Discussion–following papers by Kimbrough, Mullick and Gluck

Richard Davis, USC: We have been examining brain sections from infants who have died in our nursery. So far we have found five cases similar to those described by Dr. Lampert. However, they occurred both during the period when hexachlorophene was being used as well as after its use had been discontinued.

Dr. Shinefield: What was the concentration of hexachlorophene used?

Dr. Davis: One teaspoon of 3% hexachlorophene in a quart of water.

Moderator: With such a dilute solution, the amount of hexachborophene actually administered must have been very small. This raises the question as to whether the treated infants form a suitable study group.

Dr. Alan Hodson: We have 10 cases showing striking bilateral and symmetrical vacuobation in myelinated areas; six were newborn infants and four were dermatobogical cases. The newborn infants were all immature (27 to 34 weeks' gestation) and received daily baths of 3% hexachiorophene for approximately 8 days. They were selected from 40 infants who died between 1967 and 1971. None of the infants was asphyxiated at birth and none required artificial ventilation. These are preliminary data and we do not yet know what the incidence of these lesions might have been before hexachlorophene bathing was introduced.

Dr. Finberg: I would bike to report an observation recently made in Peru which might be a description of chronic hexachborophene toxicity following absorption of the chemical through the intact skin.

In a unit established to study nutritional problems in children with severe marasmic kwashiarkor, the children were noted to become lethargic, vomit, and develop neurological manifestations when on special diets.

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