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before the cows that are giving milk. Buttermilk is generally re- 
garded as harmless. Graff thought differently however. 
Apparently not all are equally susceptible, as it has frequently 
been noted that of several persons who partake of the poisonous milk 
or meat, some may escape while others, usually the majority, will 
contract the disease. 
A recent outbreak which I have investigated had some of the con- 
ditions of an experiment on human beings. The record, unfortu- 
nately, is based entirely upon nonprofessional observation but is, I 
believe^ fairly accurate. In brief, it is as follows : Seven persons par- 
took of a meal, 6 of whom used milk and butter and became ill with 
characteristic symptoms of milk sickness and subsequently died. The 
only person who escaped was a woman who never used either milk or 
butter. One of the 6 was a guest and had only this one meal in this 
house. This individual sickened on the day after partaking of that 
meal. The other 5 persons became ill at different times ; the last one 
about ten days after eating the meal that apparently poisoned the 
guest. A calf using the same milk sickened with “ trembles ” soon 
after the earliest cases in the family. The cow accused of imparting 
the disease developed “ trembles ” and died. The cow showed no 
symptoms until milking was neglected on account of illness in the 
family. It was believed that this cow had been on milk sick land 
about two weeks prior to the outbreak. This outbreak seems to have 
been a typical one, the sickening of the cow only after she was no 
longer milked, the sickening of the calf at about the same time that 
some of the persons were attacked, the onset of the illness at a vary- 
ing period after the use of the suspected milk and butter, finally, the 
exemption of the one woman who did not partake of the milk or 
butter, all agree with the older descriptions. As trembles and milk 
sickness are both so rare at present, an occurrence like this points 
strongly to a most intimate relation between them. 
The few recorded post-mortem examinations throw no light upon 
the nature of the disease. Horne (1844), who examined three human 
cases, found inflamed patches in the small intestine. The mesenteric 
glands were red and greatly enlarged. 
In animals, Graff found the brain “ suffused with a large quantity 
of blood, which from the amount contained within the cranium, must 
have made great pressure on every part/' In one human case he 
found softening of the brain and evidence of meningitis. Graff tells 
us that this autopsy was conducted “ by stealth at night in the open 
air, and by the light of a single candle.” 
Barbee (1810) found the colon in man “ contracted to the size of a 
common candle.” The mucous membrane of the stomach was red and 
thickened in spots; the remainder presented a pale and softened ap- 
