309 
191 6-17. J Observations on the Blood in Gas Poisoning. 
oedema of the glottis is observed in some cases. The lungs are voluminous, 
and subpleural haemorrhage occurs. On section the lungs are of a deep 
maroon-red colour, with abundant secretion flowing from the cut surface. 
Light grey patches of acute emphysema are observed along the borders. 
Microscopically, the portions of the lung not affected by emphysema show 
marked congestion of the vessels. The alveoli are filled with a homo- 
geneous amorphous exudate taking on eosin stain. Occasionally fibrin 
threads, red cells, and leucocytes are met with. 
The heart, more especially the right side, is dilated. 
The stomach shows evidence of acute catarrh. The mucosa is covered 
with thick yellowish mucus and shows submucous haemorrhages, which are 
sometimes extensive. 
The more remote effects of gassing are various. An analysis of 50 cases 
observed by us results as follows : — 
Conjunctivitis ........ 2 cases. 
Dyspnoea and bronchitis . . . . . . 33 „ 
Vomiting and dyspepsia . . . . 6 „ 
Headache, tremors, nervous symptoms, and loss of sleep 10 „ 
Broadbent ( British Medical Journal, August 14, 1915) records five 
cases of nephritis following upon gas poisoning. The albumen was not 
present when the men were first admitted to hospital, but appeared in the 
course of a few days. Epithelial and granular casts were present in 
abundance. Broadbent says that “ it looks as if in some cases the chlorine 
or bromine damages the lung epithelium so severely that it does not allow 
absorption into the general circulation, while in others the gas passes 
through the lungs without affecting them permanently, but then sets up an 
acute nephritis.” The observations of Schafer are against any such 
damage of tissue other than that of the lung. Leonard Hill combats this 
view of Broadbent, stating that the nephritis should be ascribed to the 
intense and prolonged dyspnoea and the struggles for breath. He says that 
albuminuria is a common result of the very temporary dyspnoea which 
athletes suffer in a race. It results from want of oxygen in the kidneys. 
We have not observed evidence of kidney damage in our cases. 
The striking thing about these cases of gassing is the prolonged 
disability of the men. The symptoms persist for months and years in 
many cases. We have seen a number of such cases; the following may 
be taken as instances : — 
Cases 3 and 6. — Twelve months after gassing, marked conjunctivitis 
and tremors. 
