SPECIALISED MILK 237 



(2) To be derived from healthy cows, guaranteed free from 

 tuberculosis by the tuberculin test, and living under clean and 

 sanitary conditions; 



(3) To be obtained by clean methods of milking, to be strained, 

 and to be protected from contamination by dust or dirt, or from 

 infection by disease of milker; 



(4) To be kept cool by means of refrigeration from the time it 

 leaves the cow to the time it reaches the consumer, and not to be 

 exposed to dust or uncleanliness in any way from the vessels in 

 which it is placed or from the persons by whom it is handled.* 



Specialised Milk Supplies for Infants. The movement for 'the supply of 

 modified milk for the use of infants, particularly of the artisan class, has now become 

 a considerable one, both in Europe and America. Broadly speaking, the systems repre- 

 sented in England are (i.) the Municipal Milk Depot (Liverpool, Battersea, Bradford, 

 etc.), and (ii.) the Rotch system (Walker-Gordon Laboratories), (i.) There can be 

 little doubt that this kind of milk supply may be of great service for the children of 

 the poor, in the reduction of infantile mortality due to the use of contaminated or 

 infected milk, and in special cases calling for special treatment. It is not, however, 

 of the nature of control of the milk supply, but rather, of a specialised supply, to meet 

 special needs. There is evidence to show that at Liverpool, Battersea, and other 

 places, it has had beneficial results in this special direction. It has, however, several 

 limitations, unless properly managed. Its object being the saving of life and pre- 

 vention of infant diseases, it is necessary that the system should be individualised. 

 Each mother must be separately advised, each infant inspected and weighed periodi- 

 cally, each home supervised, the condition of the milk regularly tested, and the 

 source of the milk kept under control, the cows and cowsheds from which the milk 

 is derived being supervised by a veterinary surgeon and the Medical Officer of 

 Health. And here, in any event, the quality of the milk used must reach a high 

 standard, chemically and bacteriologically. If these conditions are not fulfilled, it 

 would appear that a municipal sterilised milk supply can only be a palliative measure 

 of transient usefulness. The chief desideratum is a naturally pure milk supply, rather 

 than an artificially purified and humanised supply. The latter question is one 

 certainly requiring careful consideration, but of a different nature to the former. If 

 undertaken by a Local Authority, it would appear desirable to do it very thoroughly, 

 after the manner of Budin and Variot in Paris, each case being under strict medical 

 supervision. 



A typical municipal milk depot in this country is described in the following 

 words : 



The milk is supplied by a local dairyman, and arrives in the early morning. It is 

 guaranteed free from chemical preservatives, and to contain not less than 3*25 per 

 cent, butter fat, and 8 '75 per cent, of solids not fat, and cream which must contain not 

 less than 50 per cent, of butter fat. The milk must be drawn from healthy cows, 

 stabled and milked under clean and sanitary conditions. Utensils, etc., used must 

 be thoroughly clean. These and other requirements are set out in the contract. The 

 first process is the modification or humanisation. Three modifications are employed. 

 The first contains one part milk to two of water, seven ounces of cream and seven of 

 lactose being added to each gallon of the mixture. This modification is given to 

 infants under three months old. The second modification, which is given to infants 

 between three and six months old, consists of equal parts of milk and water, with 

 five ounces of cream and lactose added per gallon. The third consists of two parts 



* For details respecting control of milk supply, see Bacteriology of Milk, pp. 

 452-599 ; also, Report on Health of City of Manchester, 1902 ; Report on Milk Supply 

 of Finsbury, 1903; The Milk Supply 0/200 Cities and Toivns (U.S.A. Depart, of 

 Aaric., 1903, Bulletin 46); Brit. Med. Jour., 1904, vol. ii., pp. 421-429 (Newman). 



