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Poisoning by Infected Food.

Synonym.—Ptomain Poisoning.

Definition.—An acute poisoning, due to the ingestion of food in which putrefactive changes have already taken place; or the food taken may contain pathogenic micro-organisms which develop toxic conditions after being swallowed; or, lastly, the food may be in good condition when swallowed, but undergoes putrefaction in the large or small intestine, as when food is eaten hurriedly, while the patient is overexcited, overheated, or exhausted,

Ptomain poisoning, but little heard of a few years ago, is almost of daily occurrence, owing, no doubt, to the large consumption of canned goods, in which carelessness in the selection, preparation, and handling of the foodstuffs is an important factor; or the animal maybe killed when suffering from some disease. The delivery of milk from long distances during the hot summer months may also be fruitful sources of poisoning.

Meat-poisoning.—Tainted meats, such as warmed-over meat-pies, pork, veal, etc., and mincemeat, sausages, chicken salads, head-cheese, and various canned meats, are responsible for violent symptoms of poisoning.

Symptoms.—The symptoms are those of acute gastro-enteritis, and usually come on suddenly. Sometimes the initial lesion is a chill, followed by fever. The patient is seized with sharp, colicky pains, and there is vomiting and purging, with severe cramps in abdomen and legs. In severe cases, prostration early follows; the pulse becomes small and frequent; the extremities become cold; the skin relaxes, and is covered with a cold, clammy perspiration; the mind becomes dull; there is a disturbance of vision, the pupils are dilated; the face becomes pinched, and the patient passes into a collapse, which may be followed by death. The history of the case, with the above symptoms, renders the diagnosis comparatively easy.

Fish-poisoning.—Certain fish contain poison glands and ovaries, and the ingestion of these produces an intoxication. Thus, in Japan, the disease called "Kakke," which prevails during the summer-time, is due to this cause, and the "Clupea Venenosa," a fish found in the West Indies, is considered poisonous from a similar cause. In middle Europe, especially in Germany, the eating of sick "barbels" gives rise to severe gastro-enteritis known as barbel-cholera, while in Russia fish-poisoning often results from eating sturgeon and salmon suffering with an infectious disease peculiar to these fish.

In our own country, the use of tainted canned fish, eels, mussels, crabs, oysters, lobsters, etc., is followed by toxic conditions. The symptoms are similar to those already mentioned for meat-poisoning.

Milk-poisoning.—In 1884, Vaughan discovered a specific chemical poison in milk and its products, and called it tyrotoxicon, and the excessive death-rate from summer complaint in bottle-fed babies can be traced many times to the chemical changes which have taken place in the milk. This poison also occurs in cheese, ice-cream, frozen custards, cream-puffs, and other articles if made from infected milk.

The symptoms of all these ptomain-infected foods are similar; namely, those of gastro-enteritis, and vary only in degree, according to the stage or degree of toxicity of the infecting principle.

Prognosis.—The prognosis is generally favorable.

Treatment.—The first object is the removal of the offending material, though nature generally is the first to come to the patient's assistance by producing free emesis and catharsis. If, however, this has not taken place, the stomach should be thoroughly washed out by copious libations of warm saline solution, mustard-water, lobelia infusion, or powdered ipecac, to be followed by castor-oil or Epsom salts.

To overcome the gastric, irritability, small doses of specific aconite and ipecac, or gelsemium or rhus tox., should be given. An infusion of neutralizing powder will afford relief when the irritability is of unusual severity. Bismuth subnitrate and mint-water will also be useful for this painful and unpleasant symptom. Should there be threatened collapse, stimulants' would be in order.

For the poisonous effects of the ptomains, echinacea, sodium sulphite, potassium chlorate and hydrastin, and such other antiseptics as the symptomatic conditions called for, would be used.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.

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