Diethylene Glycol Poisoning: Report on Two Cases.

Few cases, if any, of death from drinking diethylene glycol have been reported in this country. This substance is, of course,, largely used as an antifreeze fluid in radiators of rmotor-cars, and is sold under a variety of trade names in this country, in America, and probably elsewhere , without any restrictions. There is little or no mention of the toxicity of this substance in British literature. It is not referred to in the latest editions of either Sidney Smith's (1943) or Glaister's (1945) textbooks, nor in Lucas's (1945) Forensic Chemistry. There is no mention of this substance in Hunter's (1943) monograph on "Industrial Toxicology." Bamford (1940) refers to the American " elixir " disaster referred to below. Brekke (1930) reported two fatal cases following the drinking of antifreeze mixture. An editorial article in the Journal of the American Medical Association (1937) describes and investigates a number of deaths in persons taking an " elixir of sulphanilamide." In all, seventy-three persons died as a result of taking this substance. The elixir was a mixture of 9-10 g. of sulphanilamide dissolved in 100 ml. of diethylene glycol. The dose recommended was three tea-spoonfuls every four hours for one or two days. The most obvious symptom was anuria. Necropsy revealed a purplish mottling of the kidneys with necrosis in severe cases. It has been suggested by the American investigators of this disaster that suiphanilamide and diethylene glycol may produce additive toxic actions when given in combination. Boemke (1943) reported an incident in which antifreeze mixture was substituted for water in making coffee in a German military unit. Many men were dangerously ill and one died. It was suggested that death was due to uraemia, caused by the oxidation of ethylene glycol to oxalic acid, which is deposited in the kidneys. Pons and Custer (1946) describe details concerning ten soldiers who drank antifreeze solution of ethylene glycol (Prestone type). Apparently this substance was drunk as a substitute for alcohol. They suggest that the minimum lethal dbse is about 100 ml. The subjects were all young males. Death occurred in from twenty-two to forty-four hours after ingertion of the fluid. There was little opportunity to study clinical manifestations as all these cases were discovered in deep coma. Post-mortem findings showed generalized congestion of all organs and marked pulmonary oedema. The kidneys were swollen and displayed prominently engorged vessels. Crystals of calcium oxalate were prominent …