§ 86. =Local Action.=--When strong nitric acid comes in contact with organic matters, there is almost constantly a development of gas. The tissue is first bleached, and then becomes of a more or less intense yellow colour. Nitric acid spots on the skin are not removed by ammonia, but become of an orange-red when moistened with potash and a solution of cyanide of potassium. The yellow colour seems to show that picric acid is one of the constant products of the reaction; sulphide of ammonium forms a sort of soap with the epidermis thus attacked, and detaches it. § 87. =Symptoms.=--The symptoms and course of nitric acid poisoning differ in a few details only from those of sulphuric acid. There is the same instant pain and frequent vomiting, destruction of the mucous membranes, and, in the less severe cases, after-contraction of the gullet, &c. One of the differences in the action of nitric and sulphuric acids is the constant development of gas with the former. This, without doubt, adds to the suffering. Tartra made several experiments on dead bodies, and showed that very considerable distension of the intestinal canal, by gaseous products, was the constant result; the tissues were corroded and almost dissolved, being transformed, ultimately, into a sort of greasy paste. The vomited matters are of a yellow colour, unless mixed with blood, when they are of a dirty-brown hue, with shreds of yellow mucus, and have the strong acid reaction and smell of nitric acid. The teeth may be partially attacked from the solvent action of the acid on the enamel. The fauces and tongue, at first blanched, soon acquire a citron-yellow, or even a brown colour; the whole cavity may swell and inflame, rendering the swallowing of liquids difficult, painful, and sometimes impossible. The air passages may also become affected, and in one case tracheotomy was performed for the relief of the breathing.[111] The stomach rejects all remedies; there are symptoms of collapse; quick, weak pulse, frequent shivering, obstinate constipation, and death (often preceded by a kind of stupor) in from eighteen to twenty-four hours. The intellectual faculties remain clear, save in a few rare instances. [111] Arnott, _Med. Gaz._, vol. xii. p. 220.