TOXIC AND ALLERGIC COMPLICATIONS OF HAIR DYES 115 but not in rats. It is due to increased permeability of the vessels, and may be prevented by diminishing the local blood supply. The reason for this restriction of the edema to the head is not known. It is not strictly spe- cific for the edema involves any other part of the body if it is rubbed with turpentine. The meta-isomer does not produce head edema, but instead causes hydrothorax, which does not occur with the para-compound. All the phenylenediamines produce rise of blood pressure, stimulation of respiration, fall of temperature, tremors, convulsions, coma, and death. With large doses, the animal may die before the edema can develop. Frogs show a narcotic action. In the monograph on cosmetic dermatitis by Louis Schwartz and my- self, published in 1946 (2), we believe to have summarized the most im- portant data concerning toxicity of the para and allied dyes which had appeared up to that time. We stated as follows: Ingram (3) reported three cases of dermatitis due to paraphenylene- diamine proved by patch tests. He states that 4 per cent of the general population have an idiosyncrasy toward it. Close (4) reports a case of nausea, colitis, and nervous symptoms caused by the use of a hair dye containing paraphenylenediamine. Greenbaum (5) reported eye injuries in the United States from para- phenylenediamine. His report was followed by reports of similar cases by Bourbon (6), Hamer (7), Jamieson (8), and Rattner (9). Moran (10) reported bilateral necrosis of the cornea following the use of a paraphen- ylenediamine product. Forbes and Blake (11) reported a case of a sloughing ulcer of the cornea and death caused by an eye make-up preparation containing paraphen- ylenediamine. Goodman (12) said that the symptoms of paraphenylene- diamine poisoning were similar to those produced by histamine. He stated that only a very few of the thousands who dye their hair with paraphen- ylenediamine were affected. Block (13) reported a case of conjunctivitis following eyelash dyeing. In Europe similar cases were reported by Bostroem (14). He stated that patch tests with diacetylaminoazotoluene were negative. Aust (15) reported a case which had had a dermatitis four years before from rabbit fur dyed with paraphenylenediamine, and now developed conjunctivitis from an eyebrow and eyelash dye. Bab (16) reported five cases of aller- gic lesions of the eyelids and conjunctiva from a so-called "henna" dye, but he states that the name "henna" is applied to dyes with various com- positions rather than to pure Egyptian henna. Preparations sold under this name sometimes contain amino compounds and aniline derivatives. Semon (17) makes a similar report of four cases in England. Neuschueler reported four cases from an "eye-stock" the composition of which he did not determine.

116 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Reports of dermatitis and systemic poisoning from the use of aromatic amines in hair dyes are too numerous for the abstraction of all of them in this work. The outstanding ones, which not only report cases but con- tribute additional knowledge about the subject, are as follows: Scanto (18), who tested 46 people with two hair dyes containing aro- matic diamines and aminophenols, obtained 19 positive reactions. He tested 32 subjects with sulfo-paraphenylenediamine, sulfo-ortho-aminophenol, and sulfo-aminodiphenylamine and obtained 6 positive reactions. He concludes that sulfonation does not destroy the toxicity of the aromatic diamines and aminophenols. He tested 47 subjects with quinone compounds formed by the oxidation of these hair dyes and obtained 28 reactions, showing that the oxidation products are the most active irritants. Baba (19) described the symptoms in 40 cases of systemic poisoning from the ingestion of paraphenylenediamine. They were vomiting, pains, mus- cular rigidity, convulsions, paralysis, edema of'the larynx and tongue, urticarial rash, and albuminuria. He devised a test for paraphenylene- diamine in the body fluids in cases of poisoning (20). Cases of occupa- tional dermatitis among hairdressers from organic hair dyes were reported by Berger (21) from 2,4-diaminotoluene, and by Gougerot and Delzant (22) from paraphenylenediamine. An attempt to desensitize the individ- ual against the latter caused a generalized eczematous reaction. In a case of scalp injury from a preparation which contained a trihy- droxybenzene as "active" ingredient the plaintiff was awarded the verdict because a patch test was not specified to determine the existence of an idio- syncrasy. Keschner and Rosen (23) reported a case of bilateral optic neuritis which developed suddenly three days after the application of a synthetic hair dye which they assumed to be of the phenylenediamine type. A review of the incidence of toxic and allergic reactions following ex- posure to para and allied compounds through 1946 can be found in the text- book by Schwartz, Tulipan and Peck (24). In a fur dyeing plant where seven hundred workers were employed four cases of dermatitis due to para were found among these workers. All gave a positive patch test with a 2 per cent solution ofpara, and negative reactions to other substances which they handled. In a factory employing an average of two hundred men where rabbit fur was dyed with para, para-aminophenol, and orthoaminophenol to resem- ble beaver, nine cases of dermatitis occurred in two years. Two workers were also found to have asthma due to hypersensitivity to para. In another factory employing 40 workers where synthetic dyes were used two cases of dermatitis and one case of asthma due to para were found. In three similar plants employing 130 men two cases of dermatitis due to para were found. In one factory employing about one hundred workers