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animal is compelled to breathe, by the products of certain germs, or by the direct absorption of bad odors. Milk is practically never free from bacteria, and even with the utmost care it is impossible to altogether prevent further contamination. Under the usual conditions, hairs and scales from the body, dust from the udder, sides of the cow and from the air in the stable, and even dried particles of animal manure, all loaded with germ life, find their way into the milk during the milking operations. When it is allowed to stand exposed in the stable until the milking is completed, as is frequently the case, more organisms are added. Further, when being delivered it is again liable to be contaminated from the dust of the roads. In some cases partially cleaned bottles taken from one house are filled at the wagon and delivered at the next. In these and many other ways milk may be contaminated with bacteria of various kinds and dirt of all descriptions. In fact, it is quite probable that, if a commission were appointed to investigate the condition of the milk supply, a worse state of affairs would be found existing than reported of the United States meat-packing houses.

Fortunately, there is a growing demand among a certain class of people for a better milk. In the past the local boards of health and other authorities dealing with the milk problem have specified that milk should contain a certain percentage of fat and solids not fat; but it has been only within comparatively recent years, and in a few districts, that any attention has been paid to the germ content. Many of the larger milk dealers have inaugurated a system of inspection, and are honestly endeavoring to furnish a pure article; but countless numbers of the smaller concerns that deliver directly to the consumer are practically under no inspection whatever.

Investigations and experience have shown that freshly drawn milk that has been produced under strictly sanitary methods should contain only a few hundred bacteria to the cubic centimeter. It has been obtained so pure that at the end of twenty-four hours there were still less than 100 germs per cubic centimeter. In this case the utmost care was taken in every detail. The cows were even taken to the milker, who remained in a thoroughly disinfected room. Such milk will remain sweet for a long time, especially if kept at a low temperature.

Country milk produced under ordinary methods, but drawn from reasonably clean cows in clean stables, and kept at a low temperature, should not contain more than 5,000 to 20,000 bacteria per cubic centimeter when first placed on the market. Milk of this nature, if free from objectionable flavor, may be regarded as satisfactory for general consumption.

However, milk produced under conditions ordinarily prevailing is

likely to contain 50,000 or more germs per cubic centimeter when first offered for sale. The number increases very rapidly at the ordinary temperature, consequently milk delivered in our larger towns and cities. may often contain several hundred thousand, or even many millions, of bacteria per cubic centimeter.

A large number of organisms in the milk indicates that the milk is old, or that it has been kept at too high a temperature, or that it has been produced under insanitary conditions. If the germs are chiefly lactic acid organisms, the milk may be old, but not necessarily dirty. The presence of many liquefying organisms is an indication that filth of some sort has gained access to the milk, and that it may contain many other germs of a harmful nature.

The consumer has a right to demand that the milk furnished him shall be clean; that it will keep at least twenty-four hours after it is received, if kept at a temperature of 60° F., or below; that the flavor be not injured by improper feeding, careless methods of handling, or by the development of bacteria which cause bad flavors; that it contain no disease germs, or any form of preservative; and that the milk have a certain known composition, which is uniform from day to day.

In order that the milk may conform to these requirements, it is essential that the cows be healthy; that they get good food and water; that they be kept out of the filth of a dirty barnyard; and that they be stabled in a clean, well-lighted and well-ventilated barn. The ceiling should be tight, excluding dust and chaff from above, the sides smooth, and the whole whitewashed annually. It is imperative that the udders be thoroughly cleaned before milking, and that every care be taken to prevent dust and dirt of all kinds from getting into the milk. As soon as the milk is drawn it should be removed from the stable to a milk room, which must be some distance from the barn, and so arranged that it can be easily cleaned and disinfected. There the milk should be aerated. and cooled to about 40° F. If it is to be bottled for direct delivery, it should be done at once, and kept at a low temperature until delivered. All utensils, cans, bottles, etc., should be thoroughly cleaned and sterilized. In fact, only the most careful attention to every detail of the work will ensure clean, pure milk.

At the present time the milk in this country is practically all sold by measure, either from the can or in the bottle. Selling milk in this way is unjust to the producer, as well as to the consumer. While the fallacy of this system is apparent to a few, the majority of people seem to think that one quart of milk is worth as much as any other, as long as it is sweet. The reason for this is partly a lack of knowledge as to what constitutes good milk, and partly because it is difficult to judge

milk from its appearance; for this reason it is possible for dishonest producers to dilute their milk or remove part of the cream.

Governing bodies have attempted to overcome this difficulty by passing laws making it unlawful to change the composition of the milk. Where these laws have been enforced, the dilution of milk to a great extent has ceased; but dealers have not been compelled to sell milk of a known composition, and surely the purchaser has a right to know the composition, and consequently the food value, of the article he is buying.

In some places a standard has been fixed, below which it is unlawful to sell milk. These standards seldom require more than 3 to 32 per cent. of fat and 12 per cent. of total solids. This has not reached the difficulty, for it makes the sale of milk coming direct from some cows that give milk low in fat unlawful, while it is good, wholesome milk, and a perfectly legitimate product when sold in its proper place. This system also hinders the man whose cows produce rich milk from getting the price he should, according to its food value and cost of production, for milk containing a high percentage of fat is not only worth more, but costs more to produce than milk containing a small amount of fat.

Other things being equal, the price of milk should depend on its composition. It is most unreasonable for milk containing but 3 per cent. of fat to sell for the same price per quart as 5 per cent. milk. Since fat in milk is the most variable constituent, the other solids remaining fairly constant, it is a comparatively simple matter to standardize milk. All that is necessary is to remove part of the fat, which is easily done by means of the cream separator, and then return it in sufficient quantities to bring the milk up to the desired standard. By use of the Babcock test and cream separator there is nothing to prevent the milk dealer from furnishing his customers with milk of a uniform or any desired richness, without regard to the quality yielded by the cow. In this way the dealer may supply milk containing 3, 4 or 5 per cent. of fat, as may be required, and the price could be regulated according to the richness in fat. This method has a further advantage, in that in passing the milk through the separator a part of the filth is removed.

Recently a grade of milk known as "certified milk" has been placed on the market. It is milk of a known composition, as clean and free from bacteria as science and skill can make it, and produced from an inspected herd. A good class of certified milk should not contain more than a few hundred bacteria per cubic centimeter, although some standards allow as many as 10,000. When milk of this grade is for sale, a public statement should be made, certifying to the methods of production and the percentage of fat it contains, and means should be devised whereby the public may have the assurance that it is really all that it is

claimed to be. Such milk should find a ready sale, even at the advanced price it would be necessary to ask for it. An effort should be made to get the public to inspect the dairies, and see for themselves the condition of affairs. Physicians should also be willing to inspect the whole process of handling, in order that they may be in a position to recommend the best milk to their patients.

Pasteurization of milk is now being extensively practiced by most of the larger milk dealers. The milk handled by these companies is usually gathered from a large number of producers, and generally has a high bacteria count by the time it reaches the company's buildings. As such milk is frequently three or even four days old before it is actually used by the consumer, it is at once evident that pasteurization is necessary; but where the milk can be bottled immediately after it is drawn, and cooled and delivered direct to the consumer, there should be no need of pasteurization.

Various chemical preservatives are sometimes added to milk, to prevent it from souring. Some of these substances are undoubtedly harmful, others may or may not be; but I think all will agree that, as milk is used freely by children, and the sick, the addition of preservatives of any kind should not be countenanced, and every effort should be made to entirely prevent their use in any form or in any quantity in milk. Moreover, it has been abundantly demonstrated that milk can be kept long enough for all practical purposes without them, and that their use only serves to encourage slovenly, slipshod methods of handling the milk.

In a word to the consumers, it may be stated that the producers are not altogether to blame for the present state of affairs. The consumers have not as a class made themselves familiar with the nature of milk, in order that they may intelligently judge of its quality and understand the care it requires after it is delivered. They have not shown a disposition to encourage the sale of the pure article to the extent of being willing to pay more for it.1 A really good milk cannot be produced as cheaply as the ordinary kind, and when the price of milk is raised, the consumer, not appreciating the added value, objects to paying the advanced price. This naturally discourages further efforts toward improvement. However, when consumers awaken to the true nature of the ordinary trade milk and realize the risk they are running in using it, demand milk of known quality and purity and are willing to pay for it, such milk will be supplied.

In conclusion, it may be stated that on every hand there is evidence of the need of closer inspection. Milk is an opaque substance, which nat

1 It will be observed that in Canada, as in Massachusetts and other States, it is the purchasing public that is chiefly responsible for the dirty condition of market milk. - ED. "BULLETIN."

urally hides impurities and adulterations, and is particularly liable to serious contamination. There are, and doubtless always will be, certain men in the milk trade who, from the slovenly methods they employ, are a disgrace to the business and a menace to the health of the community. A system of inspection should be instituted, and a standard of quality and purity for market milk should be set up, that will force these men out of business, encourage the careful producer and improve the quality of the milk offered for sale.

PECUNIARY VALUE OF MILK.

The small profits in the milk business will probably always prevent a reform in methods of distribution. The poor are wedded to the idea that milk should never cost more than 5 cents in summer and 6 in winter, for those are the prices paid for generations. They do not realize that a 5-cent piece is not worth as much as it was twenty-five years ago. They are actually paying less for the milk. The farmer and dealer profit so little that many of them give up the business. In addition, old, cheap methods produced dangerous milk, and to be clean, as modern sanitarians demand, is very costly. Milk fit for babies cannot be produced for less than 9 or 10 cents. Such rich milk at 10 cents is really cheap as compared with many meats, and the demand for 5-cent milk is therefore foolish. The baby is begrudged 5 cents a day, but the parents often consume beer ad libitum. ("American Medicine," December, 1906.)

ACETANILID POISONING.

Death from Koehler's Headache Powders. - Dr. P. Loewenthal, New York City, reports the death of a man in an hour and a half after taking two of Koehler's headache powders. The coroner's jury returned the following verdict:

The said James Tobias came to his death on the second day of September, 1906, at 1187 Lexington Avenue, by acetanilid poisoning, administered at the time and place aforesaid in Koehler's headache powders, purchased at drug store of P. Jaffe, 1133 Lexington Avenue.

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