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It is an obligation on the part of persons having colds to see to it that they do not spread these colds to somebody else. The person who neglects to cover his nose and mouth when he sneezes and coughs, the careless spitter, the person who permits his germ-laden discharges to contaminate things which are going to be handled by other people is a menace to the community. If such a person uses public swimming pools, if he is not amenable to reason and persists in distributing his infection, he should be avoided as a spreader of pestilence.

A good deal has been said about hardening people so that they will not contract colds. There is an element of danger in this, since to expose a weak person to the rigors of cold baths and cold drafts is apt to lower resistance, thus favoring the very condition which it is desired to avoid. At the same time it should not be forgotten that the Arctic explorer does not ordinarily have colds so long as he stays out in the open, and that it is not the engineer and fireman in the cold, drafty cab who have colds, but those who ride in the close, dusty, overheated coaches behind. When all is said, it must be admitted that dusty, unventilated rooms perhaps play the greatest rôle in producing colds.

Since colds are a serious condition they should be treated as such. A great many people think that they have an infallible remedy for breaking up a cold. This may be harmless in itself, but usually it is not and consists of a combination of harmful drugs and alcohol, the latter usually preponderating. The sufferer takes these preparations in large quantities, and if he is strong enough he may survive them and eventually get the best of his cold. Self-medication or medication by untrained persons is always dangerous. It is especially dangerous to those having colds and should always be scrupulously avoided. As a rule, much time, inconvenience, and suffering will be obviated by consulting an intelligent physician promptly. If this is not practicable, a brisk saline may be taken and the patient put to bed. This gives his body an opportunity to regain its vitality and at the same time isolates him from other people. The sick room should be well ventilated and the windows so opened as to keep the air moving freely. It is also wise to moisten the air a little bit by putting a pan of water on the radiator or over the register or on the stove. The handkerchiefs and bedding used by the patient should be sterilized by boiling. Kissing, and the use of drinking cups and towels, etc., in common with other members of the household should be forbidden, it being borne in mind constantly that colds are infectious and readily spread from one person to another.

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UNITED STATES PUBLIC HEALTH SERVICE

RUPERT BLUE, SURGEON GENERAL

SAFE MILK

AN IMPORTANT FOOD PROBLEM

BY

ERNEST A. SWEET

Surgeon, United States Public Health Service

SUPPLEMENT No. 31

TO THE

PUBLIC HEALTH REPORTS

MAY 25, 1917

WASHINGTON

GOVERNMENT PRINTING OFFICE

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ADDITIONAL COPIES

OF THIS PUBLICATION MAY BE PROCURED FROM THE SUPERINTENDENT OF DOCUMENTS GOVERNMENT PRINTING OFFICE

WASHINGTON, D. C.

AT

5 CENTS PER COPY

SAFE MILK.

Milk is unquestionably one of the most important of human foods. It contains practically all the elements which man requires for his sustenance and constitutes his sole dependence throughout the first year of life. In later years milk and its products make up a large proportion of our diet and go far toward furnishing the total energy expended in accomplishing man's daily tasks. In one form or another it is available to practically every citizen and there is scarcely a hamlet or home where it may not be secured. It still remains, in proportion to the energy furnished, one of our cheapest and most desirable foods and it is considered indispensable by rich and poor alike. Both its preparation and consumption are unattended by waste and its digestibility is such that even the frailest of all ages derive the maximum amount of energy from its use. Rightfully, then, this substance has attained a position in the dietary of the American people practically unequaled by any other aliment. Yet in spite of these facts, milk is, at least potentially, one of the most dangerous foods which we consume. Instead of producing strength and nourishment, it may engender weakness and death and it is capable of transforming health and vigor into frailty and decay. Annually thousands of babies are ushered to their graves because of impure milk, while other thousands journey through life maimed and injured from its action, tragedies which many of us in our ignorance gaze upon without concern.

Composition of Milk.

Milk is a substance which varies considerably in composition even in animals of the same species. A mixture of milk from several cows is much more constant in its chemical make-up than that from a single animal, and for this reason is to be preferred for infants. Dairy herds which are well fed and housed as a rule produce a supply richer in its various constituents than those which are improperly cared for.

The basic ingredient of milk is water, the remaining components either being dissolved or held in suspension by this substance. Ordinarily milk contains approximately 87 per cent of water, the laws of the majority of States requiring that 12 per cent of solids be present. Where the amount of solids falls below this average the

purchaser does not receive full value for his expenditure. On this account legal standards have been adopted in practically all communities.

From the food standpoint fat is the most valuable constituent of milk. It is present in the form of an emulsion, the droplets being held in suspension and giving to the milk its normal color, each droplet being surrounded by a thin albuminous envelope which prevents them from uniting. Upon agitation, especially when the cream has stood for several days and the envelope is partially disintegrated, the droplets coalesce and butter is formed. The fats in milk are not all of the same composition, but their properties are similar, although the size of the globules varies. Their decomposition gives to butter its well-known rancid taste. It is now recognized that milk especially rich in fat may cause digestive troubles in children, consequently such a supply may not be entirely suitable for infant feeding, although entirely satisfactory for ordinary consumption.

The amount of fat varies considerably. Many cows produce a milk which contains as high as 5 per cent of fat, while with others the percentage is much lower. The legal standard of the different States varies from 3 to 3.5 per cent, the latter figure being the more common. The output of Jersey and Guernsey cattle is relatively, richer in fat than that of other breeds. Holsteins generally produce a milk in which the fat is low in quantity and the emulsification more perfect. For this reason their product is considered a better milk for the use of infants, as fat curds are less apt to form during the process of digestion.

Factories and milk depots which use a large amount of milk pay the producer in proportion to the quantity of fat which the milk contains. Milk "strippings" are richest in fat, this being the product obtained at the very last of the milking, while the first milk drawn is poor in this ingredient. The practice in vogue in many countries of driving the milch animals from door to door for the purpose of dispensing their product, while having many advantages, is thus seen to be not altogether equitable to those first served.

Unfortunately the richness of a milk can not in every instance be determined by the thickness of the cream layer, although most housewives place entire dependence upon this method. Milk which has stood but a short time will necessarily have only a thin stratum of cream, while that which has been agitated may show none at all, the fat being evenly distributed. Again, milk which has been heated beyond a certain temperature shows only a slight cream layer. A third reason why the visual method of determining the fat content is not dependable is due to the fact that in certain instances, even wher the cream is present in more than average quantity, it fails to rise to the surface. Finally, the consumer should realize that a deficiency in

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