SEPTIC SORE THROAT 119 



In Anglesey, in 1897, 15 people who took milk of one 

 dairy, became affected at about the same time with sore 

 throat. Several persons in the affected families who 

 consumed milk from the same source but in a boiled state 

 escaped the sore throat, the chief evidence of which was 

 tonsilitis. The bacteriological examination of the milk 

 revealed the presence of Streptococcus pyogenes and 

 Staphylo coccus pyogenes, but no Bacterium diphtheria. 

 Bacteriological examination of the patients' throats 

 yielded precisely similar results. 



" In May, 1902, an outbreak occurred in Lincoln, 

 affecting a large number of persons. Dr. Brook had 

 seventy-five cases in his own practice. The chief symp- 

 toms were erythema of the face, and sore throat. In 

 many cases a drab colored 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 complica- 

 tions. The pulse rate was not increased, and no albu- 

 minuria 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 of 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. 



4 ' 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; 1st 



