92 MILK AND THE PUBLIC HEALTH chap. 



remaining twenty-three affected streets, out of eighty-six houses 

 supplied by this milkman fifty-one were invaded by the disease. 

 The number of persons attacked in each house stricken averaged 

 2 '5 per house. The "nursery," or other special milk, supplied by 

 the same milkman was not a cause of infection. The milk was 

 obtained from four farms. On one of the farms it was found that 

 foot-and-mouth disease had broken out on January 14, and that 

 milk from some of the affected cows was delivered to the Dover 

 dairyman and distributed, after mixing with the other milk, to his 

 customers. Strong confirmatory evidence of the relationship of the 

 conditions found on this farm to the outbreak was obtained from 

 the fact that on two separate occasions the farmer sold his milk 

 and cream to another purveyor, amongst whose customers a second 

 simultaneous outbreak occurred. No information given as to illness 

 amongst the milkers. 



(4) Ckaigmore [4], 1890. — The number of cases which came 

 under medical treatment was about 80. In March and April 

 1890. Symptoms were those of marked inflammatory hyperaemia 

 and swelling of the throat, enlargement of the submaxillary glands 

 and glands of the neck, with high fever and marked constitutional 

 disturbance. Some of the cases were complicated with erysipelas. 

 Three deaths occurred, all children. The evidence showed that the 

 outbreak was spread by the milk from a particular farm. The 

 period of incubation was usually three to four days, but occasionally 

 two days. In some cases the definite onset of the disease after 

 consuming the milk was very striking. For example, a Glasgow 

 family went to Craigmore from Glasgow on March 28, and started 

 using the milk. On April 1 all the members of the family were 

 attacked, including the older children who had returned on March 

 31 to Glasgow to school, except two members who remained in 

 Glasgow and did not drink the milk. The milk supply was 

 stopped on April 2, and the cases seem to have ceased almost 

 at once. The outbreak commenced about March 17, but the farm 

 was not visited until April 3. The medical officer of health 

 was told there was no illness among the people or the cows. On 

 further questioning, it was elicited that one of the dairymaids had 

 had a sore throat for a few days, but it was so slight that she had 

 been away from work for only half a day (March 17), this being 

 the same day that the outbreak began in at least three families. 

 On April 4, two days after the milk was stopped, erysipelas appeared 

 on the face of the farmer. A veterinary surgeon examined all the 

 cows and gave a certificate that they were in perfect health and 

 condition. It is not clear if he was engaged by the farmer or on 

 behalf of the local authority. The milkmaid was suggested as the 

 cause of the infection of the milk. Apparently no bacteriological 

 investigations were carried out. A cat and a dog belonging to one 



