306 
Proceedings of the Royal Society of Edinburgh. [Sess. 
XVII. — Observations on the Blood in Gas Poisoning. By James 
Miller, 31.1)., Captain R.A.M.C., and Harry Rainy, M.D., F.R.C.P.E. 
(MS. received June 30, 1917. Read May 21, 1917.) 
The subject of the following paper was suggested by the study of a case 
(No. 9 of our series) which was admitted to the Second Scottish General 
Hospital, Craigleith, suffering from general weakness and a certain degree 
of breathlessness for which no very obvious cause was apparent. Investi- 
gation revealed a somewhat unusual condition of the blood, and on seek- 
ing for a cause for this it occurred to one of us (H. R.) that it might be 
due to the effects of a comparatively slight gas poisoning which the patient 
had sustained, but to which he had not attached much importance. Investi- 
gations were therefore instituted in other cases under our own care and 
that of our colleagues, with the result that the surmise was confirmed, 
and we are now able to submit the results of the examination of fifty 
cases and to reach our conclusions from a sufficiently extended series of 
observations. 
The great bulk of the work of this joint paper has fallen upon Captain 
Miller, who, as pathologist to the hospital, took supervision of the 
laboratory and blood counts ; Dr Rainy’s share being mainly the initiation 
of the investigation and the providing of certain of the clinical cases, 
especially in the earlier stages of the research. The authors, however, 
hold themselves jointly responsible for the views which the communication 
expresses. 
The effects produced by the inhalation of chlorine gas may be divided 
into immediate and remote. 
As regards the immediate effects upon the body tissue generally, 
Schafer ( British Medical Journal , 1915, ii, 245) has shown experimentally 
that considerable quantities of Ringer’s solution, saturated with the gas, 
may be introduced directly into the circulation without producing any very 
marked effect beyond a quite temporary diminution of blood-pressure and 
a slight increase in the depth of respiration. 
With inhalation, on the other hand, the results are always serious. 
Even with air containing only 1 per cent, of chlorine a profound and sudden 
change occurs, the animal’s respirations become very deep, then convulsive, 
and ultimately cease altogether. The blood-pressure rises slightly at first, 
then falls rapidly, whilst at the same time there is marked slowing of the 
