Acids.--Ordinarily speaking, the effect of boric acid in medicinal doses on the human system is nil, an exceptionally large quantity causing diuresis. Binswanger, according to Lewin, took eight gm. in two doses within an hour, which was followed by nausea, vomiting, and a feeling of pressure and fulness of the stomach which continued several hours. Molodenkow mentions two fatal cases from the external employment of boric acid as an antiseptic. In one case the pleural cavity was washed out with a five per cent solution of boric acid and was followed by distressing symptoms, vomiting, weak pulse, erythema, and death on the third day. In the second case, in a youth of sixteen, death occurred after washing out a deep abscess of the nates with the same solution. The autopsy revealed no change or signs indicative of the cause of death. Hogner mentions two instances of death from the employment of 2 1/2 per cent solution of boric acid in washing out a dilated stomach The symptoms were quite similar to those mentioned by Molodenkow.
In recent years the medical profession has become well aware that in its application to wounds it is possible for carbolic acid or phenol to exercise exceedingly deleterious and even fatal consequences. In the earlier days of antisepsis, when operators and patients were exposed for some time to an atmosphere saturated with carbolic spray, toxic symptoms were occasionally noticed. Von Langenbeck spoke of severe carbolic-acid intoxication n a boy in whom carbolic paste had been used in the treatment of abscesses. The same author reports two instances of death following the employment of dry carbolized dressings after slight operations. Kohler mentions the death of a man suffering from scabies who had applied externally a solution containing about a half ounce of phenol. Rose spoke of gangrene of the finger after the application of carbolized cotton to a wound thereon. In some cases phenol acts with a rapidity equal to any poison. Taylor speaks of a man who fell unconscious ten seconds after an ounce of phenol had been ingested, and in three minutes was dead. There is recorded an account of a man of sixty-four who was killed by a solution containing slightly over a dram of phenol. A half ounce has frequently caused death; smaller quantities have been followed by distressing symptoms, such as intoxication (which Olshausen has noticed to follow irrigation of the uterus), delirium, singultus, nausea, rigors, cephalalgia, tinnitus aurium, and anasarca. Hind mentions recovery after the ingestion of nearly six ounces of crude phenol of 14 per cent strength. There was a case at the Liverpool Northern Hospital in which recovery took place after the ingestion with suicidal intent of four ounces of crude carbolic acid. Quoted by Lewin, Busch accurately describes a case which may be mentioned as characteristic of the symptoms of carbolism. A boy, suffering from abscess under the trochanter, was operated on for its relief. During the few minutes occupied by the operation he was kept under a two per cent carbolic spray, and the wound was afterward dressed with carbolic gauze. The day following the operation he was seized with vomiting, which was attributed to the chloroform used as an anesthetic. On the following morning the bandages were removed under the carbolic spray; during the day there was nausea, in the evening there was collapse, and carbolic acid was detected in the urine. The pulse became small and frequent and the temperature sank to 35.5 degrees C. The frequent vomiting made it impossible to administer remedies by the stomach, and, in spite of hypodermic injections and external application of analeptics, the boy died fifty hours after operation.
Recovery has followed the ingestion of an ounce of officinal hydrochloric acid. Black mentions a man of thirty-nine who recovered after swallowing 1 1/2 ounces of commercial hydrochloric acid. Johnson reports a case of poisoning from a dram of hydrochloric acid. Tracheotomy was performed, but death resulted.
Burman mentions recovery after the ingestion of a dram of dilute hydrocyanic acid of Scheele's strength (2.4 am. of the acid). In this instance insensibility did not ensue until two minutes after taking the poison, the retarded digestion being the means of saving life.
Quoting Taafe, in 1862 Taylor speaks of the case of a man who swallowed the greater part of a solution containing an ounce of potassium cyanid. In a few minutes the man was found insensible in the street, breathing stertorously, and in ten minutes after the ingestion of the drug the stomach-pump was applied. In two hours vomiting began, and thereafter recovery was rapid.
Mitscherlich speaks of erosion of the gums and tongue with hemorrhage at the slightest provocation, following the long administration of dilute nitric acid. This was possibly due to the local action.
According to Taylor, the smallest quantity of oxalic acid causing death is one dram. Ellis describes a woman of fifty who swallowed an ounce of oxalic acid in beer. In thirty minutes she complained of a burning pain in the stomach and was rolling about in agony.
Chalk and water was immediately given to her and she recovered.
Woodman reports recovery after taking 1/2 ounce of oxalic acid.
Salicylic acid in medicinal doses frequently causes untoward symptoms, such as dizziness, transient delirium, diminution of vision, headache, and profuse perspiration; petechial eruptions and intense gastric symptoms have also been noticed.
Sulphuric acid causes death from its corrosive action, and when taken in excessive quantities it produces great gastric disturbance; however, there are persons addicted to taking oil of vitriol without any apparent untoward effect. There is mentioned a boot-maker who constantly took 1/2 ounce of the strong acid in a tumbler of water, saying that it relieved his dyspepsia and kept his bowels open.