FISH POISONING 609* FOOD POISONING Food poisoning occurs occasionally as an acute illness in a number of individuals shortly after the consumption of the same food. It is due to infection of the food with living bacteria of the Salmonella group, e.g. the Bacillus enteritidis of Gaertner and the Bacillus aertrycke. These bacteria are destroyed in the process of cooking but the toxins generated by them are resistant to heat and may be present in food even after boiling it for one hour. Hsemolytic streptococci and staphylococci are reported to have produced outbreaks of food poisoning. The foodstuffs which are responsible for causing this kind of poisoning are diseased meats, fish, eggs, milk, cheese, ice-creams, and tinned foods. Such foods often appear quite fresh and do not show any alteration in taste or smell to arouse one's suspicion of their poisonous nature. Outbreaks of food poisoning were formerly described as cases of ptomaine poison- ing on the assumption that the poisoning was caused by ptomaines produced by putre- factive changes occurring in meat or other food, but there is no evidence to show that these substances are the causative agents of food poisoning. Moreover, ptomaines are late degradation products and are never found until the food has become too nasty to be eaten. Symptoms.—These usually commence soon after the ingestion of the food, when the toxins are the causative agents but they may be delayed for six to twelve or even tweny- four hours in cases where the living bacteria are the causative agents. The chief symp- toms are headache, giddiness, intense thirst, acute vomiting, diarrhoaa with colicky pain in the abdomen, dilatation of the pupils, ptosis, cold, clammy skin, rise of temperature to 101° and 103° or 104° F. with rigors, muscular weakness, cramps and paralysis of the lower limbs. The pulse becomes slow, weak and finally imperceptible. Death occurs from failure of the heart. Diagnosis.—This is made by isolating the bacteria from the vomit, urine or faeces and the suspected foods or from the bowels and solid organs of the sufferer after death and identifying them by cultural characteristics and agjgjj^tination tests. Treatment—Wash out the stomach, and give brjgk saline purgatives to empty the "bowels. Give saline infusions to promote elimination of the toxins from the system* *CJse stimulants, if necessary, Post-mortem Appearances.—The mucous membrane of the alimentary canal Jis swollen and acutely congested with submucous petechial haemorrhages. The liver, spleen and kidneys are congested. The lungs are usually congested. Food Allergy.—Owing to an inherent or acquired idiosyncrasy some individuals are hypersensitive to certain kinds of food which are ordinarily quite harmless and suffer from gastro-enteritis, local urticarial rashes or asthmatic attacks, whenever they take any of these articles, The foods which produce these symptoms are protein in nature and are meat,.fish, shell-fish, prawns, eggs, milk, cheese, etc. BOTULISM OH ALLANTTASIS This is a form of food poisoning which is caused by the toxins of the Bacillus Botulinus contained in sausages, potted meats, tinned fish, canned fruits, etc. Symptoms.—These commence generally within 24 hours after taking the unwhole- some food, but' may be delayed for 72 hours. These are dryness of the mouth, difficulty of swallowing, retching, vomiting, colic and diarrhoea followed by constipation. The nervous symptoms then appear with dilatation of the pupils, ptosis, diplopia, aphonia and a sense of suffocation. Marked muscular weakness and nervous prostration are the ^ prominent symptoms.^ The pulse becomes weak, and the face becomes cyanosed. The temperature risfts^to 103°F,f but falls below normal towards death, which is preceded by delirium or coma. Death may occur within 24 to 48 hours or may be delayed for a week. Treatment.—Inject promptly the antitoxic <(anti-botulinus) serum, if it is available. Wash out the stomach to prevent further infection. Give mild laxatives followed by high irrigation of the intestine with enemata. Administer morphine hypodermically to relieve vomiting and purging. It may be helpful to use stimulants and subcutaneous or intravenous injections of normal saline. Post-mortem Appearances.—Hypersemla of the alimentary tract. The other organs are found congested, The bacillus may be isolated from the stomach contents and faeces during life and from the liver, spleen and intestinal content after death, FISH POISONING Certain kinds of fish belonging to the species,, tetrodon, found in China an are very poisonous, and cause death within an hour.