V ACUTE INFECTIOUS DISEASES 97 



presence of streptococci in the milk, and Gordon isolated a 

 streptococcus of the pyogenes type virulent to mice. It is prob- 

 able that the farmer was the original cause of the outbreak, but 

 as infection continued over six weeks, and the farmer could 

 only have infected the milk on one or two occasions at the most, 

 some continuously acting source of infection must have been 

 present. If we assume that this continuous source of infection 

 was the diseased cows, and that they were infected from the 

 farmer, as Pierce suggests, the course of the outlareak is easily 

 explained. 



(14) FiNCHLEY [14], 1904 (reported by Professor H. Kenwood). 

 — An extensive outbreak, lasting from January 16 to January 30 

 and involving some 550 persons. The symptoms were those of 

 sore throat with enlargement of the submaxillary glands, and 

 marked malaise. Considerable temperature in most cases, with 

 much prostration. In one or two cases quinsy was present, while 

 septic conditions, such as gland abscesses and cellulitis, were met 

 with as complications. Kenwood came to the conclusion that the 

 outbreak was spread by milk. The cases occurred almost ex- 

 clusively amongst the customers of a particular milk supply, but 

 exact particulars are not furnished. He also satisfied himself that 

 " the employes of the infected supply had not been spreading the 

 complaint by reason of any one of them suffering from a bad sore 

 throat at the period when the outbreak occurred." The precautions 

 taken for the safe storage and delivery of the milk were quite 

 satisfactory. In regard to the cows, a veterinary examination of 

 every cow was made, and " the veterinary expert reported that all 

 the animals were in a condition of perfect health, with the exception 

 of two cows which had contracted a chill ; the chill had affected 

 their udders, causing their milk to become curdled ; and that probably 

 these animals had been in this condition for several days prior to 

 his inspection on January 27. Both these cows were at once removed 

 from the herd." Kenwood gives it as his opinion that "the out- 

 break was in all probability due to the two cows which were 

 suffering from an obscure condition of ill-health towards the middle 

 of January," but he gives no reasons in the report for coming to 

 this decision other than those recorded above. The bacteriological 

 examination of numerous samples of milk were negative. French, 

 one of the medical men in practice at Finchley, gives one very 

 interesting item of information. He found that one of the cases, 

 complicated with severe facial erysipelas, was markedly improved 

 both as regards the erysipelas and the throat symptoms by the 

 use of antistreptococcus serum. He then tried the serum in other 

 cases, and although they were very intractable to the usual remedies, 

 without exception they all improved markedly, the temperature 

 falling to normal within twelve hours. Pus examined from the 



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