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was obtained was carefully scrutinised as to the state of health of
the cows and of the employes, but no fact was elicited to explain the
occurrence.*
As bearing on this subject, I may remark that it is not very long
ago that a number of cases of sore throat, occurring in families
supplied from a certain dairy, were brought under my notice; and
I ascertained that illness of a similar character had prevailed in
the house of the dairyman.
Referring to this subject, Professor Parkes, in his " Practical
Hygiene," states that scarlet fever has appeared to get into milk
from the cuticle or throat discharges of persons affected with
scarlet fever who were employed in the dairy while ill or convalescent.
Remarkable cases of this kind have already been
reported, and the fact that another zymotic disease—viz., enteric
or typhoid fever—has been spread widely through the medium of
milk, only serves to increase the importance of the subject in a
sanitary point of view. It is well ascertained, however, that
enteric fever has been conveyed in the foul water used in diluting
milk—a double evil being thus inflicted on unwary purchasers.
At about the same time as the scarlatina outbreak my attention
was again directed to milk as a probable source of disease by a leading
practitioner, who gave me the particulars of a very interesting
series of cases of dysentery, attributed on apparently sufficient
grounds to the use of milk from diseased cows; and of a further
series of cases of diarrhsea, attributed to some change in the character
of milk supposed to depend on the food on which the cows
were being fed. The information came too late to admit of an investigation
of the subject, but the facts deserve to be put on record
for future guidance.
In the first set of cases, seven in number, the symptoms were
generally of a severe character. Three of the patients were young
children, and the other four adults. The child first attacked, aged
2½ years, died after seventeen days' illness. The dysenteric symptoms
were sharp and constant, and marked the first evening by
a strong convulsion. The little patient sank, worn out by incessant
tenesmus and exhausted brain.power. The body temperature was
* P.S.—(August.)—It may be mentioned that no new facts came out subsequently
either to strengthen or to weaken the suspicion above stated of milk being the
carrier of the scarlatinal poison—beyond this, that there were several cases of the
disease in another parish in which the dairy is situated, and in families supplied from
the dairy. It may be added that the Kensington cases, which were remarkable for the
suddenness with which the attack followed on the application of the supposed cause,
all did well. They ran the usual course, and were followed by very free desquamation.
There were no derivative cases. A similar outbreak was reported subsequently
also within a few days after a dinner party at West Brompton. In this case, however,
so far as I can gather—for I received little direct information on the subject—though
the idea of a common cause of disease, as in the previous outbreak, was suggested,
absolutely nothing could be traced to support the suspicion of milk.poisoning, for the
dairy—several miles from Town—was found to be in an unimpeachable condition,
and no sickness was discovered in the employes or their families, or at the London
depot. A very small quantity of cream appealed to have been consumed, the actual
supply on the day in question being one shilling's worth. For the present the bare
facts of these cases can be simply stored for future use; and with the inferences
which have been Bought to be drawn from them must be taken quantum valeant.