MILK AS A VEHICLE OF TUBERCLE 171 
city, the remaining half comes from the country districts, but, it may be said, it the 
cows kept in the cowsheds within a great and populous city are healthy, those coming 
from the sunny meadows of the country, with their fertile pastures and ample land, 
are free also. Unfortunately, experience does not bear this out, the milk sent in 
from the country is more frequently tuberculous ; thus out of 422 town samples 
examined during 1899 and 1900, five were tubercular, being a little more than one 
per cent., but out ot 490 country samples taken during the same period, twenty were 
tubercular, being a trifle over lour per cent. How can we protect ourselves against 
this ? A special Act of Parliament applying to a few great towns, including 
Liverpool, gives special powers to exclude from the city, under a penalty, the milk 
coming from the country cowsheds in which tuberculous cows are kept under dirty 
and insanitary conditions. But if it is difficult to deal with and supervise the supply 
within our own city, it is evidently both costly and difficult to maintain a staff to 
send, under the special Act of Parliament, to the insanitary and tubercle-ridden cow- 
sheds of the country cowman ; but having overcome these difficulties, the broad 
national question comes in, for, although we succeed in protecting ourselves, what 
happens with regard to the diseased cows and the diseased milk ? The dealer 
refrains from sending diseased milk to the protected city, but what is there to prevent 
him from sending his milk for sale and consumption to a district where no special 
Act of Parliament exists to enable the community to protect itself, or from selling his 
diseased cows to a dairyman in another locality. This is not the way to secure a 
supply of milk from herds free from tuberculosis, but there can be little doubt that 
the action of the great cities will not only protect themselves, but will, to a certain 
extent, protect the country districts also, and will strengthen the hands of rural 
sanitary authorities. No doubt the great cities are financially better able to protect 
themselves ; they have their larger and more costly staff, they have their bacterio- 
logical laboratories, their veterinary and medical officers, but at best they are but 
valuable allies to the rural sanitary authorities, and these, after all, must take their 
own action, since the protection the cities afford them is an indirect vicarious one, 
and as in cases already alluded to, there is nothing to prevent the cow-keeper from 
sending his diseased produce to rural districts, after he has been prohibited from 
sending it to the great cities. Furthermore, the undoubted decline in the proportion 
of tuberculous milk sent in from the country may really mean that a larger 
proportion is consumed elsewhere. The subject is quite important enough for a 
Government Department, e.g., the Local Government Board to take in hand and 
appoint a special staff to supervise the milk supply and all appertaining to it through- 
out the country. 
It is quite possible to ensure that the milk supply shall come from cows free 
from tuberculosis. Difficulties, from ignorance, obstruction, and active opposition 
may be taken for granted, but these must be overcome, and the cow-keeper will 
