27 
B. supplied about 225 households in which 352 cases occurred, a 
cafe among the frequenters of which 12 cases developed, a bakery in 
whose patrons 2 cases were found, and 2 other fever patients were 
reported who had obtained this milk in other ways. 
SCARLET FEVER. 
No organism has as yet been isolated which is generally accepted as 
the specific cause of scarlet fever. In 1882 Mr. AY. H. Power a in- 
vestigated an outbreak diagnosed as scarlet fever which he believed 
was caused by infectious matter from a cow which had recently 
calved. In 1885 Power * * 6 investigated another epidemic which was 
practically limited to users of milk from a certain dairy at Hendon 
where several diseased cows with an eruption of the udders were sup- 
posed to have been the source of the infection. Klein c isolated 
from the lesions in the cows and also from human cases a micrococcus 
which he believed to be the specific organism of the disease and prob- 
ably the cause of scarlet fever. This view has not been accepted. 
Sir George Brown/ who also investigated this outbreak, was of 
the opinion that the cow disease was possibly vaccinia, and that the 
milk had probably become infective by contact with a human case. 
Other similar outbreaks have subsequently occurred among cows 
without a corresponding epidemic among the users of the milk. 
In the scarlet fever outbreaks which appear later, the abstracts 
were made from the reports cited, and the writer is aware that in a 
few of the cases the evidence is not entirely conclusive. In two of 
the cases the source of the infection is given as supposedly diseased 
cows. This is necessarily an opinion of the reporter and not a state- 
ment of fact, and these outbreaks have been included because the 
association of the disease to milk distribution was such as to make it 
probable that the milk, if not the carrier itself, stood at least in some 
relation to the carrier of infection, whatever the original source 
might have been. 
“Power (W. H.), Report of Local Govt. Board, Lond. (Medical Officer’s 
Supplement), 1882, p. 65. 
6 Power (W. H.), Report of Local Govt. Board, Lond. (Medical Officer’s 
Supplement), 1885, p. 73. 
r Report of Local Govt. Board, Lond. (Medical Officer’s Supplement), 
1887-88, p. XIII. 
d Report on Eruptive Diseases of tlie Teats and Udders of Cows in Rela- 
tion to Scarlet Fever in Man, Agricultural Department, Privy Council Office, 
London, 1888. 
