The Perfect Food and the Filth Disease: Milk-borne Typhoid and Epidemiological Practice in Late Victorian Britain

Abstract

This article explores the initial set of epidemiological investigations in Victorian Britain that linked typhoid fever to milk from dairy cattle. Because Victorian epidemiologists first recognized the milk-borne route in outbreaks of typhoid fever, these investigations served as a model for later studies of milk-borne scarlet fever, diphtheria, and perhaps tuberculosis. By focusing on epidemiological practices conducted by Medical Inspectors at the Medical Department of the Local Government Board and Medical Officers of Health, I show that Victorian epidemiology was committed to field-based, observational methods that defined the professional nature of the discipline and its theories and practices. Epidemiological investigations of milk-borne typhoid heated up several important public health debates in the second half of the nineteenth century, and demonstrate how Victorian epidemiology was not solely wedded to examining population studies using statistical methods, as historians have typically argued, but also relied on observational case-tracing in individuals, animals, and even environments.

Versions of Milk and Versions of Care: The Emergence of Mother's Milk as an Interested Object and Medicine as a Form of Dispassionate Care

“…This is early, but not in itself surprising. As demonstrated by Hardy (1993) and Steere Williams (2010), this way of linking diseases like typhoid fever to milk was established practice before the introduction of bacteriology. This was related to a field-based observational approach that later was to merge with the bacteriological framework.…”

“…This is intimately linked to the fact that the milk issue was far from only a theoretical or academic problem. In Kristiania, as in other large cities (see Hirdman 1983; Atkins 2010; Steere-Williams 2010), a series of so-called milk epidemics emerged in these years. In Kristiania the incidents were subjected to a range of concerned discussions, not to say controversies, referred to in detail and in full length in the medical journals as well as in reports from discussions in Det Medicinske Selskab [the Medical Society].…”

Changing Veterinary Knowledge

“…Nineteenth-century pioneers of public health had established field practices of 'shoe-leather epidemiology', 141 in which investigators would travel to an area experiencing a disease outbreak to learn about local communities and the physical environment from 'physicians, chemists, veterinarians, farmers, politicians, and business owners'. 142 They would then map this information to help establish spatial relationships between disease victims and potential sources of infection, as in the famous case of John Snow and the Broad Street pump. 143 This spatial way of understanding and controlling the spread of infectious disease pointed the way towards establishing links between disease and contaminated milk-a key issue for controlling bTB.…”

Review of periodical literature published in 2010

“…Hinde and Edgar use a case study of Purbeck in Dorset to explore mortality rates among the area's stone workers. Steere‐Williams uses the case of typhoid to demonstrate the hitherto‐overlooked importance of observational techniques in epidemiological exploration, while Honigsbaum explores the role of the mass media in spreading ‘dread’ of influenza as the epidemic itself spread across Europe between 1889 and 1893. Models of medical practice also featured.…”