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I. Gaseous Chlorine
This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol2", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Effects on the System
This gas is extremely irritant, inflaming the skin if allowed to remain in contact with it, and, even when diluted with air or watery vapour, at a somewhat elevated temperature, giving rise in a few minutes to prickling sensations, followed sometimes by a papular or vesicular eruption. When undiluted, it is quite irrespirable, in consequence of the intense irritation, and spasmodic closure of the glottis, which it provokes. I once knew a violent attack of spasmodic croup to be brought on, in a child, by a bottle of chlorine held to his nostrils during inspiration. When mixed with a certain quantity of atmospheric air, it becomes respirable; but, unless much diluted, it produces inflammation of the bronchia, with violent cough, and a feeling of constriction of the chest, as if from spasm of the tubes, usually followed by copious expectoration. Even when much diluted, it is apt to produce irritation of the throat, and severe coughing. To a certain extent, the lungs may become accustomed to its presence in the air, so as to feel its irritant influence much less than at first. Sufficiently diluted, it may be inhaled without inconvenience, producing only a feeling of warmth, and an increase of the mucous secretion, and being in no other way disagreeable than by its smell.*
The effects of the gas upon the system at large have not been well determined. According to Mr. William Wallace, when applied by means of a vapour bath to the surface of the body, it tranquilizes while it invigorates the nervous system, occasions soreness of the mouth and throat, increases the flow of saliva, and has an alterative and excitant influence on the liver.
But the most important property of chlorine, in its medical relations, is that of destroying or neutralizing fetid exhalations, and correcting offensive smells, proceeding from animal putrefaction. This effect it owes to its affinity for hydrogen, by which it either directly decomposes the fetid matters, or, by the liberation of oxygen from the accompanying moisture, enables that agent in a nascent state to react on those products, and thus as it were burns them.
Chlorine has been used, in the gaseous state, for four purposes; 1. to affect the system through its application to the surface,
* Anilin is recommended as an antidote to chlorine, too largely inhaled, by M. Bolley, who has found the gas to be entirely deprived of odour by means of it. it is sufficient to use an aqueous solution of anilin, which, though very feeble, contains enough of the alkaloid for the purpose. it might be conveniently exhibited in the form of spray, by means of the atomizer. (Journ. de Pharm. et de Chim., 3e sér., xxxviii. p. 74.)-Mote to the third edition.
2. to produce curative impressions on the lungs by inhalation, 3. as an antidote to hydrocyanic acid, and other poisonous gases, and 4. as a disinfectant.
1. Mixed with atmospheric air or watery vapour, at the temperature of from 120° to 150° F., and applied by means of a vapour bath, Mr. Wallace found it very beneficial in chronic hepatitis, acting both as a revulsive to the surface, and as an alterative upon the liver; and the practice has been imitated successfully by more than one physician in Germany. The patient may remain in the bath twenty or thirty minutes.
2. The inhalation of chlorine has been recommended in phthisis and chronic bronchitis. As to its beneficial influence in the former affection, I have no faith whatever; but, on the contrary, should, on the whole, have more fear of evil from it than hope of good; nor has experience pronounced in its favour. But as a useful remedy in chronic inflammation of the air-passages, I can speak confidently of its good effects. More than forty years ago, being subject to obstinate catarrhal attacks, and delivering annually a course of lectures on chemistry, I noticed that, after lecturing on the subject of chlorine, and being consequently exposed for a number of days in my laboratory to the effects of the gas, I was, in several instances, cured or much relieved of the bronchial affection. From this fact I inferred the efficiency of chlorine inhalations in chronic bronchitis, and have ever since taught this use of the remedy to my pupils. Others have found it not less beneficial. ' in cases of foul breath with purulent expectoration, whether gangrene of the lungs be or be not supposed to exist, the inhalation of chlorine is indicated, both as a corrigent of offensive odours, and an alterative local stimulant. The most convenient and efficient method of applying it, is to cause the air of the apartment, in which the patient may be situated, to be so far impregnated with the gas as to produce a slight impression when inhaled, but not sufficient to excite continued coughing. in this way its influence is steadily maintained, instead of intermittingly, as it must be when an inhaler is used.
3. Perhaps no chemical antidote is so efficient as chlorine, in poisoning induced by the inhalation of hydrocyanic acid, sulphuretted hydrogen, or hydrosulphate of ammonia. By abstracting the hydrogen of these gases, it instantly decomposes them, and renders them comparatively harmless. The misfortune is, that, in the case of hydrocyanic acid, the effects are generally so rapid that no time is allowed for the application of the antidote. The proper method of using it is to extricate some chlorine in the vicinity of the patient, and, if he still breathes, allow him to inhale it, mixed with the atmospheric air; if not, to throw into the lungs, by the ordinary process of artificial respiration, the atmospheric air thus impregnated. Care must be taken that the gas is not too copiously extricated; and the operator's own sensations will be the best criterion of the due degree of admixture.
4. The use of chlorine to correct fetid exhalations is a most admirable result of modern science, not only promoting the comfort both of the sick and well, but operating powerfully in the prevention of disease. it should be employed in all cases of foul exhalation, in the absence of other equally effectual and less disagreeable methods, whether in sickness or health. it was a very reasonable supposition, from its great efficiency in correcting offensive odours, and purifying the air, that it might prove efficient also in the destruction of contagious effluvia, and perhaps even of those aerial influences through which epidemic diseases spread. But, in relation to yellow fever and cholera at least, it has proved utterly ineffective in preventing their progress. Though applied in every possible method, it failed to check the yellow fever in Gibraltar in 1822; and in Paris, Moscow, and other places, it was found to have quite as little restraining influence over cholera. it has not proved more efficacious in preventing hospital erysipelas, though the air of the wards might be kept by it perfectly free from offensive smell. The present state of belief on this subject is that, so far as putrid emanations are concerned, it is quite adequate to prevent all their ill effects on the health; but that it is powerless to check epidemic diseases, and of very doubtful efficacy in decomposing proper contagious effluvia.
The most convenient method of disengaging chlorine is to add sulphuric acid, diluted with a little water, very gradually, either to chloride of lime, or to a mixture of equal parts of common salt and black oxide of manganese, placed in a shallow vessel. For inhalation, Dr. Christison recommends one part of chloride of lime to be dissolved in forty parts of water, the solution to be kept at 100° F., and a drop or two of sulphuric acid to be added from time to time, as the gas is wanted; or chlorine water may be employed, as mentioned below. The application may be made from four to six times a day.
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