Biological Sciences 300/301, Smith College | Neurophysiology

Case 3: A lethal shipboard snack.

The overwhelming course of severe poisoning can be appreciated from an account given by a Dr. Julius Hellmuth, who was surgeon on board the Dutch brig of war "Postilion" (140). On September 4, 1845, in Simon's Bay on the Cape of Good Hope, two men, a boatswain and a purser's steward who had already had the ship's lunch decided to eat a local fish (identified as Diodon oscellatus) as an experiment even though they were aware of the poisonous nature of the fish.

"Scarcely ten minutes had elapsed (since ingestion of the fish's liver) when I (Hellmuth) was called upon to afford medical assistance to both, and observed the following symptoms. J. Kleinhaus (the boatswain) lay between decks, and could not raise himself without the greatest exertion; his face was somewhat flushed; his eyes glistening, and pupils rather contracted; his mouth was open, and as the muscles of the pharynx were drawn together by cramp, the saliva flowed from it; the lips were tumid and somewhat blue; the forehead covered with perspiration; the pulse quick, small and intermittent. The patient was extremely uneasy and in great distress, but was still conscious....The state of the patient quickly assumed a paralytic form; his eyes became fixed in one direction; his breathing became difficult, and was accompanied with dilation of the nostrils; his face became pale and covered with cold perspiration; his lips livid; his consciousness and pulse failed; his rattling respiration finally ceased. The patient died scarcely seventeen minutes after partaking of the liver of the fish....." "Almost the same symptoms, following each other with equal rapidity, appeared in J. Hansen (the purser's steward); vomiting ensued before an emetic was administered to him... He was still conscious, and said that he felt easier (after vomiting three times); expressing at the same time some hope; the pulse became softer; the vomiting was again repeated; but in a few moments, a single convulsive movement in the arms ensued, whereupon the pulse disappeared, the livid tongue was protruded from between the lips. His death took place about one minute later than that of his messmate."

In milder cases of poisoning, sensory and motor disturbances are not so deeply masked by severe cardiovascular derangements, and the neurological disturbances become the most prominent aspect of the symptomatology. Thus, Captain Cook (26) described his own experience as: "Having no suspicion of its being of a poisonous nature (referring to the fish), we ordered it to be dressed for supper; but very luckily, the operation of drawing and describing took up so much time that it was too late, so that only the liver and row were dressed, of which the two Mr. Forsters and myself did but taste. About three o'clock in the morning, we found ourselves seized with an extraordinary weakness and numbness all over our limbs. I had almost lost the sense of feeling; nor could I distinguish between light and heavy bodies of such as I had strength to move, a quart pot, full of water, and a feather being the same in my hand..."

Excerpted from Pharmacological Reviews 18: 997-1049 (1966)