B. The experimental subjects were all persons of middle age, almost all in a weak and underfed condition. On principle, the healthier ones were used as controls, only control number 39 (J. Rei) and the orally protected experimental subject No. 37 (A. Rei) had a localized cirrhotic productive tuberculosis of the lungs. With the others, no pulmonary disease could be found. In the first experiments up to 6g hexamethylentetramine were given orally, later despite the much higher concentrations 0.06 g/kg body weight, orally as well as intravenously.
Results
The intravenously protected experimental subjects, without exception, all survived the phosgene poisoning with a c. t. of 247 to 5,400. There were no symptoms of pulmonary oedema after intravenous protection even with a c. t. of 2,970. Only experiment No. 10 with a c. t. of 3,960 suffered pulmonary oedema of the first degree, which was overcome without any therapy and in experiment No. XIV the intravenous protection was penetrated to an extent to cause pulmonary oedema of the 3d degree, which however was overcome by oxygen inhalation. The experimental subject recovered.
All control subjects fell ill. With a c. t. of 768 and 1,180 a first degree pulmonary oedema resulted which was overcome. With a c. t. of 2,275, one control subject died, the second contracted a second degree pulmonary oedema but recovered. A c. t. of 5,400 killed one control subject after 4 hours, the other after 14 hours.
After oral protection, a c. t. of 247 to 768 was suffered without any oedema, even when the protective solution of hexamethylentetramine was drunk only 2-3 minutes before the inhalation of the phosgene. Two control subjects showed a marked oedema with a c. t. of 768. With a c. t. of 1,485 one protected subject fell seriously ill with a second degree oedema, a second subject likewise protected, having breathed the same phosgenic air, was unaffected. The cause of this striking difference must be sought in the different resorption of the hexamethylentetramine on the one hand and in the different reaction and the different volume of respiration of the experimental subjects on the other hand.
Even a c. t. of 2,275 resulted in only a slight pulmonary oedema in an orally protected test subject, whereas one control subject died after 4 hours, and a second contracted a second degree pulmonary oedema. The oral protection was penetrated by a c. t. of 5,400, the protected test subject died, as did the two control subjects.
Experiment XV is characteristic of the test schedule and its results, and will therefore again be specially described. Of four test subjects, the first was protected orally, the second intravenously, the third received an intravenous injection of hexamethylentetramine after the poisoning, in order once more to ascertain the effect of therapeutic treatment, the fourth was not treated at all. The four subjects were placed in the chamber in which a phial containing 2.7 grams of phosgene was smashed. The test subjects remained in this concentration for 25 minutes. The phosgene content was measured three times during the inhalation. The readings showed an average concentration of 91 mg. per cbm. The subject protected intravenously remained healthy, and did not show the least signs of difficulties or symptoms, the orally protected subject contracted a slight pulmonary oedema, subsequently bronchopneumonia and pleurisy, from which he recovered. One control subject also survived his pulmonary oedema; the second died a few hours later, and the autopsy showed the characteristics of very serious pulmonary oedema.
Summary
The conclusions of the experiment are impaired by the varying constitutions and the general poor state of nutrition and of physique of the experimental subjects, as well as by the different behavior and the different volume of respiration of the experimental subjects under gas, which was here demonstrated for the first time. But the experiments gave the following decisive conclusions:
1. A previous intravenous injection of 3 grams of hexamethylentetramine completely prevents serious toxic and fatal phosgene poisoning from a c. t. of 2,275.