PHENOL STUDIES XII. THE PERCUTANEOUS AND ALIMENTARY ABSORPTION OF PHENOL BY RABBITS WITH RECOMMENDATIONS FOR THE REMOVAL OF PHENOL FROM THE ALIMENTARY TRACT OR SKIN OF PERSONS SUFFERING EXPOSURE

¹ Kettering Laboratory in the Department of Preventive Medicine and Industrial Health of the College of Medicine, University of Cincinnati, Cincinnati, Ohio
² Albany Medical College, Albany, New York

1. The degree of toxicity of orally administered phenol for rabbits, under comparable experimental conditions, is determined by the absolute amount of phenol administered, rather than by the concentration of the phenol in cottonseed oil or in water.

2. Phenol given by stomach tube to rabbits is less toxic when administered as a solution in castor oil or in a 40 per cent aqueous solution of "Bacto-Peptone", than when given in a variety of other vehicles including water and aqueous solutions (sodium sulfate, methyl cellulose, sodium carbonate, calcium lactophosphate, calcium glycerophosphate, tannic acid), as well as alcohol, various vegetable or mineral oils, white or yolk of egg, milk and cream.

3. In the case of rabbits, phenol is absorbed from the stomach much more slowly than from the ileum or descending colon.

4. A concentrated solution of phenol in water (75 per cent) applied upon the abdominal skin of rabbits will generally give rise to a somewhat higher concentration of phenol in the blood than that associated with the application of a more dilute (7 per cent) aqueous solution upon a similar area.

The cutaneous damage resulting from contact with aqueous solutions of phenol varies directly with the concentration of the solution applied. Injury to the skin of rabbits, caused by contact with solutions of phenol, appeared to retard the rate of percutaneous absorption of this compound.

5. In view of the foregoing facts, the following procedures are recommended for the most rapid and effective removal of phenol from the skin following accidental contact, and for the evacuation of phenol as far as possible from the stomach and intestine following its ingestion.

a) At the earliest possible time after contact of the skin with phenol, the involved area should be washed free of phenol by a virtual flood of water so directed as not to contaminate unnecessarily any other area of the skin, and so maintained as to remove all but the merest traces of residual phenol from any part of the skin. Obviously the clothing should be removed to the extent necessary to permit flooding of the affected skin and to prevent subsequent contact of any part of the skin with contaminated clothing.

b) At the earliest possible time after phenol has been swallowed, the evacuation of the stomach should be effected, not by means of emetic drugs, but by any mechanical means that is available, such as provoking vomiting by inserting a finger in the back of the pharynx or by drinking a large volume of warm salt water. If castor oil is available, the administration of 50 ml., without delay, will help to reduce the injury to the alimentary tract and may promote vomiting.

The stomach should be washed out as promptly as possible, if a physician is available to determine the feasibility and advisability of passing a stomach tube. Otherwise this procedure may not be attempted. The promptness of gastric evacuation and lavage is the most important factor in relation to the survival of the patient as well as to the safety of passing a tube. The most readily available suitable liquid, such as water, should be employed without delay for washing out the stomach, but a 40 per cent aqueous solution of "Bacto-Peptone" is preferable because of its efficacy in reducing the toxicity of the swallowed phenol.

When the physician considers it safe in relation to the probable severity of the existing damage to the alimentary tract, and advisable in relation to the possibility for limiting further alimentary absorption of phenol, castor oil may be introduced into the stomach after gastric lavage.