Carbolic acid coagulates albumin, and in sufficiently strong solution is poison ous to all forms of life, its main use in practice depending upon its ability to destroy micro-organisms rather than as a stimulant.
Poisoning by Phenic (Carbolic) Acid, —Carbolic acid is a most deadly poison and acts rapidly. Six or seven drops have caused the most dangerous symptoms_ Death may be expected to follow immediately after taking any large quan-. tity. Death has taken place within ten minutes after swallowing about one ounce of carbolic acid, although life may be protracted two or three days. If a large dose be swallowed one may drop dead before he can get more than a few feet from the spot where he stood or he may live a few hours. Sudden death is due to failure of respiration. If death is delayed, symptoms of violent gastro enteritis ensue. The symptoms of poisoning are vertigo and intoxication, accompanied with vomiting of frothy mucus, and an intense burning pain in the mouth, (esophagus, and stomach. The pupils are contracted, the pulse rapid and intermittent, and coma, col lapse, or convulsions ensue. The skin is covered with a clammy sweat, the feat ures are pinched and anxious, and the pulse becomes very thready and almost imperceptible, as a rule. White eschars are noticed about the mouth, if the pure acid has been taken, or blackish, if the impure drug has been used. The odor is apt to hang about the person or clothes. The urine is frequently sup pressed, but, if passed or withdrawn by catheter, is dark colored and smoky. Convulsions or coma often close the scene. A very common symptom (Hare) is hoarseness of the voice, due to an effect on the larynx after the drug is absorbed, and not from its local in fluence. Cases are on record where carbolic-acid poisoning has been due to its absorption from surgical dress ings. In these cases a darkened, smoky hue of the urine, with slight nervous unrest or cerebral disturbances, is pres ent. Pain in the lumbar region is an other indication of this condition, and should suggest the removal of the dress ings.
Severe case of acute poisoning from use of vaginal injections of a carbolic acid solution, the patient, who was very anemic, being restored with difficulty in seven hours. For five days the urine
contained traces of carbolic acid. W. Sekowski (Gaz. Lekarska, No. 42, '04).
In five autopsies of carbolic-acid poisoning noted the tongue, gums, and, in fact, the whole mouth were colored white. This discoloration also affected the whole alimentary tract. The mu cosa of the oesophagus was smooth and white and could be easily stripped from the muscular's. The kidneys showed, in 1 case, principally interstitial changes; in the others the parenchyma of the organ was mainly involved. In 3 of the cases the lungs were congested and oedematous. The remaining internal organs presented no lesion which could be ascribed to the acid. William Moser (Brooklyn Med. Jour., Jan., 'VI).
In the United Kingdom in the period 1861-65 the suicides by carbolic acid were 0.00 per cent. of all suicides with poisons; in 1866-70 they were 1.00 per cent.; in 1871.75, 5.82 per cent.; in 1876-80, 7.93 per cent.; in IS8I-85, 15.37 per cent.; in 1SS6-90, 15.49 per cent.; and in 1S90-94 (four years), 28.01 per cent., thus showing that the sale of car bolic acid should be restricted as is that of the recognized poisonous substances. A. E. Harris (Lancet, Nov. 2S, '96).
One-third of the males and very nearly one-half of the females who poisoned themselves in 1895 did so with carbolic acid. These figures speak eloquently in favor of some restriction in the sale of carbolic acid to the general public. The time has come when a poison which ac counts for 244 suicidal deaths out of a total of 5S0 caused by poison in one year, should be placed out of reach of the general public. Mann (Med. Chronicle, May, '97).
Physicians cannot too often caution the public against the prolonged topical application of carbolic acid even in the weakest solutions. Among 20,417 pa tients treated in the surgical service of the hospital belonging to the Allgemeine ..krbeiterkrankenkasse, carbolic-acid gan grene was observed in 26 cases—in 12 after the topical employment of weak solutions and in 14 as the result of the use of the concentrated acid. In nearly every instance the drug was used with out medical advice, in the form of a solution kept applied continuously. J. Levai (I'ester med.-Chir. Presse, Nos. S, 10, 11, and 12, '97).