1887.] on Etiology of Scarlet Fever. 153 



liad been suffering from some ailment, seemingly from the time of 

 lier calving, of which loss of hair in patches was the most conspicuous 

 manifestation ; the other that there existed no discoverable means by 

 w^hich the milk which had coincided with scarlatina in its distribu- 

 tion could have received infective quality from the human subject." * 

 The Medical Department of the Local Government Board have from 

 these facts drawn the conclusion that " distrust must be placed on the 

 universally accepted explanation that milk receives infective properties 

 directly by human agencies," and further that " the question of risk 

 from specific fouling of milk by particular cows suffering, whether 

 recognised or not, from specific disease was seen to be arising." 

 This view received striking confirmation and proof by a report of an 

 outbreak of scarlet fever that occurred at the end of 1885 and the 

 beginning of 1886 in the north of London, which was investigated by 

 Mr. Power. His report is published in extenso in the Rej)ort of the 

 Medical Officer of the Local Government Board for 1886; and I will 

 here give you the substance of it. Mr. Wynter Blyth, Medical 

 Officer of Health for Marylebone, had last December observed a 

 sudden outbreak of scarlatina in his district to be associated with the 

 distribution of milk coming from a farm at Hendon, and had found 

 reas(m for believing that the disease had prevailed exclusively among 

 customers furnished with milk from that source. Mr. Power, on a 

 more extended inquiry, found that a similar prevalence of scarlatina 

 had occurred about the same time in other parishes in and near the 

 metropolis that were furnished with ;cQilk from the same farm. By 

 careful inquiry Mr. Power could with certainty exclude any contami- 

 nation of the milk from a human source, or that anything of the kind 

 known as " sanitary " conditions could have had any concern with the 

 infectivity of the milk. Mr. Power showed conclusively that only 

 certain sections of the milk supplies of this farm, and finally only 

 certain cows from which these sections of milk were derived, had any 

 relation to the observed results, " In the end," says the Medical 

 Officer, " he has demonstrated, beyond reasonable doubt, the depen- 

 dence of the milk-scarlatina of December on a diseased condition of 

 certain milch cows at the farm, a condition first introduced there in 

 the i^revious month by some animals newly arrived from Derbyshire ; 

 and he finds strong circumstantial evidence for believing that the 

 latter phenomena of this dependence were brought about through the 

 extension of the diseased condition of one set of animals to another 

 set, after the fashion of an infection." Now, this disease as it pre- 

 sented itself in some of these Hendon cows consisted in the presence 

 of sores and scurfiness in different parts of the skin with loss of hair 

 in patclies, ulcerations on the udder and teats, and a visceral disease, 

 notably of the lungs, liver, kidney, and spleen, which, although milder 

 in character, very much resembled the visceral lesions occurring in 

 cases of human scarlet fever. By experiment it was shown that tho 



* Medi(.al Officer's Report for 1885-86, pp. v. aud vi. 



