220 BACTERIA IN MILK AND MILK PRODUCTS 



deal of the milk became very ill with " severe inflammation of the 

 throat." * 



In 1892 there was an extensive outbreak of sore throat in Upper 

 Clapton. Dr King Warry, describing the symptoms in the 

 Practitioner, at the time held that the pathological condition was 

 scarlet fever in a mild form. His reasons for this view were three : 



(a) scarlet fever attacked one member of a family, and the sore 

 throat disease other members who had previously had scarlet fever ; 



(b) both scarlet fever and sore throat patients were isolated together, 

 but those suffering from sore throats did not contract the scarlet 

 fever ; and (c) some of the patients suffering from sore throat had 

 at the same time certain symptoms simulating scarlet fever, such 

 as desquamation of the skin, kidney disease, and rheumatic symptoms. 

 With this view of the specificity of throat illness under similar 

 circumstances Dr Parsons agrees.f In the Upton and Macclesfield 

 scarlet-fever outbreak of 1889, there were 40 cases of sore throat 

 which were apparently related to scarlet fever for the following 

 reasons: (a) The sore throat occurred in older persons in whom 

 rashes are less prone to occur, and who had had scarlet fever ; (b) 

 in some cases there was skin desquamation ; (c) when the children 

 suffered from scarlet fever the adults in the same house suffered 

 from sore throat; (d) two cases of diphtheria at the same period 

 showed symptoms simulating scarlet fever; and (e) pyrexia and 

 delirium were present in the worst cases. 



Two comparatively small milk-borne outbreaks of "follicular 

 tonsillitis" were reported in 1897, one in Anglesey}: (15 cases), and 

 the other at Surbiton (30 cases). The milk was bacteriologically 

 examined, and StapJiylococcus pyogenes and Streptococcus pyogenes were 

 found, but no B. diphtheria. Bacteriological examinations of the 

 patients' throats yielded precisely similar results. 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. 



In April and May 1900 an outbreak of septic sore throat occurred 

 in North Hackney affecting 151 persons in eighty-eight households, 

 85 per cent, of which were supplied by one milkman. 



A sore-throat outbreak at Brighton in November 1901 was 

 investigated by Dr Newsholme. Out of a total of 29 persons in a 

 private girls' school, 18 were affected. The chief symptoms were 

 high temperature, rapid pulse, tonsillitis with fibrinous exudation 

 locally except on the soft palate. In two cases there was an 

 evanescent rash. Dr Newsholme was able, after minute inquiry, to 



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



f Report to Local Government Board, 1889. 



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



Annual Report of Medical Officer of Health, 1897 (Dr Coleman). 



