In these children it is worthy of remark, that none of the symptoms began till twenty-four hours after eating. In Möhring’s cases, on the contrary, the symptoms began in a few minutes.
The other affection is well exemplified in the correct delineations of Dr. Combe. The following is his general summary of the cases, which, with the exception of the instance of peritonitis already alluded to, were all singularly alike in their leading features.—“None, so far as I know, complained of anything peculiar in the smell or taste of the animals, and none suffered immediately after taking them. In general, an hour or two elapsed, sometimes more; and then the bad effects consisted rather in uneasy feelings and debility, than in any distress referable to the stomach. Some children suffered from eating only two or three; and it will be remembered that Robertson, a young and healthy man, only took five or six. In two or three hours they complained of a slight tension at the stomach. One or two had cardialgia, nausea, and vomiting; but these were not general or lasting symptoms. They then complained of a prickly feeling in their hands; heat and constriction of the mouth and throat; difficulty of swallowing and speaking freely; numbness about the mouth, gradually extending to the arms, with great debility of the limbs. The degree of muscular debility varied a good deal, but was an invariable symptom. In some it merely prevented them from walking firmly, but in most of them it amounted to perfect inability to stand. While in bed they could move their limbs with tolerable freedom; but on being raised to the perpendicular posture, they felt their limbs sink under them. Some complained of a bad coppery taste in the mouth, but in general this was an answer to what lawyers call a leading question. There was slight pain of the abdomen, increased on pressure, particularly in the region of the bladder, which suffered variously in its functions. In some the secretion of urine was suspended, in others it was free, but passed with pain and great effort. The action of the heart was feeble; the breathing unaffected; the face pale, expressive of much anxiety; the surface rather cold; the mental faculties unimpaired. Unluckily the two fatal cases were not seen by any medical person; and we are therefore unable to state minutely the train of symptoms. We ascertained that the woman, in whose house were five sufferers, went away as in a gentle sleep; and that a few minutes before death, she had spoken and swallowed.”[[1520]] She died in three hours. The other fatal case was that of a dock-yard watchman, who was found dead in his box six or seven hours after he ate the muscles.
The inspection of the bodies threw no light on the nature of these singular effects. No appearance was found which could be called decidedly morbid. The stomach contained a considerable quantity of the fish half digested.
Dr. Combe’s narrative agrees with that of Vancouver, four of whose sailors were violently affected, and one killed in five hours and a half, after eating muscles which they had gathered on shore in the course of his voyage of discovery.[[1521]]
In closing this account, allusion may be briefly made to a case related by Dr. Edwards, which differs from all the preceding. The symptoms were uneasiness at stomach, followed by epileptic convulsions, which did not entirely cease for a fortnight. Dr. Edwards imputed the illness to muscles; but it must be observed that this is a solitary instance of simple convulsions arising from such a cause.[[1522]] The case deserves particular attention, because a suspicion of intentional poison might have been excited by the circumstances in which it occurred. The individual, a young man, was attacked soon after eating in company with another, who was about to marry his mother, and with whom on that account he lived on bad terms.
Of the Source of Poison of Muscles.
Various opinions have been formed as to the cause or causes of the poisonous qualities of some muscles.
The vulgar idea that the poisonous principle is copper, with which the fish becomes impregnated from the copper bottoms of vessels, is quite untenable. Copper does not cause the symptoms described above. I analyzed some of the muscles taken from the stomach of one of Dr. Combe’s patients, without being able to detect a trace of copper. Others have arrived at the same result in former cases. The only instance indeed to the contrary is a late analysis by M. Bouchardat; who does not mention the quantity of copper he detected, or what was the source of the poisonous fish.[[1523]]
The theory which ascribes their effects to changes induced by decay is equally untenable. In Dr. Burrows’s two cases the muscles appear to have been decayed; yet he very properly refuses to admit this fact as explanatory of their operation. And, indeed, it rather complicates than facilitates the explanation; as it shows that the poison differs from animal poison generally, in not being destroyed by putrefaction. Dr. Combe’s inquiries must satisfy every one, that in the Leith cases decay was out of the question, and I may add my testimony to the statement: the muscles taken from the stomach of one of his fatal cases, and likewise others obtained in the shell, and brought to me for analysis, were perfectly fresh.
By some physicians, and especially by Dr. Edwards, their poisonous effects have been referred to idiosyncrasy on the part of the persons who suffer. It can hardly be doubted that this is the cause in some instances. It was formerly mentioned that muscles, oysters, crabs, and even the richer sorts of vertebrated fishes, such as trout, salmon, turbot, holibut, herring, mackerel, are not only injurious to some people, while salutary to mankind generally, but likewise that this singular idiosyncrasy may be acquired. A relation of mine for many years could not take a few mouthfuls of salmon, trout, herring, turbot, holibut, crab, or lobster, without being attacked in a few minutes or hours with violent vomiting; yet at an early period of life, he could eat them all with impunity; and at all times he has eaten without injury cod, ling, haddock, whiting, flounder, oysters, and muscles. Among the cases which have come under Dr. Edwards’s notice in Paris, there is one evidently of the same nature. In two others, the idiosyncrasy existed in regard to the muscle, and although in both of these the affection induced was slight, there is no doubt but idiosyncrasy will also account even for some instances of the severe disorders specified above. In particular, it appears sometimes to operate in the production of nettle-rash and asthma; for in the instance quoted from the Gazette de Santé, as arising from ten muscles, it happened that the father of the patient partook very freely of the same dish without sustaining any harm whatever; and in each of three distinct accidents mentioned by Möhring, it appeared that other individuals had eaten of the same dish with equal impunity.[[1524]]