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
Pigmentation is common; the face becomes dusky red, the rest of the body
a dark brown shade. This darkening is most marked in situations normally
pigmented and in parts exposed to pressure of the clothes, such as the
neck, axilla, and inner aspect of the arms, the extensor aspects being
less marked than the flexor. The pigmentation resembles the bronzing of
Addison's disease, but there are no patches on the mucous membranes, and
the normal rosy tint of the lips is not altered. The skin over the feet
may show marked hyperkeratosis.
The nervous system is notably affected. The sensory symptoms appear
first: numbness and tingling of the hands and feet, pain in the soles of
the feet on walking, pain on moving the joints, and erythromelalgia.
Then come the motor symptoms, with drop-wrist and drop-foot. The patient
suffers severely from neuritis, and there may be early loss of patellar
reflex. The nervous symptoms come on later than the cutaneous
manifestations.
_Post-Mortem Appearances._--Signs of acute inflammation of stomach,
duodenum, small intestines, colon, and rectum. Stomach may contain dark
grumous fluid, and its mucous coat presents the appearance of crimson
velvet. Ulceration is rare, and cases of perforation still less common,
the patient dying before it occurs. If life has been preserved for some
days, there is extensive fatty degeneration of the organs. There may be
entire absence of _post-mortem_ signs. Putrefaction of the body is
retarded by arsenic.
_Treatment._--The stomach-pump, emetics, then milk, milk and eggs, oil
and lime-water. Inflammatory symptoms, collapse, coma, etc., must be
treated on ordinary principles. As an antidote, the best when the poison
is in solution is the hydrated sesquioxide of iron, formed by
precipitating tinctura ferri perchloridi with excess of ammonia, or
carbonate of soda. This is filtered off through muslin and given in
tablespoonful doses. It forms ferric arsenate, which is sparingly
soluble. Colloidal iron hydroxide may be used instead. Dialyzed iron in
large quantities is efficacious.
_Fatal Dose (Smallest)._--Two grains. Exceptionally, recovery from very
large doses if rejected by vomiting.
_Fatal Period (Shortest)._--Twenty minutes. Exceptionally, death as late
as the sixteenth day. The effects of arsenic are modified by tolerance,
some persons being able to take considerable quantities. The peasants of
Styria are in the habit of eating it.
Public-domain text, read in full here on John Shaqi.
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