Relation of Disease- Bacteria to Milk. 97 



milk. The outbreaks at Brandon, 1 England, in 1893, Cas- 

 tle Island, 2 Ireland, and Marlboro, 3 Mass., in 1894, were 

 traced to such an origin. 



While most outbreaks of disease associated with a pol- 

 luted milk supply originate in the use of the milk itself, 

 yet infected milk may serve to cause disease even when 

 used in other ways. Several outbreaks of typhoid fever 

 have been traced to the use of ice cream where there were 

 strong reasons for believing that the milk used in the man- 

 ufacture of the product was polluted. 4 Hankin 5 details a 

 case of an Indian confection made largely from milk that 

 caused a typhoid outbreak in a British regiment. 



Although the evidence that milk may not infrequently 

 serve as an agent in spreading disease is conclusive enough 

 to satisfactorily prove the proposition, yet it should be borne 

 in mind that the organism of any specific disease in ques- 

 tion has rarely ever been found. The reasons for this are 

 quite the same as those that govern the situation in the 

 case of polluted waters, except that the difficulties of the 

 problem are much greater in the case of milk than with 

 water. The inability to readily separate the typhoid germ, 

 for instance, from thetiolon bacillus, an organism frequently 

 found in milk, presents technical difficulties not easily over- 

 come. The most potent reason of failure to find disease 

 bacteria is the fact that infection in any case must occur 

 sometime previous to the appearance of the outbreak. Not 

 only is there the usual period of incubation, but it rarely 

 happens that an outbreak is investigated until a number of 



1 Welphy, London Lancet, 1804, 2:1085. 



2 Brit. Med. Journ., 1894, 1:815. 



3 Mass. Bd. Health Kept., 1894, p. 765. 



4 Turner, London Practitioner, 1892, 49:141; Munro, Brit. Med. Journ., 1894, 2:829.. 

 Hankin, Brit. Med. Journ., 1894, 2:613. 



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