In poisoning by nitrous acid fumes, oxygen inhalation, if applied in time, undoubtedly holds out hope of success, and should always be tried. Chloroform has been repeatedly recommended as a remedy. Probably its inhalation produces no actual curative effect, but only an abatement of the symptoms through the narcosis induced.
Nitric acid (HNO₃) in solution has an irritant corroding action if, when concentrated, it comes into contact with the skin or mucous membrane.
THE HALOGENS (CHLORINE, BROMINE, IODINE)
Chlorine (Cl) is a yellow-green, pungently smelling gas, Bromine (Br) a fuming liquid, and Iodine (I) forms crystals which volatilise slightly at ordinary temperatures.
According to Lehmann’s experiments on animals the effect of chlorine gas and bromine fumes is completely similar. Lehmann and Binz assume that chlorine has a twofold effect: (1) narcotic, paralysing the outer membrane of the brain, and (2) the well-known irritant action upon the mucous membrane, producing a general catarrh of the air passages, and inflammation of the lungs; it is, however, only the latter which causes menace to life. Other writers do not mention the narcotic effect upon the brain and assume that the halogens when brought into contact with the mucous membrane are quickly converted into halogen hydrides, and, as such, produce a corrosive effect. According to Lehmann, even 0·01 per thousand Cl or Br in the air is injurious, even 0·1 per thousand produces ulceration of the mucous membrane, and one or two hours’ exposure to the poison endangers life. Lehmann has further tested (on dogs) acclimatisation to chlorine, and finds that after a month the power of resistance to chlorine appears to be increased about ten times. In a further series of experiments the same author has proved that even the smallest quantities of chlorine present in the atmosphere are completely absorbed in breathing.
Continued or frequent action of chlorine upon the organism produces symptoms which have been described as chronic chlorine poisoning—such as anæmia and indigestion, in addition to catarrhal and nervous symptoms. Further, in factories where chlorine is produced by the electrolytic process, workers were found to be suffering from the so-called chlorine rash (first observed by Herxheimer). This skin disease consists in an inflammation of the glands of the skin, with occasional development of ulcers and scars. Severe cases are accompanied by digestive disturbance. Bettmann, Lehmann, and others maintain that it is not caused by chlorine alone, but by chlorinated tar products, which are formed in the production of chlorine and hydrochloric acid.
In acute cases of chlorine poisoning oxygen treatment should be tried, but in any case the patient should have free access to pure air. Approved remedies are inhalation of soda spray or very dilute ammonia, or of a vapourised solution of sodium hypochlorite. If the patient is in great pain, he may be allowed to inhale cocaine solution (0·2 per cent.).
The administration of arsenic (solutio arsenicalis) is recommended, especially in cases of acne. In general the usual treatment for diseases of the skin is followed; salicylic acid lotions, sulphur baths, and sulphur ointments may be made use of.
Chlorides.—Chlorides of Phosphorus, Phosphorus-trichloride (PCl₃), and Phosphorus oxychloride (POCl₃), are strong-smelling liquids, fuming in the air, and when brought into contact with water decomposing into phosphorous acid and hydrochloric acid. These halogen compounds of phosphorus have a violently irritant action upon the respiratory organs and the eyes, in that they decompose on the mucous membrane into hydrochloric acid and an oxyacid of phosphorus. Inhalation of the fumes of these compounds causes cough, difficulty of breathing, inflammation of the respiratory passages, and blood-stained expectoration.