ARTHRITIS. 



745 



pathological process is solely as follows : inflammation of the umbilical 

 vessels, notably the vein, its decomposed and softened thrombus which 

 communicates with the vena portae, and forms the point of departure or 

 the source of a metastatic pyaemia, whence embolism of the lungs is some- 

 times directly originated ; or at other times, in consequence of the alter- 

 ation in the blood, which is septic, and of the general character of the 

 inflammations, there are metastatic inflammations of the serous and 

 synovial membranes (pleurisy, pericarditis, "arthritis) of the lungs, iris and 

 choroid coat of the eye, abscesses in the muscles and connective tissue 

 — in a word, the entire series of clinical and anatomical alterations which 

 constitute the complicated arthritis of foals.* 



* The great importance of this subject in a sanitary point of view, induces me to notice it so fully as I 

 luve done. The septic or pyaemic nature of the malady has not, to my knowledge, been pointed out, or 

 at least insisted upon, in England. And yet it is a matter of vital importance that this be recognized, 

 wli2n we consider that very often the flesh of calves and lambs which have been affected with joint disease, 

 ii utilized as food when the creatures have been purposely slaughtered, which is generally the case before 

 tha malady has reached its worst stage. Doubtless such flesh, when well cooked or cleaned, is very much 

 relished, and may often be eaten without any ill effect ; but, on the o.her hand, as Bollinger has pointed 

 out, many cases of illness in human beings are due to its consumption. Poisoning from eating veal can 

 often bi traced with great certainty to the pyjeaiic or septikaemic infection of the calf ; and that authority 

 quotes an instanca in support of this assertion. The occurrence is communicated by Zann^er (Arckiv/iir 

 ThierJieilkiinde, Band xxiv., S. 204, Zurich, 1871) to Zehnder's official report, and which, notwithstanding 

 its urgent importance, has not been taken notice of by the medical journals. 



During ths epidemic of cholera in Zurich in 1867, in August, twenty-seven members of six families living 

 at Fluntern (a suburb of Zurich), were attacked with diarrhoea, accompanied by varied cerebral disturb- 

 ance. Ail tho32 who ware ta'.cen ill had eaten the fl3sh of a five days' old calf, which was the progeny of 

 a diseased Cow, and which had yellow water (^rt'fcj ivrLsser)'m. the knee-joints. The Cow w.is suffering 

 from a large dark swelling on the uddar, and which extended along the belly to beneath the breast. 



The milk from this Cow produced, in a number of people who consumed it, vomiting and diarrhoea. The 

 calf at birth was smafT and weak, and had swellings o;i its joints and limbs. As soon as it was killed, its 

 carcase wis sold and the flesh e^ten. No examination of the body was made. Chemical analysis was 

 made of its re:nains for the detection of inorganic substances, as well as a microscopical examination for 

 trichinae, but wit'i negative results. The outbreak, which was followed by fatal consequences, was ascribed 

 to the cholera ; thou:;h it ensued within from twenty-four to forty-aight hours after eating the flesh. The 

 diffarent mambers of some families — in one instance nine individuals — were seized within a few hours of 

 each othar, and tha violence of the attack varied according to the quantity of the diseased veal they had 

 eatan. Tha chief symjjtoms ware: vomiting a thin greenish matter, watery stools of the same color, great 

 and CDntinued prostration, often preceded by shivering fits; stupor, combined with delirium; involuntary 

 evacuations ; and, in the milder cases, headache and giddiness were observed. Convalescence was most 

 tedijus. The vomiting lasted, as a rule, for several days, and when it ceased it left the patients very weak 

 and prostrate. In some cases, cedematous swellings made their appearance, and of those who recovered, 

 twalva individuals ware helpless for frjm two to four weeks. In one instance, in which death took place 

 on the eleventh day, and in which the patient— a man fifty-two years of age, and who had eaten a compar- 

 atively larga quantity of the partly raw, partly cooked liver — there were found petechix over the entire 

 surfica of the body, in the epicardium, kidneys, stomach, intestines, and brain, as well as great oedema 

 of the luags— all of which corresponded with the appearances presented during life, and which led to the 

 conclusion that the alterations were due to intense blood-poisoning through putrid organic matter— the 

 appearances closely simultating those often observed in poisoning by sausages {ivurstgi/t, " Botulismus"), 

 through some change in the flesh of which they are composed, but the chemical nature of which is not yet 

 ascertained. 



It may ba noted, however, that decomposition had not begun in the flesh of this calf ; as vaal is usually 

 sold on the day on which the animal is killed, or on the following day, and at once eaten ; and that the 

 craature was affected with septikaemia or pyaemia at birth. As, for various reasons, the existence of 

 anthrax cannot ba accepted in this case, the illness of the calf may reasonably be compared to what in 

 children is called " congenital pyjemia or septikaemia." Bollinger concludes his notice of the outbreak, 

 by adding the following remarks.— " Although I do not wish to go into any further discussion on the 

 sanitary aspect of our food supply, I may be allowed to give my opinion that the celebrated epidemy at 

 Adelfingen (Greisinger, Handbuch der Speciellen Pathologie und Titer apie, Art. Ileotyphus), the nature 

 of which, according to tha latest discoveries — and particularly those of Biermer — was not typhoid, but was 

 to be attributed to a similar poisoning of the flesh eaten by the people, to that occurring in this calf. In 

 this epidemy five hundred people ware seized with illness from eating diseased meat. Although the nature 

 of the saptikae nic and pyjemic poison is not well defined, we are, I think, justified, after the numerous 

 experiments made, in considering it identical with certain substances, be they of a chemical or vegetable 

 nature, or in fact both chemical and vegetable. In other words, this poison belongs to that class of poisons 

 whicli can multiply both in and out of the human body. In conclusion, the general remark may be ven- 

 tured upon that, with regard to the etiolosy of the diarrhoea, and the multiple hsetnorrhagic and petechial 

 aoDe-arances which marked the progress of the disease in the people attacked at Zurich, the dates given in 

 Zeh-idar's report on the meat poisoning are of the P'reatest importance. If such cases occur sporadically — 

 as, for instance, in large towns — it will always be difficult to discover their etiology. Anyhow, it is cer- 

 tainly tha fact that, in the latest treatises on the subject, the occurrence of meat poisoning — with the excep- 

 tion of poisoning from eating unsound sausages — is completely proved. To assert that, as a rule, such 

 poisoning does not occur, seems to me to be scarcely right, and especially when one knows the numberless 

 tricks of the meat-market in preparing the flesh for sale. On the other hand, it is an indisr utable fact that, 

 notwithstanding the vast importance of our food supnly, for the so-called official and leeal meat inspection 

 there is no proper basis to work upon. The cause of this deficiency, the repair of which must be of the 

 greatest moment to huma# hygiene, can be traced to the complete neglect of the pathological anatomy and 



