MILK FOE INFANTS 155 



per cent., in Budapest 28 per cent., in Munich 31.4 per 

 cent, and in Ingolstadt even 40.9 per cent. 38 



In Copenhagen, the mortality, during the first year 

 of life, has decreased significantly; 1877 to 1886, 20.83 

 per cent, died each year; in the next decade 19.04 per 

 cent., during 1897 to 1899, 17.87 per cent., while only 

 15.55 per cent, died in 1900. Infant mortality is also 

 on the decrease in the provincial cities, and this is 

 certainly true of many large cities abroad. 



A comparison of normally fed children with chil- 

 dren fed on raw or prepared cow's milk, shows a far 

 greater death rate among the latter. If the cases of dis- 

 eases and death are arranged according to the separate 

 months, it is noticed that in most cities there is a marked 

 increase of deaths in July and August and a propor- 

 tionate decrease in September, and this increased mor- 

 tality pertains almost exclusively to children fed arti- 

 ficially. 



By far the greater part of the fatal diseases are af- 

 fections of the stomach and the intestines as catarrh, 

 colics and cholera infantum. Although the causal con- 

 ditions are not fully explained, it may be stated that 

 cow's milk appears to induce a predisposition to intes- 

 tinal infections, on account of its varying and hetero- 

 geneous composition. The diseases are to be attributed 

 to the action of microbes ; possibly in some cases to bac- 

 teria that have formed toxic substances during their 

 development in the milk, but in the greater number of 

 cases it is, doubtless, a question of the presence of patho- 

 genic microbes in milk (streptococci, proteus- and colon 

 forms). Therefore, milk intended for infants should be 

 sterilized. Opinions differ as to whether heating with 

 steam for an hour (Soxhlet's method) is to be preferred 



38 These figures are taken from Ohlens' Die Milch und ihre Beden- 

 tung, 1903. 



