48 
among tlie fever patients. In one instance (No. S7) the disease was attributed 
to an abscess of the udder, in another (No. 92) to a teat eruption, and in No. 
81 to a febrile disorder in the cows. Nos. 85, 103, 120, and 127 were creamery- 
cases. In No. 96 the milk had been kept in the sick room. 
SCARLET-FEVER EPIDEMICS. 
Mr. Hart collected 15 epidemics of milk scarlatina, and we have tabulated 
59, making a total of 71 epidemics spread through the medium of the milk 
supply, the details of which will be found in Table No. II. 
In 41 instances the disease prevailed either at the milk farm or dairy. In 6 
instances persons connected with the dairy either lodged in or had visited infect- 
ed houses. (See Nos. 8, 9, 10, 11, 15, 40.) In No. 12 the milkman had taken his 
can into an infected house. In 20 instances the infection was attributed to dis- 
ease among the milch cows; in 4 of these (Nos. 17, 18, 19, 35) the puerperal 
condition of the animal is blamed. In 9 instances disease of the udder or teats 
was found. (See Nos. 30, 31, 34, 39, 41, 59, 61, 62, 66.) In one instance (No. 
54) the veterinarian diagnosed a case of bovine tuberculosis. In 6 instances 
there was loss of hair and casting of the skin in the animal. (See Nos. 17, 18, 
19, 38, 40, 41.) In No. 68 the cattle were found to be suffering more or less from 
febrile disturbance. In 10 instances the infection was doubtless conveyed by 
persons connected with the milk business, while suffering or recovering from an 
attack of the disease (see Nos. 2, 22, 26, 29, 42, 57, 58, 60, 69, 71), and in at least 
8 cases by persons who also acted as nurses. (Nos. 1, 2, 7, 9, 13, 14, 25, 63.) 
In three instances (Nos. 1, 73, 74) the milk had been kept in the cottage close 
to the sick room. In No. 15 the cows were milked into an open tin can which 
was carried across an open yard past an infected house, and in No. 53 the milk- 
man had wiped his cans with white flannel cloths (presumably infected) which 
had been left in his barn by a peddler. Nos. 21 and 44 appear to have been 
instances of mixed infection of scarlet fever and diphtheria. 
DIPHTHERIA EPIDEMICS. 
Mr. Hart collected 7 epidemics of milk diphtheria and we have added 21 more. 
(See Table III.) In 10 of these 28 instances diphtheria existed at the farm or 
dairy, and in 10 instances the disease is attributed directly to the cows having 
garget, chapped and ulcerative affections of the teats and udder, while in No. 13 
the cows were apparently healthy but the calves had diarrhea. (See Nos. 2, 5, 
14, 18, 19, 20, 21, 22, 24, 25.) In No. 23 one of the dairymaids suffered from a 
sore throat of an erysipelatous character, and in No. 27 the patient continued 
to milk while suffering from diphtheria. In No. 28 one of the drivers of the 
dairy wagons was suffering from a sore throat. 
