Air..  Jem  .  Pharm.  \ 
April,  1918.  > 
Wood  Alcohol  Poisoning. 
281 
Similar  but  meager  histories  were  obtained,  and  we  were  unable 
to  determine  the  quantities  of  the  poison  taken.  Four  of  the  patients 
were  admitted  to  St.  Vincent's  Hospital,  one  to  Bellevue  Hospital, 
and  one  patient  died  in  his  own  home.  All  had  taken  whisky  a 
short  time  previously,  and  all  had  complained  of  violent  abdominal 
pains,  incessant  vomiting  and  extreme  weakness.  Three  of  the 
patients  complained  of  blindness.  Three  of  the  St.  Vincent's 
patients  and  the  Bellevue  patient  came  into  the  hospitals  in  coma; 
one  (Case  1),  who  was  admitted  while  conscious,  said  that  he  had 
taken  whiskey  a  short  time  before ;  soon  thereafter  he  noted  intense 
abdominal  pain,  vomiting,  increasing  weakness  and  dimness  of 
vision;  finally  he  collapsed  in  the  street,  and  was  brought  to  the 
hospital,  where  he  died  half  an  hour  after  admission.  The  patient 
had  the  appearance  of  being  in  a  severe  toxic  condition  or  collapse. 
The  important  points  in  all  the  physical  examinations  were  slow 
respirations,  dilated  pupils,  weak  and  rapid  heart  action,  cold  and 
clammy  extremities,  and  deep  coma. 
In  Case  1,  stomach  washings  were  obtained,  and  also  some  of 
the  liquor  that  he  had  drunk.  Both  were  found  to  contain  wood 
alcohol. 
The  examination  of  the  urine  during  life  in  Case  2  revealed 
albumin  and  casts,  and  gave  a  Fehling  reduction  (aldehyd  forma- 
tion?). 
The  diagnostic  features  of  the  acute  type  of  poisoning  are  ex- 
treme physical  weakness,  acute  gastro-intestinal  symptoms,  blind- 
ness, and  deep  and  prolonged  coma,  ending  in  death  with  cardiac 
collapse.  In  the  chronic  type  of  cases,  blindness  is  the  chief 
symptom. 
A  differential  diagnosis  from  epilepsy,  and  especially  all  types 
of  coma — uremia,  cardiac,  diabetic,  cerebral,  toxic  and  traumatic — 
must  be  made.  This  frequently  is  very  difficult ;  but  if  we  bear  in 
mind  the  important  symptoms  mentioned  above,  and  obtain  a  history 
of  whisky  drinking,  together  with  an  alcoholic  breath,  we  should  be 
suspicious,  at  least  to  the  extent  that  we  are  dealing  with  some 
form  of  alcohol  poisoning. 
The  treatment,  to  be  at  all  efficacious,  must  be  promptly  insti- 
tuted, and  consists  essentially  of  ridding  the  body  of  the  poison,  and 
supportive  measures.  The  poison  is  but  slowly  and  incompletely 
oxidized  in  the  body  to  more  dangerous  poisons,  namely,  formalde- 
hyde and  formic  acid,  and  as  such  very  slowly  (for  four  to  five  days, 
