247 
SCARLET FEVER AND DIPHTHERIA. 
The number of epidemics of scarlet fever and diphtheria where the 
infection was conveyed by milk show unmistakably that the effect on 
morbidity and mortality rates thus brought about by milk must be 
considerable. While the death rate is low among patients of the 
better classes, in hospitals and among the poor it ranges from 5 to 30 
per cent, a marked variability of the death rate in different epidemics 
being a characteristic of scarlet fever. The general mortality of 
scarlet fever is shown by the following table: 
isfumher of deaths from scarlet fever per 100,000 population. 
Country. 
Annual 
average, 
1900 to 1904. 
Country. 
Annual 
average, 
1900 to 1904. 
Registration area of United States 
11.8 
Hungary 
67.5 
England and Wales 
12.7 
The Netherlands 
2.6 
Scotland 
10.8 
Belgium 
16.3 
Ireland 
4.7 
Switzerland 
3.7 
Germany 
23.7 
Spain 
5.9 
Norway 
5.8 
Italy 
4.6 
Sweden 
8.7 
Diphtheria and croup caused an annual average of 33.6 deaths per 
100,000 in the registration area of the United States, 1900 to 1904. 
Among the means of transmission of diphtheria infected milk is a 
well-recognized medium. 
DISEASES OF CATTLE. 
Numerous other diseases in the transmission of which milk is a 
factor exert an effect on vital statistics. Milk sickness, a disease 
related to the affection in cattle known as the trembles, still occurs 
in certain parts of the United States. It is transmitted by milk and 
milk products as well as the flesh of diseased animals. In some of 
the Western States in early days it was a prominent disease and 
killed many of its victims. 
Foot and mouth disease in the cow has been frequently transmitted 
to human beings by the use of milk and milk derivatives. In one 
epidemic thus brought about the death rate was 8 per cent. 
ASIATIC CHOLERA. 
Milk is not infrequently a means of communicating Asiatic cholera. 
The evil efficacy of milk thus infected in its influence on morbidity 
and mortality statistics can be readily conjectured, when the desola- 
ting death record of cholera is reviewed and the almost universal use 
of milk considered. 
