The Home Medical Library Volume I Part 12

_Food Containing Bacterial Poisons Resulting from Putrefaction; Food Infected with Disease Germs; Food Containing Parasites--Tapeworm-- Trichiniasis--Potato Poisoning._

=FOOD POISONING.=--Much the same symptoms from all meats, fish, sh.e.l.lfish, milk, cheese, ice cream, and vegetables; namely, vomiting, cramps, diarrhea, headache, prostration, weak pulse, cold hands and feet, possibly an eruption.

_First Aid Rule 1.--Rid patient of poison. Cause repeated vomiting by giving three or four gla.s.ses of warm water, each containing half a level teaspoonful of mustard. Put finger down throat to a.s.sist. Empty bowels by giving warm injection of soapsuds and water by fountain syringe._

_Rule 2.--Support heart and rally nerve force. Give teaspoonful of whisky in tablespoonful of hot water every half hour, as needed. Put hot-water bottles at feet and about body._

=Conditions, Etc.=--Bacterial poisons, const.i.tuting irritants of the stomach and bowels, are found in certain mussels, oysters from artificial beds, eels out of stagnant ditches--as well as the uncooked blood of the common river eel--certain fish at all times, certain fish when sp.a.w.ning, putrefied fish, fermented canned fish, sausages of which the ingredients have putrefied, putrefied meat, imperfectly cured bacon, putrefied cheese, milk improperly handled and not cooled before being transported, ice cream which fermented before freezing, or ice cream containing putrid gelatin, and mouldy corn meal and the bread made from it.

These poisons are called toxins, or toxalb.u.mins, or bacterial proteids. They are no longer called ptomaines, because many ptomaines are not poisonous. They are formed within the cells of the bacteria, and result from the combination of certain const.i.tuents of the food material that nourishes the bacteria, in some way not quite understood. Some decomposition must have taken place in the food before it can furnish to the bacteria the nourishment it needs. If this has happened, the bacteria multiply rapidly, and the toxins that are formed are taken up by the lymphatics and carried away from the tissues as fast as possible. But so great is their virulence that they act on several vital organs before they can be antagonized by the natural elements of the blood.

=Symptoms.=--The symptoms are much the same in all the cases of bacterial poisoning mentioned. Sudden and violent vomiting and diarrhea appear a few hours after eating the spoiled food, or may be delayed. There may be headache, colic, and cramps in the muscles.

Marked prostration and weak pulse with cold hands and feet are characteristic. The appearance of skin eruptions is not uncommon. The occurrence of such symptoms in several persons, some hours after partaking of the same food, is sufficient to warrant one in p.r.o.nouncing the trouble food poisoning.

=Treatment.=--The objects of treatment are to rid the patient of the poison, and to stimulate the heart and general circulation, and draw on the reserve nerve force. It is best to procure medical aid to wash out the stomach, but when this is impossible, the patient should be encouraged to swallow plenty of tepid water and then vomit it. If there is no natural inclination to do so, vomiting may be brought about by putting the finger in the back of the throat. The same process should be repeated a number of times, and the result will be almost as good as though a physician had used a stomach tube. A teaspoonful of salt or tablespoonful of mustard in the water will hasten its rejection. Then the bowels should likewise be emptied. If vomiting continues this will not be possible by means of drugs given by the mouth, although calomel may be retained given in half-grain tablets hourly to an adult, until the bowels begin to move, or till eight to ten tablets are taken. When vomiting is excessive, emptying of the bowels may be brought about quickly by giving warm injections of soapsuds into the bowel with a fountain syringe. Brandy or whisky in teaspoonful doses given in a tablespoonful of hot water at half-hour intervals should follow the emptying of the stomach and bowels, and the patient must be kept quiet. He must also be kept warm by means of hot-water bags and blankets.

=INFECTED FOOD.=--A frequent source of illness is infection by disease germs transmitted in food. The meat of animals slaughtered when sick with abscess, pneumonia, kidney disease, diarrhea, or anthrax (malignant pustule) carries disease germs and causes serious illness; so does the meat of animals killed after recent birth of their young, and probably having fever. Oysters may be contaminated with excrement from typhoid patients, and may then transmit the disease to those who eat them.

Milk from diseased animals, or contaminated with germs of typhoid fever, scarlet fever, tuberculosis, diphtheria, etc., is apt to cause the same disease in the human being who drinks it.

If such infected food is eaten raw, the diseases with which it is contaminated may be transmitted. If subjected to cooking at a temperature of at least the boiling point, comparative safety is secured; but the toxins accompanying the disease germs in the infected food are not as a rule rendered harmless. Treatment must be directed to each disease thus transmitted.

Poisoning resulting from eating canned meats has sometimes been attributed to supposed traces of tin, zinc, or solder, which have become dissolved in the fluids of the meat, but in the vast majority of cases such poisoning is due to toxins accompanying the germs of putrefaction, the meats having been unfit for canning at the outset.

In such cases the symptoms are the same as in other food poisoning, and the treatment must be such as is elsewhere directed (see pp. 147 and 149).

While human breast milk is germ free, the cows' milk sold in cities is a very common source of disease. Scrupulous care of the cows, of the clothing and hands of the milkers, of the stables at which the herds are quartered, and of the cans, pails, and pans used, reduces to a minimum the amount of filth and impurity otherwise mixed with milk. In the household, as well as during transportation, milk should be kept cool, with ice if necessary. It should also never be left uncovered, for it readily absorbs gases, effluvia, and contaminating substances in the air, and affords an excellent medium for the growth and propagation of germs. When partially or entirely soured, it should not be used, except in the preparation of articles of food by cooking, as directed in cook books. It should never be used if there is any doubt about its purity. Unless all doubt has been removed, it is best to subject milk intended for children's consumption to a temperature of 160 F. for ten minutes, and then put it on the ice, especially during hot weather. Germs are thus rendered harmless, and the nourishing qualities of the milk remain unimpaired.

Summer diarrhea of children, also called cholera infantum, occurs as an epidemic in almost all large cities during the hottest days of summer. The disease is largely fatal, especially during the first hot month, because the most susceptible and tender children are the first affected. It is due to the absorption into the systems of these children of the toxins formed during the putrefying of milk in the stomachs and bowels of the little sufferers. Clean, pure sweet milk, free from bacteria should be used to prevent the occurrence of this disease. Its treatment is outlined in Vol. III. Exactly what bacteria cause the disease is not decided. Possibly the milk is infected, but probably the poisonous results come from toxins.

=FOOD CONTAINING PARASITES.=--The parasites found in food in this country are echinococcus, guineaworm, hookworm, trichina, and tapeworm. Echinococcus cannot be understood or diagnosed by the layman. Guineaworm is excessively rare in the United States; it gains access into the body through drinking water which contains the individuals. Hookworm is the cause of "miners' anaemia," and is extremely rare in this country.

The entrance of living food parasites can be absolutely prevented by thorough cooking of meats, especially pork and beef. Heat destroys the "measles" and the trichina worms.

=TAPEWORM.=--This is developed in man after eating "measly" beef or pork. "Measles" are embryo tapeworms called, from their appearance, "bladder worms." In from six to ten weeks after being received into the intestine of a man, these bladder worms become full grown, and measure from ten to thirty feet in length--the tapeworms.

=Symptoms.=--Vertigo, impairment of sight and of hearing, itching of the nose, salivation, loss of appet.i.te, dyspepsia, emaciation, colic, palpitation of the heart, and sometimes fainting accompany the presence of the tapeworm. Generally the condition becomes known through the pa.s.sage in the excrement of small sections of the worm.

These sections resemble flat portions of macaroni.

=Treatment.=--This, to be successful, must be directed by a physician.

When no physician can be procured, the patient may attempt his own relief. After fasting for twenty-four hours, pumpkin seed, from which the outer coverings have been removed by crushing, are soaked overnight in water and taken on an empty stomach in the morning; a child takes one or two ounces thoroughly mashed and mixed with sirup or honey, and an adult four ounces (see Vol. III, p. 245).

=TRICHINIASIS.=--This is a dangerous disease caused by the presence in the muscles and other tissues of the trichinae, little worms which are swallowed in raw or partly cooked pork, ham, or bacon. Nausea, vomiting, colic, and diarrhea appear early, generally on the second day after eating the infected meat. Later, stiffness of the muscles occurs, with great tenderness, swelling of the face and of the extremities, sweating, hoa.r.s.eness, difficult breathing, inability to sleep, bronchitis, and pneumonia.

There is no treatment for the disease. Many cases which are not fatal are probably considered to be obscure rheumatism. Many cases of pneumonia are caused by the worm.

=POTATO POISONING.=--There remains one variety of food poisoning which needs mention, since it occurs when least expected, and when proper food has been subjected to natural growth. As the potato belongs to the botanical family containing the dangerous belladonna, tobacco, hyoscyamus, and stramonium, it is not surprising that is should also contain a powerful poisonous alkaloid, namely, solanine. Solanine is developed in potatoes, especially during their sprouting stage.

Violent vomiting and diarrhea and inflammation of the stomach and bowels are caused by it. Careful peeling of sprouting potatoes, and removal of their eyes, will lessen, if not wholly obviate, the danger from eating them. This form of food poisoning is rare.

CHAPTER VIII

=Bites and Stings=

_Several Kinds of Mosquitoes--Cause of Yellow Fever--Bee, Wasp, and Hornet Stings--Wood Ticks, Lice, and Fleas--Scorpions and Centipedes--Poisonous Snakes--Dog and Cat Bites._

=MOSQUITOES.=--The female mosquito is the offender. During or after sucking blood she injects a poison into the body which causes itching, swelling, and, in some susceptible persons, considerable inflammation of the skin. The bites of the mosquitoes living on the sh.o.r.es of the Arctic Ocean and in the tropics are the most virulent. The most important relation of mosquitoes to man was only recently discovered.

They are probably the sole cause of malaria and yellow fever in the human being. The malarial parasite which lives in the blood of man, when he is suffering from malaria, first inhabits the body of a certain kind of mosquito. The mosquito acquires the undeveloped parasite by biting the human malarial patient, and then acts as a medium of infection by transmitting the active parasite to some healthy man, through the bite.

The more common house mosquito, the Culex, does not carry the parasite of malaria, and it is important to be able to distinguish the Anopheles which is the source of malaria. The Anopheles is more common in the country, while the Culex is a city pest. The Culex has very short palpi, the name given to the projections parallel to the proboscis; while those of Anopheles are so large that it appears to have three probosces. There are no markings on the wings of the ordinary species of Culex, while the wings of Anopheles are distinctly mottled. The Culex, sitting on a wall or ceiling, holds its hind legs above its back and its body nearly parallel to the wall or ceiling, but the Anopheles carries its hind legs either against the wall or hanging down (rarely above the back), and its body, instead of lying parallel to the wall or ceiling, hangs away at an angle of about forty-five degrees from it.

The Culex lays her eggs in sinks, tanks, cisterns, and water about houses, but the Anopheles deposits her ova in shallow pools and sluggish streams, especially those on which is a growth of green sc.u.m or algae. Such are the main distinguishing features of the malaria-carrying mosquito, the Anopheles, and the commoner house variety, the Culex.

To prevent malaria, mosquito bites must be prevented by nettings in houses, especially for the protection of sleepers. Pools, ponds, and marshy districts must be drained in order to destroy the breeding places of Anopheles, and in the malarial season, petroleum (kerosene) must be poured on the surface of such waters to arrest the development of the immature insects (larvae).

The mosquito is believed to be the sole cause of yellow fever, being capable of communicating the germ of the disease to man by its bite two weeks after it has itself been contaminated with the germ in feeding on the blood of a yellow-fever patient. This invaluable discovery was made by Dr. Walter Reed, U. S. A., in 1901, as a result of his labors and those of other members of the yellow-fever commission of the U. S. Army in Cuba, involving the death of one of the members of the commission (Dr. Lazear), and utilizing the heroism of a number of our young soldiers who voluntarily offered themselves to be bitten by mosquitoes that had previously bitten yellow-fever patients, and who experimentally occupied premises containing all sorts of articles infected by yellow-fever patients. The result of their research proves that yellow fever is not contagious at all, in the usual sense, but is communicated only through the medium of mosquitoes. This shows the fallacy of many quarantine rules regarding yellow-fever patients, and of the fear of nursing the sick, and will result in controlling the disease.

In the case of malaria or yellow fever, there is a vicious circle into which man and the mosquito enter; malaria and yellow-fever patients contaminate the mosquitoes which bite them, and the mosquitoes in their turn infect man with these diseases. A patient with malaria coming into a nonmalarial place, and being bitten by mosquitoes, may lead to an epidemic of the disorder which becomes endemic. To terminate this condition, it is necessary to prevent the contact of man with mosquitoes and to kill these insects. Both malaria and yellow fever will doubtless be practically eradicated before long through the result of these scientific discoveries.

=Treatment of Mosquito Bites.=--To prevent mosquitoes, fleas, lice, horseflies, etc., from biting, it is necessary merely to dip the clean hands into a pail of water in which, while hot, one ounce of pure carbolic acid was dissolved, and while they are thus wet rub the solution over all the exposed skin and allow it to dry naturally. A mixture of kerosene (petroleum) and water used in the same way will also afford protection. All poisons introduced into the body by insects are of an acid nature, and to this quality are due the pain and irritation which it is our object to overcome. The best remedy, naturally, is an alkali of some sort. Water of ammonia, diluted, or a strong solution of saleratus or baking soda in water, are the two most successful remedies to apply, either through bathing, or on cloths saturated in one of the solutions. Clean clay, mixed with water to make a mud poultice, is a useful application in emergencies.

=BEE, WASP, AND HORNET STINGS.=--The pain and swelling are produced by the poison of the insect which leaves the poison bag at the base of the barb at the instant that the person is stung. The bee stings but once, as the sting being barbed is broken off, and is retained in the flesh of the victim. The sting of the wasp and hornet is merely pointed, and is not lost during the stinging process so that they can repeat the act. Bee keepers, after being stung a number of times, usually become immune, i. e., they are no longer poisoned by bites of these insects.

It is well to extract the sting of bees before all of the poison has come away. A fine pair of forceps is useful for this purpose; or, by pressing the hollow tube of a small key directly down over the puncture made by the sting, it may be squeezed out.

Ammonia water, as recommended for mosquitoes, is the best remedy to relieve the pain.

=WOOD TICKS.=--Ticks inhabit the woods and bushes throughout the temperate zone, and at certain periods during the summer season attack pa.s.sing men and animals.

The common tick is nearly circular in shape, very flat, with a dark, brown, h.o.r.n.y body about one-sixteenth to one-eighth inch in diameter.

Each of its eight legs possesses two claws, and the proboscis incloses feelers which are similarly armed. The beetle plunges its barbed proboscis into the flesh of man or animals, and holds on very firmly with its other members till it is gorged with blood, growing as large as a good-sized bean, when it drops off. The bite is painless, and it is not until the insect is engorged with blood that it is perceptible; if, however, attempts are made to remove the tick before it is ready to let go, the proboscis may be torn off and left in the skin, when painful local suppuration will follow.

=Treatment.=--As the presence of tick is far from agreeable, the insect may often be removed by painting it with turpentine, which either kills it or causes the claws to be relaxed; in either case the tick loosens its hold and drops to the ground. A tropical variety, carapato, buries the whole head in the flesh of its host before it is perceived, and if turpentine does not loosen its hold, the head must be dug out with a clean needle or knife blade.

=LICE= (_Pediculi_).--Head lice are most common. They are gray with black margins, about one-twenty-fifth to one-twelfth inch long, and wingless. The color changes with the host, as the lice are black on the negro, and white in the case of the Eskimos. The female lays fifty to sixty eggs ("nits"), seen as minute, white specks glued to the side of a hair; usually not more than one or two on a single hair. The eggs hatch in six days.

The irritation produced by the presence of the parasites on the head leads to general itching, more particularly on the lower part of the back of the head. The constant scratching starts an inflammation of the skin with the formation of pimples, weeping spots, and crusts, from the dried discharge, possessing a bad odor. The denuded spots becoming infected, the neighboring glands enlarge and are felt as tender lumps beneath the skin at the back of the neck, under the jaw, or at either side of the neck. Whenever there are persistent itching and irritation of the scalp, particularly at the back of the head, lice or "nits" should be sought for. Sometimes it is more easy to find them on a fine-tooth comb pa.s.sed through the hair. Lice are very common in dirty households, and are occasionally seen on the most fastidious persons, who accidentally acquire them in public places or conveyances.