402 BACTERIA AND FOOD-POISONING 



this time and stated that it felt as if ' something came up from below' 

 that interfered with deglutition. The fourth day she remained in 

 bed, was much constipated, and noticed a marked decrease in the 

 amount of urine voided. There was at no time pain except for 

 occasional mild abdominal cramps, no headache, subnormal tem- 

 perature, and a normal pulse. The fourth and fifth days the breath- 

 ing became difficult at times and swallowing was almost impossible. 

 The patient complained of a dry throat with annoying thirst. The 

 sixth day there were periods of a sense of suffocation with a vague 

 feeling of unrest and as if there might be difficulty in getting the 

 next breath. The upper lids had begun to droop. The voice was 

 nasal. When the attempt was made to swallow liquids they passed 

 back through the nose. The patient felt markedly weak. 



" Physical examination at this time showed ptosis of both upper 

 eyelids, dilatation of the right pupil, sluggish reaction to light of 

 both pupils, apparent paralysis of the internal rectus of the left 

 eye, normal retina, inability to raise the head, control apparently 

 having been lost of the muscles of the neck, inability to swallow, 

 absence of taste. The tongue was heavily coated and the throat 

 was covered with a viscid whitish mucus clinging to the mucous 

 membrane. The soft palate could be raised but was sluggish, 

 particularly on the right side. The exudate on the right tonsil was 

 so marked that it resembled somewhat a diphtheritic membrane. 

 The seventh day there was some change in the condition; occasional 

 periods occurred when swallowing was more effective, and there was 

 less tendency to strangle. On the eleventh day there was some 

 improvement of the eyes, still strangling on swallowing, sensation 

 of taste was keener, and the general condition -improved. The 

 twelfth day the patient was able to move her head, but was unable 

 to lift it except when she took hold of the braids of her hair, and 

 pulled the head forward. The eyes could be opened slightly, speech 

 was less nasal and more distinct, and improvement in swallowing 

 was marked. At the end of two weeks the patient was able to take 

 soft diet freely, and at four weeks she was up in a chair for a couple 

 of hours complaining only of general weakness and inability to use 

 her eyes. At the end of five weeks she was able to leave the hospital 

 and return to her home and later to resume her regular work." 



Prevention. The prevention of food-poisoning from canned foods 

 consists of processing the material according to the best experience 

 available, the selection of good, sound material and the rejection of 

 any infected material. Dirty, wilted, and partly rotted food carries 

 many more organisms into the canning process than does fresh, 

 sound, clean fruits and vegetables. Dirty tables, dirty jars, lids, 

 and sewage-polluted water and flies are sources of contamination 

 which should be eliminated. 



When a can presents a convex appearance (technically called a 



