BOTULISM. 245 



had furnished Nocard the material in question, observed 

 259 cases of tetanus in the same time in animals that had 

 not been inoculated. 



BOTULISM. 



In spite of numerous investigations with regard to the 

 exciting agent of me at -poisoning this whole question was 

 involved in considerable doubt until recently, when, through 

 the discovery by Van Ermengem, in an epidemic at Elle- 

 zelles (Belgium), of a specific anaerobic microbe, the bacillus 

 botulinus, renewed attention was directed to this important 

 subject. 



Under the designation of meat-poisoning are included 

 two entirely distinct symptom-complexes, which should 

 properly be rigidly differentiated from each other. The 

 one variety, which is most appropriately designated the 

 gastrointestinal^ simulates the clinical picture of cholera 

 nostras a simple or hemorrhagic gastro-enteritis. Among 

 associated manifestations may be mentioned fever, albumin- 

 uria, and cutaneous exanthemata of most varied kind and in- 

 tensity. These gastro-intestinal lesions arise after the inges- 

 tion of decomposed meat or of meat derived from diseased 

 animals, the diseases especially concerned being pyemia, 

 septicemia, and puerperal fever. In most cases of this 

 kind the exciting agents are bacteria of the colon-group, 

 and in other cases, occurring less commonly, bacteria of 

 the proteus-group. 



The second variety is identical with so-called sausage- 

 poisoning. It is characterized especially by nervous symp- 

 toms of central origin, secretory and motor disturbances, 

 cessation of salivary secretion, dryness and redness of the 

 mucous membrane of the mouth and pharynx, dysphagia, 

 hoarseness, barking cough, paralysis of accommodation, 

 mydriasis, ptosis, diplopia, etc. For this form of the dis- 

 ease the designation meat-poisoning should no longer be 

 employed, and it has been given the name of botulism. 



Botulism may arise after the ingestion of special kinds 

 of sausage -as, for instance, blood-sausage or liver-sausage 

 which are prepared particularly in certain parts of Wiir- 

 temberg and Baden. It is further caused by decomposed 

 salt fish, by smoked meat, ham, preserved meat, venison, 

 old roasts, and the like. These are articles of food that 



