This document discusses various corrosive poisons including acids and alkalies. It describes their properties, clinical effects, post-mortem findings, and medicolegal aspects. Major acids discussed are sulfuric acid, nitric acid, hydrochloric acid, oxalic acid, and carbolic acid. Their local tissue-destroying effects and systemic toxicity are outlined. Major alkalies covered are ammonia, potassium hydroxide, sodium hydroxide, and sodium/potassium carbonates. Their caustic properties, inhalation dangers, and causes of death are summarized. The document provides details on evaluating and treating corrosive poisoning cases.

1. CORROSIVE
POISONS

2.  CORROSIVE: The corrosive have a local chemical action
of corroding and destroying the tissues they come in
contact with.
 ACIDS: are hydrogen containing substances that, on
dissociation in water, produce hydronium ions. they
produce the coagulation necrosis of tissues by the
precipitation of poison.
 ALKALIES: are substances which neutralize acids.
 INORGANIC ACIDS: are mineral acids used as
reagents. Eg- Sulphuric acid, Nitric Acid, Hydrocholric
acid.
 ORGANIC ACID: are carbon compounds, thus have
better absorption and display prominent systemic effects.

3. 6.EFFECTS: when corrosive agents come in contact with
skin, body – 3 stages.
i. Stage I: intense inflammatory reaction – first 4-7days.
ii. Stage II : granulation stage: fibroplasia, formation of
collagen, starts during 2nd-3rd week. Chance of
perforation – tissues are weak.
iii. Stage III: excessive formation of scar tissue- stricture.
7. SUPPORTIVE THERAPY:
i. Tracheotomy: suffocation with involvement of larynx.
ii. Oxygen and ventilatory support
iii. Perforation needs emergency surgery.
iv. Excoriation : treated as burns.
v. Injury to eye: moistening with plenty of water/saline.
vi. Ingestion of strong acids: shock with I.V infusion &
supportive therapy, pain controlled with morphine.
vii. To prevent stricture of the esophagus; corticosteroid

4. SULPHURIC ACID
 Pure is colorless, heavy, hygroscopic, oily
liquid and gives out no fumes when
exposed to air. With water, it gives out a
large amount of heat.
 Commercial sulphuric acid: contains
impurities is brown in color ( Industry
chemicals, battery and fertilzers
manufacturing.
 Mode of action : it has high affinity of water,
 Draws out water from the tissues and
destroys them by rapid dehydration
 Gives out large amount of heat – necrosis

5. CLINICAL FEATURES:
General symptom: burning pain in mouth, throat, esophagus
and stomach with brownish or blood stained vomit.
LIPS: swollen, abrased and brown or black streaks can be
found.
TEETH: chalky white color, rough and deprived of their
polish.
INTENSE THIRST:
VOICE: hoarse and rough – inflammation of the larynx.
HYPERSALIVATION: may seen second or third day.
FATAL DOSE- 5-10ml
FATAL PERIOD: 18-24 HOURS.
TONGUE: swollen, covered with white coating and S, -
darker/ brown in color.

6. CAUSES OF DEATH:
i. Suffocation: Death may occur instantaneously –
edema, spasmodic closure of glottis by the acid .
ii. shock and circulatory failure: death may occur in
24 hours.
iii. Peritonitis: death may be prolonged for weeks or
months- secondary to esophageal/ pyloric stenosis
or the perforation of stomach.

7. VITRIOL / ACID THROWING
(VITRIOLAGE):
 Sometimes, envious people use
vitriol or strong sulphuric acid to
disfigure the face.
 Local effects: slight burning pain,
the corrosion of tissues and
formation of brownish scars which
leave permanent scars.
 Common complications:
Conjunctival edema, corneal
destruction or blindness. Death
may also occur by severe burns.

8. POST-MORTEM APPEARANCE:
1.Lips and surrounding skin- brownish or black corroded
spots- mucus also will be in dark brown.
2. Stomach: (if Perforated – blackening is seen with the
escape gastric contents into peritoneal cavity)
(if not perforated – stomach will be contracted & collapsed,
contents- dark brown in color with mucus and blood.)
3. Liver and Kidneys shows fatty changes.
4. Blood vessels : may showed clotted blood.
MEDICO-LEGAL ASPECTS: Suicidal, homicidal, accidental
& vitriolage.

9. NITRIC ACID
PROPERTIES:
 Is clear & colorless liquid, powerful
oxidizing agent which dissolves all metals
except gold and platinum.
 Commercial nitric acid varies from yellow
to deep red ( oxides of nitrogen)
USES: used in arts and manufacturing, for
cleaning nickel ornaments, separating gold
from other metals, for the preparation of
explosives, coloring agent & as a fertilizers.

10. CLINICAL FEATURES:
1. Lips, tongue & mucous membrane of the mouth soften
and became white, but later yellow by the action of acid
with organic matters.
2. Teeth: yellow with partial destruction of enamel.
3. Skin and cloth: yellow turn orange
4. Vomitus: yellowish brown due to blood colour.
5. Abdomen, markedly distended and tender – gaseous
belching is more.
6. Urine: oliguria, anuria, albuminuria & casts.
7. Lock jaw & insensibility : frequently found.
8. Inhalation of fumes : irritation of eyes, lacrimation,
photophobia, cough and breathlessness.
9. Fatal dose: 5-15ml
10. Fatal period: 12-24 hours on an average

11. POST MORTEM APPEARANCE:
1. Skin and mucous membrane of mouth and lips;
eroded and yellow in color.
2. Stomach: mucous membrane is greenish, wall is soft,
ulcerated and may perforate.
3. Corrosion of duodenum may found.
4. If death was due to inhalation of fumes means-
larynx, trachea and bronchial tubes are congested.
MEDICO-LEGAL ASPECTS:

12. HYDROCHLORIC ACID
 It is colorless gas with irritating oddour,
extremely soluble in water.
 Commercial acid- HCL gas in water gives
fumes in damp air with yellow color.
 Produces dense white vapors with ammonia
USES: used in industry for preparing chlorine,
For dissolving metals & for medicinal purposes
For erasing the writings.

13. CLINICAL FEATURES:
1.Less active than other inorganic acids, - symptoms will be
mild .
2.Does not stain the skin or mucous membrane but stains
dark clothes reddish brown.
3. Cause salivation, convulsion, delirium or paralysis of
limbs.
4, when inhaled:
Severe irritation of air passage with spasm of glottis.
Chronic exposure cause – conjunctivitis, corneal ulcer,
pharyngitis, laryngitis & bronchitis.

14. POST-MORTEM APPEARANCE:
Mucous membrane- ash grey/ black in color.
Stomach: wall is red.
Mucosa- brownish leathery and firm.
Perforation may rarely occur.
MEDICO-LEGAL ASPECTS:
Accidental & suicidal cases are common but homicidal rare.

15. OXALIC ACID
Properties:
 Colorless, transparent, prismatic
crystals, sour taste, strongly acidic:
sublimes after heating: soluble in water
and alcohol.
 Heated with sulphuric acid, it splits up
into CO2, CO & water.
Uses:
 White cloth printing, manufacture straw
hats, cleaning brass and copper
articles & wooden surfaces.
 Bleaching powder for erasing writing
and signatures from paper and printed

16. CLINICAL FEATURES
LOCAL ACTION:
 As a corrosive
 As a irritant
 Prolonged contact with skin
 GIT: sour acid taste, thirst,
pain and burning in mouth,
throat, stomach.
 Intense vomiting –
greenish brown, black or
ground coffee due to blood
and mucus.
SYSTEMIC ACTION:
 Systemic absorption by
precipitating ionized calcium –
hypocalcemia.
 Insoluble calcium oxalate
accumulates in kidneys, liver,
heart, lungs and blood and is
excreted in the urine.
 Oliguria – diuresis,
albuminuria with hyaline casts
leading to acute renal failure.
 Numbness of limbs
 Feeble, irregular & slow pulse
 Shallow, gasping & slow pulse
 Tetany, cramps , convulsion,

17. 3. Fatal Dose: 15gm
4. Fatal period: 1-2 hours.
TRAETMENT:
 Neutralization of acid
 I.V calcium gluconate
 Gastric lavage with 1% calcium gluconate solution.
 Castor oil with purgative.
 Renal blood flow maintained by the I.V infusion of glucose.

18. POST- MORTEM APPEARANCE:
A. Oxalic acid taken in concentrated form:
1. Signs of corrosion, their mucous membrane are white,
wrinkled and can easily detached from underlying tissue.
2. STOMACH:
 Contains dark brown, thick and lumpy liquid – formation of
acid hematin.
 Blood vessels – dark brown/black streaks seen
 Deposits of calcium
 Perforation.
3. Intestines: the upper part of duodenum affected.
4. Kidneys: congested and tubules are loaded with crystals-
tubular necrosis.

19. B. If oxalic acid was dilute :
1. Local irritation may be found – redness, congestion and
the inflammation of mucous membrane.
2. Sometimes the congestion of lungs, liver, kidneys and
brain.
MEDICO LEGAL ASPECTS:
1. Accidental poisoning : common having been swallowed
by mistake as a saline purgative of magnesium sulphate.
2. Suicidal and homicidal are rare.

20. CARBOLIC ACID
Properties:
Pure acid – short, needle shaped crystals
which turn pink on exposure to light & melt
in mist air, colorless.
It has carbolic odor & a sweetish pungent
taste.
Solubility : insoluble in liquid paraffin &
soluble in water, alcohol, ether glycerine &
volatile oils.
Commercial carbolic acid –
 Phenol camphor
 Crude carbolic acid

21. CLINICAL FEATURES: poisoning by carbolic acid _
carbolism.
1.Mode of action: In concentrated form- corrosive, when
applied to skin, it causes a burning sensation- tingling
sensation & numbness.
2. Routes of excretion: urine, saliva, skin and stomach.
3. Symptoms: intense thirst and burning sensation in mouth,
throat and stomach. Vomiting of frothy mucus.
4. Causes of death: failure of respiratory center. Shock and
circulatory collapse. Renal failure.
5. Fatal dose: 2gm
6.Fatal period: 3-4 hours.

22. POST-MORTEM APPERANCE:
1. Dark brown abrasion on the angles of the mouth and the
chin.
2. The mucus membrane of lips, mouth and throat is
congested, swollen.
3. The mucous membrane of esophagus is tough, grey and
arranged in longitudinal folds.
4. STOMACH:
 brown, leathery with hemorrhagic spots and folds.
 contains reddish fluid mixed with mucus and pieces of
epithelium with the odour of carbolic acid.
1. KIDNEYS – shows haemorrhagic nepritis.
2. LUNGS – congested and edematous.
3. BRAIN – Congested
4. BLOOD – dark, semi fluid / partially coagulated.
MEDICO-LEGAL IMPORTANCE: accidental and suicidal

23. SALICYLIC ACID
OTHER
PREPARATIONS/
NAMES
USES
1. Methyl salicylate (
oil of wintergreen)
i. Used locally as
anti-fungal
ii. As the irritant
and a counter
irritant
2. Aspirin
(acetyl salicylic acid)
i. Antipyretic,
analgesic, anti-
rheumatic & anti-
inflammatory agent.
3. Sodium salicylate Anti-rheumatic and
anti-inflammatory

24. CLINCAL FEATURES:
1. Burning pain in throat and epigastrium.
2. Difficulty in swallowing, thirst, nausea, vomiting and
diarrhoea.
3. Systemic toxicity:
 Headache, dizziness, buzzing in ear and deafness.
 Vomiting, dehydration, generalized weakness & mental
changes.
 Severe acid-base imbalance.
 Renal functions and carbohydrate disturbances.
 Hyperpyrexia and encephalopathy.
 Death may occur from: cardiac and respiratory failure.
4. Chronic poisoning – SALICYLISM
 Loss of blood in stools. Loss of apetite, GIT disturbances,
Renal impairment
5. Fatal dose : 10gm.
6. Fatal Period : 1-4 days.

25. TREATMENT:
1. Gastric lavage
2. Activated charcoal
3. Purgatives
4. Advanced life support measures
5. Oxygenation for pul.edema
6. Vit K for Hypoprothrobinaemia.
7. Ventilatory support
8. Injection ACTH as a life-saving therapy.
POSTMORTEM APEARANCE
MEDICO-LEGAL ASPECTS: Accidental poisoning from
overdose administration.

26. ALKALIES
In concentrated form act as a corrosive poison, in a
dilute form they act as an irritant poison.
Concentrated alkalies are more dangerous than acids-
esophageal burns and stricture.
With fats – soaps, with protein – protinates.

27. MAJOR CORROSIVE ALKALIES
1.AMMONIA: with water forms a strong solution of
ammonia- liquor ammoniae fortis. Colorless liquid –
very pungent odour.
The gas used as refrigerant and a fertilizer.
2. POTASSIUM HYDROXIDE: Soapy to touch, rapidly
absorbs CO2 from air and soluble in water.
3. SODIUM HYDOXIDE: occurs as white mass.
4. AMMONIUM CARBONATE- translucent, hard,
crystalline mass, water soluble.
5. POTASSIUM CARBONATE: white crystalline
powder, soluble in water, insoluble in alcohol. – used
for washing and cleansing purposes
6. SODIUM CARBONATE: soluble in water but

28. Clinical features:
1. Taste : bitter, pungent and soapy.
2. Vomitus: strongly alkaline, at first thick and slimy.
Later containing dark altered blood, sheds off mucous
membrane
3. Purging: accompanied by severe pain and straining.
Stools contain fibrous mucus mixed with blood.
4. Inhalation of ammonia vapour: congestion of watering
eyes, running nose and sneezing, salivation,
suffocation.
5. Causes of death: vagal inhibition, suffocation due to
inflammation of glottis, Pul.edema, Pneumonia,
perforation.
6. Fatal dose: Ammonia: 30ml, Caustic soda: 5 gm,
Pottasium carbonate: 15gm, Sodium carbonate:

29. POST-MORTEM APPEARANCES:
1. Marks of corrosion : the mucous membranes of
mouth, throat, pharynx etc. shows- soft mucilage like
necrosed areas & inflamed patches of chocolate or
black color.
2. Stomach content : turbid, blood stained or coffee
color.
3. Perforation: esophagus/stomach
4. Stenosis may be found at the lower end of
esophagus.
MEDICO- LEGAL IMPORTANCE:
Caustic soda- homicidal, criminal abortion.

30. THANK YOU.

31. alkalies