1. The most ordinary symptoms are those of the first variety,—namely, all the symptoms that characterise the most violent gastritis, accompanied likewise with burning in the throat, which is increased by pressure, swallowing, or coughing;[247]—eructations proceeding from the gases evolved in the stomach by its chemical decomposition;—and an excruciating pain in the stomach, such as no natural inflammation can excite. The lips are commonly shrivelled, at first whitish, but afterwards brownish in the case of sulphuric acid. Occasionally there are also excoriations, more rarely little blisters. Similar marks appear on other parts of the skin with which the acid may have come in contact, such as the cheeks, neck, breast, or fingers; and these marks undergo the same change of colour as the marks on the lips. I had an opportunity of witnessing this in the case of the man who was disfigured by the Macmillans (p. 122) with sulphuric acid. He was cruelly burnt on the face as well as on the hands, which he had raised to protect his face; and the marks were at first white, but in sixteen hours became brownish. The inside of the mouth is also generally shrivelled, white, and often more or less corroded; and as the poisoning advances, the teeth become loose and yellowish-brown about the coronæ. The teeth sometimes become brown in so short a time as three hours.[248] Occasionally the tongue, gums, and inside of the cheeks are white, and as it were polished, like ivory.[249] There is almost always great difficulty, and sometimes complete impossibility, of swallowing. In the case of a child related by Dr. Sinclair, of Manchester, fluids taken by the mouth were returned by the nose; and the reason was obvious after death; for even then the pharynx was so much contracted as to admit a probe with difficulty.[250] On the same account substances taken by the mouth have been discharged by an opening in the larynx which had been made to relieve impending suffocation. The matter vomited, if no fluids be swallowed, is generally brownish or black, and at first causes effervescence, if it falls on a pavement containing any lime. Afterwards this matter is mixed with shreds of membrane, which resemble the coats of the stomach, and sometimes actually consists of the disorganised coats, but are generally nothing more than coagulated mucus. The bowels are obstinately costive, the urine scanty or suppressed; and the patient is frequently harassed by distressing tenesmus and desire to pass water. The pulse all along is very weak, sometimes intermitting, and towards the close imperceptible. It is not always frequent; on the contrary, it has been observed of natural frequency, small and feeble in a patient who survived fifteen days.[251] The countenance becomes at an early period glazed and ghastly, and the extremities cold and clammy. The breathing is often laborious, owing to the movements of the chest increasing the pain in