DISEASES CAUSED BY INFECTED MILK 125 



other indications of a virulent infection. The Klebs-Loffler 

 bacillus was absent. Cultures showed almost the constant 

 presence of streptococci, also staphylococci and pneumo- 

 cocci. In addition to the difficulty in swallowing and other 

 local symptoms, the patients had a sharp febrile reac- 

 tion, prostration, and sometimes delirium. The duration of 

 the disease was prolonged and complications occurred in 

 about one quarter of the cases. These consisted mostly of 

 enlarged regional ly mphnodes which frequently suppurated, 

 abscesses, arthritis, endocarditis, peritonitis, erysipelas, 

 pneumonia, and other sequela indicating the invasion of 

 the blood with a virulent strep toccus. 



The unusual clinical features of this epidemic disease 

 were its extraordinary virulence, the comparative immun- 

 ity of children, the high mortality among the aged and in- 

 firm. 



The disease in question, so far as any abnormal epidemic 

 prevalence was concerned, was confined to two definite 

 foci centring respectively (1) about Boston on the seacoast 

 and (2) about Marlboro, twenty-five miles to the west- 

 ward. The Boston epidemic affected the Back Bay prin- 

 cipally, the neighboring town of Brookline and the ad- 

 joining city of Cambridge. 



The outbreak which centred about Marlboro preceded 

 the Boston outbreak by a month or six weeks. There were 

 at least 392 cases in the towns of Hudson, Marlboro, and 

 Southboro. These towns did not suffer with a sudden ex- 

 plosive outbreak of the disease such as occurred in Boston. 

 Instead, the disease simply prevailed in prosodemic fash- 

 ion with fairly even distribution over a period of about five 

 weeks. In addition to this prosodemic prevalence, Marl- 

 boro and Southboro had a superadded outbreak, simul- 

 taneous with that in Boston, during the second and third 

 weeks of May, including ^,n epidemic of sixty-four cases in 

 two boys' boarding-schools supplied with Deerfoot milk. 



The Deerfoot Farms receive their milk supplies from 



