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Hypoglycaemia occurred in two patients treated with perhexiline maleate. The responsibility of the medication is discussed in each case. Blood insulin levels were increased. Blood perhexiline levels decreased very rapidly in the first patient, though much more slowly in the second.

The value of electroencephalographic recordings during eserine treatment for overdosage with anticholinergics is discussed, based on the results obtained in 6 cases. The results were spectacular in three cases, and a partial improvement was noted in one other case (suicide attempts with overdoses of atropine compounds), but only a slight effect was observed in two patients (with overdose of neuroleptics). Three points have to be underlined concerning the E.E.G. recordings: --eserine did not cause supplementary E.E.G. changes;--with eserine, the paroxystic abnormalities observed during overdoses of atropine compounds and amitriptyline rapidly disappear;--with mixed overdoses (atropine, barbiturates, or minor tranquillizers), eserine has no effect against non-anticholinergic products. Therapy with eserine, however, is still limited in its indications because of its short period of activity, its side-effects, and the possible risks of cardiac or convulsant complications.

Out of 84 patients with colchicine poisoning hospitalised between 1966 and 1976, 11 died during the first 72 hours. Amongst the 73 survivors, 20 showed signs of marrow aplasia between the 3rd and 6th days, lasting on average 4 days. The average amount of colchicine ingested by these patients was 0.5 to 0.8mg/5g. Marrow aplasia was associated with: -- infectious episodes in all cases, -- haemorrhage in 50%, -- dilution hyponatraemia in 25% (but in 50 % of patients if those in renal failure are excluded), -- regressive polyneuropathy in 10 % of cases, -- secondary alopoecia in all cases, -- weight loss of more than 10 % of initial weight in 60 %. Two patients died as a result of septicaemia. This mortality rate of 10 per cent despite the brief duration of the aplasia and the absence of underlying haematological disease would appear to be related to the susceptibility of these poisoned patients to endogenous secondary infections, essentially intestinal in origin.

Transient episodes of the syndrome of inappropriate anti-diuresis developped in two severe colchicine poisonings. These are the first cases reported. On patient also developped a reversible periphal neuropathy. The similarity of such accidents with vicristine neuro-toxicity is emphasized.

The authors report on a case of lethal lactate acidosis during acute metformine and barbiturate poisoning. The study of energetic substrates and glucoregulation hormones demonstrated a blockade of hepatic gluconeogenesis.

Clinical, immunological, and functional investigations were conducted to study possible specific factors involved in the etiology of asthma in adults. The authors emphasize the frequency of positive skin, radio-immunologic and bronchial provocation tests for domestic pneumallergens in patients with common asthma, even those over 40 years of age. These cases improve in a protected environment and may benefit from immunotherapy. In patients with clinical manifestations suggesting possible occupational etiological factors the same tests can be used to diagnose the presence of a wide variety of vegetable or animal allergens. Tests involving exposing the bronchi to various chemical compounds used during working conditions (antibiotics, plastic precursors, metals, hair preparations) show that there exists a wide variety of causes. Systematic search for etiological factors is essential when investigating asthma in adults.

The authors present 16 cases of multifocal tuberculosis observed over a period of five years on a general medical unit. These cases almost all occurred in immigrants. (14 out of 16) with at least 2 localisations in 9 of them and sometimes 3 or more. The viscera usually affected were, in order, the liver, the lymph nodes, the lungs and pleura, the joints. They emphasise the mildness of the clinical symptoms, the rareness of lung involvement and, on the contrary, the constancy of hepatic involvement so that needle biopsy of the liver is essential in diagnosis.

During last 7 years, 13 cases of acute ethylene glycol poisoning have been observed with 4 fatal outbreaks. All cases--except one--were accidental. Six patients had drunk a mixture of antifreeze in water as they were lost in a desert. A patient who had taken 970 ml of ethylene glycol survived. In one case, death was due to irreversible brain damage; two other fatalities occurred from cardiorespiratory distress. CNS involvement was noticed in 8 cases and acute renal failure-constantly controlled-occurred in 9 patients. Post mortem examination has shown bi-refringent calcium oxalate crystals in both kidney and brain. Specific treatment with ethanol has been performed in 3 cases with ingestion of large amounts of toxic who were seen before definitive renal lesions have occurred. Emphasis is placed in symptomatic treatment including gastric lavage, extrarenal epuration and conservative management.