128 THE MILK QUESTION 



able and many extra precautions are taken to insure its 

 cleanliness and purity. For twenty-eight years not a breath 

 of suspicion was attached to this milk until this catas- 

 trophe occurred. It emphasizes the lesson that raw milk 

 is apt to be dangerous milk, and our only protection 

 against these particular dangers is through pasteurization. 

 Other outbreaks of septic sore throat. As illustrations of 

 such outbreaks of sore throat, the three following cases are 

 taken from among those summarized by Swithinbank and 

 Newman.^ 



In Anglesey, in 1897, fifteen 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 mUk from the same 

 source, but in a boiled state, escaped the sore throat, the chief 

 evidence of which was tonsillitis. The bacteriological examination 

 of the milk revealed the presence of Streptococcus pyogenes and 

 Staphylococcus pyogenes, but no Bacterium diphtherice. Bacterio- 

 logical examination of the patients' throats yielded precisely sim- 

 ilar 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 symptoms 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 complications. The pulse 

 rate was not increased, and no albuminuria occurred. The onset 

 was sudden, and in no case out of 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 excep- 

 tion, 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. 



A sudden outbreak of a severe form of "septic sore throat" 

 1 Bacteriology of MUk. 



