90 MILK AND THE PUBLIC HEALTH CH . v 



probable that a large proportion of such outbreaks are 

 unrecognised and unrecorded. It has been pointed out 

 that the part played by milk in the spread of scarlet 

 fever, diphtheria, etc., was for a long time unrecognised 

 or denied. It was not until the notification of these 

 diseases was uniformly enforced that the importance of milk 

 as a vehicle of infection was admitted and proved. If 

 sore throat and similar conditions were notifiable it cannot be 

 doubted, but that the number of known outbreaks of these 

 conditions would be greatly increased. The subject being 

 somewhat obscure and its importance underrated, a summary 

 of all the recorded outbreaks which the writer has been able 

 to trace is given in the addendum at the end of the present 

 chapter. While all or nearly all these outbreaks may 

 reasonably be said to have been spread by milk, in many 

 of them the means by which the milk became infected is 

 not proved. In some the source of infection was apparently 

 from a person brought in contact with the milk while suffering 

 from sore throat. In others the evidence points to the milk 

 having been infected from a cow or cows suffering from sores 

 on the teats, mastitis, or other septic conditions. The 

 possibility of cows so infected specifically infecting the milk 

 is fully discussed in Chapter VI. 



