282 
Wood  Alcohol  Poisoning. 
Am  Jcur.  Pharm. 
April,  1918. 
and  even  longer)  eliminated  by  the  kidneys.  Mayer  has  demon- 
strated that  the  relative  toxicity  of  formic  acid  is  six  times  greater 
that  that  of  wood  alcohol.  For  a  considerable  period  of  time,  the 
alcohol  is  excreted  unchanged  into  the  stomach  and  intestine 
(Bongers),  and  it  is  therefore  important  that  early  and  frequent 
gastric  and  rectal  lavage  be  carried  out.  The  stomach  washings 
should  be  immediately  examined  for  wood  alcohol.  Intravenous 
saline  or  sodium  bicarbonate  infusions  and  phlebotomy  and  trans- 
fusions, if  the  latter  can  be  had  quickly,  should  be  administered. 
In  addition,  warmth  and  strong  stimulation  with  strychnine,  digitalis, 
caffeine,  camphor,  epinephrine,  and  oxygen  must  be  given.  It  is 
said  that  ethyl  alcohol  is  indicated  to  replace  the  methyl,  and  that 
it  acts  as  a  powerful  stimulant ;  but  we  doubt  this.  For  the  treat- 
ment of  the  chronic  form  of  poisoning,  we  refer  the  reader  to  the 
article  by  Buller  and  Wood,  who  collected  the  histories  of  275 
American  cases  up  to  1904,  and  to  Birch-Hirshfield,  who  discusses 
the  eye  condition  in  considerable  detail. 
'  The  postmortems  in  Cases  1  to  4  were  performed  by  Dr.  Otto  H. 
Schultze,  and*  in  Cases  5  and  6  by  Dr.  A.  V.  St.  George,  in  the  pres- 
ence of  Dr.  Benjamin  Schwartz,  coroner's  physician.  The  gross 
anatomic  diagnosis  in  all  the  cases  were :  marked  congestion  with 
increased  cerebrospinal  fluid;  marked  congestion  of  all  the  viscera, 
and  acute  pulmonary  edema  and  congestion.  In  addition,  in  all  cases 
except  Case  2,  only  dark  fluid  blood  was  distributed  throughout  the 
heart  and  vessels.  In  Case  2  there  was  an  aortic  stenosis,  and  a  soft 
red  clot  was  present  in  the  left  heart.  The  brain  in  Cases  1  and  5 
had  a  suspicious  odor,  not,  however,  distinctive  of  alcohol ;  no  odor 
could  be  detected  in  the  stomach  or  its  contents. 
Results  of  Tests. 
Reduced  fuchsin 
Casein  test 
Resorcin  test 
Before 
After 
Before 
After 
Before 
After 
Oxidation 
Oxidation 
Oxidation 
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