_Symptoms._—The chief symptoms occasioned by the foregoing poisons are,
an acrid, burning taste, with a sensation of excoriation and burning
extending along the mouth and throat, to the stomach. There soon ensue
exquisite pain in the epigastrium, and tenderness on pressure.
Frequently there is cough, hoarseness, dyspnœa, as well as vomiting
of altered mucus mixed with blood and detached portions of the mucous
membrane. The tongue, mouth, and fauces become swollen, soft, and
flabby, and deglutition is difficult. The surface of the body gets cold
and moist, the pulse small and feeble, and there is great pain over the
abdomen, with diarrhœa. Death took place, in the case of a boy, in
three hours from the time of swallowing a strong solution of carbonate
of potash. Ammonia, by its effect on the air passages, has proved fatal
in four minutes. When recovery from the immediate effects of the poison
has taken place, death has subsequently ensued from stricture of the
œsophagus, producing starvation. By the proper use of bougies, &c.,
life may occasionally be prolonged for many months, or even for years.
In some instances, however, it is almost impossible to effect
dilatation, owing to the whole of the gullet becoming thickened and
contracted, so that the opening into the stomach will hardly admit a
crow-quill. The pylorus may also be contracted in like manner.
_Post-mortem Appearances._—The mucous membrane of the mouth and gullet
is softened and inflamed, and portions of it detached. The coats of the
stomach and intestines are inflamed, stained of a dark color, and
sometimes ulcerated. When death has resulted from ammonia, signs of
inflammation are usually found in the larynx and bronchial tubes. The
other caustic alkalies may also destroy life by producing inflammation
of the glottis, which consequently may be found thus occluded after
death.
_Treatment._—The object must be to neutralize the poison, which may be
effected by a weak acid. Vinegar and water is perhaps the best
antidote, and that most readily procurable; its administration may be
followed up by freely allowing acidulated demulcent drinks, orange
juice, &c. The use of oil has been recommended, on the principle that it
converts the alkali into a soap. But that its efficacy is doubtful has
been in some measure shown by the death of two young children from
swallowing a mixture of ammonia and oil. In one of these cases nearly
two ounces of linimentum ammoniæ (made of one part of liquor ammonia to
two of olive oil) were poured down an infant’s throat by a child five
years old. Were, however, the oil given in much greater abundance, the
result would probably be different. At all events, its administration
should not be neglected.
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