37 
Investigation showed that all the cases in Dorchester and Milton 
were supplied with milk by one dairy, A, with the exception of 3 
which were all in one house in Milton and were secondary to a case 
reported before the onset of the outbreak. In Hyde Park all the cases 
obtained milk from dairyman B. Dairy A bought its milk from 6 
producers : J H, R B N, E T T, O H, J M B, and C F J (see diagram 
III). On none of the producing farms were any cases of diphtheria 
found except on that of C F J, where it was discovered that a child 
had been seized with the disease on April 11, and that the cooler in 
which the milk was mixed was washed in the house and that this 
office was performed by the person who had the care of the sick child. 
This same producer, C F J, also sold about one-third of his output to 
dairyman B, who delivered it in Hyde Park. Prompt action on the 
part of the local authorities in excluding sale of milk produced by 
C F J, brought the outbreak to an immediate close. 
It will be noticed from the table that the outbreak in Hyde Park 
occurred a day later than that in Dorchester and Milton. This is 
explainable by the fact that B called for his share of C F J’s milk in 
the evening and sold it on the following day, whereas A came for his 
in the morning and disposed of it at once. 
It is of further interest that C F J himself came down with the dis- 
ease after the outbreak had nearly subsided, and that dealer A’s son 
who drank milk from C F J was one of the earliest victims. 
EPIDEMICS OF SORE THROAT AND PSEUDO-DIPHTHERIA. 
Among the collected epidemics are 7 variously reported as sore 
throat, pseudo-diphtheria and septic sore throat. They all occurred 
in Great Britain. Two of the outbreaks were supposed to be due to 
milk coming from cows having mastitis, 4 to milk of cows afflicted 
with teat and udder eruption ; in one case the sequence was first severe 
sore throat, thought to be quinsy in the farmer, followed by mastitis 
in the cows and sore throats in other persons on the farm, and last an 
outbreak of sore throats on the milk route. Precautions taken 
against the milk were reported as stopping four of the outbreaks. 
CHARACTER OF MILK EPIDEMICS. 
Milk epidemics have characteristics more or less peculiar to them- 
selves and from the very nature of the case usually show the follow- 
ing features : 
(a) Explosive onset . — The onset is usually sudden and may very 
aptly be termed explosive. This is due to the fact that a certain can 
or lot of milk receives an amount of the infective material from con- 
tact with an infectious person, premises, or water. This milk may be 
delivered to the consumers by itself, in which case the number of 
