Included in this group, as in the former one, are substances chemically
very different from each other, but of which the action is especially
on the blood. Besides this common effect, these substances also produce
various other effects, such as local irritation, effect on the nervous
system, &c. The industrial blood poisons, which according to their
chemical constitution are classed among the aliphatic and the aromatic
series of organic compounds, will, for the sake of clearness, be
discussed in the following chapters.
ARSENIURETTED HYDROGEN
Acute arseniuretted hydrogen poisoning, produced by inhalation of
relatively very small quantities of arseniuretted hydrogen gas (AsH₃)
is in most cases industrial in origin. The absorption of an amount
corresponding to about 0·01 mg. arsenic suffices to produce severe
poisoning symptoms. The poisonous effect results chiefly from action upon
the red blood corpuscles, which are dissolved (hæmolysis). Arseniuretted
hydrogen is therefore a genuine blood poison. The effect upon the
blood, if not immediately fatal to life, is to cause the dissolved
blood-colouring matter to pass into the tissues where, though some is
deposited, most goes to, and acts injuriously on, the organs, especially
the liver, spleen, and kidneys. In cases running at once a fatal course,
the impoverishment of the blood caused by the lack of colouring matter
necessary to internal respiration produces tissue suffocation, which is
therefore the primary cause of death. In cases not immediately fatal, the
injury to the functions of the organs alluded to (for instance, cessation
of the functions of the kidneys, &c.) may lead to death secondarily.
Symptoms of the disease appear often only some time after the poisoning
has set in, and begin with general malaise, sickness, collapse, fainting
fits, and difficulty of breathing; after some hours the characteristic
signs follow—the urine becomes dark red to black, containing quantities
of blood colouring matter and dissolved constituents of the blood, and
later also bile colouring matter, so that a coppery jaundice comes on if
the illness is prolonged. The region of the liver, spleen, and kidneys
is painful. Severe cases often end fatally during the first stage of
the illness, more rarely later, with increased difficulty of breathing;
sometimes death occurs after a preceding comatose stage marked by
convulsions and delirium. In slighter poisoning cases the symptoms abate
in a few days and recovery follows.
The treatment of arseniuretted hydrogen poisoning is similar to that
adopted in the case of all other blood poisonings: in addition, if
possible, direct transfusion of blood from the artery of the giver into
the vein of the receiver, liquid nourishment, saline injections, and,
above all, prolonged oxygen inhalation.
CARBONIC OXIDE (CO)
Carbonic oxide (CO) is a colourless, odourless gas which frequently
causes both acute and, it is said, chronic industrial poisoning.
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