Organic Acids toxicity Carbolic acid (phenol) and oxalic acid are toxic organic acids that can cause poisoning. Phenol poisoning can occur through ingestion or skin contact and causes local tissue damage and systemic effects like CNS depression, respiratory failure, and kidney damage. Oxalic acid poisoning also occurs through ingestion and causes local corrosive effects as well as hypocalcemia due to calcium oxalate formation, resulting in tingling, muscle spasms, arrhythmias, and renal failure. Management of phenol poisoning includes gastric lavage and supportive care, while oxalic acid poisoning requires calcium supplementation in addition to gastric lavage. Both can cause death either immediately from respiratory or cardiac

1. Organic Acids toxicity
By : M.N.O
4th year (MBBS) student

2. Pure carbolic acid is a colorless crystals with specific odor,
and it is soluble in alcohol.
Carbolic acid (Phenol)
Commercial forms :
Dettol, cresol, lysol ,Phenol detergent
Both forms are absorbed after ingestion and
skin contact

3. Mode of Poisoning
Suicidal: cheap, has local anesthetic effect and rapidly fatal
Accidental: occurs with children or absorption through the skin

4. Clinical manifestations:
• It has a dual action, local and remote actions.
• 1. Local action:
a) Mild corrosive
b) Coagulative necrosis of the superficial layer of the
tissue proteins. However, detachment of these layers
may lead to hemorrhage and stricture on healing.
c) anaesthetic effect on sensory nerve endings. After
ingestion there is hot burning pain extending from
mouth to stomach but rapidly disappears due to local
anaesthetic effect so there is no vomiting
d) May cause skin gangrene if applied for long period.

5. • 2. Remote actions:
 CNS : stimulation followed by depression: Headache,
convulsion, drowsiness, confusion, coma. Constricted
pupil.
 Respiratory depression with slow breathing cyanosis
and central respiratory failure.
 Heart: myocardial depression with weak rapid or
irregular pulse.
 Kidney: acute glomerulonephritis with oliguria,
albuminuria, casts, anuria and renal failure. Urine
turns dark green on exposure to air due to oxidation
of the excreted products of phenol

6. Causes of death:
Delayed
Due to renal
failure
Within days
Immediate
Due to central
respiratory
depression
Within hours

7. Management:
• Care of respiration and coma if present
• Gastric lavage maybe done in early
presentation

8. OXALIC ACID POISONING
• It is in the form of white crystals easily soluble
in water and alcohol.

9. Used as
• bleacher and metal cleaner in industry and
houses.

11. Mode of Poisoning
• Accidental: Commonest form especially in
children.
• Suicidal : very rare.

12. Pathophysiology
• 1. Local : mild corrosive effect.
• 2. Remote : decalcification: it combines with
blood ionized calcium forming
• calcium oxalate resulting in cardiac
arrhythmias, tetany, convulsions, blocking of
renal tubules with calcium oxalates.

13. Clinical Manifestations
• I. Local Corrosive: hot burning pain in the mouth, esophagus
and stomach together with repeated vomiting
• II. Remote Hypocalcaemia :
• tingling and numbness,
• muscle twitches in the face and extremities
with carpopedal spasm,
• convulsions,
• arrhythmias or cardiac Arrest

14. oxalate crystals.
Renal : Dysuria, oxaluria, hematuria, oliguria and anuria.
gangrene.
Chronic Exposure:
skin contact lead to local erosion which may lead to cyanosis and gangrene

15. Management
• Gastric lavage.Calcium should be given rapidly
by every route 10% Ca gluconate slowly IV or
orally

16. References
KNIGHT’S Forensic Pathology 3Ed.
Text book of Forensic Medicine & Toxicology - Krishan Vij 5Ed
Text book of Forensic Medicine & Toxicology - Nageshkumar G Rao - 2nd Ed.