CORROSIVE POISONS Symptoms.—These produce severe symptoms immediately they are taken—"a burning pain" in the mouth, throat and oesophagus and pain referred from the stomach and intestines.
Vomiting occurs quickly and the vomit contains blood which may be altered in colour by the action of the poison ; often also shreds of destroyed mucosa are present. Collapse occurs early, and per foration is common when, should the patient survive, signs of general peritonitis develop.
An examination of the patient will show signs of the corrosive action of the poison on the mouth and throat, and marked tenderness will be present on palpation over the stomach and intestine. Corrosive poisons if swallowed in poisonous quantity are usually fatal within 24 hours unless immediate treatment with a suitable antidote is adopted.
Should the patient survive the immediate effects of the poison, serious after effects result owing to the damage done to the ali mentary tract and in the case of volatile corrosives often serious pulmonary complications ensue. Post-mortem examination shows evidence of the destructive action of the poison on the mucous membrane of the mouth, throat, oesophagus and stomach, there being often extensive haemorrhage in the underlying tissues.
Among examples of corrosive poisons may be named : The Corrosive Mineral Acids.—These include : Sulphuric Acid commonly known as oil of vitriol; this is used in various in dustries and in all chemical laboratories. It is a most powerful corrosive in the concentrated form, whether taken internally, or applied externally as in cases of "vitriol throwing." One drachm has caused death in an adult, and half that quantity in a child.
Hydrochloric Acid is known also as muriatic acid or spirits of salts. It is used largely for industrial and chemical purposes and is a common article of domestic use. It is readily obtainable and is very commonly used for suicidal purposes. It is a most dan gerous corrosive and one drachm has caused death in an adult. Nitric Acid is known as "aqua fortis" and is used for industrial and chemical purposes. It is a most dangerous corrosive and produces characteristic yellow staining of the tissues with which the strong acid comes in contact. The vapour of the acid, if inhaled into the lungs, often produces an acute fatal form of pneumonia which is a common cause of death in nitric acid poisoning. Two drachms of the acid have caused death.
Other mineral acids such as Hydrofluoric, Phosphoric and Sul phurous acids in concentrated form produce similar effects.
Treatment.—The treatment of poisoning by corrosive mineral acids consists in giving as soon as possible harmless alkaline remedies such as magnesia powder, lime water, sodium bicar bonate or chalk. These should be given freely, and plenty of egg albumen (white of egg) should also be given since this tends to neutralise the acid by forming a protein combination, and also it has a soothing effect on the damaged mucosa.
The stomach should not be washed out for fear of perforation Pain is relieved by the free use of morphine hypodermically and after the swallowed acid has been neutralised food should be withheld by the mouth and normal saline given as freely as can be retained per rectum.
Caustic Soda or Sodium Hydrate, or Soda lye is a powerful corrosive and quite as dangerous as caustic potash. It is com monly used industrially.
Ammonia, liquid ammonia or spirits of hartshorn, is used largely for domestic and industrial purposes. It is also used in the form of smelling salts when mixed with carbonate of ammonia. It is a powerful corrosive poison and in addition the vapour has a very injurious effect on the lung giving rise to bronchopneumonia which takes on a septic type. One drachm of the strong solu tion has caused death.
As regards treatment in respect of the foregoing, harmless acid drinks such as diluted vinegar or lemon juice or citric or tar taric acid should be given freely. Pain should be relieved by the free use of morphine hypodermically and nourishment should not be given by the mouth but rectal feeding adopted.
Carbolic Acid or phenol is commonly used as a disinfectant for domestic and surgical purposes. Allied preparations such as creasote, cresol, etc., have a similar poisonous effect. Lysol is a combination of cresol with soap and is similar in action to phenol.
Carbolic acid and the allied substances have a powerful cor rosive action causing necrosis of the tissues with which they come in contact, the superficial part of which has a whitish ap pearance, the deeper parts being dark red owing to resulting haemorrhage into them. Carbolic acid is one of the poisons most frequently used by suicides, and owing to its common use for domestic purposes accidental poisoning by it often occurs.
The symptoms caused by carbolic acid are those of corrosive poisoning but owing to its local anaesthetic action vomiting may be absent, and pain may be less marked. If death does not re sult from shock, the profound effect of the poison on the nervous system causes paralysis of the respiratory and cardiac centres, with rapid feeble pulse, and stertorous breathing, coma develops in severe cases and is usually followed by death.
One drachm of carbolic acid taken by the mouth has caused death in 12 hours. Death has resulted from the absorption of phenol by the skin, and from rectal injections of the drug in solution. Usually death occurs in from 3 to 4 hours after the taking of a large dose.
With respect to treatment, the stomach should be washed out by means of a soft stomach tube with diluted saccharated lime water, or fresh lime water; by this means the phenol is con verted into calcium phenate which is not poisonous.