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CARBOLIC ACID                                                       473

chest and upper abdomen and small areas of the back and both lower limbs. The clothes
were immediately removed and large quantities of methylated spirit were applied to the
burns. In a very short time she was unable to sit up and her consciousness rapidly
became clouded, and before three minutes from the time of the accident she was com-
pletely unconscious and became comatose. Her face and her upper and lower limbs
were continuously twitching, her pupils were semi-dilated and fixed, her colour was
greyish-blue and was visibly deepening, her respirations were laboured and bubbling,
her mouth and nasal cavities were full of frothy mucus and no pulse could be felt at
the cardiac apex or wrist. Thirty ounces of normal saline containing ninety grains of
sodium bicarbonate were infused into a vein. In about two hours' time she was com-
pletely conscious and reasonable. During the following twenty-four hours she vomited
incessantly and continued to do so during the three subsequent days. Her urine was
at first green and contained albumin ; it remained green for two days and albuminous
for three days. It was never diminished in quantity and the microscopic examination did
not show any casts. The burns which were superficial were treated by the tannic acid
method.óJ. Taylor, Proceedings of the Royal Society of Medicine, Nov. 1930, p. 63.

4.   About a tablespoonful of phenol camphor was administered to each of the two
members of the American Air Force in mistake for tincture opii camphorata.   Within a
few minutes both of them suffered from burning pain in the stomach and developed
cyanosis and convulsions, followed by unconsciousness and death in about 35 minutes.
óBeng. Chem. Examiner's Annual Rep., 1944.

5.   A man was given a drink of toddy mixed with carbolic acid by another man
who was not on good terms with him.    There was  corrosion of the tongue, lips and
cheeks with an odour of carbolic acid emanating from, the mouth.   The urine passed 12
hours after taking the drink was turbid and reddish-brown in colour,  and contained
alcohol and carbolic acid.óBeng. Chem. Examiner's Annual Report, 1947.

Carbolic acid is excreted chiefly in the urine in combination with
sulphuric and glycuronic acids and also as hydroquinone and pyrocatechin.
It is also eliminated from the system by the lungs, salivary glands, skin, liver
and stomach.

Carbolic acid may normally occur in traces in the urine in the form of
phenol-sulphonate of potassium, derived from the digestion of albuminous
substances or of their putrefaction. From his experiment Engel28 has
estimated that the quantity of carbolic acid excreted by a healthy man living
on mixed diet is 15 milligrarnrnes in twenty-four hours.

Cresol, creolin (a constituent of Jeyes' disinfecting fluid), dettol (poly-methylcresol),
lysol (a mixture of cresol and soap solution) and izal are all similar in action to carbolic
acid, but they are believed to be less toxic. Stapelmohr2t) reports a case in which the
terminal phalanx of the thumb sloughed off, and had to be amputated after application
of a 5 per cent dilution of a compound solution of cresol.

Smith30 describes the case of a man, aged 32, who, with intent to commit suicide,
swallowed 2 ounces of a weed-killer of emulsified tar acids consisting of 35 per cent
orthocresol, 40 per cent metacresol and 25 per cent paracresol. He had no pain or vomit-
ing, but became comatose in about an hour and died in about one hour and forty minutes,
Necropsy did not reveal any signs of corrosion of the lips, tongue, mouth, pharynx,
oesophagus, stomach or intestines. In a case31 where a Hindu male, 17 years old, died
after swallowing a quantity of lysol, post-mortem examination showed that the mouth,
pharynx and ossophagus were ulcerated. The tongue was white and the stomach was
perforated. The liver and kidneys were congested.

Death has occurred after swallowing one to two tea-spoonfuls of lysol. On the other
hand, recovery has followed much larger doses. A woman, 25 years old, took about
two ounces of a preparation labelled "Lysol pure" at 7-18 p.m. After swallowing she
felt no pain, but only a slight burning in the throat, and then she went off to sleep.
At 7-45 p.m. she was comatQse, the pupils were contracted, the face was cyanosed, and
the lips and skin of the face were burnt as though by some corrosive fluid. The breath-
ing was rattling and stertorous, and the breath smelt strongly of carbolic acid. There
was foam on the lips, mouth and nose, but the pulse was fairly good. The urine passed
was very dark and smoky, but did not contain albumin or blood. The stomach was
washed out with warm water, and a pint of warm water containing an ounce of magne-

28.   Annal. de Chimie et de Physique, 5 ser., and XX, p. 230, 1880; Blyth, Poisons, ikeir
Effects and Detection, Ed. V, p. 188.

29.   Hygeia Stockholm, May 16, 1917, p. 438; Jour. Amer* MecL Assoc^ July 21, 1
p. 248.                       *                                  .

30.   Brit. Med.< Jour^ April 28, 1928, p. 714.

31.   Punjab Chem. Examiner's Annual Report;. 1934, F* *&,                        * *