View report page

2
In Liverpool powers were also obtained for controlling the conditions under which ice-cream
is prepared, but the procedure of including ice-cream in the definition of milk was not adopted, special
powers boing taken under the Liverpool Corporation Act of 1898.
The Strand District Board have expreased the opinion that the Council should obtain power
to make by-laws to provide for the registration or regulation of all places where food is sold or
prepared for sale, and there would probably be no opposition to a claim for the registration and
regulation of the business of an ice-cream vendor. The conditions under which other articles of food
are prepared are less suggestive of the need for registration, and in any step taken in connection with
the application of the Strand District Board it would probably be well for this difference to be
recognised.
Shirley F. Murphy,
Medical Officer of Health.
Dr. Hamer's Report.
Two distinct lines of inquiry have been followed in connection with the subject of the production
of disease by the agency of food. The origin of the one may be traced back to the discoverr,
made in 1849 by Dr. John Snow, of the fact that cholera can be transmitted by drinking water contaminated
with cholera evacuations; the origin of the other dates from the growth of knowledge, which
first began to be acquired at about the same period, with regard to the spread of parasitic disease from
animals, the flesh of which is used for food by man. In the former instance it will be noted that the
cases of illness are the starting point of the inquiry, in the latter the fact that the food itself is unsound
leads to investigation as to its possibly harmful influence.
The one line of inquiry led to the discovery that enteric fever as well as cholera is communicated
by water, to the association of milk with outbreaks of enteric fever, scarlet fever, and diphtheria,
and to ascertainment of the fact that certain other foods act from time to time as vehicles for
infection.
The other line of inquiry, which had at first been limited to the elucidation of the life history of
tape-worms, had already led in the early sixties to the discovery of trichinosis, a discovery which
emphasized the need for special attention being given to meat inspection, and caused increased vigilance
to be manifested in this connection, at first in Germany and afterwards elsewhere. A great enlargement
of the field of inquiry was made as in course of time bacteria came to be closely studied, and it
was soon recognised that certain forms of food poisoning must be regarded as infective processes set
up by the activity of germs. There was a tendency in the first instance to assume that the trichina
spiralis was solely at fault, but after a while it became clear that there was a form of " ham or sausage
poison " distinct from that associated with the use of trichinous flesh.*
The term " botulismus " was applied in Germany to such cases of sausage poisoning, which
were attributed to " an obscure organic poison the product of putrefaction." The nature of the poison
in such cases has been in recent years the subject of much investigation; on the one hand chemical
substances allied to vegetable alkaloids and which were called ptomaines, and then later other chemical
substances related to the proteids, came to be regarded as having importance in connection with
attacks of food poisoning; on the other hand various species of bacteria were isolated from time to
time from infective food stuffs and the question was raised whether the symptoms of poisoning were
produced by the bacteria themselves, or by the dead chemical products resulting from their growth
in the food prior to its introduction into the body of the consumer.† Dr. Ballard in a paper read before
the International Congress of Hygiene in London in 1891 gave a summary of the experiences of the
medical department of the Local Government Board during the preceding 10 or 12 years in relation
to " food poisoning." Fourteen instances in all were dealt with, and they included cases in which
illness was caused by eating cold boiled ham, baked pork, sausages, tinned pigs' tongues, roast
beef, brawn, roast pork, tinned salmon, certain articles consumed at a wedding breakfast, veal
pie, pork pie or brawn, pork pies, boiled salted pork, meat pie, and lastly some " American
bacon" suspected to be concerned in the spread of an outbreak of pleuro-pneumonia at
Middlesbrough. Dr. Ballard drew particular attention to the conditions under which the implicated
foods were prepared, and to those under which they were subsequently stored, and urged that the
origin of the maladies in question was to be sought in " infectiveness of the place in which the
food was prepared or stored in association with uncleanliness of air, of soil or of surface."‡ His
concluding remarks as to the precautions to be taken to prevent " food poisoning " are of special
interest. He said, " The grand precaution of all is the common one of cleanliness. Every factory
where pork is converted into brawn or hams ought to be so arranged that light and a draught of air
can penetrate freely everywhere; there should be no corners where refuse matters can lodge and
become a centre for the cultivation of morbid micro-organisms or filth ; the rise of ground air should
be obviated by cement under the pavement or flooring; and the place should be kept scrupulously
clean and free from incursions of sewer air or putrid emanations of any kind. Kitchens, and above
all, pantries and places where food is stored in hotels, public refreshment rooms or pastry-cook's
premises, and in private houses, should be similarly cared for. It should be held to be part of the
business of conservators of public health to see that these rules are observed, as well as the business of
every master or mistress of a family."
In some of the more recent outbreaks of food poisoning the possibility that the infecting
organism had already acted as an excitant of disease in the animals whose flesh subsequently proved
infective to man has been suggested, and from this point of view it is urged that consideration must
* See page 391. Appendix to the 7th Report of the Medical Officer of the Privy Council,
†See appendices to the reports of the Medical Officer of the Local Government Board for work done in
connection with some of the chief outbreaks noted in this country. Reference to the more recent continental
observations will be found in an address by Mr. H. E. Durham on " The present knowledge of outbreaks due to
meat poisoning," published in the British. Medical Journal for December 17, 1898.
‡The frequency with which swine's flesh was implicated was insisted on by Dr. Ballard, and he was
moreover led to conclude that the gelatinous gravy obtained from such flesh was specially liable to be at fault.