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abdomen and other parts of the body. Bovine tuberculosis is almost
entirely spread by infected milk, and poses a different type of
problem. The immediate solution to the problem is almost universally
held to lie in the pasteurisation of milk supplies, particularly
the milk supplies of towns and cities. Until we can be quite certain
that the bacillus tuberculosis, which still finds its way into certain
milk supplies, has been rendered harmless, the danger of bovine
tuberculosis will remain. It is a particularly tragic corollary to
present-day conditions that the availability of pasteurising plant is
wholly unsatisfactory, and that the essential pasteurisation of milk
is being held up by lack of such plant. This is surely a problem of
sufficient magnitude to demand the attention of those responsible for
ensuring a clean, safe milk supply for our child population, particularly
when the increase in the consumption of milk, brought about
very largely by the milk-in-the-schools scheme, is taken into consideration.
We know beyond all reasonable doubt that the provision
of a safe milk supply for children will have a very definite and
beneficial effect on the incidence of bovine tuberculosis. This
knowledge should be used to the fullest possible extent, since the
problem is one amongst few which holds out every prospect of adequate
solution.
Immunisation.—1947 saw a great stride forward in our
campaign of immunisation, not only against diphtheria but against
pertussis, a disease which still holds many terrors for the anxious
parent. In January, 1947, we invited parents to have their children
immunised against pertussis alone or against diphtheria and pertussis
combined, additions to the facilities previously available for
immunisation against diphtheria. This step was not taken without
careful consideration and a detailed survey of available information,
both in this country and in the United States. We had to be sure
that the antigen was satisfactory, that there were no undue risks of
untoward effects, and that the fact that full protection could not be
guaranteed against pertussis would not prejudice the more important
scheme for immunisation against diphtheria. Having satisfied ourselves
on these points we embarked upon the scheme, not as an
experiment but as a means of providing practical protection against
two serious diseases. The results have so far been very satisfactory.
During the year, 994 children were immunised against diphtheria,
either alone or in conjunction with pertussis; while 1,207 children
were immunised against pertussis, either alone or in conjunction
with diphtheria. The total number of visits paid to local immunisation
clinics during the period under review was 6,368 one of the
highest figures yet recorded for any year. In addition to the above,
1,379 reinforcing injections against diphtheria were given, mainly
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