THE ROTCH SYSTEM 501 



30,C)CXD bacteria per c.c. Much has also been done in America in 

 the direction of improving and modifying the milk supply for 

 children, particularly by Dr Chapin of New York,^ and Dr Rotch 

 of Harvard.- 



1 Theory and Practice of Infant Feeding^ by Henry Dwight Chapin, M.D., 

 1902. 



- This system was introduced by Dr Thomas Morgan Rotch of Harvard 

 University, and is now in operation in some eighteen or twenty cities in the 

 United States and Canada, and has also a centre in London. The system, 

 which has for its object the betterment of infant feeding, consists in controUing 

 the milk supply by controlling the farms and establishing a chain of protection 

 from the time the milk leaves the cow until it arrives at the mouth of the infant. 

 But in addition to this scheme of protection, there is also combined with it a 

 scheme of modification of the milk to make it meet more exactly the require- 

 ments of infant feeding. The two-fold function of the Rotch System may be 

 briefly referred to : — {a) Protection of the Milk. — With this object in view Rotch 

 made a number of recommendations similar to those laid down by various Milk 

 Commissions, which latter indeed took many of Rotch's proposals for their 

 model. At the farms supplying milk under this system, the breed of the cow 

 and its food are matters which receive primary attention. In America the 

 Holstein has been found to be the best for its adaptability for infant feeding. 

 The cow itself must be regularly and wisely fed on the basis to which reference 

 has been made. There is regular grooming and good housing. The cowhouse 

 has cemented walls, ceilings, and floors, and is properly drained and frequently 

 cleansed. A most careful supervision of the cow^s health is maintained, and if 

 in any way abnormal the cow is isolated until in normal health. Careful 

 tuberculin testing is made of each cow used, and the milk of each cow also 

 undergoes micsoscopical examination for the purposes of detecting pus cells, 

 colostrum cells, bacteria, etc. The milkers are under strict medical supervision 

 and regulations are enforced in respect of " cleanliness." Cows are milked in 

 their own stalls, but immediately after milking the milk is taken in closely- 

 covered vessels to the milk-room where it is cooled and screened. The milk- 

 room is a specially prepared chamber having smooth surfaces of polished 

 cement, and specially constructed ventilators with cold water sprays to moisten 

 the air and prevent dust gaining access, asepsis being the requirement. The 

 milk is now ready for the laboratory, {b) Modification. — The object of the 

 Walker-Gordon Laboratories is first to insure and distribute the naturally pure 

 milk ; and secondly, to provide a place where different combinations of milk may 

 be put up, according to the prescriptions of medical men, with accuracy, and 

 under such conditions of cleanliness and asepsis as to insure the best possible 

 food for infant feeding. The necessity for modification arises from two facts, 

 namely, that milk varies in constituent percentages, and to obtain a regular and 

 imiform constitution modification is necessary ; and secondly, some children 

 require for one reason or another a milk containing certain percentages of the 

 various constituents. Thus the patient can receive on the physician's order a 

 mixture of the percentages called for, made up of either separated cream or 

 gravity cream, separated milk or whole milk. Twelve years' experience in 

 Boston, U.S.A., seem to indicate the practicability of this system in preventing 

 the summer diarrhoea of infants due to contaminated milk. The first laboratory 



