a dark gangrenous-like appearance, being much thickened and highly injected.
Although these signs of violent irritation are commonly present, it must at the same time be observed, that some cases have occurred where the stomach and intestines were quite healthy. In a girl who died about thirty minutes after swallowing an ounce of the acid, no morbid appearance whatsoever was to be seen in any part of the alimentary canal.[1] In the case of a girl, described by Mr. Anderson, where death took place in twenty minutes, there was no appearance but contraction of the rugæ of the gullet and stomach, one spot of extravasation in the latter and doubtful softening of its villous coat.[2]
The state of the other organs of the body has not been taken notice of in published cases. In several instances, as in Mr. Taylor's case, the blood in the veins of the stomach is described as having been black and as it were charred; probably by the chemical action of the acid after death.
Section IV.—Of the Treatment of Poisoning with Oxalic Acid.
The chief part of the treatment of this kind of poisoning is obvious. On account of its dreadful rapidity, remedies cannot be of material use unless they are resorted to immediately after the acid has been swallowed. Emetics may be given, if vomiting is not already free; but time should never be lost in administering them if an antidote is at hand. In particular it is necessary to avoid giving warm water with a view to accelerate vomiting, unless it is given very largely; for moderate dilution will promote the entrance of the poison into the blood, if it has not the effect of immediately expelling it.
The principal object of the practitioner should be to administer as speedily as possible large doses of magnesia or chalk suspended in water. Chalk has been given with great advantage in several cases,[3] and magnesia has also been of service.[4] As no time should be lost, the plaster of the apartment may be resorted to, when chalk or magnesia is not at hand. These substances not only neutralize the acid so as to take away its corrosive power, but likewise render it insoluble, so as to prevent it from entering the blood. There appears no particular reason for using the stomach-pump when antidotes are at hand. But fashion seems to have authorised the employement of this instrument for every kind of poison.[5] Alkalis are inadmissible. As might be inferred from the general statements formerly made on the effect of chemical changes on poisons [p. 28], the alkalis, as they form only soluble salts, will not deprive oxalic acid of its remote or indirect action; and instances are not wanting of their inutility in actual practice.
