SCIENCE. 



[N. S. Vol. XVIII. No. 440. 



of formal into the eye. This occurred once 

 to the writer, and the experience was certainly 

 the most intensely painful in his recollection. 

 Fortunately, the aiTected eye could be bathed 

 almost immediately with a stream of running 

 water and the irritant had not hit the cornea, 

 else this transparent portion of the external 

 tunic of the eye would undoubtedly have been 

 rendered more or less opaque. Where the 

 irritant had come in direct contact with the 

 ocular conjunctiva, an almost immediate and 

 intense congestion appeared, accompanied for 

 several hours by an exquisite pain. In 

 Fischer's experimentation on animals it was 

 determined that a single drop of the concen- 

 trated solution introduced into the conjunc- 

 tival sac is sufficient permanently to injure 

 the eye. A contraction of the pupil to pin- 

 hole size follows, and atropine fails to dilate it 

 again. 



The toxic effects of formal which is acci- 

 dentally swallowed are so profound that a 

 timely word of warning may not be uncalled 

 for. Medical literature contains quite a num- 

 ber of cases, of which the following brief ac- 

 counts will convey some idea. 



(a) Bock* reports the case of an inmate of 

 the Indian School for Feeble-minded Youth, 

 aged twenty-six, strong and healthy, who took, 

 while unobserved, about two ounces of con- 

 centrated formal. There was early vomiting 

 with traces of blood; collapse and uncon- 

 sciousness ensued ; heart-failure occurred after 

 sixteen hours, and drugs failing to stimulate 

 the depressed vital functions, the patient died 

 in twenty-six hours. A post-mortem exami- 

 nation showed the stomach to be highly in- 

 flamed, necrotic and oedematous, and contain- 

 ing about four ounces of dark fluid. 



(b) Kliiber-j- had a patient who took a 

 draught from a bottle labeled ' Apenta ' water, 

 which he afterwards described as ' tasting like 

 gall.' The patient became unconscious, pass- 

 ing into a state resembling that of alcoholic 

 intoxication or of a post-epileptic condition; 

 the urine was suppressed for nineteen hours, 

 and when it appeared was scant and gave the 



* C. Bock, Indiana Medical Jour., XVIII, 1899- 

 1900, p. 122. 



t Kluber, Milncli. med. Wochnschr., 1900, p. 1416. 



reaction for formic acid. He recovered in a 

 few days, owing to the prompt and careful 

 treatment. 



(c) Zorn* describes the ease of a porter, 

 aged forty-four, who swallowed about half the 

 contents of a medicinal glass of 30 c.c. capac- 

 ity, in the belief that he was taking ' HofE- 

 mannstropfen.' The burning taste made him 

 aware of his mistake and he swallowed some 

 milk. This was followed by terrible retching 

 and vomiting, then unconsciousness. The 

 pulse and respiration rose rapidly in fre- 

 quency, the temperature fell, and the urine 

 was suppressed for twenty-four hours. Other 

 symptoms pointed to a parenchymatous irri- 

 tation of the kidneys and of the gastro-in- 

 testinal tract. 



(d) Gerlachj- had a patient, a servant girl, 

 aged twenty-one, for whom he had prescribed 

 (a) formal mouth-washes and (6) a solution 

 of potassium iodide, in the treatment of 

 thrush (stomatitis). The two bottles stood 

 near each other, and the girl, on retiring, mis- 

 taking one for the other, took nearly 60 to 

 70 c.c. of the concentrated formal. Uncon- 

 sciousness, collapse, etc., ensued, and only 

 the prompt emptying of her stomach by the 

 j)hysician averted a fatal ending of the case. 

 Anuria persisted for twelve hours. 



(e) Testi| reports the case of a man who 

 by mistake swallowed a mouthful of a forty 

 per cent, solution of formaldehyd. The chief 

 symptoms were intense pain after swallowing, 

 followed by vomiting, intense congestion of 

 the face, conjunctivae, fauces and tonsils. For 

 two or three days his condition remained un- 

 changed; he was unable to swallow anything 

 but the smallest quantity of liquid. Two 

 large eschars formed on the fauces and tonsils. 

 Unlike most of the cases cited above, there was 

 no general stupor, anuria or the modifications 

 of pulse, temperature and respiration, which 

 may be accounted for upon the ground that 

 the prompt vomiting prevented absorption of 

 the poison into the system, its effect being 

 purely local. 



* Zorn, Miinch. med. Wochnschr., 1900, p. 1588. 

 t Gerlaeh, Miinch. med. Wochnschr., 1902, p. 

 1503. 

 t Testi, II PolicUnico, IX., 8, December 20, 1902. 



