In the April bulletin it was stated that in the May bulletin would be presented the detailed results of the examination of the New Hampshire dairies, together with those of further work in other towns of the same State. They are as follows: Total number of conditions to which attention was called, . 604 35 The milk produced on these farms is collected by three different contractors, who may be designated "A," "B" and "C." The sanitary condition of the barns in contractor "A's" territory was commonly found to be far from commendable; many of the cows were exceedingly filthy and not a few of them showed evidence of tubercular disease of the udder as well as of the lungs. 66 The farms which supplied contractor “B” were observed to be in a far more cleanly condition than those supplying "A," but some of them were found to be very dirty, unventilated and undrained. Some of them have proper milk houses or milk rooms, and most of them have "coolers" and use ice. Numbers of the cows were observed to have tuberculosis either of the lungs or of the udder, and many of them were very filthy. The milk bought by contractor "C" was found to be collected every other day, and hence was in part, at least, forty-eight hours old before leaving the barns. It was said that the producers themselves would prefer to ship their milk daily, but that the contractor was unwilling to run the car any oftener. Inasmuch as the milk on arrival at its destination is not immediately sold, but commonly is held upwards of twenty-four hours, it is clear that this milk must be about three days old before delivery to the consumer. The barns in contractor "C's" territory were very generally dirty, poorly ventilated and badly drained. Very few of them have milk rooms, and in most cases the milk is cooled and stored in troughs in the barn. Many of the cows show evidences of tuberculosis either of the lungs or of the udder, or both. Inquiry among the farmers developed the fact that contractor "B" has made an earnest effort to enforce cleanliness and proper storage of milk; that contractor "A" appears to have been less urgent in this particular; and that contractor "C" does absolutely nothing to promote cleanliness at the place of production or to consider the interests of the producers. AN OUTBREAK OF DIPHTHERIA IN DORCHESTER, MILTON, AND HYDE PARK, DUE TO INFECTED MILK. On April 13, after a period of comparative freedom from diphtheria, there were reported to the board of health of the town of Milton 11 cases of that disease. This sudden explosion caused, very naturally, a feeling of grave apprehension on the part of the local health authorities, who made immediate application to the State Board of Health for as sistance in determining its origin. On the following day another case. was reported. Investigation showed that all of the cases reported on April 13 and single cases reported on April 12 and 14 had this in common: that the families of the victims were supplied, without exception, by the same dealer in milk, whose route lies partly in Milton and partly in Dorchester. Inquiry at the office of the board of health of the city of Boston developed the fact that on April 12 there were reported from Dorchester 6 cases; on April 13, 19 cases, and on April 14, 11 cases of the disease, all in families supplied by this same dealer, whom we will designate as "A." Inquiry into the sources of his supply developed the fact that it was derived from six producers, as follows: J. H., Randolph. Ten cans, some of which were bought of other producers; all delivered to "A." No diphtheria on the premises of J. H. or on those of the others who contributed to his supply. R. B. N., Randolph. Four cans, all sold to "A." No diphtheria. E. T. T., Randolph. Three cans, some sold at retail and the rest to "A." No diphtheria on his premises or among his customers. O. H., Milton. Seven cans, all sold to "A." No diphtheria. J. M. B., Milton. Four or five quarts, all sold to "A." No diph theria. C. F. J., Milton. Twenty-seven cans, seventeen sold to "A" and ten to a dealer in Hyde Park, whom we will designate as "B." Inquiry as to the existence of diphtheria on the premises of C. F. J. revealed the fact that his grandchild was seized with the disease on April 11; that the cooler in which the milk was mixed was washed in the house, and that this office was performed by the person who had the care of the sick child. It appeared probable that herein lay the solution of the problem; but the absence of any reported outbreak in Hyde Park offered an obvious complication, since more than one-third of C. F. J.'s output was delivered to families in that town by dealer "B." On April 14, however, four cases; on April 15, five cases; on April 16, 1 case; on April 17, 3 cases, and on April 19, 1 case, or fourteen in all, were reported to the board of health of Hyde Park, all of which, and 2 that had been reported on April 13 without exciting comment, proved to be in families supplied by "B." Prompt action on the part of the local authorities of Milton in excluding from sale the milk of C. F. J. brought the outbreak to an immediate close. The incidence of the cases is shown by the accompanying diagram. It will be noted that in the three places concerned there occurred, between April 11 and 19, 5 cases among families not supplied by "A" or "B," namely, 2 on April 11 and 3 on April 15. One of the former was reported in Dorchester, the other in Milton; and the 3 cases reported on April 15 were all in the same household with, and secondary to, the latter. Case at place of milk production Cases on A's route in Milton Dorchester Cases on B's route in Hyde Park Cases on other milk routes There were, then, between April 12 and 19, inclusive, in the three places mentioned, 72 cases of the disease, all but 3 of which occurred in families supplied by two dealers, who obtained their milk from a man in whose household a child was seized on April 11; and the 3 cases not connected with this supply were secondary to another case reported on the same day. The fact that the outbreak in Hyde Park occurred later than that in Dorchester and Milton may perhaps be due to the fact that dealer "B" called for his share of C. F. J.'s milk in the evening and sold it on the following day, while dealer "A" came for his in the morning and disposed of it at once. It is of further interest that C. F. J. himself came down with the disease after the outbreak had nearly subsided, and that dealer "A's" son, who drank milk from C. F. J., was one of the earliest victims. The partner of dealer "B" was seized on April 18, and at about the same time also another member of his household. AN EPIDEMIC OF SCARLET FEVER IN GARDNER, DUE, APPARENTLY, IN PART TO CONTAMINATED MILK. During the months of January and February there were a number of scattered cases of scarlet fever (9 in all) in the town of Gardner. In March there was a sudden rise in the number of cases, 46 being reported, 18 of which occurred in the week ended March 7, and 11 during the week ended March 14. The cases were scattered over the entire town, and were not confined to any one class; but more than half (53.6) of those seized were children between the ages of one and five years. When the assistance of the State Board of Health was requested in ascertaining the source of the infection and putting an end to the outbreak, the total number of cases had reached (April 17) 69. There were four families with 3 cases each, and sixteen with 2 cases each. Fifty of the cases were primary and 19 were secondary. The milk supplied to the families in which the cases occurred was distributed by eighteen different dealers, but during the height of the outbreak most of the victims were supplied by one dealer, who distributes about twenty cans of milk daily, which he produces on his own farm, buying none whatever. Part of the milk was delivered at this time in cans and partly in bottles. The bottles, cans, milk pails and other utensils were usually washed by his wife, but those which were returned clean were refilled without further washing. During the month of |