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
_Post-mortem Appearances._--The body externally is healthy. The lips
and external parts of the body, which have come in contact with the
acid, are charred. The mucous membrane of the mouth, shrivelled and
eroded, is whitish, yellowish, or brownish, sometimes appearing “as
if it had been smeared with white paint” or thin arrowroot. Many of
the appearances above described will depend upon the rapidity with
which death has followed the swallowing of the poison. The mouth,
gullet, and trachea may alone show any signs of the corrosive action of
the poison, and it is important to remember that death may be due to
sulphuric acid, and yet the acid may never have reached the stomach.
In one or two cases where the poison was poured into the mouth during
sleep, and in the case of children in whom the mouth was held open,
there were no signs of the poison on the lips, and the mouth even
escaped in one or two cases. The stomach, in some cases more or less
contracted and perforated by the corroding action of the acid, may
contain a dark grumous liquid, the acidity of which will depend upon
the treatment adopted, or the length of time that may have elapsed from
the swallowing of the acid to the fatal termination. The stomach also
appears as if carbonised, this being due to the action of the acid on
the effused blood; no such appearance being produced when sulphuric
acid is poured into the dead stomach. Corrosive action may be found in
the duodenum. In cases where the patient has survived from sixteen to
twenty hours, the small intestines have been found inflamed. The blood,
Casper states, is never fluid in acute poisoning by sulphuric acid,
but always “syrupy at least, and sometimes ropy; it has a cherry-red
colour, and acid reaction.” Sulphuric acid is also said to possess
powerful antiseptic properties, and that bodies of those who have died
from its effects remain long fresh.
There are two things which may render the diagnosis difficult--(1)
Gastric ulcer. (2) _Post-mortem_ digestion of the stomach.
Gastric ulcers vary in size from that of a threepenny-piece to that
of a florin, or larger. In shape they are round or oval, and present
the appearance of shallow but level pits, with sharp, smooth, vertical
edges--appearing as if they had been punched out. The peritoneal
opening is smaller than that on the internal surface of the stomach.
The absence of injury to the mouth and gullet will distinguish gastric
ulcer and _post-mortem_ softening from the action of corrosive poisons.
_General Treatment._--Chalk, carbonate of magnesia, bicarbonate of
soda, the plaster from the walls or ceiling of the apartment stirred in
water, and followed by diluent drinks--barley water, linseed tea, &c.
The use of the stomach pump is contra-indicated.
SULPHURIC ACID
_Forms._--Sulphuric acid occurs in two forms--_concentrated_ and
_diluted_.
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