Methyl , alcohol STUART

The clinical presentation of methyl alcohol intoxication in humans may va ry from one ext reme which mimics an intracranial catastrophe to a more subtle picture which may consist only of vague constitutional symptoms and a mild visual disturbance. When many patients with similar complaints and physical findings arrive at a hospital emergency room within a short space of time, it is not difficult to infer that an intoxicant might be the responsible etiologic aent. Such a diagnosis is, however, much more difficult when one deals only with a single case. Consequently, the broad spectrum of methanol poisoning deserves the attention of neurologists. Methyl alcohol (CH3OH, methanol, wood alcohol) was produced initially by wood distillation and fractionation, yielding a liquid with a ter rible taste and odor (Wood 1912). By 189' ). production refinements had resulted in inexpecsive methods of deodorizing methanol. Consequently, the alcohol rapidl became used in industry as a solvent, as well in the manufacture of paint, rubber, synthetic textiles, linoleum, shoes and dyes. It was utilized also as a cheap substitute for eth 1 (grain) alcohol for external purposes such as liniments and toiletries (Columbian spirits, bay rum, cologne water, witch hazel, standard wood spirits), as one of many adulterants used to denature (make unfit to drink) products containing ethanol, and even as an additive to products designed for ingestion (methylated Jamaica ginger, lemon extract, essence of peppermint and lemon, and va rious patent medicines)._ Despite occasional re -ports of serious human intoxication with methyl alcohol as early as 1855 (MacFarland 1855) yL -gorous denial of the ,poisonous character of this substance persisted until the second decade of this _ century. A prime reason for this was economic. In_ 1904 untaxed methanol cost 50c. a gallon, while taxed ethanol cost $ 2.60 per gallon (Wood and Buller 1904). Ignorance of, or ignoring, the hazardous properties of this agent, abetted by inadequate product-warning labels, finally was dispelled by Wood and Buller, who in 1904 documented 275 cases of blindness or death related to methyl alcohol usage. At the present time, methanol-containing liquids still are used by alcoholics as cheap intoxicants or as a temporary alternative when ethanol is not available for consumption. Disasters occur when higher than expected proportions of methyl to ethyl alcohol are ingested. For example, in Kentucky an alcoholic drink called `heads' was made from a brand of shellac thinner costing $1.95 per gallon and which contained 51.461.5% ethanol and 2.45-2.84% methanol, by volume (Kane et al. 1968). This was diluted 1-2 times, put into half-pint bo ttles and sold for a profit of 100-200%. Little apparent injury resulted from this practice but when a shellac solvent