[56] See also a similar instance reported by Lumsden, _Hyg. Lab., U.S. Public Health and Marine Hosp. Service, Bull. 78_, p. 165. [57] For a discussion of the oyster question see G. W. Fuller, _Jour. of Franklin Institute_, August, 1905; _N.Y. City Dept. of Health, Monthly Bull._, November, 1913, and May, 1915; H. S. Cumming, _U.S. Public Health Service, Pub. Health Bull. 74_, March, 1916. [58] _Lancet_, II (1895), 46. [59] Park and Krumwiede, _Jour. Med. Research_, N.S., XVIII (1910), 363. [60] _Ztschr. f. Hyg._, XXXV (1900), 265. [61] _Centralbl. f. Bakt._, I, Orig., LXVI (1912), 194. CHAPTER VI FOOD-BORNE PATHOGENIC BACTERIA (_Continued_) PARATYPHOID INFECTION The most characteristic examples of "food poisoning," popularly speaking, are those in which the symptoms appear shortly after eating and in which gastro-intestinal disturbances predominate. In the typical group-outbreaks of this sort all grades of severity are manifested, but as a rule recovery takes place. The great majority of such cases that have been investigated by modern bacteriological methods show the presence of bacilli belonging to the so-called paratyphoid group (_B. paratyphosus_ or _B. enteritidis_). Especially is it true of meat poisoning epidemics that paratyphoid bacilli are found in causal relation with them. Hübener[62] enumerates forty-two meat poisoning outbreaks in Germany in which bacilli of this group were shown to be implicated, and Savage[63] gives a list of twenty-seven similar outbreaks in Great Britain. In the United States relatively few outbreaks of this character have been placed on record, but it cannot be assumed that this is due to their rarity, since no adequate investigation of food poisoning cases is generally carried out in our American communities. _Typical paratyphoid outbreaks._--Kaensche[64] describes an outbreak at Breslau involving over eighty persons in which chopped beef was apparently the bearer of infection. The animal from which the meat came had been ill with severe diarrhea and high fever and was slaughtered as an emergency measure (_notgeschlachtet_). On examination a pathological condition of the liver and other organs was noted by a veterinarian who declared the meat unfit for use and ordered it destroyed. It was, however, stolen, carried secretly to Breslau, and portions of it were distributed to different sausage-makers, who sold it for the most part as hamburger steak (_Hackfleisch_). The meat itself presented nothing abnormal in color, odor, or consistency. Nevertheless, illness followed in some cases after the use of very small portions. With some of those affected the symptoms were very severe, but there were no deaths. Bacilli of the _Bacillus enteritidis_ type were isolated from the meat.