Text-book of forensic medicine and toxicology

by R. J. M. Buchanan

8. The Average Period of Death.—Seven to twelve hours.

Table showing some of the Symptoms and Effects
of Opium and Belladonna

Opium.	Belladonna.
1. Slight excitement, coma,	1. Active, busy delirium preceding
lethargy, and no return of the	the coma, followed by delirium,
excitement should the patient	if recovery takes place.
recover.
2. Coma is of shorter duration than	2. Coma is of longer duration than
in poisoning by belladonna.	in poisoning by opium.
3. Pupils contracted.	3. Pupils dilated.
4. Local application to the eye	4. Dropped into the eye, the pupils
does not affect the pupil.	are dilated.
5. Bowels as a rule confined.	5. Bowels not affected.
6. Acts powerfully on children.	6. Well borne by children.

Table showing the Points of Distinction between
Apoplexy and Narcotic Poisoning

Apoplexy.	Narcotic Poisoning.
1. Apoplexy may be preceded by	1. No premonitory symptoms,
premonitory symptoms, as	except by fortuitous
giddiness, headache, noises in	combination.
the ears and partial paralysis.
2. Apoplexy chiefly attacks the old,	2. More frequently in the young,
and is very rare in young people.	especially of the female sex.
3. Most frequently among fat people.	3. In fat or thin people.
4. Symptoms may come on during	4. An interval of from ten to thirty
the meal or immediately after.	minutes always occurs,even in
	the case of opium, the
	commonest of narcotic poisons.
5. The symptoms commence abruptly,	5. The symptoms advance
sometimes with deep stupor.	gradually.
6. Patient is with difficulty, if ever,	6. Patient may be roused from
temporarily aroused.	the deepest lethargy if shaken
Convulsions common.	or spoken to in a loud voice.
Face bloated	Convulsions rare in opium
Pupils dilated, or irregular.	poisoning. Face seldom bloated.
	Pupils contracted.
7. Life may be prolonged for a day or	7. Life is seldom prolonged beyond
more. Apoplexy may, however,	six or eight hours. Shortest
kill in an hour.	time in which opium has
	caused death, three hours.
8. No response when the forehead	8. Patient may be roused by
is smartly tapped with the	tapping the forehead, &c.
finger-nails, or when water is
injected into the ear.

Table showing the Condition of the Pupils in—

Ordinary sleep	The eyes turned upwards; pupils contracted.
Chloroform narcosis	When the liquid is taken, coma; pupils
	dilated; eyes suffused or glistening, and
	turned upwards. When the vapour is
	inhaled, pupils first contracted; when coma
	supervenes, dilated.
Apoplexy	Pupils dilated; insensible to light. Sometimes
	unequal. Apoplexy of pons Varolii,
	pupils contracted.
Alcoholic coma	The pupils dilated or variable, and not affected
	by a bright light placed before them.
Poisoning by opium	Contracted in some cases to a pin‘s head; as
	death approaches, the pupils dilate.
Carbolic acid	Contracted and insensible to light.
Calabar bean	Powerful contraction of the pupils.
Hyoscyamus or atropine	Dilatation of the pupils.
Strychnine	In some cases the pupils, during the
	paroxysms, are dilated, and contracted
	during the intermissions.
Aconite	Sometimes contracted; but in 17 out of 20
	cases recorded by Dr. Tucker, dilatation
	was present.

CHAPTER IX
DELIRIANT POISONS

Under this head will be noticed those poisons whose action on the animal economy is characterised by delirium, illusion of the senses, and marked dilatation of the pupil. In some cases there is considerable irritation of the digestive organs, accompanied with a difficulty in passing water, sometimes ending in complete suppression of urine. The mydriatic alkaloids atropine, hyoscine, hyoscyamine, daturine, duboisine, scopolamine, are practically identical in chemical composition and action, and produce similar symptoms.