651 
without sensibly hurting its food value. We have authority for the 
statement that milk pasteurized at 60° C. for twenty minutes is 
“ live ” milk, rich in zymogens, and that such milk retains entirely the 
taste of fresh milk and is quite as digestible. 
THE BACTERIA AND TOXINS CONCERNED. 
Despite the great amount of work done upon this subject, there is a 
diversity of opinion as to which particular varieties of bacteria 
and their varied products are responsible for the large group of dis- 
eases comprised under the term “ gastro- intestinal infections.” There 
can be no doubt that there is a direct relation between the bacteria 
and their products in milk and the bowel complaints of children. 
It is also clear that these are not all acute specific diseases due to 
one cause. The factors are complex. It is not only the bacteria and 
their poisons in the milk, but also the bacteria always contained 
in the gastro-intestinal canal, that play an important part. While 
it is undoubtedly true that milk sows the seed and often actually 
contains the poison, it is also well known that a deranged digestion, 
which favors abnormal fermentation and putrefaction of the milk 
within the body, resulting in the class of affections known as “ auto- 
infections ” and “ auto-intoxications,” here plays a definite role. All 
clinicians agree that the first essential for the successful treatment 
of the gastro-intestinal diseases of children is to at once discontinue 
the use of milk. The great prevalence of this class of diseases in the 
heated months of summer makes it perfectly plain that the depress- 
ing influences of heat seriously affect the resistance of the infant. 
At the same time the heat favors the growth and multiplication of the 
bacteria in the milk. 
Children vary much in their susceptibility to the bacteria and the 
bacterial products concerned. The same milk may act as a violent 
poison to one child while another living under the same conditions 
may escape. 
Fliigge ® laid particular distress upon the peptonizing bacteria 
which for the most part are spore-bearing organisms. The spores 
survive the heat of pasteurization and have a free field for growth 
and activity. As a rule the organisms known as the lactic acid group 
gain the ascendancy in raw milk, and these bacteria have a restrain- 
ing effect upon the great majority of other species. Fliigge found 3 
of the 12 peptonizing bacteria isolated by him from heated milk to 
have poisonous properties. Pure cultures in milk, when injected into 
laboratory animals, cause severe symptoms, and in one instance when 
fed to a puppy produced fatal diarrhea. 
° Fliigge, C. : Die Aufgaben nnd Leistungen der Milch- Sterilisirung gegeniiber 
den Darmkrankheiten der Saulinge. Zeit. f. Hyg., vol. 17, 1894, p. 272. 
