WAR SERVICE OF MEDICAL PROFESSION 287 



posure. It causes an eruption on the skin, at first of larger 

 or smaller rose red areas, which will later form blisters con- 

 taining yellow fluid. Later the fluid may coagulate and be- 

 come infected and the mass will slough away leaving a large 

 punched out ulcer. As the fluid from a blister runs over the 

 skin it may produce secondary eruptions and even ulcers. In 

 addition to the lesions on the skin, there may be conjunctivitis, 

 and ulcerations of the cornea, and a little later vomiting, hoarse- 

 ness, cough and pain with shortness of breath ; in the severer 

 cases there is oedema of the lungs and early death. Cases of 

 intermediate severity may progress well for a day or two, and 

 then develop a broncho-pneumonia from secondary infections 

 through the damaged mucous membrane of the respiratory 

 tract. Such cases die or recover, depending upon the extent 

 of the lesion. As a precautionary measure it was customary 

 to consider all gassed men as litter cases, to be carried to the 

 rear to special gas hospitals after receiving first aid treat- 

 ment, which usually consisted of irrigations of the eyes, nose 

 and mouth with a five per cent, solution of sodium bicarbonate, 

 and an application of soft soap or of soda solution to the body, 

 or if the case be seen early enough a two per cent, solution of 

 chlorinated lime may be used to neutralize the gas. To reach 

 the throat, trachea and the bronchi, inhalations of aromatic 

 spirits of ammonia, or of two per cent, sodium thiosulphate or 

 0.5 per cent, sodium bicarbonate were used. The further 

 treatment of the skin lesions was much like that employed for 

 ordinary burns. As soon as possible the man's entire clothing 

 was changed, as the gas adhered to it and remained active for 

 long periods, and he was given a complete bath in warm water 

 and alkali and a complete new outfit of clothing. 



The gas inhalation cases which were severe enough to be 

 sent back to base hospitals were treacherous and uncertain in 

 their course, and many died after an illness of weeks. All 

 possible lesions of the lung were present from simple catarrhal 

 bronchitis and oedema to suppurative processes involving the 

 trachea and bronchi and the lung itself. In the slower but 



