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abscesses, cellulitis and neuralgia; and it was repeatedly
observed by medical practitioners that after apparent
improvement in the patient's condition there was a
recrudescence of fever and gland enlargement. In a few
cases a measly eruption on the lower limbs was observed.
Some of the cases were comparatively mild, others very
severe, but only one death occurred.
In a few cases the symptoms were nothing more than a
simple sore throat, and in one or two instances it was certainly
impossible to distinguish the condition from Mumps. I do
not intend to imply necessarily that there was specific cynanche
parotidis in these latter cases, but there was certainly a
swelling of the facial extension of the parotid gland in one or
more of them.
As the result of my enquiries I quickly came to the conclusion
that milk was the agency by which the bulk, at any
rate, of the infection was being disseminated.
In dealing with the number of cases it is not necessary to
divide them into primary and secondary cases for the purpose
of arriving at an estimate of the magnitude of the actual
milk-borne infection, because although personal infection from
case to case undoubtedly occurred, the condition cannot be
regarded as having given rise to much secondary infection.
The nature of the infection in the milk is an extremely
difficult thing to determine. There is very little doubt that
it is due to a living organism, but the circumstance that cases
were reported to me in which the infection took place after
the milk had been boiled appears to indicate that the products
of the organism were also capable of producing the condition.