1 66 MILK AND THE PUBLIC HEALTH CHAP. 



are closely allied to the epidemics of sore throat and in- 

 fectious disease considered in Chapter VI., and while they 

 have no special relationship to infant mortality they show 

 that milk may be a cause of human diarrhoea. 



The relationship between a pure milk supply and infant 

 mortality is clearly shown by the accumulated evidence 

 obtainable from the different institutions which supply pure 

 milk to infants. Such institutions are the Gout de Lait and 

 Consultation de Nourrissons in France, Milk Depots in 

 England, and Milk Dispensaries in America. 



Dealing with some of the French results Budin 1 remarks : 



From 1892, when I instituted my first consultation, till June 

 1899, counting only those infants who have been under my care 

 for at least one month, or at most two years, I have had altogether 

 435 nurslings; 238 were exclusively breast-fed and 197 were on 

 mixed or artificial feeding. Out of these 435, 32 have died, which 

 make a general mortality of 7 '3 per cent. 



Of the deaths only one was due to diarrhoea, and this 

 child during the day had been having impure milk in a day 

 nursery. Other French figures are quoted by McCleary. 2 



The figures from the various milk depots established in 

 England show that a much smaller number of the infants 

 fed from them die compared with a proportionate number of 

 infants not so fed, but otherwise similar. 



Many of the death-rates given for these infants fed at 

 depots, compared with outside infants, are not reliable since 

 they are based upon data not readily comparable, and the 

 writer agrees with McCleary (pp. cit.) that " it is doubtful 

 whether the value of these institutions can. be expressed 

 in figures. Clinical testimony is of far greater value than 

 statistics, and this testimony is almost uniformly favourable 

 to the depots." In particular the part played by the pure 

 milk cannot be altogether disassociated from the other parts 

 of the scheme the medical advice and the supervision of the 

 homes by a health visitor which usually play a part. Care- 

 fully used the figures from milk depots are, however, of value. 

 The chief particulars of the Woolwich depot are mentioned 

 on p. 356, and only the following need be mentioned here. 



1 Budin, The Nursling, 1907. 

 2 Joum. of Hygiene, 1904, iv. p. 329. 



