Preventing carbon monoxide poisoning in the Hudson River Tunnel in 1921: recounting history.

The New York Bridge and Tunnel Commission began planning for a tunnel beneath the lower Hudson river to connect Manhattan to New Jersey in 1919. At 8,300 feet, it would be the longest tunnel for passenger vehicles in the world. A team of engineers and physiologists at the Yale University Bureau of Mines Experiment Station was tasked with calculating the ventilation requirements that would provide safety from exposure to automobile exhaust carbon monoxide (CO) while balancing the cost of providing ventilation. As the level of ambient CO which was comfortably tolerated was not precisely defined, they performed human exposures breathing from 100 to 1,000 ppm CO, first on themselves and subsequently on Yale medical students. Their findings continue to provide a basis for carbon monoxide alarm requirements a century later.

George Washington Frost Mellen and Resuscitation with Nitrous Oxide in 1847.

In The Boston Medical and Surgical Journal of 1847 (later to be called The New England Journal of Medicine), Boston chemist George Washington Frost Mellen claimed that inhaled nitrous oxide gas supports human life in the manner of oxygen gas, and he proposed the use of nitrous oxide in resuscitation from drowning and from carbon monoxide poisoning. The claim was reprinted in at least one dental journal and was long cited as justification for the use of 100% nitrous oxide for inhaled anesthesia. Advocates included anesthesia pioneer and painless dentist Gardner Quincy Colton. Though misguided as to nitrous oxide, Mellen was a prominent member of the Boston community for the abolition of slavery.

Risk Factors for Non-Occupational Carbon Monoxide Poisoning: Anshan Prefecture, Liaoning Province, China, 2011-2012.

BACKGROUND: Carbon monoxide (CO) poisoning can be fatal but is preventable. From October 2010 to February 2011, Anshan Prefecture reported 57 cases of non-occupational CO poisoning in District A, with two deaths. We conducted an investigation to identify risk factors and recommend preventive measures. METHODS: We defined a possible case of non-occupational CO poisoning as onset of at least two of the following symptoms: fatigue, headache, dizziness, nausea, vomiting, cyanosis, loss of consciousness, coma, and shock from October 1, 2010, to February 28, 2011, in a resident of Anshan Prefecture with non-occupational exposure to CO poisoning. We defined a probable case as onset of at least one of the following symptoms: cyanosis, loss of consciousness, coma and shock, plus at least one of the following symptoms: fatigue, headache, dizziness, nausea, vomiting, among possible cases. A confirmed CO poisoning case was a possible case or probable case plus hemoglobin (Hb) CO higher than 10%. We searched for cases by reviewing medical records and records of hyperbaric oxygen tank usage. In a case-control investigation, we compared home heating practices of 30 case-persons and 120 control-persons who were individually matched to each case by neighborhood. RESULTS: Overall, 56% (39/70) of case-patients' households burned coal for home-heating. In the case-control investigation, 40% (12/30) of case-persons' households compared with 5.8% (7/120) of control-persons' households placed stoves in bedrooms (Mantel-Haenszel odds ratio [ORM-H] = 11, 95% confidence interval [CI] = 3.0-41); 53% (16/30) of case-patients' households and 33% (40/120) of control-patients' households did not extinguish the fire before sleeping (ORM-H = 3.6, 95% CI = 1.1-12); 13% (4/30) of case-patients' households and 3% (4/120) of control-patients' households had not installed the ventilation pipe vertically (ORM-H = 7.3, 95% CI = 1.0-56). Overall, 77% (23/30) of case-patients' households and 39% (47/120) of control-patients' households had at least one of those three risk factors (ORM-H = 10, 95% CI = 2.5-40; population attributable risk percentage: 78%). CONCLUSIONS: Dangerous practices with coal-burning stoves inside the home accounted for the majority of CO poisoning incidents. Community health centers should provide instruction to and supervision of residents on proper installation and use of home heating stoves as well as inspection of installation.

[Family suicide by carbon monoxide poisoning, Paris 1890-1899. Role of popular illustrations]. / Suicides familiaux au monoxyde de carbone à Paris, 1890-1899. RôIe de l'iconographie populaire.

History has nearly forgotten a series of six suicides by family groups composed of parents and children residing in the same household, which received wide attention in the 1890s. This period saw the launch of illustrated supplements to Parisian daily newspapers, several of which produced dramatic depictions of these tragedies. The cause of the suicides was believed to be extreme poverty or the fear thereof. In the latter cases, it is argued that newspaper illustrations facilitated the carrying out of suicidal acts by persons whose circumstances placed them at risk for suicide. The choice of death by carbon monoxide poisoning was due to a wish by parents to die together with their children and to the hope of a peaceful death.

Remembering Mr B.

In the accompanying translation and film, Gustav Störring describes the psychological profile of Mr. B. (Franz Breundl), a victim of carbon monoxide poisoning with a nearly complete short-term memory deficit. Störring diagnoses Mr. B. as lacking entirely the capacity to register or retain any information in consciousness for longer than two seconds. Here we introduce these historical documents, describe their historical context, summarize and discuss the central features of the case, and consider the potential significance of the case for contemporary theories of working memory, the self, and personal identity.

[Charcoal burners and carbon monoxide poisoning--help came from a scientific journal]. / Milebrenning og kullosforgiftning--da hjelpen kom fra et fagtidsskrift.

The breakthrough for professional journals came in the 18th century. In 1972, Hans (Johannes) Möller (1736-96), a district physician in Bratsberg County, published an article in Topographisk Journal for Norge on carbon monoxide poisoning among charcoal burners, advising on the prevention of injuries and giving guidelines for treatment. This was in the heyday of Norwegian iron mills powered by charcoal, with charcoal burners paying a heavy price in the form of numerous fatal accidents. Möller's article was based on his experience with the local iron mill at Fritzøe. It solved a problem in this major branch of industry. Rationalist clergymen spread his advice among the general public for whom it was intended. Möller's scientific work also found an audience abroad. In 1801, five years after his death, the article was translated into German and published in a recognised German journal.

The carbon monoxide poisoning of two Byzantine emperors.

CASE REPORT: In this paper, two possible cases of acute carbon monoxide poisoning previously not identified in the medical and historical literature are discussed. The first concerns the famous Byzantine Emperor Julian the Apostate, who may have suffered mild carbon monoxide poisoning from which he quickly and completely recovered. The second case involves his successor, Jovian, who may have succumbed to severe carbon monoxide poisoning. Both cases were in all likelihood due to the burning of coal in braziers, a usual method of indoor heating during that epoch.

Efficacy of bomb shelters: with lessons from the Hamburg firestorm.

Shelters for protection against the effects of nuclear weapons are often stated to be useless, largely because of firestorms. Recent models purport to show that nuclear weapons are more likely to cause firestorms than previously thought. These controversial models are based on uncertain assumptions, which are difficult or impossible to test. Regardless of the predictive validity of fire models, conclusions about the ability of shelters to protect their occupants against firestorms, if they occur, are based primarily on historical experience. A review of the original data from the Hamburg firestorm shows that almost all persons in adequate shelters survived, contradicting a currently prevailing belief that all died. The results of the strategic bombing during World War II and of nuclear weapons tests show that a considerable level of population protection can be achieved through attention to proper shelter design.

Antarctic medicine, 1775-1975. I.

An historical review is made of Antarctic medical practice, which is unique because of the absence of an indigenous population. This review begins with the primitive shipboard practice of doctors accompanying Captain James Cook around 1775 and concludes with the modern era of permanent stations and vast scientific endeavour. The heroic era of Scott, Shackleton, Amundsen and Mawson and the highly mechanized transition period are contrasted with the present day. Medical practice on modern expeditions has reached a high standard, but there is still much to be learned concerning human adaptation. Comment is made on the possible utilization of Antarctica's natural resources bringing increases in polar populations and facilitating the expansion of medical research in the future era of polar medicine.