Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
The coma may not be profound; there may be nausea and vomiting of dark
material, bounding pulse, stertorous breathing, contracted pupils, and
frequent micturition. The body exhales a “mousey odour.” There may be
involuntary dejection, with the same pungent odour, and very watery.
Delirium is present in some cases. The temperature may be subnormal,
or rise to 102° F., occasionally even to 106° F. When fatal, the coma
deepens, the pulse becomes rapid and feeble, and there is Cheyne-Stokes
respiration.
In _Hyperpyrexial_ cases the symptoms are similar to the asphyxial, but
the temperature may reach 110-115° F., and in profound coma death takes
place from asphyxia. A subconscious or automatic state, in which the
person may go on working, may precede the “stroke.”
In cases which are not so rapid, pneumonia, meningitis, cardiac and
respiratory paralysis may occur and prove fatal.
_Heat exhaustion_ may be more gradual in its onset, or come on
suddenly. Prodromal dizziness, faintness, nausea, headache, drowsiness,
epigastric and lumbar pains may precede the prostration and muscular
weakness. Fever supervenes, a rapid pulse, and in severe cases
collapse. Consciousness is seldom completely lost, and in favourable
cases is quickly regained. When there is marked prostration the heart
may fail.
The condition known as _heat prostration_ is a milder form, in which
there is little or no fever, and the circulation remains good.
After suffering from an attack of heat-stroke certain sequelæ have
been noted. The patients are rendered sensitive to slight elevations
of temperature, and, during warm weather, experience chromatopsia,
headaches, irritability, irascibility, and even delirium. Epilepsy
and insanity may persist during life. Fiske from his investigations
concludes that the habits of those working in hot atmospheres, and the
degree of temperature, are not nearly so important as the absence of
thorough ventilation as causative factors in the disease.
=Post-mortem Appearances.=--_Rigor mortis_ comes on early, and is
pronounced and disappears quickly. Putrefaction is early in onset. The
brain and cord, the lungs and spleen and splanchnic area exhibit venous
engorgement.
The blood is fluid, and the red corpuscles crenated. Extravasations of
blood may be present in the skin, the serous membranes, and cavities,
the superior sympathetic ganglia, and the vagi and phrenics. The left
ventricle is markedly contracted, the right dilated and filled with
blood.
Van Gieson records acute parenchymatous degeneration of the whole of
the cerebro-spinal nervous system, with chromatolysis of the cells.
Parenchymatous changes may be present in the liver and kidneys.
DEATH BY LIGHTNING AND ELECTRICITY
LIGHTNING
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