Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
_General Symptoms._--As soon as the acid is swallowed, the patient
complains of intense burning pain in the mouth, throat, and stomach,
the pupils are contracted, the conjunctiva insensible to touch, the
skin cold and clammy, the temperature rapidly falls, and the pulse
becomes weaker and weaker, till it is almost imperceptible. The
breathing is laboured, and, as the fatal issue approaches, becomes
stertorous; vomiting of frothy mucus occurs in some cases. The invasion
of the symptoms is most rapid, and many of the patients have been
in an insensible condition when found. The above symptoms have even
supervened when the strong acid has been used for dressing wounds.
Dr. J. Hamilton records a case where the acid was used as an
application to a wound four inches long, in a child four and a half
years of age. Direct contact of the acid with the wound was prevented.
About an hour after the dressing was applied he saw the patient, who
was then supposed to be suffering from the effects of chloroform
used during the operation on the child‘s arm. She was suffering from
symptoms like those before described. On removing the dressing, some
of the carbolic acid, it was found, had melted and run into the wound,
and to this Dr. Hamilton attributed the symptoms. The child ultimately
died. (See _British Medical Journal_, 1873, vol. i. p. 226.)
The urine and fæces, when passed, are of a dark colour, and it has
been frequently noticed that the urine passed by the assistants in
surgical hospitals, who, under the antiseptic methods adopted, are
constantly washing their hands in solutions of carbolic acid, is of
an olive-green colour. This shows that absorption takes place readily
through the skin. Bilroth, in his work on _Clinical Surgery_, gives
several instances of absorption in this way. Nephritis with casts in
the urine may occur. The hypodermic administration of carbolic acid,
twelve to twenty-four grains in a day, has failed in five cases under
my observation to be followed by carboluria.
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