i88 MILK AND ITS HYGIENIC RELATIONS 



physician. As a result, control observations in regard to other 

 methods of feeding are usually absent. 



The published investigations show that a good many children 

 appear to improve rapidly upon raw milk, while an equal number 

 appear to improve equally well upon boiled milk. 



A few experiments have been carried out in other countries upon 

 children in institutions, who could be observed for longer periods. 

 The most comprehensive experiments were carried out by Finkel- 

 stein, who observed a number of children, both healthy and sick, 

 over considerable periods. Children of both classes were fed upon 

 raw and boiled milk. The milk used was of the best quality, and was 

 used for all the children, whether fed upon raw or upon boiled 

 milk. No definite superiority of one method of feeding was 

 established, but there was perhaps a slight balance in favour of 

 the boiled milk. 



The work of Park and Holt in New York has shown that even 

 when reasonable precautions are taken and when good milk is 

 supplied, it is safer to heat the milk used for the infants. Their 

 special investigations upon some ninety infants gave results which 

 were distinctly unfavourable to raw milk. 



In all work where the results likely to be obtained from feeding 

 infants on any form of milk are analysed, it is necessary to consider 

 not only the possible original contamination of the milk, but also 

 the possibility (or rather, the probability) of contamination in the 

 home of even an ideal milk supply. 



The material which had been collected in one of the infant 

 consultations in Berlin was kindly placed at my disposal in 1911 ; 

 and I was enabled to analyse the medical notes of 300 breast-fed 

 babies, and of 204 infants fed on good milk, which was boiled in 

 the homes. This does not give a comparison of the value of raw 

 and boiled milk. The results obtained with the boiled milk were, 

 however, so favourable as to render it unlikely that any form of 

 artificial feeding would have produced more favourable results, 

 especially in view of the experience derived from previous investi- 

 gations on these lines. 



Generally, it may be stated that no form of artificial feeding 

 will produce results of as favourable a nature as are obtained by 

 natural methods of feeding. Where artificial feeding must be 

 employed, there is no evidence that milk loses any of its nutritive 

 value by boiling. The work of numerous observers indicates 

 that rather more satisfactory progress is made with boiled than 

 with raw milk. 



These remarks apply to the general infant population, and not 

 to special infants in pathological conditions. In these latter cases 

 idiosyncrasies for special forms of food are frequently exhibited. 



