An atlas of gas poisoningGreat Britain. Medical Research Committee
History
An atlas of gas poisoning
Great Britain. Medical Research Committee
Gases, Asphyxiating and poisonous -- War use
The recovery of the lung, even after severe gassing appears to be
functionally good. In the earlier stages of convalescence there may
still be signs of persisting oxygen want, so that tachycardia with
excessively rapid respiration is the result of even slight physical
effort. Later these disabilities vanish. The microscopic examination of
lungs in these stages of recovery has not been made.
[Illustration: PLATE I.]
PLATE NO. II
Blue type of asphyxia from phosgene poisoning, with intense venous
congestion.
_History of case._ Drawing made early on second day after gassing; when
there was copious frothy sputum, frequent cough, and hurried shallow
respiration of 40 to 48 with temperature of 101° and pulse 100. The
patient was bled 15 ozs. and oxygen added to the air that he breathed.
He soon made a complete recovery.
Such venous congestion was more frequent with chlorine poisoning than it
now is with phosgene. It is associated with a full strong pulse at the
outset, though later the pulse may fail and the asphyxia change to the
pallid type shown in Plate III. The patient as a rule is fully conscious
and complains chiefly of headache and pains in the chest; he turns
restlessly to and fro in extreme general discomfort, and his hurried
breathing is interrupted from time to time by short bursts of coughing
and of expectoration. The lung is in the oedematous state shown in Plate
I.
Oxygen, when given by an efficient apparatus, will at once change the
blue tint of the face to a full pink colour, showing that it can still
be absorbed by the blood through the lungs. Venesection relieves the
discomfort felt by the patient, and probably lessens the embarrassment
of the circulation.
[Illustration: PLATE II.]
PLATE NO. III
Pallid type of asphyxia from phosgene poisoning, with circulatory
failure.
The cyanotic hue of the ears and lips, despite the general pallor caused
by the failure of the circulation, indicates the intense want of oxygen
from which the patient is suffering. Respiratory difficulty is shown in
the strained effort of the muscles around the nostrils.
_History of case._ Drawing made on second day after gassing, when there
was profuse frothy expectoration, hurried shallow breathing of 50 a
minute and a rapid running pulse of 132. The patient died two hours
later.
This pallid or leaden-hued type of asphyxia is characteristically
frequent after phosgene, and it may either develop at once with a
rapidly progressive failure of the circulation or follow a stage of
venous congestion.
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