SCARLET FEVER 115 



It is certainly very difficult to prove the presence of 

 diphtheria bacilli in market milk because even if the 

 milk has been the cause of the epidemic, they are pres- 

 ent in only very small quantity and, usually, but for a 

 limited time. If one wishes to experiment in this direc- 

 tion the best method of proceeding is to make a culture 

 on blood serum (Loffler's) in a manner similar to that 

 employed in the examination of the throat of a diph- 

 theritic patient. If the culture tubes are brought to 

 body heat for 24 hours, the conditions will be more 

 favorable for the increase of the diphtheria bacilli 

 than for the greater number of milk bacteria. One 

 must then make a careful study of the colonies that have 

 developed. 



c. Scarlet fever. Reports of scarlet fever epidemics 

 that are presumably to be attributed to the spread of 

 infection through the milk, come chiefly from England 

 and America. The infectious material must come from 

 affected persons and may enter the milk directly through 

 their contact with it when it is being drawn, in the sales- 

 places, etc., or it may reach the milk in an indirect way. 

 Since the organism of this disease is unknown, it is diffi- 

 cult to form a well founded opinion concerning these 

 possibilities, and one cannot ascertain whether there is 

 an increase of the infectious material in milk. 



About 18 years ago some scarlet fever epidemics 

 aroused great attention in England because it was 

 thought that, without doubt, they could be traced to an 

 infection through milk and to a peculiar new eruptive 

 disease upon the teats and udders of cows. From the 

 evidence that is now available, one is justified in regard- 

 ing it as established that the outbreaks of scarlet fever 

 referred to had no relation to the disease of cows, 

 which was in reality only a somewhat unusual form of 

 cow pox. 



