Carbolic Acid (Phenol) - Carbolism

Poisoning by carbolic acid is called “carbolism”.

Physical properties: Pure carbolic acid is a colourless,

transparent, prismatic needle like crystals, having sweetish burring
taste and with phenolic smell. Carbolic acid is highly soluble in
water, glycerin and alcohol.

Uses: phenol is used as antiseptic & disinfectant.

Carbolic acid is present in detol and lysol.

Mode of Action: Carbolic acid has two actions:

i. Local action: Carbolic acid acts as a mild corrosive and
anesthetic upon the skin and mucous membrane.

ii. Remote action: After absorption of poison into the

system mainly affecting the kidneys.
 Symptoms and Sings:
1. Hot Burning pain extend from mouth to stomach followed by:Tingling and
anesthesia. Vomiting may not take place due to the anesthetic action of phenol
on the stomach. Swallowing & speech become painful and difficult due to
necrosis and sloughing of the tissues.
2. Lips, chin and checks may be burnt.
3. Mouth and tongue are corroded.
4. Shock results from both local (corrosive) action and remote (CNS depressant)
action of phenol. Shock manifests as: cold clammy skin, Rapid feeble pulse,
breathing labored,temperature subnormal and pupils are contracted.
Pin Point pupils may be mistaken for opium and Organophosphorus poisoning.

Nephrotoxic effects: When the death is not rapid, the damage to the renal tubules
occur. There may be suppression of urine, Oligurea – (urine output in adult is less
than 500ml/24hours). There is evidence of irritation of kidneys may be found.
a) The urine contain albumin, blood and metabolic products of carbolic acid.
b) on standing or when expose to air the metabolic products of the urine are
oxidized resulting in dark smoky green color of the urine called Carbolurea.

cause of death: Phenol attack the nervous system. Coma may be followed by
death resulting from paralysis of the respiratory and cardiac center.
Fatal Dose:20 drops of pure phenol.
1 to 2 gram crystalline powder of carbolic acid. .

Fatal Period: 3 to 4 hours.

 Treatment
Soft stomach tube should be passed with care.
1 Physical antidote:
a Stomach is washed carefully with warm water containing
charcoal, olive oil,MgSO4 or NaSO4. Liquid paraffin in
plain water until the washing no longer emit phenol smell.
Some quantity of liquid paraffin or MgSO4 may be left in
the stomach.
b Demulcents such as Fat, Oil, Milk or white of egg may be
helpful.
2. Chemical antidote: week alkalis such as: milk of
magnesia may be given.
3. If phenol falls on the body, the burns should be washed
with soap and water.
Rest of treatment is symptomatic.
 POSTMORTEM APPEARANCE OF CARBOLIC ACID
External Sings
1. Phenol smell from the body.
2. Grayish white patches may be seen on lips, angle of mouth, chin, checks
and front of the body.
Internal Sings
i. Mucous membrane of the mouth, esophagus and stomach is corroded,
swollen and hard. Hardening of the stomach wall – Leathery stomach.
ii. Tongue and glottis is usually white and swollen.
iii. Contents of the stomach are dark brown in colour with phenol smell.
iv. Kidneys: Hemorrhagic nephritis.
v. All other organs are congested.
Medicolegal Aspects of Carbolic Acid
Accidental Poisoning:By phenol may occur as phenol is in common use
as antiseptic & disinfectant.
Suicidal Poisoning:Suicidal cases are common as phenol is easily
available.
Homicidal Poisoning: Homicidal cases by phenol are rare due to its
sweetish burning taste and phenol smell.
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