310. APPENDIX I 



handle the milk while suffering themselves from the 

 disease. In 12 instances the disease is attributed di- 

 rectly to the cows having inflammatory conditions of the 

 teats and udders. (These instances, however, may be 

 regarded as typical examples of streptococcus and 

 staphylococcus infection, giving rise to a form of fol- 

 licular tonsilitis or pseudo-diphtheria, often difficult to 

 distinguish clinically from true diphtheria or scarlet 

 fever.) 



In addition to the foregoing diseases there are re- 

 corded a limited number of outbreaks of cholera which 

 have been traced to milk infection through various chan- 

 nels already referred to, chiefly in handling with in- 

 fected fingers, by contaminated water, and the agency of 

 flies. There is also reason to assume that the organism 

 of cholera infantum and the infectious agent of smallpox 

 may find in mUk a suitable medium for growth and 

 transmission. 



It is interesting to note that of the 330 epidemics 

 analyzed by Dr. Kober, 243 have been recorded by 

 English authors, 52 by American, 14 by German, 11 by 

 Scandinavian, and 6 each by French and Australian 

 writers. This is probably due to the fact that the Eng- 

 lish and Americans usually consume raw milk, while on 

 the Continent the milk is rarely used without being 

 boiled. 



— From Sanitarz Milk PRODtiCTioir. Report of a Conference 

 appointed by the Commissioners of the District of Columbia, 

 with accompanying papers. — Circular 114, Bureau of Animal 

 Industry, August 20, 1907. 



At the time of going to press with this volume, the 

 "Eeport on Milk in its Relation to Public Health," by 

 Surgeon General Walter Wyman, of the United States 



