254 Lobelia is seen ments of leaves). Fig. 40. 6 POISONING WITH FOXGLOVE. in the form of a greenish-colored powder (frag This powder acquires a reddish-brown color from strong nitric acid, and is blackened by concentrated sulphuric acid. Iodine water has no effect upon the infusion. The proto- and persulphate of iron produce with it a dark-green color, the persulphate very rapidly. The leaves and seeds contain a resinoid substance called Lobelin, which has the smell and taste of the plant. It acts as a powerful emetic in doses of from one-half to one grain. The leaves of lobelia are generally seen in frag ments which do not readily admit of identification by the microscope. The seeds are very small, of a lengthened oval shape (Fig. 40), reticulated on the surface with projecting hairs or fibres, and of a light brown color. The discovery of them among the fragments of leaves would furnish a sufficient proof of the presence of lobelia. Seeds of Lobelia. a Natural size. Magnified 70 diameters. FOXGLOVE. (DIGITALIS PURPURea.) Symptoms and effects.-Cases of poisoning with foxglove are not very common. A boy who swallowed six ounces of a strong decoction of the leaves was soon attacked with vomiting, purging, and severe pain in the abdomen. After some time, he became lethargic, and slept for several hours; in the night he was seized with convulsions. The pupils were dilated and insensible, the pulse was slow, small, and irregular; coma followed, and the boy died twenty-two hours after taking the poison. On inspection, the membranes of the brain were found much injected, and the mucous lining of the stomach was partially inflamed. The prisoner was acquitted of the charge because he had only given his fatal advice on the application of the friends of the deceased! ("Ed. Med. and Surg. Journ.," 27, 223.) A young man swallowed a strong decoction of foxglove by mistake for purgative medicine. He was soon seized with vomiting, pain in the abdomen, and purging. In the afternoon he fell asleep. At midnight he awoke, was attacked with violent sickness, colic, and convulsions; the pupils were dilated and insensible to light; the pulse was slow and irregular. He died twenty-two hours after taking the poison. (Wilmer, op. cit., Digitalis.) A few grains of the powdered leaves have been known to produce giddiness, languor, dimness of sight, and other nervous symptoms. A drachm has, however, been taken without causing death; but in this instance it produced violent vomiting. A common effect of the poison is to produce great depression of the heart's action. Analysis. When foxglove has been taken in substance, i. e. in the form of seeds or leaves, or any portion of these has been swal POISONING WITH THORNAPPLE. Fig. 41. 255 lowed in a decoction or infusion, fragments may be found in the stomach and bowels. In reference to the infusion, decoction, tincture, or extract, except there be sufficient to allow of the separation of digitaline, there is no chemical process known by which the poison may be recognized. If any fragments of leaves or seeds are found in the contents of the stomach or in food, they may be identified by the aid of the microscope. The annexed illustration (Fig. 41) represents the seeds of foxglove; they are of a reddish-brown color, remarkably small, oblong, and somewhat angular in shape. They have peculiar markings. By the aid of the microscope, they may be easily distinguished from the seeds of hyoscyamus, datura, belladonna, and most other poisonous plants. Seeds of Foxglove. a Natural size. b Magnified 30 diameters. Digitaline is the active principle of foxglove. It constitutes one per cent. of the dried leaves. Its physiological properties have been fully investigated by M. Homolle ("Journal de Pharmacie," Janvier, 1845-57; also, by Bouchardat, "Ann. de Thérapeutique," 1864, p. 155). It is an uncrystallizable substance, and has no well-defined chemical characters. Pure digitaline itself operates as a poison on man and animals in very small doses. Theth of a grain, which is considered to be equal to eight grains of the well-prepared powder of the dried leaves, is sufficient to cause symptoms of poisoning. Doses of from th to 'd part of a grain have lowered the pulse and caused nausea, vomiting, griping, purging, and an increased secretion of urine. (Pereira, "Mat. Med.," vol. 2, p. 528.) Doses of from onequarter to one-half of a grain would probably prove fatal to life. Digitaline has acquired some notority by reason of the trial of Dr. De la Pommerais, at Paris, in May, 1864, for the murder of a woman named Pauw. (See "Principles of Med. Jur.," p. 438, also " Ann. d'Hygiène," 1864, tom. 2, p. 105.) THORNAPPLE. (DATURA STRAMONIUM.) Symptoms and appearances.-The symptoms produced by stramonium whether the leaves or seeds are used, are as follows: Soon after the poison has been taken there is giddiness, dimness of sight, a sense of fainting, insensibility, fixed and dilated pupils, flushed countenance, and a slow and full puise. Sometimes there is great restlessness, with a hot and red skin, and a wild and staring expression in the countenance, the breathing hurried and gasping, incessant talking without distinct articulation, and there are attempts to drive away, or grasp at, imaginary objects. There is picking at the bedclothes, with paroxysms of excessive laughter, and, if the person can walk, it is with a staggering gait and he falls to the ground as if intoxicated, or completely exhausted. The seeds of datura were used by the Thugs of India for rendering their victims powerless and insensible. 256 PROPERTIES OF DATURIA. Appearances. In a well-marked case of poisoning by stramonium-seeds, in which death took place in less than eight hours, the following appearances were found: Great congestion of the vessels of the brain and its membranes, the brain firm and highly injected, choroid plexus turgid, ventricles containing serum, substance of the lungs congested, and the heart flaccid. The stomach contained about four ounces of digested food mixed with eighty-nine seeds of stramonium. There were two patches of extravasation in the mucous coat-one on the larger curvature, and the other near the pylorus. Many seeds and fragments were also found in the intes tines. ("Lancet," Sept. 18, 1847, p. 298.) In another case there were marks of diffused inflammation about the cardiac end of the stomach. Analysis.-The seeds of stramonium, from which accidents have most frequently occurred, are flattened, kidney-shaped, but half oval, rough, and of a dark-brown or black color. They are liable to be mistaken for the seeds of capsicum. Of the dry datura stramonium, there are about eight seeds to a grain. They are of an oblong kidney-shape, and of a dark-brown or black color. The illustration (Fig. 42) shows their appearance under a low power of the microscope. The leaves of the common datura stramonium are well characterized by their peculiar shape. Fig. 42. Fig. 43. b Seeds of Datura Stramonium. a Natural size. b Magnified 30 diameters. Crystals of Daturia, magnified 30 Daturia. The poisonous properties of thornapple are owing to the presence of an alkaloid, daturia, which forms about one per cent. of the dried vegetable. Some have considered this alkaloid to be identical with atropia, but the physiological properties are different. See Bouchardat, "Ann. de Thérapeutique," 1864, p. 24. [Prof. Wormley believes these two alkaloids to be identical in both their physiological and chemical properties. The bromine test answers equally well for each.-R.] Daturia crystallizes in long colorless prisms or needles (Fig. 43); it has a bitter taste, somewhat acrid, and slightly resembling that of tobacco. It is poisonous, The eighth of a grain killed a sparrow in three hours. When placed on the eye, or introduced into the cellular membrane of an PROPERTIES OF DATURIA. 257 animal, it is observed, like atropia, to cause dilatation of the pupil. When heated in a tube it is decomposed, and ammonia is evolved, as with other alkaloids. It is soluble in water, and the solution has an alkaline reaction. It is precipitated by tannic acid and by the chloriodide of potassium and mercury. Nitric and hydrochloric acids dissolve it without producing any change of color. Sulphuric acid produces with the crystals, a pale rose-red color which becomes paler when the acid mixture is diluted with water. The bark, seeds, berries, and leaves of the Laburnum, Yew, and Privet, have in a few cases given rise to symptoms of poisoning. These poisons affect the brain and the alimentary canal, producing vomiting and purging, followed by insensibility and convulsions. 17 258 WOUNDS-MEDICO-LEGAL DEFINITIONS. WOUNDS AND PERSONAL INJURIES. CHAPTER XXII. DEFINITION OF A WOUND.-DANGER TO LIFE.-GRIEVOUS BODILY HARM. -EXAMINATION OF WOUNDS.-DESCRIPTION OF WOUNDS.-CHARACTERS OF WOUNDS INFLICTED ON THE LIVING AND DEAD BODY.—ECCHYMOSIS ON THE LIVING AND DEAD.-EFFECTS OF VIOLENCE ON THE DEAD BODY. -ECCHYMOSIS NOT ALWAYS A RESULT OF VIOLENCE. Definition. In a medico-legal sense a wound implies a breach of continuity in the structures of the body, whether external or internal, suddenly occasioned by mechanical violence. This definition therefore includes injuries to the skin, or mucous membrane of the outlets of the body, dislocations and fractures, whether simple or compound, as well as ruptures of the viscera. In a medical point of view, a wound is commonly restricted to those external injuries in which the skin is implicated; but in legal medicine, the term has a much wider signification. Danger to life.-When a wound has been criminally inflicted on a person by the wilful act of another, one of the first questions which presents itself for consideration is how far the injury is dangerous to life. In order to justify the detention of the accused, a magistrate may require a medical opinion or a written statement from the surgeon in attendance. The meaning of the words "dangerous to life," is left entirely to the professional knowledge of a witness. It is not sufficient on these occasions that he should make a naked declaration of the wound being dangerous to life; he must, if called upon, state to the court satisfactory reasons for this opinion; and these reasons are rigorously inquired into by counsel for the defence. As a general principle it would not be proper to consider those wounds dangerous to life, in which the danger is not imminent. A wound of a great blood vessel, of any of the viscera, or a compound fracture with depression of the bones of the head, must in all instances be regarded as bodily injuries dangerous to life, because in such cases the danger is imminent. Unless timely assistance be rendered, these injuries will most probably prove fatal, and, indeed, they often destroy life in spite of the best surgical treatment. When, however, the danger is remote, as in a puncture or laceration of the hand or foot, which may be followed by tetanus, or in a laceration of the scalp, which may be followed by erysipelas, |