Medicine: Philadelphia Flounder

When Donald Kleinschmidt, 29, a machinist, sat down to dinner in Haddon Heights, N.J. last Tuesday, his wife Margaret had filet of flounder for the family—twins Donald and Donna, 6, David, 4, and Dale, 3. Half an hour after dinner, the boys felt sick. Donald and Dale were the worst. Their father called for an ambulance, and their mother rode with them to Camden's Cooper Hospital. Dale had turned blue, and died on arrival. Resident Thomas L. Singley Jr., 27, concentrated on Donald, also blue. But 100% oxygen did no good, though his breathing was strong enough. The trouble must be something in the blood. As a transfusion was started, Kleinschmidt drove in with David, who was also turning blue.

Blue v. Blue. Dr. Singley knew that he was dealing with methemoglobinemia, in which poisoned red cells carry no oxygen, and other cells cannot deliver enough, to the tissues. Many chemicals can cause the condition, and Dr. Singley had no idea which was to blame. But the remedy is the same: methylene blue, given intravenously, restores hemoglobin to normal oxygen-bearing function. Dr. Singley tried it on both boys and they responded quickly, lost their weird bluish cast.

But what had they swallowed? Best clue was that Donna had eaten no flounder and had not got sick. Dr. Singley remembered having read in medical school a 1945 report of sodium nitrite poisoning in New York City. A colleague clinched it: he had just reread the same story in Berton Roueché's Eleven Blue Men, reprinted from The New Yorker. Simultaneously, unknown to the Camden team, doctors across the Delaware River were giving methylene blue to women who had eaten flounder in a downtown restaurant.

City and federal poison detectives went to work in the morning, starting from the supplier for the restaurant and the market where Margaret Kleinschmidt had bought her fish. Charles McWade, 43, a former Philadelphian who might have been shopping for fish on Tuesday, was found dead on a chicken farm near Toms River, N.J.; in his refrigerator was a remnant of nitrite-poisoned flounder. Without saying how much they knew or how they had learned it, Philadelphia and Camden health officials sounded the alarm.

They issued warning bulletins—"All flounder should be destroyed"—through the press, radio and TV. The alarms ran through dinnertime: some families got up from the table and dumped their filleted flounder into the garbage can. Housewives who were saving it in the refrigerator got rid of it in a hurry. Hospital switchboards lit up and were jammed for hours. Emergency rooms filled fast. About 300 people who said they had eaten flounder got treatment: some were hypochondriacs, most were mild cases, a few were severely poisoned. As far as officials knew, there were no more deaths.