Serial lung-function studies on six patients with paraquat poisoning are presented. Five patients died, two after lung transplantation; one survived, but it is highly improbable that he had developed‘paraquat lung’.The usual pattern of change indicating progressive lung damage due to paraquat was restriction of lung volumes at an early stage, a falling arterial oxygen tension, and increasing alveolar to arterial oxygen tension gradient with the later development of a significant intrapulmonary shunt. However, these abnormalities are not specific for‘paraquat lung’, and we stress that serial changes must be interpreted with attention to the clinical state of the patient before attributing them to damage by paraquat.We consider serial studies essential in patients poisoned with the liquid paraquat concentrate, so that early warning of lung involvement may be given. Early warning is necessary if a suitable donor for lung transplantation is to be found. Our experience and a review of the published cases indicate that the lung damage is progressive and we consider treatment by lung transplantation the only hope of success at the present time.The first patient to die following ingestion of the granular form of paraquat is de
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