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APPENDIX 



FURTHER REMARKS ON THE COMMUNICATION OF 

 SCARLET FEVER FROM MILK TO HUMAN BEINGS. 



In the Times of April 22Dd appears a leading article, of which 

 we here append an abstract : — 



The report of the Medical Officer of the Local Government Board for the year 

 1887 contains the results of further investigations concerning the nature of the 

 disease in cows to which outbreaks of human scarlet fever have been attributed. 

 Until two or three years ago, it was thought that the power of milk to spread 

 the disease was due to its having been contaminated from human sources, 

 especially by the agency of persons who were themselves suffering or convale- 

 scent from scarlet fever, and who, nevertheless, were engaged in the work of 

 distribution. 



However, in the case of a milk epidemic which occurred at Hendon, in 1885 

 to 1886, and in which the hypothesis that the carriers might be sources of infec- 

 tion could be definitely set aside, the cows which yielded the incriminated milk 

 were found to be the subjects of an eruptive disease of a contagious character. 

 The introduction of this disease could be clearly traced to certain new arrivals, 

 and the milk of the diseased animals was that which had been consumed by the 

 human victims of the epidemic. 



Accordingly, it was ordered that the milk yielded by these animals should be 

 thrown away ; but it appears that the men employed in the dairy thought this 

 proceeding wasteful, disobeyed their orders, and gave the milk to some poor 

 families. The result was that the children of these families were affected with 

 scarlet fever in an aggravated form. 



This kind of evidence having been thoroughly sifted by Mr. Power, the 

 further investigation of the subject was committed to Dr. Klein, who obtained 

 certain micrococci from the milk and tissues of the diseased animals, and culti- 

 vated them on suitable media, and conducted inoculation experiments upon 

 animals with the cultures and sub-cultures thus obtained. 



In August 1887, the Medical Officer of the Local Government Board was able 

 to sum up the results of the investigation, by saying that the disease, whether 

 in man or cow, was characterised by closely similar anatomical features ; that 

 from the diseased tissues and organs, of man and cow alike, the same micrococcus 

 could be separated, and artificial sub-cultures be made from it ; and that these 

 sub-cultures, no matter whether from man or cow, possessed the property, when 

 inoculated into calves, of producing in them every manifestation of the Hendon 

 disease, except sore teats and udders ; this exception being probably due to the 

 fact that the milk-apparatus in calves is still undeveloped. The practical 



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