MILK AS A VEHICLE OF TUBERCLE AND 
PRESENT LOCAL LEGISLATION IN 
REGARD TO IT 
By E. W. HOPE, M.D., Medical Officer for the City of Liverpool 
It is obvious that numerous points are involved in the subject, some of which 
are difficult to dissociate from questions other than those which concern tuberculosis 
only. For example, measures taken with the sole object of checking an even more 
destructive form of disease, viz., diarrhoea, have proved incidentally a safeguard 
against tuberculosis, whilst, on the other hand, measures directed against tuberculosis 
have afforded a valuable protection from other forms of disease. 
Sterilization of milk possesses one conspicuous advantage, viz., that the 
application of the safeguard is within the reach of every reasonably prudent and 
careful household, consequently for ease of application it is beyond any comparison 
with other preventive measures. The objections to it do not appear to be important, 
but there are the facts to be reckoned with, that in the lower quarters ot every great 
town there are thousands of families neither prudent nor careful, and also that the 
population of this country as a rule prefer to take their milk raw. This preference 
results no doubt partly from thoughtlessness and partly from habit. Young children 
are trained to take it raw,and the belief is widespread, that if the milk is raised in 
temperature to say 200 0 F., or even still nearer the boiling point, it is altered in 
flavour and constitution, and is of less nutritive and digestive value than when it is 
given raw ; the raw milk in fact is regarded as more nearly approaching the natural 
milk of the mother. 
There is no clinical evidence whatever to show that sterilized or even boiled 
milk is less nutritious and valuable than raw milk. On the other hand, raw cows' 
milk, in addition to the risk of tuberculosis, brings many others. The process of 
milking may involve dirt from a dirty milker, from dirty udders into a dirty milk 
pail. From this it may be passed through a dirty strainer into a dirty railway can. 
It is discharged from the railway can into smaller vessels in which it is hawked about 
the dusty streets, passing through some half-dozen other pots and pans before it 
reaches the nursery or the table of the consumer, involving a host of possible sources 
of contamination, not excepting the contamination of Tubercle Bacillus, in fact, it 
may be safely said, there is no article of food in common use so constantly exposed 
to contamination, or so susceptible of contamination, as raw milk. The milk, on the 
w 
