Between May 22 and 28, 1978, 372 adult male Melanesians consumed a solution of 82% methanol and 18% isopropanol. One hundred and eighteen men were admitted to hospital and a further 251 subjects were treated as outpatients. Eighteen men died. Fourteen of the survivors were blind initially, but only four failed to recover some vision. Diffuse encephalopathy with residual pseudobulbar palsy and dementia occurred in four patients, two of whom remained permanently blind. Estimated quantities of undiluted spirit consumed varied from 25 mL to 750 mL (mean, 100 mL), and symptoms developed on average 30 hours after consumption. A disparity between the amounts of solution consumed and the sequelae was frequently noted. Blindness and death followed the ingestion of 100 mL in one case, while in two other cases, over 500 mL produced no apparent disability. On investigation, it was established that the mixture had been sold by a local pharmacy in the mistaken belief that it was methylated spirits. Regular consumption of methylated spirits by many adult male Melanesians has been a common practice in east New Britain for many years. The difficulties of managing an outbreak of poisoning of this magnitude in the context of a developing country are discussed.