TYPICAL PARATYPHOID OUTBREAKS 397 



Fairly large quantities of copper have to be eaten before death 

 results, and it is doubtful whether many foods would dissolve 

 sufficient to result fatally. Whereas a small small quantity of one 

 of the metallic poisons taken once may cause no ill effects, their 

 constant use would, for their action is cumulative. Moreover, 

 sanitarians insist that chemical substances likely to be irritating to 

 the human tissues in assimilation or elimination should not be 

 employed in food. Each new irritant, even in small quantities, 

 may add to the burden of organs already weakened by age or 

 previous harsh treatment. 



Animals Suffering from Disease. The milk and flesh of animals 

 suffering with certain diseases are continually being used without 

 adequate cooking, the result being that thousands die each year from 

 this cause. The majority of these cases come from the use of milk, 

 which has been considered in an earlier chapter. A typical out- 

 break of paratyphoid due to the eating of diseased meat is thus 

 given by Jordan : 



"The most characteristic examples of 'food poisoning,' popularly 

 speaking, are those in which the symptoms appear shortly after 

 eating and in which gastro-intestinal disturbances predominate. 

 In the typical group-outbreaks of this sort all grades of severity 

 are manifested, but as a rule recovery takes place. The great 

 majority of such cases that have been investigated by modern 

 bacteriological methods show the presence of bacilli belonging to the 

 so-called paratyphoid group (B. paratyphosus or B. enteritidis) . 

 Especially is it true of meat-poisoning epidemics that paratyphoid 

 bacilli are found in causal relation with them. Hiibener enumerates 

 forty-two meat-poisoning outbreaks in Germany in which bacilli of 

 this group were shown to be implicated, and Savage gives a list of 

 twenty-seven similar outbreaks in Great Britain. In the United 

 States relatively few outbreaks of this character have been placed 

 on record, but it cannot be assumed that this is due to their rarity, 

 since no adequate investigation of food-poisoning cases is generally 

 carried out in our American communities. 



" Typical Paratyphoid Outbreaks. Kaensche describes an outbreak 

 at Breslau involving over eighty persons in which chopped beef was 

 apparently the bearer of infection . The animal from which the meat 

 came had been ill with sever diarrhea and high fever and was 

 slaughtered as an emergency measure (notgeschlachtet) . On exami- 

 nation a pathological condition of the liver and other organs was 

 noted by a veterinarian who declared the meat unfit for use and 

 ordered it destroyed. It was, however, stolen, carried secretly 

 to Breslau, and portions of it were distributed to different sausage- 

 makers, who sold it for the most part as hamburger steak (Hack- 

 fleisch) . The mea^t itself presented nothing abnormal in color, odor, 

 or consistency. Nevertheless, illness followed in some cases after 



