VIII. B, 6 Musgrave: Infant Mortality 463 



infant mortality in this Archipelago would appear to be one 

 surrounded by impossible difficulties. 



Taking all the evidence into consideration, a raw, fresh milk 

 supply, sufficient to meet the absolute requirements of the coun- 

 try, does not seem to be within the bounds of possibility — at least 

 within a reasonable length of time. All authorities acknowl- 

 edge that raw milk contains elements of nutritional value not 

 found in any sterilized milk, and so far as we are informed the 

 only differences to be found between sterilized milk are dif- 

 ferences in chemical composition. Therefore, in all probability, 

 sterilized milk of local production has no advantage over im- 

 ported sterilized milk. The question, then, resolves itself purely 

 into one of financial consideration. Other things being equal, 

 the cheapest milk should be the one adopted for our general use. 



PASTEURIZATION 



So much has been written recently regarding the methods of 

 Pasteurization of milk in tropical countries that a very brief con- 

 sideration of this subject seems pertinent. Formerly, Pasteuri- 

 zation was considered an efficient method of preparing milk for 

 human consumption, because of the destruction by this method 

 of dangerous disease-producing bacteria. We now know that 

 the so-called pathogenic organisms are not the only, even if they 

 are the most dangerous, bacteria in milk. Pasteurization, of 

 course, does not destroy spore-bearing bacteria, and, therefore, 

 any milk not kept below a temperature of from 20 to 22° C. after 

 Pasteurization acts as a culture medium for those germs not 

 destroyed by the low degree of heat used in the method of Pas- 

 teurization. Intrinsically, most of the bacteria of this class are 

 not considered pathogenic, but as a result of their multiplication 

 the chemical composition of the milk is altered, and as by-products 

 of this alteration there are produced dangerous chemical poisons 

 which are very important factors in the morbidity results pro- 

 duced by the ingestion of milk. Conditions for the growth of 

 bacteria in the Philippine Islands are ideal, and with a very 

 limited ice supply and without much prospect of improving this 

 condition the after care of either fresh or Pasteurized milk be- 

 comes impossible for the vast majority of people. Actual ex- 

 perimentation has shown that the multiplication of bacteria in 

 Pasteurized milk is so rapid that within a few hours after Pas- 

 teurization such milk is almost as dangerous as if this process 

 had not been employed. 



We come, then, to completely sterilized milk as being the only 



