A clinical-pathological report of eight cases of methyl bromide poisoning.

Abstract

Methyl bromide, refrigerant, fumigant, and fire extinguisher, has proved a dangerous substance. Sch?ler demonstrated its toxic character in 1899, and von Oettingen (1946) has listed 28 fatalities and 150 non-fatal cases of methyl bromide poisoning. On November 4, 1947, at about 8 in the evening eight boys broke bounds from an approved school in Dundee, and despite a search by the police no trace of them was found until 8.30 the next morning when two of the boys reported back to the school stating that they felt ill. Very shortly after their return one of the boys collapsed in what appeared to be a severe epileptiform seizure (Case 1). First aid treatment by the school medical officer failed to improve his condition, and he was admitted to the Royal Infirmary, Dundee. Shortly afterwards the second boy (Case 2), who had given an incoherent story of the remaining six boys being aboard a boat in the harbour, also collapsed. He had a much milder epileptiform seizure, and was also brought to the Infirmary. The police searched again and found the other six boys huddled together in varied degrees of unconsciousness in a small cabin aboard a disused Royal Air Force launch. These boys were also sent to the Royal Infirmary, Dundee. The police also found a recently discharged fire extinguisher of the No. 3 Air Ministry pattern which, when full, contains 69 fluid oz. of methyl bromide. The eight cases presented a picture differing only in degree, although later some qualitative differences were appreciated. Clinical Reports On admission to hospital Case 1 (age 14), Case 5 (age 14), Case 6 (age 13|), and Case 7 (age 13) presented similar clinical features. All were unconscious with wide, staring eyes, a blue-grey, cold, moist skin, and had obvious signs of massive pulmonary oedema. In all the reflexes were depressed ; on admission three were in co vulsions, and the fourth (Case 6) developed con vulsions one hour later. No urine was passed and death occurred 14 hours, one and three quarter hours, six and three quarter hours, and 14| hours respectively after admission.