CONRTOLLING THE USE OF MILK AND MEAT FROM TUBERCULOUS ANIMALS, AS A MEANS OF PREVENTING THE SPREAD OF TUBERCULOSIS.* BY H. M. BRACKEN, M. D. Professor of Materia-Medica and Therapeutics, Minnesota; Secretary and Executive Officer Minnesota State Board of Health. The sale of milk from a tuberculous animal should be absolutely prohibited. It is a common idea that so long as the udder of a cow is not involved in the tuberculous process, the milk may be free from infection, but this is not safe reasoning, as demonstrated by various observers, and so ably set forth by Dr. Ravenal in a paper read at Philadelphia in 1897, before the American Public Health Association. There is but one way to control the sale of milk from tuberculous cows, and that is through control of the dairy. The selling of milk should be permitted to those only who have a statement from the proper authorities setting forth the fact that their cow or cows are free from tuberculosis. The tuberculin test is the only reliable means of determining the presence or absence of tuberculosis in a given cow. All cows should therefore be subjected to the tuberculin test, and those that respond to this test should be rejected as milkproducers, and placed in quarantine. There are some cattle so thoroughly infected with tuberculosis that they fail to respond to the tuberculin test. Those animals can generally be condemned on the clinical symptoms, without resorting to the tuberculin test. A single test of a cow or cows should not be considered sufficient. Cattle that are free from tuberculosis to-day may be affected at some later date. Milk-producers should be tested every six months, if possible, and at the farthest not more than one year should be allowed to pass without a retest. Dairymen should not be forced to bear the expense of these tuberculin tests. The tests are made chiefly for the good of the public, and therefore the expense should not fall upon the public, either through municipal or state authority. There should be no attempt to compensate a dairyman financially for the loss of a tuberculous milk-producer. Such a course would make it of little importance to the dairyman whether his dairy cattle were tuberculous or not. Let the dairyman understand that the financial loss associated with the existence of tuberculosis in his dairy herd rests upon himself, and he will quickly become one of our most important aids in eliminating this disease from his herd. Boards of Health, state and municipal, should be looked upon as the friends of the dairyman in his attempt to eliminate tuberculosis from his herds. They should take particular pains to urge upon the dairyman the necessity of buying only such cows as have stood the tuberculin test. They should also point out the existing dangers in a stable that has formerly contained tuberculous animals, explaining the possibility of infection from such a source. They should also insist upon the fact that cattle poorly housed, poorly fed and poorly cared for are more liable to infection than are cattle *Read at the Conference of State and Provincial Boards of Health, Aug. 10, 1898. receiving the reverse of such treatment. They should not only point out these facts, but should insist that all dairies must come up to a certain standard in cleanliness, air-space and ventilation, and that certain foods (commonly known as slops) should be excluded from use in a dairy. Dairy cattle should be as well housed, groomed and fed as the thoroughbred horses in our well-kept stables. It may be said that the dairyman cannot fulfill all these demands and sell milk at the present price. Quite true. Let him raise the price. No one, not even the poor man, can reasonably object to paying a little higher price for milk, providing he can be assured that the higher-priced milk is safe as an article of diet, when the lower-priced milk is not safe as such. If necesssary to protect the dairyman financially, Boards of Health establishing a standard for the dairies might reasonably be expected to fix the price for the milk produced at such dairies. It has been stated that all cattle responding to the tuberculin test should be condemned as milk-producers. It does not follow that all cattle responding to the tuberculin test should be condemned as meat-producers. They should be kept under strict quarantine, however, and killed under careful inspection. Cattle that have a very limited area of infection may respond to the tuberculin test. They at once become unsafe as milk-producers. At the same time they may be in good flesh, or a sufficient time may be granted the owner to fatten them, provided strict measures are taken to prevent the cattle from passing out of quarantine. Such cattle should be slaughtered under inspection, and the carcass passed or condemned, according to the judgment of the inspector. We should go still further, and say that all animals intended for meat should be killed under inspection. Prudden, in his little book, "The Story of the Bacteria," says, on page 73: "It is almost inconceivable that any man not wholly given over to the spirit of the devil should be capable of sending into the market meat from the tuberculin cattle, if he is aware of it. Yet there is reason for believing that a very considerable amount of such diseased meat is actually sent into our large towns every week, with the full knowledge of some of the unscrupulous dealers, and probably consumed, usually by the poorer and more ignorant classes." We all know this statement to be a true one. There is but one way to prevent it, viz., by establishing a strict inspection, both ante and post mortem, as is that carried out under the Bureau of Animal Industry in the inspection of meats for export. The inspectors should be of as high a grade as are those under the Bureau of Animal Industry, and should be under the control of the state or municipal Board of Health. In reviewing this subject, the following points are before us for consideration: 1. Milk should only be used from cows that have stood the tuberculin test. 2. Dairies and dairy cattle should be under constant inspection. 3. All cattle slaughtered should be subject to a thorough inspection, both ante and post-mortem. 4. This work should be under the control of Boards of Health. INDEX. Abattoir-Public, for Twin Cities and meat inspection..... Actinomycosis-Laboratory, directions for sending specimens for ex- amination Laboratory investigations of.. Transmission to man. Page. 239 201 165 358 321 133 .74, 88 163 Adair, Dr. J. H.-Paper by-"Bacillus Diphtheria and Its Variants In a Physician state school, Owatonna; letter to, in re diphtheria as.. .65, 67, 98, 100, 109, 120 Agents of Board..... Albert Lea, Minn.-Diphtheria at, and secretary's trips and action..66, 71, 387 450 108 .67, 68, 121 American Medical Association-Meeting of, attended by secretary. 80 American Public Health Association-Delegates to. .64, 95, 120, 137 .243, 252 Annand, Dr. J. G.-Special field work of in hog cholera. from diseased Coöperation of government inspectors with diseased. 199 382 .54, 79 78 Fund for infectious diseases of, share of expense for laboratory... Laboratory examinations for.... Prevalence of, during 1897.. Antitoxine for Diphtheria-Circular on. Board should produce... Laboratory, special notice No. 3. The use of.... Appendicitis with typhoid fever. Appropriation and legislation for veterinary department. .13, 136 .240, 249 .61, 89 110 192 .10, 39 296 .54, 79, 215 Assistant Bacteriologist-Attending and paper to British Medical Asso- ciation .... Dr. L. B. Wilson allowed to use title of.. Laboratory work on flagella and rabies. ..137, 139 Method of, for collecting and examining serum for typhoid fever Papers by. 52 140, 304, 305 .171, 298, 303, 315, 321, 333 To teach in university. Trip to eastern laboratories. .70, 170 181 Bacteriologists-Importance of work of.. Bacteriologist and Pathologist in Medicine-Paper by secretary. Benson, Minn.-Laboratory examination in case of rabies from. 130 70, 119 9 Black Leg-Prevalence of and work of veterinary departm't.239, 249, 256, 483 Blue Earth City-Stockyards, visit of secretary. Boards of Health, Local-Circular letter on hog cholera, to. City and village. Duties of.. Election of township.. Legislation for township.. Number of, in Minnesota. Fage. 80 227 9 5 Books, purchase of for bacteriological laboratory.. Bracken, Henry M. M. D.-(See secretary, State Board of Health.) Bronchitis-Chart of average monthly mortalities. Chart showing annual death rate per 100,000 population. 111 112 77 260 260 ..58, 137 57 and .137, 139 424 438 240 Buffalo Lake, Minn.-Diphtheria, visit of secretary to. 87 Bulletin-Monthly .57, 61 Bush, Mr. A. K.-Made special agent.. 120 Camp Ramsey-Investigations in re typhoid fever at.114, 176, 177, 179, 440, 472 94 6, 15 163 58 Cerebro Spinal Meningitis-During 1897 in Minnesota. Laboratory examinations for... Chairmen of Local Boards-Circulars and blanks sent to in 1895 and 1896. Reports by, on scarlatina and diphtheria, in 1895 and 1896. 405 ..169, 449 6 7 6, 75 415 Showing mortality from diphtheria, enteric (typhoid) fever, tubercu- lar diseases, diarrhoeal diseases of children. Append. III........16-20 Chemical analyses of water-(See water). Chemical Laboratory-Inventory and disposal of...... .54, 73 Circulars and Circular Letters-(See subjects of). Circulars, Blanks, etc.-Sent to chairmen in 1895 and 1896.. 6 216 Of veterinary department... Circular of Information Nos. 1 and 2-Bacteriological laboratory, Circular-Laboratory special notice Nos. 1, 3 and 4. Cities and Villages in State-Facts relating to sanitation. Committees of Board-Action creating revoked... Appointed for 1897...... On infectious diseases divided.. Conference of state boards of health, and work of.. 34, 67, 158, 183 .151, 191, 192, 195 400 65 72 54 . 86, 113, 114 7 Correspondence in 1895 and 1896 with chairmen of local boards. Cornstalk Disease-Prevalence of, during 1897. Creameries-Nuisances by..... Crookston-Diphtheria at and visit of secretary. Chart showing annual death rate per 100,000 population. Culture Boxes-Sent to laboratory by mail.. Culture Medium-Used in bacteriological diagnosis of diphtheria. Dairy Cows-Tuberculin test for..... Dairy Herds at State Institutions-Inspection of. Page 239 .57, 82 390 417 427 97 158 35 ∙11 120 85 .61, 70, 86, 99, 102, 118, 395 Rules for transportation of and action by other states. 396 70 .117, 171 Delegates to American Public Health Association. 64 Denmark-What it is doing in re tuberculosis and tuberculin. 212 Detroit, Mich.-Conference state boards of health at, secretary at- Diarrhoeal Diseases of Children-Chart showing annual death rate Chart of average monthly mortalities.. 113 per 435 422 20 Diphtheria at Albert Lea and secretary's trips and action. 36, 37, 38, 133, 158, 161, 171, 173, 175, 321, 323, 391, 459, 461 Chart showing annual death rate per 100,000 population. Disinfection experiments at Albert Lea and Owatonna. Laboratory examination as basis for quarantine. .450, 459 .184, 188, 189 142, 152, 188, 443 13, 34, 35, 36, 37, 38, 44, 64, 65, 125, 132, 133, 141, 149, 159. 167, 172, 321, 443, 445, 450, 468, 470 To be reported to local board before receiving bacteriological diag- "Diphtheria bacillus and its variants in a school in which diphtheria 53 321 |