WHAT IS "BOTULISM"

Dominion, Volume 12, Issue 157, 28 March 1919, Page 7

WHAT IS "BOTULISM"

roc® NOT THE CAUSE,

A Blue Book of over 70 pages issued recently is devoted to an exhaustive inquiry into "an obscure disease, encephalitis lethargies," commonly spoken Of a few months ago as "botulism,'l' carried out by .'Local Government Board experts. The investigations followed on the public unrest and professional doubt as to the cause of the mysterious malady to which a number of victims fell in Loudon, Glasgow, Sheffield, and other centres.

The report is highly technical in character, and deals with tho results with much detail, liven tho general roview of the investigation which Sir Arthur Nowsholme, Medical Officer to the Local Government Board, contributes is essentially for Hie professional man. Ho refers to the apprehension which prevailed at tho time of the outbreak, which was attributed by many to the use of food tf inferior quality and doubtful origin, and explains that, in order to make cortain on that point, arrangements were made with the Medical Research Committee for a complete bacteriological imitigation, Dr. MacFadden and medical practitioners in_ tho areas affected co-operating in investigating the food history patients and procuring for examination samples of suspected food. In these researches the.v kept in view, among other things, the suggestion of Dr. .1. Oliver that the illness might be connectedwith the use if benzine in the manufacture of oleo-margarine, and the suggestion of Dr. Copeman, one of the board's inspectors, that it might be caused by the consumption of potatoes jn which the alkaloida.l giucoside, solanin, normally present in the shoots, stalks, and leaves, might have accumulated in the tubers to such a degree as to be poisonous. Briefly, the results of this inquiry were: (i) On the bacleriolosical side, ]).• M'l'ntosh, of the London Hospital, who carried: out tli»- invest'iirntiou for tinResearch Committee, "failed entirely to recover the Bacillus botuliiius from tissues and fluids of fatal eases, and from suspicious articles of food"; lit failed also to . obtain evidence that "serum - from recovered patients agg'"l ip"te'l I-'ms Hriliu>' "r protected mice from the effects of its toxin; and iie found microscopical evidence of changes in the nervous system .which pointed to an acute infective disease, rather than to an int"sicnlion."

(2) On the epidpmibK®ieul side the iiuiuiries by Drs. and Pearse "showed that among the 58 cases investigated up to May 7. there was no instance of more than rne case ih a household; that mau.v of the patients had not eaten any food which miiht reasonably be regarded with suspicion: that in instances in which patients had eat"n such .'foods it was almost invariably found that the same food had bepn eaten bv other mcmbej-s of the family without ill effect; and. finally, that in at least two cases the patents a tiffed were in-fo-ts exclusively breast-fed."

This failure to obtain direct or- indirect evidence of an association of the illness with infection from food was, says Sir Arthur Newsholme, an important result.

The'problem of the nature of the illness was also attacked from the point of. view tha.t the virus might be closely allied to, or identical with, that of acute poliomyelitis, and in this line of research animal experiments were carried' out, Professor G. Marinesco, of Bucarest, an expert, assisting in this phase of the inquiry. In • separate contributions, Professor . Marinesco and Dr. M'lntosh describe the results of histological and bacteriological research, and Dr. James gives his conclusions in the epidemiological inquiry. As a result of their separate researches both. Professor Marinesco and Dr. M'lntosh arrive independently at the conclusion "that encephalitis lethiirgica. as it appeared in the present outbreak, is identical with the illness described by von Economo in Austria and' Professor Netter in France, and that it is a disease sui generis, anatomically and clinically distinct from analogous affections."

Although a negative 'finding is unsatisfying, remarks S : ir Arthur Newsholme, mul affords little basis for preventive action, the speedy cessation of the outbreak makes it; r.wessnrv {or the present to leave the disee.se at this point.