18 EEPOET OF THE No. 55 



Bhode Island State law requires extra precautions in the milk supply of institu- 

 tions, and in addition to this, all the milk of the Ehode Island Hospital has' been 

 pasteurized for some years with very satisfactory results. From New York. I 

 learned that the municipal hospitals paid about fifty per cent, above the market 

 price and secured milk of a higher grade. They let the contract by tender and 

 asked for tenders for two classes (1) milk containing 4 per cent, of fat and 12^ 

 per cent, of solids at least, and not more than 100,000 bacteria per cc. in May, 

 June, July and August, nor more than 60,000 the balance of the year; (2) milk 

 certified by the Milk Commission. Another New York hospital superintendent 

 who got the regular supply said, "We have a regular bacteriological examination of 

 our milk. I am obliged to confess it is' generally somewhat above the limit set by 

 the Board of Health as to the number of bacterial colonies but we all thrive on it.' 

 In a couple of cases no special attention was paid to the matter, while one reported 

 they were supplied by their own herd." 



MEDICAL MILK COMMISSIONS AND "CERTIFIED" MILK. 



As the Medical Milk Commission has had considerable influence in directing 

 attention to the necessity for safeguards in connection with the milk supply, it is 

 fitting that the history, nature and aims of this movement should be herein recorded. 



The" Medical Milk Commission and "certified" milk movement began in New- 

 ark, New Jersey, in 1892. To Dr. Henry L. Coit of that city belongs the credit 

 of originating the idea. He formulated a plan by which an organization of doctors 

 should give their practical support and endorsatlon to any dairyman who would 

 produce and handle milk in accordance with their regulations. These regulations 

 were drawn up in such a manner as to insure the absolute purity of the milk. 

 Dr. Coit succeeded in securing the co-operation of other members of his profes- 

 sion, and, in 1893, the Medical Society of Essex County, N.J., organized a Milk 

 Commission and the work of securing certified milk was begun. Dr. Coit himself 

 says the idea had its inception in his efforts to solve the problem of infant feed- 

 ing and that this, together with the general need of pure milk for invalids, has- 

 been the chief factor in sustaining public interest. That interest has been not only 

 sustained but increased, as is shown by the fact that there are now fifty-six Medical 

 Milk Commissions in almost as many cities in the United States, and the move- 

 ment has spread to Canada. 



At the Convention of the Canadian Medical Association held in Ottawa in 

 June, 1908, Dr. C. J. 0. Hastings of Toronto read a paper on "The National Im- 

 portance of Pure Milk." The matter was promptly taken up by the Executive, 

 which decided to form a Canadian Medical Association Milk Commission. It 

 was composed of representatives from all parts" of Canada, with Dr. Hastings as 

 Chairman and Dr. J. H. Elliott of Toronto as Secretary. Its object was denned 

 as being to co-operate with Boards of Health in securing a pure milk supply, and 

 to seek more stringent legislation. The meetings are held in Toronto, where 

 enough members to make a quorum reside. They have adopted the following defi- 

 nitions: 



"Certified milk is milk examined and guaranteed by any local Board of Health 

 or incorporated society or association of legally qualified medical practitioners ; 

 first to be taken from cows semi-annually subjected to the tuberculin test and 

 found without reaction, all doubtful and suspicious cases to be excluded from the 

 herd; second, to contain not more than 10,000 bacteria per cc. in the summer and 



