§ 228 .] THE TAR ACIDS. 183 
solutions cause more or less destruction of the skin. Lemaire 1 describes 
the action of carbolic acid on the skin as causing a slight inflammation, 
with desquamation of the epithelium, followed by a very permanent 
brown stain ; but this he alone has observed. Applied to the mucous 
membrane, carbolic acid turns the epithelial covering white; the 
epithelium, however, is soon thrown off, and the place rapidly heals ; 
there is the same numbing, aconite-like feeling before noticed. The 
vapour of carbolic acid causes redness of the conjunctive, and irritation 
of the air-passages. If the application is continued, the mucous mem¬ 
brane swells, whitens, and pours out an abundant secretion. 
Dr Whitelock, of Greenock, has related two instances in which 
children were treated with carbolic acid lotion (strength 2| per cent.) as 
an application to the scalp for ringworm ; in both, symptoms of poisoning 
occurred—in the one, the symptoms at once appeared ; in the other, 
they were delayed some days. In order to satisfy his mind, the ex¬ 
periment was repeated twice, and each time gastric and urinary troubles 
followed. 
Nussbaum, of Munich, records a case 2 in which symptoms were in¬ 
duced by the forcible injection of a solution of carbolic acid into the cavity 
of an abscess. 
Macphail 3 gives two cases of poisoning by carbolic acid from ex¬ 
ternal use. In the one, a large tumour had been removed from a woman 
aged 30, and the wound covered with gauze steeped in a solution of 
carbolic acid in glycerin, strength 10 per cent. ; subsequently, there 
was high fever, with diminished sulphates in the urine, which smelt 
strongly of carbolic acid, and was very dark. On substituting boracic 
acid, none of these troubles were observed. The second case was that 
of a servant suffering from axillary abscess ; the wound was syringed 
out with carbolic acid solution, of strength 2f per cent., when effects 
were produced similar to those in the first case. It was noted that in 
both these cases the pulse was slowed. J. A. Raubenheimer 4 
describes the case of a child aged 6, prepared for operation on genu 
valgum of both sides by the nurse, who wrapped the legs from 
the ankles to the groin with towels impregnated with carbolic acid 
(1 : 40) ; in an hour the patient was sleepy, in two hours unconscious, 
cyanosed, and almost pulseless. In six hours the urine showed carboluria, 
which persisted for the next twenty-five hours ; the patient, under treat¬ 
ment, recovered. Scattered throughout surgical and medical literature, 
there are many other cases recorded, though not all so clear as those 
cited. Several cases are also on record in which poisonous symptoms (and 
1 Lemaire, Jul., De VAcide phenique , Paris, 1864. 
2 Leitfaden zur antiseptischer Wundbehandlung, S. 141. 
8 “ Carbolic Acid Poisoning (Surgical),” by S. Rutherford Macphail, M.B., Ed 
Med. Journal , cccxiv., Aug. 1881, p. 134. 4 Lancet, April 18, 1903. 
