PREVENTIVE MEDICINE 239 



at the outset a period of weeks in which the lesion cannot be detected 

 by clinical examination, and, furthermore, during this period there 

 is no appreciable alteration in the character of the milk though 

 this contains tubercle bacilli. The second most dangerous animal 

 as regards human health is the milch cow affected with advanced 

 tuberculosis of the lungs, firstly, because at any moment the disease 

 may actually spread to the udder tissue, and secondly, because 

 tubercle bacilli may be accidentally added to the milk through the 

 medium of faeces which are likely to be heavily charged with bacilli. 

 The Tuberculosis Order of 1913 has done a good deal to diminish 

 the danger inasmuch as it requires compulsory notification and 

 slaughter of cases of (1) tuberculosis of the udder; (2) tuberculosis 

 with emaciation. Experience of one year's working of this Order 

 has unfortunately shown, however, that probably 3 cases out of 4 

 of clinical tuberculosis have not been reported and this has prob- 

 ably been due for the most part to deliberate concealment of the 

 disease by owners. The working of the Order would undoubtedly 

 be made much more efficient if it insisted upon a periodical 

 veterinary inspection of milch cows. Such inspections, which in 

 most cases could not extend beyond clinical examination of herds, 

 would unfortunately have to be rather frequent, with an inevitable 

 rise in the price of milk. Veterinary inspections would have to be 

 made at intervals of not less than a month, since it is well known 

 that within a period of about three months a cow may pass from 

 a state of apparent health to a dangerous state of the disease. In 

 any case magistrates should be instructed to inflict very heavy 

 penalties upon owners who have wilfully concealed cases of 

 obviously advanced tuberculosis. 



Bovine tuberculosis causes very appreciable losses among the 

 infantile population of Great Britain, and in a large proportion of 

 these cases infection is introduced through the medium of cows' 

 milk containing tubercle bacilli. As would be supposed, it is 

 especially young children which furnish the largest number of such 

 cases. Thus Delepine in Manchester reported that between 1891 

 and 1900, of children under five years of age dying from tuber- 

 culosis in all forms to the number of 3930, 3517 were infected with 

 tuberculosis other than phthisis. Furthermore, of 1936 cases 

 occurring in persons from twenty to twenty-five years of age, only 

 206 were affected with tuberculosis other than phthisis. More 

 recent reports* on this subject have been made to the Local Govern- 

 ment Board by Eastwood and Griffith, who found that of 150 

 children dying from all causes between the ages of two and ten 

 * Journ. Comp. Path., 1914, Vol. XXVII., p. 80, Abs. 



