338 MEDICAL SECTION 



infants reared on citrated whole milk, and am convinced 

 of its value. The failures are surprisingly few, and 

 very rarely has another method been substituted with 

 advantage. On the other hand, time and again I have 

 replaced other methods by it, with success. Rickets, 

 gastric dilatation, general hypotonia, and that puffy 

 and pasty appearance so commonly seen in babies fed 

 on diluted milk, do not develop ; on the contrary, the 

 muscles are particularly strong and firm. 



Another occasion for citrated milk is at the time of 

 weaning. It may be substituted gradually for the 

 breast, first using 2 gr. to the ounce of milk, and 

 then i gr. The sodium citrate may afterwards be 

 omitted. Such a gradual transition from breast milk 

 to cow's milk safeguards the baby from the dangers to 

 which a sudden change subjects it. Its efficiency in 

 the feeding of marasmic children I have recorded else- 



o 



where (Proc. Roy. Soc. Med. (Child. Sect.), vol. iii.) 



MILK IN THE POOR HOME, 

 BY DR. G. R. PISEK. 



New York City. 



THE present paper will deal with the milk problem 

 particularly as it relates to large centres of population 

 drawing their milk supply from sources distant many 

 miles (in some cases 450 miles and eighteen hours), 

 necessitating that from twenty-four to thirty-six 

 hours elapse between milking and delivery to the 

 consumer. 



In carrying out the policy of bettering the milk 

 supply, the New York Milk Committee became a 

 demonstrating as well as an investigating body. Five 

 cardinal lines of activity stand out in the Committee's 

 campaign for pure milk and its closely related object, 

 the reduction of infant mortality : 



