271 
for the year 1903. (Francis J. Allan, medical officer of health for 
the city of lYestminster. ) 
Premises where ice creams are manufactured or sold were frequently in- 
spected during the year; there were lOS premises other than hotels and 
restaurants where ice cream is manufactured and sold. Proceedings were 
taken against Pietro Necchi, 36, Berwick street, under the London County 
Council general powers act, 1902, for manufacturing ice cream in a room used 
as a sleeping room, and he was fined £2 and £2 2s. costs. 
Every itinerant vendor of ice cream, etc., is required to exhibit the name 
and address of the manufacturer on his barrow. One man was cautioned under 
this section. Lists of such vendors were prepared in several boroughs, and 
the medical officers of health gave one another information with regard to the 
places where the ice cream is made. There were 18 persons selling it in the 
city during the year, of these several resided in the city (of Westminster), 
the others came from Finsbury (4), Holborn (3), Chelsea (3), and Lambeth 
(1). In one case the medical officer of Chelsea informed me that the place 
in which the mixture was prepared was dilapidated, with water-closet ob- 
structed, and defective paving of scullery. In another (in Holborn) pro- 
ceedings were taken for making ice cream in a living and sleeping room. 
The significance of the streptococci as a disease-producing organ- 
ism in ice cream has been briefly discussed in the section of this 
report devoted to bacteriological findings of ice cream in the city of 
Washington, and to that section the reader is referred. Aside from 
the invasion of the organism by living pathogenic bacteria, and the 
characteristic s}unptoms following such invasion, there must not be 
forgotten the causation of illness by products of the bacteria them- 
selves — even though they as living cells may have been eliminated 
either by boiling, freezing, or the use of chemical preservatives. It 
is commonly supposed that the manipulation through which the 
mixtures for ice creams are apt to go, namely, pasteurization or 
scalding of at least a portion of the ingredients would tend to lessen 
the actual number of organisms present and to kill those which are 
commonly considered to be pathogenic. So far as the lessening of 
the number of organisms is concerned, the investigations embodied 
in this report offer an emphatic denial; and the heat or cold to 
which the mixture is exposed would be absolutely without effect 
upon the toxins or ptomaines produced by the organisms even should 
the latter be killed. 
Indeed, it may be very seriously questioned whether preliminary 
heating of the milk products going into the compounds known as 
“ ice cream ” is not actually deleterious and responsible, to some 
extent, at least, for such cases of poisoning as are included under 
the popular term of “ tyrotoxicon.” It has been definitely established 
that the scalding or commercial pasteurization of milk and cream 
of the usual commercial quality tends to kill off the organisms pro- 
ducing lactic acid and naturally causing the milk to curd, but leaves 
