chemical poisons either before or after the food has been eaten. This is the most common form of food poisoning known in this country.
We will briefly discuss some foods most likely to prove harmful to man.
Mussel Poisoning.—It has long been known that this bivalve is occasionally poisonous. Three forms of mussel poisoning are recognized. The first, known as Mytilotoxismus gastricus, is accompanied by symptoms practically identical with those of cholera morbus. At first there is nausea, followed by vomiting, which may continue for hours. In severe cases the walls of the stomach are so seriously altered that the vomited matter contains considerable quantities of blood. Vomiting is usually accompanied by severe and painful purging. The heart may be markedly affected, and death may result from failure of this organ. Examination after death from this cause shows the stomach and small intestines to be highly inflamed.
The second form of mussel poisoning is known as Mytilotoxismus exanthematicus on account of visible changes in the skin. At first there is a sensation of heat, usually beginning in the eyelids, then spreading to the face, and finally extending over the whole body. This sensation is followed by an eruption, which is accompanied by intolerable itching. In severe cases the breathing becomes labored, the face grows livid, consciousness is lost, and death may result within two or three days.
The most frequently observed form of mussel poisoning is that designated as Mytilotoxismus paralyticus. As early as 1827 Combe reported his observations upon thirty persons who had suffered from this kind of mussel poisoning. The first symptoms, as a rule, appeared within two hours after eating the poisonous food. Some suffered from nausea and vomiting, but those were not constant or lasting symptoms. All complained of a prickly feeling in the hands, heat and constriction of the throat, difficulty of swallowing and speaking, numbness about the mouth, gradually extending over the face and to the arms, with great debility of the limbs. Most of the sufferers were unable to stand; the action of the heart was feeble, and the face grew pale and expressed much anxiety. Two of the thirty cases terminated fatally. Post-mortem examination showed no abnormality.
Many opinions have been expressed concerning the nature of harmful mussels. Until quite recently it was a common belief that certain species are constantly toxic. Virchow has attempted to describe the dangerous variety of mussels, stating that it has a brighter shell, sweeter, more penetrating, bouillonlike odor than
