Last spring considerable alarm was awakened in Great Britain at the outbreak, notably in London and Sheffield, of cases of illness presenting a group of unusual cerebral or cerebrospinal symptoms. The distinctive features appeared to be those of an acute general disease associated with a condition of increasing languor, apathy and drowsiness, passing into lethargy; progressive muscular weakness passing into complete disablement, and a combination of various cranial nerve palsies, of which ptosis, squint and nystagmus were characteristic signs. The cases were provisionally diagnosed botulism, toxic ophthalmoplegia, epidemic stupor, epidemic lethargic encephalitis, acute poliencephalitis, poliencephalomyelitis, bulbar paralysis and Heine-Medin disease. There is some evidence that a comparable illness has appeared in France and in Austria.
At the outset there was a tendency to ascribe the obscure malady to food infected with Bacillus botulinus. The difficulties then prevailing in the war-time food situation helped to focus attention on possible outbreaks of