THROAT ILLNESS AT LINCOLN AND BEDFORD 359 



8. In May 1902 an outbreak occurred at Lincoln, affecting a 

 large number of persons.^ Dr Brook had seventy-five cases in 

 his own practice. The chief symptoms were erythema of the face, 

 and sore throat In many cases a drab-coloured fur covered the 

 tonsils. A roseolous, papular eruption, in some cases appearing to 

 be urticarial, occurred in two-thirds of the cases. There was no 

 marked fever, except in cases having complications. The pulse 

 rate was not increased, and no albuminuria occurred. The onset 

 was sudden, and in no case out of the seventy-five investigated 

 by Dr Brook was infection communicated to others by contact. 

 Nearly all the patients were adults, and well advanced in years. 

 The complication most commonly met with was swelling and 

 tenderness of the cervical glands. With one doubtful exception, 

 all the patients had had milk from the same dairy. Boiling the 

 milk appeared to prevent persons from taking the complaint. 

 The poison seemed to be present particularly in the cream. The 

 differences between the disease and scarlet fever were very marked.- 

 Dr Klein isolated a special organism from swabs taken from the 

 throats of the patients. 



9. A sudden outbreak of a severe form of " septic sore throat " 

 occurred at Bedford at the end of June 1902. On 27th June, the first 

 case occurred ; on 29th June, 4 cases occurred ; 30th June, 15 cases 

 occurred ; ist July, 1 3 cases ; 2nd July, 3 cases ; 3rd July, 2 cases ; and 

 4th July to 8th July, 4 cases — making a total of 42 cases in 22 families. 

 The symptoms included redness, swelling of the throat, fauces, 

 palate, and uvula, with numerous spots, patches of exudation, and 

 in some cases ulcers. The general symptoms consisted of severe 

 headache, giddiness, backache, and pains in the limbs, v&ry much 

 like an attack of influenza. The temperature was about 102"- 

 103'' R, but in a few cases was higher. In some cases there was 

 gastric and intestinal disturbance. Great weakness was also 

 present. 



In every case the milk supply was obtained from the same 

 dairy. On Sunday, 30th June, many persons consumed cream 

 with fruit, and these included nearly all the worst cases. In 

 some families children who drank boiled milk escaped, whilst 



^ Report of Medical Officer of Health, Lincoln, 1902. 



2 Lancet, 1902, vol. ii., p. 1391. Dr Savill compares this outbreak with one 

 occurring in certain metropolitan infirmaries in 1891 {see Trans, of Medical 

 Society of London, 1892, vol. xv., pp. 103-129), and Mr Lunn states that a 

 disease of this kind has recurred every autumn for six years, with one years 

 intermission. He has seen several such outbreaks, and believes them to be due 

 to milk. 



