London's Pulse: Medical Officer of Health reports 1848-1972

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City of London 1921

[Report of the Medical Officer of Health for London, City of ]

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58
The first series was submitted in May. and consisted of 30 samples.
Seven. out of twenty-nine samples. or over 24 per cent. were reported to contain
the tubercle bacillus. One of the samples submitted was not included in the
report of the Bacteriologist as the inoculated animal died eight days after inoculation.
a period too short to allow the milk sample to be pronounced negative.
The percentage number of infected milk was higher in this series than ever previously
recorded in the City. Although I gave consideration to the possibility
of coincidence. having regard to the small number of samples submitted. I considered
the circumstances sufficiently serious to justify the examination of a
further series of samples. Before referring to this further series. I have to state
that the samples were also examined for the presence of dirt. Of the thirty samples.
28 were clean and two distinctly not clean.
The chemical examination showed that. with one exception. all samples were
genuine milk and free from boric acid or formalin.
In the second series. 24 samples were submitted to the Bacteriologist. but the
pathological report refers only to 19. as four of the animals died within a few days
of inoculation and one was lost.
Of the 19 samples. five. or 263 per cent.. were found to be infected with
the tubercle bacillus. Having regard to the fact that five of the samples are not
included in these figures. it is quite possible that the true percentage is even more
serious than the above. but even so. I think it is a matter of very serious concern
that it is possible to purchase in the City of London 50 consecutive samples of milk
and find that 1 in 4 of these milks is tuberculous.
A third series of 24 samples was taken. and again a high percentage of tuberculous
samples was reported. Of the 24 samples submitted. three were shown to
contain tubercle bacilli. This represents a percentage of 125 and is considerably
lower than the results obtained in the two previous series. though the proportion is
still far too high.
The infected milks were despatched to London from the following areas:—
Sudbury. Lavenham. Chelmsford. Walton.on.Naze. Diss. Tivetshall. Spooner Row.
Tolleshunt Darcy. Foulsham. Capel. Gunton. Thorpe-le.Soken and Yarmouth.
The results of the bacteriological examination have of course been followed up
by action at the farms at which the milk was produced. but I have before reported.
and must here repeat. that in my opinion little permanent improvement can be expected
until the responsibility of ensuring that milk is free from tubercle is made the
direct obligation of the farmer. As the matter at present stands it has to be proved
that the farmer is aware that "he sells or suffers to be sold or used for human
consumption the milk of a cow which is suffering from tuberculosis of the udder."
The difficulty of proving "knowledge" is obvious and I am satisfied that the
obligation should rest on the farmer to ensure the milk he supplies to the public is
free from infection and that it should not be necessary for any public body first to
discover—an expensive undertaking—that infected milk is being sold and then to
notify the farmer in order that suitable remedial measures may be adopted after
the dangerous milk has been consumed by the public.

Since 1904 continuous observation has been kept on the condition of milk arriving at the several railway termini in the City and the following summary sets out the percentage number of samples of milk which have been found to be infected with the tubercle bacillus during each year:—

19047.7 per cent.191310.4 per cent.
19059.1 „191410.2 „
19068.0 „19158.5 „
19078.3 „19174.2 „
1st series190912.5 „191914-8 „
2nd „ .4.7 „192124.2 „ 1st series.
19106.25 „26.3 „ 2nd „
19126.6 „12.5 „ 3rd „