MICROBIAL FOOD POISONING 587 



this poisonous action is largely due to bacterial changes in the milk. 

 Extraordinary precautions are therefore essential in the production and 

 care of milk to be used as food for children, particularly during the 

 warmer season of the year. Severe poisoning of adults with milk, ice- 

 cream, or cheese, is relatively less frequent. Cases which have been 

 studied have been traced to the development of B. coll or B. paraty- 

 phosus in these foods. There is some evidence that other bacteria, 

 probably strict anaerobes, are also sometimes concerned. Strict 

 cleanliness, proper refrigeration, and pasteurization of milk of uncertain 

 character may usually be relied upon to prevent milk poisoning. 

 Ice-cream should be made only from wholesome materials and with 

 due regard to cleanliness in making it. The causes of serious cheese 

 poisoning are not definitely known, but such poisoning may be avoided, 

 to a large extent at least, by using only standard varieties of cheese of 

 the proper odor and flavor. 



VEGETABLE FOOD POISONING, in an acute form, has followed the use 

 of sprouting and partly decomposed potatoes, and also various canned 

 vegetables, particularly those of high protein content, such as beans. 

 The large majority and possibly all of these cases are due to decomposi- 

 tion changes in the foods, B. botulinus and B. proteus appearing to be 

 the microbes most frequently concerned. 



SPECIFIC DISEASES DUE TO FOOD POISONING 

 BOTULISM AND BACILLUS BOTULINUS. Perhaps the most serious 

 and most rapidly fatal of all the food poisonings is botulism, a disorder 

 caused by a true bacterial toxin formed in food previous to its ingestion, 

 by the growth of a specific anaerobic organism, Bacillus botulinus. 

 The earliest recognized cases of this disease were observed in Wiirtem- 

 berg, Germany, and followed the eating of sausages, hence the name 

 botulism or sausage poisoning. Mayer has recorded 812 cases of botu- 

 lism in Germany up to 1913, with 365 deaths. Dickson* has collected 

 records of 64 cases in the United States from 1894 to 1918, of which 41 

 resulted in death. The mortality in this series has been, therefore, 

 64 per cent. It seems certain that only a small proportion of actual 

 existing cases has been recognized and that milder outbreaks of the 

 poisoning, especially, have escaped record. In one outbreak the 

 mortality was 100 per cent, and ; n another only 8.3 per cent. 



* Dickson, E. C.: Botulism. Monograph No. 8 of the Rockefeller Institute for Medical 

 Research, 1918, p. 51. 



