The medical aspects of mustard gas poisoning / by Aldred Scott Warthin and Carl Vern Weller.

  • Aldred Scott Warthin
Date:
1919
Catalogue details

Licence: In copyright

Credit: The medical aspects of mustard gas poisoning / by Aldred Scott Warthin and Carl Vern Weller. Source: Wellcome Collection.

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    ments and pastes may actually inerease the intensity of the lesion owing to the solution of the mustard gas vapor in these substances. We advise against the use of any paste or ointment unless it is a chlorinating one. During our ex- perimental work, we found that bleaching-powder paste gave complete protection from mustard gas lesions on the hands when applied immediately after any ac- eidental contact with liquid mustard gas. Our experience with lead acetate, silver nitrate, sodium sulphide, magnesium sulphate and potassium perman- ganate led us to believe that these substances are of little value in lessening the intensity of the lesion and that they may actually increase its severity. Method of Treatment From the laboratory standpoint and theoretically it became very evident, to us that any form of treatment covering the surface of the injured skin areas and forming an air-excluding and germ-including coating was the worst possible method of treatment. Our animal experiments with zine stearate and other forms of oily coatings confirmed this view. Inasmuch as mustard gas causes a necrosis, more or less deep, of the skin, cornea and conjunctiva, and mucous membrane of the respiratory tract, the therapeutic problems are as follows: 1. To sterilize the. dead tissue and prevent infection of the eschar. 2. To prevent further necrosis by removing pressure. 3. To promote removal of the eschar and rapid regeneration and healing without secondary infections. Naturally, the use of Dakin’s solution suggested itself as an ideal method, particularly because the use of a chlorinating solution would also serve to de- stroy any mustard gas remaining in the skin, hair follicles, or sweat glands. burns and necrotic and: suppurative conditions of the skin, seemed an ideal method of treating severe mustard gas lesions, because of the danger of bedsores and secondary necrosis from pressure. An opportunity of applying these principles to the treatment of mustard gas lesions in human beings presented itself. A number of cases with mustard gas injuries varying from the mildest form up to the most severe and fatal degree were seen by us. When first seen they had been treated for a week by the air-excluding method of zine stearate, olive oil, mineral oil, oiled paper, ete. The severe cases were all infected, stinking with the odor of gangrene; the in- jured areas of the skin were gangrenous and dripping with a purulent san- euineous fluid, and large areas of pressure decubitus were developing. An op- portunity was afforded for the practical working of our suggestions; and the results justified this method of treatment, although, under the crude and inef- ficient conditions obtaining, the complete immersion method was not given a full trial. For local lesions, as of the genitals, the hip bath proved the efficacy of this method (see Fig. 151). We, therefore, believe that the method of treatment outlined below is of great practical value. It is founded upon the pathology of the lesions pro- duced by mustard gas, and is based upon scientific principles. It is not em- pirical or symptomatic. In practice it has produced good results. ~~