150 Scientific Proceedings (ioo). 



cells may be injured without such hydrolysis occurring. It is 

 probable that the gastrointestinal catarrh resulting from the 

 injections of dichlorethylsulphide is secondary to the nervous 

 injury, rather than to an excretion of the poison or poisonous 

 products through this tract, although this point remains unsettled. 

 No positive tests for dichlorethylsulphide or dihydroxyethyl- 

 sulphide have been obtained in the bile, intestinal contents, or 

 urine. Incidentally, it has been shown that the platinic chloride- 

 sodium iodide color test for dichlorethylsulphide is not applicable 

 to the body fluids or extracts of various organs and tissues, as 

 similar color changes are produced by some of these. 



Treatment. — The principles of treatment to be applied to 

 mustard gas injuries are primarily those that will remove any of 

 the gas remaining, lessen necrosis, prevent infection and promote 

 healing. Our experience leads us to recommend the use of 

 Dakin's solution in irrigation or full baths for the skin lesions, 

 and a 0.5 per cent, solution of dichloramine-T for the eye lesions, 

 and also as a mouth wash. The fluid intake should be forced 

 when the urine is concentrated. Pressure must be removed 

 from all injured areas. Air-excluding and infection-including 

 protections, such as oily dressings, paraffin sprays and coatings, 

 zinc stearate, olive oil, vaseline, etc., should not be used, unless 

 there is an active and persistent germicidal agent present as in 

 the case of sodium stearate impregnated with chloramine-T, or 

 the chlorcosane solution of dichloramine-T. 



Sequelae. — Among the most important sequelae of mustard 

 gassing is the apparent increased susceptibility to influenza, 

 bronchitis, pneumonia and tuberculosis following lesions of the 

 respiratory tract cicatricial contractions, pulmonary fibrosis. The 

 respiratory infections may become chronic and death from these 

 may take place months after the gassing. Persistent aphonia, due 

 to local lesions or as one expression of a traumatic neurosis, is 

 not a rare sequel. Chronic disturbances of vision are also in part 

 the result of local changes and in part psychical. In the skin con- 

 ditions of chronic eczema, itching and desquamative dermatitis, 

 and pigmentation occur as sequelae. Leucotrichia has also been 

 observed. It is safe to predict that a development of squamous 

 cell carcinoma in the extensive cicatrices, following mustard gas 



