A 45 year old man was admitted to hospital with vomiting, abdominal pain, and diarrhoea. There was no coma or confusion but the patient was agitated and suffering from headache. Arterial blood pressure was 120/80 mm Hg, heart rate 80/min, temperature 36?C, and no abnormalities were found at clinical examination. The patient was a construction worker. He had taken his lunch on the building site during which he had drunk a colourless liquid from an unlabelled bot tle by mistake. He was unable to say what was in the bottle but his vomit and breath smelt strongly of solvent. Because of his abdominal pain, an x ray exam ination was performed which showed a radio-opaque liquid in the stomach and ileum (fig 1). ECG was nor mal and few biological disturbances were found: ALAT 36mU/ml (N < 40); ASAT 53mU/ml (N < 40); serum creatinine 170/?mol/1; white blood cells 17000/mm3; and haemoglobin 17-6g/dl. Blood electrolytes were normal. After a gastric lavage the patient was transferred to our hospital. His clinical course was uneventful. The third day, his serum creatinine was 65 /nriol/1 and he was discharged a few days later in good condition; he was unable to remember the circumstances of the accident. Evidence of exposure to chlorinated hydrocarbons was searched for because of the loss of memory. Tri chloroethanol and tricholoacetic acid were measured by a colorimetric method derived from the Fujiwara method. No trichloroethanol was found in the blood (limit of detection; 001 mmol/1) but blood trichloro acetic acid level was 009mmol/1 on the first day. Urinary trichloroethanol concentrations were 0-85 mmol/1 on the first day and 0-29 mmol/1 on the fifth; urinary trichloroacetic acid concentrations were 1-5 mmol/1 and 0-89 mmol/1 on the same days. There were no evidence of arsenic, lead, mercury, or bismuth poisoning.
