I.—Sulphuric Acid.

§ 51. Sulphuric acid (hydric sulphate, oil of vitriol, H2SO4) occurs in commerce in varying degrees of strength or dilution; the strong sulphuric acid of the manufacturer, containing 100 per cent. of real acid (H2SO4), has a specific gravity of 1·850. The ordinary brown acid of commerce, coloured by organic matter and holding in solution metallic impurities, chiefly lead and arsenic, has a specific gravity of about 1·750; and contains 67·95 of anhydrous SO3 = 85·42 of hydric sulphate.

There are also weaker acids used in commerce, particularly in manufactories in which sulphuric acid is made, for special purposes without rectification. The British Pharmacopœia sulphuric acid is directed to be of 1·843 specific gravity, which corresponds to 78·6 per cent. sulphuric anhydride, or 98·8 per cent. of hydric sulphate. The dilute sulphuric acid of the pharmacopœia should have a specific gravity of 1·094, and is usually said to correspond to 10·14 per cent. of anhydrous sulphuric acid; but, if Ure’s Tables are correct, such equals 11·37 per cent.

The general characters of sulphuric acid are as follows:—When pure, it is a colourless, or, when impure, a dark brown to black, oily liquid, without odour at common temperatures, of an exceedingly acid taste, charring most organic tissues rapidly, and, if mixed with water, evolving much heat. If 4 parts of the strong acid are mixed with 1 part of water at 0°, the mixture rises to a heat of 100°; a still greater heat is evolved by mixing 75 parts of acid with 27 of water.

Sulphuric acid is powerfully hygroscopic—3 parts will, in an ordinary atmosphere, increase to nearly 4 in twenty-four hours; in common with all acids, it reddens litmus, yellows cochineal, and changes all vegetable colours. There is another form of sulphuric acid, extensively used in the arts, known under the name of “Nordhausen sulphuric acid,” “fuming acid,” formula H2S2O4. This acid is produced by the distillation of dry ferrous sulphate, at a nearly white heat—either in earthenware or in green glass retorts; the distillate is received in sulphuric acid. As thus manufactured, it is a dark fuming liquid of 1·9 specific gravity, and boiling at 53°. When artificially cooled down to 0°, the acid gradually deposits crystals, which consist of a definite compound of 2 atoms of anhydrous sulphuric acid and 1 atom of water. There is some doubt as to the molecular composition of Nordhausen acid; it is usually considered as hydric sulphate saturated with sulphur dioxide. This acid is manufactured chiefly in Bohemia, and is used, on a large scale, as a solvent for alizarine.

§ 52. Sulphur Trioxide, or Sulphuric Anhydride (SO3), itself may be met with in scientific laboratories, but is not in commerce. Sulphur trioxide forms thin needle-shaped crystals, arranged in feathery groups. Seen in mass, it is white, and has something the appearance of asbestos. It fuses to a liquid at about 18°, boils at 35°, but, after this operation has been performed, the substance assumes an allotropic condition, and then remains solid up to 100°; above 100° it melts, volatilises, and returns to its normal condition. Sulphuric anhydride hisses when it is thrown into water, chemical combination taking place and sulphuric acid being formed. Sulphur trioxide is excessively corrosive and poisonous.

Besides the above forms of acid, there is an officinal preparation called “Aromatic Sulphuric Acid,” made by digesting sulphuric acid, rectified spirit, ginger, and cinnamon together. It contains 10·19 per cent. of SO3, alcohol, and principles extracted from cinnamon and ginger.

§ 53. Sulphuric acid, in the free state, may not unfrequently be found in nature. The author has had under examination an effluent water from a Devonshire mine, which contained more than one grain of free sulphuric acid per gallon, and was accused, with justice, of destroying the fish in a river. It also exists in large quantities in volcanic springs. In a torrent flowing from the volcano of Parcé, in the Andes, Boussingault calculated that 15,000 tons of sulphuric acid and 11,000 tons of hydrochloric acid were yearly carried down. In the animal and vegetable kingdom, sulphuric acid exists, as a rule, in combination with bases, but there is an exception in the saliva of the Dolium galea, a Sicilian mollusc.

§ 54. Statistics.—When something like 900,000 tons of sulphuric acid are produced annually in England alone, and when it is considered that sulphuric acid is used in the manufacture of most other acids, in the alkali trade, in the manufacture of indigo, in the soap trade, in the manufacture of artificial manure, and in a number of technical processes, there is no cause for surprise that it should be the annual cause of many deaths.

The number of deaths from sulphuric acid will vary, other things being equal, in each country, according to the manufactures in that country employing sulphuric acid. The number of cases of poisoning in England and Wales for ten years is given in the following table:—

DEATHS FROM SULPHURIC ACID IN ENGLAND AND WALES FOR THE TEN YEARS ENDING 1892.

Accident or Negligence.
Ages,1-55-1515-2525-6565 &
upwards		Total
Males,114214233
Females,4...23...9
Totals,154417242
Suicide.
Ages, 15-2525-65 Total
Males, 425 29
Females, 519 24
Totals 944 53

During the ten years, no case of murder through sulphuric acid is on record; hence the total deaths, as detailed in the tables, amount to 95, or a little over 9 a year.

Falck,[64] in comparing different countries, considers the past statistics to show that in France sulphuric acid has been the cause of 4·5 to 5·5 per cent. of the total deaths from poison, and in England 5·9 per cent. In England, France, and Denmark, taken together, 10·8, Prussia 10·6; while in certain cities, as Berlin and Vienna, the percentages are much higher—Vienna showing 43·3 per cent., Berlin 90 per cent.

[64] Lehrbuch der praktischen Toxicologie, p. 54.

§ 55. Accidental, Suicidal, and Criminal Poisoning.—Deaths from sulphuric acid are, for the most part, accidental, occasionally suicidal, and, still more rarely, criminal. In 53 out of 113 cases collected by Böhm, in which the cause of the poisoning could, with fair accuracy, be ascertained, 45·3 per cent. were due to accident, 30·2 were suicidal, and 24·5 per cent. were cases of criminal poisoning, the victims being children.

The cause of the comparatively rare use of sulphuric acid by the poisoner is obvious. First of all, the acid can never be mixed with food without entirely changing its aspect; next, it is only in cases of insensibility or paralysis that it could be administered to an adult, unless given by force, or under very exceptional circumstances; and lastly, the stains on the mouth and garments would at once betray, even to uneducated persons, the presence of something wrong. As an agent of murder, then, sulphuric acid is confined in its use to young children, more especially to the newly born.

There is a remarkable case related by Haagan,[65] in which an adult man, in full possession of his faculties, neither paralysed nor helpless, was murdered by sulphuric acid. The wife of a day-labourer gave her husband drops of sulphuric acid on sugar, instead of his medicine, and finally finished the work by administering a spoonful of the acid. The spoon was carried well to the back of the throat, so that the man took the acid at a gulp. 11 grms. (171 grains) of sulphuric acid, partly in combination with soda and potash, were separated from his stomach.

[65] Gross: Die Strafrechtspflege in Deutschland, 4, 1861, Heft I. S. 181.

Accidental poisoning is most common among children. The oily, syrupy-looking sulphuric acid, when pure, may be mistaken for glycerin or for syrup; and the dark commercial acid might, by a careless person, be confounded with porter or any dark-looking medicine.

Serious and fatal mistakes have not unfrequently arisen from the use of injections. Deutsch[66] relates how a midwife, in error, administered to mother and child a sulphuric acid clyster; but little of the fluid could in either case have actually reached the rectum, for the mother recovered in eight days, and in a little time the infant was also restored to health. Sulphuric acid has caused death by injections into the vagina. H. C. Lombard[67] observed a case of this kind, in which a woman, aged thirty, injected half a litre of sulphuric acid into the vagina, for the purpose of procuring abortion. The result was not immediately fatal, but the subsequent inflammation and its results so occluded the natural passage that the birth became impossible, and a Cæsarean section extracted a dead child, the mother also dying.

[66] Preuss. Med. Vereins-Zeitung, 1848, No. 13.

[67] Journ. de Chim. Méd., tom. vii., 1831.

An army physician prescribed for a patient an emollient clyster. Since it was late at night, and the apothecary in bed, he prepared it himself; but not finding linseed oil, woke the apothecary, who took a bottle out of one of the recesses and placed it on the table. The bottle contained sulphuric acid; a soldier noticed a peculiar odour and effervescence when the syringe was charged, but this was unheeded by the doctor. The patient immediately after the operation suffered the most acute agony, and died the following day; before his death, the bedclothes were found corroded by the acid, and a portion of the bowel itself came away.[68]

[68] Maschka’s Handbuch, p. 86; Journal de Chimie Médicale, t. i. No. 8, 405, 1835.

§ 56. Fatal Dose.—The amount necessary to kill an adult man is not strictly known; fatality so much depends on the concentration of the acid and the condition of the person, more especially whether the stomach is full or empty, that it will be impossible ever to arrive at an accurate estimate. Christison’s case, in which 3·8 grms. (60 grains) of concentrated acid killed an adult, is the smallest lethal dose on record. Supposing that the man weighed 681⁄2 kilo. (150 lbs.), this would be in the proportion of ·05 grm. per kilo. There is also the case of a child of one year, recorded by Taylor, in which 20 drops caused death. If, however, it were asked in a court of law what dose of concentrated sulphuric acid would be dangerous, the proper answer would be: so small a quantity as from 2 to 3 drops of the strong undiluted acid might cause death, more especially if conveyed to the back of the throat; for if it is improbable that on such a supposition death would be sudden, yet there is a possibility of permanent injury to the gullet, with the result of subsequent contraction, and the usual long and painful malnutrition thereby induced. It may be laid down, therefore, that all quantities, even the smallest, of the strong undiluted acid come under the head of hurtful, noxious, and injurious.

§ 57. Local Action of Sulphuric Acid.—The action of the acid on living animal tissues has been studied of late by C. Ph. Falck and L. Vietor.[69] Concentrated acid precipitates albumen, and then redissolves it; fibrin swells and becomes gelatinous; but if the acid is weak (e.g., 4 to 6 per cent.) it is scarcely changed. Muscular fibre is at first coloured amber-yellow, swells to a jelly, and then dissolves to a red-brown turbid fluid. When applied to the mucous membrane of the stomach, the mucous tissue and the muscular layer beneath are coloured white, swell, and become an oily mass.

[69] Deutsche Klinik, 1864, Mo. 1-32, and Vietor’s Inaugur.-Dissert., Marburg, 1803.

When applied to a rabbit’s ear,[70] the parenchyma becomes at first pale grey and semi-transparent at the back of the ear; opposite the drop of acid appear spots like grease or fat drops, which soon coalesce. The epidermis with the hair remains adherent; the blood-vessels are narrowed in calibre, and the blood, first in the veins, and then in the arteries, is coloured green and then black, and fully coagulates. If the drop, with horizontal holding of the ear, is dried in, an inflammatory zone surrounds the burnt spot in which the blood circulates; but there is complete stasis in the part to which the acid has been applied. If the point of the ear is dipped in the acid, the cauterised part rolls inwards; after the lapse of eighteen hours the part is brown and parchment-like, with scattered points of coagulated blood; then there is a slight swelling in the healthy tissues, and a small zone of redness; within fourteen days a bladder-like greenish-yellow scab is formed, the burnt part itself remaining dry. The vessels from the surrounding zone of redness gradually penetrate towards the cauterised spot, the fluid in the bleb becomes absorbed, and the destroyed tissues fall off in the form of a crust.

[70] Samuel, Entzündung u. Brand, in Virchow’s Archiv f. Path. Anat., Bd. 51, Hft. 1 u. 2, S. 41, 1870.

The changes that sulphuric acid cause in blood are as follows: the fibrin is at first coagulated and then dissolved, and the colouring matter becomes of a black colour. These changes do not require the strongest acid, being seen with an acid of 60 per cent.

§ 58. The action of the acid on various non-living matters is as follows: poured on all vegetable earth, there is an effervescence, arising from decomposition of carbonates; any grass or vegetation growing on the spot is blackened and dies; an analysis of the layer of earth, on which the acid is poured, shows an excess of sulphates as compared with a similar layer adjacent; the earth will only have an acid reaction, if there has been more than sufficient acid to neutralise all alkalies and alkaline earths.

Wood almost immediately blackens, and the spot remains moist.

Spots on paper become quickly dark, and sometimes exhibit a play of colours, such as reddish-brown; ultimately the spot becomes very black, and holes may be formed; even when the acid is dilute, the course is very similar, for the acid dries in, until it reaches a sufficient degree of concentration to attack the tissue. I found small drops of sulphuric acid on a brussels carpet, which had a red pattern on a dark green ground with light green flowers, act as follows: the spots on the red at the end of a few hours were of a dark maroon colour, the green was darkened, and the light green browned; at the end of twenty-four hours but little change had taken place, nor could any one have guessed the cause of the spots without a close examination. Spots of the strong acid on thin cotton fabrics rapidly blackened, and actual holes were formed in the course of an hour; the main difference to the naked eye, between the stains of the acid and those produced by a red-hot body, lay in the moistness of the spots. Indeed, the great distinction, without considering chemical evidence, between recent burns of clothing by sulphuric acid and by heat, is that in the one case—that of the acid—the hole or spot is very moist; in the other very dry. It is easy to imagine that this distinction may be of importance in a legal investigation.

Spots of acid on clothing fall too often under the observation of all those engaged in practical chemical work. However quickly a spot of acid is wiped off, unless it is immediately neutralised by ammonia, it ultimately makes a hole in the cloth; the spot, as a rule, whatever the colour of the cloth, is of a blotting-paper red.

Sulphuric acid dropped on iron, attacks it, forming a sulphate, which may be dissolved out by water. If the iron is exposed to the weather the rain may wash away all traces of the acid, save the corrosion; but it would be under those circumstances impossible to say whether the corrosion was due to oxidation or a solvent.

To sum up briefly: the characters of sulphuric acid spots on organic matters generally are black, brown, or red-coloured destructions of tissue, moisture, acid-reaction (often after years), and lastly the chemical evidence of sulphuric acid or sulphates in excess.

Caution necessary in judging of Spots, &c.—An important case, related by Maschka, shows the necessity of great caution in interpreting results, unless all the circumstances of a case be carefully collated. A live coal fell on the bed of a weakly infant, five months old. The child screamed, and woke the father, who was dozing by the fire; the man, in terror, poured a large pot of water on the child and burning bed. The child died the following day.

A post-mortem examination showed a burn on the chest of the infant 2 inches in length. The tongue, pharynx, and gullet were all healthy; in the stomach a patch of mucous membrane, about half an inch in extent, was found to be brownish, friable, and very thin. A chemical examination showed that the portion of the bed adjacent to the burnt place contained free sulphuric acid. Here, then, was the following evidence: the sudden death of a helpless infant, a carbonised bed-cover with free sulphuric acid, and, lastly, an appearance in the stomach which, it might be said, was not inconsistent with sulphuric acid poisoning. Yet a careful sifting of the facts convinced the judges that no crime had been committed, and that the child’s death was due to disease. Afterwards, experiment showed that if a live coal fall on to any tissue, and be drenched with water, free sulphuric acid is constantly found in the neighbourhood of the burnt place.

§ 59. Symptoms.—The symptoms may be classed in two divisions, viz.:—1. External effects of the acid. 2. Internal effects and symptoms arising from its interior administration.

1. External Effects.—Of late years several instances have occurred in which the acid has been used criminally to cause disfiguring burns of the face. The offence has in all these cases been committed by women, who, from motives of revengeful jealousy, have suddenly dashed a quantity of the acid into the face of the object of their resentment. In such cases, the phenomena observed are not widely different from those attending scalds or burns from hot neutral fluids. There is destruction of tissue, not necessarily deep, for the acid is almost immediately wiped off; but if any should reach the eye, inflammation, so acute as to lead to blindness, is the probable consequence. The skin is coloured at first white, at a later period brown, and part of it may be, as it were, dissolved. If the tract or skin touched by the acid is extensive, death may result. The inflammatory processes in the skin are similar to those noticed by Falck and Vietor in their experiments, already detailed ([p. 79]).

Internal Effects of Acids generally.—It may not be out of place, before speaking of the internal effects of sulphuric acid, to make a few remarks upon the action of acids generally. This action differs according to the kind of animal; at all events, there is a great difference between the action of acids on the herb-eating animals and the carnivora; the latter bear large doses of acids well, the former ill. For instance, the rabbit, if given a dose of any acid not sufficient to produce local effects but sufficient to affect its functions, will soon become paralysed and lie in a state of stupor, as if dead; the same dose per kilo. will not affect the dog. The reason for this is that the blood of the dog is able to neutralise the acid by ammonia, and that the blood of the rabbit is destitute of this property. Man is, in this respect, nearer to the dog than to the plant-eaters. Stadelmann has shown that a man is able to ingest large relative doses of oxybutyric acid, to neutralise the acid by ammonia, and to excrete it by means of the kidneys as ammonium butyrate.

Acids, however, if given in doses too great to be neutralised, alike affect plant- and flesh-eaters; death follows in all cases before the blood becomes acid. Salkowsky[71] has, indeed, shown that the effect of lessening the alkalinity of the blood by giving a rabbit food from which it can extract no alkali produces a similar effect to the actual dosing with an acid.

[71] Virchow’s Archiv, Bd. 58, 1.

2. Internal Effects of Sulphuric Acid.—When sulphuric acid is taken internally, the acute and immediate symptom is pain. This, however, is not constant, since, in a few recorded cases, no complaint of pain has been made; but these cases are exceptional; as a rule, there will be immediate and great suffering. The tongue swells, the throat is also swollen and inflamed, swallowing of saliva even may be impossible. If the acid has been in contact with the epiglottis and vocal apparatus, there may be spasmodic croup and even fatal spasm of the glottis.

The acid, in its passage down the gullet, attacks energetically the mucous membrane and also the lining of the stomach; but the action does not stop there, for Lesser found in eighteen out of twenty-six cases (69 per cent.) that the corrosive action extended as far as the duodenum. There is excessive vomiting and retching; the matters vomited are acid, bloody, and slimy; great pieces of mucous membrane may be in this way expelled, and the whole of the lining membrane of the gullet may be thrown up entire. The bowels are, as a rule, constipated, but exceptionally there has been diarrhœa; the urine is sometimes retained; it invariably contains an excess of sulphates and often albumen, with hyaline casts of the uriniferous tubes. The pulse is small and frequent, the breathing slow, the skin very cold and covered with sweat; the countenance expresses great anxiety, and the extremities may be affected with cramps or convulsions. Death may take place within from twenty-four to thirty-six hours, and be either preceded by dyspnœa or by convulsions; consciousness is, as a rule, maintained to the end.

There are also more rapid cases than the above; a large dose of sulphuric acid taken on an empty stomach may absolutely dissolve it, and pass into the peritoneum; in such a case there is really no difference in the symptoms between sudden perforation of the stomach from disease, a penetrating wound of the abdomen, and any other sudden fatal lesion of the organs in the abdominal cavity (for in all these instances the symptoms are those of pure collapse); the patient is ashen pale, with pulse quick and weak, and body bathed in cold sweat, and he rapidly dies, it may be without much complaint of local pain.

If the patient live longer than twenty-four hours, the symptoms are mainly those of inflammation of the whole mucous tract, from the mouth to the stomach; and from this inflammation the patient may die in a variable period, of from three to eleven days, after taking the poison. In one case the death occurred suddenly, without any immediately preceding symptoms rendering imminent death probable. If this second stage is passed, then the loss of substance in the gullet and in the stomach almost invariably causes impairment of function, leading to a slow and painful death. The common sequence is stricture of the gullet, combined with feeble digestion, and in a few instances stricture of the pylorus. A curious sequel has been recorded by Mannkopf, viz., obstinate intercostal neuralgia; it has been observed on the fourth, seventh, and twenty-second day.

§ 60. Treatment of Acute Poisoning by the Mineral Acids.—The immediate indication is the dilution and neutralisation of the acid. For this purpose, finely-divided chalk, magnesia, or sodic carbonate may be used, dissolved or suspended in much water. The use of the stomach-pump is inadvisable, for the mucous membrane of the gullet may be so corroded by the acid that the passage of the tube down will do injury; unless the neutralisation is immediate, but little good is effected; hence it will often occur that the bystanders, if at all conversant with the matter, will have to use the first thing which comes to hand, such as the plaster of a wall, &c.; and lastly, if even these rough antidotes are not to be had, the best treatment is enormous doses of water, which will dilute the acid and promote vomiting. The treatment of the after-effects belongs to the province of ordinary medicine, and is based upon general principles.

§ 61. Post-mortem Appearances.[72]—The general pathological appearances to be found in the stomach and internal organs differ according as the death is rapid or slow; if the death takes place within twenty-four hours, the effects are fairly uniform, the differences being only in degree; while, on the other hand, in those cases which terminate fatally from the more remote effects of the acid, there is some variety. It may be well to select two actual cases as types, the one patient dying from acute poisoning, the other surviving for a time, and then dying from ulceration and contraction of the digestive tract.

[72] It has been observed that putrefaction in cases of death from sulphuric acid is slow. Casper suggests this may be due to the neutralisation of ammonia; more probably it is owing to the antiseptic properties all mineral acids possess.

A hatter, early in the morning, swallowed a large mouthful of strong sulphuric acid, a preparation which he used in his work—(whether the draught was taken accidentally or suicidally was never known). He died within two hours. The whole tongue was sphacelated, parts of the mucous membrane being dissolved; the inner surface of the gullet, as well as the whole throat, was of a grey-black colour; the mucous membrane of the stomach was coal-black, and so softened that it gave way like blotting-paper under the forceps, the contents escaping into the cavity of the abdomen. The peritoneum was also blackened as if burnt; probably there had been perforation of the stomach during life; the mucous membrane of the duodenum was swollen, hardened, and looked as if it had been boiled; while the blood was of a cherry-red colour, and of the consistence of a thin syrup. The rest of the organs were healthy; a chemical research on the fluid which had been collected from the stomach, gullet, and duodenum showed that it contained 87·25 grains of free sulphuric acid.[73]

[73] Casper, vol. ii. case 194.

This is, perhaps, the most extreme case of destruction on record; the cause of the unusually violent action is referable to the acid acting on an empty stomach. It is important to note that even with this extensive destruction of the stomach, life was prolonged for two hours.

The case I have selected to serve as a type of a chronic but fatal illness produced from poisoning by sulphuric acid is one related by Oscar Wyss. A cook, thirty-four years of age, who had suffered many ailments, drank, on the 6th of November 1867, by mistake, at eight o’clock in the morning, two mouthfuls of a mixture of 1 part of sulphuric acid and 4 of water. Pain in the stomach and neck, and vomiting of black masses, were the immediate symptoms, and two hours later he was admitted into the hospital in a state of collapse, with cold extremities, cyanosis of the face, &c. Copious draughts of milk were given, and the patient vomited much, the vomit still consisting of black pultaceous matters, in which, on a microscopical examination, could be readily detected columnar epithelium of the stomach and mucous tissue elements. The urine was of specific gravity 1·033, non-albuminous; on analysis it contained 3·388 grms. of combined sulphuric acid.

On the second day there was some improvement in the symptoms; the urine contained 1·276 grm. of combined sulphuric acid; on the third day 2·665 grms. of combined sulphuric acid; and on the tenth day the patient vomited up a complete cast of the mucous membrane of the gullet. The patient remained in the hospital, and became gradually weaker from stricture of the gullet and impairment of the digestive powers, and died, two months after taking the poison, on the 5th of January 1868.

The stomach was found small, contracted, with many adhesions to the pancreas and liver; it was about 12 centimetres long (4·7 inches), and from 2 to 2·5 centimetres (·7 to ·9 inch) broad, contracted to somewhat the form of a cat’s intestine; there were several transverse rugæ; the walls were thickened at the small curvature, measurements giving 5 mm. (·19 inch) in the middle, and beyond about 2·75 mm. (·11 inch); in the upper two-thirds the lumen was so contracted as scarcely to admit the point of the little finger. The inner surface was covered with a layer of pus, with no trace of mucous tissue, and was everywhere pale red, uneven, and crossed by cicatricial bands. In two parts, at the greater curvature, the mucous surface was strongly injected in a ring-like form, and in the middle of the ring was a deep funnel-shaped ulcer; a part of the rest of the stomach was strongly injected and scattered over with numerous punctiform, small, transparent bladders. The gullet was contracted at the upper part (just below the epiglottis) from 20 to 22 mm. (·78 to ·86 inch) in diameter; it then gradually widened to measure about 12 mm. (·47 inch) at the diaphragm; in the neighbourhood of the last contraction the tissue was scarred, injected, and ulcerated; there were also small abscesses opening into this portion of the gullet.

E. Fraenkel and F. Reiche[74] have studied the effects of sulphuric acid on the kidney. In rapid cases they find a wide-spread coagulation of the epithelium in the convoluted and straight urinary canaliculi, with destruction of the kidney parenchyma, but no inflammation.

[74] Virchow’s Archiv, Bd. 131, f. 130.

§ 62. The museums of the different London hospitals afford excellent material for the study of the effects of sulphuric acid on the pharynx, gullet, and stomach; and it may be a matter of convenience to students if the more typical examples at these different museums be noticed in detail, so that the preparations themselves may be referred to.

In St. Bartholomew’s Museum, No. 1942, is an example of excessive destruction of the stomach by sulphuric acid. The stomach is much contracted, and has a large aperture with ragged edges; the mucous membrane is thickened, charred, and blackened.

No. 1941, in the same museum, is the stomach of a person who died from a large dose of sulphuric acid. When recent, it is described as of a deep red colour, mottled with black; appearances which, from long soaking in spirit, are not true at the present time; but the rough, shaggy state of the mucous tissue can be traced; the gullet and the pylorus appear the least affected.

St. George’s Hospital, ser. ix., 146, 11 and 43, e.—The pharynx and œsophagus of a man who was brought into the hospital in a state of collapse, after a large but unknown dose of sulphuric acid. The lips were much eroded, the mucous membrane of the stomach, pharynx, and œsophagus show an extraordinary shreddy condition; the lining membrane of the stomach is much charred, and the action has extended to the duodenum; the muscular coat is not affected.

Guy’s Hospital, No. 1799.—A preparation showing the mucous membrane of the stomach entirely denuded. The organ looks like a piece of thin paper.

No. 179920. The stomach of a woman who poisoned herself by drinking a wine-glassful of acid before breakfast. She lived eleven days. The main symptoms were vomiting and purging, but there was no complaint of pain. There is extensive destruction of mucous membrane along the lesser curvature and towards the pyloric extremity; a portion of the mucous membrane is floating as a slough.

No. 179925 is the gullet and stomach of a man who took about 3 drachms of the strong acid. He lived three days without much apparent suffering, and died unexpectedly. The lining membrane of the œsophagus has the longitudinal wrinkles or furrows so often, nay, almost constantly, met with in poisoning by the acids. The mucous tissue of the stomach is raised in cloudy ridges, and blackened.

No. 179935 is a wonderfully entire cast of the gullet from a woman who swallowed an ounce of sulphuric acid, and is said, according to the catalogue, to have recovered.

University College.—In this museum will be found an exquisite preparation of the effects of sulphuric acid. The mucous membrane of the œsophagus is divided into small quadrilateral areas by longitudinal and transverse furrows; the stomach is very brown, and covered with shreddy and filamentous tissue; the brown colour is without doubt the remains of extravasated and charred blood.

No. 6201 is a wax cast representing the stomach of a woman who died after taking a large dose of sulphuric acid. A yellow mass was found in the stomach; there are two perforations, and the mucous membrane is entirely destroyed.

§ 63. Chronic Poisoning by Sulphuric Acid.—Weiske[75] has experimentally proved that lambs, given for six months small doses of sulphuric acid, grow thin, and their bones, with the exception of the bones of the head and the long bones, are poor in lime salts, the muscles also are poor in the same constituents. Kobert[76] thinks that drunkards on the continent addicted to “Schnaps,” commonly a liquid acidified with sulphuric acid to give it a sharp taste, often show typical chronic sulphuric acid poisoning.

[75] H. Weiske, Journ. f. Landwirthsch., 1887, 417.

[76] Lehrbuch der Intoxicationen, S. 210.

Detection and Estimation of Free Sulphuric Acid.

§ 64. The general method of separating the mineral acids is as follows: the tissues, or matters, are soaked in distilled water for some time. If no free acid is present, the liquid will not redden litmus-paper, or give an acid reaction with any of the numerous tinctorial agents in use by the chemist for the purposes of titration. After sufficient digestion in water, the liquid extract is made up to some definite bulk and allowed to subside. Filtration is unnecessary. A small fractional part (say, for example, should the whole be 250 c.c., 1⁄100th or 2·5 c.c.) is taken, and using as an indicator cochineal or phenolphthalein, the total acidity is estimated by a decinormal solution of soda. By this preliminary operation, some guide for the conduct of the future more exact operations is obtained. Should the liquid be very acid, a small quantity of the whole is to be now taken, but if the acidity is feeble, a larger quantity is necessary, and sufficient quinine then added to fix the acid—100 parts of sulphuric acid are saturated by 342 parts of quinine monohydrate. Therefore, on the supposition that all the free acid is sulphuric, it will be found sufficient to add 3·5 parts of quinine for every 1 part of acid, estimated as sulphuric, found by the preliminary rough titration; and as it is inconvenient to deal with large quantities of alkaloid, a fractional portion of the liquid extract (representing not more than 50 mgrms. of acid) should be taken, which will require 175 mgrms. of quinine.

On addition of the quinine, the neutralised liquid is evaporated to dryness, or to approaching dryness, and then exhausted by strong alcohol. The alcoholic extract is, after filtration, dried up, and the quinine sulphate, nitrate, or hydrochlorate, as the case may be, filtered off and extracted by boiling water, and precipitated by ammonia, the end result being quinine hydrate (which may be filtered off and used again for similar purposes) and a sulphate, nitrate or chloride of ammonia in solution. It therefore remains to determine the nature and quantity of the acids now combined with ammonia. The solution is made up to a known bulk, and portions tested for chlorides by nitrate of silver, and for nitrates by the copper or the ferrous sulphate test. If sulphuric acid is present, there will be a precipitate of barium sulphate, which, on account of its density and insolubility in nitric or hydrochloric acids, is very characteristic. For estimating the sulphuric acid thus found, it will only be necessary to take a known bulk of the same liquid, heat it to boiling after acidifying by hydrochloric acid, and then add a sufficient quantity of baric chloride solution. Unless this exact process is followed, the analyst is likely to get a liquid which refuses to filter clear, but if the sulphate be precipitated from a hot liquid, it usually settles rapidly to the bottom of the vessel, and the supernatant fluid can be decanted clear; the precipitate is washed by decantation, and ultimately collected on a filter, dried, and weighed.

The sulphate of baryta found, multiplied by ·3434, equals the sulphuric anhydride.

The older process was to dissolve the free sulphuric acid out by alcohol. As is well known, mineral sulphates are insoluble in, and are precipitated by, alcohol, whereas sulphuric acid enters into solution. The most valid objection, as a quantitative process, to the use of alcohol, is the tendency which all mineral acids have to unite with alcohol in organic combination, and thus, as it were, to disappear; and, indeed, results are found, by experiment, to be below the truth when alcohol is used. This objection does not hold good if either merely qualitative evidence, or a fairly approximate quantation, is required. In such a case, the vomited matters, the contents of the stomach, or a watery extract of the tissues, are evaporated to a syrup, and then extracted with strong alcohol and filtered; a little phenolphthalein solution is added, and the acid alcohol exactly neutralised by an alcoholic solution of clear decinormal or normal soda. According to the acidity of the liquid, the amount used of the decinormal or normal soda is noted, and then the whole evaporated to dryness, and finally heated to gentle redness. The alkaline sulphate is next dissolved in very dilute hydrochloric acid, and the solution precipitated by chloride of barium in the usual way. The quantitative results, although low, would, in the great majority of cases, answer the purpose sufficiently.

A test usually enumerated, Hilger’s test for mineral acid, may be mentioned. A liquid, which contains a very minute quantity of mineral acid, becomes of a blue colour (or, if 1 per cent. or above, of a green) on the addition of a solution of methyl aniline violet; but this test, although useful in examining vinegars (see “Foods,” p. 519), is not of much value in toxicology, and the quinine method for this purpose meets every conceivable case, both for qualitative and quantitative purposes.

§ 65. The Urine.—Although an excess of sulphates is found constantly in the urine of persons who have taken large doses of sulphuric acid, the latter has never been found in that liquid in a free state, so that it will be useless to search for free acid. It is, therefore, only necessary to add HCl to filter the fluid, and precipitate direct with an excess of chloride of barium. It is better to operate in this manner than to burn the urine to an ash, for in the latter case part of the sulphates, in the presence of phosphates, are decomposed, and, on the other hand, any organic sulphur combinations are liable to be estimated as sulphates.

It may also be well to pass chlorine gas through the same urine which has been treated with chloride of barium, and from which the sulphate has been filtered off. The result of this treatment will be a second precipitate of sulphate derived from sulphur, in a different form of combination than that of sulphate.

The greatest amount of sulphuric acid as mineral and organic sulphate is separated, according to Mannkopf[77] and Schultzen,[78] within five hours after taking sulphuric acid; after three days the secretion, so far as total sulphates is concerned, is normal.

[77] “Toxicologie der Schwefelsäure,” Wiener med. Wochen., 1862, 1863.

[78] Archiv. f. Anatom. u. Physiol., 1864.

The normal amount of sulphuric acid excreted daily, according to Thudichum, is from 1·5 to 2·5 grms., and organic sulphur up to ·2 grm. in the twenty-four hours, but very much more has been excreted by healthy persons.

Lehmann made some observations on himself, and found that, on an animal diet, he excreted no less than 10·399 grms. of sulphuric acid per day, while on mixed food a little over 7 grms.; but, as Thudichum justly observes, this great amount must be referred to individual peculiarity. The amount of sulphates has a decided relation to diet. Animal food, although not containing sulphates, yet, from the oxidation of the sulphur-holding albumen, produces a urine rich in sulphate. Thus Vogel found that a person, whose daily average was 2·02 grms., yielded 7·3 on a meat diet. The internal use of sulphur, sulphides, and sulphates, given in an ordinary medicinal way, is traceable in the urine, increasing the sulphates. In chronic diseases the amount of sulphates is decreased, in acute increased.

Finally, it would appear that the determination of sulphates in the urine is not of much value, save when the normal amount that the individual secretes is primarily known. On the other hand, a low amount of sulphates in the urine of a person poisoned by sulphuric acid has not been observed within three days of the taking of the poison, and one can imagine cases in which such a low result might have forensic importance.

The presence of albumen in the urine has been considered by some a constant result of sulphuric acid poisoning, but although when looked for it is usually found, it cannot be considered constant. O. Smoler,[79] in eighteen cases of various degrees of sulphuric acid poisoning, found nothing abnormal in the urine. Wyss[80] found in the later stages of a case indican and pus. E. Leyden and Ph. Munn[81] always found blood in the urine, as well as albumen, with casts and cellular elements. Mannkopf[82] found albuminuria in three cases out of five; in two of the cases there were fibrinous casts; in two the albumen disappeared at the end of the second or third day, but in one it continued for more than twenty days. Bamberger[83] has observed an increased albuminuria, with separation of the colouring matter of the blood. In this case it was ascribed to the action of the acid on the blood.

[79] Archiv der Heilkunde red. v. E. Wagner, 1869, Hft. 2, S. 181.

[80] Wiener Medicinal-Halle, 1861, Jahr. 6, No. 46.

[81] Virchow’s Archiv f. path. Anat., 1861. Bd. 22, Hft. 3 u. 4, S. 237.

[82] Wien. med. Wochenschrift, 1862, Nro. 35; 1863, Nro. 5.

[83] Wien. Med.-Halle, 1864, Nro. 29, 30.

§ 66. The Blood.—In Casper’s case, No. 193, the vena cava of a child, who died within an hour after swallowing a large dose of sulphuric acid, was filled with a cherry-red, strongly acid-reacting blood. Again, Casper’s case, No. 200, is that of a young woman, aged 19, who died from a poisonous dose of sulphuric acid. At the autopsy, four days after death, the following peculiarities of the blood were thus noted:—“The blood had an acid reaction, was dark, and had (as is usual in these cases) a syrupy consistence, while the blood-corpuscles were quite unchanged. The blood was treated with an excess of absolute alcohol, filtered, the filtrate concentrated on a water-bath, the residue exhausted with absolute alcohol, &c. It yielded a small quantity of sulphuric acid.”

Other similar cases might be noted, but it must not for a moment be supposed that the mass of the blood contains any free sulphuric acid during life. The acidity of the blood in the vena cava may be ascribed to post-mortem endosmosis, the acid passing through the walls of the stomach into the large vessel.

§ 67. Sulphates.—If the acid swallowed should have been entirely neutralised by antidotes, such as chalk, &c., it becomes of the first importance to ascertain, as far as possible, by means of a microscopical examination, the nature of the food remaining in the stomach, and then to calculate the probable contents in sulphates of the food thus known to be eaten. It will be found that, with ordinary food, and under ordinary circumstances, only small percentages of combined sulphuric acid can be present.

As an example, take the ordinary rations of the soldier, viz.:—12 oz. of meat, 24 oz. of bread, 16 oz. of potatoes, 8 oz. of other vegetables; with sugar, salt, tea, coffee, and water. Now, if the whole quantity of these substances were eaten at a meal, they would not contain more than from 8 to 10 grains (·5 to ·6 grm.) of anhydrous sulphuric acid, in the form of sulphates.

So far as the contents of the stomach are concerned, we have only to do with sulphates introduced in the food, but when once the food passes further along the intestinal canal, circumstances are altered, for we have sulphur-holding secretions, which, with ordinary chemical methods, yield sulphuric acid. Thus, even in the newly-born infant, according to the analyses of Zweifler, the mineral constituents of meconium are especially sulphate of lime, with a smaller quantity of sulphate of potash. The amount of bile which flows into the whole tract of the intestinal canal is estimated at about half a litre in the twenty-four hours; the amount of sulphur found in bile varies from ·89 to 3 per cent., so that in 500 c.c. we might, by oxidising the sulphur, obtain from 2·2 to 7·5 grms. of sulphuric anhydride.

It is therefore certain that large quantities of organic sulphur-compounds may be found in the human intestinal canal, for with individuals who suffer from constipation, the residues of the biliary secretion accumulate for many days. Hence, if the analyst searches for sulphates in excretal matters, all methods involving destruction of organic substances, whether by fire or by fluid-oxidising agents, are wrong in principle, and there is nothing left save to separate soluble sulphates by dialysis, or to precipitate direct out of an aqueous extract.

Again, sulphate of magnesia is a common medicine, and so is sodic sulphate; a possible medicinal dose of magnesia sulphate might amount to 56·7 grms. (2 oz.), the more usual dose being half that quantity. Lastly, among the insane there are found patients who will eat plaster-of-Paris, earth, and similar matters, so that, in special cases, a very large amount of combined sulphuric acid may be found in the intestinal tract, without any relation to poisoning by the free acid; but in such instances it must be rare, indeed, that surrounding circumstances or pathological evidence will not give a clue to the real state of affairs.