19O9 MILK COMMISSION. Ill 



doubtless many American cities which would not compare favorably even with On- 

 tario. Through infants' milk depots pure food has been provided, and, equally im- 

 portant, education in feeding and sanitation has been afforded. 



MUNICIPALITIES SHOULD ACT. 



In making enquiries into milk conditions generally, these facts in reference 

 to Ontario's infant mortality, illumined by comparisons from other countries, have 

 so impressed your Commission that we consider it our duty to call your attention 

 to the matter and respectfully suggest that the attention of the various municipali- 

 ties be directed to a state of affairs which cannot be regarded as other than seri- 

 ous. We recognize that it is a question which must be taken up and dealt with 

 by the municipalities and must be grappled with at close range. We are also 

 convinced that it must be dealt with aside from the general milk supply, for edu- 

 cation is equally as important as safe milk and proper feeding. This has been the 

 experience of other cities like New York and Eochester, and in the Copenhagen 

 regulations it will be noticed a sharp distinction is drawn between the general and 

 the infants' supply. If further proof were needed it is found in the fact that Ot- 

 tawa, with perhaps the best general milk supply of any Ontario city, has the high- 

 est infantile mortality. In the case of Ottawa it must of course be remembered that 

 there is a population of dual nationalities. Montreal, a neighbouring city under 

 somewhat similar racial conditions, has an infantile mortality of 270 per thousand, 

 compared with 216 in Ottawa. 



With, the exception of the very recent steps already noted in Toronto and Ham- 

 ilton, we regret to find that practically no attention has been paid to the question 

 in Ontario cities. The~ figures themselves, the records which tell the story, are 

 treated as a mere formality. Under the Act of 1896, they are received by the 

 Division Registrar, who is usually the City Clerk, $nd at stated intervals they are 

 forwarded to the office of the Deputy Registrar General at the Parliament Build- 

 ings for the annual report, which cannot be issued until all the returns are in, which 

 generally takes considerably over a year, sometimes two. Hence they frequently 

 do not come to the attention of the local health authorities until it is too late 

 for them, to be of an ore than academic value. It will therefore doubtless be a mat- 

 ter of surprise as well as pain to the majority of people, as it was to your Commis- 

 sion, to find that the records of Ontario do not compare favourably with other places. 



ACT ACCORDING TO LOCAL CONDITIONS. 



If this heavy infantile mortality is worth diminishing, and it is; if this heavy 

 infantile mortality can be diminished, and all experience shows it can; then 

 it would first seem incumbent on local health authorities to study local conditions. 

 In the doing of this some changes may be found necessary in the system of statis- 

 tics to make their usefulness more what it should be in an up-to-date city. Birth 

 and death returns should be carefully watched, increases and decreases noted, and 

 causes ascertained as far as medically and humanly possible. In most cases it will 

 doubtless be found that the heaviest toll takes place in the hot summer months 

 and that the difference between a reasonably normal and a shockingly abnormal 

 infantile mortality is caused in July and August by diarrhoeal and kindred intes- 

 tinal diseases which are caused by improper feeding when milk constitutes almost 

 the only food. If this is found to be the case, then provision for a pure milk sup- 

 ply is imperative. Whether that provision is voluntarily offered by philanthropy, 



