203 
and axillary glands, but feeding with milk shows that this may be the 
case at times. 
It has been demonstrated that goats may become infected by feed- 
ing on dust polluted with urine from cases of Mediterranean fever. 
The excretion of M. melitensis in the milk resulting from such infec- 
tion is a late phenomenon only appearing about seventy-four days 
after the blood reaction has developed. 
In report No. 6 of the commission they state that, reviewing the 
evidence already collected by the Mediterranean Fever Commission 
in its entirety, it is fairly obvious that the infective character of the 
milk of many of the goats upon the island of Malta affords a ready 
and reasonable explanation of the means by which the disease is 
transmitted. Then, too, the evidence yielded by experiments upon 
monkeys, supported by the fahts of the steamship Joshua Nicholson 
epidemic, justifies the assumption that in the ingestion of infected 
milk we have the veritable infective agency in the vast majority 
of cases. Additional weight attaches to this view by reason of the 
declining case incidence that was associated with the compulsory sub- 
stitution (owing to the goatherds strike) of imported preserved 
milks for the fresh goat’s milk by the local and military authorities. 
In report No. 6, page TO, is an account of an outbreak of Malta 
fever aboard the steamship Joshua Nicholson which conveyed a herd 
of milk goats from Malta to Antwerp in the latter part of the 
summer of 1905. These goats were collected by a representative of 
the United States Bureau of Animal Industry for shipment to the 
United States. It reads almost as if it were a planned laboratory 
experiment, and in view of the experimental work above referred to 
established almost conclusively the relation of infected goat’s milk 
to the spread of Malta fever. The following account of the outbreak 
is taken verbatim from the report of the commission : 
1. HISTORY OF THE GOATS. 
Mr. Thompson, of the United States Bureau of Animal Industry, 
visited Malta in the summer of 1905, and during a stay of some 
months gradually purchased a herd of 61 milcfi goats (all healthy 
in appearance and good milkers, many being prize animals), and* 4 
billy goats. These he shipped on board the cargo steamer Joshua 
Nicholson , on August 19, 1905, for passage to the United States 
via Antwerp. During the voyage, which lasted until September 2, 
1906, when Antwerp was reached, the goats were milking well, and 
many of the ship’s company partook freely of the milk — the officers 
drinking “ mixed ” milk collected in a large vessel, the members of 
the crew each obtaining “ whole ” milk from 1 goat in his own sep- 
arate panikin. 
