NITRIC ACID. 
§ 93-] 
ii 7 
organic matters, there is almost constantly a development of gas. The 
tissue is first bleached, and then becomes of a more or less intense 
yellow colour. Nitric acid spots on the skin are not removed by 
ammonia, but become of an orange-red when moistened with potash 
and a solution of cyanide of potassium. The yellow colour seems to 
show that picric acid is one of the constant products of the reaction ; 
sulphide of ammonium forms a sort of soap with the epidermis thus 
attacked, and detaches it. 
§ 93. Symptoms. —The symptoms and course of nitric acid poison¬ 
ing differ in a few details only from those of sulphuric acid. There 
is the same instant pain and frequent vomiting, destruction of the 
mucous membranes, and, in the less severe cases, after-contraction of 
the gullet, etc. 
One of the differences in the action of nitric and sulphuric acids is 
the constant development of gas with the former. This, without doubt, 
adds to the suffering. Tartra made several experiments on dead 
bodies, and showed that very considerable distension of the intestinal 
canal, by gaseous products, was the constant result ; the tissues were 
corroded and almost dissolved, being transformed, ultimately, into a 
sort of greasy paste. The vomited matters are of a yellow colour, 
unless mixed with blood, when they are of a dirty brown hue, with 
shreds of yellow mucus, and have the strong acid reaction and smell 
of nitric acid. The teeth may be partially attacked from the solvent 
action of the acid on the enamel. The fauces and tongue, at first 
blanched, soon acquire a citron-yellow or even a brown colour ; the 
whole cavity may swell and inflame, rendering the swallowing of liquids 
difficult, painful, and sometimes impossible. The air-passages may 
also become affected, and in one case tracheotomy was performed 
for the relief of the breathing. 1 The stomach rejects all remedies ; 
there are symptoms of collapse ; quick, weak pulse, frequent shivering, 
obstinate constipation, and death (often preceded by a kind of stupor) 
in from eighteen to twenty-four hours. The intellectual faculties 
remain clear, save in a few rare instances. 
C. A. Wunderlich has recorded an unusual case, in which the 
symptoms were those of dysentery, and the large intestine was found 
acutely inflamed, while the small one was little affected. The kidneys 
had the same appearance as in Bright’s disease. 2 Should the dose 
of nitric acid be insufficient to kill at once, or, what amounts to the 
same thing, should the acid be immediately diluted with water, or in some 
way be neutralised, the patient, as in the case of sulphuric acid, may 
yet die at a variable future time from stenosis of the gullet, impaired 
1 Amott, Med. Gaz., vol. xii. p. 220. 
2 De Actionibus quibusdam Acidi Nitrici Caustico in Corpus Humanum immissi. 
Programma Academ., Lipsiae, 1857, p. 4. 
