Aids to Forensic Medicine and ToxicologyRobertson, W. G. Aitchison (William George Aitchison )
Science
Aids to Forensic Medicine and Toxicology
Robertson, W. G. Aitchison (William George Aitchison )
Medical jurisprudence; Poisons
If called to a case supposed or suspected to be one of poisoning, the
medical man has two duties to perform: To save the patient's life, and
to place himself in a position to give evidence if called on to do so.
If life is extinct, his duty is a simple one. He should make inquiries
as to symptoms, and time at which food or medicine was last taken. He
should take possession of any food, medicine, vomited matter, urine, or
faeces, in the room, and should seal them up in clean vessels for
examination. He should notice the position and temperature of the body,
the condition of rigor mortis, marks of violence, appearance of lips and
mouth. He should not make a post-mortem examination without an order in
writing from the coroner. In making a post-mortem examination, the
alimentary canal should be removed and preserved for further
investigation. A double ligature should be passed round the oesophagus,
and also round the duodenum a few inches below the pylorus. The gut and
the gullet being cut across between these ligatures, the stomach may be
removed entire without spilling its contents. The intestines may be
removed in a similar way, and the whole or a portion of the liver should
be preserved. These should all be put in separate jars without any
preservative fluid, tied up, sealed, labelled, and initialled. All
observations should be at once committed to writing, or they will not be
admitted by the court for the purpose of refreshing the memory whilst
giving evidence. If the medical practitioner is in doubt on any point,
he should obtain technical assistance from someone who has paid
attention to the subject.
In a case of attempted suicide by poisoning, is it the duty of the
doctor to inform the police? He would be unwise to do so. He had much
better stick to his own business, and not act as an amateur detective.
VII.--TREATMENT OF POISONING
The modes of treatment may be ranged under three heads: (1) To eliminate
the poison; (2) to antagonize its action; (3) to avert the tendency to
death.
1. The first indication is met by the administration of emetics, to
produce vomiting, or by the application of the stomach-tube. The best
emetic is that which is at hand. If there is a choice, give apomorphine
hypodermically. The dose for an adult is 10 minims. It may be given in
the form of the injection of the Pharmacopoeia, or preferably as a
tablet dissolved in water. Apomorphine is not allied in physiological
action to morphine, and may be given in cases of narcotic poisoning.
Sulphate of zinc, salt-and-water, ipecacuanha, and mustard, are all
useful as emetics. Tickling the fauces with a feather may excite
vomiting.
Public-domain text, read in full here on John Shaqi.
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