WERE THE EPIDEMICS OF SICKNESS AT BOARD

ING SCHOOLS ALL OVER THE COUNTRY

LAST YEAR DUE TO TYPHOID INFEC

TION OR PTOMAINE POISON?

C. M. Curtis, M.D., College Park, Ga.

During the latter part of last year there were epidemics of severe sickness at no less than twenty-four boarding schools in the Southern States. These epidemics all came about the same time with such similar symptoms that there was a very strong opinion that there was a common cause, and that it came from the same source and that source the food supply. These epidemics of sickness were generally diagnosed at first as Bacterial poisoning, but on account of some of the patients running a temperature for several weeks they were thought by a few physicians to have had typhoid fever, and as I observed sixty-nine cases at the Georgia Academy I wish to present some correspondence in regard to same instead of reporting them in the usual man

ner.

My diagnosis of ptomaine poison was based on the following facts:

The suddenness of the outbreak, the fact that every boy was perfectly well until the day he was taken violently sick. The extremely high temperature at the beginning of the sickness. The fact that so many of the patients were entirely well in a few days. The fact that the soreness tympanitis, etc., was in the stomach instead of the bowels-the tongue, the odor of the breath both indicated gastric disturbance the irregularity of the temperature which went down to or below normal in almost every patient at least once a week, and then up again in protracted cases, indicating a re-infection too frequent for typhoid fever.

The mental condition of every patient was particularly acute, while in typhoid fever it is usually dull. Sponge baths which are usually soothing in typhoid fever were unusually irritating in these cases, making the patient nervous, as well as causing an elevation of temperature. There was present a jaundiced condition in nearly every patient, indicating a catarrhal condition of the whole alimentary canal, caused from the bacterial poisoning. There was no typhoid fever odor and no typical typhoid fever stools. At the Georgia Military Academy there was no sickness among the day pupils, and not a single case in the community outside of the school, and none in school, except the ones that came altogether at the same time.

The character and course of this sickness was very similar to the sickness that was caused by bad meals fed to the soldiers during the Cuban war, which caused the government to fine the Cudahy Packing House $80,000 at one time, and similar to the sickuess which caused the government investigation of packing houses several years ago, and which led up to the enacting of the pure food law and the government inspection of meats.

I wish to add that this sickness last year was not by any means confined to schools. There was a great many cases of ptomaine or bacterial poisoning in private praetice all over the country, and a number of deaths from same. But back to the sickness in the schools they all tried to keep the fact that there was sickness from the public, but from the best information I can get all the epidemics were very similar in the origin course and character to the one I am reporting in the following correspondence, which I use here to show. the opinions of others as well as myself.

DR. C. M. CURTIS,

GEORGIA MILITARY ACADEMY,

Physician and Surgeon.

Medical Department.

College Park, Ga., Nov. 9, 1909.

CIRCULAR LETTER TO MEMBERS OF STATE MEDICAL ASSOCIATION OF GEORGIA.

Dear Doctor:

We have recently had a very peculiar kind of sickness at the Georgia Military Academy.

Sixty-nine boys were stricken down within forty-eight hours, with what appeared to be the same malady. All had about the same symptoms more or less severe. There was a depression in the circulation, a sub-normal temperature, rising rapidly in some instances from 96 to 106 in from six to twenty-four hours.

Patients generally suffered some uneasiness in stomach and bowels, with severe pains in head, back and muscles of limbs.

The temperature rose high and fell low at different irregular intervals for a few days and then dropped to normal in from one to two weeks.

Probably 50 per cent. of cases terminated in ten days, 75 per cent. in fifteen days, and about 25 per cent. of boys are still in bed and half of those are practically convalescent, while five or six are very sick in a typhoid condition.

My diagnosis was Ptomaine poisoning, probably due to eating boneless boiled ham (boiled at the packing house

The ham was suspected because only boys who ate the ham were sick, and the boys who did not eat ham were not sick. The boys who ate most ham were the most severely sick.

Treatment was eliminative, calomel followed by salines and the castor oil and turpentine was given daily until patients were convalescent.

Nourishment was principally egg albumen, and buttermilk. Meat broths, sweet milk and ice cream were not given to my patients.

In the course of the disease from the second to the fourth day of sickness in a number of cases there was a similar condition found in a typhoid fever patient at the end of the second week. This condition alone, however, would not warrant a diagnosis of typhoid fever by a physician of experience and keen observation.

At the end of two weeks there are a few of these patients in the Infirmary-and if you would like to see them, I would be glad to have you call at the Georgia Military Academy any time it is convenient for you within the next few days, and Miss Hearn, the nurse in charge, will take pleasure in showing them to you, and also give the history of those who are well.

Very truly and fraternally yours,

I beg to acknowledge receipt of your letter of November 10th, concerning the illness of the boys at the Academy. This report is particularly interesting to me because of the fact that during April and May of last year, I suffered, myself, a similar attack and was ill for six weeks. My illness was directly traceable to so-called fresh sausage.

The symptoms and course were exactly similar to conditions described by you.

DR. L. C. FISHER,
Atlanta, Georgia.

Dr. C. M. Curtis, College Park, Ga.

My Dear Doctor:

November 15, 1909.

I am in receipt of your kind letter of November 9th, for which I thank you. If at any time I find it possible to stop by your institution, I shall be delighted to do so, as I have been very much interested in the outcome of the sickness that you have.

With very kind regards and best wishes for the success of your efforts, I have the honor to be,

Very truly yours, (Signed.)

L. C. FISCHER.

EMBRY & UPSHAW DRUG COMPANY

Villa Rica, Ga., Nov. 17, 1909.

Dr. C. M. Curtis, College Park, Ga.
Dear Doctor:

I have just read your letter with considerable interest. I agree with you in every particular, both in diagnosis and treatment. It was certainly an unusual coincidence, so many being stricken so suddenly and the same way. The most uncommon feature in your cases, was the extreme temperature high and low, and assuming the slow type of fever. Ptomaine poison was evidently the cause of the whole trouble as they all ate of the same diet. I think your treatment ideal as it was eliminating from the beginning.