1 86 POISONS : THEIR EFFECTS AND DETECTION. [§§ 23 O, 23 I. 
became livid, clonic convulsions came on, and at first loss of conscious¬ 
ness, which after an hour returned. The patient died on the ninth day. 
There was intense diphtheria of the uterus and vagina. Several other 
similar cases (although not attended with such marked or fatal effects) 
are on record. 1 
§ 230. The symptoms of carbolic acid poisoning admit of considerable 
variation from those already described. The condition is occasionally 
that of deep coma. The convulsions may be general, or may affect only 
certain groups of muscles. Convulsive twitchings of the face alone, 
and also muscular twitchings only of the legs, have been noticed. In all 
cases, however, a marked change occurs in the urine. Subissi 2 has 
noted the occurrence of abortion, both in the pig and the mare, as a 
result of carbolic acid, but this effect has not hitherto been recorded in 
the human subject. 
It has been experimentally shown by Kiister that previous loss of 
blood, or the presence of septic fever, renders animals more sensitive to 
carbolic acid. It is also said that children are more sensitive than adults. 
The course of carbolic acid poisoning is very rapid. In 35 cases 
collected by Falck, in which the period from the taking of the poison to 
the moment of death was accurately noted, the course was as follows :— 
12 patients died within the first hour, and in the second hour 3 ; so that 
within two hours 15 died. Between the third and the twelfth hour, 10 
died ; between the thirteenth and the twenty-fourth hour, 7 died ; and 
between the twenty-fifth and the sixtieth hour, only 3 died. Therefore, 
slightly over 71 per cent, died within twelve hours, and 91-4 per cent, 
within the twenty-four hours. 
§ 231. Changes in the Urine. —The urine of patients who have 
absorbed in any way carbolic acid is dark in colour, and may smell 
strongly of the acid. It is now established—chiefly by the experiments 
and observations of Baumann 3 —that carbolic acid, when introduced into 
the body, is mainly eliminated in the form of phenyl-sulphuric acid, 
C 6 H 5 HS0 4 , or more strictly speaking as potassic phenyl-sulphate, 
C 6 H 5 KS0 4 , a substance which is not precipitated by chloride of barium 
until it has been decomposed by boiling with a mineral acid. Cresol is 
similarly excreted as cresol sulphuric acid, C 6 H 4 CH 3 HS0 4 , ortho-, meta-, 
or para-, according to the kind of cresol injected ; a portion may also 
appear as hydro-tolu-chinone-sulphuric acid. Hence it is that, with doses 
1 A practitioner in Calcutta injected into the bowel of a boy, aged 5, an enema of 
diluted carbolic acid, which, according to his own statement, was 1 part in 60, and 
the whole quantity represented 144 grains of the acid. The child became insensible 
a few minutes after the operation, and died within four hours. There was no post¬ 
mortem examination ; the body smelt strongly of carbolic acid.— Lancet , May 19, 
1883. 
2 L'Archivio della Veterinaria Ital. t xi., 1874. 
3 Pfluger's Archiv, xiii., 1876, 289. 
