INFECTIONS OF THE DIGESTIVE TRACT 211 



fatal ending. The symptoms closely resembled those of 

 the so-called cases of sausage poisoning which had been 

 reported from time to time. Very recently the interest- 

 ing fact has developed in a Darmstadt outbreak that 

 the same type of poisoning may occur from eating vege- 

 table food ; namely, in this instance, beans which were 

 imperfectly canned. 1 It appears probable that the beans 

 were infected through the use of. manure obtained from 

 pigs. 



The following are the leading symptoms of classical 

 botulism: first, disturbances of the external muscles 

 of the eyeball, especially ptosis, abducens paralysis, and 

 disturbances of associated movement with nystag- 

 mic contractions; second, disturbances of the internal 

 muscles of the eye. In the majority of instances there 

 have been paralyses of accommodation. In the Darm- 

 stadt outbreak from infected beans an enlargement and 

 rigidity of the pupils was never observed, but in the out- 

 breaks from meat poisoning these pupillary conditions 

 have been usually noted. Third, there are usually 

 derangements referable to the region of the pons and 

 medulla oblongata, including disorders of the tongue, 

 such as swelling and paralysis, pharyngeal and laryn- 

 geal paralyses and disturbances of the heart and respira- 

 tion. Fourth, weakness and even paralysis of motion 

 may appear. These disturbances have almost always 

 been unaccompanied by changes in sensibility and 



1 Fischer, " Ueber eine Massenerkrankung an Botulismus in- 

 folge Genusses verdorbener Bohnenkonserven," Zeitschr. f. klin. 

 Med., lix, p. 58, 1906. 



