The introduction of gas warfare and its medical response in world war one.

The introduction of gas warfare in World War One was impactful, as it both expanded the breadth of warfare and fueled the invention of techniques required to treat these new injuries. Gas injuries were responsible for 91,000 of 1.3 million deaths in World War One. Gassed soldiers had wounds which the world had never seen. They presented in large scale to medical tents and base hospitals across Europe. As gas casualties poured in, doctors and nurses had to treat these conditions in the best way they knew. Gas warfare changed how war was performed and how casualties of this attack were treated. The techniques learned from treating the multitudes of men with gas burns led to advances in the field of burn care, which have helped to improve mortality and reduce morbidity in hospitals across the world.

Choking agents and chlorine gas - History, pathophysiology, clinical effects and treatment.

INTRODUCTION: Choking agent exposure, among them chlorine gas, occurs in household or industrial accidents, chemical warfare and terrorist attacks. AIMS: Review of published animal and human data regarding the history, pathophysiology, clinical effects and management of chlorine exposure. PATHOPHYSIOLOGY: Highly soluble agents cause quick upper respiratory tract symptoms. Chlorine gas has a medium solubility, also causing delayed lower airway symptoms, mainly due to its oxidizing potential by releasing hypochlorous and hydrochloric acid, but also by interacting with Transient Receptor Potential channels. SYMPTOMS: Eyes may show conjunctival injection, abrasions and corrosions. Burns of the oronasal mucosa and trachea can occur. Dyspnea, bronchospasm and possible retrosternal pain occur frequently. Glottis edema or laryngospasm are acute life-threatening emergencies. Chlorine gas can cause toxic pneumonitis, lung edema and acute respiratory distress syndrome (ARDS). MANAGEMENT: General management includes physical examination, pulse oximetry and arterial blood gases. Eyes should be irrigated, humidified oxygen and inhalative bronchodilators administered. An EKG, cardiac enzymes and complete-blood-count should be obtained if there is retrosternal pain. Routine chest x-ray is not recommended - except if pulmonary edema is suspected. Laryngoscopy should be performed if glottis edema is suspected. Sodium bicarbonate inhalation after chlorine gas inhalation is discussed controversially. Mechanical ventilation with continuous-positive-airway-pressure or intubation/tracheotomy with high positive-end-expiratory-pressure may be necessary. Glucocorticoids for prevention of pulmonary edema should be applied restrictively. Prophylactic antibiotics are not recommended. In severe ARDS, extracorporeal membrane oxygenation (ECMO) can be considered. CONCLUSION: Treatment is mainly symptom oriented. New and promising therapies are in development.

François-Antoine-Henri Descroizilles (1781-1825), demostrador real de química, boticario, inventor y químico industrial: padre del análisis volumétrico. Parte II / François-Antoine-Henri Descroizilles (1781-1825), démonstrateur royal de chimie, apothecary, inventor and industrial chemist: the father of titrimetric analysis. Part II

En la primera parte de esta contribución se han abordado la condiciones de contorno del nuevo método de blanqueo que idea Berthollet tras el descubrimiento del cloro (ácido muriático oxigenado) por Scheele. Esta segunda se centra en lo concerniente a la relevante figura del farmacéutico Descroizilles, y a las variadas facetas a las que se dedica (i.e. analista, inventor, químico industrial), destacando los aspectos de su vida y de su obra. Descroizilles procede de una dinastía de farmacéuticos destacada en Dieppe, ejerce en primer lugar en Rouen, marchando a París más tarde en donde llega a ser miembro del Consejo de Manufacturas. Descroizilles afronta la problemática de la sidra que afecta a la región de Normandía como consecuencia de las malas prácticas de conservación. Con ayuda de la Casa de Fontenay saca adelante el método de blanqueo por cloro en escala industrial. Idea los procedimientos y aparatos necesarios para llevar a cabo el análisis volumétrico, en especial un sistema de medida que denomina "berthollímetro" en honor de Berthollet, colaborando con el ingeniero Chevalier en la fabricación y venta del mismo. Descroizilles estudia en detalle los álcalis del comercio. Finalmente, se tratan aspectos menos conocidos relacionados con los polvos de gas y el alumbre para concluir con la contribución de Gay Lussac a la volumetría, fundamental para consolidar la obra emprendida por Descroizilles

In the first part of this contribution, the boundary conditions of the new bleaching method proposed by Berthollet after the discovery of chlorine (oxygenated muriatic acid) by Scheele have been addressed. This second part focuses more on everything concerning the relevant figure of the pharmacist Descroizilles, and the various facets (i.e. analyst, inventor, industrial chemist) in which he is involved, highlighting the aspects of his life and his work. Descroizilles comes from a dynasty of pharmacists stationed in Dieppe. He first established in Rouen, arriving in Paris later, and becoming a member of the Council of Manufactures. Descroizilles tackles the problem of cider that affects the Normandy region as a consequence of bad conservation practices. With the help of the Casa de Fontenay, it takes the chlorine bleaching method on an industrial scale. Descroizilles devises the necessary apparatus and procedures to carry out the titrimetric analysis, in special a measuring system that denominates "berthollimeter" in honour of Berthollet, collaborating with the engineer Chevalier in the manufacture and sale of the same. Descroizilles studies in detail the alkalis of the commerce. Finally, a review is made of other lesser-known aspects related to bleaching powder and alum, ending with the contribution of Gay Lussac to the titrimetry, fundamental to consolidate the work undertaken by Descroizilles

De la antigua historia de los métodos iodométricos: de los inicios a Robert Bunsen / From the early history of iodometric methods: from its inception to Robert Bunsen

Los halógenos han constituido un campo de batalla particular de los investigadores farmacéuticos. Cloro, bromo y iodo, se encuentran estrechamente relacionados con los métodos volumétricos, en sus comienzos. El color azul del complejo iodo-almidón que sirve como indicador para la detección de cantidades traza de iodo, es observado por Colin y Gaultier de Claubry, y Stromeyer (1814). Houtou de Labillardière (1825), introduce el uso del iodo en volumetría, proponiendo un procedimiento alternativo para la estimación del contenido de cloro en hipoclorito cálcico comercial. Dupasquier (1840), advierte la posibilidad de valorar exacta y rápidamente sulfuro de hidrógeno (gas hepático) libre o combinado, con la ayuda de una disolución valorada de iodo en presencia de almidón como indicador. Fordos y Gelis muestran en 1843 que dos átomos de iodo oxidan cuantitativamente dos moléculas de hiposulfito (tiosulfato) de sodio, reacción que constituye la base fundamental de la iodometría. En este trabajo se pasa revista a los métodos iodométricos de análisis desde sus inicios hasta Bunsen, cubriendo aspectos de la vida y obra de los investigadores implicados, así como sus mutuas conexiones, incluidas las transnacionales

Halogens have been a particular battlefield of pharmaceutical researchers. Chlorine, bromine and iodine, are closely related to the volumetric methods, in its beginnings. The blue colour of the iodine-starch complex observed by Colin and Gaultier de Claubry, and Stromeyer (1814), serves as an indicator for the detection of trace quantities of iodine. Houtou de Labillardière (1825) introduces the use of iodine in volumetry, proposing an alternative procedure for the estimation of the chlorine content in commercial calcium hypochlorite. Dupasquier (1840) warns the possibility of accurately and quickly assessing hydrogen sulfide (hepatic gas) free or combined, with the help of a titrated solution of iodine in the presence of starch as an indicator. Fordos and Gelis show in 1843 that two iodine atoms quantitatively oxidize two molecules of sodium hyposulfite (thiosulfate), a reaction that constitutes the fundamental basis of iodometry. This paper reviews the iodometric methods of analysis from its inception to Bunsen, covering aspects of the life and work of the researchers involved, as well as their mutual connections, including transnational ones

François-Antoine-Henri Descroizilles (1781-1825), demostrador real de química, boticario, inventor y químico industrial: padre del análisis volumétrico". Parte 1 / François-Antoine-Henri Descroizilles (1781-1825), démonstrateur royal de chimie, apothecary, inventor and industrial chemist: the father of titrimetric analysis. Part I

En esta contribución se pasa revista a la vida y obra de François-Antoine-Henry Descroizilles, personaje polifacético, reconocido como un químico hábil y sabio por eminentes científicos de su época, que ejerce como profesor de química, boticario, y químico industrial. Descroizilles contribuye a dar una solución al problema de la sidra latente en Normandía primero y al blanqueo de los tejidos por el nuevo método de Berthollet en la zona de Rouen después. A este último respecto propone un método de determinar la concentración de cloro, nudo gordiano del problema. Descroizilles puede considerarse con todo justicia como padre del análisis volumétrico, pero su ingenio va mucho más allá y su nombre puede asociarse a una variedad de inventos. En la aproximación que se realiza se hace hincapié en el contexto del nuevo proceso de blanqueo por cloro, aspecto no contemplado siempre con suficientemente profundidad en trabajos previos sobre Descroizilles. En la primera parte de esta contribución vamos a situar y estudiar las condiciones de contorno de este tema, en una época en la que se despierta en las mentes el interés por las artes químicas. Sin embargo, en el desarrollo de la industria del blanqueo con cloro no solo ejercen influencia los aspectos técnicos de los procesos involucrados, sino también los factores sociales y económicos. Aspectos de la vida y obra de Descroizilles, incluyendo temas tales como la problemática de la sidra, inventos, polvos de gas, alumbre, y la contribución de Gay Lussac a la volumetría, serán objeto de un posterior estudio (segunda parte)

In this contribution the life and work of François-Antoine-Henry Descroizilles is reviewed. He is recognized as a multifaceted person, and as a skilled and wise chemist by eminent scientists of his time. Descroizilles developed his professional career as a chemistry teacher, apothecary, and industrial chemist, contributing firstly to give a solution to the latent problem of cider in Normandy, and to the bleaching of tissues by the new method of Berthollet in the area of Rouen later. He proposes on this respect a (redox) titrimetric method of determining the concentration of chlorine, Gordian knot of the problem. Descroizilles can rightly on this way be considered as the father of titrimetric analysis, but his ingenuity goes much further, and his name can be associated to a variety of inventions. In the approach that is carried out here, emphasis is previously placed on the context of the new chloric bleaching, aspect that might not be always treated with enough depth in previous papers on Descroizilles. In the first part of this paper the boundary conditions of this topic will be located and studied, in a time, in which the intent of the study of the chemical arts rapidly acquires great importance. The development of the chlorine bleaching industry is influenced by the technical aspects of the processes involved, but also by the social and economic factors. Aspects of the life and work of Descroizilles, including topics such as the problem of cider, inventions, bleaching power and alum, as well as the contributions of Gay Lussac to titrimetry will be the subject of a future report (second part)

What happened at Vienna's Allgemeines Krankenhaus after Semmelweis's contract as Assistant in the First Maternity Division was terminated?

Ignác Fülöp Semmelweis is famous for dramatically reducing puerperal mortality while he was an Assistant in Vienna's largest hospital, the Allgemeines Krankenhaus; he did this, mainly, by requiring medical personnel to disinfect their hands by washing in a chlorine solution. But Semmelweis was soon removed from his post as assistant. The conventional view, which is suggested by Semmelweis's own account, is that his contemporaries were skeptical of his results, that he was marginalized and that once he was no longer directly responsible for caring for maternity patients, puerperal mortality returned to its former high levels. In fact, the situation appears to have been quite different. In this paper, we calculate and discuss the number of deaths at the Allgemeines maternity clinic after Semmelweis was removed from his position. As we will see, his successors maintained a relatively low mortality rate roughly consistent with the rate Semmelweis himself achieved. This suggests that the chlorine washings were probably still used conscientiously after he left and that the opposition he encountered had other sources than doubts about the effectiveness of the chlorine washings.

Gas: the greatest terror of the Great War.

The Great War began just over a century ago and this monumental event changed the world forever. 1915 saw the emergence of gas warfare-the first weapon of mass terror. It is relevant to anaesthetists to reflect on these gases for a number of reasons. Firstly and most importantly we should acknowledge and be aware of the suffering and sacrifice of those soldiers who were injured or killed so that we could enjoy the freedoms we have today. Secondly, it is interesting to consider the overlap between poison gases and anaesthetic gases and vapors, for example that phosgene can be formed by the interaction of chloroform and sunlight. Thirdly the shadow of gas warfare is very long and covers us still. The very agents used in the Great War are still causing death and injury through deployment in conflict areas such as Iraq and Syria. Industrial accidents, train derailments and dumped or buried gas shells are other sources of poison gas hazards. In this age of terrorism, anaesthetists, as front-line resuscitation specialists, may be directly involved in the management of gas casualties or become victims ourselves.

[The scientific career of Scheele cannot be reduced to chlorine discovery]. / La découverte du chlore ne saurait résumer l'oeuvre de Scheele.

The life of this poor pharmacist and very efficient man of science was made of many encounters: meeting with pharmacy, meeting with chemistry, meeting with prestigious scientists, meeting with chlorine, meeting with oxygen, meeting with organic chemistry, etc. This chemist devoid of money, working with rudimental apparatus did discover chlorine but he also discovered oxygen before Priestley, unfortunately he did not publish his results in time. He isolated also many organic acids and even glycerol, before the rising of organic chemistry.

Los Halógenos, ¿materia mineral farmacéutica? / Halogens: pharmaceutics mineral materia?

En 1906 se otorga el Premio Nobel de Química a Henri Moissan, primer farmacéuticoy primer francés en recibir tal distinción. Era el broche de oro de un largocapítulo en el que a través de más de cien años, Scheele (1774), Courtois (1813),Balard (1823) y Moissan (1886), todos ellos farmacéuticos, aíslan el cloro, iodo,bromo y flúor, respectivamente. Por esta razón se plantea el título del trabajo enclave de interrogante. La elucidación de su naturaleza demolió la teoría de laacidez de Lavoisier, y el descubrimiento del bromo contribuyó a aportar luz sobrela sistematización de los elementos químicos. Se aportan detalles de la vida de losdescubridores y, de la concesión del Premio Nobel a Moissan, que realizó la proezade domar a la bestia salvaje de los elementos químicos

In 1906 Henri Moissan was the first French person and first pharmacist to beawarded the Nobel Prize in Chemistry. It was the end of a large and gold chapterin which through more than a century, Scheele (1774), Courtois (1813), Balard(1823) and Moissan (1886), all of them pharmacists, isolated chlorine, iodine, bromine and fluorine, respectively. That is the reason why the title figures as aquestion. The elucidation of the halogen’s nature demolished the Lavoisier’s aciditytheory. Some aspects of the life of the discoverers are given. Moissan was able toisolate and study fluorine, that savage beast among the elements

Role of disinfection in suppressing the spread of pathogens with drinking water: possibilities and limitations.

Transmission of pathogens with drinking water is a widespread problem, which affects not only the countries with low hygienic standards but the industrialized countries as well. The pathogens are excreted by man or animals and are picked up orally. Chlorination of drinking water has been introduced to the water supply in the beginning of the 19th century in order to stop the spreading of pathogens especially typhoid fever by drinking water. Despite the worldwide use of chlorine for disinfection of drinking water, water-mediated disease outbreaks occur again and again. Disinfection of drinking water with chlorine has undoubtedly contributed to the reduction of typhoid fever mortality. However, it must be clear that other factors play an important role in the mortality drop. Filtration of water is a long-known and very effective process for eliminating pathogens from the drinking water. Pathogens in particles cannot be killed sufficiently by a chemical disinfectant. Even small fecal particles have to be eliminated reliably from the water by filtration. Disinfection of drinking water cannot replace filtration. The disinfection should be used to minimize the residual risk due to the presence of pathogens in the water but cannot be used for bringing fecally contaminated water into a hygienically sound condition.

Estimation of historical exposures to machining fluids in the automotive industry.

A retrospective exposure assessment study in the automotive parts industry conducted in conjunction with a cancer mortality and respiratory morbidity study [Kennedy et al. (1989): Am J Ind Med 15:627-641; Eisen et al. (1992): Am J Ind Med 22:809-824; Tolbert et al. (1992): Scand J Work Environ Health 18:351-360] describes exposure to different types of machining fluids and selected components that may contribute to the conditions investigated. A dataset of 394 industrial hygiene measurements made between 1958 and 1987 was used to estimate past machining fluid levels using a linear statistical model. The effects of different plants, machining fluid types, machining operations, and time periods were examined in the model. Separate analyses examined the effects of different sampling and analysis methods and other measurement variables. Machining fluid levels prior to 1970 were generally two to five times higher than subsequent measurements. The arithmetic mean exposure of all measurements taken before 1970 was 5.42 mg/m3. Arithmetic means for different subgroups ranged from 0.59 to 20.28 mg/m3, depending upon plant, machining fluid, and operation. The arithmetic mean exposure after 1980 was 1.82 mg/m3 with subgroups ranging from 0.45 to 2.79 mg/m3. Changes in exposure levels generally corresponded with reported changes in plant environments such as installation of enclosures and local exhaust ventilation on machines.

Desinfección del agua / Desinfection of water

Contiene: generalidades sobre desinfección de aguas; microorganismos que se eliminan con la desinfección; teoría de la desinfección química y su cinética; formas de desinfección; formas de determinar la eficiencia de la desinfección y normas bacteriológicas del agua potable; desinfección con cloro; resultados de la desinfección con cloro; métodos de aplicación del cloro en plantas de tratamiento de agua y determinaciones previas; técnicas de evaluación y control de cloro residual; cloradores e hipocloradores; otros usos del cloro en la ingeniería sanitaria; abastecimiento de agua y su desinfección en casos de emergencia; precauciones en el uso del cloro y sus derivados; efectos potencialmente tóxicos de la cloración; control de trihalometanos; métodos analíticos para la determinación de trihalometanos en aguas de consumo humano; programa de vigilancia de la calidad del agua potable; glosario de términos