Acts. It is not creditable to the Local Government Board that it should lag behind Local Authorities in their attempts to secure more efficient means to prevent the spread of disease, and still less so that the Board should obstruct these Local Authorities in their attempts.

The opposition of neighbouring Local Authorities raises a point which has already been settled in principle in favour of the clauses promoted by the Brighton Corporation in the powers relating to milk, above referred to. If it is undesirable that any medical officer of health should be disallowed to trace the disease arising within his district to its probable source without his district, there is certainly need in this as in many other matters for the immediate co-operation of inspectors of the Local Government Board to prevent the continued existence of sources of disease which the local health officials are not allowed to investigate.

Sir JOSEPH EWART (Brighton) said he had seen the accuracy with which Dr. Newsholme had pursued his investigations for two years, and he arrived, after the most careful and attentive consideration, at identically the same conclusion as Dr. Newsholme had. Those of them who had read the history of typhoid fever as distinguished from common continued fever, by Jenner, would recollect how, after putting the whole facts to the profession, Dr. Jenner was opposed, and what a long time it took, before the profession throughout the whole country were convinced that the facts given by Dr. Jenner were true, and that typhoid was a separate disease. He (Sir Joseph) happened himself to go out to India a short time after Jenner had published bis researches, and having studied in London at a time when typhoid fever was very common, when the whole profession were engaged in testing whether Jenner's work was correct or not, and having satisfied himself that Jenner's views were correct, he (Sir Joseph) found the same conditions amongst the natives of India. To show how difficult it was to get attention rivetted on any of those things, it took the official members of the profession in India many years before they would enter typhoid fever as a distinct fever in their official returns. No wonder, then, that Dr. Newsholme and those who had made similar observations should meet with some difficulty in getting an official recognition of the case he had put before the profession. He felt as convinced as he did of anything that Dr. Newsholme was in this matter supported by the great probabilities of the facts being true. If that were so, and if the government could be convinced, they should have the means placed at the disposal of the health officers of the country, by the agency of which a large proportion of the typhoid fever which occurs, and cannot otherwise be accounted for, would be prevented. There was ap

parently great fear, on the part of the Local Government Board, of offending the trading interests, but where the general health of the community was concerned, the Whitehall authorities should give way. Sir Joseph was pretty certain that the oyster trade itself would not suffer, but would ultimately benefit. Once the profession and public became convinced that the cultivation of oysters was carried on free from sewage contamination, he thought a great benefit would be obtained by the trade. The opposition which they met at the House of Commons in Committee was an opposition which was a self-interested one. The health authorities wanted only to have the same powers over oyster beds as they now had over milk. That was all, and once such a power was granted there would be no difficulty in enforcing the cultivation of the oysters under pure, wholesome and healthy surroundings. They should also contend for this, that so far from the oyster industry suffering in any degree, it would be largely benefitted by the immense security given in the public recognising once and for all that the food was as wholesome as it possibly could be.

Sir CHARLES CAMERON (Dublin) said it was exactly seventeen years since, at a meeting of the British Association, he propounded the theory that enteric fever was sometimes propogated by means of oysters taken from the estuaries of rivers into which the sewage of large towns was deposited. He gave bacterial results of the examination of oysters taken from Dublin Bay, and he thought he gave the strongest proofs that it was highly probable that enteric fever was communicated by means of shell-fish. He was sorry to say that his observations were not received with much credence, and he was asked in all seriousness by the Chairman of the section, whether what he had been saying was not one of his (Sir Charles Cameron's) usual jokes. For ten years it might have been regarded as a joke, but for the last few years he found that papers had been read from time to time, and even official documents issued, showing that the infection of oysters by sewage was by no means an infrequent occurrence. It was a curious thing that what he wished to prove seventeen years ago, that there was a possible danger in eating uncooked the oysters from our larger rivers and from the bays into which the sewage from large towns empty, was only now becoming generally accepted. Since that time he had had many opportunities of seeing the effects of oysters taken from polluted sources, and not only enteric fever, but other attacks of a nature similar to that produced by eating tainted food— choleraic attacks were due to that cause. He published not long ago a case of fourteen people being attacked by cholerine after eating oysters. He had also recorded a terrible case-a tragedy-that occurred on the shores of Dublin Bay not long ago, when a whole family died after eating mussels which were taken from an extremely filthy pool of water, and which he found to be in a diseased condition. All the mussels had increased to an enormous size, for mussels had livers as well as men. He thought Dr. Newsholme had done a good work in bringing that paper before the members of the Congress.

Dr. WILLOUGHBY (Eastbourne) said he had at the present time in the Infectious Diseases Hospital, at Eastbourne, six serious cases of typhoid fever, due, in his opinion to the eating of oysters. He was first struck by the fact that the patients were all men of from twenty-five to thirty-five years of age. Taking that fact into view, and studying the cases, he found that the patients had had oysters from one particular stall at one part of the town at a certain period. All the milk supplies were different, their houses were fairly good, they lived in different parts of the town, in fact, there was nothing in common except that the patients had had oysters from that particular stall. He traced the source of these oysters and found that they came from near Dublin. That neighbourhood Sir Charles Cameron had more than once spoken of. He was sure the public at large would be much indebted to Dr. Newsholme for bringing the matter forward.

"Milk Control, Milk Inspection, and Milk Laboratories," by G. SIMS WOODHEAD, M.D., F.R.C.P.

THE Report of the Royal Commission appointed to enquire into the effect on human health of food derived from tuberculous animals brings out no single fact more clearly than that many of those on whom depends the maintenance of public health find it impossible to shake off the trammels of tradition, especially as they bear on the causes of tuberculosis, and nothing to my mind was more interesting than the tenacity with which certain of the witnesses examined before the Commission clung to what some people look upon as almost incapable of proof— the "hereditary transmission" of tuberculosis. On the one side we had a number of men, physiologists and others, who fought for this hereditary transmission, and, in some cases, for tuberculous "atavism; whilst on the other side those who have been compelled to study tuberculosis most closely, maintained— with one or two exceptions-that although it might be difficult to disprove hereditary transmission in a certain number of cases in which it is claimed such transmission has taken place, undue prominence is given to the possibility of such transmission, attention being thus diverted from the real causes and methods of tuberculous infection, which are to be looked for rather in the inhalation and ingestion of tuberculous material from tuberculous patients-human and animal.

I am one of those who do not believe that direct hereditary transmission of tuberculosis takes place except in those cases

in which (1) there is general tuberculosis of the mother, or (2) the uro-genital organs of the father or mother are affected, and where there is such affection—as one sometimes sees in cattle the rule is that the foetus does not come to proper birth at full time. This being the case the commission very wisely tabooed this part of the question and turned its attention to sifting the evidence regarding, and making experiments on, the subject of the propagation of tuberculosis through the ingestion of the meat and milk of animals suffering from tuberculosis. It is with one of these branches of the question that I shall deal in the short time at my disposal. I do not intend to describe any special method of sterilising or rendering innocuous milk that has become infected with tuberculous material. We have a right to expect that in the case of such an important article of diet as milk, it shall at any rate be derived from uncontaminated sources, and although for the present it may be necessary to disinfect it by heat according to methods which are now, I hope, thoroughly well recognised, arrangements must be made to control the production and distribution of milk in such fashion that, ultimately -it is to be hoped at some not distant date-it will not be necessary to take precautionary measures, such as heating and the like, in order to be sure that it contains no living tubercle bacilli.

After a careful study of the question of milk control in France, Germany, Denmark, and Sweden, I am convinced that until the medical officer of health, the veterinary surgeon, and the "Local Authorities" can act together and in full accord we shall not attain an ideal control of our milk supply. In the course of my work I have had to deal with a very large number of diseased animals of various kinds, and although I may claim that I have picked up a very fair knowledge of the pathology of the diseases of animals, and an amateur knowledge of the symptoms beyond that gained by most medical men who have not gone through a special course of veterinary training, I have not the slightest hesitation in saying that wherever I want a reliable opinion on any animal, or whenever I desire to learn anything about the natural history of a disease in an animal, I at once appeal to a veterinary surgeon; and in most cases I am thoroughly satisfied with the opinion that I get. I do not say that I would take the opinion of every veterinary surgeon, even against my own, but I am satisfied-and my experience of this matter is a very extensive one-that a good veterinary surgeon, especially one who has been well trained in comparative pathology-as the younger generation of veterinary surgeons undoubtedly are-will give a more reliable opinion

than a medical man of the same standing, and this, naturally, without any disrespect to the medical man.

How, it may be asked, can the veterinary surgeon and the medical officer of health act together in such an important question. I will not attempt to go into quotations and statistics as to the number of tuberculous cattle in the various countries of the world. These have been so fully given and are now in the hands of so many Medical Officers of Health that it would be a work of supererogation to repeat what is now common knowledge. I will try rather to sketch what to my mind would be a useful and at the same time a practicable system of control a plan by which the medical officer of health would obtain a greater amount of information and control than he does at present, and would at the same time retain an increased amount of time and energy to devote to the important work that he has in hand; whilst he would have special advice on those matters of which he cannot be expected to have the same knowledge as a veterinary expert.

Every dairy should be registered-the number of cattle and the number of workers being carefully noted; each worker and each animal should have its own bill of health; the medical officer and the veterinary surgeon should, together, go over the accommodation for the cattle, the ventilation and the general conditions of the cow-houses. This being done the veterinary surgeon should, every fortnight, pay a visit along with the medical officer of health, and each should examine his own patients the doctor noting the health of the workers, making enquiries as to their general condition, and noting down anything in the hygienic condition of the house or the state of health of the inmates that may seem worthy of notice. Whilst this is being done, the veterinary surgeon should examine a certain proportion (one-half) of the dairy stock, so that every animal is examined at least once a month. But, in addition to this, each animal that is found to be suffering from any disease and especially from disease of the udder, or from tuberculosis of any kind, should be carefuly isolated and examined at each visit, and until the veterinary surgeon gives a certificate that such isolated animal may again go into the dairy, none of the milk from such animal should be allowed to be sold; it may be boiled and given to the pigs, or it may be boiled and then thrown away, but it should never be allowed to go into the supply for human consumption, or allowed to be thrown away even in the raw state.

It is not necessary to go into further detail, but it is only proper that I should justify such frequent inspection and that, think, I cannot do better than in the following part of my