115 POISONS : THEIR EFFECTS AND DETECTION. [§ 94 . 
digestion, etc. For example, in an interesting case related by Tartra , 1 
a woman, who had swallowed 42 grms. ( 1-5 oz.) of nitric acid, feeling 
acute pain, took immediately a quantity of water, and three hours after¬ 
wards was admitted into hospital, where she received appropriate treat¬ 
ment. At the end of a month she left, believing herself cured 5 but in 
a little while leturned, and was readmitted, suffering from marasmus, 
extreme weakness, and constant vomiting ; ultimately she died. The 
post-mortem examination revealed extreme contraction of the intestinal 
canal throughout. The lumen would hardly admit a penholder. The 
stomach was no larger than an ordinary intestine, and was adherent to 
adjacent organs ; on its internal surface there were spots, probably 
cicatrices ; there were also changes in the gullet, but not so marked. A 
somewhat similar case is related by the same author in his thirteenth 
observation. In the Middlesex Hospital there is preserved the stomach 
(No. 1363) of a man who died forty days after swallowing 2 ozs. of nitric 
acid diluted in a tumbler of water. The stomach is contracted, the 
mucous membrane of the lower part of the gullet, the lesser curvature, 
and the pyloric end of the stomach is extensively corroded, showing 
ulcerated patches commencing to cicatrise. 
§ 94. Post-mortem Appearances.— The pathological changes in 
the tongue, gullet, and stomach can be readily studied from the pre¬ 
parations in the different museums. The staining by the nitric acid 
appears unchanged to the naked eye for many years 5 hence, most of 
the nitric acid preparations are in an excellent state of preservation. 
A very good example of the pathological changes is to be found in 
Nos. 1049 and 1050, University College museum. 
No. 1049 presents the tongue, pharynx, and larynx of a man who had swallowed 
a teacupful of nitric acid. The epithelium of the oesophagus is for the most part 
wanting, and hangs in shreds ; the dorsum of the tongue, in front of the circumvallate 
papillae, is excavated, and over its central part superficially ulcerated ; in other places 
the tongue is encrusted with a thick, loose, fawn-coloured layer, formed probably 
of desquamated epithelium. The whole of the mucous surface is stained a dirty 
yellow. * J 
No. 1050 is a preparation showing the tongue, gullet, and stomach of a person 
who died from the effects of nitric acid. The tongue in places is smooth and glazed ; 
in others slightly depressed and excavated. On the anterior wall and upper portion 
of the gullet two large sloughs exist. 
Although perforation of the stomach is not so common with nitric as with sulphuric 
acid, such an accident may occur, as shown in a prepaiation at Guy’s Hospital, in 
which there is a perforation at the cardiac end. All the mucous membrane has dis¬ 
appeared, and the inner surface is for the most pait covered with flocculent shreds. 
Three ounces of nitric acid aro said to have been swallowed, and the patient lived 
seventeen hours. There is the usual staining. There is also in the Middlesex 
Hospital (No. 1364) the oesophagus and stomach of a woman aged 30, who died 
six hours after swallowing 2 to 3 ozs. of strong nitric acid. The inner coats of the 
mucous membrane of the gullet and stomach are in part converted into opaque yellow 
and black eschars, and in part to a shreddy, pulpy condition. At the most depending 
1 Op. cit. 
