Am'siptr,'i886arm'}     Tyrotoxicon  in  Ice  Cream,  Milk,  etc.  461 
irritative  and  nervous  fevers  are  most  easily  induced.  If  all  these 
facts  be  taken  into  consideration ,  along  with  the  experiments  which 
have  been  detailed,  and  which  show  the  readiness  with  which  the 
poison  can  be  generated,  it  will  certainly  seem  at  least  probable  to 
any  one  that  tyrotoxicon  may  be  a  cause  of  cholera  infantum.  A 
little  dried  milk  formed  along  the  seam  of  a  tin  pail,  or  a  rubber 
nipple,  tube  or  nursing  bottle  not  thoroughly  cleansed,  may  be  the 
means  of  generating,  in  a  large  quantity  of  milk,  enough  of  the  poison 
to  render  it  highly  harmful  to  children.  The  high  temperature 
observed  in  children  with  cholera  infantum,  and  which  has  not  been 
observed  in  adults  poisoned  by  tyrotoxicon,  may  be  caused  by  the 
continued  administration  of  milk,  and  by  the  greater  susceptibility  of 
the  sympathetic  nervous  system  in  children. 
If  this  casual  relation  does  exist  between  tyrotoxicon  and  cholera 
infantum,  a  knowledge  of  it  will  aid  us,  not  only  in  the  preventive, 
but  in  the  curative  treatment  of  the  disease.  The  first  thing  to  do 
in  the  treatment  of  the  disease  is  to  absolutely  prohibit  the  further 
administration  of  milk,  either  good  or  bad,  because  the  fermentation 
going  on  in  the  intestine  would  simply  be  fed  by  the  giving  of  more 
milk,  even  if  that  milk  be  of  unquestionable  purity.  I  would  sug- 
gest that  some  meat  or  rice  preparation  be  used  for  food,  though 
experience  will  soon  give  us  valuable  information  on  this  point. 
A  germ  which  forms  a  poisonous  ptomaine  by  its  growth  in 
milk  may  be  wholly  harmless  when  placed  in  a  meat  or  rice  pre- 
paration. 
Secondly,  mild  antacids  should  be  administered,  because  the  poison, 
so  far  as  our  information  goes,  is  produced  only  in  acid  solutions. 
The  great  value  of  the  chalk  mixture  in  the  treatment  of  the  disease 
is  well  known. 
Thirdly,  theoretically  at  least,  the  employment  of  small  doses  of 
some  disinfectant  would  be  of  benefit.  I  find  that  there  is  consider- 
able difference  of  opinion  in  the  professsion  as  to  the  use  of  small 
doses  of  calomel  in  this  disease. 
Fourthly,  the  use  of  opium  in  some  form  is  consistent  with  this 
theory. 
And  lastly,  the  administration  of  stimulants,  brandy  and  ammonia, 
to  counteract  the  depressing  effects  of  the  poison  already  formed  and 
absorbed,  should  be  practiced. 
All  of  these,  save  the  first  recommendation,  have  been  practiced  in 
