It would therefore appear better, after judicious appraisement, to concentrate the expense incident to the extermination of foot-and-mouth disease by purchasing and slaughtering all affected and exposed cattle. The carcasses of these animals should be totally destroyed, preferably by cremation, or otherwise by burying them in a hole 6 feet deep and covering them with air-slaked lime. The infected stable should be disinfected by thoroughly cleaning it, scrubbing the floor with hot water, brushing down all loose dust from the walls, and tearing off all woodwork which is partly decayed. Then the whole interior of the stable should be disinfected with one of the following substances:

All stable utensils should be thoroughly cleaned and disinfected by the application of a solution of one of the above-named disinfectants. The manure should be burned or disinfected and spread over ground (other than meadow land) that is to be turned under. No other cattle should be purchased for at least sixty days after the complete disinfection of the premises.

The success in eradicating the disease by combined quarantine, slaughter, and disinfection, as practiced in the United States, Denmark, Great Britain, and a few other countries, demonstrates in a striking manner the efficacy of slaughtering and the futility of relying upon quarantine alone to stamp out the disease.

Inoculation has been adopted in some countries in order to have the disease spread quickly through the herds, and while this practice has undoubted value where the disease is indigenous, it is not desirable in this country and should not be adopted.

As a rule medicinal treatment with a view of curing affected animals is not to be recommended under conditions prevailing in the United States, where the disease has not become established, and the first object is to stamp it out as quickly as possible. Even though most animals would recover, with or without treatment, it would be practically impossible, while they were being held for recovery, to prevent the spread of the infection to others. The disease would be liable to spread faster than it could be cured. As already pointed out, it has been found impossible to prevent absolutely the spread of the contagion by the strictest quarantine alone, under the usual farm conditions. In addition, the affected animals that have passed through the disease may become a source of further infection as virus carriers for weeks and months after they have apparently recovered, and are susceptible of reinfection, as one attack does not confer permanent immunity.

Foot-and-mouth disease in man.—Foot-and-mouth disease is primarily and principally a disease of cattle; secondarily and casually, a disease of man. It is transmissible to man through the eating or drinking of raw milk, buttermilk, butter, cheese, and whey from animals suffering from foot-and-mouth disease. It is also transmitted directly, though more rarely, from the salivary secretions or other infected material which may gain entrance through the mucous membrane of the mouth. It is doubtful whether the disease can be transmitted to man by cutaneous or subcutaneous inoculation, though it is probable that the infection may be communicated if the virus directly enters the blood through wounds of any kind. Children are not infrequently infected by drinking unboiled milk during the periods in which the disease is prevalent in the neighborhood, while persons in charge of diseased animals may become infected through contact with the diseased parts or by milking, slaughtering, or caring for the animals.

The symptoms in man resemble those observed in animals. There is fever, sometimes vomiting, painful swallowing, heat and dryness of the mouth, followed by an eruption of vesicles on the mucous membrane of the mouth, and very rarely by similar ones on the fingers. The vesicles appear on the lips, gums, cheek, and edge of the tongue, and are about the size of a pea. The vesicles soon rupture, leaving a small erosion which is soon covered by a thin crust under which the new formation of epithelium proceeds rapidly. The skin eruption mostly appears on the hands, tips of the fingers, base of the nails, and more seldom on the toes and other parts of the body. Besides these local changes, during the course of the disease headache, pain in the limbs, vertigo, abdominal cramps, vomiting, diarrhea, and weakness are occasionally observed. The disease is seldom fatal, usually appearing in a very mild form except in weakened children, in whom an accompanying intestinal catarrh may lead to a fatal termination.

Veterinarians who have had considerable experience with the disease among animals regard the human affection as by no means uncommon in countries where foot-and-mouth disease prevails, but the disturbance of health is usually too slight to come to the notice of the family physician.

But few outbreaks of the disease in man have occurred in the United States, and therefore cases of its transmission to man in this country are rather rare. Dr. James Law reports having observed the disease in man from drinking infected milk during the epizootic of 1870 in the Eastern States, but the outbreaks of 1880 and 1884 affected such a small number of animals and were so quickly suppressed that no instance of its transmission to man was recorded. A few cases have been reported by Brush accompanying the New England outbreak of 1902. Similar reports have been likewise received concerning the appearance of vesicular eruptions in the mouths of children during the 1908 and 1914 outbreaks, and the history of these cases incriminates the milk supply.