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The oesophageal stricture should be dilated by means of a bougie, or it
may be necessary to perform cesophagostomy or gastrostomy.

In poisoning by ammonia vapour give oxygen inhalation, or keep the
patient in an atmosphere rendered moist with steam. Anodynes may be
given for pain.

Post-mortem Appearances.—These indicate marks of corrosion, but not
so well-marked, as in poisoning by mineral acids. The mucous1 membrane
of the mouth, throat, gullet, stomach and duodenum is softened, exfoliated
and inflamed in patches of chocolate or black colour. The contents of the
stomach are turbid, usually blood-stained, but frequently coffee-coloured.
Perforation of the stomach is rare, but may occur in ammonia poisoning.
The deeper tissues are inflamed and congested.

The mucous membrane of the larynx and trachea shows the same
appearances as are found in the mouth, throat, etc. In protracted cases of
poisoning stenosis is found more often at the lower end of the oesophagus
than at the pylorus.

In the case61 of a man who died from poisoning by a solution of
ammonia, the viscera were found in a highly congested state, including the
oesophagus, the lungs and the pancreas, which latter was adherent to the
duodenum, and the contents of the stomach smelled strongly of ammonia and
had a soapy feel. The Chemical Analyser detected both free and combined
ammonia in the viscera.

Chemical Analysis.—The contents of the stomach are alkaline in reaction
and soapy to the feel. Ammonia may be separated from organic mixtures by
distillation, and other alkalies may be separated by dialysis or by incinerat-
ing them in a porcelain capsule to drive off animal and vegetable matter,
The residual ash is then dissolved in acidulated water, and tested for the
presence of sodium and potassium as given in the following table : —


1.   Caustic   potash
	Ammonia gas is given off known

and heat.
	by its odour, by its turning red

	litmus paper blue and by giving

	rise to white fumes of ammonium

	chloride when a glass rod wet

	with hydrochloric acid is brought

	into contact with it.

2.   Nessler's re-agent.
	Yellow, or brown colouration or

	dark brown precipitate.

3*   Tartaric     acid
	White   granular  preci-

(strong)    and


4.   Platinic chloride.
	Yellow, crystalline precipitate in
	Yellow, crystalline pre-

	solutions acidulated with hydro-
	cipitate   in solutions

	chloric acid, soluble in 80 per
	acidulated      with

	cent alcohol.
	hydrochloric acid, in-

	soluble in 80 per cent


5.   Flame test.

The caustic alkalies give a "brown precipitate with silver nitrate; while
their carbonates give a whitish-yellow precipitate and effervesce on the
addition of an acid.

61.   Bombay Chemical Analyser's Annual Report^ 1929, p. 5.