Milk and its Relation to the Public Health. 
INTRODUCTION. 
By Walter Wyman, 
Surgeon-General, Public Health and Marine-Hospital Service. 
During the last few j^ears increasing attention has been given to 
milk in its relation to the public health. This is especially true in 
the United States, where the more progressive health authorities of 
the larger cities and many of the States have been instrumental in 
markedly improving their milk supplies. 
The question of sanitary milk is to the American people especially 
pertinent. Milk is perhaps used to a greater extent in this than in 
any other country. It holds a peculiar place in the nation’s dietary 
because of its varied applicability. Containing as it does all the 
essentials of a perfect ration, proteids, carbohydrates, fats, inorganic 
salts, and water, it is capable of almost universal use. Because of 
this, and, in addition, its facility of ingestion and comparative ease 
of digestion, it constitutes an important food for the sick and 
convalescent. 
Of even greater importance is the use of cow’s milk as a substitute 
for mother’s milk in infant feeding. It will be perceived that those 
most dependent upon this food — the sick and convalescent, infants 
and children — constitute that part of the community suffering the 
greatest injury from the use of a food impaired in its nutritive con- 
tent. This is due to the fact that they are least able to resist the 
harmful effects of foods contaminated by toxins or pathogenic micro- 
organisms. While improved conditions of living have contributed 
to a steady decrease of the general mortality in civilized countries, 
this unfortunately does not apply to the infant population under one 
year of age. It is recognized that gastro-intestinal disease is the 
largest single factor determining infant mortality, a condition in 
great measure due to improper methods of feeding. This enormous 
loss of potential wealth is of grave concern to the State and worthy 
of most careful consideration. It is especially for these reasons that 
the question of sanitary milk and its relation to the public health 
challenges our best endeavors. 
The investigation into the origin and prevalence of typhoid fever 
in the District of Columbia during 1906 by a board of medical officers 
of the Public Health and Marine-Hospital Service brought out many 
facts evidencing the possible danger of milk as a carrier of this dis- 
ease, and stimulated investigation and renewed activity in the efforts 
to secure pure milk supply in the District of Columbia. 
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