﻿IX. B, 6 Barber: Milk Poisoning 519 



In summary, the most noteworthy points of this paper are the 

 following : 



Acute attacks of gastroenteritis were produced in milk by a 

 toxin elaborated by a white staphylococcus which occurred in 

 almost pure culture in the udder of a cow. The fresh milk was 

 harmless, and the toxin was produced in effective quantities only 

 after the milk had stood some hours at room temperature. 



Repeated attacks of the illness had occurred among residents 

 and visitors at the farm during a period of three years, and 

 the cow was apparently in good health during this time, except 

 for one attack of garget, which occurred after the cases of gastro- 

 enteritis had begun. 



Persons who had used the milk continuously had apparently 

 developed some tolerance to the toxin. Two children of the 

 family had used the milk regularly, but never had attacks. The 

 adults had occasional light attacks or, in one or two cases, some 

 chronic intestinal trouble. In my own case, 4 acute attacks, 

 3 of them severe, afforded no protection against a subsequent 

 fifth dose. Visitors at the farm and Filipino employees who 

 used the milk less regularly showed most severe attacks. Since 

 the discontinuance of the use of raw milk from this cow, all 

 trouble has ceased. 



Culturally, the toxin-producing staphylococcus differed little 

 from a nontoxin-producing strain, except that the former pro- 

 duced acid in mannite and maltose litmus agars. 



Agglutination tests with the serum of a person who had 

 recently suffered 5 attacks and that of a person who had long 

 used the milk showed little, if any, positive result. 



In guinea pigs and monkeys the toxin-producing strain showed 

 more tendency to form abscesses than a yellow staphylococcus 

 from the same source. 



Cases of gastroenteritis occurring in the tropics and in the 

 warm season elsewhere may be due to a toxin of similar origin, 

 especially where fresh milk is not properly refrigerated before 

 use. This is the more probable since staphylococci of various 

 types commonly occur in the udders of apparently healthy cows. 



Addendum. — The cow which harbored the toxin-producing 

 Staphylococcus was sold to the College of Agriculture at Muiioz, 

 Nueva Ecija. A letter from the superintendent of the school, 

 Mr. Kilmer 0. Moe, dated January 6, 1915, states that the milk 

 of the cow is being used by the students at present. However, 

 it is used fresh and principally in coffee; no bad results have 

 followed its use. 



