When meat has been kept too long exposed to the air, or when it has become contaminated in any manner with putrefactive bacteria, it is unfit for food, yet if thoroughly cooked it may not be necessarily poisonous. This is the case with " high" game. The bacilli especially associated with meat poisoning are the Bacillus enteritidis of Gartner, and the anaerobic Bacillus butyricus of van Ermenghem. Dangerous and even fatal cases of systemic poisoning by meat ptomaines have resulted from eating sausages, pork pie, ham, meat juice, beef, head-cheese, mutton, or veal. Two hundred and ninety-one severe cases of meat poisoning, one of which ended fatally, developed upon the U. S. transport City of Rio de Janeiro, in 1899, while proceeding from Honolulu to Manila. The putrefactive change may have already begun in the meat although it may not be apparent by an altered taste. Sausage poisoning is called botulism or allantiasis.

It is a curious fact that certain persons have great toleration for tainted meats. Among civilised races, and especially in England, the use of "high" game and mutton is much less in vogue at present than formerly, but the Eskimos and many savage tribes in Africa eat with relish, and digest well, decomposing meat the mere odour of which nauseates a white man. Bishop Colenso stated that among the Zulus of Natal the synonym for heaven is "ubomi," which means "maggoty meat." The natives of Siam and Cambodia prefer to keep their fish until it has begun to putrefy. In some parts of China foul eggs several months old are enjoyed as a delicacy.

Measly swine flesh rapidly decomposes, and the various processes of drying, smoking, and salting still leave it unfit for food. On the contrary, drying and smoking affect the superficial layers only, while the minor portion furnishes a culture medium for bacilli. Gluckmann has reported a case of poisoning by the Bacillus pro-teus vulgaris from eating cured ham.

The meat of very young animals should never be eaten, and the sale of young or "bob" veal two or three weeks old is prohibited by law. It is indigestible, innutritious, and it readily decomposes.

Symptoms

The symptoms of meat poisoning from these various substances are substantially the same in each case, being those of severe gastro-intestinal irritation, but in bad cases they are accompanied by dangerous collapse. The symptoms may follow almost immediately or after an interval of four or five or more hours. The former is much better for the patient, for the sooner vomiting and diarrhoea relieve the alimentary canal of the toxigenic material, the greater the chance of recovery. The symptoms usually begin with suddenness and violence, but they may be preceded by malaise, nausea, lassitude, and mild abdominal cramps. The sudden onset is ushered in by rigours with vertigo or faintness, or violent headache. Exceptionally there is dyspnoea, and there may be cold perspiration and sudden severe pains in the epigastrium or in the thorax, especially between the shoulders. Intense thirst has also been observed. Soon after one or more of these symptoms have appeared there is violent colicky pain in the bowels, accompanied by retching and vomiting, sometimes hasmatemesis, and profuse watery diarrhoea. There is an extreme degree of muscular prostration which comes on suddenly and prevents the patient from standing. It may be due to the abdominal pain, but it also occurs independently.

The tongue is dry and coated with a thick brownish-yellow fur on the dorsum, but the margins are of a bright red with distinct papillae. Fever is usually present, and the temperature may rise to 103.50 or 104° F., although the skin may feel cold and moist. The pulse is somewhat accelerated and the rate may reach 130 or 140.

Occasional symptoms which have been noted by Ballard are severe cramps in the legs and arms, convulsive twitching of the muscles of the face and hands, stiffness in the joints, and various abnormalities of sensation, such as numbness, tingling, and flashes of heat and cold in the extremities. There may also be drowsiness, photophobia, and, in the worst cases, insomnia, nervous excitement, or mild delirium. If the poison results fatally, the prostration increases, the pulse grows rapid and feeble, the watery evacuations are uncontrollable, and rapid emaciation ensues. The patient becomes cyanotic and passes into a state of collapse resembling that of the last stage of cholera.

The poisoning presents all degrees of severity, depending on the amount of the tainted food which has been taken, the nature of the putrefactive process, and the condition of the alimentary canal at the time. In mild cases, more or less abdominal pain, vomiting, diarrhoea, and headache, with slight prostration, are the only symptoms. In the more severe cases, if convalescence follows the attack, it is prolonged, and the weakness of the patient may be fully as great as after some of the severe infectious fevers affecting the alimentary canal, such as cholera or yellow fever. In cases in which the symptoms develop very slowly, after an interval of a day or more the nervous symptoms are apt to predominate over those of the gastro-enteric system. There are painful muscular cramps, dyspnoea, aphonia, delirium, and palpitation. This variety of poisoning is extremely dangerous.

Diagnosis

The diagnosis is almost always obtainable from the history of the case in connection with the symptoms above described, and when canned food has been eaten, the only difficulty consists in determining whether the poisoning is the result of eating tainted meat or of acute metallic poisoning from chloride of zinc, tin, or lead used in the process of tinning and soldering the cans (see p. 282).