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pearance. The peritoneal coat of the small intestines was inflamed. 
Symptoms . — Philips (1877) and others thought that an interval of 
days or even weeks elapsed between the exposure on infected areas 
and the development of symptoms of trembles in cattle. Drake de- 
scribes the symptoms of trembles in animals as follows : 
The animal begins to mope and droop, and to walk slower than its fellows, to 
falter in its gait. If under these circumstances it should be driven, and attempt 
to run, the debility and stiffness of its muscles are immediately apparent. It 
fails rapidly, trembles, pants, and sometimes seems blind, as it runs against 
obstacles, but this may arise from vertigo; at length it falls down, lies on its 
side quivering, and is not, perhaps, able to rise for several hours, sometimes 
never 
He also mentions a chronic form. 
The characteristic symptom, trembling, may always be brought out 
by exercising the suspected animal. It is related that cattle buyers 
never purchased animals from milk sick districts until they had given 
them a run of half a mile or more to ascertain if they had trembles. 
When a cow is regularly milked no symptoms are likely to develop. 
In at least some instances a period of several days appears to inter- 
vene between the consumption of the poisoned milk or meat and the 
onset of symptoms in man. Spalding (1881) reports an outbreak 
where three days in one case and six days in another, intervened be- 
tween suspending the use of the suspected milk and the onset of the 
symptoms. He also speaks of the onset in some cases as being 
“ almost instantaneous when milk or beef is taken.” It would appear 
that such cases, with very early onset, may be due to decomposition 
products belonging to the class of poisons usually called ptomaines. 
As judged by the description of most writers, the symptom com- 
plex in man appears to be fairly uniform. In describing it I will 
use freely the account of Wav (1898). The onset is gradual, the 
individual tires easily, there is loss of appetite, in a day or two vomit- 
ing begins, the bowels are obstinately constipated, there is great ab- 
dominal distress, the tongue becomes large and flabby, the breath 
acquires a foul odor that is regarded as highly characteristic of the 
disease, the abdomen is scaphoid, there is marked visible pulsation of 
the abdominal aorta, the temperature is not elevated; in fact, it is 
generally subnormal, there is always great thirst. The mind usually 
remains clear, but in fatal cases, coma for several hours may precede 
dissolution. The average duration of cases is about one week. The 
cases referred to in the recent outbreak in Tennessee died in from 
two to ten days after the onset of symptoms. 
A common sequel of milk sickness is a lasting debility. I have 
seen a considerable number of persons who claimed that since an at- 
tack of the disease, they were incapacitated for hard work, especially 
in warm weather. 
