Alcohol Ether And Chloroform
Alcohol, ether, and chloroform, induce general anæsthesia, often
preceded by delirious excitement, and followed by nausea and vomiting.
When they cause death, it is by inducing a state like apoplexy or by
paralyzing the heart.
=Alcohol.=--Absolute alcohol is ethyl hydroxide (C{2}H{5}OH) with not
more than 1 per cent. by weight of water. Rectified spirit (spiritus
rectificatus) contains 90 per cent. of al
consists of rectified spirit with 10 per cent. of wood spirit. Proof
spirit contains a little over 49 per cent. of absolute alcohol; brandy
or whisky, 53 per cent.; port wine, 20 to 25 per cent.; ales and stout,
4 to 6 per cent.
Symptoms.--Acute poisoning; confusion, giddiness, staggering gait,
headache, passing into stupor, with subnormal temperature, and coma.
Vomiting may occur and recovery ensue, otherwise collapse sets in.
Pupils usually dilated.
Dipsomaniacs suffer from indigestion, vomiting and purging, jaundice,
albuminuria, diabetes, cirrhosis of liver, degeneration of kidneys,
congestion of brain, peripheral neuritis, alcoholic insanity, and
various forms of paralysis. In the acute form delirium tremens is the
most common manifestation.
Post-Mortem Appearances.--Deep red colour of lining membranes of
stomach. Sometimes congestion of cerebral vessels and meninges. Lungs
congested, blood fluid. Rigor mortis persistent.
Fatal Dose.--Death from 1/2 pint of gin and from two bottles of port,
but recovery from larger quantities.
Fatal Period.--Average about twenty-four hours.
Treatment.--Stomach-tube, cold affusion, electricity, injection of a
pint of hot coffee into the rectum. Give chloride of ammonium in 30
grain doses to prevent delirium; strychnine or digitalin
hypodermically.
Method of Extraction from the Stomach.--Neutralize the contents of the
stomach, if acid, with sodium carbonate; place them in a retort and
carefully distil. Collect the distillate, mix with chloride of calcium
or anhydrous sulphate of copper, and again distil. Agitate distillate
with dry potassium carbonate, and draw off some of the supernatant fluid
for testing.
Tests.--Odour. Dissolves camphor. With dilute sulphuric acid and
bichromate of potassium turns green, and evolves aldehyde. Product of
combustion makes lime-water white and turbid.
=Methyl Alcohol: Wood Naphtha.=--Used to produce intoxication by
painters, furniture-polishers, etc.
Symptoms are those of alcoholic poisoning, but vomiting and delirium
are more persistent. Total or partial blindness may follow as a sequel
of optic atrophy. A fatal result not infrequently follows.
The following table gives the points of distinction between concussion
of brain, alcoholic poisoning, and opium poisoning:
CONCUSSION OF BRAIN. ALCOHOL. OPIUM.
1. Marks of violence 1. No marks of violence, 1. As alcohol.
on head. unless person has
fallen. History will
be of use.
2. Stupor, sudden. 2. Excitement precedes 2. Symptoms slow.
sudden stupor. Drowsiness, stupor,
lethargy.
3. Face pale, cold; 3. Face flushed; pupils 3. Face pale; pupils
pupils sluggish, generally dilated. contracted.
sometimes dilated.
4. Remission rare. 4. Partial recovery may 4. Remission rare.
Patient recovers occur, followed by
slowly. death.
5. No odour of alcohol 5. Odour of alcohol 5. Odour of opium in
in breath. in breath. breath.
=Ether= is a volatile liquid prepared from ethylic alcohol by
interaction with sulphuric acid. It contains 92 per cent. of ethyl oxide
(C{2}H{5})O. It was formerly called 'sulphuric ether.' It is a
colourless, inflammable liquid, having a strong and characteristic
odour, specific gravity 0.735. =Purified ether= from which the ethylic
alcohol has been removed by washing with distilled water, and most of
the water by subsequent distillation in the presence of calcium chloride
and lime. It is this preparation which is used for the production of
general anæsthesia. It has a specific gravity of 0.722 to 0.720, and its
vapour is very inflammable.
Symptoms.--When taken as a liquid, same as alcohol. When inhaled as
vapour, causes slow, prolonged, and stertorous breathing; face becomes
pale, lips bluish, surface of body cold. Pulse first quickens, then
slows. Pupils dilated, eyes glassy and fixed, muscles become flabby and
relaxed, profound anæsthesia. Then pulse sinks and coma ensues,
sensation being entirely suspended. Nausea and vomiting not uncommon.
Post-Mortem Appearances.--Brain and lungs congested. Cavities of heart
full of dark, liquid blood. Vessels at upper part of spinal cord
congested.
Treatment.--Exposure to pure air, cold affusion, artificial
respiration, galvanism.
Method of Extraction from the Contents of the Stomach.--Same as for
alcohol. During distillation pass some of the vapour into concentrated
solution of bichromate of potash, nitric and sulphuric acids, and note
reaction as for alcohol.
Tests.--Vapour burns with smoky flame, depositing carbon. Sparingly
soluble in water. With bichromate of potash and sulphuric acid same as
alcohol.
=Chloroform.=--A colourless liquid, specific gravity 1.490 to 1.495,
very volatile, giving off dense vapour. Sweet taste and pleasant odour.
Symptoms.--When swallowed, characteristic smell in breath, anxious
countenance, burning pain in the throat, stomach, and region of the
abdomen, staggering gait, coldness of the extremities, vomiting,
insensibility, deepening into coma, with stertorous breathing, dilated
pupils, and imperceptible pulse. When inhaled, much the same as ether,
but produces insensibility and muscular relaxation more rapidly. It
would be impossible to instantly render a person insensible by holding a
pocket-handkerchief saturated with chloroform over the face. Statements
such as this, which are often made in cases of robbery from the person
and in cases of rape, are incredible.
Delayed Chloroform-Poisoning.--Death may take place in from four to
seven days after chloroform has been administered, especially in the
case of children. The internal organs are found to be fattily
degenerated, and death is thought to be due to acetonuria.
Post-Mortem Appearances.--Cerebral and pulmonary congestion. Heart
empty, or right side distended with dark blood.
Treatment.--Stomach-tube and free lavage; cold affusion; drawing
forward tongue; artificial respiration; galvanism and suspension with
head downward. Inhalation of nitrite of amyl; strychnine hypodermically.
Fatal Dose.--When swallowed, from 1 to 2 ounces.
Method of Extraction from the Stomach.--By distillation at 120° F. The
vapour, as it passes along a glass tube, may be decomposed by heat into
chlorine, hydrochloric acid, and carbon--the first shown by setting free
iodine in iodide of starch, the second by reddening blue litmus-paper,
and the last by its deposit.
Tests.--Taste, colour, weight; burns with a green flame; dissolves
camphor, guttapercha, and caoutchouc.
=Iodoform.=--Poisoning may result from its use in surgery. It produces
delirium, sleepiness, and coma. It may lead to mental weakness or optic
neuritis.
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