THE MILK CONTRACTOR 281 



milk pasteurized at high temperatures without undue prevalence of 

 rickets and scurvy among the children, and the like experience of child 

 welfare stations in this country using milk pasteurized at low temperatures. 

 On the other, statistics are offered from hospitals and other sources to the 

 effect that out of a considerable number of babies who developed rickets 

 and scurvy a considerable percentage were being fed pasteurized milk 

 prior to the onset of the disease. The studies of Hess which were made at 

 a New York institution where the babies remained for a year or more 

 and were weighed and measured at regular intervals, have made plain 

 the relation between pasteurized milk and infantile scurvy. He finds 

 the disease belongs to the same class as beriberi and others that are due 

 to the continued use of a food that is deficient in some essential substance. 

 Pasteurized milk is this sort of food for its antiscorbutic vitamines are 

 partially destroyed in the pasteurizing process and so when babies are fed 

 on such milk, unless an antiscorbutic such as orange juice is given with 

 it, they develop a subacute type of scurvy. This is the most common 

 form of the disorder and is easily overlooked. Babies derive antiscor- 

 butic material from their mothers but when artificial feeding is begun 

 this protection is lost. Since pasteurized milk still contains some vita- 

 mines it takes an infant that is fed on it without antiscorbutics, 7 or 8 

 months to develop scurvy from its use. During the development of the 

 disease the growth of the baby is usually arrested. The weight stops in- 

 creasing and remains stationary for weeks or months, but the child re- 

 sponds quickly to orange juice or its equivalent, often making supergrowth 

 till it attains the correct weight for its age. An underfed child, if given 

 the amount of food it needs, may respond to this impulse and increase 

 its weight throughout the scorbutic condition. Measurements show that 

 the growth of the infant in length is retarded during a long attack of 

 scurvy but that on the administration of "orange juice, growth begins 

 again as vigorously as ever. Hess recommends the use of pasteurized 

 milk in infant feeding on account of the security which it affords 

 against infections, but he advises that when infants are fed exclusively 

 on a diet of pasteurized milk, antiscorbutics should be given far earlier 

 than at present, even as early as at the end of the first month of life. 

 The question whether an infant ought or ought not to have pasteurized 

 milk is purely a medical one and should be settled by the orders of the 

 physician. As illustrative of the results obtained in the use of pasteurized 

 milk in child welfare stations those obtained from April 24, 1911, to Oct. 

 24, 1912, at the George M. Oyster, Jr. Milk Philanthropy in Washington, 

 D. C., are presented. 



Of the babies 131, or 18.8 per cent,, were born out of wedlock and 

 were regarded as burdens by those having them in charge. 



The reasons given for bottle feeding by those who brought the babies 

 to the station were: 



