SECTION VII.— VARIOUS DISINFECTING AGENTS. (Part 4)

botulinicum ; but the acids of the former proved to be inert, and that of the latter to have no existence. Schlossberger suggested that the poisonous substance is most probably basic in character, and he found an odoriferous, ammoniacal base, which could not be found in good sau- sage, and which did not correspond to any known amides, imides, or nitric bases. However, this substance has not been obtained by any one else, nor has it been demonstrated to be poisonous. Liebig, Duflas, Hirsch, and Simon believed in the presence of a poi- sonous ferment. Van den Corput described scarcina botulina, which were believed to constitute the active agent. Muller, Hoppe-Seyler, and others have found various micro-organisms, and Virchow, Eichenberg, and others have examined microscopically the blood of persons poisoned with sausage. Recently Ehrlich has attempted to isolate the poisonous substance by employing Brieger's method ; but he obtained only inert substances. In the light of the knowledge of to-day concerning the nature of putre- faction, there can scarcely be a doubt that the active agent of poisonous sausage consists of an easily decomposable base, and we predict its iso- lation in the very near future. Poisonous Ham. Under this head we shall not discuss cases of poi- soning from trichina or other parasites, but shall refer only to those instances in which the toxic agent has originated in putrefactive changes. A number of such cases have been observed within the past ten years, but only a few of them have been investigated scientifically. The best I92 REPORT OF COMMITTEE ON DISINFECTANTS. known of these, as well as the most thoroughly studied, is the Wellbeck poisoning, which Dr. Ballard investigated successfully. In June, 1880, a large number of persons attended a sale of timber and machinery on the estate of the Duke Of Portland, at Wellbeck. The sale continued for four days, and lunches were served by the proprietress of a neighboring hotel. The refreshments consisted of cold boiled ham, cold boiled or roasted beef, cold beefsteak pie, mustard and salt, bread and cheese, pickles, and Chutnee sauce. The drinks were bottled and draught beer, spirits, ginger beer, lemonade, and water. Many were poisoned ; and Dr. Ballard obtained the particulars of seventy-two cases, among which there were four deaths. The cause of this illness was traced conclusively to the hams eaten. Klein found in the meat a bacillus, cultures of which were used for inoc- ulating animals. These inoculations were found generally to be followed by pneumonia. No attempt was made to isolate a ptomaine. Later, Ballard reported fifteen cases, with symptoms similar to the above, and with one death, from eating baked pork. Not all of those who ate of this pork were made sick. This might have been due to inequality in the putrefactive changes in different portions of the meat, or it may have been due to differences in temperature in various portions of the meat during the cooking. In the blood, pericardial fluid, and lungs of the fatal case, Klein observed bacilli similar to those discovered in the Wellbeck inquiry. Pneumonia was produced by inoculating Guinea-pigs and mice with these bacilli. Poisonous Canned Meats. Cases of poisoning from eating canned meats have become quite frequent. Although it may be possible that in some instances the untoward effects result from metallic poisoning, in the great majority of cases the poisonous principles are formed by putrefac- tive changes. In many instances, it is probable that decomposition be- gins after the can is opened by the consumer. In others, the canning is carelessly done, and putrefaction is far advanced before the food reaches the consumer. In still other instances the meat may be taken from dis- eased animals, or it may have undergone putrefactive changes before the canning. What is true of canned meats is also true of canned fruits and vegetables. Poisonous Cheese. In 1827, Hiinnefeld made some analyses of poi- sonous cheese, and experimented with extracts upon the lower animals. He accepted the ideas of Kerner in regard to poisonous sausage in a somewhat modified form, and thought the active agents to be sebacic and caseic acids. About the same time, Sertiirner, making analyses of poi- sonous cheese for Westrumb, also traced the poisonous principles, as he supposed, to these fatty acids. We see from this that during the first part of the present century the fatty acid theory, as it may be called, was generally accepted. In 1S48, Christison, after referring to the work of Hiinnefeld and Ser- tiirner, made the following statement : " His [Hiinnefeld's] experiments, however, are not quite conclusive of the fact that these fatty acids are REPORT OF COMMITTEE ON DISINFECTANTS. ' 1 93 really the poisonous principles, as he has not extended his experimental researches to the caseic and sebacic acids prepared in the ordinary way. His views will probably be altered and simplified if future experiments should confirm the late inquiries of Braconot, who has stated that Proust's caseic acid is a modification of the acetic acid combined with an acrid oil." In 1852, Schlossberger made experiments with the pure fatty acids, and demonstrated their freedom from poisonous properties. These ex- periments have been verified repeatedly, so that now it is well known that all the fatty acids obtainable from cheese are devoid of poisonous properties. It may be remarked here that there is every probability that the poison- ous substance was present in the extracts obtained by the older chemists : indeed, we may say that this is a certainty, since the administration of these extracts to cats was, in some instances at least, followed by fatal results. The great mass of these extracts consisted of fatty acids, and as the chemists could find nothing else present, they very naturally con- cluded that the fatty acids themselves constituted the poisonous substance. Since the overthrow of the fatty acid theory, various conjectures have been made, but none of them are worthy of consideration. We make the following quotations from some of the best authorities, who wrote during the first half of the present decade upon this subject : Hiller says, — " Nothing definite is known of the nature of cheese poi- son. Its solubility seems established from an observation of Husemann, a case in which the poison was transmitted from a nursing mother to her child." Husemann wrote as follows: " The older investigations of the chemi- cal nature of cheese poison, which led to the belief of putrefactive cheese acids and other problematic substances, are void of all trustworthiness ; and the discovery of the active principle of poisonous cheese may not be looked for in the near future, on account of proper animals for controlling the experiments with the extracts, as dogs can eat large quantities of poi- sonous cheese without its producing any effect." Brieger stated in 1885, — "All kinds of conjectures concerning the nature of this poison have been formed, but all are even devoid of histor- ical interest, because they are not based upon experimental investiga- tions. My own experiments towards solving this question have not progressed very far." In the above quotation, we think that Brieger has hardly done justice to the work of Hiinnefeld and Sertiirner. Their labors can hardly be said to be wholly devoid of historical interest, and they certainly did em- ploy the experimental method of inquiry. We shall soon see as to the correctness of the prediction of Husemann, as given above. In the years 1883 and 1884, there were reported to the Michigan State Board of Health about 300 cases of cheese poisoning. As a rule, the first symptoms appeared within from two to four hours after eating the cheese. In a few the symptoms were delayed from eight to ten hours, 194 REPORT OF COMMITTEE ON DISINFECTANTS. and were very slight. The attending physicians reported that the grav- ity of the symptoms varied with the amount of cheese eaten, but no one who ate of the poisonous cheese wholly escaped. One physician reported the following symptoms: M Every one who ate of the cheese was taken with vomiting, at first of a thin, watery, later a more consistent reddish- colored, substance. At the same time, the patients suffered from diar- rhoea with watery stools. Some complained of pain in the region of the stomach. At first, the tongue was white, but later it became red and dry ; pulse was feeble and irregular ; countenance pale, with marked cyanosis. One small boy, whose condition seemed very critical, was covered all over his body with bluish spots." Dryness and constriction of the throat were complained of by all. In a few cases the vomiting and diarrhoea were followed by marked ner- vous prostration, and, in some, dilatation of the pupils was observed. Notwithstanding the severity of the symptoms in many, there was no fatal termination among these cases, though several deaths from cheese poisoning in other outbreaks have occurred. Many of the physicians at first diagnosed the cases from the symptoms as due to arsenical poison- ing, and on this supposition some administered ferric hydrate. Others gave alcohol and other stimulants, and treated upon the expectant plan. Vaughan, to whom the cheese was sent for analysis, made the follow- ing report : " All of these 300 cases were caused by eating of twelve dif- ferent cheeses. Of these, nine were made at one factory, and one each at three other factories. Of each of the twelve I received smaller or larger pieces. Of each often I received only small amounts ; of each of the other two I received about eighteen killograms. The cheese was in good condition, and there was nothing in the taste or odor to excite sus- picion. However, from a freshly cut surface there exuded numerous drops of a slightly opalescent fluid, which reddened litmus instantly and intensely. Although, as I have stated, I could discern nothing peculiar in the odor, if two samples, one of good and the other of poisonous cheese, were placed before a dog or cat, the animal would invariably select the good cheese. But if only poisonous cheese was offered, and the animal was hungry, it would partake freely. A cat was kept seven days, and furnished only poisonous cheese and water. It ate freely of the cheese, and manifested no untoward symptoms. After the seven days, the ani- mal was etherized, and abdominal section was made. I predicted, how- ever, in one of my first articles on poisonous cheese, that the isolated poison would affect the lower animals. As to the truth of this predic- tion we will see later. " My friend Dr. Sternberg, the eminent bacteriologist, found in the opalescent drops above referred to numerous micrococci. But inocula- tions of rabbits with these failed to produce any results. "At first, I made an alcoholic extract of the cheese. After the alcohol was evaporated in vacuo at a low temperature, a residue consisting mainly of fatty acids remained. I ate a small bit of this residue, and found that it produced dryness of the throat, nausea, vomiting, and diarrhoea. The REPORT OF COMMITTEE ON DISINFECTANTS. 1 95 mass of this extract consisted of fats and fatty acids, and for some weeks I endeavored to extract the poison from these fats, but all attempts were unsuccessful. I then made an aqueous extract of the cheese, filtered this, and, drinking some of it, found that it also was poisonous. But after evaporating the aqueous extract to dryness on the water-bath at ioo°, the residue thus obtained was not poisonous. From this I ascer- tained that the poison was decomposed or volatilized at or below the boiling point of water. I then tried distillation at a low temperature ; but by this the poison seemed to be decomposed. k' Finally, I made the clear, filtered aqueous extract, which was highly acid, alkaline with sodium hydrate, agitated this with ether, removed the ether, and allowed it to evaporate spontaneously. The residue was highly poisonous. By resolution in water and extraction with ether, the poison was separated from foreign substances. As the ether took up some water, this residue consisted of an aqueous solution of the poison. After this was allowed to stand for some hours in vacuo over sulphuric acid, the poison separated in needle-shaped crystals. From some sam- ples the poison crystallized from the first evaporation of the ether, and without standing in vacuo. This happened only when the cheese con- tained comparatively a large amount of the poison. Ordinarily, the microscope was necessary to detect the crystalline shape. From sixteen kilograms of one cheese I obtained about 0.5 gram of the poison, and in this case the individual crystals were plainly visible to the unaided eye. From the same amount of another cheese I obtained only about 0.1 gram, and the crystals in this case were not so large. I have no idea, however, that by the method used all the poison was separated from the cheese. " To this ptomaine, Vaughan has given the name tyrotoxicon {turos, cheese, and toxikon, poison). During 1887, Wallace found tyrotoxicon in two samples of cheese which had caused serious illness. The first of these came from Jeans- ville, Penn., and the symptoms as reported to Wallace by Dr. Doolittle, who had charge of the cases, were as follows : "There were at least fifty persons poisoned by this cheese. There were also eight others who ate of the cheese, but felt no unpleasant effects : whether this was due to personal idiosyncrasy, or to an uneven distribution of the poison through- out the cheese, I am unable to say. " The majority, however, comprising fifty or sixty persons, were seized in from two to four hours after eating the cheese with vertigo, nausea, vomiting, and severe rigors, though varying in their order of appearance and in severity in different cases. The vomiting and chills were the most constant and severe symptoms in all the cases, and were soon followed by severe pain in the epigastric region, cramps in the feet and lower limbs, purging and griping pain in the bowels, a sensation of numbness, or pins and needles, especially in the limbs, and, lastly, very marked prostration, amounting almost to collapse in a few cases. " The vomit at first consisted of the contents of the stomach, and had a strong odor of cheese ; afterwards, it consisted of mucus, bile, and in 196 REPORT OF COMMITTEE ON DISINFECTANTS. three or four of the severest cases blood was mixed with the mucus in small quantities. Microscopic examination of the same was not made, but to the eye it appeared as such. The vomiting and diarrhoea lasted from two to twelve hours ; the rigors and muscular cramps, from one to two hours. The diarrhoea, at first fecal, became later watery and light- colored. No deaths occurred, and for the most part the effects were transient, and all that remained on the following day were the prostra- tion and numbness; the latter occurred in about one half the cases, and disappeared in from one to three days. " Children, as a rule, seemed to suffer less than adults, and, of course, it was not possible to elicit as definite symptoms from them. The sud- denness of the attack was remarked by all, some feeling perfectly well until the moment of attack. Nor did the symptoms seem to be in pro- portion to the amount of the cheese taken. Some of the severest cases declared they had not eaten more than a cubic inch of it. One of the severest cases was about six and a half months pregnant, but no inter- ference with pregnancy occurred. All the cheese which caused the sick- ness came from the same piece." The second sample of cheese examined by Wallace came from River- ton, N. J. This outbreak included a smaller number of persons, all of whom recovered. Still more recently Wolf has detected tyrotoxicon in cheese which poi- soned several persons at Shamokin, Penn. The pores of this cheese were found filled with a grayish-green fungoid growth, though it is not supposed that this fungus was connected in any way with the poisonous nature of the cheese. Tests were made for mineral poisons with nega- tive results, after which tyrotoxicon was recognized both by chemical and physiological tests. u A few drops of the liquid (extract) placed on the tongue of a young kitten produced prompt emesis and numerous watery dejections, with evident depression and malaise of the animal. A larger cat was similarly affected by it, though the depression and malaise were not so marked nor so long continued." Cheese poisoning caused the death of several children in the neighbor- hood of Heiligenstadt in 1879, an<^ there were many fatal cases from the same cause in Pyrmont in 1878. Unfortunately, we have not been able to find any detailed account of either the symptoms or the post-mortem appearances in these cases. Poisonous Milk. In 18S5, Vaughan found tyrotoxicon in some milk which had stood in a well stoppered bottle for about six months. It was presumed that this milk was, when first obtained, normal in com- position ; but since this was not known with certainty, the following experiments were made : Several gallon-bottles were filled with normal milk, tightly closed with glass stoppers, and allowed to stand at the ordi- nary temperature of the room. From time to time a bottle was opened, and the test for tyrotoxicon was made. These tests were followed by negative results until about three months after the experiment was begun. Then the poison was obtained from one of the bottles. The coagulated REPORT OF COMMITTEE ON DISINFECTANTS. 197 milk was filtered through paper. The filtrate, which was colorless and decidedly acid in reaction, was rendered feebly alkaline by the addition of potassium hydrate, and agitated with ether. After separation, the ethereal layer was