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The sputum is frothy and contains dull red streaks, later
it becomes yellow changing to yellowish green. Hemorrhage
may occur from any mucous membrane. The lungs are gradually
swamped with fluid, but even until the end there is no
precise localisation of the effusion. Profound oxygen-starvation
coupled with an intense toxaemia quickly leads to cardiac
syncope and the end.
Thirty fatal cases occurred in Harrow up to 31st December,
1918.
MILK SUPPLY.
The dairy farms and milkshops were inspected several
times during the year. The milkshops have been on the
whole kept fairly clean. The dairy farms are not clean
Cowsheds have been found anything but clean, and repeated
inspection has often found no improvement. The excuse has
always been "no hands to do the work."
Six complaints were made during the year of dirty milk
I had samples taken from the dairies named in the complaints
and examined them bacteriologically and microscopically:
two were found to be filthy. No legal action could be taken
as in this country there are no standards of cleanliness.
America possesses and acts on such standards: one can get
clean milk in the State of New York but not in the County of
Middlesex. One sample contained 21,000,000 bacteria per
cubic centimetre, growing at 37°c.
I tested 29 samples for the tubercle bacillus by animal
innoculation : all were negative.
FOODSTUFFS.
I analysed for the Food Committee the following:
1 Sample of dripping Result.—Genuine
3 Samples of margarine „ All rancid.
1 Chocolate ,, Genuine.
1 Milk „ Fair.
1 Loaf ,, Good
2 Jams ,, 1 good 1
bad, but no metallic or other ingredient
was discovered to account for the bitter
taste.
The water supply continued as in previous years.