(ftoniefpmlcitcc. FISH POISONING. To the Editor. "Indian Medical Gazette." Sir,?Your suggestive article on Fish-poisoning comes, I think, in good time. I, for one, am firmly persuaded that not a few of these so-called sporadic cases of cholera are nothing more or less than cases of Ptomaine-poisoning, the result of the consumption of some article of food which has undergone putrefactive change. I will give you an example of the kind. When I was officiating as Health Officer of the Port of Calcutta, I learnt that the Captain and some of the officers of a certain ship had died from cholera soon after leaving the Sandheads. I was informed that these people had partaken of some meat, which was so far advanced in a state of decomposition that the Pilot drew attention to the extreme offensiveness of the joint; nevertheless certain persons partook of it, and next day were seized with poisoning, which was said to have been "Cholera." It is more reasonable to believe that the case Our knowledge of these was one of Ptomaine-poisoning. important poisons is yet so obscure that it is impossible to determine the exact vole played by them in disease. We know, as you say, that they act as powerful irritant poisons when introduced into the system from without, and we have reason to believe that they have important pathogenic influences when generated within the system, as for example in the course of diabetes, accetonfemia, and in Bright's disease, uraemia, and there are, in my opinion, very strong grounds for the belief that not a few of the rapidly fatal cases of pneumonia are instances of poisoning by the same agents, as was evidenced to my mind in the course of my experiments with the alvine discharges of cholera-stricken patients. Altered?or shall I call them abnormal?proteids have a similar lethal effect upon the respiratory centres, as is demonstrated in Cobra-poisoning. Here we are presented with a problem, which sooner or later must engage the attention of scientific investigation, and the solution of which will mark an era of a new departure in the Science and Practice of Medicine. If, on the one hand, bacterial activity plays an important part in the production of toxic alkaloids, what, on the other, causes the generation of toxic proteids 1 Surely, there is some patent force in operation other than the dreaded bacillus. At lease, so far as we know, poisonous proteids may be produced without its agencj', as in the secretion of snake-venom. There is one statement in your article which may be open to question, viz..?" Thorough boiling even of putrid material would probably prevent serious effects." I think this extremely doubtf ul. Even to destroy a toxic proteid, prolonged boiling is sometimes necessary, and it is unlikely that a chemical poison such as an alkaloid would ever be destroyed by boiling. Prolonged or thorough boiling of meat is of advantage, because the better the food is cooked, the longer will putrefactive changes and the consequent formation of akaloids be delayed ; but if putrefactive change has already taken place while the meat is raw, the alkaloids will remain unaffected by boiling?except that some of them may be (Unsolved in the water used in the process of boiling ; and others, the volatile ones, may be driven off. The most that can be said is. I think, that prolonged boiling reduces the risk of poisoning, but does not entirely remove it. I have been asked the question if there is so much risk in eating semi-rotten fish, how is it that so few natives die in consequence? You have partly answered this question as I did. We cannot be sure that so few natives do die in consequence, but even supposing death was not a frequent result-, The consumption of semiwe could explain it in this wise. rotten fish has been customary among natives for generations, hence their organisms have become habituated to the action of small doses of the alkaloids ; but when an overdose is taken, either by the consumption of an extra quantity of fish, or a larger proportion of alkaloids in the ordinary allowance, the result of more advanced putrefaction, symptoms of poisoning are developed. Those who are not habituated to the consumption of semi-rotten food would perhaps succumb to the smallest dose of alkaloid, much as a novice is prostrated by nicotine when he essays his first cigar. It is highly probable that even fresh fish contains alkaloids, to the action of which many people are peculiarly sensitive?the effects manifesting themselves in the form of nettle-rash or diarrhoea. _

April, 1888.]

APPOINTMENTS, LEAVE, &c.

It would be interesting to know the results of the examination of the urine (as suggested by Crombie) in all cases of cholera, and whether the triple test discloses any variation in the condition of the urine in acute Ptomaine, poisoning.

Yours truly, vmrp-MT prntiipm VINCENT ltlCHARDS.

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