If lethal, but not excessive doses of the diluted acid are taken, the symptoms are--a burning in the mouth and throat, a peculiarly unpleasant persistent taste, and vomiting. There is faintness with pallor of the face, which is covered by a clammy sweat, and the patient soon becomes unconscious, the pulse small and thready, and the pupils sluggish to light. The respiration is profoundly affected; there is dyspnœa, and the breathing becomes shallow. Death occurs from paralysis of the respiratory apparatus, and the heart is observed to beat for a little after the respiration has ceased. All these symptoms may occur from the application of the acid to the skin or to mucous membranes, and have been noticed when solutions of but moderate strength have been used--e.g., there are cases in gynæcological practice in which the mucous membrane (perhaps eroded) of the uterus has been irrigated with carbolic acid injections. Thus, Küster[202] relates a case in which, four days after confinement, the uterus was washed out with a 2 per cent. solution of carbolic acid without evil result. Afterwards a 5 per cent. solution was used, but it at once caused violent symptoms of poisoning, the face became livid, clonic convulsions came on, and at first loss of consciousness, which after an hour returned. The patient died on the ninth day. There was intense diphtheria of the uterus and vagina. Several other similar cases (although not attended with such marked or fatal effects) are on record.[203] [202] _Centralblatt. f. Gynäkologie_, ii. 14, 1878. [203] A practitioner in Calcutta injected into the bowel of a boy, aged 5, an enema of diluted carbolic acid, which, according to his own statement, was 1 part in 60, and the whole quantity represented 144 grains of the acid. The child became insensible a few minutes after the operation, and died within four hours. There was no _post-mortem_ examination; the body smelt strongly of carbolic acid.--_Lancet_, May 19, 1883. § 225. The symptoms of carbolic acid poisoning admit of considerable variation from those already described. The condition is occasionally that of deep coma. The convulsions may be general, or may affect only certain groups of muscles. Convulsive twitchings of the face alone, and also muscular twitchings only of the legs, have been noticed. In all cases, however, a marked change occurs in the urine. Subissi[204] has noted the occurrence of abortion, both in the pig and the mare, as a result of carbolic acid, but this effect has not hitherto been recorded in the human subject. [204] _L’Archivio della Veterinaria Ital._, xi., 1874. It has been experimentally shown by Küster, that previous loss of blood, or the presence of septic fever, renders animals more sensitive to carbolic acid. It is also said that children are more sensitive than adults.