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ASHBY and ROBERTSON have recently given an account of an outbreak of illness in Manchester which had come under their notice and which they attributed to the consumption of rye bread made from rye meal contaminated with ergot. On one or two occasions during the past few years isolated instances of illness which were suspected to have been due to the consumption of ergotised rye have been reported to the Ministry of Health, but on enquiry it has not proved possible to arrive at definite or certain conclusions as to their causation. In view, however, of the circumstances of the outbreak mentioned above I was instructed by the Ministry of Health to visit Manchester and investigate the matter with the object, if possible, of bringing to light further facts with regard to the nature of the illness and its causation, the likelihood of recurrence of similar outbreaks and the measures which should be taken to prevent such recurrences. NATURE OF THE ILLNESS. On reference to Robertson's and Ashby's article it appears that the first symptoms observed in the patients (all of whom were Jews) were coldness and numbness in the extremities; tailors, button-makers, etc., noticed their fingers felt numb and they experienced difficulty in keeping up with their work. Sensation was also impaired; they could prick their fingers without feeling anything. Formication was a very typical symptom in all well-defined cases, and many of the patients stated that they experienced a sensation as if an insect was creeping over or under their skin. Itching was also a common symptom. Nervousness, depression, headaches and abdominal pains were frequent, and in the more severe cases ataxia with a staggering gait occurred. In most cases of long standing, the blood pressure was definitely raised, for example, a woman aged 44 had a systolic blood pressure of 174 mm. During a visit to Manchester I saw both Dr Ashby and Dr Robertson who gave me some further particulars of the cases. Dr Robertson's attention was first seriously attracted to the prevalence of the condition in October 1927, although previously to that cases had come under his notice. He has had some 200 cases in all, most of whom were adults (male and female) with some children. All his patients were Jews and consumers of rye bread: no case was observed in a person who did not consume rye bread. Unfortunately detailed clinical records of the cases were not available, so that

Report on an Outbreak of Alleged Ergot Poisoning by Rye Bread in Manchester