Ice Cream Sickness

Eric Lis

As I write this, my home town of Montreal is, yet again, coping with the aftermath of a large freezing rain storm, which is nothing terribly unusual for us. As often happens, this initially made me consider picking a topic related to snowstorms, but instead, in the spirit of perversity, let's talk about how ice cream can kill you.

Ice cream, of course, is far from being a modern invention. There’s good quality evidence that the Chinese had ice cream-like desserts more than two thousand years ago, and even in the blazing heat of the Middle East before the rise of the Roman Empire, technology existed which allowed the nobility to consume flavoured frozen snacks at the height of summer. Although not necessarily cheap or easy to access, ice cream (and snow cones) are plausible foods for societies at almost any technological level, potentially even in desert kingdoms. In fact, odds are good that many societies in your campaign setting actually have easier access to ice cream than they have to the sugar we sweeten it with.

Unfortunately, throughout history, people seeking to create better, cheaper ice cream have made occasional missteps, accidentally creating highly dangerous treats. Sometimes, these missteps have been due to using tainted water; through the miracle of refrigeration, for example, cholera can survive in ice cream for a long, long time and be potentially disseminated to many people at once. Other missteps have been due to the inclusion of poisons and toxins as flavours, colorants, or preservatives. Given the potentially deadly concoctions a clueless alchemist is able to create in the real world, one can only imagine what sorts of hilarious, story-driving horrors an alchemist might come up with in a fantasy setting. Here’s one historical example that will hopefully inspire you to cause your players no end of trouble.

In the Victorian era, when ice cream was first becoming something commonly available to the public, the United States was struck by a rash of illnesses collectively called “ice cream poisoning.” Within a day of eating ice cream, people would fall suddenly, violently ill, often developing symptoms of severe intestinal distress. Such outbreaks were rarely fatal, although the occasional vulnerable child or elder might suffer life-threatening or even deadly dehydration. The funny thing here is that, at the time, the cause of ice cream poisoning was one of the great medical mysteries of the era. This was, of course, in the days when many diseases were still thought to be spread by sickening clouds called “miasmas.” The English physician John Snow had already proven that some diseases, notably cholera, were spread by tainted water, but by and large this new information hadn’t spread as well as one might hope, and although the existence of bacteria had already long since been proven, the proof that germs cause illness was still some way in the future.

Reading the descriptions of ice cream poisoning events, we can suspect that many of them were due to ice cream being made with water containing cholera, E.coli, or any of a host of other bugs capable of harming the human gut. Infection certainly wasn’t the only cause however. Nineteenth century food regulations were a good deal looser than ours, and based on the descriptions of some cases of poisoning, it’s very, very likely that there were people out there producing and selling ice cream which contained lead, formaldehyde, and even arsenic. We can only speculate as to why someone might manufacture ice cream in this way. The most likely answer is that such chemical were added to keep the ice cream fresh – formaldehyde would, after all, prevent bacteria from growing in the cream – or as a colouring – arsenic was a common contaminant of red dyes of the time – but it’s not impossible that some poisonings were due to manufacturers unscrupulously putting known poisons in to cut costs, or even to knowingly cause sickness and panic.

One of the most popular explanations for ice cream poisoning is the now largely discredited theory of “ptomaine.” According to the theory, when organic matter rotted, it had the potential to degrade into potentially poisonous chemicals called ptomaines. The theory suggested that this explained all manner of food poisonings, of which ice cream poisoning was really a minority, and also played a role in many other diseases. The theory was popular in the days when germ theory was contentious, because it allowed an alternate explanation for the role of bacteria: rather than causing sickness themselves, bacteria were the organisms that caused safe food to transform into ptomaine. Ptomaine theory is exactly the sort of thing that might be found in a pre-modern historical setting, as it explains many of the observations being made by the healers of the day while still getting enough wrong for players to find it amusing, or more importantly, for storytellers to create story-hooks and plot complications. Ptomaine theory might be the leading explanation for disease in a society which understands food spoilage and the importance of sanitation but don’t have microscopes and therefore have no understanding of bacteria or microorganisms. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on February 27, 2016. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system