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Meat seizure
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Meat Seizure
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MEAT SEIZURE. ~ BY F. VACHER, F.R.C.S, Medical Officerof Health of the County of Cheshire. :I HAVEbeen asked to open a discussion on this subject, and I do so willingly, as it is a matter which has interested me for a quarter of ~a century, and deserves far more attention than it ordinarily receives. Since my appointment, in 1873, as Medical Officer of Health of Birkenhead I have had exceptional opportunities of :studying animal diseases in connection with the meat trade. Even at that time Birkenhead had a public abattoir, and only two pt~vate slaughter-houses. This abattoir was abandoned in 1887, having been replaced by entirely new premises (slaughter-houses, lairages, and cooling-rooms) as good as any provided in England at that .time. In 1878 the first of the extensive buildings for sheltering, inspecting and slaughtering cattle arriving from infected countries were erected on the Cheshire side of the river Mersey, and in 1879 the Foreign Animals Wharf was opened at Woodside, under ¢he Contagious Diseases (Animals) Act, 1878. Thus it fell out that on June 3rd, 1878, I had facilities for investigating a very remarkable outbreak of swine (typhoid) fever in a cargo of upwards of 1,800 swine, and on the 25th of the same month I read my firs~ paper on the diseases of animals rendering them unfit for food before the North-Western Association of Medical Officers of Health at Manchester. This drew so much attention to the subject that in the following year I was invited to open a discussion on animal diseases in connection with the meat-market at the annual meeting of the British Medical Association at Cambridge. Referring to my paper of June, 1878, and to the report of what I said at Cambridge, I find that I then held that the following diseases rendered the meat unfit for the food of man : Cattle plague. Acute rheumatism. Swine typhoid fever. Scarlatina and quinsy of swine. Epizootic pleuro-pneumonia. Anthrax. Sheep-pox. Disease due to presence of cystiNormal cow-pox. eerci. Influenza. Disease due to presence of trichinae. The following diseases of animals I held as depreciating the quality of the meat, or making it pr~eternaturally liable to decom. pose, but not necessarily, except in their later stages, rendering the meat unfit for the food of man : * Read before the Incorporated Society of Medical Officers of Health, November, 1900.
December, 1900]
Meat Seizure
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Foot-and-mouth disease. Dropsy. Hoof-rot. Acute inflammatory diseases of Tuberculosis. lungs, intestinal canal, or serous Liver-fluke. sacs. Jaundice. The opinion expressed twenty-two years ago is practically my opinion to-day. As regards tuberculosis, however, I began to modify my opinion after the discovery of the bacillus of tubercle by Koch. Then came the report of the Departmental Committee which was appointed by the Lord President of the Council in April, 1888o This report, dated July 16th, 1888, expressed the opinion of the Committee as follows : "Although the bacilli may be found but rarely in the flesh, still, the chance of their being present either there or in the blood is too probable to ever allow the flesh of a tubercular animal being used for food under any circumstances, either for man or the lower animals." This official opinion commended itself to my intelligence. It seemed to me unreasonable that, because the disease was apparently limited to the lungs, and not far advanced, the inspector should be instructed to pass the meat. Here was a disease communicable from one of the lower animals to man by means of a bacillus, which might infect the air breathed, the food eaten, or be directly introduced into the blood ; surely any carcass infected with this disease could not be safely used for human food. The fact that the disease seemed to be localized I regarded as of little significance, as~bacilli would be carried from one part of the body to other parts by the blood, or by the lymph stream. Thus it fell out that I endeavoured to obtain orders for the destruction of animals whenever there was proof positive of the presence of tuberculosis. I did this for three or four years--that is, Until I left the service of the Birkenhead Corporation, in J.anuary, 1892. My efforts were sometimes successful and sometimes not. Whether I or the butchers won depended largely upon the magistrate hearing the application, and considerably upon the number of the witnesses called on either side. It was a disagreeable position for a local authority to be in to have the meat trade in organized opposition to it, and much money and time were spent in litigation. Still, I cannot, on the whole, regret this. Public attention was drawn to the matter, and doubtless the butchers in Birkenhead and elsewhere became a little more particular as to the quality of the meat they ventured to expose for sale. Since 1892 1 have had very little to do with the inspection of unsound meat, except occasionally as a consultant. What has impressed me during the past nine years is the infrequency of any carcass or meat being seized on account of any disease other than
19 8
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tubercle. As for cattle disease, it is thirty-three years since we have had a case in this country. Then pleuro-pneumonia is grown so rare thai even an imported case makes quite a stir. The last case I saw was that landed at Liverpool by s.s. Toronto from Montreal on May 20th, 1894, which formed the subject of an elaborate Government inquiry. Foot-and-mouth disease was for some time stamped out. Even when present, as it has been in many a county since January, 1900, this disease, though interfering much with the movement of stock, and causing much falling off in condition, gives no trouble to the meat inspector. Anthrax and swine fever are so well looked after by the police that it is quite an extraordinary event if a carcass infected with either disease finds a place in the meat-market. Cases of cysticerci-infected swine one still sees occasionally, cases of trichinse practically never. Even liver-fluked sheep appear to be scarcely ever put on the market. Thus the question, Where to draw the line as regards diseased meat, has resolved itself generally into, Where shall we draw the line as regards t~tbercuIous meat ? That question was officially answered for all authorities early last year. The Local Government Board, in circular letters to councils of boroughs and urban and rural districts, dated t~arch 10th, 1899, issued the following: " INSTRUCTIONS TO M E A T
INSPECTORS W I T H REGARD TO TUBERCULOSIS
IN ANI~IALS INTENDED FOR FOOD. " The Royal Commission recommended that the Board should be empowered to issue instructions from time to time for the guidance of meat inspectors, prescribing "the degree of tubercular disease which, in the opinion of the Board, should cause a carcass, or part thereof, to be seized. "Pending the issue of such instructions, we are of opinion that the following principles should be observed in the inspection of tuberculous carcasses of cattle : "(a) When there is miliary tuberculosis of both lungs ......... "(b) When tuberculous lesions are present on t h e pleura and peritoneum ............ "(c) When tuberculous lesions are present in the muscular system or in the lymphatic glands embedded in or between the muscles "(d) When tuberculous lesions exist in any par~ of an emaciated carcass
The entire carcass and all the organs may be seized.
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"(a) When the lesions are confined to the lungs and the thoracic lymphatic gIands ......... "(b) When the lesions are confined to the liver . . . . . . . . . . . . "(c) When the lesions are confined to the pharyngeal lymphatic glands ... "(d) When the lesions are confined to any combination of the foregoing, but are colIectively small in extent ............ +
The carcass, if otherwise healthy, shall not be condemned, but every part of it containing tuberculous lesions shall be seized.
" I n respect of foreign dead meat, seizure shall ensue in every case where the pleura have been ' stripped.' " The Board do not consider it necessary at present that anything should be added to these instructions, or that they should be modified, and the Board think that the Council should direct those of their officers who are employed as meat inspectors to act in accordance with the principles thus laid down. However, as regards swine, the opinion expressed is as fOTlows : " I n view of the greater tendency to generalization of tuberculosis in the pig, we consider that the presence of tubercular deposit in any degree should involve seizure of the whole carcass and of the organs." The meat inspector is therefore officially instructed to regard tuberculosis in swine as a disease of animals which renders the meat unfit for human food, and tuberculosis in oxen and cows as a disease of animals which ordinarily renders portions only of the carcass unfit for human food, though in its later stages it may unfit the whole carcass for human food. As the Central Authority were so long before they consented to draw the line at all in this matter, the ruIe now laid down is likely to serve for many years to come. There will be little use in medical officers of health trying to get it varied for the present. The difficulty is that when the specific conditions as indicated under the firs~ (a), (b), (c), or (d) obtain, and the medical officer of health or inspector seizes a carcass and organs, and applies for an order to destroy the same, the magistrates may refuse to grant the order, or after an order is made it may be appealed against, and if the appeal is sustained the authority may be mulct in heavy damages. This is the present impediment in the way of effective action under the unsound meat clauses, and this is what medical officers of health must do their best to remove.
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Of course there is a large proportion of unsound meat which is not diseased--tha~ is, meat partially decomposed through having been kept too long, or ill-kept, meat from animals not killed by man, or only killed when moribund, etc.--but there is not much difference of opinion as regards the unfitness for food of this, and not much difficulty in getting an order to destroy i~, DISCUSSION. Dr. BOND said he was convinced that the only way to secure satisfactory and efficient inspection of meat was by the abolition of private slaugh~er-houses, and the provision of public abattoirs, with skilled meat inspectors under the supervision of the medical officer of health, or a specially trained veterinary surgeon. I n a paper he read to the Sanitary Institute last year he gave many reasons for this opinion, and also for thinking that properly constructed public abattoirs would be advantageous not only to the consumer, but also to the stock-owner and the butcher. There could be no doubt inspection of meat ought to be carried out on pathological principles. It was often found that there was a great want of uniformity, especially with regard to the carcasses of animals suffering from tuberculosis. I n his opinion the recommendations of the Royal Commission on the subject were excellent. I t was difficult to frame regulations which would apply to every case, but generally these recommended of the Royal Commission were satisfactory. I n the experiments of Dr. S. Martin, of eighty-one highly susceptible animals fed with large quantities of raw meat from sixteen cows affected with tuberculosis in a mild or moderate degree, not a single one developed tuberculosis, although many of those animals--the flesh of which was used for the experiments--would have been condemned under the regulations recommended by the Royal Commission. Even with the raw " t r i m m e d " meat of cows affected with ~dva,nced o~" generalized tuberculosis which was employed in seven feeding experiments, in no case did the allhnal develop the least tuberculosis, although if the recommendations of the Commission were followed, such meat would not have been used for human food. By " t r i m m i n g " most of the tubercular material which might have accidentally contaminated the surface of the carcass would be removed. On the other hand, of fourteen feeding experiments with raw " u n t r i m m e d " meat of advanced or generalized cases, six of the animals developed tuberculosis. It should also be remembered that in the great majority of experiments in which the animals were fed with undoubted bovine or human tubercular material, even when comparatively small amounts were given, tuberculosis was developed. I n all kinds of life they had to run some risk. They ran risks when travelling by road or rail, but that was no reason why t h e y should not so travel. The risk which would be run under these recommendations would be infinitesimal, and therefore he thought the society should adopt the recommendations of the Royal Commission. They would do great good by acting in a reasonable spirit, and not in a dogmal~c or harsh manner. He knew that a number of medical officers of health almost ridiculed the idea of tuberculosis being localized. Even such an authoriSy as Dr. Sedgwick Sannders stated in the July number of PUBLIC H~ALTH that he did not recognise " l o c a l i z e d " tuberculosis. That was contrary to their experience as medical men. All the surgical operations for the
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removal of tubercular glands or joints or bones were conducted on the principle of localized tuberculosis. Most of t h e m had heard of the St. Pa~cras case. H e h a d in t h a t case, acting on the lines laid down by the Royal Commission, advised that the carcass should not be seized. The carcass was fat and in good condition, and there were no tubercles on the pleura, or on the peritoneum, or any other part of the carcass. H e h a d no hesitation in saying t h a t the eareass would not have been seized in the City or in any market. H e moved that the Society r e c o m m e n d the adoption of the r e c o m m e n d a t i o n s of the Royal Commission, and of the Local Government Board. Dr. COLLINGRIDaE said t h a t the opinions on the subject h a d been a n d were very conflicting, and t h a t the recommendations of the Royal Commission were a compromise, but he could not see why the Society of Medical Officers of H e a l t h should endorse those recommendations. They were useful as a practical working basis, but was the Society prepared to say thin tuberculosis as such was a local disease ? He was m u c h interested in Dr. Bond's remarks. He (Dr. Bond) h a d said that the risks incurred were exceedingly small. H e quoted the well-known series of experiments of Professor Martin, showing t h a t in a long series of cases where animals were fed on tuberculous meat no tuberculous lesions were found, and yet he advised t h e m to accept the recommendations of the Royal Commission. That appeared to h i m (the speaker) to be a somewhat illogical position to adopt. If, as Dr. B o n d suggested, this meat did not cause tuberculosis, why seize it at all ? I n the speaker's opinion there was no reason because the Royal Commission had brought out a compromise why they should endorse it. On the question of veterinary inspectors, he said they of course knew t h a t veterinary inspectors of the present day were highly educated men, but they ought not to allow the question of the effects of diseased meat on the h u m a n being to pass from the medical officer of health to the veterinary inspector. They should co-operate with the veterinary surgeon as to the condition of the meat, but when it came to the effect of the consumption of t h a t meat in the community it became a question for the medical officer of health. Dr. R. DUDFIELD,adverting to the St. Paneras case, said the condition of the animal w h e n slaughter~ed was described in the July issue of PUBLIC HEALTH. Bearing the whole of t h a t description in mind, was Dr. Bond of opinion that the carcass should be allowed to pass 9 H e ventured to say if ever there was a case of generahsed tuberculosis, t h a t was one. He (Dr. Dudfield) would have condemned it without hesitation. He could further state that Dr. Sedgwiek Saunders expressed his opinion on the description submitted to him, and he said no such animal would have been passed at the Meat Market. Dr. Bond h a d quoted a series of experiments with some eighty animals. He would point out t h a t the whole of the evidence in those experiments was negative. The value of negative evidence was almost nothing. Dr. Bond had mentioned t h a t where the meat was " u n t r i m m e d " the results were positive. Those results carried more weight with h i m t h a n all the negative results, as t h e y were more in h a r m o n y with daily practice. Admitting for a m o m e n t t h a t there was a m i n i m u m of risk in the matter, he submitted that the temperature to which m e a t was rMsect in domestic cookery was insufficient to obviate t h a t risk. Supposing they had in a n y case a limited n u m b e r of centres of visible tuberculous lesions, were they justified in saying t h a t the disease was "localized " 9 Were ~he lesions purely " l o c a l " infections, or were the 5, only local manifestations of a systemic disease .9 Lastly, was it honest and fair to sell meat from an a n i m s l k n o w n to be tuberculous as sound meat or without declaration .9 W h e n he boug]lt
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meat at top prices, he trusted to the honesty of the butcher t h a t he was selling meat from a sound carcass. Was it honest that he should sell as prime meat the flesh of a tuberculous animal ? Dr. PORT~ said it was a matter of indifference whether the Society endorsed the recommendations ,of the Royal Commission or not, because no medical officer of health who had regard to the success of a prosecution would venture to condemn a carcass without being strictly guided by those recommendations. H e would be confronted with t h e m by the defendant, and the magistrate would certainly not convict unless the recommepdations had been adhered to. Cooperation with the veterinary surgeon was most valuable, a s t h a t flmctionary appeared to carry a great deal of weight with the ordinary magistrate, who for some reason appeared to think the veterinary surgeon knew more about the condition of meat t h a n did the medical officer~ although he (Dr. Porter) believed the veterinary surgeon was as little capable of giving expert evidence in the matter as a n ordinary medical m a n who had left the hospital m a n y years was able to give expert evidence in a post-mortem operation on the h u m a n subject. Dr. SOURm~LD agreed with Dr. Bond t h a t there was such a thing as localized tuberculosis. He was under the impression t h a t the leading pathologists in this countiy and abroad taught that tuberculosis was usually at first a localized disease, which became established in the lymphatic system of some particular organ after effeeting an entrance through some point in the mucous membrane, and subsequently a generalized disease either by the comparatively slow method of progressing through the lymphatics till it reached the venous system through the lymphatic duct, or by the comparatively quick method of the ulceration of a bloodvesseI in the neighbourhood of a tubercular nodule and the infection of the ruptured bloodvessel with the contents of the nodule. Those who did not believe t h a t tuberculosis was ever localized were committed to the view t h a t 40 per cent. of the cattle in the country were unfit to be used as h u m a n food. H e at the same time regretted t h a t only those recommendations of the Royal Commission which lessened the severity of the methods of dealing with meat h a d been acted upon, because the question of infection by milk appeared to him so m u c h more important t h a t he h a d hoped t h a t some practical effort would have resulted from the recommendations of the Royal Commission as to the question of the extirpation of bovine tuberculosis. H e thought it a reasonable thing that a veterinary surgeon should examine carcasses and report as to the extent of the disease present, but it appeared to h i m to be the province of the medical officer of hes~lth to say what extent of disease ought to preclude the use of the carcass for h u m a n food. H e a ~ e e d with Dr. Porter t h a t any medical officer of health who pitted his opinion against the recommendations of the Local Govermnent .Board would have a very poor chance of success in any prosecution, and he thought t h a t the Society of Medical Officers of H e a l t h ought to consider these recommendations, and if they thought alterations or amendments desirable, ought to approach the Local Government Board on the subject. Dr. XAYE said he had recently seen a cow in a public abattoir weighing some 600 p o u n d s - - a very fine-looking carcass. H e insisted on seeing the whole of the entrails. One was missing--the l i v e r - - a n d he threatened to condemn the cow if the liver could not be found. W h e n it was produced he found it weighed 81 pounds, and was a mass of tuberculous abscesses. So far as they could see, t h e liver, a n d the liver only, was affected. W a s this a localized o1" general disease? Dr. SCURFIEnD was disposed to t h i n k it localized disease.
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Dr. LEGG~ thought it distinctly localized, but he would like to ask what became of it. Dr. KAYEsaid the carcass was brought before the magistrate and condemned. Dr. BOND could not see why it was called general tuberculosis if there was no tuberculosis in the carcass. What did the word "local" mean ? Dr. PA~ES said because nothing could be seen with the naked eye it did not follow that the flesh was absolutely innocuous. Would Dr. Bond be prepared m say it was impossible that this meat should contain the toxfl~ of tuberculosis sufficient to light up tuberculous mischief in a person already infected in the exact way that Koch's tuberculLn did ? I n his opinion it was a general disease, and the food would be dangerous. He objected ~o the word "small" in the last paragraph of the recommendations of the Royal Commission and hoped the Society would not approve then/. Dr. E. P. MANBYsaid the time was not ripe for any definite statement in this matter, and they ought ~o be glad that they had reached the point where the Royal Commission took them. The feeling among the butchers was very s~rong, whilst public opinion was almost indifferent. The whole thing was a question of education. Later on, when bacteriologists had taken them another step, they could apply to the Local Government Board for some modifications. In Liverpool they went practically on the lines of the recommendations of the Royal Commission, and they had very little trouble. Dr. TuBB THO~IASsuggested that efforts should be made to obtain bactcrio: logical examination of the flesh of all animals where localized tuberculosis existed. Dr. FEaEN said these recommendations had been of the greatest benefit to many medical officers of health in the country. They seized the carcass of an animal and :brought it before the magistrate with these recommendations, and on the strength of them obtained convictions. For the larger districts; where the medic/1 officer of health had practical experience~ they should not be asked to appro~'e or disapprove. Localized tuberculosis was the outward sign of a general disease. He would object to eat meat even slightly tainted with tuberculosis. It w~s resolved unanimously, on the motion of Dr. R. Dudfield, that the meeting stand adjourned to Saturday, January llth, 1901, at 2.80 p.m., and that the resolutions now submitted by the Council be forwarded to the various branches of the Society for consideration and report.
A METHOD FO~ DETECTION OF HORSEFr,J~SH.--The New York Mec~ccd Journal claims t h a t horseflesh can be readily detected, and even in as small proportion as 5 per cent. when mixed w i t h other flesh. The process is as follows: 20 grains of the suspected meat are finely minced, a n d boiled from a halLhour to a n hour in 100 e.c. of water. The volume of water is then reduced by evaporation to 30 e.c. ; the liquid is t h e n cooled a n d filtered. About 10 c.c are tested with a few drops of the compound iodine solution (1 part of iodine and 12 parts of potassium iodide in 100 parts of water). A fugitive reddish-violet coloration indicates the presence of horseflesh. The reagent must be added very carefully, so that no excess i s added, as this is apt ~o change the colour to a reddish brown.*--British Food #ou~'~zat. * See also PUBLICHEALTH, xi., p. 593.
Meat Seizure
[Pubne a~aa~
MEAT SEIZURE. ~ BY F. VACHER, F.R.C.S, Medical Officerof Health of the County of Cheshire. :I HAVEbeen asked to open a discussion on this subject, and I do so willingly, as it is a matter which has interested me for a quarter of ~a century, and deserves far more attention than it ordinarily receives. Since my appointment, in 1873, as Medical Officer of Health of Birkenhead I have had exceptional opportunities of :studying animal diseases in connection with the meat trade. Even at that time Birkenhead had a public abattoir, and only two pt~vate slaughter-houses. This abattoir was abandoned in 1887, having been replaced by entirely new premises (slaughter-houses, lairages, and cooling-rooms) as good as any provided in England at that .time. In 1878 the first of the extensive buildings for sheltering, inspecting and slaughtering cattle arriving from infected countries were erected on the Cheshire side of the river Mersey, and in 1879 the Foreign Animals Wharf was opened at Woodside, under ¢he Contagious Diseases (Animals) Act, 1878. Thus it fell out that on June 3rd, 1878, I had facilities for investigating a very remarkable outbreak of swine (typhoid) fever in a cargo of upwards of 1,800 swine, and on the 25th of the same month I read my firs~ paper on the diseases of animals rendering them unfit for food before the North-Western Association of Medical Officers of Health at Manchester. This drew so much attention to the subject that in the following year I was invited to open a discussion on animal diseases in connection with the meat-market at the annual meeting of the British Medical Association at Cambridge. Referring to my paper of June, 1878, and to the report of what I said at Cambridge, I find that I then held that the following diseases rendered the meat unfit for the food of man : Cattle plague. Acute rheumatism. Swine typhoid fever. Scarlatina and quinsy of swine. Epizootic pleuro-pneumonia. Anthrax. Sheep-pox. Disease due to presence of cystiNormal cow-pox. eerci. Influenza. Disease due to presence of trichinae. The following diseases of animals I held as depreciating the quality of the meat, or making it pr~eternaturally liable to decom. pose, but not necessarily, except in their later stages, rendering the meat unfit for the food of man : * Read before the Incorporated Society of Medical Officers of Health, November, 1900.
December, 1900]
Meat Seizure
19 7
Foot-and-mouth disease. Dropsy. Hoof-rot. Acute inflammatory diseases of Tuberculosis. lungs, intestinal canal, or serous Liver-fluke. sacs. Jaundice. The opinion expressed twenty-two years ago is practically my opinion to-day. As regards tuberculosis, however, I began to modify my opinion after the discovery of the bacillus of tubercle by Koch. Then came the report of the Departmental Committee which was appointed by the Lord President of the Council in April, 1888o This report, dated July 16th, 1888, expressed the opinion of the Committee as follows : "Although the bacilli may be found but rarely in the flesh, still, the chance of their being present either there or in the blood is too probable to ever allow the flesh of a tubercular animal being used for food under any circumstances, either for man or the lower animals." This official opinion commended itself to my intelligence. It seemed to me unreasonable that, because the disease was apparently limited to the lungs, and not far advanced, the inspector should be instructed to pass the meat. Here was a disease communicable from one of the lower animals to man by means of a bacillus, which might infect the air breathed, the food eaten, or be directly introduced into the blood ; surely any carcass infected with this disease could not be safely used for human food. The fact that the disease seemed to be localized I regarded as of little significance, as~bacilli would be carried from one part of the body to other parts by the blood, or by the lymph stream. Thus it fell out that I endeavoured to obtain orders for the destruction of animals whenever there was proof positive of the presence of tuberculosis. I did this for three or four years--that is, Until I left the service of the Birkenhead Corporation, in J.anuary, 1892. My efforts were sometimes successful and sometimes not. Whether I or the butchers won depended largely upon the magistrate hearing the application, and considerably upon the number of the witnesses called on either side. It was a disagreeable position for a local authority to be in to have the meat trade in organized opposition to it, and much money and time were spent in litigation. Still, I cannot, on the whole, regret this. Public attention was drawn to the matter, and doubtless the butchers in Birkenhead and elsewhere became a little more particular as to the quality of the meat they ventured to expose for sale. Since 1892 1 have had very little to do with the inspection of unsound meat, except occasionally as a consultant. What has impressed me during the past nine years is the infrequency of any carcass or meat being seized on account of any disease other than
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tubercle. As for cattle disease, it is thirty-three years since we have had a case in this country. Then pleuro-pneumonia is grown so rare thai even an imported case makes quite a stir. The last case I saw was that landed at Liverpool by s.s. Toronto from Montreal on May 20th, 1894, which formed the subject of an elaborate Government inquiry. Foot-and-mouth disease was for some time stamped out. Even when present, as it has been in many a county since January, 1900, this disease, though interfering much with the movement of stock, and causing much falling off in condition, gives no trouble to the meat inspector. Anthrax and swine fever are so well looked after by the police that it is quite an extraordinary event if a carcass infected with either disease finds a place in the meat-market. Cases of cysticerci-infected swine one still sees occasionally, cases of trichinse practically never. Even liver-fluked sheep appear to be scarcely ever put on the market. Thus the question, Where to draw the line as regards diseased meat, has resolved itself generally into, Where shall we draw the line as regards t~tbercuIous meat ? That question was officially answered for all authorities early last year. The Local Government Board, in circular letters to councils of boroughs and urban and rural districts, dated t~arch 10th, 1899, issued the following: " INSTRUCTIONS TO M E A T
INSPECTORS W I T H REGARD TO TUBERCULOSIS
IN ANI~IALS INTENDED FOR FOOD. " The Royal Commission recommended that the Board should be empowered to issue instructions from time to time for the guidance of meat inspectors, prescribing "the degree of tubercular disease which, in the opinion of the Board, should cause a carcass, or part thereof, to be seized. "Pending the issue of such instructions, we are of opinion that the following principles should be observed in the inspection of tuberculous carcasses of cattle : "(a) When there is miliary tuberculosis of both lungs ......... "(b) When tuberculous lesions are present on t h e pleura and peritoneum ............ "(c) When tuberculous lesions are present in the muscular system or in the lymphatic glands embedded in or between the muscles "(d) When tuberculous lesions exist in any par~ of an emaciated carcass
The entire carcass and all the organs may be seized.
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"(a) When the lesions are confined to the lungs and the thoracic lymphatic gIands ......... "(b) When the lesions are confined to the liver . . . . . . . . . . . . "(c) When the lesions are confined to the pharyngeal lymphatic glands ... "(d) When the lesions are confined to any combination of the foregoing, but are colIectively small in extent ............ +
The carcass, if otherwise healthy, shall not be condemned, but every part of it containing tuberculous lesions shall be seized.
" I n respect of foreign dead meat, seizure shall ensue in every case where the pleura have been ' stripped.' " The Board do not consider it necessary at present that anything should be added to these instructions, or that they should be modified, and the Board think that the Council should direct those of their officers who are employed as meat inspectors to act in accordance with the principles thus laid down. However, as regards swine, the opinion expressed is as fOTlows : " I n view of the greater tendency to generalization of tuberculosis in the pig, we consider that the presence of tubercular deposit in any degree should involve seizure of the whole carcass and of the organs." The meat inspector is therefore officially instructed to regard tuberculosis in swine as a disease of animals which renders the meat unfit for human food, and tuberculosis in oxen and cows as a disease of animals which ordinarily renders portions only of the carcass unfit for human food, though in its later stages it may unfit the whole carcass for human food. As the Central Authority were so long before they consented to draw the line at all in this matter, the ruIe now laid down is likely to serve for many years to come. There will be little use in medical officers of health trying to get it varied for the present. The difficulty is that when the specific conditions as indicated under the firs~ (a), (b), (c), or (d) obtain, and the medical officer of health or inspector seizes a carcass and organs, and applies for an order to destroy the same, the magistrates may refuse to grant the order, or after an order is made it may be appealed against, and if the appeal is sustained the authority may be mulct in heavy damages. This is the present impediment in the way of effective action under the unsound meat clauses, and this is what medical officers of health must do their best to remove.
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Of course there is a large proportion of unsound meat which is not diseased--tha~ is, meat partially decomposed through having been kept too long, or ill-kept, meat from animals not killed by man, or only killed when moribund, etc.--but there is not much difference of opinion as regards the unfitness for food of this, and not much difficulty in getting an order to destroy i~, DISCUSSION. Dr. BOND said he was convinced that the only way to secure satisfactory and efficient inspection of meat was by the abolition of private slaugh~er-houses, and the provision of public abattoirs, with skilled meat inspectors under the supervision of the medical officer of health, or a specially trained veterinary surgeon. I n a paper he read to the Sanitary Institute last year he gave many reasons for this opinion, and also for thinking that properly constructed public abattoirs would be advantageous not only to the consumer, but also to the stock-owner and the butcher. There could be no doubt inspection of meat ought to be carried out on pathological principles. It was often found that there was a great want of uniformity, especially with regard to the carcasses of animals suffering from tuberculosis. I n his opinion the recommendations of the Royal Commission on the subject were excellent. I t was difficult to frame regulations which would apply to every case, but generally these recommended of the Royal Commission were satisfactory. I n the experiments of Dr. S. Martin, of eighty-one highly susceptible animals fed with large quantities of raw meat from sixteen cows affected with tuberculosis in a mild or moderate degree, not a single one developed tuberculosis, although many of those animals--the flesh of which was used for the experiments--would have been condemned under the regulations recommended by the Royal Commission. Even with the raw " t r i m m e d " meat of cows affected with ~dva,nced o~" generalized tuberculosis which was employed in seven feeding experiments, in no case did the allhnal develop the least tuberculosis, although if the recommendations of the Commission were followed, such meat would not have been used for human food. By " t r i m m i n g " most of the tubercular material which might have accidentally contaminated the surface of the carcass would be removed. On the other hand, of fourteen feeding experiments with raw " u n t r i m m e d " meat of advanced or generalized cases, six of the animals developed tuberculosis. It should also be remembered that in the great majority of experiments in which the animals were fed with undoubted bovine or human tubercular material, even when comparatively small amounts were given, tuberculosis was developed. I n all kinds of life they had to run some risk. They ran risks when travelling by road or rail, but that was no reason why t h e y should not so travel. The risk which would be run under these recommendations would be infinitesimal, and therefore he thought the society should adopt the recommendations of the Royal Commission. They would do great good by acting in a reasonable spirit, and not in a dogmal~c or harsh manner. He knew that a number of medical officers of health almost ridiculed the idea of tuberculosis being localized. Even such an authoriSy as Dr. Sedgwick Sannders stated in the July number of PUBLIC H~ALTH that he did not recognise " l o c a l i z e d " tuberculosis. That was contrary to their experience as medical men. All the surgical operations for the
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removal of tubercular glands or joints or bones were conducted on the principle of localized tuberculosis. Most of t h e m had heard of the St. Pa~cras case. H e h a d in t h a t case, acting on the lines laid down by the Royal Commission, advised that the carcass should not be seized. The carcass was fat and in good condition, and there were no tubercles on the pleura, or on the peritoneum, or any other part of the carcass. H e h a d no hesitation in saying t h a t the eareass would not have been seized in the City or in any market. H e moved that the Society r e c o m m e n d the adoption of the r e c o m m e n d a t i o n s of the Royal Commission, and of the Local Government Board. Dr. COLLINGRIDaE said t h a t the opinions on the subject h a d been a n d were very conflicting, and t h a t the recommendations of the Royal Commission were a compromise, but he could not see why the Society of Medical Officers of H e a l t h should endorse those recommendations. They were useful as a practical working basis, but was the Society prepared to say thin tuberculosis as such was a local disease ? He was m u c h interested in Dr. Bond's remarks. He (Dr. Bond) h a d said that the risks incurred were exceedingly small. H e quoted the well-known series of experiments of Professor Martin, showing t h a t in a long series of cases where animals were fed on tuberculous meat no tuberculous lesions were found, and yet he advised t h e m to accept the recommendations of the Royal Commission. That appeared to h i m (the speaker) to be a somewhat illogical position to adopt. If, as Dr. B o n d suggested, this meat did not cause tuberculosis, why seize it at all ? I n the speaker's opinion there was no reason because the Royal Commission had brought out a compromise why they should endorse it. On the question of veterinary inspectors, he said they of course knew t h a t veterinary inspectors of the present day were highly educated men, but they ought not to allow the question of the effects of diseased meat on the h u m a n being to pass from the medical officer of health to the veterinary inspector. They should co-operate with the veterinary surgeon as to the condition of the meat, but when it came to the effect of the consumption of t h a t meat in the community it became a question for the medical officer of health. Dr. R. DUDFIELD,adverting to the St. Paneras case, said the condition of the animal w h e n slaughter~ed was described in the July issue of PUBLIC HEALTH. Bearing the whole of t h a t description in mind, was Dr. Bond of opinion that the carcass should be allowed to pass 9 H e ventured to say if ever there was a case of generahsed tuberculosis, t h a t was one. He (Dr. Dudfield) would have condemned it without hesitation. He could further state that Dr. Sedgwiek Saunders expressed his opinion on the description submitted to him, and he said no such animal would have been passed at the Meat Market. Dr. Bond h a d quoted a series of experiments with some eighty animals. He would point out t h a t the whole of the evidence in those experiments was negative. The value of negative evidence was almost nothing. Dr. Bond had mentioned t h a t where the meat was " u n t r i m m e d " the results were positive. Those results carried more weight with h i m t h a n all the negative results, as t h e y were more in h a r m o n y with daily practice. Admitting for a m o m e n t t h a t there was a m i n i m u m of risk in the matter, he submitted that the temperature to which m e a t was rMsect in domestic cookery was insufficient to obviate t h a t risk. Supposing they had in a n y case a limited n u m b e r of centres of visible tuberculous lesions, were they justified in saying t h a t the disease was "localized " 9 Were ~he lesions purely " l o c a l " infections, or were the 5, only local manifestations of a systemic disease .9 Lastly, was it honest and fair to sell meat from an a n i m s l k n o w n to be tuberculous as sound meat or without declaration .9 W h e n he boug]lt
202
Meat S e i z u r e
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meat at top prices, he trusted to the honesty of the butcher t h a t he was selling meat from a sound carcass. Was it honest that he should sell as prime meat the flesh of a tuberculous animal ? Dr. PORT~ said it was a matter of indifference whether the Society endorsed the recommendations ,of the Royal Commission or not, because no medical officer of health who had regard to the success of a prosecution would venture to condemn a carcass without being strictly guided by those recommendations. H e would be confronted with t h e m by the defendant, and the magistrate would certainly not convict unless the recommepdations had been adhered to. Cooperation with the veterinary surgeon was most valuable, a s t h a t flmctionary appeared to carry a great deal of weight with the ordinary magistrate, who for some reason appeared to think the veterinary surgeon knew more about the condition of meat t h a n did the medical officer~ although he (Dr. Porter) believed the veterinary surgeon was as little capable of giving expert evidence in the matter as a n ordinary medical m a n who had left the hospital m a n y years was able to give expert evidence in a post-mortem operation on the h u m a n subject. Dr. SOURm~LD agreed with Dr. Bond t h a t there was such a thing as localized tuberculosis. He was under the impression t h a t the leading pathologists in this countiy and abroad taught that tuberculosis was usually at first a localized disease, which became established in the lymphatic system of some particular organ after effeeting an entrance through some point in the mucous membrane, and subsequently a generalized disease either by the comparatively slow method of progressing through the lymphatics till it reached the venous system through the lymphatic duct, or by the comparatively quick method of the ulceration of a bloodvesseI in the neighbourhood of a tubercular nodule and the infection of the ruptured bloodvessel with the contents of the nodule. Those who did not believe t h a t tuberculosis was ever localized were committed to the view t h a t 40 per cent. of the cattle in the country were unfit to be used as h u m a n food. H e at the same time regretted t h a t only those recommendations of the Royal Commission which lessened the severity of the methods of dealing with meat h a d been acted upon, because the question of infection by milk appeared to him so m u c h more important t h a t he h a d hoped t h a t some practical effort would have resulted from the recommendations of the Royal Commission as to the question of the extirpation of bovine tuberculosis. H e thought it a reasonable thing that a veterinary surgeon should examine carcasses and report as to the extent of the disease present, but it appeared to h i m to be the province of the medical officer of hes~lth to say what extent of disease ought to preclude the use of the carcass for h u m a n food. H e a ~ e e d with Dr. Porter t h a t any medical officer of health who pitted his opinion against the recommendations of the Local Govermnent .Board would have a very poor chance of success in any prosecution, and he thought t h a t the Society of Medical Officers of H e a l t h ought to consider these recommendations, and if they thought alterations or amendments desirable, ought to approach the Local Government Board on the subject. Dr. XAYE said he had recently seen a cow in a public abattoir weighing some 600 p o u n d s - - a very fine-looking carcass. H e insisted on seeing the whole of the entrails. One was missing--the l i v e r - - a n d he threatened to condemn the cow if the liver could not be found. W h e n it was produced he found it weighed 81 pounds, and was a mass of tuberculous abscesses. So far as they could see, t h e liver, a n d the liver only, was affected. W a s this a localized o1" general disease? Dr. SCURFIEnD was disposed to t h i n k it localized disease.
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Dr. LEGG~ thought it distinctly localized, but he would like to ask what became of it. Dr. KAYEsaid the carcass was brought before the magistrate and condemned. Dr. BOND could not see why it was called general tuberculosis if there was no tuberculosis in the carcass. What did the word "local" mean ? Dr. PA~ES said because nothing could be seen with the naked eye it did not follow that the flesh was absolutely innocuous. Would Dr. Bond be prepared m say it was impossible that this meat should contain the toxfl~ of tuberculosis sufficient to light up tuberculous mischief in a person already infected in the exact way that Koch's tuberculLn did ? I n his opinion it was a general disease, and the food would be dangerous. He objected ~o the word "small" in the last paragraph of the recommendations of the Royal Commission and hoped the Society would not approve then/. Dr. E. P. MANBYsaid the time was not ripe for any definite statement in this matter, and they ought ~o be glad that they had reached the point where the Royal Commission took them. The feeling among the butchers was very s~rong, whilst public opinion was almost indifferent. The whole thing was a question of education. Later on, when bacteriologists had taken them another step, they could apply to the Local Government Board for some modifications. In Liverpool they went practically on the lines of the recommendations of the Royal Commission, and they had very little trouble. Dr. TuBB THO~IASsuggested that efforts should be made to obtain bactcrio: logical examination of the flesh of all animals where localized tuberculosis existed. Dr. FEaEN said these recommendations had been of the greatest benefit to many medical officers of health in the country. They seized the carcass of an animal and :brought it before the magistrate with these recommendations, and on the strength of them obtained convictions. For the larger districts; where the medic/1 officer of health had practical experience~ they should not be asked to appro~'e or disapprove. Localized tuberculosis was the outward sign of a general disease. He would object to eat meat even slightly tainted with tuberculosis. It w~s resolved unanimously, on the motion of Dr. R. Dudfield, that the meeting stand adjourned to Saturday, January llth, 1901, at 2.80 p.m., and that the resolutions now submitted by the Council be forwarded to the various branches of the Society for consideration and report.
A METHOD FO~ DETECTION OF HORSEFr,J~SH.--The New York Mec~ccd Journal claims t h a t horseflesh can be readily detected, and even in as small proportion as 5 per cent. when mixed w i t h other flesh. The process is as follows: 20 grains of the suspected meat are finely minced, a n d boiled from a halLhour to a n hour in 100 e.c. of water. The volume of water is then reduced by evaporation to 30 e.c. ; the liquid is t h e n cooled a n d filtered. About 10 c.c are tested with a few drops of the compound iodine solution (1 part of iodine and 12 parts of potassium iodide in 100 parts of water). A fugitive reddish-violet coloration indicates the presence of horseflesh. The reagent must be added very carefully, so that no excess i s added, as this is apt ~o change the colour to a reddish brown.*--British Food #ou~'~zat. * See also PUBLICHEALTH, xi., p. 593.