FOOD POISONING. 55 



and wide distribution of the poison-producing bacteria. Further- 

 more, during the summer time these bacteria grow abundantly in 

 all kinds of filth. Witliin recent years the medical profession has 

 so urgently called attention to the danger of infected milk that 

 there has been a great improvement in the care of this article of 

 diet, but that there is yet room for more scientific and thorough 

 work in this direction must be granted. The sterilization and Pas- 

 teurization of milk have doubtlessly saved the lives of many chil- 

 dren, but every intelligent physician knows that even the most 

 careful mother or nurse often fails to secure a milk that is alto- 

 gether safe. 



It is true that milk often contains germs the spores of which 

 are not destroyed by the ordinary methods of sterilization and Pas- 

 teurization. However, these germs are not the most dangerous 

 ones found in milk. Moreover, every mother and nurse should 

 remember that in the preparation of sterilized milk for the child 

 it is not only necessary to heat the milk, but, after it has been 

 heated to a temperature sufficiently high and sufficiently prolonged, 

 the milk must subsequently be kept at a low temperature until the 

 child is ready to take it, when it may be warmed. It should be 

 borne in mind that the subsequent cooling of the milk and keeping 

 it at a low temperature is a necessary feature in the preparation 

 of it as a food for the infant. 



Cheese Poisoning. — Under this heading we shall include the 

 ill effects that may follow the eating of not only cheese but other 

 milk products, such as ice cream, cream custard, cream puffs, etc. 

 Any poison formed in milk may exist in the various milk products, 

 and it is impossible to draw any sharp line of distinction between 

 milk poisoning and cheese poisoning. However, the distinction is 

 greater than is at first apparent. Under the head of milk poison- 

 ing we have called especial attention to those substances formed in 

 milk to which children are particularly susceptible, while in cheese 

 and other milk products there are formed poisonous substances 

 against which age does not give immunity. Since milk is prac- 

 tically the sole food during the first year or eighteen months of life, 

 the effect of its poisons upon infants is of the greatest importance ; 

 on the other hand, milk products are seldom taken by the infant, 

 but are frequent articles of diet in after life. 



In 1884 the writer succeeded in isolating from poisonous cheese 

 a highly active basic substance, to which he gave the name tyro- 

 toxicon. The symptoms produced by this poison are quite marked, 

 but differ in degree according to the amount of the poison taken. 

 At first there is dryness of the mouth, followed by constriction of 

 the fauces, then nausea, vomiting, -and purging. The first vomited 



