216 THE MILK QUESTION 



taken raw the fewer bacteria present the better are the results. 

 Of the usual varieties, over 1,000,000 bacteria per cubic centi- 

 metre are certainly deleterious to the average infant. However, 

 many infants take such milk without apparently harmful results. 

 Heat above 170° F. (77° C.) not only destroys most of the bacteria 

 present, but apparently some of their poisonous products. No 

 harm from the bacteria previously existing in recently heated 

 milk was noticed in these observations, unless they had amounted 

 to many millions, but in such numbers they were decidedly dele- 

 terious. 



When milk of average quality was fed sterilized and raw, those 

 infants who received milk previously heated did on the average 

 much better in warm weather than those who received it raw. 

 The difference was so quickly manifest and so marked that there 

 could be no mistaking the meaning of the results. 



A few cases of acute indigestion were seen immediately follow- 

 ing the use of pasteurized milk more than thirty-six hours old. 

 Samples of such milk were found to contain more than 100,000,000 

 bacteria per cubic centimetre, mostly spore-bearing varieties. 

 The deleterious effects, though striking, were not serious or last- 

 ing. 



After the first twelve months of life, infants are less and less 

 affected by the bacteria in milk derived from healthy cattle. Ac- 

 cording to these observations, when the milk had been kept cool 

 the bacteria did not appear to injure the children over three years 

 of age at any season of the year, unless in very great excess. 



The general practice of heating milk, which has now become 

 a custom among the tenement population of New York, is un- 

 doubtedly a large factor in the lessened infant mortality during 

 the hot months. 



Only the purest milk should be taken raw, especially in sum- 

 mer. 



Physicians who have had large experience in the care 

 and feeding of infants have a prejudice against the use of 

 heated milk for prolonged periods. While it is admitted 

 that the use of heated milk greatly diminishes the amount 

 and seriousness of infantile diarrhoeas, it has been stated 

 that while the children at first do well they may become 



