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Butane 'Fire-Breathing'

Robert F. Thomas, USAF, MC
Arch Intern Med. 1984;144(5):1085. doi:10.1001/archinte.1984.00350170255042.
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To the Editor.  —In the October 1983 Archives, Cartwright et al1 describe a patient who inhaled butane gas. As noted in the article, most hydrocarbon incidents have been associated with aspiration of aliphatic hydrocarbons of a higher molecular weight (C8 and above). Butane, however, is a low molecular weight (C4) gaseous hydrocarbon that has been designated as a simple asphyxiant,2,3 since no systemic effect had been linked to its inhalation.3 The dosage far exceeds that noted in an industrial environment, but the case does demonstrate that butane gas, at higher concentrations, has a definite lower respiratory irritant effect.Most accounts of aspiration of the higher hydrocarbons have the cause of the pulmonary pathologic condition clouded by the presence of gastric contents, contaminants of the fractionation process (ie, aromatic hydrocarbons), preservative, or additives. The authors have described the inhalation of a gaseous aliphatic hydrocarbon that can


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