DISEASES COMMUNICABLE IN MILK 63 



in an uncleanly manner thus affording opportunity for the milk to re- 

 ceive heavy fecal contamination. The diarrhea of infants may be due 

 to various causes ; it may be incited from improper food without definite 

 connection with bacteria but Kendall has pointed out that the acute 

 summer diarrheas that show " prostration and fever associated with 

 mucus, pus and sometimes even blood" in the movements may be caused 

 by various bacteria. He found that on the Boston Floating Hospital, in 

 "one year the dysentery bacillus was the dominant type met with; the sec- 

 ond year streptococci were conspicuous; the third summer was note- 

 worthy because of the great number of cases in which the gas bacillus was 

 the predominant organism encountered; while in the fourth summer an 

 entirely different organism, somewhat resembling B. mucosus, made its 

 appearance." This bacterial diarrhea is believed to be in part derived 

 from milk that shows high bacterial count, the tender gastro-intestinal 

 membrane being overwhelmed by mere numbers of the germs. Also, it 

 cannot be denied that there may be in the feces of healthy animals germs 

 which if they get into the milk may attain considerable development 

 therein and become noxious to consumers, particularly to babies. This 

 is believed to be the case at times with yeast cells and B. subtilis and 

 even with the common B. coli. The milk of scouring cows is thought by 

 some to be more likely than that of well ones to give trouble in this way 

 and in herds whose milk is used especially for infant feeding the milk of 

 such cows is withheld. Another organism, Bad. welchii which is often 

 called the gas bacillus and by English writers B. enteritidis sporogenes and 

 which is also known by other names, was found by Klein in the stools 

 of the victims of an outbreak of diarrhea and Andrewes studied three 

 outbreaks of a mild type which occurred in St. Bartholomew's Hospital, 

 London, England, in which this organism was present in the stools of the 

 patients and in the milk which was incriminated as the cause of the out- 

 break. In one of these epidemics 146 persons were taken ill in one night. 

 The pathogenic power of the organism is variable ; certain strains accord- 

 ing to Theobald Smith form toxins if they are grown in media con- 

 taining minimal amounts of sugar. In the vast majority of cases Bad. 

 welchii seems to be a saprophyte living upon the intestinal contents and 

 not a true invading organism. This microbe is an anaerobe and is 

 rather widely distributed in nature, occurring in dust, the excrement of 

 man, cows and the higher animals; in many samples of market milk and 

 in large numbers in sewage. It is not a normal inhabitant of the intesti- 

 nal tracts of nurslings. Kendall and Smith examined for Bad. welchii, 

 293 stools, some of which were normal and some were not. In 271 the 

 result was negative, showing that the organism is rare in the stools of 

 infants and young children. Eight of the stools showed the germs present 

 but not in quantity to warrant their being considered significant. This 

 result was not unexpected for the discharges of older children on a mixed 



