Guanidine Retention and Calcium Reserve as Antagonistic Factors in Carbon Tetrachloride and Chloroform Poisoning.

Abstract

An earlier note' reported the rather empirical observation that dogs on a lean meat diet can 1)e made either highly resistant or susceptible to carbon tetrachloritle intoxication by adding or withholding calcium salts for a few (lays previous to the administration of carbon tetrachloride. Furthermore calcium therapy was found highly effective in the treatment of cases of poisoning.The intoxication produced in susceptible dogs was described in the earlier note and is characterized by gastro-intestinal irritation, nervous disturbances and convdsions, followed by yveakness, depression, and death. There is a retention of bile pigments in the blood and a hypoglycemia which usually becomes extreme before death and which seems in most cases to be the immediate cause of death. The level of total calciuni in the blood is usually within normal liniits, nevertheless either a lack of or excessive demand for calcium ions seems to be indicated by the relief affordecl by the furnishing of extra available calciuni. It was a t first suggested that a depression of ionized calcium tlue to coni1)ination with bile pigments might account for the apparent calciuni lack. This is probably one factor in the need for extra calcium, but further work has indicated that it is probably not the only or even the inost important factor.A similar toxic picture can be produced by the administration of guanidine compounds. Following subcutaneous doses of 250 mgm. of guanidine hydrochloride per kilo body weight, dogs show fibrillary twitching of muscles, tetanic convulsions, gastro-intestinal irritation with bloody vomitus and diarrhea, with usually a period of extreme depression and weakness for some time before death. which occurs 12 to 15 hours after the tlrug is injectect. Four or 5 hours after the guanitline is administered there is a marked fall in blood sugar arid the hypoglycemia lxxoines extrenie tinless a diet very rich in calcium and car1)oliydrate has k e n ied for sonle time pre-* This iiivestigation is OIW of :t w r k s of studies being made under the direction of Dr. P. I). h m S o I 1 011 tlw ~~1~~~~~~~~:~~ mid toxidcology of carbon tetrachloride. Thc work i R hcing c*:rrricd 011 with the support of the International IIealth Board.

Carbon Tetrachloride Poisoning

“…Hamilton3 notes the danger of carbon tetrachloride as a fire extinguisher in the presence of heat in a closed space, under which conditions phosgene is generated. The New York Titmes, July 7,1932, reported a fire in a New York subway in which "Pyrene" fire extinguishers were used and 150 persons were overcome with the fumes, which were probably a mixture of carbon tetrachloride, phosgene, and chlorine. The Journal of the American Mledical Association,4 in an editorial on the subject, states that in Portsmouth Navy Yard in 1919 two men died from the fumes produced when the clothing of one caught fire and Pyrene was used to extinguish the flames.…”