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30
ADMINISTRATION AND LEGISLATION".
Dairies, Cowsheds and Milkshops.
The Council's inspectors paid 10,085 visits to dairies and milkshops, and 3,460 visits to cowhouses.
In three cases prosecutions were instituted and in two cases penalties were imposed
amounting to £2 5s. Cases of infectious disease occurred on 69 premises where milk was sold, and the
necessary steps were taken for the prevention of the contamination of the milk.
The Council as a licensing authority received in 1892 546 applications for renewal of licence
for the keeping of cows, and two applications in respect of premises not previously licensed, of the
former 535, and of the latter both were granted.
On May 10th, 1892, Dr. Corner, medical officer of health for Poplar, informed me that a cowman
in that district was suffering from cow-pox. Dr. Hamer made inquiry into the matter, and learnt
that a cowkeeper in Poplar had on the 8th April bought two cows which were said to have come from
St. Ives ; one of these cows was at the time of purchase affected with sores on the teats. Shortly afterwards
22 more cows were purchased and placed with the two cows from St. Ives. Nearly all these
cows became affected with sore teats, but the companion of the St. Ives cow which originally suffered
remained free from eruption throughout.
On April 29th the man who milked the cow from St. Ives which had sore teats, and three others,
noticed swelling of his lips, and a day or two later his arm became similarly affected. On May 3rd this
man's wife noticed a pimple on her chin. On May 11th the man was found to present three scabs (on
the upper lip, lower lip and forearm); the lesion on the chin of his wife was passing from the
vesicular into the pustular stage, at this time it was surrounded by a reddened area of skin, and resembled
a vaccine pustule. Both man and wife had been vaccinated in infancy, but not since.
The cow originally affected, and six others each had one or more, usually five or six scabs on the
teats, and in one instance at the base of the udder close to the origin of the teat. No cases of infectious
disease could be traced among the customers of the cowkeeper.
A report by Dr. Turner on an outbreak of enteric fever in south-east London in 1891 was
presented to the Council in 1892, and Dr. Hamer's report on scarlet fever in the same locality of which
account is given on page 17, led the Council to instruct the Public Health and Housing Committee
to report: "as to the amendments of the law required to check and prevent the sale of impure or
infected milk, whether alone or in the form of ice creams or otherwise." The Public Health and
Housing Committee and the Public Control Committee were instructed to report whether any
communication could be made to the Board of Agriculture as to including eruptive diseases of the teats
and udder of the cow under the Contagious Diseases (Animals) Act.
While Dr. Turner's report afforded evidence of the distribution of enteric fever by ice cream there
was no proof as to the manner in which the ice cream received its infection. It was possible that the milk
used in this ice cream was infected before it arrived on the premises occupied by the ice cream vendor;
it had much opportunity for contamination on these premises. The need for the preservation of milk
supplies from contamination by special measures was already recognised by the legislature, but the practicability
of subjecting to the same conditions all premises in which milk was used for the preparation of other
articles of food had to be considered. Certainly the insanitary conditions found to be present on the
premises of the vendors of the ice cream in question were such as could and should be dealt with under
the general provisions of the Public Health (London) Act. The Committee had already taken this view
and had communicated a copy of Dr. Turner's report to the several sanitary authorities and medical
officers of health in London. The reference to the two Committees arising from Dr. Hamer's report
was duly considered by them. The reference raised questions of much importance.
Outbreaks of scarlatina due to milk infection had not infrequently been observed, but the
circumstances under which the milk had acquired its infective properties were obscure. Certainly in
some instances there was, after careful inquiry, absence of evidence that the milk had been infected by
human agency. Investigations of such outbreaks by Mr. W. H. Power had led to the consideration of
the possibility of such infection being caused by a cow malady, and in 1887 Sir George Buchanan, then
medical officer of the Local Government Board, thus wrote of an outbreak of scarlatina due to milk
received from a farm at Hendon. (Aunual report of the medical officer of the Local Government Board
for the year 1886.)
(1.) The disease in man and in the cow alike is characterised by closely similar anatomical
features.
(2.) From the diseased tissues and organs of man and cow alike the same micrococcus can be separated,
and artificial sub-cultures be made from it.
(3.) These sub-cultures, no matter whether established from man or cow, have the property, when
inoculated into calves, of producing in them every manifestation of the Hendon disease; except sores on
the teats and udders ; no doubt for the reason that the milk apparatus is not yet developed in calves.
(4.) But—and this I learn from Dr. Klein's later observations while this report is in preparation—
the sub-cultures made from human scarlatina and inoculated into recently calved cows, can produce in
those cows, along with other manifestations of the Hendon disease, the characteristic ulcers on the teats;
ulcers identical in character with those observed at the Hendon farm.
(5.) The sub-cultures, established either from the human or the cow disease, have an identical
property of producing in various rodents, a disease similar in its pathological manifestations to the
Hendon disease of cows and to scarlatina in the human subject.
(6.) Calves fed on sub-cultures established from human scarlatina obtain the Hendon disease.
(7.) Children fed on milk from cows suffering under the Hendon disease obtain scarlatina.
The above combine, I think, to form a mass of evidence to show that the Hendon disease is a form,
occurring in the cow, of the very disease that we call scarlatina when it occurs in the human subject.
Later, in 1889, Sir George Buchanan reported that "Dr. Klein succeeded in recognising one
particular bacillus which is constantly present in every membrane of diphtheria, and in identifying it
from among others that are only occasionally present there," and that Dr. Klein proceeded to inoculate
two cows with this bacillus. The results of his experiments are thus summarised in the report for that
year of the medical officer of the Local Government Board.