Apr. 15, 1921 
Carbon Tetrachlorid for the Removal of Worms 
161 
two stockmen think that they killed two calves and one steer by its use 
in cases of screw-worm infestation. 
The findings of the various writers cited above are conflicting. Tuson, 
Blanch, Smith, and Morel report good results; Ure, Andrews, and Laffont 
report unsatisfactory results; Simpson, Sansom, and Nunneley report 
good results with distinct reservations as to the danger present in the 
use of this drug. The last attitude is perhaps the best, as well as the 
most conservative. The evidence indicates that when inhaled the drug 
gives rise to an initial excitation comparable to that produced by ether, 
and that subsequently it acts as a heart depressant comparable to 
chloroform. Knowing as we do that adequate amounts of chloroform 
by inhalation or by mouth may give rise to acute yellow necrosis of the 
liver, it would be expected that carbon tetrachlorid, with a formula 
very similar to chloroform, would produce somewhat similar effects. 
Owing to the small amount of work on this drug, the evidence on this 
point is somewhat meager, but apparently carbon tetrachlorid does 
cause some injury to the liver. The statement in the British Medical 
Journal of September 25, 1920, already noted, that frequent inhalations 
may ultimately give rise to toxic jaundice is such evidence. Additional 
evidence is furnished me by Dr. Ch. Wardell Stiles, to whose attention 
these anthelmintic findings have been brought. He states that experi¬ 
ments at the Hygienic Laboratory show that carbon tetrachlorid does cause 
some injpry to the liver. In this connection more study is evidently 
necessary. The acute yellow necrosis due to chloroform poisoning is 
sometimes fatal; but when this is not the case there is a complete repair 
and recovery in the course of two weeks. Apparently the administra¬ 
tion of sodium bicarbonate is of value in combating the acidosis present 
in such cases. The capacity of the liver for disposing of poisons and for 
regeneration makes it the organ of choice for anthelmintic insult. 
On the available evidence carbon tetrachlorid deserves further study 
in connection with its administration in labor. That it relieves pain 
without diminishing the uterine contractions would indicate that it is 
superior to chloroform and should be restudied in connection with 
present-day interest in the production of the so-called “twilight sleep.” 
It seems to warrant further study in connection with its employment 
in hay fever, hysterical headache, and the other conditions in which it 
gave such good results. 
The foregoing facts are given in some detail for the reason that they 
cover fairly well what is known about this drug, so far as literature may 
be readily traced, and because, in suggesting the employment in a new 
r 61 e of a substance which is not well known, it seems advisable to state 
what is known about its physiological action in connection with the first 
report of its anthelmintic action. 
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