DISEASES OF THE COW 119 



to the effect that the earliest cases among this vendor's (i.e. vendor 

 A.) customers were not notified until June 18. Further inquiry, 

 however, was made into the matter, and the Medical Officer of 

 Health of the district concerned wrote as follows : ' The doctor 

 who notified nearly all the cases, on the 18th, says that he had 

 several cases of sore throat during the week previous, not followed 

 by rash and not notified. I have also notes of three similar cases 

 where other persons in the house subsequently developed scarlet 

 fever with rash.' The records of milk distributed show that 

 vendor A. received two churns of milk sent from farm X. on 

 June 7 ; possibly the anomalous character of the early cases 

 among his customers may justify the assumption that the milk 

 possessed on that date a modified infective property as compared 

 with that derived from the same source at a later date." No 

 further evidence is adduced that the sore throat without rash was 

 scarlet fever ; we do not know if these cases peeled or not, if they 

 suffered from any scarlet fever complications, or if they had pre- 

 viously suffered from that disease. In view of the great importance 

 of accurately determining the date at which the milk was first 

 infective, it is a singular omission not to furnish more details as to 

 these cases. The fact that the Medical Officer of Health has notes of 

 three similar cases in which other persons in the house developed 

 scarlet fever with rash is, of course, no evidence, since presumably 

 the milk was not stopped, and the latter cases might as reasonably 

 be direct infection from the milk as cases contracted from the sore 

 throat without rash cases. The first notification was apparently 

 only made on June 14. The only detailed statement as to cases 

 is in regard to those at Croydon, and in all of these the onset was 

 June 1 6 or later. 



The evidence given in the report as to dates of onset is not 

 sufficient to exclude G. L., the milker and carter, from being the 

 source of the mischief. 



In favour of the view that the carter-milker, G. L., was the 

 source of infection, we have the fact that he continued to milk cows 

 up to June 14, when the first case in his family was June 11, and 

 that the 14th of June was the day the milk was the most harmful. 

 The author of the able criticism in the Journal of Comparative 

 Pathology ^ supplies another reason for regarding G. L. as the source 

 of the infection. He says: "G. L. had nothing to do with the 

 mixing of the milk, and assuming that he was the sole cause of the 

 epidemic, the only milk infected as it left the farm would be in the 

 churns containing the milk of cows milked by him. As at most he 

 milked only two cows at each farmstead, the chances are greatly in 

 favour of the view that any milk supplied to the milker at farm- 



1 Editorial, Journ. of Comparative Piithohiijn and Therapeutics, xxii. , 1909, 

 p. 34.5. 



