k 210 ADMINISTRATIVE SECTION 



control of the milk supply in India before a European 

 audience which was unacquainted with the local conditions. 

 In the few remarks which he made yesterday he emphasized 

 the difficulties which beset the path of the sanitary reformer 

 in India difficulties largely due to the prejudices of the 

 people and the conditions of their environment. These 

 difficulties reached their maximum when they came 

 to deal with the problem of the native control of 

 the milk supply and the artificial feeding of infants. 

 It must be remembered in the first place that in 

 India the cow is looked upon as a sacred animal, and 

 secondly that caste prejudices prevented the taking of food 

 prepared by outside agencies, or which had been touched by 

 persons of another caste. For these reasons it was very 

 difficult, even in. the large cities, either to ensure efficient 

 control of the milk supply, or to render polluted milk 

 innocuous by pasteurization, or to substitute dried milk in 

 lieu of a doubtful supply of the fresh article. And this 

 difficulty became an impossibility when they had to deal 

 with the small scattered villages in which eight-tenths of 

 the population resided. Luckily for them, Indian cattle 

 did not suffer at present to any great extent from tubercu- 

 losis, and on the rare occasions on which tubercular disease 

 had been traced to milk the contamination had nearly 

 always been by tubercle bacilli of human origin, which had 

 been introduced as the result of . the carelessness of the 

 native milkmen. Moreover, Indians always boiled their 

 milk before using it. An Indian would be horrified at the 

 idea of drinking unboiled milk, even more so than any of 

 those present would be if they were asked to devour a raw 

 mutton chop. But, although milk-borne tuberculosis was 

 not yet a serious problem in India, the question of infant 

 feeding was one of vital importance. Major Robertson, 

 the Sanitary Commissioner with the Government of India, 

 who had made a special study of infant mortality, was of 

 opinion that the four chief causes of death in that country 

 were: (i) Malaria, which may act either directly on the 

 child, or indirectly through the mother. (2) Diseases due 

 to insanitary surroundings. (3) Diseases due to ignorance 

 on the part of the mother with regard to the feeding and 

 care of the infant. (4) Accident of childbirth and diseases 

 attendant thereon. As regarded the last two causes, a con- 

 sideration of the available material led him to the conclusion 

 that early marriage was a very important factor in the 

 causation of excessive infantile mortality in India, where 

 the marriage of girls was almost universal, and that at the 

 earliest practicable age. And he thought there could be no 



