MILK-BORNE DIPHTHERIA 211 



adjoining the cow yards, with the object of keeping the milk cool. 

 The water in this was polluted, and it was found that four of nine 

 milk-cans leaked when inverted. Hence it became evident that 

 water could gain access if the cans were submerged as they had 

 been. The investigators suggest that as the typhoid excreta of the 

 patient were placed, undisinfected, in the privy, and the contents of 

 the latter spread over the tobacco field, the germs of typhoid may 

 have gained access to the well by dirt from the labourers' boots, who 

 both worked in the field and at the milk. Coliform organisms were 

 found in the well water.* 



Milk-borne Diphtheria 



Milk is a favourable medium for the B. diphtherice. The organism 

 both lives and multiplies in ordinary sterilised milk, but it thrives 

 better in milk at comparatively low temperatures than at 37 C. In 

 ordinary milk, unsterilised and unprepared, the commoner organisms 

 multiply much more rapidly, and so the diphtheria bacillus is in 

 all probability soon crowded out. 



The cases, however, in which the B. diphtherice has been actually 

 isolated from market milk are extremely few. In the outbreak of 

 diphtheria at Senghenydd in South Wales, in 1899, Bowhillf 

 isolated a diphtheria bacillus from the suspected milk. The culture 

 of the bacillus in broth proved fatal to a guinea-pig in two days. 

 In the same year, EyreJ isolated a virulent diphtheria bacillus 

 from some milk implicated in an outbreak of diphtheria in a 

 school. In 1900, Klein also reported the isolation of a genuine 

 diphtheria bacillus in an examination of 100 samples of milk in 

 London. Lastly, Dean and Todd, isolated the B. diphtherice from cow's 

 milk in 1901.11 These are the only four authentic cases of actual 

 detection of the B. diphtherice in ordinary milk with which we have 

 met. 



There is a question which must now be considered, viz. : the 

 relationship existing between diphtheria in man and animals and the 

 milk supply. How does the milk become infected ? 



(1) In the first place, it is now generally held that the B. 

 diphtherice has a comparatively wide distribution in nature ; whilst 

 it appears not to be conveyed by water, it is believed that certain 

 conditions of soil favour its growth as a saprophyte. But this is 

 not proved. (2) In the second place, it has been proved that persons 



* Boston Med. and Surg. Jour., 1893, ii., p. 485 (Sedgwick and Chapin). 

 t Veterinary Record, 8th April 1899, No. 561. Jour, of Stale Medicine, 1899, 

 pp. 705-710. 



J Brit. Med. Jour., 1899, vol. ii., p. 586. 

 Jour, of Hygiene, 1901, vol. i., p. 85. 

 || Ibid., 1902, vol. ii., pp. 194-205. 



