Ptomaine poisoning may be developed from taking into the system food that is in a state of decomposition, or it may be produced by taking wholesome food into the system in too large quantities. Ptomaine poisoning, then, may be exogenous or endogenous. The exogenous is taken in, while the endogenous is developed within. Sometimes the poison is due to errors in food combinations. This style of poisoning comes from taking into the system animal food that is undergoing putrefaction,

Sausage, blood-pudding, etc., more than other meats are inclined to create ptomaine poisoning. Imported sausage has been known to create death after lying in the bowels for one week after it had been eaten.

Several years ago I was called to see a young girl, about nine years of age, who was dying when I got to her bedside. 'The symptoms were very strange; in fact, she passed out so rapidly that I could not have a very definite opinion in regard to her condition. I got no clue pointing to food poisoning of any kind, but I diagnosed the case as ptomaine poisoning. One week after, her sister, two years older, died under the same circumstances, within twenty-four hours of the appearance of her first symptoms, which were similar to those of the sister who had died previously.

A year or more after the two deaths I learned that just before the illness of the first girl the family had eaten more or less of imported sausage, and that no more had been taken after that time; showing that in one case death came almost immediately after eating the meat, and in the other case the sausage required a week to develop the poisoning that produced death.

Any fresh meat, if not well taken care of, and allowed to become tainted, may poison, unless cooking has been so thorough as to kill the putrefaction. The period of incubation--or, in other words, the period required from the time of eating the poison meat until it develops its symptoms--ranges very widely.

We often hear of wholesale poisoning at church suppers, where a hundred or more people are poisoned in one night; showing that this poisoning comes on very rapidly, as a rule.

The symptoms usually start with a feeling of languor, perhaps headache, aching all over, and vomiting, Sometimes there are griping pains in the bowels, and at other times there is a real cholera morbus. Sometimes there will be trembling almost equal to the ague. In many cases there are precordial oppression, difficult breathing, and a feeling of faintness.

During the summer there are quite a good many attacks of poisoning from ice cream. Nausea and vomiting, preceded by a chill, and sometimes diarrhea, are the prominent symptoms.

Treatment

There is but one way to treat any kind of poisoning, and that is to clear out the bowels with large enemas. If the stomach is not already emptied by vomiting, it should be emptied with the stomach-pump, or by giving copious drinks of salt water. No food should be taken until the symptoms have entirely disappeared, even if that requires one or more weeks. Feeding during ptomaine poisoning has a tendency to prolong the disease; in fact, food eaten takes on decomposition very rapidly . Under such circumstances, fermentation is imparted to all fresh intake of food, so that the patient continues to poison himself.

Many cases of chronic ptomaine poisoning are treated for something else. Where too much food has been eaten--twice as much perhaps as the amount for which there is digestive capacity--decomposition starts up, with symptoms of diarrhea, pain in the bowels, and vomiting. Then, if feeding is begun as soon as the patient is relieved, the symptoms may lead off into chronic gastro-intestinal disease, which may break down the constitution to such an extent that the patient will die in a year or two. Other cases may be fed so soon after being relieved that there will be a relapse and death will follow. I remember one case where a patient was thrown into a desperate illness by eating calves' brains. When I was called to see her, she was delirious, with a temperature of 107° F. I had the nurse wash her bowels out thoroughly, and in about twenty-four hours she came out from under the influence of the coma into which she had settled after six hours of delirium, She wanted something to eat. I had instructed the nurse not to give her anything at all; but the sick woman was so insistent that the nurse yielded and gave milk--two quarts during the night and the following forenoon. The poisoning was renewed by the milk taking on decomposition; the patient had a relapse, which swept her out of existence within twenty-four hours.