MILK IN ITS RELATION TO THE PUBLIC HEALTH ()91 
F. (77° C.) not only destroys most of the bacteria present, but, appar- 
rently, 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 deleterious. 
"4. 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. 
"5. No special varieties of bacteria were found in unheated milk, 
which seemed to have any special importance in relation to the sum- 
mer diarrhea of children. A few cases of acute indigestion were seen 
immediately following 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 centimeter, mostly spore-bearing 
varieties. The deleterious effects, though striking, were neither serious 
nor lasting. 
"6. After the first twelve months of life, infants are less and less 
affected by the bacteria in milk derived from healthy cattle. Accord- 
ing 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. 
"7. Since a large part of the tenement population must pm-chase 
its milk from small dealers, at a low price, everything possible should 
be done" by health boards to improve the character of the general milk 
supply of cities by enforcing proper legal restrictions regarding its 
transportation, delivery and sale. Sufficient improvements in this 
respect are entirely feasible in every large city, to secure to all a milk 
which will be wholesome after heating. The general practice of heating 
milk, wdiich has now become a custom among the tenement population 
of New York, is imdoubtedly a large factor in the lessened infant 
mortality during the hot months. 
"8. Of the methods of feeding now in vogue, that by milk from 
central distributing stations unquestionably possesses the most 
advantages, in that it secures some constant oversight of the child 
and, since it furnishes the milk in such a form that it leaves the mother 
least to do, it gives her the smallest opportunity of going wrong. 
This method of feeding is one which deserves to be much more exten- 
sively employed and might, in the absence of private philanthropy, 
wisely be undertaken by municipalities and continued for the four 
months from May 15 to September 15. 
"9. The use, for infants, of milk delivered in sealed bottles, should 
be encouraged whenever this is possible, and its advantage duly 
explained. Only the purest milk should be taken raw, especially in 
summer. 
"10 Since what is needed most is intelligent care, all possible means 
