THROAT ILLNESS AT CRAIGMORE AND IN ANGLESEY 355 



On one of these latter apthous fever had broken out, and it was 

 from this farm that the dairyman obtained his impHcated milk 

 and cream. Moreover, when the supply from this farm was 

 diverted temporarily it set up a simultaneous second outbreak of 

 sore throat elsewhere.^ 



4. In 1890 there occurred an epidemic of sore throat at Craig- 

 more which was referred to milk infection. The number of cases 

 was 80. The disease manifested itself chiefly in the form of severe 

 sore throat, but in a number of the cases erysipelas developed in 

 addition. The milk appears to have been infected by two milk- 

 maids who were suffering from sore throat. Those attacked most 

 severely had drunk most of the implicated milk. The period of 

 incubation was three or four days. The disease was chiefly confined 

 to the mouth and throat ; in most of the cases there was high fever, 

 general constitutional disturbance, rigors, vomiting, and muscular 

 pains. The disease was differentiated from either diphtheria or 

 scarlet fever. A dog and cat which had a good deal of the milk 

 became very ill with "severe inflammation of the throat"* 



5. Two comparatively small milk-borne outbreaks of "follicular 

 tonsillitis" were reported in 1897, one in Anglesey^ and the 

 other at Surbiton.* In the Anglesey outbreak the total number of 

 cases was 15, and there were no deaths. They all partook of a 

 common milk supply implicating one dair>\ Several persons and 

 children in the affected families who consumed the same milk as 

 the patients, but in a boiled state, escaped the tonsillitis. All the 

 patients had the same milk supply. The milk was bacteriologically 

 examined, and Staplylococcus pyogenes and Streptococcus pyogenes 

 were found, but no B. diphtJiericE. Bacteriological examinations of 

 the patients' throats yielded precisely similar results. The total 

 number of cases at Surbiton was 30, and the milk supply was 

 derived from one milkman. A man whose business it was to 

 milk the cows was found to be out of health, with well-marked 

 tonsillitis, and suppurating whitlows on both hands. Dr Coleman 

 was able to trace more than 30 cases, some very severe, and he 

 assumed that in all probability there were others. No other cause 

 except milk was traceable. 



6. Outbreak at Hackney, 1900. — In April and May 1900, an 

 outbreak of septic sore throat occurred in North Hackney. The 



1 Practitioner^ 1884, vol. i., p. 467 (Dr M. K, Robertson). 



- Glasgow Med. Jour. ^ 1890, vol. xxxiv., pp. 241-258. 



3 Brit. Med.Jour.^ 1897, vol. ii., p. 339 (Dr C. Grey-Edwards of Beaumauris). . 



-» Annual Report of Medical Officer of Healthy 1897 (Dr. Coleman). 



