528 MEDICAL JURISPRUDENCE phate in doses of i to 1 gramme in a ten per cent solution has been recommended, but administration by mouth of 10 ml. of a ten per cent solution of sodium hypophosphite with 5 ml. of hydrogen peroxide m a glass of water and gastric lavage with the same solution are regarded more effective. Intramuscular injections of a solution containing ten per cent B.A.L. and 20 per cent benzyl benzoate in arachis oil are suggested as a useful remedy in acute mercurial poisoning, provided it is administered as early as possible. An initial injection of 300 mgm. of the solution is to be administered at once, and is to be followed within the first twelve hours by two or even three further injections of 50 mgm. each. Sodium formaldehyde sulphoxylate is also used as a chemical antidote, as it reduces the perchloride to metallic mercury. A freshly prepared solu- tion of 5 to 10 per cent of the sulphoxylate with 5 per cent of sodium bicarbonate should be used for washing out the stomach, and 200 cc. of the solution should be left in the stomach. This should be followed immediately by a slow intravenous injection of 10 Gm. of sulphoxylate dissolved in 100 to 200 cc. of distilled water. The injection may be repeated after 4 to 6 hours. High colonic lavage with 1 in 1,000 solution of sulphoxylate should be carried out twice daily in case colitis should develop. It must be remembered that this treatment is beneficial only if tried within the first half hour. Intravenous injections of 20 to 40 cc. of a 25 per cent solution of glucose have been recommended. The solution of glucose in the form of a drop by drop enema has also a beneficial effect. Later, the symptoms should be treated as they arise. It is said that sodium chloride is to be avoided, as it favours the absorption of mercury, but Professor Michaud °° recommends the liberal supply of sodium chloride (about 15 grammes daily) with the food in order to combat the dangerous acidosis and, in addition, a 0.9 per cent solu- tion of sodium chloride and a 40 per cent solution of sodium bicarbonate hypodermically and intravenously. Since the introduction of this method he has saved two cases of serious poisoning by corrosive sublimate. Post-mortem Appearances.—The appearances of corrosive poisoning will be present if the poison is taken in a concentrated form. Otherwise the signs of irritant poisoning will be observed. The mucous membrane of the lips, mouth and pharynx presents a diffuse greyish-white escharotic appearance. The same appearance is noticeable in the oesophagus; its mucous membrane appears also corrugated and eroded. The stomach contents are masses of coagulated albumen mixed with mucus and liquid blood. Its mucous membrane is corroded, inflamed, and covered with a greyish deposit of mercury, or a black deposit of its sulphide. During the post-mortem examination great care should be taken in removing the stomach from the abdominal cavity, lest it might be ruptured owing to the gre^^tenmg of its walls. Perforation of the stomach is very rare. The intestines, chiefly the caecum, colon and rectum, are found inflamed, ulcerated and gangrenous, if the patient has lived for some days. The liver is congested and shows cloudy swelling. The spleen is congested, The kidneys are usually swollen with necrosis of the tubules. The heart may show fatty degeneration. It must be remembered that the post-mortem lesions are found in the alimentary canal even if death has occurred from absorption of corrosive sublimate as a result of the external application to the skin or irrigation of wounds or abscess cavities, or of the uterus and vagina, 60. Fortschrittee der Therapie, No. IS, 1930; Ars, Medici, Nov. m0, p. 502.