matter consists of food, then it becomes watery and is frequently stained with blood. The stools are at first semisolid, and then are watery and serous. The heart is depressed, the pulse becomes weak and irregular, and in severe cases the face appears cyanotic. There may be dilatation of the pupil, but this is not seen in all. The most dangerous cases are those in which the vomiting is slight and soon ceases altogether, and the bowels are constipated from the beginning. Such cases as these require prompt and energetic treatment. The stomach and bowels should be thoroughly irrigated in order to remove the poison, and the action of the heart must be sustained.
At one time the writer believed that tyrotoxicon was the active agent in all samples of poisonous cheese, but more extended experimentation has convinced him that this is not the case. Indeed, this poison is rarely found, while the number of poisons in harmful cheese is no doubt considerable. There are numerous poisonous albumins found in cheese and other milk products. While all of these are gastro-intestinal irritants, they differ considerably in other respects.
In 1895 the writer and Perkins made a prolonged study of a bacillus found in cheese which had poisoned fifty people. Chemically the poison produced by this germ is distinguished from tyrotoxicon by the fact that it is not removed from alkaline solution with ether. Physiologically the new poison has a more pronounced effect on the heart, in which it resembles muscarin or neurin more closely than it does tyrotoxicon. Pathologically, the two poisons are unlike, inasmuch as the new poison induces marked congestion of the tissues about the point of injection when used upon animals hypodermically. Furthermore, the intestinal constrictions which are so uniformly observed in animals poisoned by tyrotoxicon was not once seen in our work with this new poison, although it was carefully looked for in all our experiments.
In 1898 the writer, with McClymonds, examined samples of cheese from more than sixty manufacturers in this country and in Europe. In all samples of ordinary American green cheese poisonous germs were found in greater or less abundance. These germs resemble very closely the colon bacillus, and most likely their presence in the milk is to be accounted for by contamination with bits of fecal matter from the cow. It is more than probable that the manufacture of cheese is yet in its infancy, and we need some one to do for this industry what Pasteur did for the manufacture of beer. At present the flavor of a given cheese depends upon the bacteria and molds which accidentally get into it. The time will probably come when all milk used for the manufacture of cheese
