Toxic Action of Dichlorethylsulphide. 145 



minutes after exposure to dilute concentrations, degeneration or 

 necrosis of the corneal surface may be demonstrated by the 

 application of a 2 per cent, alkaline aqueous solution of fluorescein, 

 the injured cells retaining a greenish fluorescent coloration. In 

 more severe injuries the cornea may be killed throughout its entire 

 thickness at the vertex. The mildest cases show a slight cloudi- 

 ness ; the severe cases present a characteristic porcelain appearance 

 of bluish white opalescent cloudiness, often with a more opaque 

 band or line running horizontally across the cornea just below its 

 transverse diameter. The injury to the conjunctiva is shown by 

 the development of a more or less severe catarrhal, seropurulent 

 or purulent conjunctivitis with marked edema of the subcon- 

 junctival tissues leading often to "ruffling" of the lids, entropion, 

 ectropion or a combination of these. Even the lighter cases tend 

 to run a chronic course with disturbances and reduction of vision. 

 In the severe cases cicatrization and vascularization of the cornea 

 take place slowly with resulting impairment or loss of vision. 

 The injured eye is more susceptible to infection; and in infected 

 cases suppurative panophthalmitis may develop with complete 

 destruction of the eyeball. Recovered cases of mild mustard gas 

 conjunctivitis often show an increased sensitivity to the action of 

 light, dust, and other irritants, including mustard gas fumes. 



Respiratory Tract. — Upon the mucosa of the respiratory tract 

 mustard gas vapor produces a local injury to the epithelium as 

 shown by the development of a catarrhal, desquamative, mem- 

 branous, diphtheritic or purulent inflammation (rhinitis, stoma- 

 titis, pharyngitis, laryngitis, tracheitis and bronchitis), these 

 lesions being most severe in the nose, back of tongue, palate, 

 pharynx and larynx, decreasing in intensity downwards. Coryza, 

 salivation, dryness of mouth and throat, aphonia and persistent 

 cough are the chief symptoms, with physical signs of laryngeal, 

 tracheal and bronchial involvement, and atelectasis, emphysema 

 and edema of the lungs. As a result of secondary infection a 

 purulent bronchopneumonia may develop. 



Gastrointestinal Tract. — Through the swallowing of air, saliva 

 or secretions from the upper respiratory tract containing mustard 

 gas, or from the ingestion of contaminated food local corrosive 

 action upon the alimentary mucosa may be produced, varying 



