398 BACILLUS BOTULINUS. 



examined microscopically to ascertain the characters of the 

 organisms present. Though it is not possible to identify ab- 

 solutely the bacillus of malignant oedema without cultivating it, 

 the presence of spore-bearing bacilli with the characters de- 

 scribed above is highly suspicious (Fig. 132). In such a case 

 the fluid containing the bacilli should be first exposed to a 

 temperature of 80 C. for half an hour, and then a deep glucose 

 agar tube should be inoculated. In this way the spore-free 

 organisms are killed off. Pure cultures may be thus obtained, 

 or this procedure may require to be followed by the roll-tube 

 method under anaerobic conditions. An inoculation experi- 

 ment, if available, may also be made on a guinea-pig. 



BACILLUS BOTULINUS. 



The term " meat-poisoning " embraces a number of conditions 

 produced by different agents, and the relation of the bacillus of 

 Gaertner to one class of case has already been discussed. Another 

 group was shown by Van Ermengem in 1896 to be caused by an 

 anaerobic bacillus to which he gave the name bacillus botulinus. 

 He cultivated the organism from a sample of ham, the ingestion 

 of which in the raw condition had produced a number of cases 

 of poisoning, some of them followed by fatal result. The 

 symptoms in these cases closely corresponded with those occur- 

 ring in the so-called " sausage-poisoning " met with from time 

 to time in Germany and other countries where sausages and 

 ham are eaten in an imperfectly cooked condition. Such cases 

 form a fairly well-defined group, the symptoms in which are 

 chiefly referable to an action on the medulla, and, as will be 

 detailed below, similar symptoms have been experimentally 

 produced by means of the bacillus mentioned or its toxins. 

 The chief symptoms of this variety of botulismus, as detailed 

 by Van Ermengem, are disordered secretion in the mouth and 

 nose, more or less marked ophthalmoplegia, externa and interna 

 (dilated pupil, ptosis, etc.), dysphagia, and sometimes aphagia 

 with aphonia, marked constipation and retention of urine, and 

 in fatal cases interference with the cardiac and respiratory 

 centres. Along with these there is practically no fever and no 

 interference with the intellectual faculties. The symptoms 

 commence at earliest twelve to twenty-four hours after inges- 



