the dilution of milk with specifically contaminated water
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special wards of the infirmaries, and we think that these
might be regarded as more than mere rest-houses on the
way to asylums. They might be made suitable for the
reception of the class of patients we have in mind and beplaced under the consulting charge of practising psychia-trists. With another recommendation of the AsylumsCommittee, that every alleged lunatic should go in thefirst place to a receiving house, we do not altogether sym-pathise. There are many patients who come under observa-tion too late for treatment at a mental hospital adapted forthe class of patients we have above mentioned, and forwhom the asylum is the proper place. It appears to us to
be of little advantage that the journey to the asylum shouldbe interrupted for a few days’ purposeless sojourn at a
receiving house, where the presence of such patients wouldinvolve arrangements wholly inappropriate to the atmosphereof the mental hospital.
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THE DILUTION OF MILK WITH SPECIFICALLYCONTAMINATED WATER.
THE addition of water to milk is not such an exceptionaloccurrence as to call for special reference in these columns,but when the water which is added is not only grosslypolluted but is found to actually contain the organisms ofenteric fever the affair assumes a special importance. A
case has recently come to light near Preston in which waterto the extent of 3’ 6 per cent. had been added and in whichthe county analyst discovered the enteric fever organisms.The milk itself as drawn from the cow’s udder was ofexcellent quality, but the water separately analysed yieldedenteric fever bacilli. The bench quite rightly took a seriousview of the offence and the defendants were mulcted in allto the extent of &44. A case such as this should turn<the attention of local authorities and their officers to theenormous importance as regards health of securing a purewater-supply for dairies and cowsheds, but we are afraidthat, especially in rural districts, this question does notreceive the attention which it deserves. The positionof the wells supplying many dairies in rural districts is
often such as to actually cause pollution, and this althoughthe dairies may have been registered with the local authorityfor many years. There can be no doubt that the standard of
- cleanliness of cowsheds in rural districts is far lower than
it ought to be, and, although the milk cans are commonlywashed with water which has been boiled, the utensils inwhich the cans are sometimes washed and those in which themilk is drawn are not infrequently used for other purposes.Water added to milk by way of dilution seldom undergoesany treatment whatever. In connexion with this importantsubject we are glad to see that a Milk and Dairies Bill
.[No. 123], providing for reforms with respect to the sale ofmilk and the regulation of dairies, is being introducedinto the House of Commons. Whatever may be its fate
it will have some educational value, and many of its
provisions represent a distinct advance on the existinggeneral conditions. Amongst other things the Bill providesfor the compulsory registration of dairymen and a penaltynot exceeding .f:5 for failure to register, and the local
authorities are empowered to refuse registration as wellas to remove from the list dairies already registered.Procedure with regard to the inspection of dairies andthe prohibition of the supply of milk is simplified, andadvances are made upon Section 4 of the InfectiousDiseases (Prevention) Act, 1890, Section 71 of the
Public Health (London) Act, 1891, and the Milk Clausesincorporated in many local Acts. With respect to tuber.culous milk power is given to the local officers to requirea cow to be milked in their presence, and the milk from any
particular teat must, if so desired, be kept quite separate.
A penalty is also imposed where the dairyman and those
in his employ refuse to assist the officers in their investiga-tions, a provision which in practice would prove decidedlyuseful. Similarly, as regards the sale of tuberculous milk orthe use of such milk in the manufacture of products for
human consumption, a fine of .E10 is imposed unless proof isforthcoming that the milk has been boiled or otherwise
sterilised. But this proviso as to sterilisation is obviouslyopen to criticism. Greater facilities are afforded underthe proposed legislation for procuring samples of milk,and power is conferred upon the Local GovernmentBoard by agreement with the Board of Agriculture andFisheries to make any necessary orders as regards certainspecified particulars, amongst which we note the pre-vention of impurities in milk, the cleanliness of milk vessels,the prohibition or regulation of preservatives, the identifica-tion of churns, and the prohibition or regulation of the
mixing of the milk in one churn with the milk in
another. The duty is also imposed upon the LocalGovernment Board of making regulations under the PublicHealth (Regulations as to Food) Act, 1907, as regards theimportation of milk or milk products ; and the Board may,after holding a local inquiry, make orders compelling acouncil in default to do its duty as regards the milk-supply.Presumably the provisions of this Bill would have the effectof enabling the existing regulations under the Dairies, Cow-sheds, and Milkshops Order to be replaced by somethingmore modern and workable, and, if this alone were procured,a substantial step forward would be taken. In many in-
stances thelexisting regulations are so vague and difficultto interpret that they possess very little practical utility froman administrative point of view.
MEASLES AND THE POST-OFFICE AUTHORITIES.
WE have received a copy of a report presented to theBrixham urban district council by Mr. George Blacker
Elliott, the medical officer of health, concerning the actionof the Post-Office authorities in regard to a case of measlesoccurring in the family of a postman. Briefly stated, thefacts as reported by Mr. Elliott are that on April 15th thewife of a postman was taken ill with measles. On beinginformed of this next day, Mr. Elliott saw the postmasterand advised him to order the man off duty, so as to avoid thedanger of infection. The postmaster stated that he had nopower to do this, and accordingly Mr. Elliott telephoned toTorquay, where the head office for the district is situated.The officials there replied that they had no power to suspendthe postman from duty, but promised to communicate with theauthorities at the General Post Office. Three days afterwardsthe postman was ordered back to duty, and he has continuedat his work from that time. Mr. Elliott has since learnt thatthe rule of the Post Office authorities is to the effect that noPost Office employee can be absent from duty on accountof his coming from a household infected with measles.This is the more remarkable in view of the fact that thereare stringent regulations barring employees from work if thereis either scarlet fever or enteric fever in their homes. In
commenting upon this case Mr. Elliott rightly maintains thatit is not merely a matter of local interest, but one affectingthe public health of the whole kingdom. Measles, as he
points out, is by no means a trivial disease, when it is re-
membered that the deaths in England and Wales alonehave varied during a period of 30 or 40 years from 6000to 14,000 in a year. It is, moreover, one which is readilyspread by fomites, and there is every reason to believe thatletters, telegrams, or postage stamps may act as infectiveagents when handled by a person who has been attendingon a patient suffering from the disease. Moreover, the