Food Poisoning(Annotated)

CONTENTS
CHAPTER PAGE
I. INTRODUCTION 1 The Extent of Food Poisoning Various Kinds of Food Poisoning The Articles of Food Most Commonly Connected with Food Poisoning
II. SENSITIZATION TO PROTEIN FOODS 9
III. POISONOUS PLANTS AND ANIMALS 13 Poisonous Plants Poisonous Animals
IV. MINERAL OR ORGANIC POISONS ADDED TO FOOD 26 Arsenic Antimony Lead Tin Copper Various Coloring Substances Food Preservatives Food Substitutes
V. FOOD-BORNE PATHOGENIC BACTERIA 44 Typhoid Food Infection Asiatic Cholera Tuberculosis Various Milk-borne Infections Possible Infection with B. proteus
VI. FOOD-BORNE PATHOGENIC BACTERIA (Continued) 58 Paratyphoid Infection Typical Paratyphoid Outbreaks General Characters of Paratyphoid Infection Toxin Production Sources of Infection Means of Prevention
VII. ANIMAL PARASITES 79 Trichiniasis Teniasis Uncinariasis Other Parasites
VIII. POISONOUS PRODUCTS FORMED IN FOOD BY BACTERIA AND OTHER MICRO-ORGANISMS 85 Ergotism Botulism Symptoms Anatomical Lesions Bacteriology Epidemiology Prevention and Treatment Other Bacterial Poisons Spoiled and Decomposed Food
IX. POISONING OF OBSCURE OR UNKNOWN NATURE 100 Milksickness or Trembles Deficiency Diseases Beriberi Pellagra Lathyrism Favism Scurvy Rachitis The Foods Most Commonly Poisonous
INDEX 109
CHAPTER I
INTRODUCTION
How frequently food poisoning occurs is not definitely known. Everybody is aware that certain articles of food are now and again held responsible for more or less severe "attacks of indigestion" or other physiological disturbances that have followed their consumption, but in many cases the evidence for assuming a causal connection is of the slightest. That convenient refuge from etiological uncertainty, "ptomain poisoning," is a diagnosis that unquestionably has been made to cover a great variety of diverse conditions, from appendicitis and the pain caused by gallstones to the simple abdominal distention resulting from reckless gorging.
No doubt can be entertained, however, that intestinal and other disorders due to particular articles of food occur much more frequently than they are recorded. There are few persons who have not experienced gastro-intestinal attacks of moderate severity which could be reasonably attributed to something eaten shortly before. It is often possible to specify with a fair degree of certainty the offending food. The great majority of such attacks are of a mild character, are quickly recovered from, and are never heard of beyond the immediate family circle. Only when the attack is more serious than the average or when a large number of persons are affected simultaneously does knowledge of the occurrence become more widely spread. A small proportion of food-poisoning cases receives notice in the public press and a still smaller proportion is reported in the medical journals. Very few indeed are ever completely investigated as to their origin.
Although most attacks of food poisoning are usually of a slight and apparently temporary nature, it does not follow that they are to be considered negligible or of trivial importance from the standpoint of public health. The human organism is always more or less weakened by such attacks, many of them, as we shall see, genuine infections; and, as is known to be the case with many infectious diseases, some permanent injurious impression may be left on the body of the affected individual. Under certain conditions it is possible that degenerative changes are initiated or accelerated in the kidneys or blood vessels by the acute poisoning which is manifested for a short time in even the milder cases. In yet greater degree these changes may follow those insidious forms of food poisoning due to the frequent ingestion of small quantities of mineral or organic poisons, which in each dose may cause little or no measurable physiological change, but whose cumulative effect may be vicious. In view of the grave situation evidenced by the increase in the degenerative diseases affecting early middle life in the United States,[1] the extent, causes, and means of prevention of food poisoning seem pressing subjects for investigation.
THE EXTENT OF FOOD POISONING
Since cases of food poisoning, "ptomain poisoning," and the like are not required by law to be reported, public health authorities in general possess no information respecting their occurrence. Very indirect and imperfect indications of the prevalence of certain kinds of food poisoning are afforded by casual press reports. Such as they are, these accounts are the only available material. Tables I and II summarize data I have gathered through a press-clipping bureau and other sources during the period October, 1913, to October, 1915. They serve to show at least the universality and complexity of the problem.
The 375 group and family outbreaks together involved 5,238 persons. While it is not probable that all the instances reported as due to food poisoning can prop