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It is evident that further legislation is required before this state of affairs can be remedied, but
much good would no doubt at once result if every urban and rural authority were to exercise the
power it now possesses under the Order of 1899, of examining cows for tubercular disease of the
udder and preventing the sale of milk from cows found to be suffering from such disease. We note in
this connection that the last Royal Commission on Tuberculosis made the following recommendation—
" 14. We recommend that, where cows housed in one district supply milk to another district, the
" local authority of the district in which the cows are housed shall be bound, when required, to
" supply to the local authority of the district in which the milk is sold or consumed full information
" and veterinary reports regarding the condition of the cows, byres, &c., whence the milk is drawn.
" Where the local authority of one district are dissatisfied with the reports so obtained, they may
" apply to the Local Government Board, with a view to an independent inspection and report
" being made."
It must, moreover, be borne in mind that there is no power to seize a cow which is certified to be
suffering from tubercular disease of the udder. Such cows should undoubtedly be slaughtered at once,
and if it is then found that there has been error in the diagnosis of the disease the cowkeeper should
be compensated. Nothing is more unsatisfactory than leaving in the cowshed a cow believed to be
Buffering from tubercular disease of the udder while the owner considers what he will do with the
animal. There is too much opportunity for such a cow to be sold and again brought into the milk
business elsewhere.
We also do not think it satisfactory that the flesh of cows which have suffered from tubercular
disease of the udder should be sold for human food, except after inspection by some competent authority.
One of the recommendations of the last Royal Commission on Tuberculosis was that all udder
diseases of the cow should be notified, and the experience of the last few months has amply demonstrated
the need for such requirement. If this requirement had existed in London it may be anticipated that a
large proportion of the 680 cows, to which Mr. Simpson specially refers, would have been at once
inspected, and the milk of those with tubercular disease of the udder excluded earlier from the milk
supply.
Before recommending the Council to apply for fresh legislation, we think it desirable that the
Council should have a number of samples of milk taken from various parts of London and subjected to
examination by an eminent bacteriologist. If the result shows that a large number of such samples is
tuberculous, the case for legislation would be strengthened, and the public would be warned of the
danger to which they are subjected. This danger would no doubt be obviated were all milk boiled
before consumption, but English people seem loth to adopt this practice.
We have ascertained that Dr. Klein would be prepared to undertake the bacteriological examination
of 100 samples at an inclusive fee of 205 guineas, and we strongly recommend the Council to employ
him on these terms.
The annual maintenance votes provide for the expenditure of a sum not exceeding £200 for
incidental expenses as to dairies, slaughterhouses, and cowhouses, and of a sum not exceeding £250 on
special county account under the head of " Public Health (London) Act, 1891—Incidental expenses,"
and we think that these suras will be found sufficient to cover the expenditure we now propose for the
present financial year. We recommend—
(а) That, for the purpose of giving effect in London to the Dairies, Cowsheds, and Milkshops
Order of 1899, the cows in London cowsheds be examined by a veterinary surgeon and two
assistants at intervals of three mouths, and suspected cows at more frequent intervals, at an
estimated cost of about £300 per annum, and that the Committee be instructed to report as to the
necessary arrangements.
(b) That 100 samples of milk from various parts of London be sent to Dr. Klein for bacteriological
examination at an inclusive fee of £215 5s.
These recommendations were adopted by the Council on the 12th December, 1899,
recommendation (a) being extended by the addition of the following words—" And tbat a letter be
" sent by the Clerk of the Council to the Sanitary Authorities of tbe home counties, asking what steps
" they would be willing to take with a view of supplying to the Council the information recommended
" in paragraph 14 of the report of the Royal Commission on Tuberculosis."
The only outbreak of disease which was definitely attributed to the consumption of milk
occurred in the Greenwich district. On the afternoon of July 22nd, about 110 children were taken to
a school treat in the grounds of an untenanted house—" The Knoll," at Blackheath. They were given
tea, consisting of tea, madeira and currant cake, scones with butter, milk, some sweetstuff and cherries,
and shortly after the meal upwards of 50 of the children were seized with pain in the stomach, vomiting
and diarrhoea, followed by great prostration, and in some cases by collapse. Many attacks
occurred within half-an-hour of the meal. The majority of the children were taken to the Seamen's
Hospital, some were taken to the Miller Hospital. None of the cases of illness proved fatal.
Enquiry by Ur. Hartt, medical officer of health of Greenwich, showed that all the children
attacked had partaken of milk, while not all of those who suffered had consumed the cake, scones,
sweetstuff, or cherries. Enquiry was made as to the water used, and questions as to its storage were
raised ; but no further doubt as to the cause of tbe outbreak could be felt when it was ascertained
that cases of illness of a similar kind to that affecting the school-children had occurred on the evening
of the school treat in three families obtaining milk from the local dairy from which that used at the
school treat was supplied.
This milk was traced, on information furnished by the secretary of the company supplying it,
to a farm in Berkshire. Inspection was made of this farm by Dr. Ashby, the medical officer of health
of the district, and Dr. Hamer, but no explanation of the manner of pollution of the milk was forthcoming.
It transpired that some 30 or 40 imperial gallons of milk were delivered from this farm
daily, sometimes at Blackheath, sometimes at Woolwich. On the day of the school treat about
28 gallons were supplied and delivered at Blackheath. It was not found possible to fully ascertain
where the rest of the milk (over and above the quantity consumed at the school treat) was distributed.
About 1£ gallons of milk from the farm was, however, consumed in Berkshire, without as far as could
be ascertained, any ill result. There were 25 cows in milk at the farm, and the cowshed was of
modern construction. No fresh cows had been recently brought to the shed, and no illness had been
observed among the cows or in the milkers.
I forwarded samples of the food materials supplied at the school treat, of material vomited
by one of the patients, and of blood from the fingers of three of the patients, to Dr. Klein, who
concluded that the cause of the outbreak was " the presence in the milk consumed at the school treat