gg Effect of Internal Influences. 



The appearance of the milk showed nothing abnormal, but it coagulated on 

 boiling and showed a tremendous number of bacteria, especially streptococci, which 

 could not be distinguished from the Streptococcus pyogenes. 



The veterinary examination confirmed the suspicion that a pus-containing secre- 

 tion was being yielded by one cow. 



The milk from the cow with mastitis on the day in question was added to the 

 whole milk through the neglect of a newly hired attendant. 



2. Several hours after the drinking of raw milk five persons, and as found 

 later other cases also became affected with acute gastro-intestinal catarrh. In this 

 case a milk dealer was implicated, and it was found on inquiry that the milk con- 

 tained secretion from a cow affected with streptococcic mastitis. 



3. According to the observations of Johannesen two persons (mother and 

 child) became sick after the drinking of milk. The milk was thin, flaky, and contained 

 pus-like lumps. In the herd from which this milk originated two cows were found 

 to be affected with streptococeic mastitis. 



4. After the drinking of freshly drawn raw milk four children of the same 

 family became affected with acute gastro-intestinal catarrh. The milk appeared ap- 

 parently normal, but contained large quantities of streptococci. It originated in 

 a stable from which on the day in question a cow was sold on account of mastitis. The 

 milk from this cow appeared to have been mixed with the whole milk due to the 

 neglect of a new milker (the regular one being sick). 



The affections which occurred in Stockholm with symptoms of fever, dullness, 

 attacks of fainting, nausea, vomiting, diarrhea and cramps in the calf of the leg 

 (nine families being involved), cannot according to the obtainable reports, be de- 

 clared to be streptococcic infections. The milk, through the drinking of which the cases 

 could be traced, originated from a dairy of 14 cows, among which one cow had mas- 

 titis. It is possible that in this case an infection with bacteria of the paratyphus 

 group, which plays an important part in the development of acute mastitis, was con- 

 cerned. 



Further contributions to the casuistics of "milk- poisoning" were published by 

 Jakobsen and Weigmann and Gruber. 



II. In 1905, Jakobsen observed symptoms in several persons which he traced to 

 the drinking of milk from one stable. The symptoms were diarrhea, vomiting and 

 fever. Out of 17 persons, 10 who drank the milk became affected, while 7 who did 

 not take any remained well. On May 30, 1905, other persons became affected. 



The examination of the 32 cows of the dairy showed a streptococcic mastitis 

 in one animal. The cow was slaughtered and no further cases were reported. 



III. Edwards and Severn described an epidemic of follicular tonsilitis which de- 

 veloped from the drinking of milk. They found in the exudate of the throat, and in 

 the milk, in addition to other bacteria pyogenic streptococci which as shown by the in- 

 vestigation were also contained in the secretion of a cow affected with mastitis. 



[In various cities of the United States epidemics of sore throat 

 with swelling of the cervical lymph' glands, colic, diarrhea and 

 fever lasting several days have occurred which were traced to the 

 use of milk from cows affected with streptococcic mastitis. Such 

 milk when examined was found to contain pus and streptococci in 

 great abundance. Trans.] 



IV. Lameris and Harreveld observed an outbreak of diarrhea among the inmates 

 of a hospital after the drinking of boiled milk, which in part was obtained from cows 

 affected from streptococcic mastitis. 



Whether the authors of the last cases are correct in their view 

 that very likely a heat-resisting toxin brought on the disease, or 

 whether the streptococci might remain alive in the milk foam or 

 in the formed membrane, etc., as suspected by Jensen, it becomes 

 evident that boiling does not carry with it an assurance that the 

 danger from streptococcic milk is eliminated. If Jensen's sus- 

 picion is correct a proof would be offered that even the smallest 



