190 THE MILK QUESTION 



So long as the average market milk is apt to contain these 

 insidious foes, the only protection we have is to destroy 

 them with heat. 



It must be remembered that even with the most exacting 

 care known to science milk occasionally is apt to become 

 infected. This sometimes happens to the cleanest, fresh- 

 est, and purest grades. Even certified milk has, on several 

 occasions, been responsible for diphtheria and scarlet fever. 

 The reason for this is that cases of these diseases are some- 

 times so mild that they cannot be recognized even by a 

 skillful clinician. Finally the danger is unfortunately com- 

 plicated by the occasional presence of a bacillus carrier. 

 A number of outbreaks of typhoid fever have been traced 

 to bacillus carriers. 



Why pasteurization is forced upon us as a public health 

 safeguard 



Raw milk is apt to be dangerous milk. Pasteurization is 

 our only safeguard against certain of the dangers conveyed 

 in milk. The question now arises whether these dangers 

 are sufficiently real or sufficiently frequent to justify all the 

 fuss that is made about them. Is the danger from the use of 

 the average raw market milk a serious one? Yes, it is. 

 The numerous outbreaks of typhoid fever, scarlet fever, 

 diphtheria, sore throat, as well as the relation of milk to 

 tuberculosis and other infections, is sufficiently real, suffi- 

 ciently frequent, and sufficiently serious to arouse sanita- 

 rians and the public to a realization of the danger. In our 

 studies on typhoid fever in Washington, for example, we 

 found that the general market milk is, for the most part, 

 old, stale, and dirty. Further, that at least 11.3 per cent 

 of the cases of typhoid fever which occurred during the 

 summer of 1906 in our capital city were due to infected 

 milk; in 1907, 9.18 per cent; and in 1908, about 10 per cent 

 of the typhoid cases were traced to infected milk. Similar 

 conditions have been found in other cities wherever the 



