From Big Medical Encyclopedia

CARBOLIC ACID (Acidum carbolicum, Phenolum purum; With 6 H 5 OH), phenol (hydroxybenzene) — the simplest representative of the organic compounds containing the OH group in a direct connection with benzene ring; has bactericidal properties therefore it is used for disinfection and disinsection. Solutions K. to. use at disinfection concerning infectious diseases of respiratory tracts (except for tuberculosis), intestinal infections and at some zoonoza; in medicine To. to. means is applied also as local cauterizing and soothing (in stomatology). At intake and steam inhalation To. to. its toxicity is shown: it influences c. the N of page, destroys blood cells, etc. In pharmaceutical practice To. to. apply to conservation of medicinal substances, serums, etc. To. to. it is used also in pharmaceutical industry, in production of synthetic dyes, for receiving polymeric materials, synfils, in production of explosive substances.

To. to. it was open in coke-oven coal tar in 1834 it. chemist F. F. Runge. Chemically pure To. to. represents white crystal matter with a pungent characteristic smell; t ° pl 42,3 °, t ° kip 182,1 °, ud. weight 1,071 (at 25 °). At 15 ° in water 8% are dissolved To. to. It is well dissolved in alcohol, ether, benzene, lipoida. With water forms hydrate To. to. — With 6 H 5 (OH) - H 2 O. The insignificant amount of moisture translates To. to. from crystal in liquid state (Acidum carbolicum liquefactum). Technical To. to. represents red-brown, sometimes a black viscous liquid. It is cleared by distillation and recrystallization. Acid properties K. to. are expressed very poorly. It forms simple and esters; easily is oxidized on air that is followed by a pinkness of its crystals.

To. to. receive directly allocation from the pitch which is formed at dry distillation of a tree or black coal, or synthetic. For industrial receiving To. to. in the synthetic way use alloyage of salts of benzene sulphonic acid with alkalis or effect of caustic alkalis on benzene chloride at high temperature and high pressure in the presence of copper.

Bactericidal properties

Antiseptic properties K. to. were found in 1834, but in surgical practice it was introduced for the first time in 1867 by J. Lister. The mechanism of antiseptic action To. to. connect with its denaturant action on proteins of microorganisms or with disturbance of a redox system of bacterial cells as a result of accumulation in them To. to. and interactions of its hydroxylic group with amino groups of proteins. 1 — 8% solutions K. to. cause an irreversible denaturation and sedimentation of protein, and the concentration to - you is higher, the more intensively there is a process of a denaturation of protein.

It is established that 1 — 2% solutions K. to. destroy mold fungi and reduce ability of yeast cells to ferment, and 4 — 5% solutions absolutely destroy these cells. Solutions K. to. have the expressed bactericidal properties concerning vegetative forms of microorganisms: 3% solution the hemolitic streptococcus almost instantly kills, diphtheritic sticks find reduction of growth already in 30 sec. after addition it in culture, more resistant to action To. to. microorganisms (causative agents of typhus and cerebrospinal meningitis, stick of a sap, etc.) perish for 15 — 60 sec. Typroid and dysenteric sticks perish under the influence of solution K. to. in cultivation 1:80 or 1: 100 at the room temperature in 5 — 10 min.

On disputes of bacteria To. to. makes very slight attachment. Disputes of sticks of a malignant anthrax do not perish in 5% solution K. to. even within a month. The majority of viruses rezistentno to it. On putrefactive bacteria To. to. influences only in konts. solutions.

Bactericidal properties K. to. amplify with temperature increase of its solutions. Addition to solutions K. to. insignificant quantities salt to - you sharply increase their bacterial action therefore at disinfection usually use mix from 4 h 5% of solution K. to. and 1 h 0,01 N of solution salt to - you. To strengthening of bactericidal properties K. to. also addition to its solutions of others to - t, napr, sulfuric, oxalic, acetic, and salts of alkali metals promotes. Presence at solution K. to. serum proteins, oils and alcohol lowers its bactericidal action.

Toxic and physiological action

To. to. has toxic properties which come to light at outside influence, at intake and at inhalation of its vapors. To. to. it is easily soaked up by skin and causes formation of a white scab which then grows brown, and becomes later white, surrounded with the red border disappearing in several days, at the same time the scab is mummified and disappears. At long impact on skin of 5% solutions K. to. cause a burning sensation, pains, and then loss in this place of sensitivity owing to paralysis of the terminations of sensory nerves; 2% solutions K. to., influencing it is long on skin, can cause gangrene of an extremity, it is probable owing to vasoconstriction, staz and thromboses. To. to. causes an inflammation and a necrosis of mucous membranes. The entered per os K. to. the hl is soaked up. obr. in a stomach from where comes to blood and affects c. N of page. Toxic action To. to. it can be shown at careless washing of wound surfaces by it. Erythrocytes at direct action on them 3 — 4% of solutions K. to. gradually shrivel, hemoglobin separates from a stroma; solution has the same destroying effect on leukocytes, muscle and nerve fibrils.

To. to. at first excites, then oppresses motoriums of a spinal cord and bark of cerebral hemispheres. Affecting a respiratory center, To. to. causes the accelerated dispnoetichesky breath which is replaced by easing it and paralysis. At introduction To. to. in an organism in high doses there is at first an increase, and then weakening of reductions of heart, falling of the ABP and a collapse. Febrifugal action To. to. most of authors connects with the phenomena of a collapse, allowing only as the minor reason the oppressing action to - you on the center of thermal control. At the si-lenny department of saliva and sweat observed at poisonings To. to., central origin.

Poisonings with carbolic acid

the Possibility of fatal poisoning To. to. at its rubbing in in large numbers in the unimpaired skin it is proved by pilot studies on animals.

The undesirable phenomena can develop even after acceptance in very small doses To. to. At the same time the slight headache, sometimes dizziness, feeling of intoxication or devocalization, feeling of crawling of goosebumps, perspiration, the general weakness are observed, vomiting, a diarrhea, signs of irritation of kidneys — protein, erythrocytes, even hemoglobin in urine develop. Urine in mild cases of poisoning is painted in dark color that is caused by transition of a significant amount entered into an organism To. to. in hydrochinone which at further oxidation gives colored compounds. After acceptance of per os of the concentrated solution K. to. in the beginning severe pains in a gullet and a stomach are felt, vomiting develops; then owing to anesthetic effect To. to. pains and burning can stop, but quickly there come the phenomena connected with a systemic effect of poison: blanching, then cyanosis, dizziness, difficulty of breath, weakening of cordial activity, temperature drop of a body, often spasms, data of jaws. Emetic masses has a smell of phenol; the mocheotdeleniye in most cases falls apart, urine contains protein, sometimes hemoglobin. Despite the consciousness which is returned from time to time, death, as a rule, comes very quickly owing to difficulty of breath and decline of cordial activity.

Made To. to. burns of a mucous membrane went. - kish. a path seldom get more deeply than a muscular layer and ordinary are not observed distalny a duodenum; sometimes limited and diffuse bruises in upper parts of the digestive channel are found or the mucous membrane gets firmer consistence, reminding tannage. The stomach contains the brown turned blood, the mucous membrane of intestines is covered with blood slime, the fluid lungs is often observed, in kidneys the hyperemia, swelling of cortical substance, blood blood clots in it and fatty regeneration of a renal epithelium is found.

Cases of hypersensitivity in the relation are described To. to. The persons who are often addressing with To. to., sometimes have eczema of hands, a nephrosis. From complications pneumonia and toxic nephrites are most dangerous.

To. to. can be present at air of production rooms at production of artificial pitches (e.g., bakelite, etc.), at a razgonka of coal tar, at synthesis of some painting and medicinal substances etc. Acute poisonings To. to. as a result of inhalation of its vapors under production conditions meet seldom; poisonings are more often observed hron. At acute poisonings with couples To. to. the picture similar to that what is after reception To is observed. to. per os. Hron, poisonings are shown by irritation of respiratory tracts, a digestive disturbance, nausea, vomiting in the mornings, the general and muscular weakness, perspiration, a skin itch, irritability, sleeplessness, sometimes a disease of kidneys, heartbeat and pains in an anticardium. Cases of poisoning are described To. to., followed by anemia and nevrol, symptoms.

From an organism To. to. it is allocated quickly enough: an insignificant part in the changed look through respiratory tracts, other — with urine in the form of fenolserny to - you. At introduction to a stomach of a high dose To. to. fenolserny to - that was found in contents of a stomach, in blood, a liver, kidneys, a spleen, muscles and in urine.

First aid at poisonings To. to. 10% solution of alcohol, and then water for removal of the entered alcohol consist in perhaps bystry gastric lavage at first. Appoint inside the enveloping means, and at approach of coma and a collapse enter the means raising the ABP (ephedrine, a phenylephine hydrochlorides) strengthening cordial activity (cardiac glycosides). In case of need support breath by means of medical ventilators. At hit To. to. on skin or wetting of clothes by it — immediate washing of all body of the victim water, rubdown by alcohol of sites of skin on which got To. to., change of clothes.

Maximum allowable concentration To. to. in air of a working zone of 5 mg/m 3 .

On productions where it is applied To. to., it is recommended to use overalls from dense fabric and rubber mittens. For prevention of poisoning with couples To. to. the industrial filtering gas mask is suitable. Measures of the prevention of poisoning To. to.: frequent change of clothes, mechanization of production, ventilation and control of concentration To. to. in air of workrooms.

For detection and quantitative definition of vapors K. to. in air use reaction with Millon's reactant or reactions of formation of azoic dyes.

Use in medical practice

In dental surgery practice To. to. also an anesthetic (in mix with novocaine) and in the form of paste with Acidum arsenicosum is applied to destruction of a pulp of carious tooth as cauterizing. For introduction to an ear at average otitis use 5% solution K. to. in anhydrous glycerin. In surgical practice of 1 — 3% solution is applied to disinfection of tools, by storages of a suture material, to preparation of an antiseptic dressing material.

For disinfection (see) rooms (walls, windows, doors and so forth) apply soap and carbolic solution, e.g. 2% of green soap, 5% To. to. and 93% of water. 1 — 2% soap solutions K. to. (about 100 — 200 g To. to. on a bucket of water) apply to disinfection of linen: linen is presoaked and kept in solution 2 hours. Soap and carbolic solutions have good detergency.

To. to. phenolic turpentine - nykh mixes is used in the form of phenolic and kerosene, for disinsections (see), it is applied to disinfecting of the infected masses and gelatinous mixes.

Use in the microscopic equipment

To. to. it is applied to an enlightenment macro - and microscopic drugs, to preparation of solutions of dyes (a karbolfuksin, karbolgentsianovy violet, etc.), to-rymi in bacteriology, disinfectings of solutions of dyes, gelatin, injection masses etc., and also for dehydration and an enlightenment macro - and microscopic drugs widely use. As To. to. actively connects water and thereof dehydrates fabrics, it is added sometimes to chloroform or to a xylol (2 g on 100 ml) during the filling of pieces of bodies to paraffin (A. V. Rusakov, 1942). At dehydration of cuts for the subsequent conclusion them in Canada balsam (see).

A. V. Rusakov recommends instead of absolute alcohol 2% solution K. to. in 96% alcohol. To dehydration and an enlightenment of drugs after carrying out they through a series of alcohols of the ascending fortress and before the room in a xylol are applied karbolksilol, and also karbolbenzol, karboltoluol or karbolskipidar (1 h kristallich. To. to. on 3 — 5 h solvent). In some cases (is more often in bacteriology) for achievement of more intensive coloring solutions of the main dyes are prepared for 1 — 5% solution K. to. (e.g., karbolfuksin across Tsil, karboltionin across Nikoll, carbolic gentsianovy violet or kristallofioletovy, etc.). Seki (M. of Seki) recommends to part for 3 — 5% solution crystal To. to. solution of magenta acid for identification of mitochondrions.

Carbolic acid in the medicolegal relation

At necropsy of the person who died from poisoning To. to., note a pungent smell of phenol; a mucous membrane of a mouth, a gullet, a stomach, and sometimes and a duodenum dense, gray-yellow color, with a well-marked skladchatost. The stomach is reduced. If death was caused hron, poisonings To. to., note bronchitis, bronchial pneumonia, toxic nephrite, dystrophy of parenchymatous bodies.

For high-quality detection To. to. to the studied solution add a bromine water therefore the white deposit of tribromophenol is formed or there occurs opacification. At microscopy of this deposit crystals in the form of needles which compare to the same deposit received as a result of reaction of a bromine water and divorced solution of phenol are visible. The second qualitative test on To. to. consists that 1 — 2 drops of 5% of freshly cooked solution of chloride of oxide iron at interaction with the studied solution give blue and blue-violet coloring. This reaction is less sensitive (1: 1000), than reaction with bromine.

For quantitative definition use volume bromatometrichesky titration or weight definition of the tribromophenol formed in reaction.

See also Desinfectants , Phenols .

Bibliography: Harmful substances in the industry, under the editorship of N. V. Lazarev and E. N. Levina, t. 1, page 403, L., 1976; Mashkovsky M. D. Pharmaceuticals, p. 2, page 358, M., 1977; Merkulov G. A. Course of the patologogistologichesky equipment, L., 1969; Forensic medicine, under the editorship of V. M. Smolyaninov, page 239, M., 1975; Shvaykova M. D. Toxicological chemistry, page 111, M., 1975.

O. D. Halizova; E. 3. Bronstein (court. medical), Ya. E. Hesin (gist.).