46 
further use and the milk emptied into the mixing tank. Other meth- 
ods entirely free from criticism are commonly used by careful dairies. 
(9) Bottles . — It is at present the custom to deliver milk to the 
consumer in bottles. This is especially so in the cities. It can be 
seen how this practice properly operated may be better than any 
other ; but, on the other hand, if carelessly conducted may be a source 
of much danger. Clean milk in sterile, well-capped bottles, handled 
and delivered by clean men, free from disease, is a condition much to 
be desired. But where empty bottles returned from the consumers’ 
bouses are not properly scalded before being again filled, the possi- 
bility of contamination by pathogenic organisms is necessarily con- 
siderable. Bottles left at houses where there are cases of scarlet fever, , 
typhoid, or diphtheria, if refilled without being properly scalded, are 
undoubtedly a source of much danger. Many cities have ordinances ^ 
to prevent this, but the constant presence of mild cases of disease, so 
mild and, according to present standards, atypical, that a correct 
diagnosis is not rnade, renders all regulating measures more or less 
ineffective. The accidental infection of bottles in an orderly, well- 
regulated household need not be considered so long as certain classes 
of people persist in using them for various other purposes, such as 
urinals and receptacles for sputum. Dr. Herbert Fox, chief of the i 
laboratories of the Pennsylvania state department of health, states: 
The attention of the commissioner of health, Dr. Samuel G. Dixon, was 
called to a slimy mass of material on the under surface of a milk-bottle cap. J 
He sent this to the laboratory and it was received in a very dry condition. 
Upon softening down and smears made from it we were able to obtain suffi- 
cient proof that it was sputum. Doctor Dixon informs me that he has known 
of milk bottles used for cuspidors on more than one occasion. 
The practice of drinking directly from the bottles is a habit that 
must also be borne in mind as a possible means of contamination 
with tubercle and Klebs-Loffler bacilli. An example of apparent 
bottle infection is found in the typhoid outbreak at Montclair, N. J., 
in 1902. 
Montclair epidemic . — During the summer and autumn of 1902 
there was only an occasional case of typhoid in Montclair.® The 
1st of December several cases occurred, apparently having milk from 
one dairy as the only factor in common. Investigation of the farms 
producing this milk failed to reveal any cases of disease which could 
be the source of the infection. All persons coming in contact with 
the milk were apparently in good health. More careful examination 
® Ninth Annual Report, Board of Health, Town of Montclair, N. J., 1903. 
