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most part, old, stale, and dirty (in 1907 the milk averaged over 
22,000,000 bacteria per cubic centimeter and in 1908 over 11,000,000) , 
and further, that at least 11.3 per cent of the cases of typhoid fever 
which occurred during the summer of 1906 in TTashington were cer- 
tainly attributable to contaminated milk. In 1907 9.18 per cent 
and in 1908 about 10 per cent of the typhoid cases were traced to in- 
fected milk. Similar conditions have been found in other cities 
wherever the matter has been investigated. In addition to typhoid 
fever, the milk frequently conveys the infection of tuberculosis, 
scarlet fever, diphtheria, diarrhoeal and other diseases. One needs 
only to refer to other parts of this bulletin to assure himself of the 
extent to which death and disease are caused by impure milk. That 
phase of the subject therefore needs no further emphasis here. 
The average commercial milk of large cities is not a safe food. 
The principal reasons for this are the ignorance and indifference of 
those engaged in the dairy business, filthy barns, unclean and un- 
healthy cows, improper care of containers, insufficient cooling of the 
milk, long transportation, unnecessary and frequent handling, im- 
perfect cleaning and lack of sterilization of the bottles, and the fre- 
quent close association with contagious disease. 
The difficulty of obtaining a clean fresh milk supply is soon 
appreciated when we investigate the subject in any large city. For 
instance, in TTashington the milk supply comes from over 1,000 
different dairy farms, situated in the surrounding counties of Vir- 
ginia and Maryland. Some of the cream comes from distant points 
in Pennsylvania and Xew York. Boston gets a large part of its 
milk supply from distances of 40 to 100 miles. The milk supply 
of the city of Xew York is produced at 35,000 farms scattered over 
5 different States, passes through 400 creameries, and comes over 
12 different lines of transportation. Some of the milk, at certain 
seasons, reaches Xew York from Canada, and shipments of cream 
arrive daily from Ohio. One hundred and fifty wholesale dealers 
are engaged in the business and the retail stores number 12,000, the 
daily consumption being 1,500,000 quarts. From this extreme case 
we will find every grade of complexity down to the small village 
and the individual farmhouse where fresh milk may be obtained 
twice daily. In Xew York only 16,000 quarts of the total of 
1,500,000 quarts daily used are “ certified ” as clean milk. 
THE EXTENT OF PASTEURIZATION. 
Freeman tells that it was about 1892 that the sterilization of the 
milk in the tenements of Xew York was widely adopted. So general 
has this become that the inspectors of the Rockefeller Institute for 
Medical Research, when recently seeking statistics concerning the 
