Fish poisoning is quite frequently observed in the West Indies, where the complex of symptoms is designated by the Spanish term siguatera. It is believed by the natives that the poisonous properties of the fish are due to the fact that they feed upon decomposing medusæ and corals. In certain localities it is stated that all fish caught off certain coral reefs are unfit for food. However, all statements concerning the origin and nature of the poison in these fish are mere assumptions, since no scientific work has been done. Whatever the source of the poison may be, it is quite powerful, and death not infrequently results. The symptoms are those of gastro-intestinal irritation followed by collapse.
In Russia fish poisoning sometimes causes severe and widespread epidemics. The Government has offered a large reward for any one who will positively determine the cause of the fish being poisonous and suggest successful means of preventing these outbreaks. Schmidt, after studying several of these epidemics, states the following conclusions:
(a) The harmful effects are not due to putrefactive processes. (b) Fish poisoning in Russia is always due to the eating of some member of the sturgeon tribe. (c) The ill effects are not due to the method of catching the fish, the use of salt, or to imperfections in the methods of preservation. (d) The deleterious substance is not uniformly distributed through the fish, but is confined to certain parts. (e) The poisonous portions are not distinguishable from the nonpoisonous, either macroscopically or microscopically. (f) When the fish is cooked it may be eaten without harm. (g) The poison is an animal alkaloid produced most probably by bacteria that cause an infectious disease in the fish during life.
The conclusion reached by Schmidt is confirmed by the researches of Madame Sieber, who found a poisonous bacillus in fish which had caused an epidemic.
In the United States fish poisoning is most frequently due to decomposition in canned fish. The most prominent symptoms are nausea, vomiting, and purging. Sometimes there is a scarlatinous rash, which may cover the whole body. The writer has studied two outbreaks of this kind of fish poisoning. In both instances canned salmon was the cause of the trouble. Although a discussion of the treatment of food poisoning is foreign to this paper, the writer must call attention to the danger in the administration of opiates in cases of poisoning with canned fish. Vomiting and purging are efforts on the part of Nature to remove the poison, and should be assisted by the stomach tube and by irrigation of the colon. In one of the cases seen by the writer large doses of morphine had been administered in order to check the vomiting and purging and to relieve the pain; in this case death resulted. The danger of arresting the elimination of the poison in all cases of food poisoning can not be too emphatically condemned.
Meat Poisoning.—The diseases most frequently transmitted from the lower animals to man by the consumption of the flesh or milk of the former by the latter are tuberculosis, anthrax, symptomatic anthrax, pleuro-pneumonia, trichinosis, mucous diarrhœa, and actinomycosis. It hardly comes within the scope of this article to discuss in detail the transmission of these diseases from the lower animals to man. However, the writer must be allowed to offer a few opinions concerning some mooted questions pertaining to the consumption of the flesh of tuberculous animals. Some hold that it is sufficient to condemn the diseased part of the tuberculous cow, and that the remainder may be eaten with perfect safety. Others teach that "total seizure" and destruction of the entire carcass by the health authorities are desirable. Experiments consisting of the inoculation of guinea pigs with the meat and meat juices of tuberculous animals have given different results to several investigators. To one who has seen tuberculous animals slaughtered, these differences in opinion and in experimental results are easily explainable. The tuberculous invasion may be confined to a single gland, and this may occur in a portion of the carcass not ordinarily eaten; while, on the other hand, the invasion may be much more extensive and the muscles may be involved. The tuberculous portion may consist of hard nodules that do not break down and contaminate other tissues in the process of removal, but the writer has seen a tuberculous abscess in the liver holding nearly a pint of broken-down infected matter ruptured or cut in removing this organ, and its contents spread over the greater part of the carcass. This explains why one investigator succeeds in inducing tuberculosis in guinea pigs by introducing small bits of meat from a tuberculous cow into the abdominal cavity, while another equally skillful bacteriologist follows the same details and fails to get positive results. No one desires to eat any portion of a tuberculous animal, and the only safety lies in "total seizure" and destruction. That the milk from tuberculous cows, even when the udder is not involved, may contain the specific bacillus has been demonstrated experimentally. The writer has suggested that every one selling milk should be licensed, and the granting of a license should be dependent upon the application of the tuberculin test to every cow from which milk is sold. The frequency with which tuberculosis is transmitted to children through milk should justify this action.
That a profuse diarrhœa may render the flesh of an animal unfit food for man was demonstrated by the cases studied by Gärtner. In this instance the cow was observed to have a profuse diarrhœa for two days before she was slaughtered. Both the raw and cooked meat from this animal poisoned the persons who ate it. Medical literature contains the records of many cases of meat poisoning due to the eating of the flesh of cows slaughtered while suffering from puerperal fever. It has been found that the flesh of animals dead of symptomatic anthrax may retain its infection after having been preserved in a dry state for ten years.
One of the most frequently observed forms of meat poisoning is that due to the eating of decomposed sausage. Sausage poisoning, known as botulismus, is most common in parts of Germany. Germans who have brought to the United States their methods of preparing sausage occasionally suffer from this form of poisoning. The writer had occasion two years ago to investigate six cases of this kind, two of which proved fatal. The sausage meat had been placed in uncooked sections of the intestines and alternately frozen and thawed and then eaten raw. In this instance the meat was infected with a highly virulent bacillus, which resembled very closely the Bacterium coli.
In England, Ballard has reported numerous epidemics of meat poisoning, in most of which the meat had become infected with some nonspecific, poison-producing germ. In 1894 the writer was called upon to investigate cases of poisoning due to the eating of pressed chicken. The chickens were killed Tuesday afternoon and left hanging in a market room at ordinary temperature until Wednesday forenoon, when they were drawn and carried to a restaurant and here left in a warm room until Thursday, when they were cooked (not thoroughly), pressed, and served at a banquet in which nearly two hundred men participated. All ate of the chicken, and were more or less seriously poisoned. The meat contained a slender bacillus, which was fatal to white rats, guinea pigs, dogs, and rabbits.
Ermengem states that since 1867 there have been reported 112 epidemics of meat poisoning, in which 6,000 persons have been affected. In 103 of these outbreaks the meat came from diseased animals, while in only five was there any evidence that putrefactive changes in the meat had taken place. My experience convinces me that in this country meat poisoning frequently results from putrefactive changes.