814 
PROCEEDINGS OF SECTION I. 
In connection with the frequency of the intestinal affection in 
young children, I wish to refer to a matter that 1 think has not been 
sufficiently taken into consideration by European authorities. I mean 
the extreme degree of mortality in young children in large cities and 
centres of industry in the old world* In one town in Lancashire, in 
which there are large flax and jute works employing mainly women 
and boys, the mortality in children under five years during the year 
1886 was 55 per cent, of the total deaths in the borough. This 
seemingly enormous infantile death-rate was increased the following 
year (1887), during which 30 per cent, of the total deaths were in 
children under one year. Considering that in these large towns a 
great number of the children of the poorer population must inevitably 
he fed by the bottle on cow’s milk when their mothers are out at work 
for the greater portion of the day — and considering, too, that bovine 
tuberculosis is infinitely more common in city dairies than in extra- 
urban ones — would it not be well that more attention should be directed 
to this phase of the question, with the object of ascertaining whether 
a larger proportion of these infant deaths than is now suspected is 
due to a tubercular milk supply ? 
There are two other difficulties in the way of ascertaining to 
what extent tuberculous milk is a source of infection in the human 
being that I wish to refer to specially. The first is that, except in some- 
what rare instances, there are no means of ascertaining, except by post- 
mortem examination, the exact nature of the many fatal cases of 
infantile diarrhoea met with in medical practice — of deciding whether 
they are of tubercular or uon -tubercular origin, so that in private 
practice a lot of what might be valuable evidence on the subject is 
lost:. Another difficulty is the present lack of means whereby a 
medical man might trace the infection in a case of acquired intestinal 
tuberculosis to what may be its proper source — namely, the milk of an 
affected cow. In the present condition of legislation and public 
health administration touching the inspection of dairy cattle he would 
have to pursue his quest single-handed, and in his attempt to indicate 
the identical animal w r ould probably be at fault so often that the 
search would be unfruitful* 1 n parenthesis I am tempted to speculate 
how different this would be if he could at any time consult with and 
obtain information as to infected dairies and cattle from a veterinary 
official, whose regular duties and intimate acquaintance with all 
possible foci for the distribution of the disease would enable him to 
allay or endorse the suspicion. At present a medical man can only 
suspect infection from a dairy, but he has not the means at hand to 
prove the correctness of his suspicions, and without this proof he will 
not be believed. Veterinary surgeons, too, are alike handicapped in 
any endeavour to afford proof of the danger to children of infected 
milk. In everyday practice they frequently encounter cows suffering 
from tubercular mammitis, the milk from which is mixed with that 
of others and distributed for family use, but, except in very rare 
instances, they have not the opportunity for observing its effect. 
In short, there is no connecting link between w r hat the medical 
man sees and suspects and what the veterinary surgeon sees and 
suspects. In the absence of this, proof is out of the question ; the 
perhaps well-founded suspicions of each cannot be either confirmed or 
disproved. 
