TUBERCULOUS MILK IN BRISTOL

1114 the original contention of Marrack and Smith3 of the herd took place. In two cases the i that the amount precipitated is independent of thesupply was still infected after six months. Profs. concentration of non-specific protein in the reacting Parry and Hall suggest lines of action which would mixture. Heidelberger and Kendall in 1934, andlead to more effective protection of the community Dean, Taylor, and Adair4 this year found that the and are prepared to justify them as less disturbing same amount of protein was precipitated from the to economic conditions than is routine tuberculin antiserum, whether the precipitation took place in testing. That is not the only direction in which one stage or in two ; while Heidelberger and Kabat6 Bristol looks for progress. The efforts made in recent have shown that pneumococci when agglutinated years to educate the farmer and dairyman in the carry down with them from a given amount of antiproduction of milk have borne fruit in a uniformly serum the same amount of protein as is precipitated improved standard. This fact is not however widely by the corresponding polysaccharide. These experi- enough appreciated, for only a few consumers have ments strongly support the theory that this prefollowed the developments in the industry. The is This is conthe actual introduction by the Marketing Board of the " milk in antibody. cipitable protein firmed by the recovery, from the precipitate formed school " scheme now offers an opportunity for the by pneumococcal polysaccharide and antiserum, of a diffusion of this information via the school-children protein which is active as antibody and can be almost to the general public. The preventive medicine and completely precipitated again by the polysaccharide agricultural advisory departments of the University (L. D. Felton, 1932). Breinl and Haurowitz (1930), of Bristol are accordingly providing a course of and more recently L. F. Hewitthave shown that lecture-demonstrations for school teachers on such this precipitable protein is chemically indistinguishsubjects as production, nutrient values, health and able from serum globulin. disease in the cow, and the means of increasing the It is now reported that J. B. Sumner and S. F. safety of milk and storage of food. Accompanying the Howell, of New York, haveprepared the hsemag- syllabus is a brochure on milk as a food, written in glutinin of the jack bean as a crystalline protein. In simple language as a lesson for children under 12 years, this form, it is stated, it caused perceptible agglutina- with a supplement for those over 12 years. The tion of dog and cat red blood corpuscles in dilutions children are invited to write essays or make drawings, up to 1 in 10 million ; on human cells it was much suitable for posters, upon the subject " A Glass of less effective, agglutinating them only in dilutions Milk," and prizes will be awarded to senior and up to 1 in 1000. This protein, however, cannot be junior boys and girls. The Bristol education comconsidered an antibody, since it occurs naturally- mittee is cooperating in all these arrangements. not in response to the stimulus of the introduction AGRANULOCYTOSIS of a foreign substance ; nor is there evidence that IN the last few years there have been many reviews it has the specificity characteristic of most antibodies. Nor are such crystalline agglutinins a new and reports of cases of the peculiar syndrome discovery. Edestin will agglutinate sheep and commonly known as agranulocytic angina, agranulohuman red blood corpuscles in dilutions up to 1 in cytosis, or malignant neutropenia. (Since a sore10,000, as was shown by B. White and 0. T. Avery throat and mouth, though often, is not always as long ago as 1913. Even tannin acting on red blood associated with this condition, probably the two last names are preferable.) Dr. E. W. Adams ha now in dilutions up to 1 in 10,000 will reprocorpuscles reviewed " certain aspects " of this syndrome in a duce phenomena (agglutination, haemolysis, complement fixation, and preparation for phagocytosis) report issued by the Ministry of Health.’ He empharesembling those caused by antibodies, though sises the value of pentose nucleotide in the treatment lacking the characteristic specificity (Reiner, 1929). and the importance of amidopyrin in the aetiology. Certain of his statements-some of them lacking Nevertheless the discovery of a pure protein agglutinin which acts in such extreme dilution may afford exact references-are hardly in agreement with the valuable information on the mechanism of the action authoritative review of Jackson and Parker,2 who havehad extensive experience of the disease. Dr. of antibodies. Adams, for example, says that it may occur in TUBERCULOUS MILK IN BRISTOL children, though they are definitely of opinion that no authentic case has been seen under the age of ten. IN another column Prof. R. H. Parry and Prof. He also states that the total white cell count is not I. Walker Hall, respectively medical officer of health lowered, whereas Jackson and Parker necessarily for Bristol and director of the preventive medicine and the majority of other workers agree that leucoof tell us the farms in the infected area laboratories, from which Bristol draws its milk-supply and which penia is a sine qua non of the syndrome. In writing act as reservoirs for the dissemination of bovine on the etiology of the disease, Dr. Adams does not tubercle bacilli. Last year 5 per cent. of 485 samples mention any of the papers describing the pathoof milk from one area were found to contain virulent logical findings in haemopoietic tissues ; he is content bacilli, but it proved possible to track the infection with the statement under the heading of clinicalis features, that " after death the bone-marrow down to 14 farms, the milk from which was interdestitute of granumittently tuberculous over several months. It would found to be destitute or almost have shown however, observers, Many indeed have been an achievement if these 14 reservoirs locytes." that at least in in the patients dying early stage of of infection could have promptly been cleared, but the inevitable delay in procedure, of which several the disease, though mature polymorphs may be there may be an excess of stem cells; and striking examples are given, resulted in the supply absent, it this was finding that led FitzHugh and Krumbhaar3 in one case of known tuberculous milk for three months or more before clearance and the distribution to make the important suggestion that an arrest of maturation at this level is a key to the etiology of 3Marrack, J. : Med. Research Council, Spec. Rep Ser. No. 194, 1934, p. 52. 4 Dean, H. R., Taylor, G. L., and Adair, M. E.: Jour. of Hyg., 1935. xxxv., 69. 5 Heidelberger, M., and Kabat, E. A.: Jour. Exp. Med., 643. 1934, lx., 6 Hewitt, L. F. : Biochem. Jour., 1934, xxviii., 2080.

1 Min. of Health Rep. on Public Health and Med. Subjects, No. 76. London : H.M. Stationery Office. 1935. Pp.21. 6d. 2 Jackson, H., Jr., and Parker, F.: New England Jour. Med., 1935, ccxii., 137. 3 FitzHugh. T., Jr., and Krumbhaar, E. B.: Amer. Jour. Med. Sci., 1932, clxxxiii., 104.