TARTAHIC ACID 479 collapse. The symptoms of suffocation are usually more marked, as the acid being volatile affects the larynx and lungs during the act of swallowing. According to Skiod- waski53 hcemoglobinuria is a constant feature in this poisoning. It appears within the first twelve hours, and is evident even in the benign form. This sign may be helpful in differential diagnosis from other poisons. Fatal Dose.—One drachm of the concentrated acid has caused the death of a child, but recoveries have taken place in adults after swallowing two54 and six55 fluid ounces respectively. Fatal Period.—Death usually takes place within from one to forty-eight hours, although it has been delayed for three, seven and fourteen days.5^ Treatment.—Neutralize the acid by giving magnesia, and then produce emesis by giving emetics. Give demulcents, and allay pain by hypodermic injections of morphine. Laryngeal symptoms may be treated by the application of cold compresses to the throat and by giving the patient pieces of ice to suck. Tracheotomy may be performed, if necessary. Post-mortem Appearances.—Erosion or corrosion of the mucous membrane of the mouth, oesophagus, stomach and intestines with ecchymosed patches. Chemical Analysis.—Acetic acid may be separated from organic mixtures by distil- lation. If combined, it should be liberated by adding phosphoric acid. Tests.—Acetic acid is recognized by its characteristic odour. When heated with alcohol and sulphuric acid, acetic ether (ethylacetate) is formed, which is known by its peculiar aromatic smell. Ferric chloride added to its solution, after it is neutralized with ammonia, produces a deep-red colour which disappears on the addition of hydrochloric acid. The red solu- tion, when boiled, changes to a red-brown precipitate of ferric subacetate. Medico-Legal Points.—Poisoning by acetic acid is rare in India, although a few suicidal and accidental cases have recently occurred in Travancore. TARTARIC ACID (CHOH, COOH)3 This acid is a constituent of a large number of plants, and occurs in many fruits, especially grapes. It may be prepared from potassium acid tartarate. It occurs as colour- less crystals or as a white powder, is odourless and strongly acid in taste. It is soluble in less than 1 part of water, in about 2.5 parts of alcohol and slightly soluble in ether. It is a pharmacopceial preparation, the dose being 5 to 30 grains. It is also a constituent of Seidlitz powder (Pulvis effervescens compositus). Ordinarily, tartaric acid is not regarded as a poison, but in large doses it may act as a poison. A few severe and fatal cases by poisoning by it have been recorded. Symptoms.—These are more of a strongly irritant nature than corrosive. There is a burning sensation in the throat and stomach, followed by vomiting-and diarrhoea. Death may occur from exhaustion. There may occasionally be convulsions. Fatal Dose and Fatal Period.—The fatal dose may be regarded as one ounce of tartaric acid, although a strong solution containing at least 140 to 180 grains of tartaric acid killed a woman, aged 67 year,57 while recovery followed a dose of 4 tolas (720 grains) given to a man in Delhi in place of some "salts" for his constipation from an Indian medicine shop.58 Death may occur in from seven to nine days. Treatment—Neutralize the acid by giving calcium hydroxide or magnesium hydro- xide freely hi water. Then pass the stomach tube gently and wash out the stomach with a solution of sodium bicarbonate. Administer 1 ounce of castor oil as a purgative. Mor- phine may be used to relieve pain. Post-mortem Appearances.— Erosions of the mucous membrane of the oesophagus, and inflammation of the greater part of the alimentary canal. According to Tardieu the blood remains persistently fluid and acquires the colour of red currant juice. Chemical Analysis.—Tartaric acid forms large transparent crystals and is readily soluble in water and in alcohol, but with difficulty in ether. Calcium chloride yields a white precipitate, soluble in acetic acid (Distinction from oxalic acid). Boiling darkens , tartrates, and potassium permanganate decolourises them. 53. Presse Medicate, Paris, Nov. 28, 1925, p. 1573: Jour. Amer. Med. Assoc., Jan. 9, 1926, p. 156. 54. Karunakaran and Pillai, Ind. Med. Goz.» Dec. 1944, p. 600. 55. Drxonmann, Forens. Med. and Toxic., Ed. VI, p. 362. 56. Karunakaran and Pillai, Ind. Med. Goz., Dec. 1944 p. 600. 57. Trevithick, Brit. Med. Jour,, 1893, VoL I, p. 1321. 58. Punjab Chemical Examiner's Annual Report, 1926.