HYDROCHLORIC ACID. 
§ 82.] 
109 
twenty-four hours. From the secondary effects, of course, death may 
take place at a remote period ; e.g., in a case recorded by Dr Duncan 
{Lancet, April 12, 1890), a man drank about 1 oz. of HC1 accidentally, 
was admitted to Charing Cross Hospital the same day, and treated with 
small quantities of sodium carbonate, and fed by the rectum. On the 
eighth day he brought up 34 oz. of blood ; in a month he left apparently 
perfectly well, but was admitted again in about six weeks, and died of 
contraction of the stomach and stricture of the pylorus on the ninety- 
fourth day. 
§ 82. Post-mortem Appearances. —The pathological appearances are 
very similar to those found in the case already detailed ; though the 
skin of the face may not be eroded in any way by the acid, yet the more 
delicate mucous membrane of the mouth, gullet, etc., appears mostly to 
be changed, and is usually white or whitish-brown. There is, however, 
in the museum of the Royal College of Surgeons the stomach and gullet 
(No. 2386c) of an infant 13 months old ; the infant drank a teacupful 
of strong hydrochloric acid, and died nine hours after the dose. The 
pharynx and the upper end of the gullet are quite normal, the corrosive 
action commencing at the lower end, so that, although the acid was con¬ 
centrated, not the slightest effect was produced on the delicate mucous 
membrane of the throat and upper part of the gullet. The lower end of 
the gullet and the whole of the stomach were intensely congested ; the 
rugae of the latter were ecchymosed and blackened by the action of 
the acid. There were also small haemorrhages in the lungs, which were 
ascribed to the action of the acid on the blood. Perforation of the 
stomach has not been noticed in hydrochloric acid poisoning. 
In Guy’s Hospital museum (prep. 1799 11 ), the stomach and duodenum 
of the case mentioned exhibit the mucous membrane considerably 
injected, with extravasations of blood, which, at the time when the 
preparation was first arranged, were of various hues, but are now some¬ 
what altered, through long keeping in spirit. In St George’s Hospital 
museum (ser. x. 43, d. 200) are preserved the stomach and part of the 
duodenum of a person who died from hydrochloric acid. The case is 
detailed in the Medical Times and Gazette for 1853, vol. ii. p. 513. The 
whole inner surface appears to be in a sloughing state, and the larynx 
and lung were also inflamed. In St Bartholomew’s Hospital museum 
(1946, f. 1899) are preserved the oesophagus and stomach of an infant 
aged 1 year who died from hydrochloric acid poisoning. The mucous 
membrane of the gullet is white and shrivelled, that of the stomach 
covered with large patches of a dark brown colour which represent 
altered blood. The effect ceases at the pylorus. 
A preparation, presented by Mr Bowman to King’s College Hospital 
museum, exhibits the effects of a very large dose of hydrochloric acid. 
The gullet has a shrivelled and worm-eaten appearance ; the stomach 
