MILK SICKNESS. 



MILK SICKNESS. 



jionnce on the character of the disease. This 

 fetor can no more be mistaken by a person 

 accustomed to it, than that which is so univer- 

 sally attendant on variola ; and it may in fact 

 be safely stated to be pathognomonic of the 

 forming and early stage of milk sickness. 

 This halitus from the lungs, which I have 

 never found entirely wanting even some days 

 previous to an attack, increases in intensity 

 until the disease is fully developed, when it 

 gradually disappears with the speciric symp- 

 toms, and at the termination of 4 or 5 days 

 cannot be detected. A person labouring under 

 the peculiar effluvia from the air passages, in 

 many cases complains of no illness, and ap- 

 pears entirely unconscious of his situation, 

 unless advised of it by his friends or attend- 

 ants. His appetite may be, and usually is, 

 destroyed; and after the lapse of a few days 

 he is taken down with pain and excessive irri- 

 tability of the stomach, obstinate constipation 

 of the bowels, a cessation of all biliary secre- 

 tion, general febrile action, sometimes an in- 

 tense burning sensation in the epigastric region, 

 with early and obstinate coldness of the ex- 

 tremities. Often the symptoms are observed 

 to differ widely from these. Besides the pecu- 

 liar smell emitted, there is a premonition of the 

 attack ; for some days previous to its develope- 

 ment, the patient experiences a restlessness 

 and uneasiness which he cannot describe, with 

 a dread of some impending calamity, confu- 

 sion of ideas, and other indications of irrita- 

 tion of the brain and nervous system. Vomit- 

 ing announces the onset of an attack. This 

 continues at short intervals for many days, th> 

 matters thrown off the stomach consisting of the 

 fluids swallowed, mixed with a glairy mucus, 

 and not unfrequently tinged with blood. Some 

 days frequently elapse before pain in the 

 stomach is complained of, but during the time 

 the suffering is intolerable, consisting of a sen- 

 sation of deep distress, which, though referred 

 to the praecordia, or abdomen, the sufferer can- 

 not locate in any particular spot. Pain in the 

 limbs is complained of, and is severally referred 

 to each of the extremities, but is more constant- 

 ly located in the spine, particularly at the nape 

 of the neck. The pulse, during the forming 

 stage, possesses greater force and volume, with 

 slightly increased action. The bowels will 

 remain obstinately constipated, the powers of 

 nature being incompetent to relieve the condi- 

 tion, so that unless it be done by appropriate 

 remedies, at the end of 6 or 8 days an offensive 

 discharge takes place, quickly followed by dis- 

 solution, the symptoms being those which 

 would indicate disorganization of the struc- 

 ture of the intestines. The tongue, during the 

 initiatory stage, is slightly furred, but other- 

 wise not much changed in appearance. This 

 coat disappears soon after the occurrence of 

 vomiting, and becomes clean, of a pale-red or 

 pink colour, greatly resembling a piece of raw 

 veal. Next to the fetor mentioned, the change 

 of volume occurring in the tongue may be 

 viewed as the great characteristic of this dis- 

 ease. It rapidly attains an inordinate size, 

 completely filling the mouth, and so flabby and 

 soft in its texture as to retain perfectly the im- 

 pressions left by the teeth, when extruded. 



Often a number of efforts are necessary before 

 it can be forced out, and then it has a tremu- 

 lous motion. This condition of the tongue 

 changes with the stage of the disease. When 

 the vomiting has been suspended, and free 

 evacuations from the bowels obtained, it is re- 

 duced in volume, the surface is for a time 

 smooth and glazed, soon after becomes dark, 

 cracks open in transverse fissures, is hardened, 

 with an obstinately dry and rough surface. Of 

 all the primary symptoms, vomiting is the last 

 to disappear; it ceases very gradually to annoy 

 the patient, and its continued absence is the 

 most certain indication of a state of convales- 

 cence. In no disease is there a greater differ- 

 ence or diversity of symptoms than are usually 

 found in different cases to constitute what may 

 be properly termed the secondary stage of milk 

 sickness. 



In some cases the patient is affected with 

 drowsiness, low muttering delirium, nervous 

 tremors, and the whole train of symptoms asso- 

 ciated in low typhus fever. When recovery 

 takes place after severe attacks, the convales- 

 ence is very slow, and years may elapse before 

 a perfect restoration to health. Indeed, it has 

 been a question with many, whether those once 

 severely attacked ever regain a perfect integrity 

 of constitution. In cases which terminate fa- 

 tally (of which description is a large majority), 

 a length of time of from 1 to 4 weeks is re- 

 quired, proportionate to the intensity of the 

 primary effects, the propriety of the treatment, 

 and the natural powers of the resistance of the 

 constitution, as they often seem to die from a 

 wearing out, or gradual destruction of cerebral 

 and nervous energy. Those cases which occur 

 during the summer months, are most decidedly 

 inflammatory, whilst in the winter there is 

 always observed a disposition to assume a low 

 form. The autumnal cases, in their secondary 

 fever, are liable to assume a remittent aspect, 

 and I have seen them eventuate in a well- 

 marked intermittent. When recovery has taken 

 place, the patient retains not the slightest recol- 

 lection of any thing which occurred during the 

 progress of the disease, and this forgetfulness 

 often extends as far back as some days previous 

 to the active developement of the disease. 



Cause. The cause of this disease in animals 

 is as yet shrouded in mystery and uncertainty. 

 No satisfactory account of its nature has ever 

 yet been given, and it has in turn been sup- 

 posed to be of vegetable, mineral, and even 

 aerial origin. The limits of its prevalence is 

 not often over a large continuous tract of 

 country, but rather circumscribed, and sur 

 rounded by localities never known to produce 

 it. No example is known in which the property 

 of producing the disease has been acquired by 

 any locality which did not previously possess 

 it. The boundaries which were at the first dis- 

 covery of the country found to separate the 

 infected from healthy districts, remain un- 

 changed. The locality which serves to pro- 

 duce the disease, most commonly extends as a 

 vein of variable breadth, traversing the country 

 for a considerable distance. It can be traced 

 in one instance for nearly a hundred miles, 

 running parallel to the course of the Wabash 

 river, in the state of Indiana. 



819 



