An atlas of gas poisoning.

Date:
1937
Catalogue details

Licence: Public Domain Mark

Credit: An atlas of gas poisoning. Source: Wellcome Collection.

    6/34 (page 4)
    INTRODUCTION Out of all the various substances which could be used in gas warfare, only two have been chosen for illustration of their effects in this Atlas (except for Plate IV). They are Phosgene (COCI,) and Mustard gas or di-chloro-di-ethyl sulphide (CH,C1.CH,),S. Phosgene is the chief of the many gases and liquids that are used for their effects as pulmonary irritants. These pulmonary irritants are inhaled as gases or vapours. They may cause some watering of the eyes, but the chief effect noticed at once is a catching of the breath or a choking sensation so that the chest feels gripped and incapable of free respiration. Coughing and vomiting may follow, and then after some time, varying from a few minutes to several hours, an inflammatory reaction appears in the lungs with the development of an acute oedema that may commence insidiously and yet progress so rapidly as soon to be a menace to life itself. The alveoli fill with oedema fluid, which then rises into the bronchial tubes and may appear in a most abundant thin, frothy expectoration. Aeration of the blood is seriously interfered with, because the air sacs are either drowned with oedema fluid or burst by the efforts of coughing. Moreover the circulation through the lungs is embarrassed, both by the pressure of the fluid on the capillary vessels and by the local thrombosis that occurs in many places in the smaller lung vessels. The blood is concentrated by the loss of serum so that the count may rise to even eight or nine million red corpuscles to the cu. mm. This change adds to the difficulties of the circulation. 3 The affected person can no longer get the oxygen he wants, and he either dies from obvious asphyxia with progressive circulatory failure, or he collapses as the result of some muscular effort that suddenly makes a greater call for oxygen and so reveals the deficiency of the supply. Death is the result of this inflammatory oedema of the lung, and it occurs chiefly on the first or second day after exposure to phosgene. A few cases may chance to develop secondary bacterial infections of the lungs and to succumb to a later broncho-pneumonia, but they are relatively rare. , The main clinical features of acute phosgene poisoning may be sum- marised as follows: (i) Catching of the breath, choking, and coughing immedsately on exposure to the gas. (ii) Inability to expand the chest in a full breath after removal from the poisoned air. (iii) Vomiting, hurried shallow respiration, and sometimes coughing with an abundant expectoration, follow. Pain is felt behind the sternum and across the lower part of the chest. Fine rales are heard in the axillae and over the back.