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February 22, 1919


JAMA. 1919;72(8):593. doi:10.1001/jama.1919.02610080059027

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To the Editor:  —The article in The Journal, February 8, p. 395, on "Methemoglobinemia Due to Poisoning by Shoe Dye" is interesting, but there are some facts which make it appear doubtful that Dr. Stifel is correct in his judgment as to the toxic agent. I have had occasion to examine considerable numbers of shoe dyes, and in all cases have found nitrobenzene present in large percentages. It is, in fact, extremely difficult to prepare a satisfactory commercial product of this type without the use of nitrobenzene in substantial quantity. For that reason it seems highly probable that if this were truly the cause of the symptoms described in Dr. Stifel's paper, there would have been a great number of similar cases reported. This material has been used in large quantities for many years and under conditions just as likely to produce poisoning as those described by Dr. Stifel. Is

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