Chronic benzol poisoning.

Abstract

Our purposes were to verify in human pathology, the morbid anatomical changes described in animals poisoned with benzol, and to observe the effects of benzol medication on patients with chronic myelogenous leukemia.

The first studies were on a patient occupationally exposed to the fumes from a vat of benzol from January 6, 1925, to March 20, 1925. The symptoms, findings and course including a terminal sepsis were typical of chronic benzol poisoning. Entrance to the hospital was on May 27, 1925, and death on June 7, 1925.

Blood: R.B.C. 860,000; W.B.C. 1400; Hb. 20 per cent. Differential. Polymorphonuclear neutrophiles 13 per cent; lymphocytes 48 per cent; endothelial leucocytes 39 per cent. No norma-blasts were seen. Blood platelets 70,000. Coagulation time 9 minutes. Bleeding time 13 minutes.

Necropsy showed hemorrhages into the skin, mucous membranes and meninges. The lungs had the gross appearance of broncho-pneumonia. Microscopically the alveoli were plugged with fibrin which contained many organisms bat no inflammatory cells. Numerous areas of focal necrosis were present in the liver. Organisms were plentiful in these areas but no inflammatory cells could be found. The bone marrow contained very few cells of any type and there was no evidence of active formation of either red or white corpuscles. No megacaryocytes were seen.

Our findings conform clinically to those of reported cases, 1 and confirm, in the human, numerous morbid anatomical changes observed in experimental animals, namely :

1. Leucopenia.

2. Aplastic anemia. 2 Our own case did not verify the destruction of adult forms, as reported by Selling, since there was no excess of iron pigment in the tissues.

3. Thrombocytopenia. 3

4. Aplasia of bone marrow, i. e., replacement of the erythropoetic, leucopoetic and platelet forming elements by fat.