2. MILK AS A CAUSE OF EPIDEMICS OF TYPHOID FEVER, 
SCARLET FEVER, AND DIPHTHERIA. 
By John W. Trask, 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 
That milk may play a part in the spread of certain diseases has, 
for many years, been appreciated. From our present knowledge the 
more important of these are typhoid fever, scarlet fever, diphtheria, 
and possibly tuberculosis. 
Milk, from the time it leaves the cow’s udder, receives from its sur- 
roundings bacteria of various kinds. Certain of these organisms come 
from the teats of the cow and the dust and dirt of the stable, and are 
possibly in most cases harmless; others come from the hands of the 
milker and those handling the milk, and from the pails and cans used 
for milking, storage, and transportation. During the last fifty years 
there has been piling up a mass of evidence which would seem to show 
that milk may receive from man the specific organisms of certain 
infectious diseases, and that these organisms may retain their viru- 
lence for some time and produce the disease in susceptible individuals 
drinking the raw milk. Many epidemics supposedly spread in this 
way have been reported in the literature since 1857. Compilations of 
these cases have been made by Hart® in England, Schlegtendal * * 6 in 
Germany, Car0e c in Denmark, and by Busey d and Kober, e R. G. Free- 
man f and H. B. Baker o in this country. 
^ Up to 1895 Hart, and Busey and Kober had collected 240 such epi- 
demics. In addition to these, there are here presented 260 compiled 
from the literature and from special reports. (I desire here to 
ackowledge the great assistance rendered by the many health officers 
® Hart (E.), Transactions Internat. Med. Cong. London, 1881, IV, 491, also 
Brit. Med. Jour. Lond., 1897, 1, 1167, 1229, and 1292. 
6 Schlegtendal, Deut. Vierteljahrschr. f. Offentl. Gesundheitspflege, 1900, Bd. 
XXXII, 287. 
c Car0e (K.), Ugeskrift for Laeger, Kobenhavn, 1898, 5 R., V, p. 1009. 
— d Busey (S. C.) and Kober (G. M.), Report of Health Officer of District of 
Columbia, 1895, p. 299. 
e Kober (G. M.), Senate Doc. 441, Fifty-seventh Congress, 1st session. 
' f Freeman (R. G.), Medical Record, N. Y., 1896, XLIX, 433. 
^ 9 Baker (H. B.), Annual Report Michigan State Board of Health, 1896. 
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