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Full text of "Medical Jurisprudence And Toxicology"

CARBOLIC ACID                                                          471

Fatal Period.—Death usually occurs within three to four hours, but it
has taken place within three to twenty minutes. On the other hand, death
has been delayed for sixty hours and even for some days.

Treatment.—Ordinary enjejtics often fail to produce vomiting owing to
the local anaesthesia. Pass a soft stomach tube with caution, and wash out
the stomach with lukewarm water containing syrup calcis or sodium
sulphate, until the contents of the stomach lose their peculiar odour.
Sodium^sulphate ha a strong solution is one of the best known antidotes. It
forms a harmless, soluble salt of sodium sulphocarbolate. In the absence
of sodium sulphate, magnesium sulphate may be used. Liquid paraffin may
be used for washing out the stomach and a qtlantity may be left in the
stomach after the washing is complete. AJsohpl is not an antidote, but a
10 per cent solution is used in the belief that it will neutralize the action of
carbolic acid and thus prevent extensive sloughing of the tissues. No doubt
the effect of alcohol is simply that of diluting and washing away the carbolic
acid. Give demulcents, such as white of egg and milk. Give atropine
sulphate hypodermically before administering stimulants, such as caffeine,
strophanthin and strychnine. Administer intravenously no^naL^-saline
containing 3 grains of sodium bicarbonate to the ounce to combat the
circulatory depression, as also to dilute the carbolic acid content of the blood
and to encourage excretion by promoting a flow of urine. Use oxygen
inhalation or carry on artificial respiration, if necessary.                       ""

Apply castor oil or liquid paraffin to the burns caused by carbolic acid
on the skin after washing the surface with alcohol or soap and water.

Post-mortem Appearances.—Dark brown excoriations may be seen on
the angles of the mouth and on the chin.   The mucous membrane of the lips,
mouth and throat is corrugated, sodden, wfclt.ened or ash-gray, and partially/
detached, marked by numerous small submujpous haemorrhages.

The mucous membrane of the oesophagus is tough, white or grey,
corrugated and arranged in longitudinal folds.

The stomach is brown and leathery with haemorrhagic spots and pro-
minent rugae, or it is sometimes soft and greyi^-white in colour. It may
contain a reddish fluid mixed with mucus and shreds of epithelium, emitting
an odour of carbolic acid. The same changes are observed in the duodenum.
The kidneys show haemorrhagic neghritis in cases of delayed death. The
lungs are congested and oedematousT^The brain is congested. The blood is
dark and semifluid, or only partially coagulated,

Chemical Analysis.—Carbolic acid may be separated from organic matter
by washing it with ether, decanting the ethereal liquid, and allowing the
ether to evaporate. It may also be readily separated from organic matter
by distillation with dilute sulphuric acid. The following tests may then be
applied to the distillate : —

1.   A few drops of very dilute ferric chloride solution added to a solution
of carbolic acid yields a bluish-violet colour, which disappears on the addi-
tion of alcohol, but changes to yellow on the addition of a dilute mineral acid.

2.    Landolfs    Test.—Bromine    water    produces    a    white    crystalline
precipitate  of tribromo-phenol,  soluble  in  alkali,   ether  and  alcohol,  but
insoluble in acids.

3.    Millon's Test.—Heated with Millon's reagent, a solution of carbolic
acid produces a red colour.   This test is very delicate, as it will give a red
colour to a solution containing only 1 part of carbolic acid in 100$CM> jparts of
water.   It is, however, not characteristic of carbolic acid, as it ja$$jipsieŁ& Hie
same  reaction with  many  other  substances,   especially

proteins.                                                      *