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Proceedings of the Royal Society of Edinburgh. [Sess. 
exhibited, ending in capillary stasis as a result of concentration of their 
contents through the exudation of plasma. Death, however, is regarded 
by Hill as due, not to capillary stasis, but to the presence of fluid in 
the air cells and passages, the man being actually drowned in his own 
secretions. 
In man the immediate effects of chlorine gas poisoning since the 
Germans introduced gas into warfare in the spring of 1915 has been 
observed in a large number of cases. Notes on a series of 685 cases 
were published in the British Medical Journal , 1915, ii, 165, by Black, 
Glenny, and McNee. Cases have also been described by Broadbent ( British 
Medical Journal, 1915, ii, 247), and an excellent summary will be found 
in Hurst’s Medical Diseases of the War, 1917. 
The most marked immediate effects are burning pain in the throat and 
eyes, associated with a feeling of suffocation. Pain is also felt in the chest, 
especially behind the sternum. Respiration is painful, rapid, and difficult. 
Retching and vomiting very commonly occur, the latter sometimes giving 
temporary relief. Severe headache soon comes on, and unconsciousness 
may occur almost immediately ; at other times it is delayed for some hours. 
In very severe cases the face may assume a pale, greenish-yellow colour ; 
in less severe cases it is violet-red, and the ears and finger-nails blue. 
The skin is cold and the temperature subnormal. The pulse-wave is 
large, unless collapse is present, and it rarely rises to over 100 per minute. 
Respirations are jerky, shallow, and rapid, often 40 or even 80 to the 
minute. The auxiliary muscles of respiration are in active motion. 
Coughing may be frequent and painful, and much frothy sputum is 
brought up. 
On examination the percussion note is impaired, and auscultation reveals 
the presence of moist sounds of varying qualities over the whole chest. 
The dyspnceic and asphyxial stage lasts some thirty-six hours, after which 
the patient may fall asleep and waken much better. After a few hours of 
comparative quiet, symptoms of bronchial irritation begin to show them- 
selves. Sometimes broncho-pneumonia supervenes. The sputum becomes 
viscid, yellowish, or greenish, with occasional streaks of blood. Respira- 
tions are rapid and shallow, 70-80 to the minute. The pulse is small 
and rapid and the temperature rises, sometimes to 104° F. Other com- 
plications which may supervene are pleurisy, empyema, and gangrene of 
the lung. 
The post-mortem examination of acute cases shows thin, light yellow, 
frothy secretion filling the trachea and bronchi. The mucous membrane 
of the respiratory passages is swollen and oedematous. A slight degree of 
