48 BACTERIAL POISONS. 



were in some respects so peculiar that I am indisposed to 

 give to the disease any name otherwise p;eneraliy recognized. 

 As might have been anticipated from our experience of 

 diseases in general, there were varieties in severity among 

 the cases investigated ; and symptoms strongly marked in 

 some, were slightly marked or altogether wanting in others. 

 Perhaps I shall do the best service by giving first a general 

 sketch of the course of the illness, subsequently illustrating 

 it by a description of a few well-marked cases. 



"A period of incubation preceded the illness. In fifty- 

 one cases where this could be accurately determined, it 

 was twelve hours or less in five cases ; between twelve and 

 thirty-six hours in thirty-four cases ; between thirty-six 

 and forty-eight hours in eight cases ; and later than this in 

 only four cases. In many cases the first definite symptoms 

 occurred suddenly, and evidently unexpectedly, but in some 

 cases there were observed during the incubation more or 

 les;: feeling of languor and ill health, loss of appetite, 

 nausea, or fugitive, griping pains in the belly. In about 

 a third of the cases the first definite symptom was a sense 

 of chilliness, usually with rigors, of trembling, in one case 

 accompanied by dyspnoea ; in a few cases it was giddiness 

 with faintness, sometimes accompanied by a cold sweat and 

 tottering; in others, the first symptom was headache or 

 pain somewhere in the trunk of the body, e. g., in the 

 chest, back, between the shoulders, or in the abdomen, to 

 which part the pain, wherever it might have commenced, 

 subsequently extended. In one case the first symptom 

 noticed was a difiiculty in swallowing. In two cases it was 

 intense thirst. But however the attack may have com- 

 menced, it was usually not long before pain in the abdomen, 

 diarrhoea, and vomiting came on, diarrhoea being of more 

 certain occurrence than vomiting. The pain in several 

 cases commenced in the chest or between the shoulders, and 

 extended first to the upper and then to the lower part of 

 the abdomen. It was usually very severe indeed, quickly 

 producing prostration or faintness, with cold sweats. It 

 was variously described as crampy, burning, tearing, etc. 

 The diarrhoeal discharges were in some cases quite unre- 



