Chapter XLI: Part VII: Poisons Derived From Living or Dead Animal Substances (3)

1891. =Poisoning by a Meat Pie at Portsmouth.=--Thirteen persons suffered from serious illness. Portions of the pies were poisonous to mice.

The symptoms in all these cases were not precisely alike; but they were so far identical as to show as great a similarity as in cases when a number of persons are poisoned by the same chemical substance. Arsenic, for instance, produces several types of poisoning; so does phosphorus.

Severe gastro-enteric disturbance, with more or less affection of the nervous system, were the main characteristics. These symptoms commenced, as before stated, at various intervals after ingestion of the food; but they came on with extreme suddenness. Rigors, prostration, giddiness, offensive diarrhœa, followed by muscular twitchings, dilatation of the pupil, drowsiness, deepening in bad cases to coma, were commonly observed. The _post-mortem_ appearances were those of enteritis, with inflammatory changes in the kidney and liver. Convalescence was slow; sometimes there was desquamation of the skin.

In many of these cases Dr. Klein found bacteria which, under certain conditions, were capable of becoming pathogenic; but in no case does there seem to have been at the same time an exhaustive chemical inquiry; so that, although there was evidence of a poison passing through the kidney, the nature of the poison still remains obscure.

The deaths in England and Wales from unwholesome food during ten years were as follows:--

DEATHS IN ENGLAND AND WALES FROM UNWHOLESOME FOOD DURING THE TEN YEARS 1883-1892.

+----------+-----+---+-----+---+-----+---+-----+---+-----+----+----+
| |1883.| |1885.| |1887.| |1889.| |1891.| |To- |
| | |1884.| |1886.| |1888.| |1890.| |1892.|tal.|
+-----------+---+-----+---+-----+---+-----+---+-----+---+-----+----+
|Diseased | 1 | ... |...| ... |...| ... |...| ... |...| ... | 1 |
|meat, | | | | | | | | | | | |
|Poisonous | 2 | 3 | 2 | 1 | 1 | 4 | 3 | 2 | 9 | 6 | 33 |
|fish, | | | | | | | | | | | |
|Unwholesome|...| 1 |...| ... |...| ... |...| ... |...| ... | 1 |
|brawn, | | | | | | | | | | | |
|Tinned |...| 2 |...| ... |...| ... |...| ... |...| ... | 2 |
|salmon, | | | | | | | | | | | |
|Putrid |...| 1 | 1 | 1 |...| ... | 1 | ... |...| ... | 4 |
|meat, | | | | | | | | | | | |
|Diseased |...| 1 |...| ... |...| ... |...| ... |...| ... | 1 |
|food, | | | | | | | | | | | |
|Mussels, |...| 1 |...| ... |...| ... | 1 | ... |...| ... | 2 |
|Tinned |...| ... |...| ... | 2 | ... |...| ... |...| ... | 2 |
|foods, | | | | | | | | | | | |
|Whelks, |...| ... |...| ... | 1 | ... |...| ... |...| ... | 1 |
|Winkles, |...| ... |...| ... |...| ... |...| 1 |...| ... | 1 |
|Ptomaines, |...| ... |...| ... |...| ... |...| ... | 1 | ... | 1 |
| +---+-----+---+-----+---+-----+---+-----+---+-----+----+
| | 3 | 9 | 3 | 2 | 4 | 4 | 5 | 3 |10 | 6 | 49 |
+-----------+---+-----+---+-----+---+-----+---+-----+---+-----+----+

§ 687. =German Sausage Poisoning.=--A series of cases may be picked out from the accounts of sausage poisoning in Germany, all of which evidently depend upon a poison producing the same symptoms, and the essentially distinctive mark of which is extreme dryness of the skin and mucous membranes, dilatation of the pupil, and paralysis of the upper eyelids (ptosis). In an uncertain time after eating sausages or some form of meat, from one to twenty-four hours, there is a general feeling of uneasiness, a sense of weight about the stomach, nausea, and soon afterwards vomiting, and very often diarrhœa. The diarrhœa is not severe, never assumes a choleraic form, and is unaccompanied by cramps in the muscles. After a considerable interval there is marked dryness of the mucous membrane (a symptom which never fails), the tongue, pharynx, and the mouth generally seem actually destitute of secretion; there is also an absence of perspiration, the nasal mucous membrane participates in this unnatural want of secretion, the very tears are dried up. In a case related by Kraatzer,[678] the patient, losing a son, was much troubled, but wept no tear. This dryness leads to changes in the mucous membrane, it shrivels, and partly desquamates, aphthous swellings may occur, and a diffuse redness and diphtheritic-like patches have been noticed. There is obstinate constipation, probably from a dryness of the mucous lining of the intestines. The breath has an unpleasant odour, there is often a croupy cough, the urinary secretion alone is not decreased but rather augmented. Swallowing may be so difficult as to rise to the grade of aphagia, and the tongue cannot be manipulated properly, so that the speech may be almost unintelligible. At the same time, marked symptoms of the motor nerves of the face are present, the patient’s sight is disturbed, he sees colours or sparks before his eyes; in a few cases there has been transitory blindness, in others diplopia. The pupil in nearly all the cases has been dilated, also in exceptional instances it has been contracted. The _levator palpebrae superioris_ is paralysed, and the resulting ptosis completes the picture. Consciousness remains intact almost to death, there is excessive weakness of the muscles, perhaps from a general paresis. If the patient lives long enough, he gets wretchedly thin, and dies from marasmus. In more rapidly fatal cases, death follows from respiratory paralysis, with or without convulsions.

[678] Quoted by Husemann, _Vergiftung durch Wurstgift_ (Maschka’s _Handbook_).

=The post-mortem appearances= which have been observed are--the mucous membranes of the mouth, gullet, and throat are white, hard, and parchment-like; that of the stomach is more or less injected with numerous hæmorrhages: the kidneys are somewhat congested, with some effusion of blood in the tubuli; the spleen is large and very full of blood, and the lungs are often œdematous, pneumonic, or bronchitic.