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4
November 19th I communicated with the dairyman who supplied milk
and asked for particulars and suggested that the milk supplied to this
particular District should be procured from another source pending
further enquiry, this suggestion was cordially agreed to, and information
was given that lead to later enquiries, in the meanwhile, the medical
officer of Health of an adjoining district was energetically carrying on a
close examination. On December 4th I visited and inspected the dairyfarm
where part of milk supplied to this District was drawn. I was
accompanied by the proprietor and Professor Axe, this visit mas made by
the permission of the owner, and every facility was afforded for examination
of the cows and men, and this action did not require the uses of
the Infectious Diseases Prevention Act, which is in force in your District
The farm and buildings were situate on high ground, the farm was not
of modern construction, the shed for cows had been recently constructed
and was built to accommodate between 30 and 40 cows, the ground had
recently been disturbed to lay drains. The cows drank water from a
trough supplied with water from wells, also from water in a shallow
pond, which at time of visit was dirty and foul. In the further corner
of the shed three cows had been isolated on account of the appearance on
the teats of papules which in two days had become vesicles the size of a sixpence
situated at base of teat, the surrounding vesicle was red when I
examined the cows the teats of two had two or three vesicles. From
the other cow the vesicles had disappeared and become pustules and in
one the sore was covered with a hard brown scab, which, when removed
showed an irregular ragged sore, bleeding excavated and the edges raised
and thickened, I was told these had been slightly raised papules two
days, before there were also to be seen cracks or chaps totally distinct
from vesicles. These cows had been purchased at Derby a fortnight
previously. The cows were not off feed, but the owner remarked he
thought they had a slight cold and cough. The milk obtained from these
cows the man had used in his own house with no illness following, in the
three children who drank the milk. It was discovered later that one
child had suffered from a sore throat, there was no evidence of illness
amongst the farm-servants or the cow-man who milked the cows and
whose hands were free from sores of any kind. I drew off a portion of
milk into a sterilized bottle, into another sterilized bottle was placed a
portion of scab, and into a third bottle some pus from base of ulcer was
placed, these bottles were carefully packed and delivered by hand to the
bacteriologist of St. Mary's Hospital, who, after cultivations and microscopical
examination, reported that "the milk was free from any growths
and practically sterile." Cultivations from scab and pus "showed a grey
growth on gelatine which under microscope did not show characters
of Diphtheria Bacillus, the Bacilli were square-ended instead of dumbbell
shaped."
The question to determine was whether this illness in the cows was
the cause of sore-throat illness and Diphtheria, that is, was it a similar
disease to that already described as being cause of epidemics of Milk
Diphtheria at Camberly Yorktown, Enfield and Croydon? The answer to
this question is that the Diphtheria bacillus could not be found either in