282 ANNUAL, REPORT OF THE Off. Doc. 



who may be an irresponsible fellow buying a little milk from some 

 shipper or wholesaler, or it may be the driver for some great com- 

 pany having hundreds or thousands of shippers scattered from a 

 few miles to several hundred miles from the city. New York gets 

 some of its milk as far as 4Ul) miles away, Pittsburg has gone as 

 far as Cleveland, Columbus, Chicago and Philadelphia when short 

 from sources nearer at hand. 



The condition created by the necessity of shipping so far have 

 developed and added faults that were not know-n when the "milk 

 man" was the fellow who owned the cows and peddled the milk 

 from them. The danger in milk, even for infants, is not primarily 

 the ordinary souring due to lactic acid producing bacteria, but 

 rather to other forms and the products of their growth. 



The real danger which may be in milk are: preservatives, a polite 

 name for poisons; the germs of such diseases as typhoid fever, scar- 

 let fever, tuberculosis, and infant intestinal disorders; the germs 

 which in the process of their growth develop products that are in- 

 jurious to the delicate stomach of the infant or invalid, uncleanli- 

 ness and pasteurization. 



Taking these one by one: Preservatives have been resorted to 

 by the ignorant and unscrupulous, but thanks to the activity of the 

 city boards of health this danger has been reduced to a minimum in 

 most of our large cities. 



Disease-Producing Bacteria: Fortunately the danger from this 

 source is occasional rather than constant (excepting possibly tuber- 

 culosis) though very real w^hen it does exist. It is reported that 

 there were 368 cases of typhoid fever in the homes served by one 

 milk man, while there were 8 of cases who got their milk from a 

 man who also sold milk to the man whose customers had so many 

 cases. Similar records are available relative to the carrying of 

 scarlet fever, differing only in the number of cases. In another in- 

 stance milk was sold from a farm, where there was a case of diph- 

 theria, to two men who peddled it in three towns among people 

 who got milk from the infected farm, while there were only three 

 cases in the homes served by the other five milk men. 



These instances are sufficient to show that the milk may be the 

 carrier of those diseases, and to suggest the responsibility that rests 

 on him who would supply milk to the i)ublic. 



Tuberculosis: As yet there is difference of opinion among medical 

 men as to the danger of tran<'xnit(ing tuberculosis to man by the 

 use of milk from infected coavs. The British Royal Commission ap- 

 pointed to invesliyate tliis subject has reported, after several years' 

 study, tha'. in its 0])inion it has found some unmistakable evidence 

 that certain cases of tuberculosis were transmitted from the milk 

 us<\l. As long as tbeie i.s uncertainty in the matter the milk con- 

 sumer naturally desires to be on the safe side and wants milk pre- 

 ferably from cows known to be free from the disease, or milk from 

 which the possibility of infection has been rpinnvcl by ellicicnt Pas- 

 teurization. 



Prod'icts of Bacterial Growth: Changes commonly called souring 

 inevitably and unavoidable occur in milk and practically all of them 

 are direitly or indirectly the result of bacterial growth. As a re- 

 sult of this growth many products are formed, lactic acid, gas, tox- 



