AROMATIC GROUP 593 



Among the bodies of this group greatest interest is attached to phenol 

 (hydroxybenzol, carbolic acid), first, because, on account of the extensive medi- 

 cinal use of the drug, these cases of poisoning have become uncommonly fre- 

 quent, and secondly, because the course of this poisoning is similar in type to 

 that of poisoning by the hydroxylens of benzol. 



_ Phenol in concentrated solution causes the formation of eschars upon the 

 skin and mucous membrane; even local necroses may be produced or stub- 

 born acute eczemas vi^hich may be distributed over the entire body. In spite 

 of this, however, the dangers would be slight if these were the only effects of 

 the poison. But, introduced into the organism in somewhat larger quantities, 

 it gives rise to headache, vertigo, spasms, mydriasis, tinnitus aurium, severe 

 cyanosis and cardiac collapse, to which the patient may succumb in a short 

 time. Even a 2 to 3 per cent, solution injected in large quantity into the 

 pleural cavity, into the rectum, etc., may produce this effect. 



The diagnosis of pheno-toxicosis is easy. The characteristic odor of the 

 breath, the very dark, discolored urine, deficient in sulpho-sulphuric acid, 

 will at once identify the case. 



In regard to treatment, if the poison has been taken through the mouth, 

 the stomach should be washed at once. This is best done with water and wine 

 viaegar in equal amounts. The comatose stage should be treated with luke- 

 warm baths and cold affusions. Sugar of lime and sodium sulphite should be 

 employed as antidotes. 



The best practice is to be cautious in the use of carbolic acid and its 

 preparations for medical purposes, and the sale of unauthorized preparations 

 should be forbidden. Even dilute solutions should never be used for washing 

 out the cavities of the body. 



Chronic carbolic toxicosis is an evil to which many physicians were par- 

 ticularly exposed at the time when operations were carried on under the car- 

 bolic spray, a method which has now been abandoned. Dermatoses of all 

 varieties, loss of memory, renal affections — briefly, a marasmus praecox — are 

 the distressing symptoms of this toxicosis, which has now almost disappeared. 

 The prognosis is always serious. A number of physicians have succumbed 

 to this poisoning, but it is now rare. 



Analogous affections are produced by other derivatives of the phenol group, 

 particularly by the dioxybenzoles. Picric acid (trinitrophenol) causes, as an 

 important symptom, a yellow discoloration of the skin which is not due to 

 biliary coloring matter. 



Particular 'stress must be laid upon poisoning with fees salicylic acid, 

 as this has a highly corrosive effect upon the mucous membranes, and thus 

 gives rise to serious gastroenteritis. I emphasize this because, apparently 

 through ignorance of these facts, free salicylic acid is repeatedly advised 

 medicinally, and I desire to caution physicians against its use ! The salicylates 

 are also poisons, although local irritative effects are not peculiar to them; 

 taken in very large doses, or by individuals who are very susceptible to the 

 action of salicylic acid, they produce toxic phenomena consisting of transitory 

 amaurosis, difficulty in hearing, hematuria and hemoglobinuria. In contrast 

 with free salicylic acid, however, their effect is relatively slight: 

 39 



