Regarding the conveyance of tuberculosis in the colder countries, 
Cobb points out that an absence of tuberculosis does not necessarily 
follow the absence of milk from the dietary. He shows on trust- 
worthy evidence that the Alaskan Indian, including the Esquimo and 
Aleut, is the victim of consumption of the lungs to a great and in- 
creasing extent, though these people do not use to any extent milk of 
any kind as an article of diet, and cow's milk not at all. Of interest 
in this connection is the report made in 1906 by the medical officer 
of health of the city of London showing that at least 8 per cent of the 
milk sold within the city limits of London is derived from animals 
affected with tuberculosis, and that of 500 cows examined after 
slaughter by the city veterinarian evidence of tuberculosis was found 
in 46.8 per cent. 
EPIDEMICS CAUSED BY MILK. 
In epidemics caused by milk (typhoid fever, scarlet fever, diph- 
theria, etc.), the mortality of the disease does not appear to differ 
from that of the same disease otherwise conveyed. The effect of milk 
epidemics on morbidity and mortality returns may be surmised by 
the frequency with which epidemics of such a character occur. 
MILK AND TYPHOID FEVER. 
Raudnitz, of Prague, states that one-fourth of the epidemics of 
typhoid fever in Austria are traceable to contaminated milk, and Mc- 
Crae records that an inquiry into the causation of 638 epidemics of 
tyjffioid fever showed that in IT per cent the infection was conveyed 
by milk. The bearing of this observation on the general sick and 
death rate is obvious when it is considered that the mortality in ty- 
phoid fever, though often as low as 5 per cent in private practice, 
sometimes reaches 20 per cent. Typhoid fever causes more deaths 
than any of the other epidemic diseases. The United States census 
reports show that in 1905 there were 28.1 deaths from typhoid fever 
per 100,000 population. The death rate from typhoid fever was 
smaller in 1905 than in any of the five preceding years. The annual 
average for the registration area of the United States, 1900 to 1904 
inclusive, was higher than that for any of the countries given in the 
following table except Italy : 
Deaths from typhoid fever per 100,000 of population. 
Annual 
j Annual 
Country. 
, average. 
Country. 
; average, 
[1900 to 1904. 
1900 to 1904. 
Registration area of United States | 33. 7 
England and Wales 12.9 
Scotland 12.7 
Ireland 1 14. 2 
Germany I 8. 5 
Norway 6.2 
Sweden 12.2 
Hungary 28. 3 
Belgium 20. 2 
Switzerland 6. 5 
Italy 37.8 
