MYTILOTOXISMUS. 189 



before or after the food has been eaten ; this is the most common 

 form of food poisoning. 



Mytilotoxismus. — Judging from the symptoms induced, there 

 seem to be three kinds of poisonous mussel. In some cases the symp- 

 toms resemble those induced by a gastro-intestinal irritant. For- 

 dere reports the case of a soldier, who, after eating a large dish of 

 mussels, suffered from nausea, vomiting, pain in the stomach, tenes- 

 mus, and rapid pulse ; after death, which occurred within two days, 

 the stomach and intestines were found inflamed and filled with tena- 

 cious mucus. Combe and others also reported cases of the choleraic 

 form of mussel poisoning. 



However, the symptoms most frequent in man after the eating of 

 poisonous mussels are more purely nervous. A sensation of heat 

 and itching appears, usually in the eyelids, and soon involves the 

 whole face, and perhaps a large portion of the body. An eruption 

 usually called nettle rash, though it may be papular or vesicular, 

 covers the parts. The itching is most annoying, and may be ac- 

 companied by marked swelling. Often there is asthmatic breathing, 

 which is relieved only by ether. In some cases reported by Mohr- 

 ing dyspnoea preceded the eruption, the patients became insensible, 

 the face livid, and convulsive movements of the extremities were 

 noticed. Burrows reports similar cases with convulsive tremors, 

 coma, and death within three days. 



In a third class of cases there may be observed intoxication re- 

 sembling that of alcohol, followed by paralysis, coma and death. 



In 1827, Combe observed thirty persons poisoned, two of them 

 fatally, with mussels. He described the symptoms as follows : 

 "None, so far as I know, complained of anything peculiar in the 

 smell or taste of the animals and none suffered immediately after 

 taking them. In general, an hour or two elapsed, sometimes more ; 

 and the bad effects consisted rather in uneasy feelings and in de- 

 bility than in any distress referable to the stomach. Some children 

 suffered from eating only two or three ; and it wUl be remembered 

 that Robertson, a young and healthy man, only took five or six. In 

 two or three hours they complained of a slight tension of the stom- 

 ach. One or two had cardialgia, nausea and vomiting ; but these 

 were not general or lasting symptoms. They then complained of a 

 prickly feeling in their hands, feet, and constriction of the mouth 

 and throat, difficulty of swallowing, and speaking freely, numbness 

 about the mouth, gradually extending to the arms, with great de- 

 bility of the limbs. The degree of muscular debility varied a good 

 deal, but was an invariable symptom. In some it merely prevented 

 them from walking firmly, but in the most of them it amounted to 

 perfect inability to stand. While in bed they could move their 

 limbs with tolerable freedom, but on being raised to the perpendicu- 

 lar posture they felt their limbs sink under them. Some complained 



