Report on medical jurisprudence

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  • PART III.

    HALF-YEARLY REPORTS.

    REPORT ON MEDICAL JUR ISPRUDENCE.

    By STEWART WOODMOUSE, M.A, M.D., Dubl. ; Lecturer on Institutes of ]Vi, edicine, Carmichael College of Medicine and Surgery.

    STRYCHNIA--- ITS ANATOMICAL AND ITS- PHYSIOLOGICAL EFFECTS

    UPON THE B]~IN~ SPINAL CORD AND NERVES.

    DR. W. It. KLAPP (Journal of Nervous Diseases) details at length some very elaborate experiments made upon the above topic. The care and skill exhibited lead us to the belief that his conclusions are approximately correct. They are: (1) Strychnia produces no appreciable primary lesion of nerve substance proper; that secondary lesions are produced--granular degeneration--by the engorgement of the vascular system, and that this is more marked in the brain and cord than in the nerves. (2) The convulsions of strychnia are not cerebral, and they are much more severe after the ablation of the cerebrum, owing to the removal of Setschenow's ganglia. (3) Strychnia does not affect either the sonsory,or motor nerves at their periphery. (4) Both sensory and motor nerves in their course are unaffected by strychnia. (5) The tetanus-producing power of strythnia has its only action in the gray matter of the spinal cord. (6) In small doses the primary actdon of strychnia is to excite the vasomotor centre, causing thus a rise in the arterial pressure, and secondarily to paralyse this centre, and hence to supplement this rise by a fall. (7). In large doses, the vasomotor centre is immediately paralysed. (8~) The slowing of the pulse produced by the exhibition of strychnia to both warm and cold blooded animals is in neither case produced by any action on the central or peripheral ends of the pneumogastrics; but in warm- blooded animals is due to action on the excito-motor ganglia of the heart, and in cold-blooded animals is due to action on the ganglia, situated in the sinus venosus. (9) The main vasomotor centre for strychnia is situated in the medulla oblongata, but simpler c~ntres

  • 62 Report on Medical Jurisprudence.

    exist in the splnal cord. (10) The pneumogastrie nerves are not paralysed by strychnia in either warm or cold blooded animals. (11) Stryehnia decreases the number of respiratory movements-- at first from too little blood, and afterwards from too much blood flowing to the respiratory centres. (12) The decrease is not due to any action of the pneumogastrics. (13) Artificial respiration always moderates and sometimes stops the spasms; and this power is due to a maintenance of the oxygenation of the blood until the poison can be eliminated, and is not due to a reflex stimulation of the pneumogastrlcs.

    A FOR]~RUNNER OF DEATH,

    Dr. Chiapelli says, in .Lo Sperimentale (No. 1, 1879), that he has frequently noticed in patients who were apparently very far from death an extraordinary opening of the eyelids, so as to give the eyes the appearance of protruding from the orbits, which was invariably a sign that death would, occur within twenty-four hours. In some cases only one eye is wide open, while the other remains normal; here death will not follow quite so rapidly, but in about a week or so. It is easy to observe this phenomenon when the eyes are wide open; but when, as is generally the case, the eyes are half shut, and only opened from time to time, it will be found advisable to fix the patient's attention on some point or light so as to make him open his eyes, when the phenomenon will be seen. The author is utterly at a loss to explain this symptom, and ascribes it to some diseased state of the sympathetic nerve.--Brit. Med. Zo u ~'.

    TRICHINOSIS IN SPAIN AND FRANCE.

    M. Darder, veterinary inspector at Barcelona, has communicated to the Revue M~dicale an account of an outbreak of trichinosis in Catalonia, in February. A druggist had invited twenty-eight guests to dinner, when the principal dish was a pig just killed. All the guests were attacked with the characteristic symptoms, and six of them died. Since then the presence of the parasite has been discovered in several districts throughout the North of Spain, and in some places the use of pork has been abandoned. In France (Selne-et-Oise), 1VI. Laboulb~ne has recorded the first appearance of the disease ever known in that country. In his locality, out of twenty persons who had eaten a dinner of pork, apparently healthy, eleven were seized with serious symptoms, but up to the date of

  • Report on Medical Jurisprude~ce. 63

    his communication (3rd May) none had died. He has found from experiment that trichinae can bear a wide range of heat and cold. A temperature of 20 ~ (centigrade) below freezing point during an entire night did not kill them, and for seventy-two hours they were exposed to a heat ranging from 50 ~ to 60 ~ (centigrade), and yet remained alive. At 70 ~ (centigrade) they perish. Alcohol kills only if it penetrates within the cyst.

    POISONING BY DOMESTIC REMEDIES.

    M. Duclaux, of Nancy, has communicated to the Medical Society of that town particulars of a case of poisoning by santonine. To a child four and a half years of age twelve vermifuge chocolate tablets had been given. Two hours and a half afterwards the child was comatose; the pupils dilated and insensible to light; the lips swollen; respiration stertorous; the pulse 4,5 per minute; the skin cold and covered with. profuse sweat. The urine was orange, or reddish-brown ; it flowed drop by drop, and came away continually. It was not till twelve hours after the accident that the pulse and temperature began to rise, and for twelve hours more the child continued insensible. Energetic frictions and the administration of stimulants were the treatment employed~ Ultimately recovery took place. About 5 grains of santonine had been given.

    Mr. T. Wood Hill reports in The Lancet a case of poisoning by sweet spirits of nitre. A child, aged three years, had drunk out of a bottle that lay inadvertently within its reach about 3 ounces of sweet spirits of nitre. Almost immediately he fell into a state of collapse---becoming cold, almost pulseless, insensible ; both pupils fixed and widely dilated; breathing hardly perceptible. He had vomited freely--the contents of the stomach being undigested food (no blood), with a smell of spirit. Although the temperature of the body grew a little warmer and the pulse slightly improved, the vomiting and purging recurred; the breathing became stertorous, and death took place jus~ ~welve hours after the fatal dose. On opening the abdomen after death a strong alcoholic odour was emitted. The stomach contained food, chiefly bread, in a state of semi-digestion; the mucous coat was highly inflamed and red near the pyloric end, on the anterior surface of the posterior border, and in one spot very much attenuated. The duodenal end of the small intestines was red and inflamed and bile-stained, the remainder of intestines healthy. Kidneys slightly congested; the other organs healthy. On removing the skull-cap the membranes of the brain

  • 64 Report on Medical Jurisprudence.

    were found highly congested, containing a large quantity of dark- coloured blood. Brain soft, pulpy; vessels congested; no trace of fluid in the ventricles.

    DANGEROUS COLOURS IN WALL-PAPERS.

    Mr. S. Siebold (London), in a lecture on this subject, stated that out of sixty or seventy papers of various colours---blue, red, brown, pink, &c.--analysed by him, ten only were harmless, the rest containing arsenic. There is a popular impression that green papers only are to be feared; but the result of Mr. Siebold's examination should have the effect of rendering householders and heads of families suspicious of some of the most innocent-looking colours. It is reasonable to assume that to the presence of dele- terious ingredients contained in certain wall-papers may be ascribed many little illnesses of children, where no apparent cause exists for them, and which sometimes puzzle the medical attendant.

    DIFFERENTIAT ION OF COMA FROM ALCOHOL.

    Dr. MaeEwen, in a letter to T]~e Lancet, has controverted Dr. Riehardson's statement that in alcoholic coma the temperature falls, and that this is a distinguishing mark from other forms of coma. Dr. MacEwen states that he has observed the temperature in a series of cases of t~acture of the skull, opium poisoning, and apoplexy, and that in all these cases the temperature was found much below the normal. He also disputes the statement that in alcoholic coma there is dilatation of the pupil. He had found contraction the rule; but he has accidentally discovered that if a patient was shaken or disturbed, the pupil dilated--very soon, however, contracting again, l ie tihere~fore lays down the rule that an insensible person who, being left undisturbed for from ten to thirty minutes, has contracted pupi~ls, which dilate on his being shaken without any return of consciousness, and then contract again, can be labouring under no other state than alcoholic coma. But the test must have a wider trial before it is finally accepted.

    THE DETERMINAT ION OF SEX IN UTERO.

    Dr. Upton, of Michigan, in New York Medical Record, writes : - - I am led in this connexion to air a theory of the generation of the sexes which, if correct, will throw more light on this mysterious subject of embryology, and will explain the law discovered by M. Thury, Professor in the Academy of Genera, and. referred to in Dr. Mudd's

  • .Report on Medical Jurisprudence. 65

    communication. My experience extends over nearly eight years of obstetric practice, and in every case where I can obtain sumcient and accurate data upon which to base my calculations, I am able to predict the sex previous to delivery. The law is substantially thus--vlz., conception resulting from intercourse subsequent to the menstrual flow will result in female offspring ; while conception from intercourse in the latter half of the menstrual period, or previous to the menstrual flow, will result in male offspring. Observations and inquiries carefully made with a view to determine the correct- ness of this law have established its truth, in my own mind, beyond question.

    THE RELAT ION ]~ETWEEN THE AGE OF THE MOTHER AND THE

    SEX OF THE CHILD.

    Bidder, in the Zeitschrift fi~r Geburtshi~lfc und Gyn(ikologie, Band 2, gives the result of his observations on this subject. In 4,441 primiparm, the proportion was 100 female to 111"5 male children. Very young primiparm gave birth to a large proportion of boys; those of twenty or twenty-one years old had more girls than boys ; while, as the age increased, the proportion of male children again rose. In 7,430 muli~ipar~e, there were 100 female to 112"4 male children. The proportion of males exceeded that of females in those aged from seventeen to twenty-one; the number sank in the twenty-second and twenty-~hird years, reached its minimum at the ages of twenty-four and twenty-five, and then again increased in proportion to the age of the mothers.--Br/t. Med. Jour.

    :PRECOCIOUS MATERNITY .

    At the last winter (1878)assizes, Maidstone, in a case of criminal assault on a girl under twelve, tried before Mr. Day, Q.C,, acting as Commissioner, it was proved in evidenee that a girl had been delivered at the age of twelve years and one month of a full-grown child, which is still living. With the exception of two cases quoted in " Taylor's Medical Jurisprudence," this is the earliest age of delivery recorded as having occurred in this country.