Substance
Phosphorus and phosphides

Pathology
Local irritation and tissue burns; direct toxic effect to myocardium and vessels; hepatic, renal, and GI damage due to latent systemic toxicity.

Symptoms
Painful burns to mucous membranes and skin on contact, nausea, vomitus and diarrhea with garlicky odor, jaundice, metabolic derangements, dysrhythmias, coma, shock, seizures, hepatic or renal failure, cardiac arrest. Inhalation can cause pneumonitis and pulmonary edema.

Emergency Measures
Maintenance of airway, breathing, circulation; endoscopy to assess GI burns; cautious gastric lavage with hydrogen peroxide or potassium permanganate, followed by activated charcoal and mineral oil cathartic; fluid replacement and correction of electrolyte imbalance.

Comments
After acute effects from ingestion, a symptom-free period of a few weeks may be followed by a stage of systemic toxicity involving the liver, kidneys, heart, CNS, and GI tract.