Læknablaðið - 01.10.1966, Blaðsíða 52
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LÆKNABLAÐIÐ
of confusion. On admission, clinical examination revealed crepitations
over both lungfields and enlarged liver. He was found uraemic, hyper-
kaliaemic, hyponatriaemic, hypochloroaemic and with lowered bicar-
bonate in plasma. Roentgen examination showed infiltrations in both
lungs. Electrocardiogrammes are shown and explained in figs. 3 and 4.
During the first day the pt. was anuric. He was then cautiously infused
and afterwards quit some urine. However, during the 3rd day the pt.
suffered increasingly from dyspnoe and died. The post mortem ex-
amination showed massive lung oedema, fluid in pericardium, pleura
and peritoneum, necrosis and haemorrhages in liver and parenchym-
atous degeneration of kidneys (cf. fig. 5).
Table 3 shows the amounts of tetrachloromethan, trichloroethylene
and tetrachloroethylene sold during the years 1952—1964. The figures
indicate that trichloroethylene was sold in amounts approximateiy five
times greater than those of tetrachloromethan, whereas tetrachloro-
ethylene was sold in negligible amounts. From this and the obser-
vations mentioned above, it was concluded that the incidence of acute,
serious poisonings with tetrachloromethan had been absolutely greater
during the years 1945—1964 than that of serious poisonings d.ue to
trichloroethylene. It was likewise concluded that tetrachloromethan
must be definitely more dangerous than trichloroethylene. Emphasis
was therefore given to the rigorous restriction on the sale of tetrachloro-
methan stipulated in a newly drafted bill on toxic and dangerous sub-
stances. It was also suggested that methylchloroform, being less dang-
erous than tetrachloromethan and trichloroethylene, should be substi-
tuted, as far as is possible, for these substances for domestical and
industrial usage.
(Our gratitude is due to professor Sigurður Samúelsson and as-
sociate professor Theodór Skúlason, Department of Intsrnal Medicine,
Landspítalinn (The University Hospital), Reykjavík, and to physician
in chief Óskar Þórðarson, Department of Internal Medicine, Borgar-
spítalinn (The Municipal Hospital), Reykjavík, for giving us access to
the case reports of the patients treated in their departments and per-
mission to use the information contained therein for this publication.)
Heimildir.
Abrahamsen, A. M.: Quantitative estimation of trichloroacetic acid in
urine and serum in trichloroethylene poisoning. Acta pharmacol. et
toxicol. 1960, 17, 288—294.
Alha, A.: Carbon tetrachloride mass poisoning. Ann. MecL. Intern. Fenn.
1950, 39 (suppl. 8), 3—32.
Bartonícek, V.: MetaboJism and excretion of trichloroethylene after
inhalation by human subjects. Brit. J. lndustr. Med. 1962, 19, 134—141.
Dvorácková, I.: Ein fall von tödlicher oraler Tetrachlorokohlenstoff-
vergiftung. Arch. f. Toxikologie 1963, 20, 72—78.
Fassett, D. W.: Toxicology of organic compounds: A review of current
problems, Ann. Rev. Pharmacol. 1963, 3, 267—292.