94 POISONS : THEIR EFFECTS AND DETECTION. [§ 65 . 
Acids, however, if given in doses too great to be neutralised, alike 
affect plant- and flesh-eaters ; death follows in all cases before the 
blood becomes acid. Salkowski 1 has, indeed, shown that lessening 
the alkalinity of the blood by giving a rabbit food from which it 
can extract no alkali produces a similar effect to the actual dosing with 
an acid. 
2. Internal Effects of Sulphuric Acid. —When sulphuric acid is 
taken internally, the acute and immediate symptom is pain. This, 
however, is not constant, since, in a few recorded cases, no complaint of 
pain has been made ; but these cases are exceptional ; as a rule, there 
will be immediate and great suffering. The tongue swells, the throat 
is also swollen and inflamed, swallowing of saliva even may be im¬ 
possible. If the acid has been in contact with the epiglottis and vocal 
apparatus, there may be spasmodic croup and even fatal spasm of the 
glottis. 
The acid, in its passage down the gullet, attacks energetically the 
mucous membrane and also the lining of the stomach ; but the action 
does not stop there, for Lesser found in eighteen out of twenty-six cases 
(69 per cent.) that the corrosive action extended as far as the duodenum. 
There is excessive vomiting and retching ; the matters vomited are acid, 
bloody, and slimy ; great pieces of mucous membrane may be in this 
way expelled, and the whole of the lining membrane of the gullet may 
be thrown up entire. The bowels are, as a rule, constipated, but 
exceptionally there has been diarrhoea ; the urine is sometimes retained ; 
it invariably contains an excess of sulphates and often albumen, with 
hyaline casts of the uriniferous tubes. The pulse is small and frequent, 
the breathing slow, the skin very cold and covered with sweat ; the 
countenance expresses great anxiety, and the extremities may be affected 
with cramps or convulsions. Death may take place within from twenty- 
four to thirty-six hours, and be either preceded by dyspnoea or by con¬ 
vulsions ; consciousness is, as a rule, maintained to the end. 
There are also more rapid cases than the above ; a large dose of 
sulphuric acid taken on an empty stomach may absolutely dissolve it, 
and pass into the peritoneum ; in such a case there is really no difference 
in the symptoms between sudden perforation of the stomach from 
disease, a penetrating wound of the abdomen, and any other sudden 
fatal lesion of the organs in the abdominal cavity (for in all these 
instances the symptoms are those of pure collapse) ; the patient is ashen 
pale, with pulse quick and weak, and body bathed in cold sweat, and 
he rapidly dies, it may be without much complaint of local pain. 
If the patient live longer than twenty-four hours, the symptoms are 
mainly those of inflammation of the whole mucous tract, from the mouth 
to the stomach ; and from this inflammation the patient may die in a 
1 Virchow’s Archiv, lviii. 1. 
