and death. =Primula obconica= is another plant which. laboured breathing. when handled.ulceration. and when absorbed act as active poisons. as the following: =Laburnum= (_Cytisis Laburnum_). It has a bitter taste. warmth and friction to the surface of the body. convulsions. Death may occur suddenly. The symptoms are convulsions. =Yew= (_Taxus baccata_) contains the alkaloid _taxine_._--Diluents. with much oedema and hyperæmia of the skin. Most of the cases are in children. and the berries may be eaten by children. artificial respiration. coma. which is also contained in arnica. insensibility. vomiting. It gives rise to symptoms of irritant poisoning. dilated pupils. pallor. followed by insensibility. insensibility. and submucous effusion of dark blood. dilated pupils. abdominal fomentations. purging. the seeds. and pains in the abdomen.--All parts of the plant are poisonous. but fragments of leaves or berries may be found in the stomach and intestines. opium. which are contained in pods. The inflammation spreads rapidly. etc. gives rise to an acute dermatitis of an erysipelatous character. softening. The effects may last a week. restlessness. stimulants freely. Contains the alkaloid _cytisine_. The face swells. . and there is formation of blebs with much itching. Treatment consists of stomach-pump or emetics. collapse. though not uncommon in the United States. Post-mortem appearances not characteristic. followed by drowsiness. stimulants. nausea. are often eaten by children. =Arum= (_Arum Maculatum_). vomiting. Poisoning by this plant is rare in England.

In deep. of the Schedule of Poisons. The pupils are contracted._. which contains 1 grain opium in 15 minims. Young children and infants are specially susceptible to the poison.--OPIUM AND MORPHINE =Opium. drowsiness and stupor. and in Godfrey's cordial. followed by insensibility. and come under the Dangerous Drugs Regulations. In the latter one can seldom rouse the patient. they are insensible to the action of light. The most important active principles of opium are the alkaloids morphine and codeine. and Collis Browne's chlorodyne. and opium-eaters are able to take enormous quantities of the drug.=--The inspissated juice of the unripe capsules of the _Papaver somniferum_. Remissions are not infrequent. morphine. along with all other preparations (_e. morphine. subconjunctival hæmorrhages may be seen. but quickly relapses. Laudanum contains 1 per cent. _Symptoms_ usually commence in from twenty to thirty minutes: Giddiness.XXIX. the pupils are unequal and dilated. countenance livid. Bowels confined. pulse weak. stooping posture.g. _Diagnosis_ is not always easy. and hemiplegia is present. Nausea and vomiting are sometimes present. In _compression of the brain_. The opium-eater may be known by his attenuated body. paregoric) which contain 1 or more per cent. the patient appearing about to recover and then relapsing. and . The habitual use of opium is not uncommon. Opium is found in almost all so-called 'soothing syrups' for children. Breathing slow and stertorous. In _uræmic or diabetic coma_ the urine must be examined. As coma increases. fracture of the skull may be present. As a poison it is generally taken in the form of the tincture (laudanum). are included in Part I. may be roused by loud noise. and one has to differentiate poisoning from _cerebral apoplexy_. withered yellow countenance. Temperature subnormal. skin cold and livid or bathed in sweat. and the paralysis increases. and it. Dalby's carminative. Patient seems asleep. Hæmorrhage into the pons may give rise to contracted pupils. even to a pin's point. the pupils are often unequal. natural sleep the eyes are turned upwards and the pupils contracted. pulse becomes slower and fuller.

and may be used in the presence of ._--Four grains of opium is the smallest fatal dose in an adult. decompose iodic acid. When the alkaloid is heated in a watchglass with a drop of strong sulphuric acid until the acid begins to fume. Filter. a green turning to brown. and meconic acid set free. Lungs gorged. _Tests. The iodic acid test is very delicate. this treatment must not be continued. Turgescence of cerebral vessels. walking about. Filter. Belladonna by mouth. spirit. _Fatal Dose. and tests applied. with bichromate of potassium. or one drachm of laudanum. Acetate of morphine passes through. ammonia to nostrils.glassy. _Post-Mortem Appearances. children are proportionately much more susceptible to the action of opium than adults. however. but requires great care. The solution of acetate of morphine may be freed from excess of lead by hydrogen sulphide and filtered. sulphide of lead is formed. strong coffee or tea. Rarely extravasation of blood. _Treatment. Patient must be kept roused by dashing cold water over him. becoming brighter on standing. a drop of nitric acid produces a brilliant red colour. In conditions of collapse._--Not characteristic. _Method of Extraction from the Stomach. and meconate of lead remains. flagellating with a wet towel. These may be separated from organic mixtures thus: Boil the organic matter with distilled water. but everything should be done to preserve the strength. or atropine hypodermically. skin livid. at base of the brain. into ventricles. Treatment must be continued as long as life remains. Stomach and intestines usually healthy. sunken eyes. Give 10 grains of permanganate of potassium in a pint of water acidulated with sulphuric acid. Concentrate the solution of meconic acid. etc. There may be effusion under arachnoid. and apply tests. Put the meconate of lead with water into a beaker and pass hydrogen sulphide. allow a portion to crystallize. with perchloride of iron. gives a rich indigo-blue. but we test for morphine and meconic acid. and to the fluid passed through add acetate of lead till precipitate ceases. _Fatal Period. emetics._--Morphine and its acetate give an orange-red colour with nitric acid. setting free iodine._--Stomach-tube. excess of hydrogen sulphide driven off by heat. and acetic acid. recovery takes place._--Opium itself cannot be directly detected. and is then allowed to get quite cold. and repeat the dose every half hour. if life is prolonged for eight hours._--Usually nine to twelve hours. and around the cord. filter. but in many cases.

dilated pupils. AND STRAMONIUM =Belladonna. intense thirst._--Atropine may be recognized by its action on the pupil. quick pulse. not discharged by corrosive sublimate or chloride of gold.--BELLADONNA. _Symptoms. or tannin. and berries. =Morphine Habit. Strangury and hæmaturia. =Hyoscyamus= (Henbane). _Treatment. The chloro-iodide of potassium and mercury precipitates it from very dilute solutions. Tea. XXX.=--Individuals who have acquired this habit take the drug usually by hypodermic injection. The victim suffers from nausea and vomiting. especially of the face. followed by hypodermic injections of pilocarpine or morphine._--Wash out the stomach freely. leaves. a hypodermic injection of apomorphine as an emetic.=--The root. like that of scarlatina. the . noisy delirium and stupor._ =Stramonium= (Thorn-Apple). _Tests. whether the poison be taken internally or applied locally to the eye. Dilatation of the pupil occurs. The similar colour produced by sulpho-cyanide of potassium and perchloride of iron is discharged by chloride of gold and corrosive sublimate. to precipitate the alkaloid. have been noticed.--_Hyoscyamus niger. coffee. _Post-Mortem Appearances. and redness of the skin._--Congestion of cerebral vessels.organic matter. Meconic acid gives a blood-red colour with perchloride of iron. red patches in alimentary canal. of the _Atropa belladonna_ are poisonous from the presence of alkaloid atropine._--Identical with those of belladonna and hyoscyamus._--Dryness of mouth and throat.--_Datura stramonium. and becomes so mentally debilitated that asylum treatment is required. dysphagia and dysphonia._ _Symptoms. HYOSCYAMUS.

oil. giddiness.=--Any dose above 1/2 grain applied to a mucous membrane or injected hypodermically may give rise to alarming symptoms._. The =Cocaine Habit= consists in the self-administration of the drug hypodermically._--Odour of breath.--CAMPHOR The liniment. and weak pulse. rapid.--When smoked.=--The fruit of _Anamirta cocculus_. giddiness. =Cocculus Indicus. XXXI. used in the East as a narcotic. produces intoxication and mania. which is followed by prostration. difficulty of breathing. _Hashish_. faintness. In time melancholia or mania develops._--Thirty grains. may cause persons to run 'amok' and commit murder. It induces excitement. 1920' (p. but stimulants by mouth--_e. dilatation of pupils. XXXII. _Fatal Dose. =Cannabis Indica= (Indian Hemp). Contains a . These are intense pallor.--COCAINE =Cocaine. languor. intense prostration verging on collapse. with great irritation of the skin ('cocaine bugs'). 82). intermittent. For care in the prescribing of cocaine see under the 'Dangerous Drugs Act. flushed face. and spirit have been poisonous in large dose. ammonia--and the hypodermic injection of brandy or ether may be necessary. convulsions. and convulsions. faintness. nausea and vomiting. delirium. paroxysmal dyspnoea.g. The patient may recover if allowed to remain in a recumbent position. and dilated pupils. _Symptoms. with hot skin. dimness of vision. with the inhalation of nitrite of amyl._post-mortem appearances_ and _treatment_ being also the same.

_--Remove from work. chiefly liver.T. may be absorbed through skin or be inhaled.poisonous active principle.=--An explosive solid which stains the skin an orange colour._--Shortness of breath.--ALCOHOL.). Later. rest in bed. diuretics. =Tetrachlorethane= ('Cellon').N. gastritis. _Post-Mortem. and chloroform._--Gastric symptoms and marked jaundice. followed by stupor and complete loss of voluntary power. of alcohol. =Trinitrotoluene (T._--Convulsions. _Symptoms. jaundice. it is by inducing a state like apoplexy or by paralyzing the heart. by weight of water. When they cause death. Proof . drowsiness. vapour has caused poisoning in aeroplane ('dope') and cinema film works. _Symptoms. and by poachers to stupefy fish. ETHER. XXXIV. blood degeneration. death. used to adulterate beer. ether.--TETRACHLORETHANE. alkalies. skin irritation. often preceded by delirious excitement. picrotoxin.=--Absolute alcohol is ethyl hydroxide (C_{2}H_{5}OH) with not more than 1 per cent. ETC. of wood spirit._--Fatty degeneration of internal organs. purgatives.--Acetylene tetrachloride. This may be followed in days or weeks by stupor. and followed by nausea and vomiting. _Symptoms. _Treatment. Rectified spirit (spiritus rectificatus) contains 90 per cent. AND CHLOROFORM Alcohol. =Alcohol. headache. induce general anæsthesia. Methylated spirit consists of rectified spirit with 10 per cent. XXXIII. coma.

_--Death from 1/2 pint of gin and from two bottles of port. peripheral neuritis. place them in a retort and carefully distil. Rigor mortis persistent.. cold affusion. _Treatment. but recovery from larger quantities. headache. =Methyl Alcohol: Wood Naphtha. congestion of brain. alcoholic insanity. and again distil. degeneration of kidneys. Pupils usually dilated.spirit contains a little over 49 per cent. _Tests._--Average about twenty-four hours. with subnormal temperature._--Neutralize the contents of the stomach. ales and stout. _Symptoms_ are those of alcoholic poisoning. of absolute alcohol. jaundice. injection of a pint of hot coffee into the rectum. _Fatal Period._--Stomach-tube. but vomiting and delirium . and evolves aldehyde. Lungs congested.. etc. In the acute form delirium tremens is the most common manifestation. if acid. With dilute sulphuric acid and bichromate of potassium turns green. Dissolves camphor._--Odour. and various forms of paralysis. port wine. _Method of Extraction from the Stomach. Give chloride of ammonium in 30 grain doses to prevent delirium. confusion. albuminuria. furniture-polishers. staggering gait. giddiness. and coma. _Symptoms. Product of combustion makes lime-water white and turbid. vomiting and purging. Sometimes congestion of cerebral vessels and meninges. _Fatal Dose. electricity. with sodium carbonate.=--Used to produce intoxication by painters. brandy or whisky. 53 per cent. Collect the distillate. Agitate distillate with dry potassium carbonate. strychnine or digitalin hypodermically. diabetes. Dipsomaniacs suffer from indigestion. cirrhosis of liver._--Deep red colour of lining membranes of stomach. blood fluid. _Post-Mortem Appearances. Vomiting may occur and recovery ensue. otherwise collapse sets in._--Acute poisoning. 20 to 25 per cent. mix with chloride of calcium or anhydrous sulphate of copper. passing into stupor. 4 to 6 per cent. and draw off some of the supernatant fluid for testing.

2. Excitement precedes 2. 1. Drowsiness. The following table gives the points of distinction between concussion of brain. It contains 92 per cent. Remission rare. having a strong and characteristic odour. It is this preparation which is used for the production of general anæsthesia. surface of body cold. and stertorous breathing. _Symptoms. prolonged. Symptoms slow. pupils 3. History will be of use. Partial recovery may 4. Remission rare. 3.720. Face flushed. 5. 2. face becomes pale. Patient recovers occur. OPIUM. of ethyl oxide (C_{2}H_{5})O.735. on head. No marks of violence. Marks of violence 1. alcoholic poisoning. . contracted. It has a specific gravity of 0. eyes glassy and fixed.' It is a colourless. causes slow. lips bluish. Total or partial blindness may follow as a sequel of optic atrophy. No odour of alcohol 5. muscles become flabby and relaxed. followed by slowly. and opium poisoning: CONCUSSION OF BRAIN. =Ether= is a volatile liquid prepared from ethylic alcohol by interaction with sulphuric acid. 1. sudden stupor. and its vapour is very inflammable. unless person has fallen. 3. and most of the water by subsequent distillation in the presence of calcium chloride and lime. Face pale. ALCOHOL. same as alcohol._--When taken as a liquid. Face pale. then slows. Odour of opium in in breath.722 to 0. generally dilated. specific gravity 0. A fatal result not infrequently follows. profound anæsthesia. 4. in breath. lethargy. sudden. When inhaled as vapour. Odour of alcohol 5. inflammable liquid. Stupor. Pupils dilated. As alcohol. It was formerly called 'sulphuric ether. pupils pupils sluggish. death. Pulse first quickens. Then pulse sinks and coma ensues. sometimes dilated. =Purified ether= from which the ethylic alcohol has been removed by washing with distilled water. stupor. cold. breath. 4.are more persistent.

Sparingly soluble in water._--When swallowed. galvanism. and imperceptible pulse. vomiting. Cavities of heart full of dark. especially in the case of children. galvanism and suspension with head downward. _Post-Mortem Appearances. It would be impossible to instantly render a person insensible by holding a pocket-handkerchief saturated with chloroform over the face. deepening into coma. =Chloroform.495. Inhalation of nitrite of amyl.490 to 1. stomach. _Post-Mortem Appearances. characteristic smell in breath. burning pain in the throat. coldness of the extremities. very volatile. _Tests._--Exposure to pure air. but produces insensibility and muscular relaxation more rapidly._--Same as for alcohol._--Brain and lungs congested. and note reaction as for alcohol. artificial respiration. much the same as ether._--Vapour burns with smoky flame. depositing carbon. With bichromate of potash and sulphuric acid same as alcohol. The internal organs are found to be fattily degenerated. Statements such as this. _Symptoms._--Stomach-tube and free lavage. giving off dense vapour. and region of the abdomen. _Delayed Chloroform-Poisoning. nitric and sulphuric acids. dilated pupils. are incredible. with stertorous breathing. Vessels at upper part of spinal cord congested. anxious countenance. .sensation being entirely suspended. drawing forward tongue. Sweet taste and pleasant odour. cold affusion. insensibility. which are often made in cases of robbery from the person and in cases of rape. staggering gait._--Death may take place in from four to seven days after chloroform has been administered._--Cerebral and pulmonary congestion. artificial respiration. Nausea and vomiting not uncommon. When inhaled.=--A colourless liquid. _Treatment. and death is thought to be due to acetonuria. _Method of Extraction from the Contents of the Stomach. During distillation pass some of the vapour into concentrated solution of bichromate of potash. _Treatment. or right side distended with dark blood. cold affusion. Heart empty. strychnine hypodermically. specific gravity 1. liquid blood.

_--When swallowed.--CHLORAL HYDRATE It was formerly largely used as a hypnotic. colour._--Stomach-tube or emetic. and. _Symptoms._Fatal Dose. it yields chloroform and potassium formate._--By distillation at 120° F. XXXV. if the solution be concentrated._--Heated with caustic potash. dissolves camphor. _Treatment. burns with a green flame. Supposed to act in the blood by being decomposed into chloroform and sodium formate._--By distillation in strongly alkaline solutions. weight. loss of muscular power. Pulse may become quick. by separating as a heavy layer at the bottom . when it may be obtained as chloroform and tested as such. the second by reddening blue litmus-paper. Prolonged use of this drug may produce a peculiar eruption on the skin. the medulla being the last part of the nervous system to be attacked. diminished or abolished reflex action and sensibility. from 1 to 2 ounces. The chloroform is readily recognized by its odour. It is prepared from alcohol and chlorine. may be decomposed by heat into chlorine. and caoutchouc. and face flushed or livid and bloated. _Tests. and inject a pint of hot strong coffee into the rectum. It produces delirium. _Method of Extraction from the Stomach. followed by loss of consciousness and marked fall of temperature. sleepiness. and coma. Keep patient warm._--Taste. _Tests. as it passes along a glass tube. =Iodoform. Its effects are due chiefly to depression of the central nervous system.=--Poisoning may result from its use in surgery. and many fatal consequences ensued. Hypodermic injections of strychnine. Nitrite of amyl and artificial respiration. It may lead to mental weakness or optic neuritis. _Method of Extraction from the Stomach. hydrochloric acid. The vapour. and the last by its deposit. and carbon--the first shown by setting free iodine in iodide of starch. guttapercha._--Deep sleep.

XXXVI. and is often called mineral naphtha. and is then free from colour. and benzoline. also known as kerosene and mineral oil._--In the case of an adult. and there may be vomiting. _Treatment. =Paraffin=. Different varieties are sold under the names of cymogene. and patients have recovered after drinking a pint._--These substances are not very active poisons. syncope. as a rule. XXXVII. and is a mixture of the higher saturated hydrocarbons. Death may result from gastro-enteritis or from coma. and each is sold for the other without prejudice. but retains its peculiar penetrating odour. AND ANILINE ._--Emetics. the face is pale and cyanotic. and petroleum spirit. hot and dry. From its very general use as a fuel in motor-cars many accidents have happened from inhaling the vapour of petrol. Benzoline is not the same as benzene or benzol. The crude petroleum is purified by distillation. petrol. which is one of the products of the dry distillation of coal. and. is a mixture of saturated hydrocarbons obtained by the distillation of shale. but seldom death. 1/2 pint should not prove lethal. naphtha. =Petroleum= is a natural product. petroleum naphtha. shallow respiration. Benzoline is highly inflammable. and occur chiefly in children. By the retailer the terms 'petroleum' and 'paraffin' oil are used indifferently. gasolene. _Symptoms. and insensibility. even children recover. purgatives.--PETROLEUM AND PARAFFIN-OIL Cases of poisoning by petroleum and paraffin are common. _Fatal Dose.--ANTIPYRINE. It gives rise to coldness. ANTIFEBRIN. PHENACETIN. The breath has the odour of paraffin.of the test-tube. and stimulants.

_--May be extracted from acid solutions by ether or chloroform. if liquid. Of all the members of the group. vomiting. insoluble in water. =Exalgin. Aspirin. It is insoluble in water. odour of aniline is given off. _Treatment. destroyed by the addition of mineral acids. as well as the above. patient to be kept in the recumbent position. It is in colourless.Many of the synthetical coal-tar products now so largely employed as analgesics are powerful toxic agents. scaly crystals. aceto-acetic ether._--Can be extracted from an alkaline solution of chloroform. _Tests. when it is warmed with a few drops of chloroform. is produced by the interaction of glacial acetic acid and para-phenetidin. _Tests. Ferric chloride gives a blood-red coloration. is a complex benzene derivative prepared from aniline. The residue left on the evaporation of chloroform should be employed for testing.--Nausea. or Analgesin=. =Phenacetin. hurried . it most rarely produces toxic symptoms. Phenylacetamide= (a constituent of 'Daisy' or 'headache' powders). inodorous. inodorous. If heated with strong nitric acid and allowed to cool. inhalation of ether._--Emetics. which have a slight pungent taste. and methyl iodide. glistening. lamellar crystals. a penetrating and unpleasant odour of isocyanide. =Phenazone. is obtained by the interaction of acetic acid and aniline. If heated with solution of potassium hydroxide._--As for the other members of this group. inhalation of oxygen. Phenacetinum=. scaly crystals. Antifebrin. =Acetanilide. It is soluble in its own weight of water. stimulants. _Treatment. _Treatment. and even small medicinal doses may cause serious and even fatal consequences. It is in white. recumbent position. which have a bitter taste._--Stimulants freely. may all act as poisons to certain persons. etc.=. inodorous. _Symptoms_ (more or less common to all). tasteless. a purple colour is produced. Antipyrine. It is in colourless.

and forms a soluble sulphate with sulphuric acid. syncope. It is used in the manufacture of aniline dyes. stimulants. Throbbing and pulsation of all the arteries in the body. or digitalin hypodermically.--SULPHONAL. or inhaled. _Treatment. marked cyanosis. TRIONAL._--Wash out stomach. Persistent sneezing and widespread urticaria may be present. =Dinitrobenzene= causes symptoms resembling nitro-benzol poisoning. inhalation of oxygen. jaundice. _Symptoms. but is very poisonous when swallowed. strychnine._--Emetics. XXXVIII. =Aniline= is an oily liquid. and may act as an industrial poison. A solution of bleaching-powder gives with solution of the sulphate a purple colour changing to red-brown. vomiting. The symptoms closely resemble those of aniline poisoning. TETRONAL._--Nausea._--About 6 drachms.--It is used in perfumery. =Nitroglycerine= gives rise to intense and persistent headache ('powder headache'). but there is perhaps greater mental confusion. collapse. VERONAL. drowsiness. It is colourless or reddish-brown. transfusion. peripheral neuritis. and when acting as a chronic poison gives rise to weakness. it is soluble in alcohol. In its _industrial use_ it may act as a poison either by inhalation of the fumes or by absorption through the skin. transfusion of saline or blood. pituitrin. heavier than. _Treatment. The symptoms then are mainly those of peripheral neuritis with blindness. and marked cyanosis._--Eight to ten drops have caused death. _Fatal Dose. flushing of the face and collapse may follow. artificial respiration. feeble pulse. giddiness. stimulants. intoxication. =Nitro-benzol= (Artificial Oil of Bitter Almonds). it has a peculiar tar-like odour. _Fatal Dose. or absorbed through skin. and not soluble in. PARALDEHYDE . gasping for breath.respiration. water.

hypodermic injections of strychnine. The ordinary _symptoms_ of the group are noises in the ears. All the above-named aniline derivatives are included in Part I. It contains albumin and casts. Hypnogen is apparently identical with veronal. Cases of chronic poisoning from the 'als' are not uncommon. of the scheduled poisons. Delirium._--Emetics. The stomach and intestines should be examined for fragments of the leaves and fruit. XXXIX. occasionally. _Symptoms. saline injections. dysphagia. dilated pupil. a volatile liquid alkaloid with a mousy smell. tannic acid or gallic acid. but no red corpuscles. coma.--CONIUM AND CALABAR BEAN =Conium Maculatum= (Spotted Hemlock). . _Post-Mortem Appearances. In cases of hæmatoporphyrinuria the prognosis is bad._--Dryness of throat. and it is said that these cases invariably end fatally. It also contains methyl coniine. Contains the poisonous principle _coniine_. insoluble in water. vertigo. and convulsions. The most interesting point is the condition of the urine. Diffusible stimulants. ether. loss of muscular power. due to the presence of _hæmatoporphyrin_. strong coffee. inability to stand or to walk properly. recognized by their microscopical appearances._--Congested brain and lungs. and are increasing in frequency.--All parts of the plant are poisonous. insensibility. _Treatment. soluble in alcohol. and cyanosis. In cases of poisoning it is dark or reddish-brown in colour. and transfusion.These are dangerous drugs. passing into complete paralysis. headache. often mistaken for parsley. headache._--In an ordinary case emetics. _Treatment. redness of the mucous membrane of the stomach. and chloroform.

contraction of the pupils. The drug has an intense depressant action on the heart and respiratory centre._--Use Stas-Otto process. hypodermic injection of 1/50 grain sulphate of atropine. but the stomach and intestines should be examined for portions of the plant. XL. delirium. and chloroform. dilated pupils._Method of Extraction from the Stomach. _Tests. _Symptoms. It contains an active principle. paralysis of lower extremities. and death from asphyxia. especially to cattle.--TOBACCO AND LOBELIA =Tobacco._--The contraction of the pupil which it causes. Pale red._--The mousy odour. The water dropwort (_Oenanthe crocata_) is undoubtedly poisonous. which in some respects is allied to strychnine and picrotoxin. _Treatment. insensibility. _cicutoxin_. it has been mistaken for parsnip and celery. or lesser hemlock (_Æthusa cynapium_). with hydrochloric acid.=--The bean of _Physostigma venenosum_ contains the alkaloid physostigmine or eserine. alcohol. irregular cardiac action. soluble in water. The post-mortem appearances are not characteristic. a volatile. _Test. with the antagonistic alkaloid calabarine. . is another member of this group. deepening. with an acrid taste and ethereal odour. repeated if necessary. There are several other umbelliferous plants which are poisonous. slow pulse.=--_Nicotiana tabacum_ owes its poisonous properties to its alkaloid nicotine. The fool's parsley. _Method of Extraction from the Stomach. In man it produces abdominal pain with diarrhoea and vomiting. although doubt has been expressed as to whether it is really poisonous._--Emetics. ether. amber-coloured liquid. The water hemlock (_Cicuta virosa_) produces symptoms not unlike those of hemlock. oily. giddiness. and convulsions._--Use Stas-Otto process._--Vomiting. and cyanosis. =Calabar Bean or Physostigma. Deepened colour and dense white fumes with nitric acid.

and is also poisonous. cold sweats. feebly acid. _Symptoms. prostration. then shake with ether in a test-tube._--No change of colour with the mineral acids. filter.--Much used in America by the Coffenite practitioners. stupor. Death has occurred after seventeen or eighteen pipes at a sitting. White deposit with corrosive sublimate. =Lobelia Inflata= (Indian Tobacco). Test resulting alkaloid. engorgement of cerebral and pulmonary vessels._--Emetics. and vomiting. vomiting. It often contains undecomposed carbonate of potassium. and make solution alkaline with potash. The diluted hydrocyanic acid of the Pharmacopoeia contains 2 per cent. _Post-Mortem Appearances. muscular tremors. Evaporate the filtrate to half its bulk. oxide of chromium. It is a colourless liquid. and press residue. tremors. stertorous breathing. XLI. fainting. Precipitate with bichloride of platinum and with carbazotic acid._--Digest the contents of the stomach in cold distilled water and _very dilute_ sulphuric acid. and convulsions. stimulants._--Giddiness. Warmth to the surface by hot bottles. Congestion of gastric mucous membrane. digest with alcohol._--Not uniform or characteristic. with odour of bitter almonds. Headache. Dissolve residue (sulphate of nicotine) in water._Symptoms._--Nausea. _Method of Extraction from the Stomach. giddiness. strain. nausea. and a valuable remedy for asthma. Scheele's 4 per cent. Sulphuric acid and bichromate of potassium give a green colour. with syncope.--HYDROCYANIC ACID =Prussic Acid= is the most active of poisons. giddiness. _Tests. _Treatment. Remove ether and allow it slowly to evaporate. and evaporate alcohol off in a water-bath. and insensible pupil. which may act as a corrosive poison and cause . General relaxed condition of muscles. hypodermic injection of 1/25 grain of strychnine. of hydrocyanic acid. =Cyanide of Potassium= is largely used in photography and in electro-plating. insensibility. hot blankets.

_Method of Extraction from the Stomach. If the fatal termination is prolonged for a few minutes. and wash it out with a solution of sodium thiosulphate. jaws fixed. small and frequent pulse. Death results from paralysis of the central nervous system. or violet. as the drug promptly arrests the heart's action. It also kills the protoplasm of the red blood-corpuscles.erosion of the mucous membranes of the lips._--The symptoms usually come on in a few seconds._--From two to five minutes after a large dose. There may be convulsions or tetanic spasms. venous system gorged. chloric ether. dilatation of the pupils. Stimulants freely--brandy. and the patient drops down dead. 1 grain of the anhydrous acid is fatal. acid.P. _Fatal Period. Strong ammonia to the nostrils. _Fatal Dose (Smallest). _Post-Mortem Appearances. odour of acid from body. mouth. inject hypodermically either brandy or ether. with evacuation of urine and fæces._--Having previously carefully fitted a watchglass to a wide-mouthed bottle. nails blue. blood.P. secretions. pallor of the skin. the symptoms are intense giddiness. may contain (when improperly prepared) from 5 to 15 per cent. Place a few drops of a solution of nitrate of silver on the concave surface of the . nearly fill the bottle with the contents of the stomach. etc. Eyes prominent and glistening. =Oil of Bitter Almonds=. ammonia. and stomach. pale. Hypodermic injection of 1/50 grain atropine. owing to the presence of cyanmethæmoglobin. froth about mouth.6 grain of the anhydrous. _Treatment. Douche to the face. for in specimens the percentage of anhydrous acid varies enormously._--Half a drachm of the B. The gastro-intestinal mucous membrane is bright red in colour. alternately hot and cold. rendering them useless as oxygen-carriers._--Empty the stomach by the tube at once. There is a sudden gasp for breath. acid. Practically. _Symptoms. possibly a loud cry. Death commonly occurs so rapidly that there is no time for treatment. sal volatile _ad libitum_. with bright red patches on the dependent parts. If patient cannot swallow._--Skin livid. of the anhydrous acid. _Recovery_ from 1/2 ounce of the B. These records are fallacious. Hands clenched. used as a flavouring agent. equal to 0. and are of the shortest possible duration. but may be less. but artificial respiration is useless. laboured and irregular breathing. followed by insensibility.

dimness of sight. Warmth to whole body.--Root and leaves. which turns to Prussian blue with hydrochloric acid. Digitalis also useful. insoluble in cold. which should therefore be sought for. aconitine. and also strychnine. Poisonous property depends upon an alkaloid.--ACONITE =Aconite= (_Aconitum Napellus_. bleached by corrosive sublimate. will form a white precipitate which may be tested. Death often sudden. Sulphide of ammonium gives sulpho-cyanide of ammonium. first of the lower and then of the upper extremities. gentle warming of the bottle in a water-bath will assist the evolution of the vapour. loss of sensation. The vapour may be obtained by distillation. with a pink flame. Liquor potassæ and sulphate of iron give a brownish-green precipitate. 1/50 grain hypodermically. deafness. and shallow respiration. but this process is open to objections to which the other is not. If the acid is not at first detected. and burning. throat. Jacob's Oil. irregular. ._--Emetics. paralysis. will give the reactions of the acid with appropriate tests. _Treatment. Aconite is one of the constituents of St. Pupils dilated. but soluble in boiling. This method removes all objections as to foreign admixture. giddiness. when lighted. Best antidote is sulphate of atropine. The vapour of hydrocyanic acid.watchglass. nitric acid. having an odour of peach-blossoms. Liquor potassæ and sulphate of copper give a greenish-white precipitate. In some cases it becomes changed in the body into formic acid. finally imperceptible. stimulants freely._--Numbness and tingling in mouth. and stomach. The precipitate heated. This develops a blood-red colour with perchloride of iron. Patient to make no exertion. if present. _Tests. Pulse small. vomiting. The mind remains unaffected._--Venous congestion. becoming white with hydrochloric acid. Other watchglasses. _Symptoms. XLII. engorgement of brain and membranes. monkshood). treated with sulphide of ammonium or sulphate of iron and liquor potassæ. evolves cyanogen. _Post-Mortem Appearances. and cover the mouth of the bottle with it._--With nitrate of silver a white precipitate.

inflammation of gastric mucous membrane. remarkably slow and irregular. It may be found in the urine._--Average._Fatal Dose. The most active kind is probably made from _A. cold sweat. giddiness. Salivation occasionally. _Aconitum ferox_. Effects on mice. _Tests. purging. infusions containing tannin._--Chiefly physiological. tea. Headache. _Post-Mortem Appearances. pupils dilated. It contains a large proportion of pseudaconitine._--Congested condition of brain and membranes. The Indian aconite. XLIII. Stimulants.--DIGITALIS All parts of the plant _Digitalis purpurea_ (purple foxglove) are poisonous. Death sometimes quite suddenly. _Method of Extraction from the Stomach. Vomited matter grass-green in colour. =Aconitine= varies much in activity according to its mode of preparation and the source from which it is derived. A cadaveric alkaloid or ptomaine has been found in the body. pulse weak. as coffee._--Extraction from contents of stomach by Stas-Otto process. 1 drachm. and abdominal pains. insensitive. galls. less than four hours. but no distinctive chemical test known._--Nausea. and loss of sight. _Fatal Period. etc._--Of root or tincture. but for criminal purposes. ferox_. _Symptoms. not only for the destruction of wild beasts. The presence of this substance was suggested in the Lamson trial. _Treatment. Hypodermic injection of 1/120 . oak-bark. vomiting. or syncope and stupor. tingling and numbness when applied to tongue or inner surface of cheek._--Emetics freely. gives usual alkaloidal reactions. etc. etc. Contains the glucoside digitalin and other active principles. possessing many of the actions of aconitine. the Bish poison. is much more active than the European variety. and is frequently employed in India.

of poisoning by nux vomica are the same as for strychnine._--A white substance. rigor mortis persistent. _Tests for Digitalin. and treatment. face congested and anxious. as a rule. The minutest trace of digitalin moistened with sulphuric and treated with bromine vapour gives a rose colour. turns yellow. twitchings of muscles. lockjaw is an early symptom. lips livid. with hydrochloric acid. post-mortem appearances. Symptoms. followed by tetanic convulsions and opisthotonos. eyes staring. and forms the active ingredient of many 'vermin-killers. come on soon after food has been taken. _Symptoms. but in experienced hands the physiological test is more reliable. Death is delayed for some days. feet arched and inverted. _Post-Mortem Appearances. more or less soluble in benzol. not changed by nitric acid. ether. In _Tetanus_ there is usually history of a wound.' It occurs as a white powder or as colourless crystals. _Method of Extraction from the Stomach. and only later complete convulsions. This is very delicate. each lasting half to two minutes. the intervals between the fits are never entirely free from rigidity. =Strychnine= is a powerful poison. XLIV. The period of accession of the symptoms varies with the mode of administration of the poison._--Heart empty. etc. blood fluid. From these strychnine and brucine are obtained. and alcohol. changing to green. The symptoms._--Sense of suffocation. sparingly soluble in water. very slightly soluble in water. Mental faculties unaffected. The chemist who has had no practical experience in pharmacological methods would be wiser to keep to his chemical tests.--NUX VOMICA. turning to mauve. AND BRUCINE =Nux Vomica= consists of the seeds of the _Strychnos nux vomica_. Congestion . with a persistent bitter taste. STRYCHNINE. Patient may die within a few hours from asphyxia or from exhaustion._--Use Stas-Otto process.grain of aconitine. Hands usually clenched. much thirst. the symptoms come on slowly.

or blistering beetle. and sometimes produces haæmaturia and a good deal of temporary discomfort. headache. _Method of Extraction from the Stomach.=--This alkaloid. is the basis of most of the blistering preparations._--Strychnine has a characteristic. Vomiting of mucus mixed with blood. ferricyanide of potassium. the motions containing blood and mucus. quick pulse. _Fatal Period (Shortest)._--Emetics or stomach-pump if the patient is deeply anæsthetized. _Tests. changing to crimson and light red. though in a less powerful degree. Tenesmus. _Treatment._--The alkaloid may be separated by the process of Stas-Otto. It is sometimes taken as an abortifacient or given as an aphrodisiac. found associated with strychnine. spinal cord._--Quarter of a grain. diarrhoea. =Brucine. it is unaffected by sulphuric acid. _Fatal Dose (Smallest). or permanganate of potassium.of brain. pain and difficulty in swallowing. This test is so delicate as to show the 1/25000 of a grain of the alkaloid. Peritonitis. but whether it has any such action is open to question._--Ten minutes.=--Spanish fly. _Symptoms. but gives a purple-blue colour. changed to purple with protochloride of tin. very bitter taste.--CANTHARIDES =Cantharides. and lungs. It acts as an irritant to the kidneys and bladder. with salivation. repeated if necessary. potassium bichromate. when the edge of this solution is touched with dioxide of manganese. Nitric acid gives a blood-red colour. A very minute quantity (1/5000 grain) in solution placed on the skin of a frog after drying causes tetanic convulsions. Tannic acid and permanganate of potassium._--Burning sensation in the throat and stomach. possesses the same properties. with passage of small amounts of albuminous and bloody urine. XLV. Dysuria. usually two to four hours. high temperature. Bromide of potassium 1/2 ounce with chloral 30 grains. loss of . it imparts this taste to even very dilute solutions.

with a hypodermic injection of morphine to allay pain. The urine will probably be albuminous. Lead in some parts of the country is a popular abortifacient._--The vomited matter often contains shining particles of the powder. _Symptoms. but tenesmus and strangury. savin. _Treatment. The twigs obtained from the stomach. _Post-Mortem Appearances. digitalis. and nutmeg. The vegetable substances commonly reputed to be abortives are ergot. linseed-tea and gruel (but not oils)._--An emetic of apomorphine. A medicine may be an emmenagogue without being an ecbolic. white of egg and water. such as barley-water. pennyroyal. washed and dried and then rubbed. are drugs which excite contraction of the uterus. and are supposed to have the power of expelling its contents._--Those of irritant poisons. ecbolics.sensibility. but _there is no evidence to show that any drug possesses this property_. but will not produce abortion. Acute nephritis. XLVI. aloes (Hierapicra). and convulsions. =Savin= (_Juniperus Sabina_). Green powder found. The vegetable substances frequently used as abortives are savin and ergot. and if an infusion of the twigs has been taken the twigs may be detected with the microscope. gives odour of savin. Permanganate of potassium and binoxide of manganese are valuable remedies for amenorrhoea. or abortives. _Test. dried .--ABORTIFACIENTS Emmenagogues are remedies which have the property of exciting the catamenial flow. Purging not always present._--Gastro-intestinal mucous membrane inflamed._--A watery solution of savin strikes deep green with perchloride of iron.--Leaves and tops of the plant yield an acrid oil having poisonous properties. This. demulcent drinks. with gangrenous patches. Genito-urinary tract inflamed. colocynth. _Tests. and which has even produced death. _Post-Mortem._--Acute inflammation of alimentary canal.

are the most potent. _Treatment. especially in the liver. convulsions. _Symptoms. slow pulse. coma. and are firm in substance. _Edible fungi_ have an agreeable taste and smell._--These may be of the narcotic or irritant types. with thirst. mental excitement. this liquid filtered gives a precipitate of same colour with nitric acid. and thromboses occur. with fatty degeneration of the internal organs. numerous hæmorrhages are present.=--Of the poisonous mushrooms. barley. Usually._--In phallin-poisoning the blood remains fluid. anuria. XLVII. are often of a bright colour. Fibrin is liberated. vomiting. _Post-Mortem. The _Agaricus muscarius_ is bright red with yellow spots. or _Agaricus muscarius_. and of the latter _muscarine_. _Tests. Muscarine affects the nervous system chiefly. _Symptoms. followed by delirium._--Use the stomach-tube to give a solution of permanganate of . especially that of the uterus. and diarrhoea. and dilated pupils. however. and rye. Phallin is a toxalbumin which destroys the red blood-corpuscles. the _Amanita phalloides_ and the fly agaric. Small quantities frequently repeated have in the past produced gangrene of the extremities. The active principle of the former is _phallin_. convulsions. oats. will give the odour of savin. cold extremities. _Poisonous fungi_ have an offensive smell and bitter taste. and soon become pulpy. nausea. causing the serum to become red in colour and the urine blood-stained. headache. diarrhoea. cyanosis. or anæsthesia of fingers and toes.--POISONOUS FUNGI AND TOXIC FOODS =Fungi. there is violent colic. which is reputed to have the power of causing contraction of unstriped muscular fibre.and rubbed between the finger and thumb. The symptoms may be mistaken for phosphorus-poisoning or acute yellow atrophy of the liver. The _Amanita phalloides_ is distinguished from the common mushroom (_Agaricus campestris_) by having permanent white gills and a hollow stem. =Ergot= (_Secale Cornutum_)._--Lake-red colour with liquor potassæ. coma. stertorous breathing._--Lassitude.--A parasitic fungus attacking wheat.

and brawn. and shell-fish are not uncommonly contaminated with pathogenic micro-organisms. sausages. enteric fever. and perhaps tuberculosis. and _lathyrism_. such as diarrhoea. and cholera. but it is more probably the result of the formation of a toxine during life. _Symptoms. and not after decomposition has set in. veal. They may resemble those of an infectious disease or those of acute enteritis._--Emetics. are still common in Southern Europe. Mussel-poisoning was formerly supposed to be due to the copper in them derived from ships' bottoms. with hypodermic injections of strychnine and atropine along with stimulants. Ergotism from eating bread made with ergotized wheat is now rare. and delirium.=--The kinds of food which most frequently produce symptoms of poisoning are pork. followed by a hypodermic injection of 1/50 grain of atropine. potted and tinned meats. may be caused by eating infected food. or from the presence of toxalbumoses or ptomaines. XLVIII. Milk. a condition due to ptomatropine. due to the admixture with flour of the seeds of certain kinds of vetch. rigors. emetics. anorexia. from inoculation with micro-organisms. Usually there are headache. stimulants. intestinal disturbance. but _pellagra_ from the consumption of mouldy maize. In some cases their appearance is delayed from twenty-four to forty-eight hours. Transfusion of saline fluid. should make himself thoroughly acquainted with . pains in the back and limbs. =Foods. beef. meat-pies. It may arise from the use of the flesh of an animal suffering from some disease. Trichiniasis may also be mentioned. Tinned fish often gives rise to symptoms of poisoning. It is not necessary that the food should be 'high' to give rise to poisoning. before presenting himself to give evidence in a case of suspected poisoning. A dose of castor-oil would be useful. Sometimes the symptoms resemble atropine-poisoning.--PTOMAINES OR CADAVERIC ALKALOIDS Every medical man._--The symptoms which result from the ingestion of poisonous meat are often very severe. may give rise to gastro-intestinal irritation from the occurrence in it of chemical changes. Many diseases. _Treatment.potash. too. purgatives. Sausage-poisoning is common in Germany. There have been epidemics of poisoning from eating cheese containing _tyrotoxicon_.

and endeavour to elicit an admission that the reactions which have been attributed to a poison may possibly be accounted for on the theory of the formation of a ptomaine. diarrhoea. the _B. Ptomaines or toxalbumins are sometimes found in potted meats and sausages. They are probably allied to neurine. albumins. dilatation of pupils. and collapse. 42 Acetanilide. and they closely resemble many of the vegetable alkaloids--veratrine. 116 . or the _B. There is practically no counter-move to this form of attack. for example--not only in chemical characters. but in physiological properties. 147 Abortion. faintness. and globulins. and are due to organisms--the _Bacillus botulinus_. counsel for the defence. alkaloids generated during the process of putrefaction. tinned meats. 136 Acetate of lead. etc. Some are proteids. INDEX Abdomen. abdominal pain. The symptoms of _botulism_ are dryness of skin and mucous membranes. morphine. for the most part. ham. milk. The symptoms produced by the latter are usually vomiting. and codeine. vertigo. paralysis of muscles. will probably cross-examine the medical expert on this subject. an alkaloid obtained from the brain and also from the bile. after exposure under insanitary conditions. criminal. pains in the limbs and cramps. the _B. the active principle of the fly fungus.recent researches on the subject. Ptomaines are. have been excluded from the air. cheese. enteritidis_ of Gärtner. mussels. baked meat-pie. In a case of suspected poisoning. veal. diplopia. coldness. Ptomaines may be produced abundantly in animal substances which. Some of them are analogous in action to muscarine. injuries of. proteus vulgaris_. Articles of food most often associated with poisoning are pork. if he knows his work. bacon. ærtrycke_ (which is perhaps the most common of all). 29 Abortifacients.

135 Aqua fortis. 112 Antipyrine.Aconite. 130 Alcoholic insanity. 21 Assizes. 137 Arum. 102 Anæsthetics. 62 Age. 18 Adultery. 12 Alcohol. 136 Antimony. 7 . 19 Aniline. death from. 76 Alkaloids. 124 Asphyxia. 136 Antifebrin. 107 Arsenious acid. determination of. 143 Adipocere. 107 Artificial oil of bitter almonds. 13 Assaults. 93 Alum. 97 Arsenic. 103 Ammonia.

22 Cadaveric alkaloids. 146 Bruises. 60 Bladder. 127 Bestiality. 119 Bismuth. 26 Breslau's life test. 24 Burnett's fluid. 139 . 150 rigidity.Atropine. 59 Bichromate of potassium. 30 Born in wedlock. 119 Burns. injuries to. 58 Barium salts. 119 Blackmailing. 104 Belladonna. 52 Botulism. 49 Brucine. 17 Calabar bean. injuries of. 22 Bullet wounds. 127 Barberio's test. 151 Brain. 30 Blood-stains.

55 Cellon. 122 Chloroform. 103 Chloride of zinc. fibres of. 34 Coal-gas. 129 Cantharides. 28 Chloral. 91 Chest injuries. 100 Carbonic acid gas. 119 Chlorine. 120 oxide. 19. 119 Chronic lead-poisoning. 121 Chromium. 132 Choke-damp. 121 Carnal knowledge.Camphor. 39 . death from. 129 Cold. 128 Cocculus indicus. 146 Carbolic acid. 134 Chlorate of potassium. 129 Chemical analysis. 121 Cocaine. 117 Clothing.

45 of pregnancy. 45 Conium. 138 Contused wounds.Coma. 28 Dangerous Drugs Bill. 82 Death in the foetus. rate of. 14 Common witness. 7 Culpable homicide. 16 Copper. 42 Criminal Appeal Court. 50 . 113 Corrosives. 1 Criminal abortion. 2 Concealment of birth. 69 Crimes. 3 Crown Court of Assize. 24 Cooling. 8 courts. 117 Coroners. 21 Cut throat. 4 Coroner's court. 7 Cross-examination. 86 Cretinism. 4 Corrosive sublimate.

65. 50 Dyeing of hair. 22 Electricity. 144 Dinitrobenzene. 36 Duration of pregnancy. giving of.signs of. wounds of. 41 Dementia." 129 Drowning. 137 Divorce. 29 Digitalis. 70 Depositions. 6 Determination of sex. 3 . 60 "Dope. 10 Ecchymosis. 75 Ergot. 148 Ether. 2 Examination-in-chief. 38 Epilepsy. 16 Delivery. 11 Dying declarations. 132 Evidence. 117 Diaphragm. 11 Diachylon pills.

wounds of. 8 Gunshot wounds. 24 . 7 Feigned diseases. 2 Eye injuries. 11 Florence's test. 63 Felony. 5 Fruit stains. 5. 27 Face injuries. 1 Ferro-silicon. 71 Genital organs. 30 Grand jury. 58 Foeticide. poisonous. 69 Fees for medical witness. 27 Feeble-minded. 150 Found dead. 120 General paralysis.Experiments on animals. 33 Fungi. 111 Finger prints. 42 Foods. 148 Gaseous poisons. 85 Experts.

69 Impotence. 59 Incised wounds. 26 Heart. 21 Hydrochloric acid. 39 Hemlock. 11 Hanging. 29 Heat. death from. injuries of. personal. 68 Imbecility. 122 Hydrocyanic acid. 33 dyeing of. 128 Hypostasis. 16 Identification of dead.Hæmin crystals. 12 Identity. 54 Incest. 23 . 128 Homicide. 32 Hair. 98 gas. 140 Hyoscyamus. 138 Henbane. 10 Idiocy. 35 Head injuries. detection of.

62 Jury. 87 gases. 116 . 44 Inheritance. 123 Judicial separation. 104 Irritants. 73 Laborde's method. 24 Lead. coroner's. 37 Laburnum. 78 Infanticide. 123 Lacerated wounds. 67-76 Intestines. 57 Indictable offences. 4 Kidney. 30 Kleptomania. wounds of. 21 Insanity. injuries of. 54 Injuries. 122 vegetable. 30 Iodide of potassium. 104 Iodine.Indecent assault. 2 Inebriates Act.

Lee-Metford bullet. 44-46 Liver. 52 Lightning. 7 Malingering. 63 Malpractice. 25 . 71 Manslaughter. 24 Legitimacy. 67 certification. 47 Magistrate's court. 21 Marriage. 110 Martini-Henry bullet. 66 Lunacy. 45 Mauser bullet. 77 Lungs. 140 Lucid intervals. injuries of. 60 Marsh's process. 20 Malum regimen. injuries of. 29 evidences of live-birth from. 73 Lumbago. 29 Lobelia. 38 Live-birth. 21 Mania. 25 Maturity of infant.

141 Opium. 94 Misdemeanour. 113 Methyl alcohol. 9 Oil of bitter almonds. 137 Notes. 145 Oaths Act. 143 Monomania. 95 Nitro-benzol.Medical evidence. 99 . 98 Naphtha. 21 Muriatic acid. 9 Nux vomica. 124 Oxalate of potash. 127 Murder. 72 Morphine. 135 Nitrate of silver. 119 Nitric acid. 131 Mineral acids. 1 Monkshood. 70 Mercury salts. 2 Mentally deficients.

86 treatment of. 73 . 85 scheduled. 50 insanity of. 100 Phosphorus. 135 Paranoia. 73 Personal identity. 91 evidence. 139 Picrotoxin. 88 classification of. 33 Pregnancy. 40. 80 Poisonous foods.Oxalic acid. 7 Phenacetin. 129 Poison. 136 Phenol. 84 detection of. 10 Petroleum. 81 symptoms and post-mortem appearances. 90 Potash. definition of. 106 Physostigma. 149 Poisons acting on the brain. 98 Paraffin oil. 105 Phossy-jaw. 134 Petty Sessions. 101 Precipitin test for blood.

110 Reports. 9 Responsibility.Presumption of death. 124 Privilege. 27 Rape. 20 survivorship. 3 Reinsch's process. 7 Prussic acid. 23 Purgatives. 36 . medical. 130 Re-examination. 8 Procurator Fiscal. 140 Ptomaines. 76 Resuscitation. 73 Punctured wounds. 77 Rectified spirit. 18 Quarter Sessions. 55 Reception orders. 150 Puerperal mania. 123 Putrefaction. 7 Railway spine. 21 Primula.

9 Secrets. 16 Silver. 11 Signs of death. determination of. 18 Satyriasis. 118 Skin diseases. 111 Saponification. 24 Seminal stains.Rhus. 81 Scotch oath. 58 Sewer-gas. 33 Sale of arsenic. 36 Scheduled poisons. 122 Sex. 124 Rigor mortis. 66 Soda. 11 Schiller's method of resuscitation. 101 Sodomy. 147 Scars. 146 . 17 Rust stains. 8 Self-inflicted wounds. professional. 59 Spanish-fly. 73 Savin.

39 Superfoetation. injuries of. 92 Status lymphaticus. post-mortem. 38 Stas-Otto process. 15 Sterility. 122 Sulphuric acid. 95 Sulphurous acid gas. 128 Strangulation. 32 Spinal cord injuries. 27 Spleen. 35 Strychnine. 53 . 137 Sulphuretted hydrogen. 29 Stramonium.Spectroscopic examination of blood. 54 Stomach. 16 Starvation. 145 Sudden death. 13. injuries of. 29 Staining. 2 Sunstroke. 122 Summary offences. 116 Sulphonal. 34 Sugar of lead. 15 Suffocation.

51 Vitriol. 145 Tetrachlorethane. 13 Tartar emetic. 129 Trional. 137 True bill.Syncope. 74 Unnatural offences. 28 Tobacco. 10 Teichman's crystals. 1 Trinitrotoluene. 137 Viability. 63 . 59 Unsound mind. 112 Tattoo marks. 8 Undue influence. 95 Voidable marriage. 67 Veronal. 139 Treason. 32 Tetanus. 137 Throat injuries. 129 Tetronal.

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