657 
if a child must be artificially fed it is best to use fresh, pure milk; 
but when we consider that thousands of infants in our large cities 
must depend upon the milk of a cow many miles away, we are con- 
fronted with a difficulty not readily overcome. Nature did not intend 
the young of one species to be raised upon the milk of another, much 
less did it intend that milk to be dirty, stale, and bacteria-laden. We 
have unanimous testimony that such milk, especially in the heated 
months of summer, is the cause directly or indirectly of the excessive 
infant morbidity and mortality. 
The average city market milk that has already deteriorated in 
quality can not be revivified. No known process will make bad milk 
good milk ; but further fermentation and putrefaction in the milk can 
be stopped, and pathogenic organisms killed, by heating it to 60 ° C. 
for twenty minutes. Bad milk, whether heated or unheated, is unfit 
for infant feeding, but if infants must depend upon old dirty and un- 
cared for milk it would be much better, especially in the summer 
months, to practice pasteurization, in spite of its alleged disad- 
vantages. 
The quantity of certified or clean milk in any community is but a 
drop in the bucket, and until health officers can assure a good quality 
of milk the only protection we have is the expedient of heating it. 
It is by no means claimed that heated milk is the ideal to be at- 
tained. On the contrary, we want good, fresh milk that needs no 
heating. At present it is exceedingly difficult to obtain such milk 
in our large cities, and anyone who investigates the matter care- 
fully will soon convince himself that it will be many years before 
this is possible and only after a revolution of the milk industry. In 
the meantime we must protect ourselves. 
Physicians who have had large experience in the care and feeding 
of infants have a prejudice against the use of heated milk for pro- 
longed periods. While it is admitted that the use of heated milk 
greatly diminishes the amount and seriousness of infantile diar- 
rheas, it has been stated that while the children at first do well they 
may become flabby and anemic and the subjects of scurvy. It is 
probably not the heating but some other factor in the milk that 
induces scurvy. 
We have the published testimony of a large number of physicians 
to the effect that the use of pasteurized milk produces no harmful 
effects that may be attributed to the heating. But when all is said 
and done the pasteurization of milk for infant feeding can neither 
be recommended nor discountenanced as a general proposition. The 
saying that “ one man’s meat is another man’s poison ” applies with 
special significance to the artificial feeding of infants. The general 
pasteurization of all milk used for the nourishing of infants would 
1414— Bull. 56 — 09 42 
