SCARLET FEVER. 121 



the disease has made it hitherto impossible, by bacteriological 

 means, to trace this disease to its source in the dairy. It is 

 uncertain .whether the scarlet fever infectious material may 

 come directly from the cow or only from secondary external 

 sources. One or two instances have been recorded where 

 epidemics resembling scarlet fever have been traced with 

 considerable certainty to a peculiar udder infection occur- 

 ring in a dairy herd, and this had led to the conclusion 

 that scarlet fever is a disease that may attack cows, produc- 

 ing a mild infection in them, and then, through their milk, 

 may be distributed to the milk consumers (145). There is, 

 however, some uncertainty in regard to the matter. It has 

 been questioned whether the disease in the cases referred to 

 was true scarlet fever. It is, therefore, at present an unset- 

 tled question whether milk may be contaminated by the 

 primary source of the cow's udder. But it is beyond 

 question that secondary contamination is perfectly possible. 

 Scarlet fever is, at certain stages, a very contagious disease 

 and the infectious material is, beyond question, eliminated 

 from the body of the patient. Such persons, if they are 

 employed in a dairy in milking, in handling milk or milk 

 vessels, may undoubtedly cause an infection of the milk with 

 the specific agent of scarlet fever, and thus be a source from 

 which the disease may be distributed. 



As in the case of diphtheria, milk is not the common source 

 of scarlet fever. Most epidemics are distributed by direct 

 contagion of individual with individual. But it is always 

 well to remember, in trying to trace the source of scarlet 

 fever, that there have been at least thirty tolerably well- 

 authenticated instances of the distribution of this disease by 

 milk. 



Miscellaneous Diseases. It is only necessary to mention, 

 in a word, a few miscellaneous diseases which are occasion- 

 ally distributed by milk. Certain forms of throat infection 

 characterized by throat inflammation have been thus traced. 



