NITRIC ACID. 
§95-1 
119 
part of the stomach is a large ragged perforation, with pulpy margins, which allowed 
the contents of the stomach to escape into the peritoneal cavity. 
. In St Bartholomew’s museum there is a very good specimen (No. 1870) of the 
appearances in the gullet and stomach after poisoning by nitric acid. The case is 
detailed in St Bartholomew's Hospital Reports, vol. v. p. 247. A male died in fifteen 
hours after swallowing 1 oz. of nitric acid. The whole mucous membrane is wrinkled, 
or rather ploughed, into longitudinal furrows; the yellow discoloration stops abruptly, 
with an irregular border, at the commencement of the stomach, the epithelial and mucous 
coats of which are wanting—its surface being rough and of a brownish-red colour. 
The following preparations are to be found in the museum of the London 
Hospital:—A. b. 1 and A. b. 8. A. b. 1 shows the pharynx, oesophagus, larynx, 
and stomach of a young woman, who, after taking half an ounce of nitric acid, died 
in eight hours. The staining is very intense ; as an unusual feature, it may be 
noted that the larynx is almost as yellow as the oesophagus. The abrasion or solu¬ 
tion of the epithelium on the dorsum of the tongue has dissected out the circumvallate 
and fungiform papillae, so that they project with unusual distinctness. The lining 
membrane of the gullet throughout is divided into minute squares by longitudinal 
and transverse furrows. The mucous membrane of the stomach appears wholly 
destroyed, and presents a woolly appearance. 
A. b. 8 shows a very perfect cast of the oesophagus. The case was that of a 
woman, aged 35, who swallowed half an ounce of nitric acid. The symptoms for the 
first four days were the usual pain in the throat and stomach, which might be 
expected ; the bowels were freely open, and the stools dark and offensive. On the 
sixth day, there was constant vomiting with offensive breath ; on the ninth, the 
appearance of the patient was critical, and she threw up the cast preserved. She died 
on the tenth day after the taking of the acid. The gullet, stomach, trachea, and 
larynx were found after death much inflamed. 
The following preparations are in St Thomas’s Hospital :—P. 5. A stomach with 
gullet attached. The stomach is covered with yellowish-green patches of false mem¬ 
brane and deposit; the gullet has the usual longitudinal furrows so characteristic 
of corrosive fluids. 
P. 6 is also from a case of nitric acid poisoning. It shows the lining membrane 
of the stomach partly destroyed and shreddy, yet but little discoloured, the hue being 
a sort of delicate fawn. 
To these may be added a case described and figured by Lesser. To a baby, a few 
days old, an unknown quantity of fuming nitric acid was given ; the child made a 
gurgling, choking sound, and died in a few minutes. The corpse, nine days after 
death, showed no signs of decomposition. The tongue and gums were yellow, the 
gullet less so, the stomach still less, and the small intestine had no yellow tint; the 
whole of the mouth, gullet, and stomach showed the corrosive action of the acid. The 
graduation of tint, Lesser remarks, is what is not seen when the yellow colour is due 
to poisoning by chromic acid or by strong solution of ferric perchloride ; in such 
cases, wherever the liquid has gone, there is a yellowness. 1 
§ 95. Detection and Estimation of Nitric Acid. —The detection 
either of free nitric acid or of its salts is not difficult. Free nitric acid, 
after preliminary estimation of the total acidity by decinormal soda, 
may be separated by the quinine process given at p. 98. On pre¬ 
cipitation by ammonia or soda solution, the nitrate of ammonia or soda 
(and, it may be, other similarly combined acids) remain in solution. 
If free nitric acid is present in small quantity only, it may be necessary 
to evaporate the filtrate from the quinine nearly to dryness, and to 
test the concentrated liquid for nitric acid. The ordinary tests are as 
follows :— 
1 A. Lesser, Atlas der gerichtlichen Medicin, Berlin, 1884, Tafel i. fig. 2. 
