462 BACTERIA PATHOGENIC TO MAN 



in that it secures some constant oversight of the child, and, since it 

 furnishes the food in such a form that it leaves the mother least to do, 

 it gives her the smallest opportunity of going wrong. This method of 

 feeding is one which deserves to be much more extensively employed, 

 and might, in the absence of private philanthropy, wisely be under- 

 taken by municipalities and continued for the four months from May 

 15th to September 15th. 



9. The use, for infants, of milk delivered in sealed bottles, should 

 be encouraged whenever this is possible, and its advantages duly ex- 

 plained. Only the purest milk should be taken raw, especially in sum- 

 mer. 



10. Since what is needed most is intelligent care, all possible means 

 should be employed to educate mothers and those caring for infants 

 in proper methods. This, it is believed, can most effectively be done by 

 the visits of properly qualified trained nurses or women physicians to 

 the homes, supplemented by the use of printed directions. 



11. Bad surroundings, though contributing to bad results in feed- 

 ing, are not the chief factors. It is not, therefore, merely by better 

 housing of the poor in large cities that we will see a great reduction in 

 infant mortality. 



12. While it is true that even in tenements the results with the best 

 bottle feeding are nearly as good as average breast feeding, it is also 

 true that most of the bottle feeding is at present very badly done; so 

 that, as a rule, the immense superiority of breast feeding obtains. This 

 should, therefore, be encouraged by every means, and not discontinued 

 without good and sufficient reasons. The time and money required 

 for artificial feeding, if expended by the tenement mother to secure better 

 food and more rest for herself, would often enable her to continue 

 nursing with advantage to her child. 



13. The injurious effects of table food to infants under a year old, 

 and of fruits to all infants and young children in cities, in hot weather, 

 should be much more generally appreciated. 



Influence of Temperature upon the Multiplication of Bacteria in Milk. 

 Few, even of the well informed, appreciate how great a difference a few 

 degrees of temperature will make in the rate of bacterial multiplication. 

 Milk rapidly and sufficiently cooled keeps almost unaltered for thirty- 

 six hours, while milk insufficiently cooled deteriorates rapidly. 



The majority of the bacteria met with in milk grow best at tempera- 

 tures above 70 F., but they also multiply slowly even at 40 F.; thus 

 of 60 species isolated by us, 42 developed good growths at the end of 

 seven days at 39 F. Our observations have shown that the bacteria 

 slowly increase in numbers after the germicidal properties of the milk 

 have disappeared, and the germs have become accustomed to the low 

 temperature. In fact, milk cannot be permanently preserved unaltered 

 unless kept at 32 F. or less. The degree of cooling to which ordinary 

 supplies of milk are subjected differs greatly in various localities. 

 Some farmers chill their milk rapidly, by means of pipe-coils over 

 which the milk flows; others use deep wooden tanks rilled with water 



