B. supplied about 225 households in which 352 cases occurred, a café among the frequenters of which 12 cases developed, a bakery in whose patrons 2 cases were found, and 2 other fever patients were reported who had obtained this milk in other ways.

SCARLET FEVER.

No organism has as yet been isolated which is generally accepted as the specific cause of scarlet fever. In 1882 Mr. W. H. Power investigated an outbreak diagnosed as scarlet fever which he believed was caused by infectious matter from a cow which had recently calved. In 1885 Power investigated another epidemic which was practically limited to users of milk from a certain dairy at Hendon where several diseased cows with an eruption of the udders were supposed to have been the source of the infection. Klein isolated from the lesions in the cows and also from human cases a micrococcus which he believed to be the specific organism of the disease and probably the cause of scarlet fever. This view has not been accepted. Sir George Brown, who also investigated this outbreak, was of the opinion that the cow disease was possibly vaccinia, and' that the milk had probably become infective by contact with a human case. Other similar outbreaks have subsequently occurred among cows without a corresponding epidemic among the users of the milk.

In the scarlet fever outbreaks which appear later, the abstracts were made from the reports cited, and the writer is aware that in a few of the cases the evidence is not entirely conclusive. In two of the cases the source of the infection is given as supposedly diseased cows. This is necessarily an opinion of the reporter and not a statement of fact, and these outbreaks have been included because the association of the disease to milk distribution was such as to make it probable that the milk, if not the carrier itself, stood at least in some relation to the carrier of infection, whatever the original source might have been.

a Power (W. H.), Report of Local Govt. Board, Lond. (Medical Officer's Supplement), 1882, p. 65.

Power (W. H.), Report of Local Govt. Board, Lond.

(Medical Officer's

(Medical Officer's Supplement),

Report on Eruptive Diseases of the Teats and Udders of Cows in Relation to Scarlet Fever in Man, Agricultural Department, Privy Council Office, London, 1888.

EXPLANATION OF DIAGRAM I.

The large square M N O P represents the town of Stamford. B. is the dairy distributing the implicated milk, and the dash-lines running from B. into the city represent the milk route of this dairy. Each of the dots represents one case of typhoid fever and is placed upon the route of the dairy from which it was supplied with milk. There are 368 such cases on B.'s route, including the 12 around the S which is meant to represent the café supplied by B. B. supplied about one-eleventh of the milk used in the town.

H. H. and H. are distributing dairies similar to B.

C. H. and E. B. L. are producing farms selling milk to B. and also peddling some themselves. The dash-line extending from E. B. L. represents his personal route of 5 houses in which 8 cases of typhoid occurred.

J. H. B. and J. B. H. are producing farms selling milk to B. and' also to distributing dairies H. and H. H.

The double lines show the dairy to which the producer sold most of his milk.

Dash-lines show the apparent course of the infective agent.
CDEFG are other dairies having routes in Stamford.

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