CHAPTER LXXll 



TROPICAL POISONINGS 



General Remarks — Ackee poisoning — Onyalai — References. 



GENERAL REMARKS. 



We have already defined a poison and discussed criminal poisoning, 

 accidental poisoning, stimulant and sedative poisoning, and the 

 poisons used in trial by ordeal in Chapter X. (p i6i), in which we 

 gave a brief outline of the symptoms produced by a number of these 

 poisons, as well as some few remarks with regard to treatment. 



There, however, remains one form of accidental poisoning, to 

 which we have already referred on p. 173, to which special reference 

 may be made here, and that is ackee poisoning, w^hich was long known 

 as the vomiting sickness of Jamaica, and was included in the clinical 

 part of the last edition. 



This particular variety of poisoning might also be looked upon as 

 a form of vegetal food poisoning, a subject which is considered in 

 Chapter XIIL, p. 193. 



Other forms of poisoning, such as arrow poisons, animal poisons, 

 trade poisons, can be found in Chapters XL (p. 180), and XII. 

 (p. 187). 



ACKEE POISONING. 



Synonym. — ^The vomiting sickness of Jamaica. 



Definition. — An acute and often fatal illness, occurring mostly 

 in children and to a less extent in adults in Jamaica, characterized 

 by sudden onset, persistent vomiting, causing in fatal cases collapse, 

 and brought about by eating the unsound fruit of the ackee tree, 

 Blighia sapida Koenig, or drinking the water in which such fruit 

 has been cooked. 



History. — For many years the term ' vomiting sickness ' was 

 applied to any disease associated with this symptom, but as various 

 diseases became differentiated and better diagnoses were made, it 

 became evident to Turton in 1904 and to Kerr in 1905 that there was 

 a definite disease in Jamaica to which the term could be applied. 



This disease only appeared in the cooler months, and was asso- 

 ciated with vomiting and convalsions, and a death-rate of 80 per 

 cent, to 90 per cent., the end coming in a few hours. 



In 1906 Branch considered it to be a syndrome, and men- 



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