Carbolic acid & Oxalic acid

DR. Zakir Hossain

MBBS, DFM(BSMMU)
Assistant Professor
Department of Forensic Medicine &
Toxicology
Carbolic acid (Phenol)
Physical properties are:
 Pure carbolic acid is colorless, short

prismatic needle-shaped crystalline

substance have burning sweetish taste.
 One exposure to air it turns pink & gets

liquefy & have a peculiar phenolic smell.

Contd.
 It is fat soluble.
 It is soluble in ether, alcohol, glycerin &
slightly in water.
 Other members of phenol are cresol (Lysol),
chlorinated phenol (Detol),house hold
disinfectants(5% phenol in water)
 In Our Dept. it is brown in colour due to
commercial preparation where mixed with
some impurities like cresol.
 Routes of Absorption
 Through the skin
 Oral ingestion
 Pre rectum, per vaginum,etc.
 Through inhalation
 USES
 Antiseptics
 Disinfectants
 Preservatives
 Industrial solvents
 Medical use: in skin disorder and as a local
anesthesia
 Carbolic acid has a peculiar phenolic odour which
intolerable to snake so it is used in village house to
eradicate snake
Fatal dose & Fatal period
 Fatal dose: 10-15 gm.
 Fatal period- 3-4 hrs.
 Rapid death occurs if injected
intrauterine.
 Action
 Local action: act as corrosive.
 Systemic action: first stimulate CNS then
depressed it(convulsion followed by
necrosis),Later damage kidneys and
liver.
 Metabolism & Excretion
 Metabolized mainly by the kidneys, where it
gets oxidized into hydroquinone & pyrocatechol
and excreted through urine and further
oxidation occur when it exposed to air during
and after urination which produce a olive green
coloration of urine are called Carboluria.
 Complication: carboluria followed by anuria &
turns in to renal failure.
Signs/Symptoms
 Carbolic acid poisoning is called carbolism
and the usual signs/symptoms are as
follows:
 Headache, giddiness, vomiting, diarrhea,
abdominal pain, convulsions, tinnitus
 Collapse, unconsciousness, coma
 Cold, clammy, sweating
Contd.
 Initially the victim has burning sensation-
tingling sensation, later anesthesia
 Vomiting is seen rarely on consuming dilute
solution of phenol= are the gastrointestinal
tract effects consumed orally
Contd.
 Stertorous breathing with cyanosis
 Dilated pupils
 If the victim survives for 48 hr- Passes dark,
smoky, urine which rapidly turns olive-green on
standing giving the idea of prognosis of the case
 Death result from circulatory or respiratory failure
within hour and renal,hepatic failure if death
within days.
Contd.
 Inhalation of phenol vapors- laryngeal &
pulmonary edema- stertorous breathing &
cyanosis= are the respiratory tract effects
Diagnosis
 Corrosion on the face, inside & around the
mouth as grayish white or brownish in case
of phenol or Lysol respectably
 Breath or vomit has phenol odor
 Carboluria
 Dilated pupils
 Stertorous breathing
Treatment
 In case of poisoning through skin
absorption:
 Removal of contaminated garments
 Washing the area with soap & water,
mopping with wet cloth
 Application of olive oil, spirit, 10% ethyl
alcohol etc. to prevent further absorption
Contd.
 Shifting the victim to fresh air & let him
breath in fresh atmosphere
 Normal saline infusion with sodibicarb
Contd.
 In case of poisoning through oral route:
 Stomach wash carefully with plenty of
lukewarm water containing animal charcoal,
olive oil, magnesium or sodium sulfate or
saccharated lime, soap solution, 10%
glycerin, etc. may be used
 Carbolic acid is the only corrosive asid where
stomach wash can be given.
Contd.
 When wash is completed, 30 gms. Of
magnesium sulfate or liquid paraffin is to
be left in the stomach to prevent further
absorbtion.
Contd.
 Egg white or other demulcents orally
Symptomatic:
 Artificial respiration

 Aspiration of tracheal froth or secretion

 Glucose saline to induce diuresis

Postmortem findings
 Brownish or grayish corrosions at the angle
of mouth, chin, front of the chest, arms &
hands with characteristic odor-externally
 Internally corrosion of gastrointestinal
mucosa, laryngeal & pulmonary edema
 Stomach changes are: Marked corrosion of
gastric mucosa & swelling of folds
Contd.
 Coagulated grayish or brownish silvery
mucous on the folds of mucosa of the
stomach
 Stomach is leathery & wall is hard
 Odor of phenol
Contd.
 Stomach wash material or vomit may show
partially detached gastric mucosa
 Kidneys show hemorrhagic nephritis
 Medico legal importance
1. Usually consumed accidentally as mistaken for
medicine or spilt over the body.
2. Suicidal poison.
3. Rarely used for homicial.
4. Indiscriminate medical use sometimes causes
poisoning.
5. Used for criminal abortion.
 Oxalic acid

 Other name: Acid of sugar.

Salt of sorrel.
 Physical properties It is a colorless,
transparent, prismatic crystalline substance
resembling magnesium sulfate and zinc
sulfate, having burning sour in taste.
Fatal dose & Fatal period
 Fatal dose- 15-20 gm
 Fatal period- 1-2 hours
 About 20 mg is excreted daily through
urine.
Action
 Locally- acts as a corrosive on skin &
mucosa
 Remotely- on absorption into the blood
affects different systems:
 Cardiovascular system- Shock then death
 Renal system- Tubular necrosis then
uremia & death
Contd.
 Electrolyte system:
Extract tissue calcium causing
hypocalcaemia then tetani & ventricular
fibrillation
Signs/Symptoms
Classified in 3 types:
 Fulminating poisoning: With large doses of
15 gm or more orally can lead to sour and
acidic taste, sense of constriction in the
throat and burning pain from mouth to
epigastrium then radiates to whole
abdomen.
Contd.
 There will be tenderness in the
epigastrium, nausea, followed by vomiting
of coffee ground colored fluid, intense
thirst, diarrhea, electrolyte imbalance &
death.
Contd.
 Acute poisoning:
All findings are mainly due to
hypocalcaemia such as muscle irritability,
tenderness, tetany, convulsions, tingling of
extremities, coma, collapse & death
Contd.
 Delayed or chronic poisoning:
There will be uremia, scanty urine with
albumin, blood & calcium oxalate crystals
seen microscopically followed by metabolic
acidosis and ventricular fibrillation.death
was due to renal failure.
Treatment
 Stomach wash with calcium lactate 2 tsf
 Antidotes are lime water, calcium lactate,
calcium gluconate, chalk suspension in
water, calcium chloride, etc. may be given
orally as specific antidote which form
insoluble calcium oxalate & excreted easily
Contd.
 Intravenous injection of 10%,10 ml calcium
gluconate frequently
 Intramuscular injection of 100 units of
parathyroid extracts
 Demulcent drinks
 Bowel wash by enema & purgatives
 Symptomatic treatment
Postmortem findings
 No specific external findings but rarely
burns on the skin and face seen
 Internal findings are specific and are:
mucosa of mouth, tongue, pharynx and
esophagus are bleached, if a strong
solution is consumed
Stomach changes
 The stomach mucosa is reddened &
punctate due to erosions giving “velvety
red” or blackish appearance
 Wall of the stomach is soft but no
perforation
 Contents of the stomach is gelatinous
brown due to formation of acid hematin
Contd.
 Kidneys are swollen & congested, the
tubules are found filled with oxalate
crystals
 All other viscera show congestion
Medico legal importance
 Usually consumed accidentally as mistake of
magnesium sulfate
 Rarely suicidal or homicidal
 Occasionally used to induce criminal abortion
 Used for illegal erasure of signature called
Forgery
Contd.
 Naturally exists in vegetables such as in
cabbage,onion, spinach, etc.

 Used commercially in cleaning or bleaching

leather, in calico printing, removal of iron
moulds from linen, to remove ink stains &
nail removal
 Nitric Acid
 Characteristics of Nitric acid: Heavy, colorless,
fumes in the air have a peculiar choking odor,
Fatal dose : 10-15 ml,
Fatal period :12-24 hrs,
used in industries- accidental poison
 Other name: Aqua Fortis
Red spirit of nitrate
 Xantroproteic Reaction
 A local reaction producing yellowish discoloration of
the tissues by concentrated Nitric acid in the skin of
the fingers on touching the acid.
 When nitric acid comes in to contact with any organic
matter or living tissue it reacts and destroyed it by
oxidation producing Picric acid which is yellowish in
color and stains the tissue deeply so this reaction is
called Xantroproteic Reaction.
 Uses
 Use by Gold smith for separation of gold
from other metal
 It is used as explosive in nitrocellulose and
nitroglycerine.
 It is a powerful oxidizing agent and desolved
all the metals except gold & platinum.so
gold smith are vernarable to poisoning by
nitric acid.
 M/I imp
 Most cases of poisoning are result of an
accident or suicide
 Homicide is rare.