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89
Summarising the evidence on the above points the following conclusions are
arrived at :—
"1. That oysters, mussels, and cockles are at times responsible for isolated
"cases and groups of cases of enteric fever, of gastro-enteritis, and of mytilotoxine
"poisoning.
"2. That such shellfish have also to be held responsible for extensive
"outbreaks of enteric fever and gastro-enteritis, and that the amount of mischief
"in this latter sense has not hitherto been adequately appreciated.
"3. That these shellfish have also been shown to have played, and to be
"still playing, an important part in certain towns in maintenance of enteric fever
"prevalence.
"4. That for the most part the specific contamination of such shellfish takes
"place on the beds or layings, in the storage ponds, or in the process of 'washing,'
"but that occasionally the shellfish may become infected by the retailer."
Evidence is given pointing to the conclusion that shellfish which have been cooked
are less liable to act as disease disseminators than shellfish from the same source
eaten saw.
"It must be regarded as being in accordance with expectations that the
"exposure of shellfish to heat should reduce the chances of such shellfish trans"mitting
disease dependent upon vegetable organisms, and this general statement
"will remain true although it can be shown that the application of heat in the
"process of 'boiling' or 'steaming' shellfish is not as a rule sufficiently prolonged
"or intense to effect the entire sterilisation of the shellfish in question.
"There seems need for a better appreciation on the part of the public of the
"fact that some risk must attend the consumption of all raw foods, whether
"vegetable or animal.
"As regards vegetable foods eaten raw or uncooked, mention may be made
"of watercress, which is not infrequently collected from sources liable to sewage
"contamination, and washed in water sometimes similarly liable, as well as of
"lettuces, mustard and cress, cabbage, celery, horse-radish, strawberries, and
"radishes, all of which latter, being in contact with the earth, are liable to be
"contaminated by manure, while fruits such as blackberries, raspberries, goose"berries,
plums, &c., which grow at some elevation from the ground, are only
"liable to contamination by the employment of dirty hands in the process of
"gathering, and by infected dust or dirt after collection. In the case of many
"fruits, however, the risk of infection is reduced by the practice of peeling them
"prior to consumption.
"With respect to animal foods, the only one of material consequence other
"than shellfish, which is consumed raw, is milk, which, as everyone is aware is
"frequently responsible for outbreaks of enteric fever, and doubtless to some
"extent for the introduction of bovine tuberculosis into the animal economy. By
"careful boiling, however, risks in the above sense can be avoided.
"It is a curious circumstance that the only animals eaten raw and actually
"living are certain shellfish such as oysters, mussels, and cockles ; or rather the