THE importance of nitrous fumes as a cause of pulmonary tissue damage gained universal recognition with the demonstration that these were the mysterious toxic gases evolved in silos during the first week after ensilage.1,2
Two types of pulmonary chemical injuries have been described: (1) pulmonary edema may occur within 24 hours of a prolonged or concentrated exposure; (2) a more subtle bronchiolar injury may cause life-threatening bronchiolar obstruction during the repair phase, one to four weeks after a brief encounter with the toxic gases.3
There are simple and accurate descriptions of man's experience with the fumes of nitric acid, but there is none more vivid than the first recording 175 years ago.
To give this classical description wider reading and its due historical prominence, an edited translation of the story of a man and his dog is presented here.4 The clinical events are discussed in terms of
Ramírez-R J. The First Death From Nitrogen Dioxide Fumes: The Story of a Man and His Dog. JAMA. 1974;229(9):1181–1182. doi:10.1001/jama.1974.03230470023017
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: