By the mouth or by means of an oesophageal tube 1 ounce of sulphate of magnesia in a quart of hot water is to be administered, as this will form an in nocuous sulphocarbolate with the car bolic acid. It may be necessary, also, to bleed the patient and then to perform intravenous transfusion or hypodermo clysis, the injection consisting of 300 grains of chloride of sodium in a quart of boiled distilled water. Morphine and heat should be applied to the extremi ties, and, if the fluid which has been in jected into the rectum to wash it out has passed away, a small injection of strong black coffee should be given as a respiratory stimulant. Tea and hot punch may also be administered. Lan douzy (La Presse Med., Mar. 19, '98).
Case of woman who swallowed 7 drachms of ordinary commercial carbolic acid. She was comatose and collapsed and death seemed imminent. The stom ach was washed out with water contain ing sodium sulphate; 8 ounces of blood were removed from the saphenous vein and 4 pints of a normal saline solution at a temperature of 100° F. were injected into the vein. Atrophic sulphate, grain, was administered hypodermically, and half a pint of milk, beaten up with 2 eggs and 1 minim of croton-oil, was introduced through the stomach-tube. Recovery was eventually complete. T. Oliver (Lancet, Mar. 19, V).
Case of carbolic-acid poisoning from use of vaginal douche. Large eschars formed wherever solution had touched. Syringing with warm solution of sodium sulphate, a drachm to the pint, pro duced relief in ten minutes, absolute freedom from pain in a half-hour; satu rated cloths were kept on the blistered parts all night and complete recovery was obtained within twenty-four hours. Carbolic acid, so called, is not really an acid; and hence alkaline solutions are of no avail. Sodium sulphate forms with the carbolic acid sodium sulphocarbolate, which is soothing in effect and prevents further damage. B. Weiss (N. Y. Med. Jour., Jan. 7, '99).
Case of woman, who had swallowed over an ounce of 95-per-cent. carbolic acid. A short time after her swallowing of the acid hypodermic of sulphate of sodium was given. Then the stomach
was washed with a 35-per-cent. solution of alcohol, about 2 quarts of the alcohol solution being used. The patient en tirely recovered, although her face was badly burned with the acid and the mu cous membrane of the mouth seemed entirely destroyed. This is believed to be the first time that alcohol has been used internally for the burns of carbolic acid. J. Drysdale Buchanan (Med. Rec., Aug. 12, '99).
Alcohol will prevent and remove the caustic and poisonous effects of carbolic acid. The primary step in poisoning is to wash the stomach out with alcohol; then whisky may be given hypodermic ally with the idea of neutralizing the acid in the blood. Other heart-stimu lants may be required. As the acid is quite rapidly taken up into the blood, it has been suggested that no treatment is complete without bleeding, but that has not been done to any great extent. Alcohol is the most perfect, the most certain, and the most handy antidote to carbolic acid. G. W. Sargent (Therap. Caz., Dec. 15, 1901).
Personal record kept of seven cases of internal poisoning by carbolic acid, either from intent or otherwise, whose lives have been saved b5- administration of about twice the amount of alcohol as carbolic acid. It is a well-established fact that when carbolic acid is mixed with whisky or brandy it will not kill. Information such as this should be dis seminated through the public press, and physicians should see to it that the people are made aware of these facts. S. D. Powell (Amer. Jour. of Surg. and Gyniec., April, 1002).
Therapeutics. — ORAL DISORDERS. Solutions of carbolic acid have been recommended in stomatitis, a spray of 1 grain to the ounce of water, or a mouth-wash or gargle containing 2 to 5 grains to the ounce of water may be used. Offensive breath may be sweet ened by the use of a 5-per-cent. spray. The cavity of a carious tooth may be packed with a pledget of absorbent cot ton dipped lightly in a concentrated so lution of carbolic acid to relieve the pain. In diphtheria and foetid sore throat a 2- to 5-per-cent. solution may be used with brush or atomizer.