ROLE OF CARBON MONOXIDE IN THE CAUSATION OF MYOCARDIAL DISEASE

In the course of study of a large group of patients whose illness could unquestionably be attributed to frequent and prolonged exposure to carbon monoxide gas, we were forcibly impressed with the frequency with which cardiac symptoms appeared. In most instances these symptoms were chiefly functional. However, in some cases the clinical manifestations were predominantly those of organic heart disease. Carbon monoxide chemically considered is nontoxic; that is, it has no direct effect on the tissues of the body. Its injurious action is due indirectly to its extraordinary affinity for hemoglobin, because of which the oxygen of the oxyhemoglobin molecule is replaced by carbon monoxide, thus producing a state of anoxemia. In consequence of this anoxemia, functional disturbances arise. These are due primarily to mere oxygen want and secondarily to the anoxemic lesions produced through oxygen deprivation. Structures endowed with a rich blood supply, such as the myocardium and the