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of the u nutmeg ” liver. The spleen and the kidneys were markedly 
congested. The mucous membrane of the small intestine was deeply 
injected and had much tenacious mucus adhering to it. In horses 
the lesions were similar to those described in cattle. The liver showed 
marked cloudy swelling and less fatty change than in cattle. There 
were small nodules embedded in the wall of the small intestine. 
These nodules were 4 or 5 millimeters in diameter and were elevated 
above the surface. They were found to originate in the lymph nodes 
embedded in the mucosa. 
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 Way (1893). The onset is gradual, the indi- 
vidual tires easily, there is loss of appetite, in a day or two vomiting 
begins, the bowels are obstinately constipated, there is great abdom- 
inal 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 gen- 
erally subnormal, there is always great thirst. The mind usually 
