LECTURE ON CORROSIVES
Doctor Amina Rao
Corrosion means dissolution or gradual
wearing away by chemical action.
Classification Of Corrosives
Mineral Acids
Sulphuric Acid, Nitric Acid ,Hydrochloric Acid
Organic Acids
Carbolic Acid , Acetic Acid , Salicylic Acid , Oxalic
Acid
Vegetable Acids
Hydrocyanic Acid
Alkalis
Caustic potash and Soda , Ammonium
Hydroxide
Mineral Acids and Caustic Alkalis
 These are called corrosive poisons.
 In dilute solutions they act as irritants.
Mechanism Of Action
 Their action is mainly a local one on the tissues of
the alimentary tract and to some extent on the
respiratory tract.
 As a rule, there is no remote Systemic Action with
the exception of shock.
There action is characterized by :
 Extraction of water from the tissues.
 Coagulation of cellular proteins.
 Conversion of hemoglobin into Haematin.
1) Immediately , soon after swallowing the poison
following can happened :
2) BURNING SENSATION in the mouth , throat ,
esophagus , stomach and abdomen followed by
INTENSE THIRST , DYSPHAGIA, and VOMITING of
shreddy blood stained material.
3) VOMIT may b acidic or alkaline in reaction
depending upon the substance taken.
4) Signs of corrosion of mouth , lips or both.
5) The tongue is shriveled according to the nature of
the corroding agent.
4) With the ingestion of
a. Corrosive acids
The bowels tend to be constipated and urine
scanty.
b. With Alkalies
There may be tenesmus and frequency of stool
with blood and mucus.
5) Traces of poison may also find their way into
Trachea followed by Respiratory Symptoms
e.g Dyspnoea is often present from oedema of
glottis and is more marked in the volatile or
strong fuming fluids.
 Corrosive irritant if diluted. Colourless,odourless.non fuming,
hygroscopic and produces coagulation necrosis of the tissues in
contact.
 Perforation of stomach is commonest in poisoning due to
sulphuric acid.
Signs and Symptoms :
Burning pain , Thirst , Black Vomit ,detachment of corroded
mucous membrane , dysphagia ,
chalky white teeth.
Black trickle marks on lips ,
cheeks and chin , abdominal pain ,
collapse , coma and death.
Fatal Dose : 10 – 15 ml
Fatal period : 12 hours
 Accidental
 Vitrolage
 Abortificent
 Succidal
Vitrolage
Throwing of any corrosive on a person with malicious intent.
 These fluids are usually thrown on the face with the object of
destroying vision or causing facial disfigurement and this
result in Grievous hurt.
 E.g Sulphuric Acid ( OIL OF VITRIOL)
is most commonly employed for this purpose and hence it is
called vitriolage.
Nitric Acid and carbolic acid are fewer times used.
2) The use of caustic soda , caustic potash , iodine and marking
NUT juice has also been recorded.
3) Sulphuric acid produces severe chemical burns.
 They are characterized by discolouration and staining of
stan and clothing ( colour changes).
 Brown or black in case of
Sulphuric acid .
 Yellow in case of Nitric acid.
4) In H2SO4 vitriolage
Trickle marks, Appearance of
vesication And real line of demarcation and presence
of chemical substance in the stains noticed.
1)
 Wash away corrosive acid with large amount of
water and soap or dilute solution of NaHCO3 or
KHCO3.
 Later a thick paste of magnesium oxides applied.
 skin raw surfaces can be covered by Antibiotic
ointment.
EYE Involved:
Treatment with large amount of water followed by
irrigation 1 % solution of sodium bicarbonate .
 Few drops of olive oil instilled into eyes.
 Steroids and Antibiotic containing eye drops are
very helpful.
 Stomach wash with soft rubber tube (Levine






tube )
Give milk + egg white + melted butter.
Magnesium oxide ( thick paste apply on skin )
10 mg Morphine IM ( injection ) for pain.
IV fluids
Oxygen / Cortisone.
Oesophageal stictures in sulphuric acid
poisoning can be prevented by giving steroids.
Hydrochloric Acid (HCL)
Physical and Chemical Properties:
Colourless,volatile,odourless
liquid has a burning sour taste.
Sources: Industries,Commercial
,Laboratories e.g. A normal digestive fluid of
stomach.
Action Locally : Corrosive, Inflammation of
respiratory tract due to inhalation of fumes.
Indirectly : Shock due to severe pain.
Fatal Dose : 15 – 20 ml concentrated.
Fatal Period : 18 – 36 hours or more.
Features :
1) Burning pain in mouth ,throat, esophagus and
stomach, spreading over the abdomen.
2) Erosion :
1) Of Skin Appearance :
usually no erosion after a few days.
2) Of Mucous Membrane Of Mouth and Tongue:
Similar as in case of skin.
3) Difficulty in Speech and Swallowing.
4) Teeth Damage
5) Eructation is present.
6) Thirst Present.
7) Vomiting and Vomitus Reaction : Strongly
present.
8) Altered blood : Present
9) Tenesmus : May be Present
10) Tenderness over Abdomen : Present
11) Stiffness of Abdomen : May be due to
distension of stomach.
12) Perforation or rupture of Stomach : uncommon
13) Urination : Suppressed.
14) Nature of Stool : Mucus with altered blood may
be present.
15) Cause of Death : Shock,Laryngeal
spasm,pulmonary oedewr due to tickling of
acid or vomitus or inhalation of vapour of the
acid.
1) Here there may not be much corrosion of the
skin. There my be damage of the skin over
these areas with brownish
parchmentisation.The mucous membranes of
the mouth and tongue show reddish brown
corrosion. Similar changes may be seen on the
inner surface of esophagus.
2) The stomach is soft, swollen with congestion
desquamation,haemorrhagic points and
ulceration of the inner surface. It contains
altered blood with mucous shreds.
3) Perforation is uncommon.
4) The upper part of the small intestine shows
signs of Irritation.
5) In case if vapours are inhaled, there occurs
congestion of the respiratory tract with the
congestion and oedema of the lungs.
Similarly if vomits is inhaled same findings
appear.
In all these cases,
I.
II.
III.
IV.
V.
VI.
Stomach with contents.
A loop of upper part of small intestine.
Half of the liver.
Half of each kidney in 1 container.
Corroded areas of skin in other container.
Acid stained clothes are preserved separately.
Preservatives
Viscera and skin are preserved in absolute
alcohol or rectified spirit , clothes are sent
without any preservation.
Inflammatory reaction first : 4 – 7 days
Granulation Stage : Fibroplasias and formation of
collagen starts.
2nd and 3rd Week : Tissues become weak.
Third Stage (Cicatrisation Stage) : Formation of scar
tissue which increases the chances of perforation.
Their action is characterized by :
I. Extraction of water from tissues.
II. Coagulation of cellular proteins
III. Conversion of hemoglobin into haematin.
Diagnosis
 Radiology
I. Acute Stage :1 – 10 days in peeding perforations.
II. Sub. Acute Stage : 11 – 16 days . Atony,dilation
and rigidity of the antrum and pylorus seen.
III. Chronic Stage : Stenosis and contraction of the
antrum and pylorus occurs.
 Chest and abdominal X-rays and routine
Laboratory testing should be obtained to
evaluate for Aspiration, perforation and organ
dysfunction.
 Endoscopy : performed for getting better results
12 – 24 hours e.g. to check perforation
Treatment
1. Weak acid : carbonated beverage or citrus juice.
2. Base Antacid.
3. Do not perform gastric levag,it increases the
chances of perforation.
4. Do not give any orally for 2-3 days after water
milk ,water electrolytes shafted be green.
5. Broad spectrum Antibiotics.
6. For Esophageal stictures and gastric outlets :
obstruction may require subsequent dilatation
or surgical reconstruction.
Treatment(CONT…)
6) Laprotomy is required for patients with
gastric perforations and peritonitis.
7) Skin lesions need to be washed with soap
and water followed by the application o
some ointment.
8) Eye involvement needs irrigation with water
or normal saline, also refer to
ophthalmologist.
Accidental Poisoning : Commonly found in
many house hold agents e.g drain detergents,
drain openers .
ii. Accidental Ingestion : The intestine accidently
warms the unintentional taken of his mistake
causing him to spit of the acid which dribbles
out on his chin and some stains on his clothes.
Further more attempts to wipe the burning
stuff from the lips may result in spreading it
over the surrounding area and cheeks etc.
i.
Medicolegal Aspects(CONT…)
III. Succidal Poisoning : in intentional swallowing of
the acid, intense pain may result in spluttering
and staining of the mouth,chin, and clothing.
IV. Homicidal Poisoning : homocidal victims are
usually incapable infants or intoxicated persons.
V. An acute exposure to the vapours in the
industries may lead to death due to Respiratory
distress.
VI. Prolonged exposure to the vapours of the agent
in the industries may lead to Respiratory
copmlications.
Medicolegal Aspects(CONT…)
VII. In case of Fatal Poisoning Cases : By these acids
, no trace of poisons may be discoverable in
viscera. The quantity of free acid present
,specially important in HCL poisoning as this
acid is contained uncombined with bases in the
gastric juice to the extent of about 0.2% or
more.
VIII.Sometimes disposal of the dead body may be
affected by throwing the dead body into the
acid with an attempt to dissolve the body of the
victim as was practised by John George Haigh so
called Acid Bath Murder.
 Corrosive irritant if diluted.
 Nitric acid is a powerful
oxidizing agent.
Signs and Symptoms:
Burning pain,thirst,yellow
colouration of mucous
membrane and teeth,yellow brown
vomitus,tender and distended abdomen,
oligurea,shock,choking,lacrimation, dyspnoea and
cough are due to INHALATION.
Fatal Dose :15-20 ml
Fatal Period : 18 hours.
Xanthoproteic Reaction

Xanthoproteic reaction occurs with
ingestion of nitric acid .
 Nitric Acid is a powerful oxidizing agent and
reacts with organic matter ( protein) to
produce tri nitro phenol liberating nitrogen
mono oxide is called Xanthoproteic
Reaction.
Treatment
o
o
o
o
o
o
Stomach wash (with soft rubber tube)
Give milk – Magnesium oxide – Egg white
Melted Butter
10 mg Morphine (pain relieft)
IV Fluids ( ice Sucking )
Cortisone (for treatment of shock and to prevent
oesophageal stictures)
Medicolegal Points
o Accidental
o Succidal
o Abortificiental / Vitriolage
Postmortem Appearances
 There may be signs of corrosion and partial
destruction of the parts with which the poison has
been in contact.
Externally : The lips may be burnt and trickle marks
may be found running from the mouth to the chin,
neck,chest.
Internally : they vary in extent from localised
patches to extensive AREAS particularly in
stomach.
 Stomach Perforation is common with sulphuric
acid.
 Irritation of Respiratory tract is found in case of
volatile poisons e.g nitric acid,HCL.
Medicolegal Aspects
 Attempted succide with corrosives is not seen now
owing largely due to the use of other less painful
substances like barbiturates and synthetic
narcotics and organophosphate compounds.
 Corrosives are rarely used for
homocide owing to their
painful action.
 Corrosives usually thrown on
 the face out of jealousy or in fits of rage , called
vitriolage. They cause severe injury even death
from accidental spilling.
Collapse from shock sets in with
a. Cold clammy skin, sunken eyes, dilated pupil.
b. Pale anxious face
c. Rapid feeble pulse and sighing respirations.
Consciousness is usually retained until near the end.
Death : death may result from primary shock,
suffocation,due to oedema of glottis or
perforation of stomach.
 If quantity of poison swallowed is small, death may be
delayed until Hypostatic pneumonia develops.
 Patient may be recover and death may be later due to
complications.
e.g Sticture of oesophagus with resulting emaciation and
malnutrition.
 The sites likely to be affected by local contact.
Treatment
Stomach tubes and emetics are contraindicated.
1) Soft stomach tube (Levine Tube) can be pass with
case within about an hour of ingestion of poison to
prevent serious caustic burns of the stomach walll
followed by ulceration,cautraction and stricture.
If an acid has been taken alkaline carbonates
are contraindicated because they liberate CO2
which may distend and rupture a damaged
stomach.
2) Weak alkalis and plenty of water or neutralizing
agents such as milk and egg albumin should be
given.
Treatment(CONT…)
3) In case of Alkali : A weak acid such as vinegar (acetic
acid) will neutralize its effects.
4) 10 mg Morphine IM injection for relieving pain.
5) ICE CUBES to suck to relieve thurst and bring
effects.
6) IV Fluids to combat fluid loss.
7) Corticosteroids : for shock treatment and to prevent
oesophageal sticture.
8) Tracheostomy may be necessary if there is acute
oedema of the glottis.
9) Melted Butter
10) Magnesium Oxide ( along with general treatment of
poisoning)