784 
method of chemical or bacteriological analysis can the possibility, or 
even the probability, of the presence in milk of the typhoid bacillus 
or the diphtheria bacillus be excluded with any reasonable degree 
of certainty; that the colon bacillus is not an infrequent inhabit- 
ant of milk, its presence indicating merely contamination with the 
excrement of the cow and not even suggesting sewage pollution ; and 
that the organism that causes scarlet fever is as yet entirely un- 
known. Under such circumstances, the following method has been 
adopted to facilitate the detection of contagious diseases on the 
daiiw farm : 
Upon receipt by the health department of a report of a case of 
ttq^hoid fever, scarlet fever, or diphtheria, an inspector from the 
health department visits the premises where the patient is and ascer- 
tains the name of the dairyman who furnished the milk consumed by 
the patient prior to the onset of his illness. The dairyman is im- 
mediately notified to discontinue leaving milk bottles at the infected 
premises or apartment until after the recovery or removal of the 
patient, of which event he is notified at the time of its occurrence. 
Bottles containing milk, if left at infected places, may be taken into 
the sick room and possibU even directly used by the patient, and then, 
in view of imperfect methods of disinfection adopted b}^ the attend- 
ants and of imperfect methods of cleaning adopted by the dairymen, 
ma}^ be the means of spreading disease. The name of the dairyman 
who supplies milk to the patient having been ascertained, and the 
dairyman having been notified to discontinue the deliveiw of bottles 
at the infected place, the case is entered on the records of the health 
department to the dairyman's account. This is done by the inspector 
in charge of the contagious-disease service personally, and if at any 
time it seems that the number of cases being charged to any one dairy- 
man is out of proportion to the size of his business, due regard being 
paid to the general extent to which the disease is prevailing in the 
District, then inquiry is immediately begun to ascertain whether his 
milk supply is or is not exposed to infection. Such investigations are 
made by medical officers in the contagious-disease service and by the 
veterinary surgeons in the milk-inspection service. The local estab- 
lishment of the milk dealer is visited and an effort made to ascertain 
whether he or anyone in his family, or any employee or his family, or 
anyone to whom the}^ have been exposed, is suffering from the disease 
under consideration. A similar course is pursued with reference to 
the dairy farm. The water from the dairy farm is analyzed, if there 
is any indication for such procedure. If the circumstances show that 
the milk supply is exposed to infection, then immediate action is taken 
to remove the danger. Permits are suspended or revoked, with or 
without notice, if circumstances indicate that such action is called for, 
and are renewed or reissued only after all danger is passed. In some 
