DISEASE FROM INOCULATION OF DEAD ANIMAL MATTER. POST MORTEM POISONING.
Under the head of disease from venomous substances we may include examples of diseased phenomena arising from inoculation of the living body with fluid or semifluid material derived from bodies that are dead. The most striking examples of this affec tion are witnessed in what are called post-mortem wounds. A physician or surgeon is performing a post-mortem operation, or a student or professor is making a dissection of the dead body. He accidentally wounds himself with a needle or knife which be has in use, and thereby inflicts a poisoned wound. If he can im mediately suck out the poison or destroy the part by caustic he may escape. If he is not so fortunate he is subjected, in a few hours, to pain in the wounded spot, with redness round about it, inflammation running along the lymphatics, swelling of the lym phatic glands and fever, ending, not infrequently, in prostration and death. In less formidable cases the acute symptoms are brought to a crisis by the forniation of an abscess or abscesses in volving the lymphatic glands, as the glands of the armpit if the hand has been the part that has received the poison. In such ex amples the formation of the abscess may lead to subsidence of the more dangerous symptoms and slow recovery may be the result.
The disease thus induced is, I think, less frequent in these days than it was formerly, owing probably to greater care and cleanliness. I have seen four instances of it in my career, three of which terminated fatally. The nature of the poisonous mat ter or infection is little understood, but it seems to be a poison having a comparatively short duration in the dead subject. It does not seem to be formed immediately after death, and it ap pears to be destroyed very soon after the dead structure begins to undergo putrefaction. The late distinguished anatomist, Dr. Amadee Deville, who had seen many examples of the affection, told me that he had on no occasion witnessed the poisoning from a subject that had actually undergone decomposition.
Cases of poisoning somewhat similar to these are sometimes due to the eating of food which in a partially decomposed state comes into contact with an abraded surface or a wound in the mouth. I have elsewhere described an accident of this kind which affords a good typical example. A man partook of some jugged hare the flesh of which had become high previous to cook ing. Beneath the tongue of the man there was an abraded ulcer ated spot caused by friction from the stump of a broken tooth. A portion of the animal food lodged in this sore, and within twenty-four hours the symptoms of acute poisoning, local and general, had set in. The tongue became enormously swollen, there was intense fever and rapid prostration. The offending matter was sought for and removed, but without avail. The patient gradually succumbed.
I have on two or three occasions witnessed symptoms of dis ease in persons who have partaken of decomposing or, as it is vulgarly called, " high" food, although no wound was inflicted. The phenomena are those of indigestion, nausea, fetid breath and prostration : they continue until the poisonous material which has been swallowed is eliminated from the body.
Accidents somewhat similar to the above are occasionally met with by surgeons and veterinary surgeons when they are profes sionally engaged in dressing the wounds or sores of living ani mals. The accident may occur in very rare instances without the infliction of a wound on the person who becomes infected, that is to say, by absorption through the skin. I have known one ex ample of this kind where the poison from a specific wound came simply into contact with the reddened surface of an inflamed fin ger. More frequently a fresh wound is the centre of the infec tion, and the poison is thus directly inoculated. A surgeon of my acquaintance was once, unfortunately, inoculated fatally from a point of bone in the limb of a patient upon whom he was per forming an operation.
The symptoms induced in these instances of poisoning vary according to the disease affecting the person from whom the poison is taken. If the poison is that of specific disease, syph ilis, the person inoculated suffers from that disease should the poison take effect. In this manner it sometimes happens that the disease in question is communicated in vaccination by the use of impure lymph, that is to say, lymph taken from the arm of a subject who is at the time a sufferer from the specific affection.
In other instances the accidental inoculation of the morbific matter excites erythema in the part immediately around the wound that has been inflicted, which erythema may spread, and assuming the character of erysipelas may pass into an attack of erysipelatous inflammation.
In these forms of poisoning by inoculation the period of incu bation varies according to the nature of the poison that has been introduced. The development of symptoms from the specific poison of syphilis is slow, the incubation being forty days. The action of the poison of erysipelas is rapid, the incubation being from a few hours to four days at the latest. The action of the poison derived from a post-mortem wound is still more rapid, commencing generally within a few hours after the infliction of the injury.