36 
SUMMARY OF EPIDEMICS. 
Of the 23 diphtheria epidemics reported as spread by milk and 
compiled since 1895, 15 occurred in the United States and 8 in Great 
Britain; cases of the diseases occurred at the producing farm, dis- 
tributing dairy or milk shop at such a time as to have been the possi- 
ble cause of the outbreak in 18 cases ; the diseased person milked the 
cows in 4; the same person nursed the sick and handled the milk in 
1 the outbreak was supposed to be due to disease of the cows in 2 ; 
all cases of the disease were reported as living in households supplied 
with the suspected milk in 15 instances; measures taken upon the 
presumption that milk was the carrier of infection were reported as 
followed by subsidence of the outbreak in 5 cases; the Klebs-Ldffler 
bacillus was isolated from the suspected milk in 2 of the epidemics. 
The following outbreak is one of many interesting examples : 
OUTBREAK OF DIPHTHERIA IX DORCHESTER, MILTOX, AXD HYDE PARK.® 
On April 13, 1907, after a period of comparative freedom from 
diphtheria, there were reported to the board of health of the town of 
Milton 11 cases of that disease. This sudden explosion caused very 
naturally a feeling of grave apprehension on the part of the local 
health authorities. The following is an account of the epidemic: 
Cases of diphtheria were reported in Milton as follows: April 12, 1 
case; 13, 11 cases; 14, 1 case; 15, 4 cases (of these 4 cases, 3 were 
in the same house and secondary to a case which had developed be- 
fore the 12th and can therefore be considered as not belonging to this 
explosive outbreak) ; 16, 1 case. In Dorchester cases were reported 
as follows: April 12, 6 cases; 13, 19 cases; 14, 11 cases. In Hyde 
Park the number and dates were : April 13, 2 cases ; 14, 5 cases ; 15, 6 
cases; 16, 1 case; 17, 3 cases, and 19, 1 case. 
The following table shows the relationship of the cases in the differ- 
ent places: 
Place. 
April. 
Total by 
11. 
12. 
13. 
14. 
15. 
16. 
17. 
18. 19. 
towns. 
Milt.rvn 
1 
11 
1 
4 
1 
18 
Dorchester 
6 
19 
11 
36 
Hyde Park 
2 
5 
6 
1 
3 
1 
18 
Total 
7 
32 
17 
10 
2 
3 I 
1 1 
72 
1 
1 1 
® Monthly Bulletin, State board of health, Mass., May, 1907, vol. 2, No. 5, 
p. 117. 
