The substitution of carbolic acid for medicine happened as follows:—
| Cases. | |
|---|---|
| Taken instead of Tincture of Opium, | 1 |
| Ta„en inst„ad of Infusion of Senna, | 3 |
| Ta„en inst„ad of Mineral Water, | 2 |
| Ta„en inst„ad of other Mixtures, | 3 |
| Ta„en inwardly instead of applied outwardly, | 3 |
| 12 |
Of these 12, 8 died.
Again, 10 persons took carbolic acid in mistake for various alcoholic drinks, such as schnapps, brandy, rum, or beer, and 9 of the 10 succumbed; 17 persons drank carbolic acid simply “by mistake,” and of these 13 died. Thus, of the whole 85 cases, no less than 51 ended fatally—nearly 60 per cent.
It must be always borne in mind that, with regard to statistics generally, the term “carbolic acid” is not used by coroners, juries, or medical men, in a strictly chemical sense, the term being made to include disinfecting fluids which are almost wholly composed of the cresols, and contain scarcely any phenol. In this article, with regard to symptoms and pathological appearances, it is only occasionally possible to state whether the pure medicinal crystalline phenol or a mixture of tar-acids was the cause of poisoning.
§ 220. Fatal Dose.—The minimum fatal dose for cats, dogs, and rabbits, appears to be from ·4 to ·5 grm. per kilogram. Falck has put the minimum lethal dose for man at 15 grms. (231·5 grains), which would be about ·2 per kilo., basing his estimate on the following reasoning. In 33 cases he had a fairly exact record of the amount of acid taken, and out of the 33, he selects only those cases which are of use for the decision of the question. Among adults, in 5 cases the dose was 30 grms., and all the 5 cases terminated by death, in times varying from five minutes to an hour and a half. By other 5 adults a dose of 15 grms. was taken; of the 5, 3 men and a woman died, in times varying from forty-five minutes to thirty hours, while 1 woman recovered. Doses of 11·5, 10·8, and 9 grms. were taken by different men, and recovered from; on the other hand, a suicide who took one and a half teaspoonful (about 6 grms.) of the concentrated acid, died in fifty minutes. Doses of ·3 to 3 grms. have caused symptoms of poisoning, but the patients recovered, while higher doses than 15 grms. in 12 cases, with only one exception, caused death. Hence, it may be considered tolerably well established, that 15 grms. (231·5 grains) may be taken as representing the minimum lethal dose.
The largest dose from which a person appears to have recovered is, I believe, that given in a case recorded by Davidson, in which 150 grms. of crude carbolic acid had been taken. It must, however, be remembered that, as this was the impure acid, probably only half of it was really carbolic acid. The German Pharmacopœia prescribes as a maximum dose ·05 grm (·7 grain) of the crystallised acid, and a daily maximum quantity given in divided doses of ·15 grm. (2·3 grains).
§ 221. Effects on Animals.—Carbolic acid is poisonous to both animal and vegetable life.
Infusoria.—One part of the acid in 10,000 parts of water rapidly kills ciliated animalcules,—the movements become sluggish, the sarcode substance darker, and the cilia in a little time cease moving.