THE JOURNAL OF PEDIATRICS HALLSTRAND ET AL VOLUME 141, NUMBER 3 23. Thole RT, Sallis RE, Rubin AL, Smith GN. Exercise-induced bronchospasm preva- lence in collegiate cross-country run- ners. Med Sci Sports Exerc 2001; 33:1641-6. 24. Rundell KW, Wilber RL, Szmedra L, Jenkinson DM, Mayers LB, Im J. Ex- ercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 2000;32:309-16. 25. Lowhagen O, Arvidsson M, Bjarneman P, Jorgensen N. Exercise-induced respi- ratory symptoms are not always asthma. Respir Med 1999;93:734-8. 26. Frank PI, Frank TL, Cropper J, Hirsch S, Niven RM, Hannaford P, et al. The use of a screening questionnaire to identify children with likely asthma. Br J Gen Pract 2001;51:117-20. 27. Rossini GJ, Crocetti J, Rogers J, Que- denfeld T, D’Alonzo G. Asthma deaths associated with sporting activities [ab- stract]. Am J Respir Crit Care Med 2000;161:623. 28. Suissa S, Ernst P, Benayoun S, Baltzan M, Cai B. Low-dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med 2000;343:332-6. 29. Pedersen S, Hansen OR. Budesonide treatment of moderate and severe asthma in children: a dose-response study. J Allergy Clin Immunol 1995;95:29-33. 349 50 Years Ago in The Journal of Pediatrics ADDICTION TO THE INHALATION OF GASOLINE FUMES IN A CHILD Faucett RL, Jensen RA. J Pediatr 1952;41:364-8 This report by Faucett and Jensen of an 11-year-old boy’s addiction to the inhalation of gasoline fumes was truly a landmark paper. It detailed for the first time both the habituation of a child to hydrocarbon vapors as well as a boldly successful technique for abreacting the repressed memories deemed causally related to his compulsion. They describe a slender, anxious child with moderate conjunctival injection. Symptoms included nervousness, withdrawn behavior, depression, hallucinations, and preoccupation with thoughts of death. Among factors deemed responsible for the child’s addiction were poor parental marital adjustment, paternal alcoholism, and divorce. Intravenous sodium Amytal (amobarbital) was used to conduct multiple interviews to uncover the psychogenic factors responsible for the child’s 6-year abuse of gasoline vapors. Despite the authors’ successful application of this technique to cure the patient’s addiction, they cautioned against its indiscriminate use. Amobarbital interview as a form of psychotherapy has largely fallen out of favor; it is rarely, if ever, used anymore as a result of safety is- sues and legal challenges to “recovered memory” and accusations of “false memories.” So what does this lead us to conclude? The physical, mental, and social descriptions of Faucett and Jensen’s patient sound hauntingly familiar to today’s cases of inhalant abuse. This has not changed. Plus ça change, plus c’est la même chose. The psychosocial stressors affecting our children continue to exist and perhaps have increased. Al- though drawing a direct causal relationship is perhaps tenuous, paralleling this increase has been the use of inhalants and other substances. Coupled with alcohol and drug abuse (eg, crystal methamphetamine and Ecstasy), our children continue to find an escape. What perhaps has changed is that less obvious inhalants are now being used, such as cooking sprays and air fresheners. Overall, huffing has become one of the most common forms of substance abuse among school-aged children and preadolescents. Sadly, while we continue to recognize the full extent of the toxic neuropsychiatric effects of inhalant abuse and elucidate its psychosocial causality, the practice continues to be widespread in our society and crosses all socioeco- nomic and racial lines. Anthony J. Scalzo, MD, FAAP, FACMT Division of Toxicology Saint Louis University Department of Pediatrics Cardinal Glennon Children’s Hospital St Louis, MO 63104 9/37/127646 doi:10.1067/mpd.2002.127646

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Page 1: Addiction to the inhalation of gasoline fumes in a child

THE JOURNAL OF PEDIATRICS HALLSTRAND ET AL

VOLUME 141, NUMBER 3

23. Thole RT, Sallis RE, Rubin AL, Smith GN.Exercise-induced bronchospasm preva-lence in collegiate cross-country run-ners. Med Sci Sports Exerc 2001;33:1641-6.

24. Rundell KW, Wilber RL, Szmedra L,Jenkinson DM, Mayers LB, Im J. Ex-ercise-induced asthma screening of eliteathletes: field versus laboratory exercisechallenge. Med Sci Sports Exerc2000;32:309-16.

25. Lowhagen O, Arvidsson M, Bjarneman P,Jorgensen N. Exercise-induced respi-ratory symptoms are not always asth-ma. Respir Med 1999;93:734-8.

26. Frank PI, Frank TL, Cropper J,Hirsch S, Niven RM, Hannaford P, etal. The use of a screening questionnaireto identify children with likely asthma.Br J Gen Pract 2001;51:117-20.

27. Rossini GJ, Crocetti J, Rogers J, Que-denfeld T, D’Alonzo G. Asthma deaths

associated with sporting activities [ab-stract]. Am J Respir Crit Care Med2000;161:623.

28. Suissa S, Ernst P, Benayoun S, Baltzan M,Cai B. Low-dose inhaled corticosteroidsand the prevention of death from asth-ma. N Engl J Med 2000;343:332-6.

29. Pedersen S, Hansen OR. Budesonidetreatment of moderate and severe asth-ma in children: a dose-response study.J Allergy Clin Immunol 1995;95:29-33.

349

50 Years Ago in The Journal of PediatricsADDICTION TO THE INHALATION OF GASOLINE FUMES IN A CHILD

Faucett RL, Jensen RA. J Pediatr 1952;41:364-8

This report by Faucett and Jensen of an 11-year-old boy’s addiction to the inhalation of gasoline fumes was trulya landmark paper. It detailed for the first time both the habituation of a child to hydrocarbon vapors as well as aboldly successful technique for abreacting the repressed memories deemed causally related to his compulsion.They describe a slender, anxious child with moderate conjunctival injection. Symptoms included nervousness,withdrawn behavior, depression, hallucinations, and preoccupation with thoughts of death. Among factors deemedresponsible for the child’s addiction were poor parental marital adjustment, paternal alcoholism, and divorce.

Intravenous sodium Amytal (amobarbital) was used to conduct multiple interviews to uncover the psychogenicfactors responsible for the child’s 6-year abuse of gasoline vapors. Despite the authors’ successful application ofthis technique to cure the patient’s addiction, they cautioned against its indiscriminate use. Amobarbital interviewas a form of psychotherapy has largely fallen out of favor; it is rarely, if ever, used anymore as a result of safety is-sues and legal challenges to “recovered memory” and accusations of “false memories.”

So what does this lead us to conclude? The physical, mental, and social descriptions of Faucett and Jensen’s pa-tient sound hauntingly familiar to today’s cases of inhalant abuse. This has not changed. Plus ça change, plus c’est lamême chose. The psychosocial stressors affecting our children continue to exist and perhaps have increased. Al-though drawing a direct causal relationship is perhaps tenuous, paralleling this increase has been the use of in-halants and other substances. Coupled with alcohol and drug abuse (eg, crystal methamphetamine and Ecstasy),our children continue to find an escape. What perhaps has changed is that less obvious inhalants are now beingused, such as cooking sprays and air fresheners. Overall, huffing has become one of the most common forms ofsubstance abuse among school-aged children and preadolescents.

Sadly, while we continue to recognize the full extent of the toxic neuropsychiatric effects of inhalant abuse andelucidate its psychosocial causality, the practice continues to be widespread in our society and crosses all socioeco-nomic and racial lines.

Anthony J. Scalzo, MD, FAAP, FACMTDivision of Toxicology

Saint Louis University Department of PediatricsCardinal Glennon Children’s Hospital

St Louis, MO 631049/37/127646

doi:10.1067/mpd.2002.127646