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TREASURY DEPARTMENT 
Public Health and Marine-Hospital Service of the United States 

HYGIENIC LABORATORY.— BULLETIN No. 56 

March, 1909 



MILK AND ITS RELATION TO THE 
PUBLIC HEALTH 

[Revised and enlarged edition of Bulletin No. 41] 
(BY VARIOUS AUTHORS) 



(SECOND EDITION) 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1912 



Honograph. 



/ 



TREASURY DEPARTMENT 
D ublic Health and Marine-Hospital Service of the United States 



U.S. HYGIENIC LABORATORY.— BULLETIN No, 56 

March, 1909 



MILK AND ITS RELATION TO THE 
PUBLIC HEALTH H^ 



[Revised and enlarged edition of Bulletin No. 41] 



(BY VARIOUS AUTHORS) 



(SECOND EDITION) 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1912 






ORGANIZATION OF HYGIENIC LABORATORY. 

Rupert Blue, Surgeon General, 
United States Public Health and Marine- Hospital Service. 

ADVISORY BOARD. 

Lieut. Col. Walter D. McCaw, surgeon, United States Army; Surg. Charles S. 
Butler, United States Navy; Dr. A. D. Melvin, Chief of United States Bureau of 
Animal Industry; and John F. Anderson, United States Public Health and Marine- 
Hospital Service, ex officio. 

Prof. William H. Welch, Johns Hopkins University, Baltimore, Md.; Prof. Simon 
Flexner, Rockefeller Institute for Medical Research, New York; Prof. Victor C. 
Vaughan, University of Michigan, Ann Arbor, Mich.; Prof. William T. Sedgwick, 
Massachusetts Institute of Technology, Boston, Mass.; and Prof. Frank F. Wesbrook, 
University of Minnesota, Minneapolis, Minn. 

LABORATORY CORPS. 

Director. — Passed Asst. Surg. John F. Anderson. 
Assistant director. — Passed Asst. Surg. Edward Francis. 
Senior pharmacist. — L. W. Ryder. 
Junior pharmacist. — C. 0. Sterns, Ph. G. 
Artist. — Leonard H. Wilder. 
Acting librarian. — E. B. K. Foltz. 

DIVISION OF PATHOLOGY AND BACTERIOLOGY. 

In charge of division. — Passed Asst. Surg. John F. Anderson. 

Assistants. — Passed Asst. Surgs. Edward Francis, L. L. Lumsden, T. B. McClintic, 
J. W. Schereschewsky, Allan J. McLaughlin, B. S. Warren, A. M. Stimson, W. H. 
Frost; Asst. Surgs. Joseph R. Ridlon, S. C. Hotchkiss; and Walter D. Cannon, A. M., 
M. D. 

DIVISION OF ZOOLOGY. 

Professor of zoology. — Ch. Wardell Stiles, Ph. D. 
Assistant. — Passed Asst. Surg. Joseph Goldberger. 

DIVISION OF PHARMACOLOGY. 

Professor of pharmacology . — Reid Hunt, Ph. D., M. D. 

Assistants.— A therton Seidell, Ph. D.; W. H. Schultz, Ph. D.; Worth Hale, A. B., 
M. D.; Murray Gait Motter, A. M., M. D.; Martin I. Wilbert, Ph. M.; G. A. Menge, 
Ph.D. 

DIVISION OF CHEMISTRY. 

Professor of chemistry. — Edward C. Franklin, Ph. D. 

Assistants. — Passed Asst. Surg. Norman Roberts; Elias Elvove, M. S., Phar. D. 



IM, • 



TABLE OF CONTENTS. 



Page. 

1. Introduction (by Walter Wyman) 13 

2. Milk as a Cause of Epidemics of Typhoid Fever, Scarlet Fever, and 

Diphtheria (by John W. Trask) 23 

Typhoid fever , 26 

Bacillus typhosus in milk 27 

Summary of epidemics 29 

Stamford epidemic 30 

Scarlet fever 32 

Summary of epidemics 33 

Scarlet lever in Norwalk, Conn 33 

Diphtheria 34 

Klebs-Loffler bacilli in milk 35 

Summary of epidemics 36 

Outbreak of diphtheria in Dorchester, Milton, and Hyde Park . . 36 

Epidemics of sore throat and pseudo-diphtheria 37 

Character of milk epidemics 37 

( a ) Explosive onset 37 

(b) Disease follows the milk 38 

Elkton epidemic 39 

(c) Special incidence in milk drinkers 40 

( d) The better houses suffer greater invasion 40 

(e) Age and sex 41 

Bacillus carriers 41 

Source of milk contamination 44 

( 1 ) From hands of milker 44 

(2) Air and dust of the stable 44 

(3) Themilkpail 44 

(4) Water supply , 44 

(5) Milk cooler 45 

(6) Cans 45 

( 7 ) Transportation 45 

(8) Distributing dairy 45 

(9) Bottles 46 

Montclair epidemic 46 

Detection of milk epidemics 47 

Prevention of milk epidemics 48 

Points of interest in reporting milk epidemics 49 

Busey & Kober — Summary of epidemics ... r 49 

Milk epidemics 51 

Table L— Typhoid 51 

TaBle II.— Scarlet fever 95 

Table III. —Diphtheria 107 

Table IV. — Sore throat and pseudo-diphtheria 115 

(3) 



Page. 

3. The Milk Supply op Cities in Kelation to the Epidemiology of Typhoid 

Fever (by Leslie L. Lumsden) 151 

Milk and other dairy products as factors in spread of infection 153 

Ways in which the milk may become infected 154 

At the dairy farm 154 

At the dairy 157 

At the grocery 157 

At the home 158 

Determination of milk outbreaks 158 

Measures to prevent the dissemination of the infection of typhoid 

fever L 163 

The prevention of the introduction of infection into milk 163 

The destruction of infection in milk 163 

4. Frequency of Tubercle Bacilli in the Market Milk of Washington, 

D. 0. (by John F. Anderson) 165 

Introduction 167 

Eeview of literature 168 

The number of tubercular cows in the dairies supplying Washington, 

DO < 178 

Eesults of tuberculin tests elsewhere than in herds supplying Wash- 
ington 179 

Characteristics of Rabinowitsch's butter bacillus 180 

Collection of samples and technic 182 

Use of tuberculin to eliminate infection with other acid-fast organisms . 184 

Table of results of autopsies on guinea pigs 184 

Resume 196 

5. The Relation of Goat's Milk to the Spread of Malta Fever (by John 

F. Anderson) 199 

Characteristics of Malta fever 201 

Geographical distribution of the disease 202 

Methods of infection 203 

Epidemiology of Malta fever 203 

Susceptibility of goats to Malta fever 206 

Methods through which the infection is acquired by the goats 207 

Clinical indications of infected animals 208 

Outbreak of Malta fever on the Joshua Nicholson 209 

History of the investigation of the disease at Gibraltar, and preventive 

efforts and legislation 212 

6. Milk Sickness (by George W. McCoy) 215 

Definition 217 

Synonyms „ 217 

Historical . r 21 7 

Distribution 218 

Etiology and pathology 219 

Symptoms 224 

Treatment 225 

Bibliography 225 

7. Relation of Cow's Milk to the Zooparasitic Diseases of Man (by Ch. 

Wardell Stiles) 227 

Remoteness of danger of infection through milk 229 

Methods of possible contamination of the milk with preventive 

measures 229 

Water-borne parasites 230 

Improper disposal of fecal matter , 230 



Page. 

7. Relation of Cow's Milk to the Zooparasite Diseases op Man — 

Continued. 
Methods of possible contamination of the milk with preventive 
measures — Continued. 

Persona] habits 231 

Fecal material from animals 231 

Infections from dogs and cats 231 

8. Morbidity and Mortality Statistics as Influenced by Milk (by J. M. 

Eager) .'. 233 

Quantities of milk consumed 235 

Milk and disease 235 

Statistics of infantile mortality 236 

Diarrheal diseases and milk ' 238 

Mothers' milk and lessened infantile mortality 239 

Infantile mortality, a class mortality. 240 

Scientific artificial feeding and the mortality rate 241 

Milk and tuberculosis . 245 

Milk and typhoid fever . 246 

Scarlet fever and diphtheria . „ 247 

Milk and Asiatic cholera 247 

9. Ice Cream (by Harvey W. Wiley) 249 

Summary of chemical data relating to cream . . . „ 252 

Summary of chemical data relating to ice cream. 253 

Bacteriological investigations of ice cream in the District of Columbia. 255 
The significance of a pure ice cream supply in relation to the public 

health 269 

Definitions and descriptions of ices in trade and other books ........ 273 

Ice cream standard . 284 

The quantity of butter fat in ice cream „ 295 

General conclusions . 297 

10. The Chemistry of Milk (by Joseph H. Kastle and Norman Roberts) . . . 313 

Preface 315 

The composition and general characteristics of milk 316 

Changes in the composition of milk 328 

By the action of heat and acids 328 

Heat and acid coagulation 328 

Effect of heat on milk enzymes... 332 

The digestibility of raw and boiled milk 338 

Effect of heat on enzymes in general 339 

By the action of milk enzymes 342 

By the digestive ferments — the rennin coagulation of milk 348 

By the action of bacteria and other micro-organisms. 359 

The lactic acid fermentation 359 

Abnormal fermentations of milk. 368 

Milk poisons — galactotoxismus 372 

Legal standards governing the sale of milk 377 

United States and State standards 378 

Harwood's views on milk standards 380 

Milk adulterations 381 

Skimming, watering, and the addition of foreign substances ; . . . 381 

Significance of watering in relation to the public health 383 

Artificial coloring matters and milk preservatives 384 

Effect of artificial coloring matters and preservatives on diges- 
tion and health 385 



10. The Chemistry op Milk — Continued. Pa ge. 

The Washington milk supply 396 

Methods of analysis 396 

Conclusions regarding the Washington milk supply 401 

Table I, results of the chemical analyses of Washington milks. . . 405 

Table II, milks below standard and those containing dirt 414 

References to the literature of milk 417 

11. The Number op Bacteria in Milk and the Value op Bacterial 

Counts (by Milton J. Rosenau) 427 

The initial contamination of milk 431 

Legal standards 434 

The practical value of bacterial examinations of milk 435 

Bacterial counts in Washington 437 

Methods 437 

Results tabulated 439 

Results of bacterial counts of market milk in Washington in 1906 

and 1907 439 

Bacterial counts in other cities 449 

Report of committee on bacteriological standards of American Asso- 
ciation of Medical Milk Commissioners 453 

12. The Germicidal Property of Milk (by Milton J. Rosenau and George 

W. McCoy) 455 

Introduction 457 

Examples of the germicidal action 459 

The effect of temperature 460 

Relation to agglutination 470 

Germicidal action compared with that of blood serum 473 

Relation to phagocytosis 474 

Is the "germicidal " action specific ? 475 

The effect of dilution 476 

The effect of heating and freezing 477 

Review of the literature upon the subject 479 

Summary and conclusions 486 

13. The Significance of Leucocytes and Streptococci in Milk (by W. W. 

Miller) 489 

14. Conditions and Diseases op the Cow Injuriously Affecting the Milk 

(by John R. Mohler).. 499 

Importance of a wholesome milk supply „ 501 

Milk from unhealthy cows as a factor in the spread of disease 502 

Tuberculosis 502 

Tubercle bacilli in other dairy products 507 

Value of the tuberculin test 509 

Foot-arid-mouth disease 514 

Actinomycosis 518 

Botryomycosis 519 

Anthrax 519 

Cowpox 519 

Rabies 519 

Mammites mastitis or garget 520 

Leucocytes in milk 520 

Gastro-enteritis • 521 

Milk sickness 522 

Septic or febrile condition 523 

Abnormal appearance and conditions of milk. . . , 523 



14. Conditions and Diseases of the Cow Injuriously Affecting the Milk — Page. 

Continued. 

Slimy, stringy, or ropy milk . , 523 

Bitter milk 523 

Colored milk 524 

Taste and odor 524 

Poisonous milk 525 

Colostrum 525 

Recommendations 525 

15. The Relation of the Tuberculous Cow to Public Health (by E. C. 

Schroeder) 527 

Need of pure milk 529 

Character of tuberculosis as a disease of cattle 531 

Manner in which tubercle bacilli are expelled by tuberculous cattle. 533 

Technic used in demonstrating bovine tubercle bacilli 534 

The appearance of cattle that expel tubercle bacilli 535 

How tubercle bacilli expelled by tuberculous cows get into milk and 

dairy products 537 

The virulence arid vitality of tubercle bacilli in dairy products 540 

The proportion of tuberculous cows among those in use for dairy 

purposes 549 

The frequency with which dairy products have been proven to con- 
tain tubercle bacilli 550 

Summary 553 

16. Sanitary Inspection and its Bearing on Clean Milk (by Ed. H. 

Webster) 557 

Clean milk 559 

What is contamination ? 559 

Sources of contamination 560 

Milk utensils 562 

Cleaning milk utensils 562 

Milk houses _ 563 

Caring for the milk 563 

The city distributing plant 564 

Sanitary inspection of dairies 565 

Directions for scoring dairies 566 

Sanitary inspection of city milk plants 566 

Twenty-one suggestions 570 

The cows 570 

The stables 571 

The milk-house 571 

Milking and handling milk 571 

17. Sanitary Water Supplies for Dairy Farms (by B. Meade Bolton) 573 

Requirements of a sanitary water supply 576 

Sources of water supply 577 

Sources of pollution 578 

Purification of water in the soil 581 

Protection from pollution 582 

Abundance of supply 586 

Convenience of supply 586 

18. Methods and Results of the Examination of Water Supplies of 

Dairies Supplying the District of Columbia (b.y B. Meade Bolton) . 589 

19. The Classification of Market Milk (by A. D. Melvin) 605 

Class 1, certified milk 608 

Class 2, inspected milk 609 

Class 3, pasteurized milk 609 



8 

Page. 

20. Certified Milk and Infants' Milk Depots (by John W. Kerr) 611 

Certified milk 613 

Copy of agreement with dairymen 615 

Organization of the medical milk commissions 620 

Functions of the commissions 621 

Working methods and standards 621 

The standards of purity „ 624 

Regulations for the production of 625 

Results accomplished 628 

Infants' milk depots 629 

Formulae for modified milks 629 

Cities in the United States in which are located infants' milk 

depots 631 

21. Pasteurization (by Milton J. Rosenau) 637 

Introduction 639 

The extent of pasteurization 642 

Laws and regulations concerning pasteurization 643 

Changes in milk produced by heating 646 

Temperature and time of heating 648 

The bacteria and toxines concerned 651 

Infant feeding 656 

Scurvey 658 

Infant mortality 663 

Home pasteurization 665 

Commercial pasteurization 675 

Resume — Advantages and disadvantages 676 

22.. The Thermal Death Points of Pathogenic Microorganisms in Milk 

(by M. J. Rosenau) 681 

Methods 683 

Bacillus tuberculosis 684 

Conclusions 686 

23. Infant Feeding (by Joseph W. Schereschewsky ) 687 

Part I.— Infant mortality 689 

Death rates of various cities 690 

Seasonal fluctuations 694 

Part II.— The infants' dietary 697 

Woman's milk 697 

Cow's milk. 702 

Part III.— Infant feeding 706 

Nutritive requirements of infants 706 

Methods of feeding..., 708 

Maternal nursing 708 

Artificial feeding 715 

24. The Relative Proportion of Bacteria in Top Milk (Cream Layer) and 

Bottom Milk (Skim Milk), and its Bearing on Infant Feeding (by 

John F. Anderson) 737 

25. National Inspection of Milk (by Harvey W. Wiley) 741 

26. The Municipal Regulation of the Milk Supply of the District of 

Columbia (by Wm. Creighton Woodward) 745 

The development of the milk-inspection service 747 

Organization and duties of the milk-inspection service 768 

Supervision and control 771 

Inspection of dairy farms - . = - i ..-...- . 772 



9 

26- The Municipal Regulation of the Milk Supply of the 1 District of Page. 
Columbia — Continued. 

Inspection of dairies 779 

Inspection of milk 780 

Contagious-disease service 783 

Cost of milk inspection 785 

Results of milk-inspection service 786 

Supplementary memorandum government of the District of Columbia. 789 

General Index 831 

Author Index 835 

Serial Publications — Hygienic Laboratory Bulletin 837 



LIST OF ILLUSTRATIONS, CHARTS, ETC. 



Article No. 2. — Milk as a Cause of Epidemics of Typhoid Fever, Scarlet 

Fever, and Diphtheria. 

1. Chart showing typhoid fever cases by ages, in ten-year periods, Stamford, 

Conn., 1895. 

2. Chart showing typhoid fever cases by ages, in five-year periods, Stamford, 

Conn., 1895. 

3. Chart showing number of cases of typhoid fever reported each day during 

the Stamford, Conn., outbreak, 1895. 

4. Diagram I, showing relation of milk routes to fever cases during the typhoid 

epidemic at Stamford, Conn., 1895. 

5. Diagram II, showing relation of milk routes to scarlet fever during outbreak 

at Norwalk, Conn., 1897. 

6. Diagram III, showing relation of milk routes to diphtheria cases during the 

outbreak at Dorchester, Milton, and Hyde Park, Mass., 1907. 

7. Diagram IV, showing relation of milk routes to typhoid fever cases at 

Elkton, Md., in the autumn of 1900. 

Article No. 9. — Ice Cream. 

8. Variations in bacterial content during cold storage of four samples of com- 

mercial ice creams. 

Article No. 12. — The Germicidal Property of Milk. 

9. Chart showing the growth of B. lactis aerogenes in milk at 15° C. 

10. Chart showing the growth of B. lactis aerogenes in milk at 37° C. 

11. Chart showing the growth of B. dysenterise in milk at 15° C. 

12. Chart showing the growth of B. dysenterise in milk at 37° C. 

13. Chart showing the growth of B. typhosus in milk at 15° C. 

14. Chart showing the growth of B. typhosus in milk at 37° C. 

Article No. 15. — The Relation of the Tuberculous Cow to Public Health. 

15. A cow affected with advanced tuberculosis. 

16. Hogs rooting in manure pile adjacent to cow stable. 

17. Three tuberculous cows. 

18. A tuberculous bull. 

19. An exceptionally dangerous tuberculous cow. 

20. A dangerously tuberculous cow. In fat condition. 

21. A dangerously tuberculous cow. Well-kept family cow. 

22. A dangerously tuberculous cow. Apparently well kept. 

23. An exceptionally dangerous tuberculous cow. 

24. Sections of tuberculous udder and lymph gland. 

25. A dangerously tuberculous cow. Under observation two years. 

26. Sections of tuberculous udder and public lymph gland. 

27. A tuberculous dairy cow. Visibly diseased. 

28. A very old and. visibly tuberculous cow. 

(10) 



11 

Article No. 16. — Sanitary Inspection and its Bearing on Clean Milk. 

29. Dirty flanks. 

30. Cleaning cows preparatory to milking. 

31. Dirty stable yard. 

32. Dirty stable yard. 

33. Dirty barn interior. 

34. Dirty barn interior. 

35. Clean barnyard and well lighted barn. 

36. A clean, light, airy barn interior. 

37. A good type of milking suit and pail. 

38. A blind compliance with the regulation as to windows. 

39. Following the letter but not the spirit of the law. 

40. Types of milk pails. 

41. A good type of inexpensive milk house. 

42. The interior of figure 41. 

43. A mere pretense of a milk house. 

44. A dirty, untidy milk house. 

45. A very neat, inexpensive, small bottling room. 

46. A milk room with poorly located tank. 

47. Children washing milk bottles. 

48. Entrance to dairy in basement. 

49. Dairy room in cellar. 

50. A sterilizing oven. 

51. Bottling room in a high-class city dairy. 

52. A modern high-class pasteurizing plant. 

Article No. 17. — Sanitary Water Supplies for Dairy Farms. 

53. Geological formation of artesian wells. 

54. Cesspool not polluting well lower down. 

55. Cesspool polluting well opening above it. 

56. Bad pump surroundings. 

57. Good pump surroundings. 

58. Good well situation in building. 

59. Good natural spring situation. 

60. Bad natural spring situation. 

Article No. 18. — Methods and Results of Examination of Water Supplies 
of Dairies Supplying the District of Columbia. 

61. Field kit. 

62. Shipping box. 

63. Alcohol lamp. 

Article No. 21. — Pasteurization. 

64. Home pasteurizer. 

Article No. 23. — Infant Feeding. 

65. Chart showing deaths from gastro-enteritis in infants, Paris, 1897. 

Article No. 26. — The Municipal Regulation of Milk Supply of the District 

of Columbia. 

66. Bertillon classification applied to cattle. 

67. Chart showing the death rate in the District of Columbia from diarrhea and 

enteritis among children under 2 years of age, 1880-1906. 



1. INTRODUCTION. 



(13) 



Milk and its Relation to the Public Health. 

INTRODUCTION. 



By Walter Wyman, 
Surgeon-General, Public Health and Marine-Hospital Service. 



During the last few years increasing attention has been given to 
milk in its relation to the public health. This is especially true in 
the United States, where the more progressive health authorities of 
the larger cities and many of the States have been instrumental in 
markedly improving their milk supplies. 

The question of sanitary milk is to the American people especially 
pertinent. Milk is perhaps used to a greater extent in this than in 
any other country. It holds a peculiar place in the nation's dietary 
because of its varied applicability. Containing as it does all the 
essentials of a perfect ration, proteids, carbohydrates, fats, inorganic 
salts, and water, it is capable of almost universal use. Because of 
this, and, in addition, its facility of ingestion and comparative ease 
of digestion, it constitutes an important food for the sick and 
convalescent. 

Of even greater importance is the use of cow's milk as a substitute 
for mother's milk in infant feeding. It will be perceived that those 
most dependent upon this food — the sick and convalescent, infants 
and children — constitute that part of the community suffering the 
greatest injury from the use of a food impaired in its nutritive con- 
tent. This is due to the fact that they are least able to resist the 
harmful effects of foods contaminated by toxins or pathogenic micro- 
organisms. While improved conditions of living have contributed 
to a steady decrease of the general mortality in civilized countries, 
this unfortunately does not apply to the infant population under one 
year of age. It is recognized that gastro-intestinal disease is the 
largest single factor determining infant mortality, a condition in 
great measure due to improper methods of feeding. This enormous 
loss of potential wealth is of grave concern to the State and worthy 
of most careful consideration. It is especially for these reasons that 
the question of sanitary milk and its relation to the public health 
challenges our best endeavors. 

The investigation into the origin and prevalence of typhoid fever 
in the District of Columbia during 1906 by a board of medical officers 
of the Public Health and Marine-Hospital Service brought out many 
facts evidencing the possible danger of milk as a carrier of this dis- 
ease, and stimulated investigation and renewed activity in the efforts 
to secure pure milk supply in the District of Columbia. 

(15) 



16 

This investigation and the work of the Department of Agriculture 
concerning the milk supply at the farms were referred to in a letter 
to the President, June 11, 1907, by Dr. G. Lloyd Magruder, of Wash- 
ington, in which it was suggested that the Bureau of Public Health 
and Marine-Hospital Service be directed to make an investigation of 
the milk industry in the District of Columbia from the farm to the 
consumer, with the cooperation of other departments.* 

The Surgeon-General, being called upon by the President for an 
opinion as to whether such an investigation should be made, replied 
affirmatively, with detailed reasons therefor, and with special recom- 
mendations as to cooperation of the several bureaus in the Depart- 
ment of Agriculture, and the President and the Secretary of the 
Treasury thereupon directed the said investigation. 

In order to properly study the subject as it exists in the District 
of Columbia, it was deemed necessary to treat the matter from a 
broad point of View ; that, to study the local aspect of a world-wide 
problem, the findings and experiences of others must necessarily be 
considered. In many respects the Federal Government has peculiar 
advantages for the study of these problems which, strictly speaking, 
are not confined to any one locality, but are national in scope. It is 
therefore incumbent on the National Government to assume its re- 
sponsibilities and attempt the solution of scientific questions of this 
character influencing the lives and health of its citizens. Because of 
the relation the Public Health and Marine-Hospital Service bears to 
the conservation of the public health it was determined to make this 
investigation of such a character that, in addition to being of local 
value, it would also be of assistance to health officers at large, and 
especially to those not as yet provided with the necessary laboratory 
facilities and corps of workers such as can be afforded only by the 
richer and more densely populated centers. 

It has been the object to include in this volume all available data 
showing the influence of milk as a carrier of infection, its chemical 
composition, the contaminations found therein, their influence upon 
it as an article of food, and the measures necessary in its produc- 
tion and handling to prevent such contamination. 

Milk in the udder of a healthy cow is rarely sterile, but with 
proper methods can occasionally be removed in small quantities free 
from micro-organisms. In this condition it may theoretically be 
considered normal milk, and as such has been kept for over two years. 
But this is not the milk of commerce. In the healthy cow, milk may 
contain organisms while still in the udder, or receive its initial con- 
tamination with the omnipresent microphyte in its passage through 
the ducts of the animal's teats. This may be considered its first point 
of contact with the outer world, for these organisms in the healthy 
animal have gained access to the ducts from without. At every other 

°Annual Report, Public Health and Marine-Hospital Service, 1907, p. 35. 



17 

point of contact on its twelve to forty-eight hour journey to the con- 
sumer it receives additional bacteria. 

Milk holds a peculiar position among foodstuffs in that it is an 
excellent medium for the growth of many micro-organisms, both the 
ordinary saprophytic varieties and those pathogenic to man. These 
factors often produce in market milk an enormous bacterial content. 
Zakharbekoff found that in St. Petersburg examination of samples of 
milk as delivered to the houses showed the presence of from 10,200,000 
to 82,300,000 bacteria per cubic centimeter. Samples of market milk 
at Giessen have shown over 169,000,000 per cubic centimeter, New 
York City milk as high as 35,200,000, London milk 31,888,000. In 
Washington, examinations made at the Hygienic Laboratory of the 
Public Health and Marine Hospital Service during the summer of 
1906 showed a maximum of 307,800,000 and an average bacterial 
content of 22,134,289. Were milk transparent, this luxuriant growth 
would be evident to the naked eye, but because of its opacity such 
contamination occurs unnoticed. Fortunately, most of these organ- 
isms are saprophytes, but there are good reasons to believe that they 
may elaborate toxins, rendering milk dangerous as a food. 

It is evident, from a broad view of the subject, that a pure and 
wholesome milk supply is possible, and this volume contains all the 
necessary information to attain that end, as well as the existing stand- 
ards of purity to which it should conform. 

The three cardinal requirements, cleanliness, cold, and speedy trans- 
portation from the cow to the consumer must be observed, and the cow 
herself must be free from disease. For their observance, intelligence 
and care on the part of the dairyman and milk dealer are absolutely 
essential. 

The bearing of all these points upon the wholesomeness of milk, 
its treatment when contaminated, and its use as an article of food, 
especially for infants, has been treated in detail by the various col- 
laborators. To ascertain how serious an indictment might be returned 
against milk as a carrier of disease, a compilation of epidemics pro- 
duced by this means has been made by Doctor Trask. Reports of 
500 epidemics have been abstracted in tabular form and appear in 
the text. These are only the few that have been reported and are 
accessible in the literature ; how small a fraction of all cases this must 
be can only be surmised. 

As a result of large experience, Doctor Lumsden describes how the 
milk supply of cities becomes contaminated with typhoid bacilli, and 
the best epidemiological methods of determining the influence of milk 
as a factor in the propagation of typhoid fever. 

With a view to determining the presence or absence of tubercle 
bacilli in the market milk of Washington, Doctor Anderson examined 

45276°— Bull. 56—12 2 



18 

272 samples from 104 dairies. He found that 6.72 per cent of the 
samples contained tubercle bacilli virulent for guinea pigs, and that 
11 per cent of the dairies whose milk was examined supplied milk 
containing these micro-organisms in sufficient number and virulence 
to render guinea pigs tuberculous. The milk purchased by one 
charitable institution for the use of children caused tuberculosis in 
the animals upon which it was tested. 

Evidence of this character again emphasizes the necessity of apply- 
ing the tuberculin test among dairy herds, and taking necessary pre- 
cautions with respect to milk of doubtful character. 

In a second paper Doctor Anderson summarizes the evidence prov- 
ing that Malta fever may be spread by infected goat's milk. 

A peculiar disease, known as " milk sickness," is described by 
Doctor McCoy. Although fortunately rare at the present time, cases 
continue to occur in the mountainous sections of Tennessee and else- 
where. 

Doctor Stiles shows that so far as the zoo-parasitic diseases of man 
are concerned, there is little to fear concerning the presence of such 
parasites in milk. 

Statistical studies of mortality and morbidity, as influenced by 
milk, have been made by Doctor Eager. He gives figures to prove 
that the high infantile mortality may be attributed almost entirely 
to impure milk. 

Doctor Wiley discusses the subject of ice cream, its use as an arti- 
cle of food, its composition, the extent to which it may be con- 
taminated or adulterated, and the result of such contamination upon 
the public health. He also refers to the established standards govern- 
ing its manufacture, and presents evidence to show their reasonable- 
ness both to the manufacturer and consumer. 

Doctors Kastle and Roberts give a general survey of our present 
knowledge regarding the physical and chemical characteristics of 
milk, as well as the chemical changes in milk brought about by the 
action of heat and acids; and also those changes accomplished by the 
action of enz}^mes and micro-organisms. The subject of milk adul- 
teration is also considered. It has been shown, as the result of origi- 
nal investigations, that the milk ferments can withstand a tempera- 
ture of 60° to 65° C. for some time without material injury. Twelve 
per cent of the samples of Washington market milk examined were 
found to be below the legal standard, 3.7 per cent gave evidence of 
having been watered, and a very large proportion of the samples 
examined contained appreciable quantities of dirt. None of the 
samples examined contained artificial coloring matters, and only one 
contained milk preservatives. 



19 

Doctor Eosenau shows, as a result of many hundred bacteriologic 
examinations of the market milk of Washington made in the 
Hygienic Laboratory, that for the most part it is old, warm and 
dirty. In the summer of 1906 the market milk contained on an 
average of 22,134,289 bacteria per cubic centimeter, and was delivered 
at an average temperature of 16.5° C. During 1907 the average was 
11,000,000 bacteria per cubic centimeter, and temperature 14.2° C. 
The advantages of bacterial counts to the health officer and to the 
practical dairyman are pointed out. 

As a result of original investigations, Doctor Rosenau and Doctor 
McCoy demonstrate the causes of the phenomenon known as the " ger- 
micidal property of milk." They show that the decrease in the num- 
ber of bacteria in fresh milk is for the most part apparent, not real, 
and further that the restraining action of milk can not take the place 
of cleanliness and ice, but may be taken advantage of in good dairy 
methods. 

Doctor Miller reviews the significance of leucocytes and strepto- 
cocci in milk and points out the unsatisfactory state of our knowledge 
concerning their sanitary significance. 

Doctor Mohler points out that probably the most important disease 
of cows from the standpoint of public health is tuberculosis, and that 
it is also the most prevalent. The German commission on tubercu- 
losis found over 10 per cent (6 out of 56) cultures of tubercle bacilli 
of human origin, virulent for cattle. In a similar series of tests con- 
ducted by the British Royal Commission on tuberculosis, 60 cases of 
the disease in the human being were tested with the result that 14 
were claimed by this commission to have been infected from bovine 
sources. It has been found by Schroeder in this country that even 
when tubercle bacilli are not being excreted by the udder the dirt and 
manure of the stables where the diseased animals are kept are in many 
cases contaminated with tubercle bacilli. This contaminated material 
may readily infect the milk even though it comes from a healthy cow. 
In a recent examination at the Bureau of Animal Industry, Experi- 
ment Station, of the manure passed by 12 cows purchased from dairy 
farms in this city and infected with tuberculosis to an extent only 
demonstrable by the tuberculin test, tubercle bacilli were found in 
over 41 per cent of the cases. 

Mohler estimates that probably 25 per cent of all the cows which 
supply milk to the District of Columbia are tuberculous. He fur- 
ther points out the great practical value of the tuberculin test and in- 
sists that all milk should come from either tuberculin tested cattle or 
be subjected to pasteurization under the supervision of the Health 
Department in case the herd is not tuberculin tested, 



20 

Mr. Webster, among other things, emphasizes the value of the score 
card in the sanitary inspection of dairies and its bearing on the pro- 
duction of- clean milk. He also gives 21 very useful suggestions con- 
cerning the cows, stables, milk houses, and methods of milking and 
handling milk. 

Doctor Bolton writes of the dangers from contaminated water sup- 
plies on dairy farms and shows that a pure water supply on the farm 
appears to present much fewer difficulties than the same problem in 
towns. Each supply presents its own problem which must be solved 
for itself, with proper recognition of the objects to be aimed at, and 
these are purity, abundance, and convenience. 

Doctor Bolton also gives the methods and results of the examination 
of the water supply of dairies supplying the District of Columbia. 
The analysis of results seems to show that there are comparatively few 
water supplies on the dairy farms visited which are free from sanitary 
objection, but in spite of this fact it is nevertheless probable that in 
many or most cases the faults can be rectified with little expense. 

Doctor Melvin offers a practical solution of the classification of 
market milk. He proposes three grades : (1) Certified milk ; (2) in- 
spected milk, and (3) pasteurized milk. 

Doctor Kerr gives a brief outline of the organization and conduct 
of medical milk commissions in the United States, established to 
foster the production of " certified milk." Emphasis is laid on the 
fact that the plan was formulated by a physician, and that it contem- 
plates the sanitary supervision of dairies by a commission appointed 
by the local medical society for the purpose of producing pure milk 
especially for the use of infants and invalids. In this paper are 
included copies of the first contract entered into between a medical 
milk commission and a dairyman ; also the requirements of the milk 
commission of the medical society of the county of New York, which 
contain all of the essential rules required by other commissions for 
the production of pure milk. 

It appears that this movement has been a potent factor in improv- 
ing the character of the milk supply in various parts of the country, 
as it has required that only tuberculosis-free cattle should be used 
for the production of milk, that their milk should be cooled to a 
temperature of 45° F. and transported in a manner so that it reaches 
the consumer before noticeable biological or chemical changes have 
occurred therein. He also refers to the founding of infants' milk 
depots in the United States, and presents in tabular form the num- 
ber of such organizations and other pertinent information relating 
thereto. 

The important subject of pasteurization has been carefully studied 
by Doctor Eosenau, who points out its advantages and discusses its 



21 

inconveniences. He recommends 60° C. for twenty minutes as the 
best temperature to use in pasteurizing milk, as this degree of heat 
is sufficient to destroy the pathogenic micro-organisms without de- 
vitalizing the milk itself. While pasteurization is not the ideal to 
be sought, practically, it is forced upon us by present conditions. 
It prevents much sickness and saves many lives — facts which justify 
its use under proper conditions. It is recommended that in large 
communities at least, pasteurization should be under direct supervi- 
sion of the health authorities. 

The trend of our modern knowledge upon the important subject 
of infant feeding is stated in Doctor Schereschewsky's article on this 
subject. The importance of breast feeding is emphasized. It is 
shown that the caloric needs of the infant must be considered in 
order to insure success in artificial feeding. Some of the errors of 
formula feeding are pointed out, and stress is properly laid upon 
the disastrous results which frequently ensue from overfeeding, espe- 
cially with excessive amounts of butter fat. Schereschewsky believes 
that there is no relation between the heating of milk and infantile 
scurvy, and shows how this disease may result from qualities in the 
milk, other than those resulting from heating. 

In the last three articles named, as well as elsewhere in this bulle- 
tin, references will be observed to the achievements of Mr. Nathan 
Straus in promoting the use of clean pasteurized milk for infants 
and the establishment of infants' milk depots both in the United 
States and abroad, and it is proper here to give recognition to his 
philanthropic and successful efforts. 

Doctor Woodward describes the municipal regulation of the milk 
supply of the District of Columbia. He recounts the history of the 
development of the milk inspection service, which consists of super- 
vision, inspection of dairies and dairy farms, and inspection of the 
milk. It is shown that these measures have resulted in the improve- 
ment of the milk supply, and that there has been a notable reduction 
of morbidity following their inauguration. 

The laws and ordinances governing the supervision of milk are 
given, and in addition copies of the forms of reports, etc., which are 
of value to those having supervision of milk supplies. 

Acknowledgments are here made to Doctor Woodward and the 
officers of the Bureaus of Animal Industry and Chemistry for their 
hearty cooperation and contributions upon this important subject. 



22 

A SECOND EDITION. 

The first edition of this bulletin, which was issued January, 1908, 
has been of great value to health officers and others interested in 
improved milk supplies, as is shown by the enormous and constant 
demand throughout the world for copies. It was abstracted by 
Mr. Nathan Straus, and the abstracts were generously distributed 
by him throughout Europe in connection with his propaganda for 
safe milk. 

The first edition has long since been exhausted, and it therefore 
becomes necessary to publish a second edition. On account of the 
short time since the first edition appeared and the character of some 
of the data relating to the investigation, especially that contained in 
the statistical tables, it has been impracticable to include the corre- 
sponding statistics for the year 1908. The limitations of the volume 
have prevented the inclusion of chapters relating to certain milk 
products, although discussion dealing with butter, dried milk, pre- 
pared milk, and milk substitutes would be of value. It is expected 
that these subjects will be given consideration in later publications. 

Important chapters added in this edition include a discussion of 
the relationship of the tuberculous cow to public health, by Dr. E. C. 
Schroeder, of the Bureau of Animal Industry. In this article, 
Doctor Schroeder invites attention to the manner in which tubercle 
bacilli are expelled by tuberculous cattle, the technique used in 
demonstrating bovine tubercle bacilli, the ways in which tubercle 
bacilli expelled by tuberculous cows get into milk, and the dangers 
involved therein. 

In a chapter on the thermal death point of pathogenic micro-organ- 
isms in milk, Surg. M. J. Rosenau concludes that the heating of milk 
to 60° C. for twenty minutes is sufficient to destroy the tubercle 
bacillus, the diphtheria bacillus, the cholera vibrio, the dysentery 
bacillus, and the Micrococcus melitensis. He also refers to recently 
enacted laws relating to pasteurization, discusses home pasteuriza- 
tion, and gives directions for its employment. 

Passed Asst. Surg. John F. Anderson, in a new chapter, deals with 
the relative proportion of bacteria in top milk and bottom milk, and 
its bearing on infant feeding. 

Dr. H. W. Wiley, Chief of the Bureau of Chemistry of the Depart- 
ment of Agriculture, has also contributetd an additional chapter on 
the national inspection of milk. 

It is a pleasure to acknowledge the interest shown in this publica- 
tion, as well as again express appreciation to Doctor Woodward 
and the officers of the Department of Agriculture for their coopera- 
tion in the preparation of this work. 



2. MILK AS A CAUSE OF EPIDEMICS OF TYPHOID 
FEVER, SCARLET FEVER, AND DIPHTHERIA. 



(23) 



2. MILK AS A CAUSE OF EPIDEMICS OF TYPHOID FEVER, 
SCARLET FEVER, AND DIPHTHERIA. 



By John W. Trask, 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 



That milk may play a part in the spread of certain diseases has, 
for many years, been appreciated. From our present knowledge the 
more important of these are typhoid fever, scarlet fever, diphtheria, 
and possibly tuberculosis. 

Milk, from the time it leaves the cow's udder, receives from its sur- 
roundings bacteria of various kinds. Certain of these organisms come 
from the teats of the cow and the dust and dirt of the stable, and are 
possibly in most cases harmless; others come from the hands of the 
milker and those handling the milk, and from the pails and cans used 
for milking, storage, and transportation. During the last fifty years 
there has been piling up a mass of evidence which would seem to show 
that milk may receive from man the specific organisms of certain 
infectious diseases, and that these organisms may retain their viru- 
lence for some time and produce the disease in susceptible individuals 
drinking the raw milk. Many epidemics supposedly spread in this 
way have been reported in the literature since 1857. Compilations of 
these cases have been made by Hart a in England, Schlegtendal & in 
Germany, Car0e c in Denmark, and by Busey d and Kober, e R. G. Free- 
man f and H. B. Baker s in this country. 

Up to 1895 Hart, and Busey and Kober had collected 240 such epi- 
demics. In addition to these, there are here presented 260 compiled 
from the literature and from special reports. (I desire here to 
ackowledge the great assistance rendered by the many health officers 

a Hart (E.), Transactions Internat. Med. Cong. London, 1881, IV, 491, also 
Brit. Med. Jour. Lond., 1897, 1, 1167, 1229, and 1292. 

& Schlegtendal, Deut. Vierteljahrschr. f. Offentl. Gesundheitspflege, 1900, Bd. 
XXXII, 287. 

c Car0e (K.), Ugeskrift for Laeger, Kobenhavn, 1898, 5 R., V, p. 1009. 

d Busey (S. C.) and Kober (G. M.), Report of Health Officer of District of 
Columbia, 1895, p. 299. 

e Kober ( G. M. ) , Senate Doc. 441, Fifty-seventh Congress, 1st session. 

f Freeman (R. G.), Medical Record, N. Y., 1896, XLIX, 433. 

9 Baker (H. B.), Annual Report Michigan State Board of Health, 1896. 

(25) 



26 

and other physicians who so kindly responded to the circular letter 
sent out by the Surgeon-General requesting reports of milk epi- 
demics.) The 90 epidemics compiled by Car0e have not been in- 
cluded because of lack of time and space. No attempt has been made 
to note every outbreak reported as spread by milk ; many cases where 
the evidence did not seem entirely convincing have been omitted. 
Necessarily much of the evidence upon which it is determined 
whether or not an epidemic is conveyed by milk is circumstantial; 
the same may be said of water-borne disease, and indeed of many of 
the things in daily life which we firmly believe. In an explosive 
outbreak of an infectious disease, to find that all persons attacked 
had used one milk supply, that they had apparently nothing else in 
common, that no cases occurred except among users of this milk, and 
then to isolate from the milk the specific organism of the disease in a 
virulent state, is believed to be good evidence in the absence of other 
explanation. It is not to be inferred that this has been taken as an 
absolute standard up to which all epidemics must come before being 
considered as spread by milk, for to do this the outbreak would have 
to occur in a locality previously entirely free from the disease and 
the development of secondary-contact cases, which is necessarily a 
common occurrence, would wrongly exclude such epidemics. Then, 
too, the difficulty of isolating the Eberth bacillus when in small 
amount and accompanied by large numbers of other organisms and 
our lack of absolute knowledge as to its specificity, and the fact that 
no organism has as yet been isolated which is commonly accepted as 
the causal agent of scarlet fever, would lead to erroneous conclusions 
if the isolation of a specific organism were insisted upon. 

TYPHOID FEVER. 

Schuder a in 1901 collected from the literature 650 typhoid epi- 
demics the supposed cause of which had been reported. Four hun- 
dred and sixty- two were reported as spread by water, 110 by milk, 
and 78 by all other means. This places milk second only to water as 
a carrier of typhoid infection. But the ratio of 462 to 110 probably 
by no means shows the true relation of water and milk as producers 
of such outbreaks. Schiider's epidemics were collected mainly from 
continental Europe, where milk epidemics are apparently not as com- 
mon as in England and America, due possibly to the more or less cus- 
tomary practice in Europe of using pasteurized or cooked milk. The 
result of such a compilation as the above may also have been affected 
by the fact that until comparatively recently water has received 
much more attention in typhoid epidemiological work than has milk. 

«SchMer, Zeitschrift f. Hyg. und Infectionskrankheiten, 1901, XXXVIII, 
p. 343. 



27 

It is evident that Schuder did not include in his list the approxi- 
mately 90 typhoid epidemics collected by Car0e.° These occurred in 
Denmark between 1878 and 1896, and were reported as in all prob- 
ability due to milk. It is also apparent that he did not include the 
combined milk typhoid epidemics collected by Hart, and Busey and 
Kober, 138 in number, which had been previously compiled. 

Undoubtedly the relative importance of the various agencies by 
which typhoid fever is distributed varies with the locality and condi- 
tions. The various factors, water, milk, flies, and contact, have dif- 
ferent values in the city and in the town. They will naturally also 
vary in importance with the season, the latitude, and the local cus- 
toms. Improved water supplies have eliminated water as a factor 
in many places, while regulation of the production, handling, and 
sale of milk is lessening its influence for harm in some communities. 
It would seem that water has been so apparent as a frequent carrier 
of the infection that other agents have not been looked for, or at least 
not commonly found, until improved water supplies had demon- 
strated that there were other factors at work. The experience in 
Massachusetts has been given by Harrington 6 as follows : 

In the public mind outbreaks and epidemics of this disease (typhoid) are 
commonly associated with polluted drinking water, but when water supplies 
are properly guarded, as in Massachusetts, for example, they are more com- 
monly found to be caused by contaminated food, and especially by that one 
which is most subject to pollution and which offers the specific organism the 
most favorable conditions for preserving its virulence and increasing its num- 
bers — namely, milk. During the past two years, of 18 local outbreaks of 
typhoid fever in different parts of Massachusetts investigated under my direc- 
tion, 14 were traced to milk. 

Jensen c also makes the statement : 

The principal means by which typhoid fever is distributed in places where 
there is a safe and hygienic water supply is through milk. 

BACILLUS TYPHOSUS IN MILK. 

V. C. Vaughan^ reported in 1890 the isolation of a bacillus from 
the water of a dairy well, and from the milk sold by the dairy. There 
had been one or more cases of typhoid in the family of the milkman, 
and one or more cases existed in every family patronizing this dairy. e 
The bacillus was highly pathogenic to white rats and guinea pigs. 
It was nonliquefying and toxicogenic. The bacillus resembled but 

«Car0e (K.), Ugeskrift for Laeger, 1898, V, p. 1009. 
6 New York Med. Jour., 1907, p. 697. 
c Essentials of Milk Hygiene, English ed., 1907, p. 106. 

a Vaughan (V. C), Ann. Report State Board of Health, Michigan, 1891, p. 216. 
eVaughan (V. C), Trans. Seventh Internat. Cong, of Hyg. & Demography, 
1891, Vol. Ill, Section III, p. 121. 



28 

was not identical with that of Eberth. When the use of the milk was 
discontinued the outbreak ceased. 

Dr. A. R. Reynolds, then commissioner of health of Chicago, stated 
in 1902 that although special search had been frequently made during 
the last eight years the typhoid bacillus had been found in Chicago 
city milk only three times, and then in cases of local epidemics, and 
that in 1902 the presence of the typho-colon group of bacilli had 
been repeatedly demonstrated. 

Konradi & isolated the typhoid bacillus from milk in 1905. In 
Kolozsvar there was an unusual number of cases of typhoid. (See 
Table of epidemics.) The water could in no way be connected with 
the increase, and attention was attracted to a bake shop from which 
many cases seemed to originate. The typhoid bacillus was isolated 
from a sample of milk taken from this bake shop. Proper precau- 
tions were immediately taken against this shop and its milk, and the 
number of cases of typhoid fell in the next month back to the usual 
average number. He also examined 32 other samples of milk and 
isolated the typhoid bacillus from one taken from a dairy where the 
farmer's son had a mild attack of typhoid fever which was not severe 
enough to keep him from working and milking the cows. 

Shoemaker reports an outbreak of milk typhoid in Philadelphia 
in October, 1906. He states: 

A culture made from the milk proved the presence of the typhoid bacillus 
in it. 

A visit to the dairy revealed that the proprietor and one of his 
servants were ill with typhoid and that — 

the son was convalescing from typhoid fever and was filling the milk bottles 
from a tank by siphonage, starting the flow by sucking with the mouth at one 
end of the tube. A culture made from this end of the tube revealed many 
typhoid bacilli. 

Cautley d infected milk with the typhoid bacillus and recovered the 
bacillus after seven days. In his summary he states : 

The typhoid bacillus will live in milk under the conditions that ordinarily 
prevail in a household. When this bacillus has been artficially added in large 
amount to milk in the condition in which it commonly reaches the consumer, 
the presence of the microbe in the living state may be demonstrated after the 
milk thus treated has been kept several days. * * * It will also live in 
milk which has turned sour at the temperature of the room in which it is kept. 

o Reynolds (A. R.), Chicago Medical Recorder, 1902, p. 222. 
& Konradi, Centralbl. f . Bakt. etc., 1 Abt, Bd. 40, p. 31. 
c Journal Am. Med. Assn., May 25, 1907, p. 1748. 

a Cautley (Edmund), Report Med. Officer, Local Govt. Board, London, 1896-97, 
p. 243. 



29 

Broers a demonstrated the ability of the typhoid bacillus to live in 
milk and butter for from two to three weeks. 

Bruck in 1903 & took ordinary market milk and infected it with 
the bacillus typhosus. He then ran the milk thus treated through 
a separator and found the viable organism persisting in the cream 
for ten days after separation. Butter made from this cream showed 
the presence of the viable bacillus for twenty-seven days. The bacil- 
lus typhosus could be recovered from the buttermilk for ten days. 
Pfuhl c showed the ability of the Eberth bacillus to persist in market 
milk for thirteen days and in butter for twenty-four days. 

Eyre d undertook experiments to demonstrate the growth of the 
typhoid bacillus in milk. To avoid the false ideas arising from the 
use of the sterilized product, he drew the milk from a healthy cow 
under aseptic conditions and gives the following results showing the 
possible rate of increase: 





hours. 


2 hours. 


4 hours. 


6 hours. 


8 hours. 


12 hours. 


24 hours. 




78 


50 


42 


42 


46 


460 


6,000 






This shows a decrease for the first few hours, due to the germicidal 
action of fresh milk. In another case the count showed the following : 




hours. 


24 hours. 


48 hours. 


7 days. 




78 


60, 000 


10, 300. 000 


440. 000. 000 





















SUMMARY OF EPIDEMICS. 

Of the 179 typhoid epidemics reported as spread by milk, compiled 
by the writer, 107 occurred in the United States, 43 in Great Britain, 
23 in continental Europe, 3 in Australia, 1 in New Zealand, and 2 in 
Canada; all cases enumerated in the outbreak were reported as living 
in houses supplied with the suspected milk in 96 of the epidemics; a 
case, suffering from the disease at such a time as to have been the pos- 
sible source of infection, was found at the producing farm, distrib- 
uting dairy, or milk shop in 113 cases; the outbreak was supposed to 
have been due to bottles returned from infected households and re- 
filled and distributed without previous sterilization in 4 cases; the 

° Broers (C. W.), Nederlandsch. Tijdschrift voor Geneeskunde, 1904, XL, p. 
1260. 

6 Bruck, Deut. Med. Woch., 1903, XXIX, p. 460. 

« Pfuhl, Zeit. Hyg., 1902,- XL, p. 555. 

<*Eyre (J. .W.), Jour. State Med., London, 1904, XII, p. 728. 



30 

diseased person or persons were mentioned as handling the milk or 
milk utensils in 2; the sick milked the cows in 6; the same person 
nursed the sick and handled the milk or milk utensils in 6; same 
person was mentioned as nursing sick and milking cows in 10; ice 
cream was given as the infective medium in 3 ; whipped cream in 1 ; 
typhoid dejecta were reported as thrown on the ground in such a way 
as to have more than probably contaminated the well water used for 
washing the milk utensils in 4 ; in many cases mention was made of 
special incidence of the disease among persons in the habit of drinking 
milk; the Eberth bacillus was isolated from the milk in 1 case (Kon- 
radi) ; it was reported that measures taken upon the presumption that 
milk was the cause of the epidemic, and looking to the removal of 
this as a factor, were followed by abatement of the outbreak after 
due allowance for the usual period of incubation from the distribu- 
tion of the last infected milk in 78 of the cases. 

The following is an example of a typhoid epidemic apparently due 
to milk : 

STAMFORD EPIDEMIC, APRIL 15 TO MAY 28, 1895.* 

Stamford, Conn., a town of 15,000 population, had for some months 
been comparatively free from typhoid fever. During the nine days 
following April 14, 1895, 160 cases were reported in addition to 24 
noted as suspicious. One hundred and forty-seven out of the 160 and 
all of the suspected cases had used milk delivered by one dairyman, 
B. Between April 15 and May 28, 386 cases living in 160 houses were 
reported. The dairy was closed April 21, and on May 6, just fifteen 
days after the sale of milk was stopped, the outbreak had practically 
subsided. (See charts 1, 2, and 3.) 

Of the 386 cases 352 (91.2 per cent) lived in houses taking milk 
from dealer B., 12 were known to have used this milk at a cafe sup- 
plied by him, 2 obtained it at a bake shop selling the same milk, and 
2 obtained it in other ways, making 368 cases so traced or 95.3 per 
cent. (See diagram I.) Eight cases were supplied directly by a 
producer, E. B. L., who produced the bulk of the milk peddled by B. 
This makes 376, or 97.1 per cent, connected with this milk supply. 
Of the other cases 4 were supplied by one dealer, 5 were supplied by 5 
different dealers, and 1 could not be connected with any milk supply. 
It was estimated that 3,000 quarts of milk were peddled daily in 
Stamford, of which B. supplied about 275 quarts. He therefore 
supplied about one-eleventh of the milk and had 95.3 per cent of 

a Smith (Herbert E.), Connecticut State Board of Health Report, 1895, pp. 
161-179, 



CHART I. 
SHOWING IN TEN-YEAR PERIODS THE AGES OF CASES DURING THE STAMFORD OUTBREAK. 

AGES 

Under 10 Years I 10T02.0 20 to 30 30 to ^o 40T0 50 over 50 




J. 



NOTE THE UNUSUAL NUMBER OF CASES UNDER 10 YEARS OF AGE AS COMPARED WITH 
THOSE BETWEEN 20 AND 30 YEARS, THE PERIOD USUALLY MOST SUSCEPTIBLE TO 
TYPHOID. 



CHART 2. 
SHOWING IN FIVE-YEAR PERIODS THE AGES OF CASES DURING STAMFORD OUTBREAK. 



UND6R AGES OVER 

5Yt/\ps StolO 10-15 15-2.0 7.0-2.5 25-30 30-35 35-40 40-45 45-50 50 




LLl 

h 

k tr- 
ee O 
< o. 

I ^ 

o Q= 



CO 



LJ 




o 


in 


o 


ir> 


o 


ir> 


o 


in 


*• 


*r 


IO 


ro 


cvi 


oi 



S19VD 



EXPLANATION OF DIAGRAM I. 



The large square M N O P represents the town of Stamford. 

B is the dairy distributing the implicated milk, and the dash lines 
running from B into the city represent the milk route of this dairy. 
Each of the dots represents one case of typhoid fever and is placed 
upon the route of the dairy from which it was supplied with milk. 
There are 368 such cases on B's route, including the 12 around the 
[~S~1, which is meant to represent the cafe supplied by B. B supplied 
about one-eleventh of the milk used in the town. 

H H and H are distributing dairies similar to B. 

C H and E B L are producing farms selling milk to B and also 
peddling some themselves. The dash line extending from E B L 
represents his personal route of 5 houses in which 8 cases of typhoid 
occurred. 

J H B and J B H are producing farms selling milk to B and also 
to distributing dairies H and H H. 

The double lines show the dairy to which the producer sold most 
of his milk. 

Dash lines show the apparent course of the infective agent. 

C, D, E, F, and G are other dairies having routes in Stamford. 



DIAGRAM I. 

SHOWING RELATION OF MILK ROUTES TO TYPHOID FEVER CASES DURING THE EPIDEMIC 
AT STAMFORD, CONN., 1895. 




31 

cases. B. obtained the milk sold by him from other parties and pro- 
duced none himself. He was supplied regularly by 3 producers, 
E. B. L., C. H., J. B. H., and after April 12 also by J. H. B. C. H. 
besides furnishing milk to B. also supplied some in town himself, and 
among his customers only one case occurred. J. B. H. produced 4 
cans of milk a day ; one can went to B. ad 3 cans to dairyman H. H., 
on whose route occurred only 5 cases of typhoid. E. B. L. furnished 
B. from 140 to 150 quarts of milk daily; this constituted over one- 
half of B.'s supply. In fact, all that E. B. L. produced went to B., 
except a few quarts which he distributed to 5 families. It is signifi- 
cant that in these 5 households there were 8 cases of typhoid. 

B.'s dairy was situated in a low, poorly drained part of the city. 
The water used to wash cans was from an uncemented dug well with 
a loose board cover 6 inches above the ground level. The well was 
13J feet deep and the water stood within 1 foot 9 inches of the top. 
There was a shallow, foul privy 25 feet west of the well on slightly 
higher ground, and another 40 feet to the east. The water supply 
was therefore a shallow surface well, uncemented, in poorly drained 
soil and in close proximity to two privies. Chemical and bacterio- 
logical examination of the water showed gross pollution. The last 
act in the washing of milk cans by B. was to rinse them in cold well 
water and invert them to drain and dry. The next morning these 
cans were taken to the producing farms for use. B.'s method of 
delivery was such that there was no part of his route which might 
not have received milk from the E. B. L. farm. B. washed all the 
cans coming to him and returned them clean to the producers. 
Farmer C. H. scalded the returned cans before refilling. E. B. L. 
refilled the cans just as they came from B., all of his milk going into 
them, including that which he delivered to his 5 personal customers. 
J. B. H. refilled cans returned from B. without any extra treatment. 
He had, however, in use 8 cans, one of which was returned daily from 
B., and 3 taken to H. H. No precautions were taken to keep separate 
the cans coming from the two dealers. J. H. B. did not begin to 
furnish milk to B. until after the outbreak was well started and H., 
who handled most of his milk, had only one case on his route. 

No case of typhoid was found at the dairy or producing farms, 
but the hypothesis that the well water at dairy B. was infected would 
explain all the features of the epidemic, and whatever the source of 
the infection the fact remains that the disease followed the milk of 
this one dairy, B., and of that distributed to the 5 houses personally 
supplied by E. B. L. 



32 

B. supplied about 225 households in which 352 cases occurred, a 
cafe among the frequenters of which 12 cases developed, a bakery in 
whose patrons 2 cases were found, and 2 other fever patients were 
reported who had obtained this milk in other ways. 

SCARLET FEVER. 

No organism has as yet been isolated which is generally accepted as 
the specific cause of scarlet fever. In 1882 Mr. W. H. Power a in- 
vestigated an outbreak diagnosed as scarlet fever which he believed 
was caused by infectious matter from a cow which had recently 
calved. In 1885 Power 6 investigated another epidemic which was 
practically limited to users of milk from a certain dairy at Hendon 
where several diseased cows with an eruption of the udders were sup- 
posed to have been the source of the infection. Klein c isolated 
from the lesions in the cows and also from human cases a micrococcus 
which he believed to be the specific organism of the disease and prob- 
ably the cause of scarlet fever. This view has not been accepted. 
Sir George Brown,** who also investigated this outbreak, was of 
the opinion that the cow disease was possibly vaccinia, and that the 
milk had probably become infective by contact with a human case. 
Other similar outbreaks have subsequently occurred among cows 
without a corresponding epidemic among the users of the milk. - 

In the scarlet fever outbreaks which appear later, the abstracts 
were made from the reports cited, and the writer is aware that in a 
few of the cases the evidence is not entirely conclusive. In two of 
the cases the source of the infection is given as supposedly diseased 
cows. This is necessarily an opinion of the reporter and not a state- 
ment of fact, and these outbreaks have been included because the 
association of the disease to milk distribution was such as to make it 
probable that the milk, if not the carrier itself, stood at least in some 
relation to the carrier of infection, whatever the original source 
might have been. 

a Power (W. H.), Report of Local Govt. Board, Lond. (Medical Officer's 
Supplement), 1882, p. 65. 

& Power (W. H.), Report of Local Govt. Board, Lond. (Medical Officer's 
Supplement), 1885, p. 73. 

c Report of Local Govt. Board, Lond. (Medical Officer's Supplement), 
1887-88, p. XIII. 

d Report on Eruptive Diseases of the Teats and Udders of Cows in Rela- 
tion to Scarlet Fever in Man, Agricultural Department, Privy Council Office, 
London, 1888. 



33 

SUMMARY OF EPIDEMICS. 

Of the 51 scarlet fever epidemics reported as spread by milk, com- 
piled by the writer, 25 occurred in the United States and 26 in Great 
Britain ; all cases enumerated in the outbreak were reported as living 
in houses supplied with the suspected milk in 27 of the epidemics ; a 
case suffering from the disease at such a time as to have been the pos- 
sible source of infection was found at the producing farm, the dis- 
tributing dairy, or milk shop in 35 cases ; the outbreak was supposed 
to have been due to bottles returned from infected households and 
refilled without previous sterilization in 3 cases ; the diseased person 
or persons were mentioned as handling the milk or milk utensils in 3 ; 
the sick milked the cows in 12 ; the same person nursed the sick and 
handled the milk in 1; same person nursed sick and milked cows in 
1; the outbreak was supposed to be due to disease of the cow in 2; 
it was reported that measures taken upon the presumption that milk 
was the cause of the epidemic were followed by abatement of the out- 
break in 22 cases. 

The following outbreak is one of many interesting illustrations: 

SCARLET FEVER IN NORWALK, CONN.° 

In November, 1897, an unusual number of cases of scarlet fever 
occurred in Norwalk. Population of Norwalk, South Norwalk and 
East Norwalk, 22,000. Previous to October 25 scarlet fever had 
been reported as follows: August, no cases; September, 5 cases; Oc- 
tober 10, one case. The source of infection in most of these cases 
had been traced. Between October 25 and November 9, 29 cases 
developed. The 29 cases were distributed in 25 families and 24 
houses. School infection was eliminated. Many cases did not at- 
tend school, and some were in families where they had no school 
children. The cases were widely separated; 17 of the infected 
houses were in South Norwalk, 3 in Norwalk, and 4 in East Nor- 
walk. The families were of different social positions and contact- 
infection seemed improbable. The only factor in common to prac- 
tically all of the cases was the milk supply. Twenty-seven out of 
the 29 obtained milk from one dealer, H. The other two were in 
one family in East Norwalk; they were a girl of 12 and boy of 9 
years, and were taken ill on November 7 and 9, respectively. They 
had no connection with the milk route, nor could their infection be 
traced to any source. 

a Smith, (Herbert E.) ; Report Connecticut State Board of Health, 1897, p. 259. 
45276°— Bull. 56—12 3 



34 

The estimated daily supply of milk in Norwalk was 3,500 quarts. 
Dealer H. furnished 450 quarts, or about one-eighth of the whole, 
whereas he had twenty-seven twenty-ninths of the scarlet fever 
cases on his route. 

H. bought his milk from three producers. There were no cases 
of disease in the family of the milk dealer nor in those of two of 
the producers, A. and B. but on the third producing farm, K., a case 
of scarlet fever was found. This farm was in the Bald Hill dis- 
trict. The district school had opened September 7 with a registra- 
tion of 23 pupils. On September 20 one of the pupils fell ill with 
scarlet fever; other cases followed, and the school was closed Octo- 
ber 19. In all there were 20 cases, all in school children or in those 
coming in contact with them. Two of the above cases, living near 
farm K., were exceedingly mild and frequently visited and played 
at this farm with K.'s son, a lad of 4 years. This son broke out with 
a scarlatinous rash October 24. 

Milk from this farm was carted to Norwalk and all of it sold to, 
and delivered by, dealer H., who placed the cans of milk from K. in 
his wagons with that from the other two producers, A. and B. No 
attempt was made to keep the cans separate, and, therefore, one day 
part of his customers might receive K.'s milk and the next day it 
would be delivered to others. H. supplied about 300 families, of 
which 24 were invaded. The sale of this milk was stopped Novem- 
ber 7. The number of cases and the dates on which they occurred 
would indicate that the milk was not continuously infected. Dur- 
ing the outbreak several cases of sore throat occurred among users 
of H.'s milk, which may possibly have had some casual relation to 
the infectious milk. 

It would seem that cases of scarlet fever belonging to a school 
outbreak and visiting a dairy farm, and possibly also the boy on the 
farm, infected from his playmates, were the source or sources ren- 
dering the milk infective. The relation here of the two outbreaks 
is of interest, the one spread by school contact being the original 
source of the milk epidemic. 

DIPHTHERIA. 

Diphtheria epidemics apparently due to milk began to be reported 
in 1877 and 1878 in England. In certain cases the suspected milk 
came from herds where cows were found suffering from an eruptive 
disease of the udder, and this was thought to be the source of the in- 
fection. In this connection Klein a conducted some experiments on 
cows with the Klebs-Lomer bacillus. He took healthy milch cows 
and inoculated them subcutaneously in the shoulder with 1 cubic cen- 
timeter of a broth culture of the Klebs-Lomer bacillus taken from a 

° Klein, Report Med. Officer, Loc. Govt. Board, London, 1889, p. 167. 



EXPLANATION OF DIAGRAM II. 

A, B, and K are dairy farms selling their product to retail milk 
dealer H. K is the farm on which a case of scarlet fever occurred 
antedating the outbreak in Norwalk. 

The large square TOWN represents the city of Norwalk. 

H is the retail milk dealer among whose customers all cases but two 
occurred. The dash lines represent H's milk route, and each dot is a 
case of scarlet fever. 

C, D, E, F, G, I, and J are other dairymen having routes in Nor- 
walk. The lines extending from them into the city represent their 
milk routes and are introduced to show their freedom from the 
disease. 



DIAGRAM II. 

SHOWING RELATION OF MILK ROUTES TO SCARLET FEVER CASES DURING OUTBREAK 
AT NORWALK, CONN., 1897. 








35 

human case. These cows became ill, had a rise in temperature, and 
on the fifth day there appeared upon the udder an eruption character- 
ized by papules, vesicles^ and crusts. He states that he isolated the B. 
diphtheriae from the vesicles, pustules, and milk. Other experiment- 
ers a 6 have however failed to get similar results. The Klebs-Loffler 
bacillus has been isolated from market milk by Bowhill, Eyre,<* 
Klein, 6 and Dean and Todd/ 

KLEBS-LOFFLER BACILLI IX MILK. 

Dean and Todd reported that in certain families supplied with 
milk from two cows there occurred 2 cases of clinically typical diph- 
theria and 3 of sore throat, that in one family using the milk only 
after sterilization no case occurred. Inspection of the cows showed 
papules, crusts, and ulcers on the teats and udders. One of the cows 
seemed well and gave apparently normal milk; the other had a 
mammitis and gave a scanty, ropy, semipurulent and slightly blood- 
tinged milk. Cultures were made from the throat of one of the diph- 
theria patients and also from the ulcers and milk of each cow, and 
typical Klebs-Loffler .bacilli were isolated in all cases. The milk of 
the cow with mammitis also contained streptococci. The bacillus 
isolated was virulent and markedly pathogenic to guinea pigs, but 
diphtheria antitoxin protected guinea pigs against large doses. The 
udder eruption was shown to be contagious to cows and capable of 
spread by the hands of the milker, but no B. diphtheriae were found 
in vesicles and ulcers of the secondary bovine cases. Calves were not 
protected from this disease by diphtheria antitoxin, nor by this dis- 
ease from cowpox. The conclusions drawn were that the ulcers on 
the udders had become secondarily infected with B. diphtheria?, 
probably accidentally from some apparently healthy throat, and that 
the udder affection was a separate disease. 

Eyre 9 has shown the ability of the B. diphtheria? to proliferate in 
raw milk drawn from the cow under aseptic conditions as follows : 



B. diphtheriae. 



hours. 



24 hours. 



48 hours. 



1,170 22,000 19,000,000 



7 days. 



Abbott (A. C), Jour. Path. & Bact, 1894, II, p. 35. 

6 Ritter, Centralblatt f. Bakt, Referat, 1896, XIX, p. 662. 

c Bowhill, Veterinary Record, 1899, April 8th. 

d Eyre, Brit., Med., Jour., 1899., II, p. 586. 

e Klein, Journal Hygiene, Camb., 1901, I, p. 85. 

f Dean & Todd, Jour. Hygiene, Camb., 1902, II, p. 194. 

fi'Eyre, loco citato. 



36 



SUMMARY OF EPIDEMICS. 

Of the 23 diphtheria epidemics reported as spread by milk and 
compiled since 1895, 15 occurred in the United States and 8 in Great 
Britain; cases of the diseases occurred at the producing farm, dis- 
tributing dairy or milk shop at such a time as to have been the possi- 
ble cause of the outbreak in 18 cases; the diseased person milked the 
cows in 4 ; the same person nursed the sick and handled the milk in 
1 ; the outbreak was supposed to be due to disease of the cows in 2 ; 
all cases of the disease were reported as living in households supplied 
with the suspected milk in 15 instances; measures taken upon the 
presumption that milk was the carrier of infection were reported as 
followed by subsidence of the outbreak in 5 cases; the Klebs-Loffler 
bacillus was isolated from the suspected milk in 2 of the epidemics. 

The following outbreak is one of many interesting examples : 

OUTBREAK OF DIPHTHERIA IN DORCHESTER, MILTON, AND HYDE PARK. 

On April 13, 1907, after a period of comparative freedom from 
diphtheria, there were reported to the board of health of the town of 
Milton 11 cases of that disease. This sudden explosion caused very 
naturally a feeling of grave apprehension on the part of the local 
health authorities. The following is an account of the epidemic: 
Cases of diphtheria were reported in Milton as follows: April 12, 1 
case; 13, 11 cases; 14, 1 case; 15, 4 cases (of these 4 cases, 3 were 
in the same house and secondary to a case which had developed be- 
fore the 12th and can therefore be considered as not belonging to this 
explosive outbreak) ; 16, 1 case. In Dorchester cases were reported 
as follows: April 12, 6 cases; 13, 19 cases; 14, 11 cases. In Hyde 
Park the number and dates were: April 13, 2 cases; 14, 5 cases; 15, 6 
cases ; 16, 1 case ; IT, 3 cases, and 19, 1 case. 

The following table shows the relationship of the cases in the differ- 
ent places: 





Place. 


April. 


Total by 




11. 


12. 


13. 


14. 


15. 


16. 


17. 


18. 


19. 


towns. 







1 
6 


11 

19 
2 


1 

11 
5 


4 


1 








18 




36 


Hyde Park 




6 


1 


3 




1 


18 












Total 




7 


32 


17 lft 


2 


3 




1 


72 


1 









a Monthly Bulletin, State board of health, Mass., May, 1907, vol. 2, No. 5, 
p. 117. 



EXPLANATION OF DIAGRAM III. 



JH, EBN, ETT, OH, JMB, and CF J are the farmers pro- 
ducing milk. 

A is the milk dealer delivering milk in both Milton and Dorchester. 
B is the milk dealer delivering milk in Hyde Park. 

The lines connecting the producing farms and the milk dealers 
show to which dairy the farmer sold his milk. 

The large squares represent Milton, Dorchester, and Hyde Park. 

The dash-lines extending from A to B into the towns represent the 
milk routes carrying the supposedly infectious milk. 

Each dot represents a case of diphtheria and is placed on the 
milk route from which it was supplied. 

C, D, E, F, G, and H represent the other dairies selling milk. The 
lines extending from them into the towns represent their routes and 
are inserted to show their freedom from diphtheria cases. 



DIAGRAM III. 

SHOWING RELATION OF MILK ROUTES TO DIPHTHERIA CASES DURING THE OUTBREAK 
AT DORCHESTER, MiLTON, AND HYDE PARK, 1907. 










••« 










. 


. 






o 




i 


• 


» • 






/ 


1 

i __ 


fc 






g 


/ 






i 















Dorchester 













t. 




(d 






1 • 

1 


o e o o e 






• • • o 


—fcl 


• 


• • % e • 







lak 





Hyde Park 










V 


• • • » 




\ 


i • • • • 


1 W 




!• 

, • • « • 






• • • • 


E 









37 

Investigation showed that all the cases in Dorchester and Milton 
were supplied with milk by one dairy, A, with the exception of 3 
which were all in one house in Milton and were secondary to a case 
reported before the onset of the outbreak. In Hyde Park all the cases 
obtained milk from dairyman B. Dairy A bought its milk from 6 
producers : J H, E B N, E T T, O H, J M B, and C F J (see diagram 
III). On none of the producing farms were any cases of diphtheria 
found except on that of C F J, where it was discovered that a child 
had been seized with the disease on April 11, and that the cooler in 
which the milk was mixed was washed in the house and that this 
office was performed by the person who had the care of the sick child. 
This same producer, CFJ, also sold about one-third of his output to 
dairyman B, who delivered it in Hyde Park. Prompt action on the 
part of the local authorities in excluding sale of milk produced by 
CFJ, brought the outbreak to an immediate close. 

It will be noticed from the table that the outbreak in Hyde Park 
occurred a day later than that in Dorchester and Milton. This is 
explainable by the fact that B called for his share of C F J's milk in 
the evening and sold it on the following day, whereas A came for his 
in the morning and disposed of it at once. 

It is of further interest that CFJ himself came down with the dis- 
ease after the outbreak had nearly subsided, and that dealer A's son 
who drank milk from CFJ was one of the earliest victims. 

EPIDEMICS OF SORE THROAT AND PSEUDO-DIPHTHERIA. 

Among the collected epidemics are 7 variously reported as sore 
throat, pseudo-diphtheria and septic sore throat. They all occurred 
in Great Britain. Two of the outbreaks were supposed to be due to 
milk coming from cows having mastitis, 4 to milk of cows afflicted 
with teat and udder eruption ; in one case the sequence was first severe 
sore throat, thought to be quinsy in the farmer, followed by mastitis 
in the cows and sore throats in other persons on the farm, and last an 
outbreak of sore throats on the milk route. Precautions taken 
against the milk were reported as stopping four of the outbreaks. 

CHARACTER OF MILK EPIDEMICS. 

Milk epidemics have characteristics more or less peculiar to them- 
selves and usually show the following features : 

(a) Explosive onset. — The onset is usually sudden and may very 
aptly be termed explosive. This is due to the fact that a certain can 
or lot of milk receives an amount of the infective material from con- 
tact with an infectious person, premises, or water. This milk may be 
delivered to the consumers by itself, in which case the number of 



38 

persons exposed to the infection is small. Or it may be mixed in a 
dairy with that from many other cans, and thus a larger amount of 
more dilute infectious material be delivered to the community. If 
kept cool, the milk may remain thus dilute as regards the pathogenic 
organism and the disease may crop out among the consumers only in 
those most susceptible or in persons drinking a comparatively large 
amount. But if the milk becomes warm because of lack of care or 
long transit and the contained organism is such that it will prolif- 
erate in milk, each quart delivered to the consumer may be more 
infectious than the original can. In either case the users of the 
infectious milk will receive their dosage of the organism at approxi- 
mately the same time and will therefore, making due allowance for 
the normal variations in period of incubation, fall ill simultaneously. 

The initial explosion may therefore consist of but a few cases if 
the amount of infected milk is small or if very dilute; or of many 
if the amount of infected milk is large or the number of organisms 
great. If the milk is infected at but one milking, the outbreak will 
rapidly subside and, aside from secondary cases spread by contact 
or other means, no new ones will appear. If the milk is infected 
day after day, the outbreak continues; and in contagious diseases, 
after the lapse of the period of incubation from the initial outbreak, 
secondary cases due to contact are apt to appear and grow more 
numerous, so that the picture presented of a typical milk epidemic 
may become less clear. A milk epidemic is therefore most typical 
in its onset, although under efficient systems of notification and quar- 
antine secondary contact cases may be largely prevented and it may 
then maintain its characteristics throughout. The development of 
these secondary cases contracted by contact and otherwise explains 
why in the epidemics reported later in tabular form not all of the 
cases in the outbreak are reported as consumers of the suspected 
milk. Another explanation is that in most cities there are always 
a certain small number of cases of the commoner contagious diseases 
which have varied sources of origin and may be termed residual. 
It is on top of this as it were that an epidemic occurs. 

(b) Disease follows the milk. — Disease carried by milk can occur 
only among users of the infectious milk. Milk routes may therefore 
at times be considered thoroughfares of infection. During an epi- 
demic other cases of course may occurr among nonconsumers, but 
the contagion is carried to these by other means. In typhoid fever 
for example it is possible to conceive a water and a milk epidemic 
occurring at the same time, or what is possibly more common in 
the cities, during an unusual prevalence of typhoid due to various 
and in some cases unknown causes, smaller milk outbreaks may occur. 

° Bull. No. 35, Hyg. Lab., U. S. Pub. Health and Mar.-Hosp. Serv., Wash., p. 20. 



39 

But milk epidemics necessarily follow the milkman, and often his 
route can be plotted by the incidence of the disease. The outbreak 
may be limited to a certain section of the city if the route is small 
and circumscribed in extent. This will usually eliminate water as 
a cause of typhoid where a public supply is in use. Or where various 
water supplies are used the cases may occur among the users of the 
different sources. If the dairy is a large one, delivering to all parts 
of the city, the cases may be widely separated and much scattered, 
having nothing in common but the milk supply. The children may 
go to different schools, the families be of varied social status. These 
points will usually eliminate schools and contact as sources. 

At times where the area covered by the milk route and therefore the 
district involved in the outbreak is circumscribed, occasional isolated 
cases will be found at a distance, and upon careful investigation it will 
be found that they had friends or relatives on the involved route and 
used the suspected milk while on a visit. 

Very interesting cases have been reported where the evidence seemed 
quite convincing of persons drinking a single glass of the suspected 
milk and falling ill after a due period allowed for incubation. 

Milk outbreaks are as a rule more typical in small towns where the 
organization is less complicated and fewer extraneous factors occur 
to conceal the true picture. An example of this is the outbreak at Elk- 
ton, Md., in 1900. 

Elkton epidemic." — Elkton had a population of 2,542. The town 
water supply was obtained from the Elk River about 1J miles above 
the town. Part of the families drank the town water, the rest used 
private wells. The inhabitants were supplied with milk from 4 dairy 
farms having routes in the town. Dairyman B on his way to town 
each day with his own milk obtained an additional amount from 2 
other farmers, C and D, both of whose farms remained free from 
typhoid. In September, 1900, a case of typhoid fever occurred on 
farm A (see diagram IV) adjoining farm B. Mrs. B, wife of the 
dayman, assisted in nursing the case at A for two or three weeks up 
to October 5. For some days before this Mrs. B and one of her sons 
had been ailing, but the boy continued milking and the mother han- 
dling the milk up to October 8, when both became too ill to work. 
(Later another son fell ill.) Previous to this time there had been in 
Elkton only 3 cases of typhoid and they were all in one family, oc- 
curring August 12, September 12 and September 19. On October 11, 
3 cases of typhoid fever were reported; 12, 1 case; 13, 2 cases; 14, 
3 cases; 15, 3 cases; 16, 3 cases; 18, 6 cases. By October 28, 32 fam- 
ilies had been invaded. All used milk supplied by B, 18 used the 

Fulton (John S.) Jour. Hyg., Camb., 1901, 1, p. 422. 



40 

town water supply, and 14 private wells. The total number of cases 
was 39. On this day B stopped selling milk and in three weeks the 
epidemic subsided. The final summary of the outbreak was: In- 
vaded houses, 39 ; all used B's milk, 21 used public water supply, and 
18 used private wells. B claimed to supply regularly 80 houses with 
milk. One hundred and eighty people lived in the 39 invaded house- 
holds. 

There were several occurrences during this outbreak of special 
interest. Miss M, living in New Jersey, visited Elkton for two days, 
October 5 and 6, returning home on the 7th. While in Elkton she 
was at a house supplied with milk from B's farm. No typhoid had 
occurred at this house up to that time. On October 14 Miss M fell 
ill with typhoid. In one family a negro servant, whose chief food 
consisted of oatmeal and milk, left Elkton the middle of October and 
went to Glasgow, Del., where she became ill of typhoid and died. In 
another family was a married daughter who left Elkton the last of 
October to visit friends. In about ten days she fell ill with typhoid. 
At the jail where there were from 15 to 20 prisoners who received no 
milk whatever, 3 members of the jailer's family, and 2 men assisting 
about the place, all of whom used B's milk in one form or another, 
fell ill with typhoid, while the prisoners were not attacked. 

In cities where large dairies are the rule, receiving milk from per- 
haps hundreds of farms some of which are situated miles away, it is 
necessarily very difficult at times to find the infecting focus. Cases of 
the disease may occur on two or three milk routes, and search will show 
that they all receive part of their milk from the same farm or else that 
one dairyman at times sells surplus milk to the others, but the milk 
consumed will all be directly or indirectly traced to some common 
source of contact of disease with the milk. In tracing the relationship 
between milk and the disease, ice cream and other forms of milk prep- 
arations such as whipped cream are to be borne in mind. A confec- 
tioner's shop or bakery may be the focus producing an epidemic. 

(c) Special incidence in milk drinkers. — In addition to the fact that 
as a rule cases occur only in houses using the infectious milk, many 
times interesting incidents occur where in a family the only person 
attacked will be one drinking raw milk, or where the only person 
exempt will be the sole one not using it. Usually cases are found 
mainly among the milk drinkers. 

(d) The better houses suffer greater invasion. — The so-called better 
class of houses are often attacked in greater proportion than others. 
This is explained by the fact that families with larger incomes are sup- 
posed to drink more milk, whereas those with lesser resources use it 
mainly in tea or coffee or cooked in food preparations and for children. 



EXPLANATION OF DIAGRAM IV. 

Each red dot represents a case of typhoid fever. 

A — Farm where original case occurred in September and was 
nursed by wife of farmer B. 

B — Dairy farm where wife nursed preceding case and prepared 
the milk for market. She and one son were ailing for some days but 
did not stop work until October 8. 

The dash-lines represent the course and distribution of the milk 
from farm B. All the cases of typhoid were on this milk route. 

C and D were farms selling milk to farmer B. No typhoid oc- 
curred on these 2 farms. 

E — Farm receiving a small amount of milk daily from B for use of 
girl staying at farm. This girl contracted typhoid. 

F, G, and H — The 3 other dairy farms supplying milk to Elkton. 
The solid lines represent their routes. No case of typhoid on these 
routes. 

Population of Elkton 2,542 

Total cases 64 

Houses invaded 39 

Invaded houses using B's milk 39 

Invaded bouses using well water IS 

Invaded houses using town water 21 

The large square — " TOWN " — represents the town of Elkton. 



DIAGRAM IV. 
SHOWING RELATION OF MILK ROUTES TO TYPHOID FEVER CASES AT ELKTON, MD., 1900. 



N 



E [J] 









E\ 


pE 


1 






i-m 


• •••••• 






j • 

• • 

• * 
i • 
i • 

t * 


• 


. ] 


















Q 


b 




( 


Y 




} 


^ 



w 



41 

Among the well to do therefore it frequently happens that infectious 
milk finds more victims, while among the poor the children are the 
ones most likely to suffer. 

(e) Age and sex. — Women and children are usually credited with 
drinking more milk than men, and it is generally believed that a 
greater incidence of the disease in them is a characteristic of milk- 
borne outbreaks. 

BACILLUS CARRIERS. 

The term " bacillus carrier " is most commonly associated with 
carriers of typhoid or Klebs-Loffler bacilli, and is used to designate 
persons who discharge the former in their feces or urine, or both, or 
harbor Klebs-Loffler bacilli in their nose or throat. They may be 
acute or chronic carriers depending on whether they carry the organ- 
isms for short or long periods of time. 

Diphtheria carriers may become such from having had an acute 
attack of the disease, or by associating with others having acute 
attacks, or with other bacillus carriers. Klebs-Loffler bacillus carriers 
have undoubtedly frequently infected milk, and thus produced epi- 
demics of milk diphtheria. This in all probability is more likely 
to happen when the carrier is a milker at a dairy farm. 

Typhoid carriers are of particular interest because it has been 
found that an appreciable number of typhoid convalescents dis- 
charge typhoid bacilli in the urine or feces, or both, and that from 
2 to 4 per cent continue to do so and become chronic typhoid bacillus 
carriers, that some continue so for years and some during the re- 
mainder of their lives. It is now known that not only may convales- 
cents become carriers, but that nurses and those coming in contact 
with the sick or with other carriers may in turn become typhoid ba- 
cillus carriers for longer or shorter periods of time and that, at times, 
without themselves falling victims to the disease. 

Undoubtedly these bacillus carriers constitute one of the important 
factors in the spread of typhoid fever by milk. Individuals in the 
ear]y stages of typhoid may be physically well enough to continue at 
work milking or handling milk; others with very mild attacks may 
not cease work at all. Both may be discharging typhoid bacilli in 
the excretions. On the other hand, the chronic typhoid bacillus car- 
riers may continue to discharge bacilli not only for weeks but for 

C W. T. Graham, C. L. Overlander, John E. Overlander, and M. A. Dailey 
found 23 per cent. (Boston Med. and Surg. Journ., Jan. 14, 1909.) Officers 
of the medical and sanitary departments of the Government of India at the 
Central Research Institute at Kasauli found 11.6 per cent. ( Scientific Memoirs, 
No. 32, "An enquiry on enteric fever in India," p. 7.) 



42 

years, and being well, remain at work and continue a menace over 
long periods of time. 

When it is considered that available evidence seems to show that 
between 2 and 4 per cent of typhoid convalescents become chronic 
bacillus carriers, the probability that some of them are employed at 
dairies in milking cows and handling milk is very great. 

Several epidemics, due to milk infected by these chronic typhoid 
bacillus carriers, have been reported. Others will undoubtedly be 
found with increasing frequency as epidemics are studied with this 
possibility in mind. 

Dr. Henry Albert reports a small but interesting outbreak of this 
kind occurring in the autumn of 1907 at Cedar Falls, Iowa : 

A certain gentleman had typhoid fever a year ago and recently 4 cases of 
typhoid fever developed in his own family, 7 in the family of one neighbor and 
2 in the family of another neighbor. The man who had typhoid fever a year 
ago owned a cow, did his own milking, and supplied milk to the 2 families in 
which the cases, respectively, 7 and 2, developed. The man who is supposed to 
be the source of this infection is apparently perfectly well, but has a slight cysti- 
tis and on the examination of his urine, typhoid bacilli were isolated. The 
water used by this man and his family came from a rather shallow well. It 
contained a large number of Colon bacilli, but no typhoid bacilli were found. 
This water was, however, not used by any member of the other 2 families. 
Just how the bacteria gained entrance to the milk, whether from the hands of 
the bacillus carrier or from the water used for cleaning milk pails, is difficult 
to determine, but it seems very certain that the milk was the medium through 
which the infection of the 9 cases in the neighboring families was carried. 

Branthwaite reports an outbreak at Brentry Reformatory, an in- 
stitution for the detention and treatment of habitual inebriates. The 
reformatory consisted of 16 buildings, scattered over about 98 acres 
of ground. The institution was practically isolated from other com- 
munities and housed usually about 265 persons. It ran its own dairy. 
From 1899 to 1906 the institution remained free from infectious dis- 
eases. The first case of typhoid occurred in September, 1906, and by 
November, 1907, 28 cases had developed. The patients fell ill at 
irregular intervals and always in groups of from three to five. The 
first patient was a woman who had been in the institution several 
months, and therefore removed from the possibility of outside in- 
fection. Careful search was made as to the possible introduction of 
the disease, but in spite of all precautions others continued to be 
attacked. A detailed investigation pointed to the milk as the carrier 
of infection. All milk had been regularly sterilized, and therefore 
if it were the cause it was necessarily due to defective methods or 
to subsequent contamination. A new sterilizing plant was installed, 
and all handling of milk after heating was limited to two persons, a 



43 

man and a woman. But still cases developed, and all evidence con- 
tinued to point to the milk. It was therefore concluded that infec- 
tious material reached the milk after sterilization, and it was decided 
to find whether one of the two persons handling it was a bacillus 
carrier. The woman milk handler was removed from the dairy and 
her feces examined. Pure cultures of the typhoid bacillus were 
isolated from her stools. She was permanently removed from the 
dairy, and, after a lapse of the usual incubation period of two weeks, 
no new cases had developed up to the time of the report, three months 
later. 

Dr. A. JL Chalmers, medical officer of health of Glasgow, Scot- 
land, reported an outbreak in Glasgow in December, 1907, and 
January, 1908. This outbreak is of interest because of the parts 
played by a bacillus carrier and an acute case of typhoid fever in the 
production of the epidemic. There were 126 cases of typhoid, in all 
of which the patients obtained milk from one dairy. Eight of the 
patients sickened between December 5 and 14. One of these 8 cases 
developed at Parkhouse dairy farm, which supplied milk to the dis- 
tributing dairy from which all the other patients obtained their milk. 
Then for four days there were no cases. Following this, between 
December 19 and January 13, 93 cases developed. The result of 
much careful work in studying the relationship of the milk distri- 
bution to the incidence of the disease showed that the Parkhouse 
farm was the undoubted source of infection, and while the acute 
case which developed there could, from a standpoint of time and 
opportunity, have been the direct cause of the 93 and more cases 
which formed a typical milk epidemic, and undoubtedly was the 
cause, yet there remained to be found the source of infection of the 
first 8 cases, of which this patient was one. The water supply of 
the farm could not be found at fault, and so an investigation was 
made of the dairy hands. There was found an elderly woman milker 
who gave a history of having been previously associated with out- 
breaks of typhoid fever. She had had the disease sixteen years 
before. Her stools were examined and the typhoid bacillus isolated. 
Her blood gave a positive Widal reaction with ' ; the laboratory strain 
of the typhoid bacillus." The conclusions drawn were that this 
woman was the source of infection of the first 8 cases occurring be- 
tween December 5 and 14, one of which developed on this same farm 
in a woman who was ill from December 7 to 24, when her case was 
diagnosed as typhoid fever, and that this latter case was the source 
of infection causing the typical milk outbreak between December 19 
and January 13. 



44 

Kayser, in 1905, reported two small milk outbreaks of typhoid 
fever traced to chronic bacillus carriers as the source of infection. 

SOURCE OF MILK CONTAMINATION. 

(1) From hands of milker.— -Many dairy employees take no pre- 
cautions to keep the hands clean, and in fact the milker who washes 
his hands before milking is the exception and not the rule. He may 
be a typhoid bacillus carrier and be discharging typhoid bacilli in the 
excretions, and any carelessness in toilet is apt to deposit bacilli on 
the hands and under the finger nails. In the act of milking it is 
more than likely that he will wash at least some of them into the milk 
pail, and especially so if he resorts to a custom, all too common, 
of moistening his hands by squirting milk upon the palms pre- 
liminary to milking. 

The milker's hands may have become soiled in acting as nurse 
for some case of typhoid in the family. He may be a convalescent 
from scarlet fever and be shedding particles of epidermis into the 
milk, or he may have diphtheria, or possibly tuberculosis, and with 
every act of sneezing and coughing spray tubercle or Klebs-Loffler 
bacilli with particles of sputum. If he does, as is not entirely un- 
known among careless milkers, and moistens his hands by spitting 
into the palms to facilitate the action of the fingers upon the teats, 
it is easily seen how infective material may find its way into the milk. 

(2) Air and dust of the stable. — The stable dust may contain 
organisms eliminated by those working in it, and as some of this 
dust and other stable refuse adhering to the flanks, buttocks, and 
udders of the cows and floating in the air finds its way into the milk, 
under the conditions sometimes employed, it may carry with it these 
organisms. 

(3) The milk pail. — The milk pail may have been washed and 
taken care of by some person or member of the family suffering from 
a contagious or infectious disease and in the handling have received 
its quota of typhoid or other bacilli which thus find their way into 
the milk. 

(4) Water supply. — The water supply of the farm or dairy may 
be at fault. Farms are often very unfortunate in the location of their 
wells, which very frequently become polluted by cases of typhoid on 
the premises. The privy vaults are at times not far distant and are 
apt to be leaky and subject to seepage, and when a case of typhoid 

°A further discussion of the subject of bacillus carriers and epidemics due 
to them will be found in the chapter on " The milk supply of cities in relation 
to the epidemiology of typhoid fever." 



45 

fever occurs on the place or a person eliminating the bacilli sojourns 
temporarily on the premises, the possibility of water contamination 
exists. In some cases the dejecta of typhoid patients are buried in 
shallow holes around the house and often unwittingly around the 
well, while at other times, as occurred in some of the epidemics 
reported later, the dejecta were simply thrown on the ground where 
they could easily find their way into the water supply. Pails washed 
in polluted water, if not afterwards scalded, may contain the infect- 
ive material and the more so if some of the last rinsing water still 
remains in them. The possibility of this water being added directly 
to the milk need not be considered, although it has undoubtedly 
played an important part in some epidemics. The water used may 
be a stream into which some household higher up empties its sewage. 
It has been supposed that cows wading into polluted streams might 
get upon the udders contaminated water, which in the act of milking 
would find its way into the pail. This at least is one of the rarer 
means of infecting milk. 

(5) Milk cooler. — If a milk cooler is used and not properly taken 
care of, infectious material may reach the milk through it. 

(6) Cans. — If the milk is then put into cans the same possibilities 
are again met as in the pails. 

(7) Transportation. — If the milk is now shipped to a distributing 
dairy in the city there is always the possibility of its infection in 
transit by those handling it, and it must always be borne in mind that 
some person may surreptitiously dip into the container with a soiled 
vessel or dipper or even drink from the mouth or top of the can. 

(8) Distributing dairy. — Then there are the receptacles used by 
the retailer. In many distributing dairies the milk comes in by train 
in large cans, and before the contents are poured together in the mixer 
each can of milk must be tasted to ascertain whether or not it is sour. 
One man usually does the tasting. It may be done in a manner free 
from criticism or the taster may tip each can before it is lifted from 
the wagon and, removing the top, place his mouth to the can and taste 
the milk. When milk has been treated in this manner it has at times 
been the custom to draw into the mouth a sufficient amount and then 
spit it upon the ground. One taster has been mentioned who was so 
economical that he returned the tasted milk to the can. Another 
means of tasting which has at times been employed is to use a spoon 
or small dipper, inserting it into one can after another, and of course 
between cans into the mouth of the taster. A method less subject to 
criticism is to tip each can, then removing the cap, taste of the milk 
adhering to it. The cap can then be cast aside and scalded before 



46 

further use and the milk emptied intojhe mixing tank. Other meth- 
ods entirely free from criticism are commonly used by careful dairies. 
(9) Bottles. — It is at present the custom to deliver milk to the 
consumer in bottles. This is especially so in the cities. It can be 
seen how this practice properly operated may be better than any 
other ; but, on the other hand, if carelessly conducted may be a source 
of much danger. Clean milk in sterile, well-capped bottles, handled 
and delivered by clean men, free from disease, is a condition much to 
be desired. But where empty bottles returned from the consumers' 
bouses are not properly scalded before being again filled, the possi- 
bility of contamination by pathogenic organisms is necessarily con- 
siderable. Bottles left at houses where there are cases of scarlet fever, 
typhoid, or diphtheria, if refilled without being properly scalded, are 
undoubtedly a source of much danger. Many cities have ordinances 
to prevent this, but the constant presence of mild cases of disease, so 
mild and, according to present standards, atypical, that a correct 
diagnosis is not made, renders all regulating measures more or less 
ineffective. The accidental infection of bottles in an orderly, well- 
regulated household need not be considered so long as certain classes 
of people persist in using them for various other purposes, such as 
urinals and receptacles for sputum. Dr. Herbert Fox, chief of the 
laboratories of the Pennsylvania state department of health, states: 

The attention of the commissioner of health, Dr. Samuel G. Dixon, was 
called to a slimy mass of material on the under surface of a milk-bottle cap. 
He sent this to the laboratory and it was received in a very dry condition. 
Upon softening down and smears made from it we were able to obtain suffi- 
cient proof that it was sputum. Doctor Dixon informs me that he has known 
of milk bottles used for cuspidors on more than one occasion. 

The practice of drinking directly from the bottles is a habit that 
must also be borne in mind as a possible means of contamination 
with tubercle and Klebs-Loffler bacilli. An example of apparent 
bottle infection is found in the typhoid outbreak at Montclair, N. J., 
in 1902. 

Montclair epidemic. — During the summer and autumn of 1902 
there was only an occasional case of typhoid in Montclair. The 
1st of December several cases occurred, apparently having milk from 
one dairy as the only factor in common. Investigation of the farms 
producing this milk failed to reveal any cases of disease which could 
be the source of the infection. All persons coming in contact with 
the milk were apparently in good health. More careful examination 

<* Ninth Annual Report, Board of Health, Town of Montclair, N. J., 1903. 



47 

of the invaded houses showed that cases of typhoid existed only in 
those houses receiving milk in pint bottles. There were no cases 
among the quart-bottle customers. Cases continued to be reported 
on this route and the sale of milk from the dairy was therefore 
stopped. After two weeks new cases ceased to develop. It was then 
found that a man from New York City had come to Montclair ill 
with typhoid fever and had remained for a few days at a house sup- 
plied with milk from this dairy until he could be removed to a hos- 
pital. This house had during the patient's stay been supplied daily 
with three pint bottles of milk. The empty bottles were removed 
daily and, without sterilization, refilled and delivered to other 
houses. It seemed that this was the means of spreading the disease. 
Eighteen cases occurred in Montclair and 10 in Bloomfield, all in 
houses supplied with milk in pint bottles from this dairy. 

Pathogenic organisms may possibly reach the milk through dust 
while in the care of the vendor, but most likely the vendor himself is 
the more important and that, while organisms floating in the air can 
undoubtedly settle into milk, yet the chief danger is from contact 
with diseased persons or those having an intimate relation with the 
sick. 

DETECTION OF MILK EPIDEMICS. 

When in a city an unusual number of cases of scarlet fever, diph- 
theria, or typhoid fever occurs among the customers of any one dairy, 
it may be considered a sufficient reason for causing a careful inquiry 
to be made and a search for some source of milk infection. The mere 
finding of cases on one milk route is not by any means conclusive 
that milk is the carrier of the infection, but it is sufficient to cast 
suspicion and at times, undoubtedly, also to warrant regulation, even 
if no source of contamination is found, for it is often exceedingly 
difficult to find the infective focus. 

The health officers of many cities have for some time been charging 
each case of typhoid fevor, scarlet fever, and diphtheria to the dairy- 
man supplying the milk to the invaded household. In this way it 
is apparent when an unusual number occurs on one route, and meas- 
ures can be taken to ascertain whether the incidence of the disease 
has an etiologic relationship to the milk. Cases which otherwise 
would show no relationship to each other are revealed as associated, 
and the milkman makes neighbors of families separated by consider- 
able distance. In the complicated life of cities this gives the health 
officer a valuable aid in the control of certain of the common in- 
fectious diseases. 



48 

PKEVENTIOtf OF MILK EPIDEMICS. 

Inspection and regulation of the production, handling, and sale of 
milk will lessen the number of milk epidemics. In cities the proper 
charging of each case of scarlet fever, diphtheria, and typhoid fever 
to the dairy on whose route it occurs will often reveal milk outbreaks, 
which can then be suppressed before reaching too great proportions. 
The most rigid inspection and regulation practicable at the present 
time, however, are impotent to prevent chronic bacillus carriers from 
being employed on milk farms and at dairies. They are also unable 
to keep mild ambulant cases of infectious diseases from being so en- 
gaged, for the reason that such cases can often not be diagnosed until 
after other cases have developed. Soper's case ° of " Typhoid Mary " 
was a constant danger in her capacity as family cook to the members 
of the family in which she happened to be employed and to visitors 
eating of the salads and food prepared by her, but what might have 
happened had she been employed in the handling of milk distributed 
over a large city route can only be surmised. 

The only way to prevent these epidemics entirely would appear to 
be to pasteurize or sterilize the milk, either at the dairy before de- 
livery to the consumer or in the household after delivery. 

a Soper ( George A. ) , Jour. Am. Med. Assn., June 15, 1907, p. 2019. 



49 

POINTS OF INTEREST IN REPORTING MILK EPIDEMICS. 

In reporting milk epidemics some of the points of special interest 
are the following : 

1. The number of cases of the disease existing in the involved ter- 
ritory during the time covered by the epidemic. 

2. The number of houses invaded by the disease. 

3. The number of invaded houses supplied in whole or in part, 
directly or indirectly, by the suspected milk. 

4. The number of cases occurring in invaded houses so supplied. 

5. The number of houses supplied with the suspected milk. 

6. The relative proportion of houses so supplied to those supplied 
by other dairies. 

7. The time covered by the epidemic. 

8. The location of the case or cases from which the milk became 
contaminated. 

9. The relation of the original case to the milk. 

10. The time relation of the original case to the epidemic. 

11. The special incidence of the disease among milk drinkers. 

12. The elimination of other common carriers of infection. 

13. The effect upon the epidemic of closing the dairy or taking 
such measures as will eliminate possibility of milk contamination 
from the suspected focus. 

14. The finding of the specific organism in the milk. 

BUSEY AND KOBER'S SUMMARY OF EPIDEMICS. 

Busey and Kober summarized the epidemics compiled by them as 
follows : 

TYPHOID-FEVER EPIDEMICS. 

Mr. E. Hart tabulated 50 epidemics of typhoid fever and we have collected 
88, making a total of 138 epidemics traceable to a specific pollution of the 
milk, the main facts of which are presented in a subjoined table. In 109 in- 
stances there is evidence of the disease having prevailed at the farm or dairy. 
In 54 epidemics the poison reached the milk by soakage of the germs into the 
well water with which the utensils were washed and in 13 of these instances 
(Nos. 5, 24, 39, 45, 70; 89, 90, 98, 99, 103, 111, 116, 124), the intentional dilution 
with polluted water is admitted. In 6 instances (Nos. 10, 74, 104, 107, 112, 
121) the infection is attributed to the cows drinking or wading in sewage-pol- 
luted water. In three instances (Nos. 118, 123, 131) the infection was spread 
in ice cream prepared in infected premises. In 21 instances the dairy em- 
ployees also acted as nurses (Nos. 1, 6, 12, 16, 17, 24, 30, 37, 38, 41, 46, 52, 
65, 68, 82, 110, 111, 115, 126, 127, 133). In 6 instances (Nos. 101, 102, 113, 
117, 132, 134) the patients while suffering from a mild attack of enteric fever, 
or during the first week or ten days of their illness continued at work, and those 
of us who are familiar with the personal habits of the average dairy boy will 
have no difficulty in surmising the manner of direct digital infection. In one 
instance (No. 24) the milk tins were washed with the same dishcloth used 

45276°— Bull. 56—12 4 



50 

among the fever patients. In one instance (No. 87) the disease was attributed 
to an abscess of the udder, in another (No. 92) to a teat eruption, and in No. 
81 to a febrile disorder in the cows. Nos. 85, 103, 120, and 127 were creamery 
cases. In No. 96 the milk had been kept in the sick room. 

SCARLET-FEVER EPIDEMICS. 

Mr. Hart collected 15 epidemics of milk scarlatina, and we have tabulated 
59, making a total of 74 epidemics spread through the medium of the milk 
supply, the details of which will be found in Table No. II. 

In 41 instances the disease prevailed either at the milk farm or dairy. In 6 
instances persons connected with the dairy either lodged in or had visited infect- 
ed houses. (See Nos. 8, 9, 10, 11, 15, 40.) In No. 12 the milkman had taken his 
can into an infected house. In 20 instances the infection was attributed to dis- 
ease among the milch cows; in 4 of these (Nos. 17, 18, 19, 35) the puerperal 
condition of the animal is blamed. In 9 instances disease of the udder or teats 
was found. (See Nos. 30, 31, 34, 39, 41, 59, 61, 62, 66.) In one instance (No. 
54) the veterinarian diagnosed a case of bovine tuberculosis. In 6 instances 
there was loss of hair and casting of the skin in the animal. ( See Nos. 17, 18, 
19, 38, 40, 41.) In No. 68 the cattle were found to be suffering more or less from 
febrile disturbance. In 10 instances the infection was doubtless conveyed by 
persons connected with the milk business, while suffering or recovering from an 
attack of the disease (see Nos. 2, 22, 26, 29, 42, 57, 58, 60, 69, 71), and in at least 
8 cases by persons who also acted as nurses. (Nos. 1, 2, 7, 9, 13, 14, 25, 63.) 
In three instances (Nos. 1, 73, 74) the milk had been kept in the cottage close 
to the sick room. In No. 15 the cows were milked into an open tin can which 
was carried across an open yard past an infected house, and in No. 53 the milk- 
man had wiped his cans with white flannel cloths (presumably infected) which 
had been left in his barn by a peddler. Nos. 21 and 44 appear to have been 
instances of mixed infection of scarlet fever and diphtheria. 

DIPHTHERIA EPIDEMICS. 

Mr. Hart collected 7 epidemics of milk diphtheria and we have added 21 more. 
(See Table III.) In 10 of these 28 instances diphtheria existed at the farm or 
dairy, and in 10 instances the disease is attributed directly to the cows having 
garget, chapped and ulcerative affections of the teats and udder, while in No. 13 
the cows were apparently healthy but the calves had diarrhea. (See Nos. 2, 5, 
14, 18, 19, 20, 21, 22, 24, 25.) In No. 23 one of the dairymaids suffered from a 
sore throat of an erysipelatous character, and in No. 27 the patient continued 
to milk while suffering from diphtheria. In No. 28 one of the drivers of the 
dairy wagons was suffering from a sore throat. 



51 



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3. THE MILK SUPPLY OF CITIES IN RELATION TO 
THE EPIDEMIOLOGY OF TYPHOID FEVER. 



(i5i; 



THE MILK SUPPLY OF CITIES IN RELATION TO THE 
EPIDEMIOLOGY OF TYPHOID FEVER. 



By Leslie L. Lumsden, 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 



Milk is a favorable culture medium for the typhoid bacillus. 
Therefore, if a small particle of matter containing this organism is 
introduced into milk the organism may undergo rapid multiplication 
and become disseminated throughout the bulk of the milk. The tem- 
perature at which the milk is kept and the number and kind of other 
bacteria present affect the rate at which the multiplication of typhoid 
bacilli takes place, and in some instances, no doubt, the bacilli, after 
gaining access to a body of milk, die out before that milk is drunk. 
In the majority of instances, however, it is probable that the bacilli 
will survive and so endanger all susceptible persons into whose 
alimentary canals such milk is taken. 

Considering the tremendous multiplication which the bacilli can 
undergo within twenty- four hours in milk it is easy to appreciate 
how one bottle or can of infected milk taken into a dairy and there 
mixed with a large volume of milk may be responsible for exposure 
to infection of several thousand persons. 

Dairy products, such as ice cream, buttermilk, butter and cheese, 
etc., made from infected milk may be factors in the spread of typhoid 
fever. 

Ice cream. — It has been proven experimentally that the process of 
freezing does not at once destroy all typhoid bacilli, and outbreaks 
of typhoid fever have been traced quite definitely to infected ice 
cream. 

Butter and cheese. — Butter made from milk experimentally 
infected with typhoid bacilli may retain the bacilli, according to 
Bruck, a as long as twenty-seven days, and according to Washburn & 
for as long as sixty days or more. Although it would seem, under 
ordinary circumstances, that the presence of many vigorous sapro- 

« Bruck, Deut. Med. Woch., vol. 29, 1903, p. 460. 

6 Washburn, Washington Medical Annals, Vol. VII, No. 1, 1908, p. 107. 

(153) 



154 

phytes, the washing out of large numbers of bacteria in the butter- 
milk, and the salting would lessen the chances of typhoid bacilli 
remaining in the butter, yet in view of the experimental evidence this 
dairy product should be kept in mind as a possible factor in the 
spread of typhoid fever infection and its manufacture from pre- 
sumably infected milk prohibited. 

Buttermilk of course would be fully as dangerous as the cream 
from which it was derived. 

Cheese. — The time required for the ripening of cheese makes the 
chances of infection from this dairy product certainly very slight. 

Butter and cheese from a given source are usually so widely dis- 
tributed that should an outbreak of typhoid fever in a large city be 
caused by infection in them it would be very difficult to trace unless 
the outbreak were very pronounced and other possible factors could be 
excluded so that attention would be directed to these dairy products. 

WAYS IN WHICH THE TYPHOID BACILLUS MAY GET INTO MILK. 

At the dairy farm. — The milk supply for the average American 
city is obtained from a large number of dairy farms, and the lia- 
bility of cases of typhoid fever developing every year among per- 
sons living on these farms can be readily appreciated. The city of 
Washington, for example, obtains its milk supply from about 1,000 
dairy farms. Estimating the average number of persons living at 
a dairy farm at about 7, and considering the fact that every year, 
in the United States, about 1 person in every 300 has typhoid fever, 
some 25 cases per year may be expected to occur on the dairy farms 
supplying Washington with milk. 

When cases exist on the dairy farms, there is, in the majority of 
instances, much likelihood of the infection being conveyed from the 
patients to the milk. Frequently the cases are not recognized as 
typhoid until the second or third week of illness, during which period 
no precautions are taken. In many instances there are mild cases 
unattended by a physician and cases following an irregular course, 
which go through the attack without being recognized. Too fre- 
quently when the cases are correctly diagnosed in the comparatively 
early stages of the disease the disinfection of the patient's stools and 
urine and the other precautions necessary to prevent the spread of 
the infection are found to be woefully inefficient. 

When the infection is not destroyed as it leaves the body of the pa- 
tient, there are many ways in which the typhoid bacilli may be carried 
from a patient on a dairy farm to the milk. Thus, those caring for 
the sick or handling the soiled bedding or excreta of the patient may 
convey the infection on their hands or clothing. Persons who have 
recovered from the symptoms of the disease, but are still discharging 
the bacilli in their stools or urine may directly contaminate the milk 



155 

in handling it. Some persons after passing through an attack of 
typhoid fever continue to discharge the bacilli in their stools or urine 
for years. One of these "bacillus carriers" working in milk at a 
dairy farm or dairy may contaminate a can of milk from time to 
time and be the source of infection for a number of cases. 

There have been reported recently several outbreaks of milk-borne 
typhoid fever traced to infection from bacillus carriers. Albert 
reports an outbreak in October, 1907, at Cedar Falls, Iowa, in which 
13 cases occurred in the three families supplied with the suspected 
milk. The man who owned the cow and did the milking had had 
typhoid fever one year previous to the outbreak. He was found to 
have a slight cystitis and typhoid bacilli were demonstrated in the 
urine. No source other than the urine of this man could be discovered 
to account for the infection in the milk. 

Lumsden and Woodward & report an outbreak in September and 
October, 1908, in Washington, D. C, in which 54 cases occurred. The 
cases were among the customers of two different dairymen, both of 
whom, however, received a part of their milk supply from a certain 
farm. All the evidence obtained pointed to this farm as the source 
of the infection in the milk. No history of recent sickness on the 
farm could be ascertained. A search for bacillus carriers among the 
persons on the farm was made and in the specimen of feces obtained 
from one of the milkers — a woman who had had an attack of typhoid 
fever about eighteen years before the time of the outbreak — typhoid 
bacilli were found in large numbers. No source other than the feces 
of this woman could be discovered to account for the infection in the 
milk. 

Scheller, c in the course of an investigation of an unusual preva- 
lence of typhoid fever in a section near Konigsburg, Germany, 
directed his attention to the milk supply. He discovered, among 
those who handled the milk, a woman who was excreting in her 
stools and urine typhoid bacilli. There appeared to be no doubt 
that this woman, who had had an attack of typhoid fever seventeen 
years before, constituted the source of infection for the outbreak. 
There were on the estate 180 persons ; of these, 140 neither consumed 
nor in any way handled the milk and the excreta of all of them 
were found to be free from typhoid bacilli. Of the 40, however, 
who either handled or consumed the milk, 18 were found to be bacillus 
carriers. Only 4 of the 18 had had an a'ttack of typhoid fever and 
these 4 had had the attack some years before. Some of the car- 
riers were excreting the typhoid bacilli in the feces, some in the urine, 

a Hyg. Lab. Bull. No. 41, Jan., 1908, p. 49. 

6 Journ. Am. Med. Assn., March 6, 1909, vol. lii, pp. 749-752. 

c Centblt. f. Bakt, vol. 46, 1908, p. 385. 



156 

and some in both feces and urine. The large number suggested 
that they might be temporary or acute carriers. The woman origi- 
nally discovered to be a carrier was removed from the dairy. The 
milkers were required to wash their hands in a disinfectant solution 
before milking. Those who had typhoid bacilluria were treated with 
urotropin. Within a month after these precautions were taken the 
stools and urine of all the carriers were again examined bacterio- 
logically and all found negative except those of the original woman, 
whose excreta still contained typhoid bacilli in large numbers. 

The Strasbourg School has found, in a number of instances, such 
temporary or acute carriers among healthy persons living in close 
association with typhoid fever cases. 

The possibility of there being chronic or acute bacillus carriers 
among those concerned in handling the milk should be kept in mind 
in the investigation of a suspected milk supply. 

It is possible for persons in the early stage of the disease, and 
even before becoming ill enough to take to bed, to contaminate milk. 
The spread of infection from cases in the early stage has generally 
been considered of infrequent occurrence on the ground that the 
bacilli rarely appear in the urine before the end of the third week 
of illness and that few if any are discharged in the feces during the 
first week or two. On the contrary, H. Conradi, a who has made 
extensive studies on the conveyance of typhoid infection in Germany, 
states that he has reached the conviction that not only is the infection 
transmitted most often during the earliest stages of the disease, before 
its true nature has been recognized, but that it also frequently takes 
place during the incubation period. He bases this opinion on the 
observation that of 89 cases which he attributed to infection by con- 
tact, some 58 per cent of the secondary cases had onset of illness 
within a week after the onset of illness of the primary cases. 

Flies passing from infected excreta to the milk or the milk cans 
may readily convey the infection. 

The excreta of patients thrown into the privy or in the yard or field 
near by may be carried by drainage, seepage, on the feet of persons, 
etc., to the well, spring, or stream from which water is used for wash- 
ing cans, and so be conveyed to the milk. 

In country places there are frequent instances where chickens and 
other fowls have free access to the privy contents and may readily 
carry infection on their fe*et to the well or spring or to the dairy- 
house yard in which milk cans are set. The excreta of patients, care- 
lessly handled, may become dried and carried as dust into exposed 
milk or, more frequently perhaps, into exposed milk vessels. 

°Deut. Med. Woch., Oct. 10, 1907. 



157 

Bottles or cans in some way contaminated at the home or dairy in 
the city and without previous disinfection are again filled with milk 
at the dairy farm may be the means of conveying infection from the 
dairy farm back to the city. 

At the dairy. — Milk after it reaches the city dairy is exposed again 
to the danger of becoming contaminated by persons handling it or 
by flies, dust, etc. 

At the average large city dairy there are a number of employees 
who reside at their own homes. At times some of these persons may 
come directly from the bedside of a case of unrecognized typhoid 
lever in the family to the dairy and, as is the case too frequently, 
without being required to change their clothes or to wash their hands 
in a germicidal solution, engage in handling the milk. 

In some American cities many of the dairies are located in the 
most unhygienic sections, and frequently cases of typhoid fever are 
cared for in houses adjoining the dairy or even in the same building. 
In these instances it is easy to understand how flies may pass from 
the dejecta of a patient to a can or bottle of milk and so be the 
means of conveying the infection. Cans or bottles returned from 
houses in which there are typhoid patients and which have been 
handled by persons caring for the sick and not disinfected before 
being refilled may be the means of disseminating the infection in 
the milk. 

From the water used for washing the bottles or cans, etc., at the 
city dairy, the typhoid bacillus may reach the milk. Considering the 
immense dilution in which the typhoid bacillus must usually exist 
in water taken from a large volume, such as a river or lake, for supply- 
ing a city, it may be that persons are rarely infected directly by the 
organism in the water; but the occasional typhoid bacillus in the 
water, upon being introduced into the milk and there multiplying, 
may infect persons drinking that milk. 

At the grocery. — In the studies of Rosenau, Lumsden, and Kastle 
on the prevalence of typhoid fever in the District of Columbia there 
were found a number of instances in which typhoid patients were 
being cared for in rooms above or to the rear of small grocery 
stores. In these stores milk was sold in small quantities, often as 
little as a cent's worth at a time, so that a quart bottle would be 
divided among several customers. The same hands that nursed the 
patient purveyed the milk. In such instances not only is there a 
likelihood of infection being sent out in the milk directly from the 
store, but these much-handled bottles may do damage when returned 

to the dairy. 

, « 

° Hygienic Laboratory Bulletin No. 35, Report on the Origin and Prevalence 
of Typhoid Fever in the District of Columbia, 1907. 



158 

At the home. — Milk after being delivered to the house may become 
contaminated by the hands of those caring for the sick or by flies, 
etc., and be the medium of conveyance of infection to other members 
of the household. 

DETERMINATION OF AN OUTBREAK OF TYPHOID FEVER DUE TO 

INFECTED MILK. 

In the epidemiological studies of typhoid fever in a city a card 
should be kept for each milk dealer and on this card should be noted 
all cases of typhoid fever in persons who within thirty days previous 
to onset of illness have used milk supplied by that dealer. Thus, as 
soon as an unusual number of cases are reported along the route of 
any dairyman it is apparent on the card and attention may be given 
at once to the dairy and the farms supplying the dairy with milk. 

A number of conditions should be taken into consideration in 
determining what constitutes an unusual number of cases among the 
customers of a given dairyman. Of those conditions to be especially 
considered are the general prevalence of typhoid fever in the com- 
munity, the amount of milk sold, the method of handling the milk 
at the dairy, the number of sources from which the milk comes to 
the dairy, and the way in which milk is served to customers. 

Ten or fifteen cases occurring in the course of ten days among 
the customers of a dairyman who sold 1,000 gallons of milk daily, 
and who at his dairy mixed the milk received from the various 
dairy farms supplying him before delivering it to his customers, 
might not impress an investigator as being an unusual number of 
cases, especially if typhoid fever was generally quite prevalent in 
the community and the cases among the dairyman's customers were 
distributed over a large section of the city. On the other hand, if it 
were learned that at the dairy the milk was bottled directly from 
the individual cans as they came from the different farms, and that 
the 10 or 15 cases had occurred among persons who had been served 
with milk from one farm which supplied the dairy with 10 or 20 
gallons of milk daily, suspicion would fall at once upon the milk. 

In the first case, however, the milk might have been equally at 
fault, the infection having been originally in one can of milk as it 
came from the farm; but as the milk in this can was mixed with a 
large volume of other milk in which, due to temperature, lack of time, 
or other conditions, the infective organisms did not undergo much 
multiplication, and so were distributed in high dilution in the milk, 
even as they may be at times in cases of water infection. 

In order to properly charge to each dairyman the cases having 
used milk supplied by him it is necessary to take into consideration 
not only the source of the milk used regularly by the patient during 



159 

the thirty days previous to onset of illness but also of that used occa- 
sionally. Frequently it will be found that a family receiving its 
regular milk supply from a certain dairy will on occasions, when the 
regular supply is not sufficient for the needs of the day, obtain milk 
from some other dairy, directly or through the grocery store. The 
milk obtained on one of these occasions may be infected and so respon- 
sible for the case. The source of milk used at places other than the 
regular one for taking meals also should be ascertained if possible. 

Cases resulting from infection in the milk are by no means confined 
to persons who use milk as a beverage. The cream or milk used on 
cereals, fruits, or even in coffee may convey the infection. In the 
summer of 1906 in Washington there were six cases in one family of 
eight persons, all of which were attributed quite definitely to infected 
milk. None of the members of this family drank milk, but they all 
used cream on fruits and cereals. Of course the chances of contract- 
ing the infection from milk is greater among persons who use milk 
freely. 

George Newman a sums up the characteristics of milk-borne epi- 
demics as follows: 

(a) There is a special incidence of disease upon the track of the implicated 
milk supply. It is localized to such area. 

(&) Better-class houses and persons generally suffer most. 

(c) Milk drinkers are chiefly affected and they suffer most who are large 
consumers of raw milk. 

(d) Women and children suffer most, and frequently adults suffer propor- 
tionately more than children. 

(e) Incubation periods are shortened. 

(/) There is a sudden onset and rapid decline. 
(g) Multiple cases in one house occur simultaneously. 

(h) Clinically the attacks of the disease are often mild. Contact infectivity 
is reduced and the mortality rate is lower than usual. 

In the different outbreaks due to infected milk it is interesting to 
note how greatly the proportion of persons affected among the users 
of the milk varies. In some outbreaks the proportion is as great as 
25 per cent; for instance, in the epidemic at Palo Alto, Cal., in 1903, 
which was traced to infected milk by Fish, Mosher, and Snow. Of 
the 900 persons who used milk from the infected supply, 232 had 
typhoid fever. In other outbreaks the proportion is as low as 1 or 2 
per cent. Several conditions no doubt influence the proportion of 
persons affected, the most important of which probably is the amount 
of infection in the milk. In the Palo Alto epidemic it was deter- 
mined that the milk became infected through the water used for 
washing the cans and also at times for diluting the milk. This water 
was obtained from a creek which received the drainage from several 
houses in which there were patients with typhoid fever. The water 

a George Newman, Bacteriology and the Public Health, 1904. 



160 

of the creek for two or three weeks must have been quite heavily- 
charged with typhoid bacilli, so that probably the majority of the 
milk cans washed in this water received some of the organisms. 

It is easy to understand how a milk supply thus almost if not quite 
continuously infected for several weeks may cause the infection of a 
large proportion of the persons who use that milk; but when the 
infection is introduced into the milk at irregular intervals for a like 
period, as would be expected when the infection is conveyed on the 
hands or clothing of persons or by flies, etc., a very small proportion 
of the consumers of the milk may become infected. 

The susceptibility of the people supplied with infected milk, of 
course, would affect the proportion. In a community where typhoid 
fever had been prevalent for years, and in which there would be a 
number of persons rendered relatively immune by previous infection, 
we would expect less susceptibility than in a community where the 
disease had never prevailed. 

That it takes susceptibility plus exposure to infection for the 
disease to occur was strongly suggested by an instance in the course 
of a milk outbreak in the District of Columbia in the fall of 1906. In 
a children's home having about 100 inmates 7 children came down 
with typhoid fever within a period of two or three days. The way in 
which the milk was delivered to and served at the institution made it 
practically impossible for the 7 children affected to have drunk milk 
from any one can, or one day's delivery, from which at least 75 per 
cent of the children did not drink. Thus of 75 children almost cer- 
tainly drinking infected milk only 7 had the disease. It is conceiv- 
able that in such an instance the typhoid bacilli in the can or cans of 
infected milk either were very few in number or that they were not 
uniformly distributed through the bulk of the milk, so that only one 
or two of the children drinking from a 5 -gallon can of milk actually 
received any of the bacilli; but it seems much more reasonable to 
conclude that all of the 75 children received some of the bacilli and 
the escape of the majority was due entirely to lack of susceptibility 
at the time the organisms were ingested. 

It seems quite probable that different strains of the typhoid bacillus 
vary markedly in their infectiveness. The writer has become im- 
pressed with this view by observing in the course of his studies of 
typhoid fever in the District of Columbia frequent instances in which 
there are one or more cases of typhoid fever in a household in a most 
unhygienic and crowded neighborhood, many persons having free 
association with the patients, the excreta of the patients being handled 
with the grossest carelessness, flies swarming over the excreta as well 
as over the food for the sick and well, and yet under these apparently 
very favorable conditions for the spread of typhoid- fever infection 



161 

not a single secondary case develops among other persons in the 
household, or even in the neighborhood. In other instances, one or 
more cases are being cared for in a household in good sanitary sur- 
roundings, ordinary care as to cleanliness, disposal of patients' ex- 
creta, personal contact with patients, etc., being exercised, and yet 
two or three or more secondary cases develop among other persons in 
the house or in houses near by. 

Of course in making a comparison of such instances it can not be 
stated how much the results are affected by individual susceptibility 
or by the operation of some as yet unknown factor or factors in the 
conveyance of or in the establishment of susceptibility (perhaps 
specific) to typhoid- fever infection. 

It may be readily understood how strains of the organism of a low 
degree of infectiveness (and of virulence) getting into milk, there 
undergoing tremendous multiplication and so being distributed in 
large doses, may cause outbreaks of typhoid fever. This view of low 
infectiveness and virulence of the organism being offset by large 
dosage is supported by some of the features observed in a number of 
the reported milk-borne outbreaks. For instance, short period of 
incubation, sudden onset and rapid decline of attack, reduced contact 
infectivity and low fatality rate. 

It is theoretically possible, however, that these features are due to 
large dosage alone. Thus, a large number of virulent organisms 
upon being introduced suddenly into relatively highly resistant 
tissues, a pronounced reaction occurs (sudden onset of definite symp- 
toms) with resulting formation of relatively large amount of anti- 
bodies (rapid decline of attack, reduced contact infectivity, etc.). 

The establishment of milk as the causative factor in an outbreak of 
typhoid fever is based on the following points : 

(a) A sudden and marked increase in the number of cases along 
the route of some dairyman, without a corresponding increase in the 
number of cases among persons living in the same sections of the city 
but supplied with milk from other sources. In a town supplied largely 
or entirely by one dairyman a sudden increase in the number of cases 
would not implicate the milk unless other facts pointed to it and 
other factors could be excluded, but in large cities, where the people 
of practically every square are supplied with milk by two or more 
dairymen, an increase in the number of cases distinctly on the route 
of a given dairyman is quite easily determined. This fact alone is 
evidence that the milk is responsible, and if an investigation reveals 
that at a time corresponding to the period in which the group of cases 
along the dairyman's route became infected there was at the dairy or 
45276°— Bull. 56—12 11 



162 

one of the dairy farms a patient with typhoid fever whose discharges 
could readily have reached the milk, the chain of evidence is suffi- 
ciently strong to justify the assumption that the outbreak was due to 
the milk supplied by this dairyman, especially if the cases can not 
positively be proven to have been due to some other factor. 

(b) The demonstration of the typhoid bacillus in the suspected 
milk. When this is done, the chain of evidence is, of course, complete. 
But frequently it can not be done, because in the period of usually 
three or four weeks — covering the incubation period, diagnosis, and 
report of the cases — elapsing between the time of infection of the cases 
and the recognition of the outbreak, the typhoid bacillus has disap- 
peared from the milk. 

If cases of typhoid fever are not discovered to account for the 
infection of an implicated milk supply, it is well to examine bacteri- 
ologically the stools and urine of all persons who handle the milk at 
the farms and the dairy. In this way the source of the infection may 
be found in the discharges of some person who has the disease in an 
ambulant and unrecognized form (temporary bacillus carrier) or of 
some one who has been carrying the infection for months or even 
years (chronic bacillus carrier). 

Besides the large groups of cases of typhoid fever caused by in- 
fected milk, there must be in large cities frequently single cases or 
small groups of cases which are due to infection in the milk and yet 
can not be traced to that source. In a community where factors other 
than milk were operating to cause a rather extensive prevalence of 
typhoid fever, 5 or 6 cases occurring within a few days among the 
customers of a dairyman supplying several hundred families with 
milk would direct some suspicion toward that milk supply, but if 
this small group of cases should not be followed by an unusually 
large number of cases on the route of this dairyman and no typhoid 
cases were found on the dairy farm or at the dairy, these 5 or 6 cases 
would be placed by the investigator among those due to causes unde- 
termined or to causes other than milk. In many such instances, how- 
ever, these groups of cases are doubtless due to infection introduced 
in one of the many possible ways — hands, clothes, flies, water for 
washing cans, etc. — into a part of the dairyman's output of milk for 
perhaps only one day. . 

In cities having milk supplied by a number of dairymen, if several 
of these small groups of cases among customers of different dairy- 
men occur at about the same time, a list of the farms supplying each 
of the suspected dairies should be studied, and if it is found that two 
or more of these dairies receive milk from any one farm, an investiga- 
tion should be made of that farm, and in this way the source of the 
infection for the several groups of cases may be determined. 



163 

MEASURES TO PREVENT THE DISSEMINATION OF THE INFEC- 
TION OF TYPHOID FEVER IN MILK. 

(a) The prevention of the introduction of infection into milk. — 
This at once suggests itself as the proper measure ; but the difficulty 
of carrying it out practically becomes evident when we consider the 
number of farms from which the milk supply of the average Amer- 
ican city is obtained, the liability of cases of typhoid fever occurring 
on these farms, and the numerous ways in which the infection may be 
conveyed from the patient to the milk. New York City's milk sup- 
ply, according to Darlington, is derived from 35,000 farms, and 
shipped from 700 creameries, located in 6 States. It is easy to ap- 
preciate how difficult and expensive it would be to keep up a suffi- 
ciently thorough supervision of the multiple sources of that city's 
milk supply. It is practicable to accomplish much toward the pre- 
vention of the infection getting into the milk after the milk is de- 
livered to the city. The f ollowing requirements are suggested : 

1. Location of the dairies in good surroundings. 

2. The prevention of the handling of the milk by persons who are 
in contact with typhoid fever patients or who themselves are liable 
to be discharging typhoid bacilli in their excreta. It does not 
seem unreasonable to require the owner of a store in which milk is 
sold and in which there is a patient with typhoid fever to either 
remove the patient to a hospital or some other house or to close up 
the business until the danger from that patient is passed. 

3. Exclusion of flies ancf other insects so far as possible, by screen- 
ing, etc. 

4. Sterilization of bottles and cans returned from houses before 
being again filled with milk, or the use of paper bottles which would 
not need to be returned. 

5. The sealing of the bottles or cans of milk so that they may not 
be infected in the course of delivery. 

(b) The destruction of infection in milk. — This at the present time 
seems to be the cheapest and the most practicable method to prevent 
the spread of typhoid infection in the milk supply of cities. In 
exceptional instances when a dairy receives its supply of milk from 
only one or two farms over which a thorough supervision may be 
exercised, efforts to prevent the infection reaching the milk may be 
attempted. But for the general supply of cities officially supervised 
pasteurization of the milk is the best measure. Supplement this with 
an intelligent supervision over the depots and stores where milk is 
sold and milk as a causative factor of typhoid fever in cities would be 
removed. 

In other words, pasteurization appears at the present time to be 
the only practical solution of the milk problem. All objections to 
the proper pasteurization of milk seem to be entirely theoretical or 
such as may be readily overcome. 



164 

Of the theoretical objections, one frequently advanced in written 
or spoken arguments and placarded at model dairy farm exhibits is, 
" Pure milk is better than purified milk." That maj be true ; but 
how can pure milk be obtained in sufficient quantity to supply our 
larger cities and at what cost? 

Milk to be desirably clean must be obtained from especially well- 
equipped dairy farms and handled entirely by highly skilled and 
highly conscientious or closely guarded persons. The cost of install- 
ing such equipment and the employment of such a class of labor 
would have to be met by a decided increase in the price of milk, 
while pasteurization — certainly if done on a large scale — should not 
increase the price of milk more than a small fraction of a cent on 
the quart. 

Another objection to the pasteurization of milk is that the heat 
does not remove the objectionable bacteria, but simply kills them, so 
that the consumer gets the dead bacteria anyhow. That is true; 
but does it not appear safer to ingest these dead bacteria than to 
take into the alimentary canal the same bacteria living, which may 
continue to multiply and generate an increasing amount of products 
harmful to the human organism? No reasonable advocate of pas- 
teurization can hold that grossly dirty milk should be used as a food, 
either pasteurized or unpasteurized, the aim being to get milk as 
pure as practicable and then purify it to a point of safety. Milk 
containing only 10 bacteria to the cubic centimeter would not be safe 
if some of those bacteria were typhoid bacilli. 

Another seemingly entirely theoretical objection to pasteurization 
is that the heat changes the milk in some way so that it induces cer- 
tain diseases, such as scurvy and rickets, or lowers the resistance of 
persons using it so that they are more liable to certain infections, 
particularly intestinal diseases. The vast bulk of reliable evidence 
so far recorded on this subject indicates that this objection is not 
supported by facts, while there is constantly accumulating indis- 
putable evidence that there is much sickness caused by organisms in 
raw milk, which organisms would be destroyed by pasteurization. 

A removable objection to the pasteurization of milk is that the 
heat destroys the lactic acid producing organisms which cause the 
" natural souring " of milk, and leaves organisms which produce 
other kinds of fermentation ("putrefaction") to flourish. Should 
this objection prove, by further study, to be valid, it could be met 
readily by adding to the milk after it is pasteurized some pure cul- 
ture of lactic acid forming organisms. 

It seems that in pasteurization we have a practical, unobjection- 
able, immediately needed remedy, while in the necessary measures 
to obtain a pure milk supply for our larger cities we have but a 
hope for the future. 



4. FREQUENCY OF TUBERCLE BACILLI IN THE 
MARKET MILK OF WASHINGTON, D. C. 



(165) 



THE FREQUENCY OF TUBERCLE BACILLI IN THE MARKET 
MILK OF THE CITY OF WASHINGTON, D. C. 



By John F. Andebson, 

Passed Assistant Surgeon and Assistant Director Hygienic Laboratory, Public 
Health and Marine-Hospital Service, Washington, D. C. 



INTRODUCTION". 

Numerous investigators in recent years have shown the infectious- 
ness of milk containing tubercle bacilli for animals. Whether the 
milk from animals with tuberculosis but with healthy udders con- 
tains tubercle bacilli is not definitely settled. Many prominent scien- 
tists seem to have shown that at times the milk from such animals 
does contain tubercle bacilli virulent for laboratory animals, but in 
the view of recent work there may be some doubt as to whether the 
bacilli really passed through the udder but gained access to the milk 
from contamination with feces containing tubercle bacilli. 

Schroeder and Cotton a have recently shown that cows so slightly 
affected with tuberculosis as only to be discoverable by the tuberculin 
reaction pass virulent bacilli in their feces. Many believe that milk 
from a tuberculous cow with unaffected udder is free from infection 
and becomes infected from the feces of the animal or its environment. 
This observation is of the very greatest importance, and if confirmed 
shows, more than ever, that the greatest care is necessary in guarding 
milk from contamination from the time it is drawn until it is con- 
sumed. 

The milk supply of many of the cities of Europe and England has 
been examined for tubercle bacilli. Most observers have used the 
animal test; they have injected various amounts, either centrifugal- 
ized or not, into guinea pigs or rabbits. The percentage of samples 
showing tubercle bacilli has varied between very wide limits, no 
doubt dependent upon the difference in the number of tuberculous 
cows in the herds supplying milk to the different cities and on dif- 

a Schroeder, C. C. and Cotton, W. E. : Bull, of the Bureau of Animal Industry, 
1907. 

(167) 



168 

ferences in technic. Some observers have found that when a number 
of animals are inoculated with the same samples of milk only one, 
perhaps, will develop tuberculosis. Some centrifugalized the milk 
and gave sediment alone, while others gave sediment and cream. 

I will not enter into the question whether the tubercle bacilli found 
in milk are virulent for man, but give my results solely as to whether 
the market milk of the city of Washington contains tubercle bacilli 
virulent for guinea pigs. For myself I object most strenuously to 
using milk containing tubercle bacilli virulent for laboratory ani- 
mals arid prefer to leave the question as to their pathogenicity for 
man to be discussed by others. 

Before presenting the results obtained by me with the market milk 
of the city of Washington it will be interesting to refer briefly to 
results obtained elsewhere by others. 

REVIEW OE LITERATURE. 

Bang, B. Deut. Zeit. f. Thiermed. XI, 1884, p. 45. 

Injected apparently normal milk from the sound quarter of an 
udder another part of which was diseased, into the belly wall of two 
rabbits, which developed inoculation tuberculosis and died after 2% 
and 3J months, respectively. This was repeated later with two more 
specimens of milk, with the same result. He also demonstrated that 
the milk of tuberculous cows without demonstrable udder lesions, 
could contain tubercle bacilli. 

Stein, G. Experimentelle Beitrage zur Infektion der Milch perlsuchtiger Kuhe. 
Inaug. Dissert., Berlin, 1884. 

Intraperitoneal inoculation of guinea pigs with raw milk of tuber- 
culous cows. Ten negative and four positive results. In two of the 
latter tubercle bacilli were demonstrated, and two negative. Some 
of the cows had tuberculosis of the udder. 

Hirschberger, K. Experimentelle Beitrage zur Infectiositat der Milch tubercu- 
loser Kuhe. Deut. Arch. f. klin. Med., XLIV, 1889, p. 400. 

Twenty specimens of milk from tuberculous cows injected into the 
peritoneum of guinea pigs. None of the animals inoculated died of 
septic peritonitis. Eleven of the specimens proved to contain tubercle 
bacilli. (Other acid-fast organisms, of course, were not differen- 
tiated.) By microscopic examination only one of the specimens of 
milk was shown to contain tubercle bacilli. Tubercle bacilli oc- 
curred not only in milk from tuberculous udders, but also where 
the udders were sound, and where the cow was but slightly affected 
with tuberculosis. 

Gebhardt, F. Experimentelle Untersuchungen ueber den Einfluss der Verdun 
nung auf die Wirksamkeit des tuberkulosen Giftes. Virch. Arch., CIX, 
1890, p. 127. 



169 

First series (2.5 cubic centimeters of milk or dilutions injected into 
guinea pigs intraperitoneally ; milk from a tuberculous udder) : Un- 
diluted milk and 1 to 20, positive result ; 1 to 40 to 1 to 100, negative. 

Second series (2 cubic centimeters fluid injected intraperitoneally) : 
Undiluted milk, positive; 1 to 50 to 1 to 200, negative. 

Third series (1 cubic centimeter subcutaneously) : Undiluted milk 
and 1 to 50, positive; 1 to 100 to 1 to 1,000, negative. 

These results show the effect of dilution of infected milk by unin- 
fected milk, as it will be seen that dilutions of greater than 1 to 50 
failed to produce tuberculosis in the inoculated animals. 

In an examination of market milk from ten different sources in 
Munich, 2 cubic centimeters were injected into the peritoneum of 
guinea pigs with negative results in all cases. 

Ernst, H. C. How far may a cow be tuberculous before her milk becomes 
dangerous as an article of food? Amer. Jour. Med. Sci., XCVIII, 1890, p. 
439. 

1. Microscopic examination of cover-glass preparations made from 
milk of tuberculous cows without udder tuberculosis. Various parts 
of milk and cream examined : 

Specimens examined 114 

Specimens containing tubercle bacilli IT 

Per cent 31.5 

Cows examined 36 

Cows having tubercle bacilli in milk 10 

Per cent 27.7 

2. Inoculation of rabbits (method not stated) with similar milk: 

Rabbits surviving first few days, etc 49 

Rabbits becoming tuberculous 5 

Per cent 10.2 

Cows used 13 

Cows with milk shown tuberculous 3 

Per cent 23 

3. Inoculation of guinea pigs (method not stated) with similar 
milk: 

Guinea pigs after necessary exclusions 54 

Guinea pigs becoming tuberculous 12 

Per cent 22 

Per cent (author says) 28.57 

Cows used 14 

Cows giving tuberculous milk 6 

Per cent 42. 8 



170 

4. Feeding calves with similar milk, 5 out of 12 (41.66 per cent) 
became tuberculous. 

5. Feeding pigs with similar milk, 2 out of 5 (40 per cent) became 
tuberculous. 

McFadyean & Woodhead. On the transmission of tuberculosis, etc. Internat. 
Cong. Hyg. and Demog., 1891, sec. 2, p. 197. 

Inoculations with tuberculous udder juice and milk from tubercu- 
lous udders TO per cent were positive (14 of 19). Inoculations with 
nontuberculous udders and milk from tuberculous cows (udders not 
affected), 16 per cent were positive (2 of 13). 

Bang, B. Experiinentelle Untersuchungen ueber tuberculose Milch. Deut. 
Zeit. f. Thiermed. XVII, 1891, S. 1. 

Examined the milk of 28 cows having advanced tuberculosis, but 
no udder involvement. Rabbits injected, with 1 or 2 cubic centi- 
meters intraperitoneally. The milk of two of these cows was shown 
to contain virulent tubercle bacilli. 

Fiorentini, A. Giornale della R. Soc. d'igiene. 1892, p. 198. (Ref. in Baum- 
gartens Jahresb., 1892, p. 698.) 

Injected the milk of tuberculous cows into the peritoneum of 
guinea pigs, with positive results (tuberculosis) in three cases. In 
two of these there was udder tuberculosis. 

Friis, St. Beitrag zur Beleuchtung der Frage ueber die Ansteckungsgefahr 
der Handelsmilch mit bezug auf die Tuberkulose. Deut. Zeit. f. Thiermed., 
Bd. XIX, 1893, p. 115. 

Samples of mixed milk from 46 establishments in and about Co- 
penhagen were examined. Experiments from May to October. 
Eighteen samples must be excluded from consideration on account of 
the early death of the inoculated animals. Of the remaining 28 speci- 
mens, 4 were found to contain tubercle bacilli (14.3 per cent). One 
of the positive specimens was from a herd of 30 cows, only 1 of which 
was suspected of having tuberculosis, showing the danger of diluted 
tuberculous milk. The other milk in which the tubercle bacilli was 
found was from dairies having one or more tuberculous cows. 

Friis, St. Fortgesetzte Untersuchungen u. s. w. Deut. Zeit. f. Thiermed. Bd. 
XX. 1894, p. 195. 

In a former paper, q. v., the author has considered town milk, 
from Copenhagen. He now investigates country milk, taking the 
specimens at the railroad station upon the arrival of the milk. Ex- 
periments from January to May ; the former examinations were at a 
later time in the year. 



171 

Five cubic centimeters each of 40 specimens were injected intra - 
peritoneally into rabbits. Seven specimens excluded by early death 
of the animals. No tubercle bacilli were demonstrated in any of the 
remaining 33 specimens, although in one instance the findings were 
extremely suspicious. Consequently the country milk is regarded as 
being much freer from tubercular infection than the town milk. 
Also a much smaller percentage of animals died of peritonitis when 
injected with the country milk. 

Schroeder, E. C. Further experimental observations on the presence of tu- 
bercle bacilli in the milk of cows. Bulletin No. 7, B. A. I., Agric. Dept. 
1894, p. 75. 

1. Samples of mixed milk from dairies. Forty cubic centimeters of 
milk centrifuged, 5 cubic centimeters of sediment layer injected into 
the peritoneum of guinea pigs. Other pigs inoculated with 5 cubic 
centimeters of the whole milk. Of 19 specimens, 1 apparently con- 
tained tubercle bacilli as the animal receiving the whole milk died 
of tuberculosis. Its companion getting the centrifuged sediment 
remained normal. 

2. Samples of milk from tuberculous cows diagnosed clinically or 
by tuberculin. Milk of 12 such cows injected into guinea pigs. Only 
1 showed tubercle bacilli. 

3. Repeated injections into the same guinea pig of milk from the 
same tuberculous cow not having udder tuberculosis. Four such 
cows used, from 2 to 7 pigs receiving several injections of the milk 
of the same cow. None of the pigs became tuberculous. 

The author concludes that careful inspection of all dairy herds, 
which has for its object the detection and removal of all advanced 
cases of tuberculosis, and especially of cows with diseased udders, 
would probably exclude the sale of most infected milk. 

Ernst, H. C. Article on The Infectiousness of Milk, Boston, 1895. Pub. by Soc. 
for Promoting Agriculture. 

Modifies the statements of results made in a former article which 
was published before the completion of the experiments. 
A. Milk from cows having tuberculosis, but healthy udders. 

1. Cover-glass examinations. Thirty-six cows examined; tubercle 
bacilli in milk of 12 (33.33 per cent). 

2. Subcutaneous inoculation of guinea pigs. Eighty-eight guinea 
pigs inoculated; 12 became tuberculous. Fifteen cows examined; 
tubercle bacilli in milk or cream of 6 (40 per cent). 

3. Subcutaneous inoculation of rabbits. Ninety rabbits inoculated ; 
6 became tuberculous. Nineteen cows examined; tubercle bacilli in 
milk of 4 (21 per cent). 



172 

4. Feeding rabbits, details not given. Forty-eight rabbits fed; 2 
became tuberculous. Five cows examined; tubercle bacilli in milk 
of 1 (20 per cent). 

5. Feeding pigs. Ten pigs fed ; 5 became tuberculous. 

6. Feeding calves. Twenty-one calves fed; 8 became tuberculous. 

B. Milk at random from Boston supply. 

1. Cover-glass examination ; 1 specimen out of 33 contained tubercle 
bacilli. 

2. Inoculation of rabbits. Three out of 25 rabbits became tuber- 
culous. (From the tables it appears that 3 of 13 specimens contained 
tubercle bacilli, although this is not stated in the text.) 

C. Of 19 calves born of tuberculous cows, and autopsied within six 
days of birth, no evidence of tuberculosis was found. 

Obermuller, Kuno. Ueber Tuberkelbacillenbefunde in der Marktmilcn. Hyg. 
Rundsch., V, 1895, No. 19, p. 877. 

At first injected the milk without centrifuging. Some, at least, of 
the specimens had been freed from the slime layer in the creamery. 
Of 40 guinea pigs inoculated, 3 died of peritoneal tuberculosis. Eight, 
however, had died within a few hours of inoculation. Later he im- 
proved his technic by first centrifuging the milk and then injecting a 
mixture of the cream and sediment layers. By this method 38 per 
cent of all the animals injected became tuberculous. (Although the 
author does not specifically state it, it appears from the tables that of 
the 19 specimens the animals injected with which remained alive long 
enough to determine the presence of tuberculosis, 9 contained tubercle 
bacilli. 

Buege, A. Ueber die Untersucbung der Milcb auf Tuberkelbacillen. Inaug. 
Dissert., Halle, 1896. 

Nine specimens of Halle market milk were injected into IT guinea 
pigs intraperitoneally. Three specimens were excluded on account of 
the early death of the animals. In 2 of the remaining 6 specimens 
tubercle bacilli were demonstrated by the findings in the animals after 
death. He injected 5 cubic centimeters of a mixture of cream and 
sediment from the centrifuged 40 cubic centimeters sample used in 
each case. 

Delepine, S. Jour. Comp. Path, and Tber., vol. 10, pp. 150, 189. 

By microscopic examination found tubercle bacilli in 4 out of some 
40 specimens of unmixed milk. By the inoculation method, 20 to 
25 per cent of these milks were found to be tuberculous. He prefers 
the subcutaneous method of inoculation to the intraperitoneal, as 
being more delicate. 



173 

Hope, W. E. Report of the Medical Officer of Health, Liverpool, 1897, on tuber- 
culosis as affecting the milk supply of the city. 

Two hundred and twenty-eight samples of milk from town dairies 
were examined and 12, or 5.2 per cent, were found to contain tubercle 
bacilli. Sixty-seven samples from country dairies showed 9, or 13.4 
per cent, with tubercle bacilli. The work was done by Boyce, Dele- 
pine, Hamilton, and Woodhead. Animal inoculations, intraperitoneal 
or subcutaneous, of plain milk or of the sediment after eentrifuging. 

Massone, A. Annali d'igiene sperimentale, 1897, p. 239. (Ref. in Hyg. Rundsch., 
VIII, 1897, p. 605.) 

Examined a large series of samples of Genoa market milk for the 
presence of the tubercle bacillus. Centrifuged TO to 80 cubic centi- 
meters of the mixed milk for 15 minutes, and then injected 5 to 6 
cubic centimeters of a mixture of the cream and sediment into the 
peritoneum of guinea pigs. In 9 per cent of the cases tubercle 
bacilli were demonstrated in the milk by these means. 

Ott. Ein weiterer Beitrag zur Milchhygiene. Zeit. f. Fleisch und Milch- 
hygiene, 1897, VIII, p. 69. 

Examined specimens of mixed market milk for the presence of 
tubercle bacilli. By staining specimens of the milk, treated by a 
special process, he demonstrated tubercle bacilli in 5 out of 43 speci- 
mens. — 11.6 per cent. Guinea pigs were then inoculated intraperi- 
toneally with 5 cubic centimeters of a mixture of cream and sediment 
of centrifuged milk, obtained from the dealers who had furnished 
the tuberculous specimens. 



Speci 
men. 



Tubercle bacilli microscopic- 
ally. 

A few 

+ first examination; —second 
5 per field 

Few 

do 



Inoculation result. 



II 
III 



Pig 1 died in 23 days; tuberculous. Tubercle bacilli found. 
Pig 2 killed in 30 days; tuberculous. Tubercle bacilli found. 
Both pigs normal after 5 weeks. 

Pig 1 died in 28 days; tuberculous. Tubercle bacilli found. 
Pig 2 died in 35 days; tuberculous. Tubercle bacilli found. 
Both killed in 6 weeks. First normal; second tuberculous. 



Tubercle bacilli found. 
Pig 1 died in 40 days; 

mentioned. 
Pig 2 killed in 40 days; 

mentioned. 



tuberculous. Tubercle bacilli not 
tuberculous. Tubercle bacilli not 



In another series, 30 specimens of market milk were injected intra- 
peritoneally into 30 guinea pigs, 5 cubic centimeters each. Six ani- 
mals died of intercurrent diseases, only 2, however, too early for the 
development of tuberculosis. 

Four died of tuberculosis, but it was subsequently found that 2 of 
them had received milk from the same dealer. 

To sum up (after making the necessary exclusions), of 27 (author 
says 28) specimens, 3 contained virulent tubercle bacilli, (11.1 per 
cent) (author says 10.7 per cent). 



174 

Delepine, S. Brit. Med. Jour., 1898, vol. 2, p. 918. 

In a popular lecture, gives the following results with milks col- 
lected by health officers of Liverpool, Manchester, and elsewhere : 

(a) Seven specimens unmixed milk from cows showing no evidence of tuber- 
culosis. Tubercle bacilli in none of the specimens. 

(&) Twenty-two specimens unmixed milk from cows showing distinct evi- 
dence of tuberculosis and in 6 cases udder involvement. Tubercle bacilli in 
27.24 per cent. 

(c) Fifty -four specimens mixed town milk. Tubercle bacilli in 5.55 per 
cent. 

(d) One hundred and twenty-five specimens country farm milk. Tubercle 
bacilli in 17.6 per cent. 

The presence of tubercle bacilli was determined by inoculation of 
guinea pigs and their post-mortem examination. 

Petri. Zum Nachweis der Tuberkelbacilli in Butter und Milch. Arb. a. d. 
kais. Ges.-Amt., XIV, 1898, p. 1. 

Milk specimens taken from various places in Berlin. Centrifuged 
in 150 cubic centimeter flasks. Three cubic centimeters each of 
cream, skim milk, and sediment injected into 4 guinea pigs (12 
animals for each specimen). Later, on account of the lack of 
animals, 5 cubic centimeters from each specimen were inoculated into 
each of 4 guinea pigs. 

Sixty- four specimens were examined. Tubercle bacilli were dem- 
onstrated in nine (14 per cent). Tubercle bacilli-like rods, not true 
tubercle bacilli in 4 specimens (6.3 per cent). 

It appears that 200 out of the 478 animals died, mostly of peri- 
tonitis within the first three weeks, thus eliminating 7 specimens 
from consideration, and leaving 57 on which to base a percentage of 
incidence. As 9 of these contained tubercle bacilli, the corrected 
percentage would be 17.5. 

The importance of using a large number of animals for each speci- 
men is shown by the fact that in only 3 of the 9 positive specimens 
did more than 1 animal become tuberculous. In these 3 cases there 
were 2. 

Ascher. Untersuchungungen von Butter und Milch auf Tuberkelbacillen. Zeit. 
f. Hyg., Bd. 32, 1899, S. 329. 

Injected 17 specimens of Koningsberg milk into guinea pigs intra- 
peritoneally. One of the animals became tuberculous. The milk 
was partly centrifuged, and the cream and sediment injected, and 
partly uncentrifuged. No other acid- fast bacilli found. 

The first streams from the milking were used, which may account 
for the lower percentage of infected specimens detected by him than 
by Eabinowitsch, who used the last part of the milking. The com- 



175 

parison of results with these different portions of the milking may 
throw light upon the source of infection r>i the milk, whether from 
feces or from the milk glands. 

Jaeger. Ueber die Moglichkeit tuberkuloser Infektion des Lymph-systems durch 
Milch und Milchproducte. Hyg. Rundsch, 1899, IX, p. 801. 

Examined the milk supplied to a large hospital in Konigsberg. 
The dairy was in good condition and frequently inspected, but the 
cows were not tested with tuberculin. 

Six guinea pigs were injected with the milk intraperitoneally. 
Two died of sepsis, 2 remained normal, and 2 developed tuberculosis. 

One hundred specimens were examined by the coverglass method 
for the tubercle bacillus, which was demonstrated in 7 specimens. 

Kanthack, A. A., and Sladen, E. S. St. B. Influence of the Milk Supply on the 
Spread of Tuberculosis. Lancet, 1899, vol. I, p. 74. 

Examined the milk supply of the various colleges in Cambridge 
for the presence of the tubercle bacillus. Milk from 16 dairies was 
examined, 3 specimens from each. Two guinea pigs were injected 
subcutaneously with each specimen, one from the cream layer and 
the other from the sediment, after centrifuging 10 cubic centimeters 
of the milk for minutes; guinea pigs examined after death 
from disease or killed, the characteristic histological tubercle being 
deemed necessary for the diagnosis of tuberculosis. Of 33 animals 
suspected of being tuberculous 10 were found by microscopical exam- 
ination to be free from the disease, while of 23 having typical histo- 
logical tubercular lesions, 16 showed the presence of the bacillus. 

Eesults: Of 16 daries examined, 9 furnished tubercular milk. Of 
90 guinea pigs inoculated, 23 died from tuberculosis (25.55 per cent). 
It is interesting to note that 13 of these were inoculated with the 
cream layer, while only 10 received the sediment. 

Macfadyen, Allan. Lancet, 1899, vol. II, p. 849. 

In a report of work done at the Jenner Institute for the Hackney 
vestry, it appears that of 100 specimens submitted for examination 23 
had to be excluded from the results because of the premature death 
of the test animals. Of the remaining 77 specimens, 17, or 22 per 
cent, were found to be infected with virulent tubercle bacilli. The 
milk was centrifuged 30 minutes, the cream removed and the milk 
recentrifuged for 30 minutes. The sediment was then used for inocu- 
lating guinea pigs. 

Ostertag. Zeit. f Fleisch- und Milchhygiene, IX, No. 12, 1899, p. 221. 

Examined the milk of some 50 cows which had no clinical evidence 
of tuberculosis, but had reacted to tuberculin. Milk received with 



176 

complete precautions into liter flasks and immediately cooled. The 
cream rose during transportation and was pipetted off, and to it was 
added enough of the milk to make 80 cubic centimeters. This mix- 
ture was then centrifuged, and a mixture of cream, skim milk, and 
sediment injected into guinea pigs. Three or four animals were 
injected with 10 cubic centimeters of each specimen. Each specimen 
was also examined microscopically for the presence of tubercle bacilli 
and the remainder was fed to guinea pigs. 

Tubercle bacilli were not found in any specimen of the milk by 
microscopic examination. No pseudo-tubercle bacilli were found. 
Only 1 animal contracted tuberculosis out of all those injected, rep- 
resenting 1 specimen of 49. The other 3 animals receiving this same 
milk remained healthy and proved normal on section. The authors, 
for reasons which they give, do not regard this one case of tubercular 
infection as being due to the milk. They conclude that there were 
no tubercle bacilli in any of the 49 specimens. Fourteen specimens of 
the mixed milk from this herd were then examined. Only 11 re- 
mained for consideration. One of the injected guinea pigs was found 
tuberculous on being killed after seventy-one days, but the lesions 
were slight and the animal had lost only 20 grams. None of the fed 
animals became tuberculous. 

Rabinowitsch, Lydia, and Kempner, Walter. Zeit. Hyg. XXXI, 1899, p. 137. 

Recalls the results of earlier experiments of Rabinowitsch, in 
which of 25 samples of Berlin milk examined (1897), 7 (28 per cent) 
contained tubercle bacilli. The milk was centrifuged and a mixture 
of the cream and sediment layers injected into the peritoneum of 
guinea pigs. 

The present article deals with an examination of the milk of cows 
reacting to tuberculin. Of 14 such cows, 10, or 71.4 per cent, gave 
milk containing tubercle bacilli. The condition of these cows is here 
detailed : Only 1 had pronounced udder tuberculosis. Another had 
udder tuberculosis demonstrable only histologically. Three cows 
with advanced generalized tuberculosis gave histologically the picture 
of chronic interstitial inflammation of the udder. One cow had low 
grade tuberculosis. One had rales on one examination, but none on 
the next two. Two cows had no symptom of tuberculosis. Another 
showed symptoms of beginning tuberculosis only on the second and 
third examinations. 

This demonstrates that in beginning tuberculosis without discov- 
erable udder disease, and in latent tuberculosis demonstrable only by 
the tuberculin reaction, the tubercle bacilli may be present in the 
milk. They believe that repeated examination would have shown 
tubercle bacilli in the milk of more of these cows. 



177 

Boyce. (Results given by Annett, Lancet, 1900, p. 160.) 

He examined the market milk of Liverpool, England; his results 
are given in the following table: 

Year 1898 : Per cent tuberculous. 

Town milk (75 specimens) 6.6 

Country milk (28 specimens) 17.8 

Year 1899 : 

Town milk (75 specimens) 6.6 

Country milk (63 specimens) 17.4 

The superiority of the town milk is attributed to the inspections 
conducted in town. 

Rabinowitsch, Lydia. Deut. med. Wocb., XXVI, 1900, p. 416. 

Kepeatedly examined the milk of eight Berlin dairies. This milk 
was designed especially for the use of children, was not sterilized, and 
sold for 35 to 60 pfennig per liter. In three of these dairies the cows 
were rigidly tuberculin tested. No tubercle bacilli were ever found 
in this milk. In the other five the cows were subjected to clinical 
oversight by veterinarians, but the tuberculin test was employed only 
now and then upon suspicious animals. In three of these five dairies 
the milk was found to contain tubercle bacilli. The percentage of 
specimens containing tubercle bacilli is not stated. 

Klein. Zur Kenntnis der Verbreitung des Bacillus tuberculosis and pseudo- 
tuberculosis in der Milch sowie der Biologie des Bacillus tuberculosis. 
Centralbl. f. Bakt., 1900, 1. Abt, v. 28, Orig., p. 111. 

Klein examined 100 samples of milk from various country farms in 
the vicinity of London. The samples were placed in conical glasses 
and allowed to sediment. Smears were made from the sediment and 
examined microscopically for tubercle bacilli; guinea pigs were also 
inoculated subcutaneously and intraperitoneally with the sediment. 

Klein's results were : Eight guinea pigs died acutely, 7 showed 
positive tuberculosis, while 42 gave negative results at autopsy. The 
remainder showed staphylococcic and Streptococcic infection. 

Tonzig. Ueber den Antiel, den die Milch an der Verbreitung der Tuberkulose 
nimmt, mit besonderen Untersuchungen ueber die Milch des Paduaner 
Marktes. Arch. f. Hyg., 1900, v. 41. 
This author examined the market milk of Padua. Forty-six 
samples were centrif ugalized ' and the cream and sediment injected 
intraperitoneally into 103 guinea pigs. Nine died within forty-eight 
hours, and none of the remainder when they were killed showed tuber- 
culosis. Tonzig is of the opinion that the danger of infection with 
tubercle bacilli in mixed milk is only slight. 

The tubercle bacillus in milk. Swithinbank & Newman's Bacteriology of Milk, 
1903, p. 213. 
During 1901, 310 samples of milk were taken at the Manchester 
(England) railway station from the milk cans representing 272 

45276°— Bull. 56—12 12 



178 

farms. One hundred and seventy-two of these farms were in Chesh- 
ire, and 18 of them (10.46 per cent) supplied milk found to con- 
tain the tubercle bacillus; 65 were in Derbyshire, and 6 (9.23 per 
cent) supplied milk infected with tubercle bacilli; 25 in Stafford- 
shire, of which 2 (8 per cent) supplied tuberculous milk. 

Thus the milk sent by rail to Manchester from 272 farms, and 
examined by Professor Delepine, was tuberculous from 26 of the 
farms (9.5 per cent). (See Report Health City of Manchester, 1901, 
p. 238.) 

Collingridge. Tubercle bacilli in milk. (Editorial Abstract in Brit. M. J., 
1907, v. 1, p. 763.) 

In 1904, milk samples representing 22 counties in England were 
taken at the railway station and submitted to Doctor Klein, with the 
result that out of 39 samples tubercle bacilli were found in 3; in 
August, 1905, a second series representing 22 counties, and out of 22 
samples 2 contained tubercle bacilli; in 1906, a third series, repre- 
senting 13 counties, yielded 2 positive tuberculous milks out of 25 
samples. 

Proskauer, Seligmann, and Croner. Zeit. Hyg., Bd. 57, 1907, p. 173. 

Made an examination of the milk sent in from Denmark, compar- 
ing it with Berlin milk. The examination was very thorough, in- 
cluding a search for tubercle bacilli by means of animal inoculation. 
Danish milk: Thirteen specimens examined, 5 found to contain 
tubercle bacilli (38.5 per cent). There appears to have been a verbal 
agreement with the contracting parties that the milk furnished should 
have been heated 80° to 84° C. Berlin milk: Of 9 samples, 5 con- 
tained tubercle bacilli (55.5 per cent). However, in five tests of milk 
from dairies controlled by veterinary inspections no specimens were 
found to contain tubercle bacilli. 

Hess, Alfred H. The incidence of tubercle bacilli in New York City milk, 
with a study of its effects on a series of children. J. A. M. Ass., Vol. LII, 
No. 13. (19—.) 

One hundred and twelve specimens of raw milk were examined by 
inoculation into 224 guinea pigs of the cream and sediment obtained 
by centrifugalization, but in 5 instances the animals died within two 
weeks, or were lost in other ways, leaving only 107 samples to be con- 
sidered. 

There were 17 positive results out of the 107, which means that 16 
per cent contained tubercle bacilli. 

THE NUMBER OE TUBERCULAR COWS IN THE DAIRIES SUPPLYING 

WASHINGTON, D. C. 

A letter was addressed to Dr. W. C. Woodward, health officer, 
Washington, D. C, and to the Agricultural Department, requesting 
data as to the number of cows in dairies supplying milk to the city of 



179 



Washington that had responded to the tuberculin test. Dr. J. R. 
Mohler stated October 4, 1907, that of 1,147 recently tested cows sup- 
plying milk to the city of Washington, 214, or 18.6 per cent, responded 
to the tuberculin test. He stated that he did not consider this a fair 
estimate of the extent of tuberculosis in the dairy herds of this vicinity 
as the tests were only being applied to those herds which had recently 
been cleansed by private tests or appear so healthy that their owners 
have no fear of having them tested. 

I am informed by the District health department that 1,059 cows, 
from 51 herds in Virginia, Maryland, and the District of Columbia, 
supplying milk to the city of Washington were tested for their reac- 
tion to tuberculin; of this number 160, or 15.1 per cent of the total 
number of cows tested, responded to the tuberculin test. 

Of course the above figures furnished by the Department of Agri- 
culture and the District health department do not give a fair idea of 
the prevalence of tuberculosis in the herds supplying milk to Wash- 
ington, as only the owners of those herds who had reason to think 
that their cows were free from tuberculosis permitted the test to be 
made. If the test had been applied to all the cows supplying milk 
to the District, I have no doubt that the percentage would be very 
much higher than the above figures would seem to indicate. 

RESULTS OF TUBERCULIN TESTS ELSEWHERE THAN IN HERDS 
SUPPLYING WASHINGTON. 

The following figures by Salmon show the number and percent- 
age of cattle carcasses condemned for tuberculosis during the years 
1901-1905 in the meat-inspection service of the Bureau of Animal 
Industry : 



Year. 


Number ex- 
amined. 


Per cent 

con- 
demned. 


1901 
1902 
1903 
1904 
1905 


5,219,149 
5, 559, 969 
6, 134, 410 
6,350,011 
6,096,597 


0.10 
.14 
.14 

.16 
.18 



This does not show the total number of animals affected with tuber- 
culosis, for in many cases only a part of the carcass was condemned 
and probably many had the disease so slightly that the entire carcass 
was passed as fit for food. 

The following table, also taken from Salmon's article, showing the 
results of the tuberculin test of cattle in some States, is of value as 
showing the wide distribution of bovine tuberculosis. It must be 
remembered that most of the herds tested were suspected herds, 
which may account for the very high percentages found. 

° Salmon, D. E. : Bull. No. 38, Bureau Animal Industry, 1906. 



180 



Results of the tuberculin tests of cattle in various States. 



State. 



Number 
tested. 



Number 
tubercu- 
lous. 



Per cent 
tubercu- 
lous. 



Vermont 

Massachusetts 

Massachusetts, entire herds 

Connecticut 

New York, 1894 

New York, 1897-98 

Pennsylvania 

New Jersey 

Illinois, 1897-98 

Illinois, 1899 

Michigan 

Minnesota 

Iowa 



60,000 
24, 685 

4,093 

6,300 
947 

1,200 
34,000 

2,500 
929 

3,655 



Wisconsin: 

Experiment station tests — 

Suspected herds 

Nonsuspected herds 

State veterinarian's tests- 
Suspected herds 

Tests of local veterinarians under State veterinarian on cattle 
intended for shipment to States requiring tuberculin certificate. . . 



,430 
873 



323 

935 

588 
3,421 



2,390 

12, 443 

1,080 



66 

163 

4,800 



122 



115 

81 



191 

76 



3.9 
50.0 
26.4 
14.2 

6.9 
18.4 
14.1 
21.4 
12.0 
15.3 
13.0 
11.1 
13.8 



35.6 
9. 



32.5 
2.2 



THE CHARACTERISTICS OF RABINOWITSCH'S BUTTER BACILLUS. 

The results of some of the earlier workers are open to criticism in 
view of Rabinowitsch's discovery of an acid- fast bacillus in butter 
morphologically similar to the tubercle bacillus. If guinea pigs are 
inoculated with milk or butter containing the acid-fast butter bacillus 
they may often die and will present lesions to the naked eye very 
similar to those produced by the tubercle bacillus. For that reason I 
give the following description of the cultural characteristics and 
post-mortem appearances caused by this organism taken from 
Annett's article. 

The characteristics of Rabinowitsch's micro-organism are as fol- 
lows : It is immotile, and in form closely resembles the bacillus tuber- 
culosis. The bacilli generally occur singly and are often slightly 
curved; but when growing rapidly in tissue bacilli are often found 
lying parallel. Sometimes they form long unbranched threads and 
sometimes are divided into short pieces. The bacilli are somewhat 
thicker than the tubercle bacillus and often show a club-shaped 
swelling on one side. Spores are not formed, but one portion of the 
bacillus stains often more intensely than the rest. The bacilli stained 
by many methods of staining tubercle bacilli can not be distinguished 

a Annett, H. E. : Tubercle bacilli in milk, butter, and margarine. Report 
Thompson Yates Laboratory, 1898-99, pp. 29-35. 



181 

from the latter; only by the employment of very dilute watery 
solutions of methylene blue could any distinguishing feature be ob- 
served, viz, that bacilli from a culture of bacillus tuberculosis stain 
only at one spot, the rest of the bacillus remaining unstained ; while 
in the case of bacillus pseudo-tuberculosis the whole bacillus stains 
faintly and generally uniformly, seldom showing a more deeply 
stained part. 

Cultural differences, however, occur. On agar, the bacilli taken 
direct from an infected animal produce visible colonies on the second 
or third day. At first the agar surface is covered with a thick, moist, 
creamy layer; in old cultures by a folded membrane often orange or 
copper colored. After repeated passages through animals cultures 
on agar or glycerin-agar show a dry, brittle, crumpled membrane 
resembling that of bacillus tuberculosis. In plate cultures the deep 
colonies are gray in color, round or oval, and uniformly granular. 
On the surface, colonies are better developed, have a uniform granu- 
lar gray center, and a clear, wavy outer zone. The surface of the 
colony is often dry and conical. On butter-agar in fresh cultures the 
colonies are small, white, and dry, later spreading over the whole sur- 
face and becoming yellow or copper colored. On potato a luxuriantly 
growing, moist, gray layer is formed. In gelatin, growth proceeds 
very slowly at ordinary room temperatures, colonies becoming visible 
on the third day. In broth, and especially in glycerin broth, growth 
is rapid, forming in two or three days a folded membrane on the 
surface, the broth remaining clear, the culture closely resembling that 
of bacillus tuberculosis. Broth cultures are distinguishable from 
those of bacillus tuberculosis by their characteristic odor, being un- 
pleasant and ammoniacal; that of bacillus tuberculosis being agree- 
able and resembling the odor of flowers. A small quantity of indol 
is formed in broth cultures, which is not so in bacillus tuberculosis 
cultures. Milk is not coagulated, and on the surface is an abundant 
yellowish-red layer which clings firmly to the glass. On albumin- 
free colorless media a growth appears in two or three days, becoming 
in. ten days a thick, yellow, folded membrane; bacillus tuberculosis in 
the same time on such media forming a thin layer just covering the 
surface and just beginning to fold. The presence of fat in these ba- 
cilli can easily be demonstrated, as in the case of bacillus tuberculosis. 

PATHOGENIC PROPERTIES OF BACILLUS PSEUDO-TUBERCULOSIS. 

The following are the post-mortem appearances observed in a 
guinea pig killed three or four weeks after intraperitoneal injection 
of butter containing the bacillus pseudo-tuberculosis: There is a 
slightly distended abdomen; also peritonitis, with adhesions varying 
in nature from delicate fibrinous bands to firm connective tissue. 



182 

The peritoneum and mesentery are studded with nodules. The 
mesenteric glands are swollen and may contain purulent or caseous 
matter. The liver is covered with nodules and patches which may 
be raised above the liver substance or may penetrate into the liver 
parenchyma. The spleen is sometimes only enlarged; at other times 
thickly studded with nodules. The kidneys show yellowish patches. 
The lungs are covered with small transparent nodules which do not 
penetrate into the lung tissue. The sternal lymphatic glands are 
swollen, but show no caseation. Numerous bacilli can be demon- 
strated in these lesions. Many animals after injection show con- 
siderable signs of illness during the first fourteen days, with diminu- 
tion in weight, and then recover. Pure cultures of this bacillus 
are only pathogenic for guinea pigs (but not always) ; rabbits 
and white mice are immune. After intraperitoneal inoculation of 
guinea pigs some die in from four to eight weeks, with considerable 
emaciation, and show the following post-mortem appearances: At 
the seat of inoculation there is a purulent infiltration containing 
the characteristic bacilli; also peritonitis, varying in intensity from 
a flocculent fibrinous exudation to strong connective tissue adhesions. 
The mesentery is studded with small nodules ; the glands are en- 
larged, but not caseous; there are patches on the liver, and miliary 
nodules throughout an enlarged spleen. The thoracic cavity and or- 
gans are often almost exempt from lesions. Infected animals do not 
react to tuberculin. Histologically the nodules in the liver and 
spleen consist of a collection of lymphoid elements with but very 
few epithelioid and multinuclear cells. The bacilli are found in the 
middle of a young nodule, toward the periphery if caseation has 
commenced. The typical giant cells of tuberculosis do not occur. 
More often — especially after inoculation with butter containing 
the pseudo-tuberculosis bacilli — the nodules appear to consist of a 
central necrosed portion surrounded b}^ a leucocytic infiltrated area. 

COLLECTION OF SAMPLES AND TECHNIC. 

The samples of milk were all collected and brought to the Hygienic 
Laboratory by an inspector of the health department of the District 
of Columbia. Usually a pint bottle, though sometimes a quart, with 
the paper cap untampered with was obtained either from the diary 
or delivery wagon. The bottle was at once placed on ice by the col- 
lector and usually reached the laboratory in about one hour after 
collection. A few samples were obtained from some of the hospitals 
and charitable institutions of the District. The milk and cream were 
well mixed by vigorously shaking the bottle. The sample for plat- 
ing was taken out with a sterile pipette, and then 50 cubic centimeters 
of the mixed milk was put into a large sterile centrifuge flask. To 



183 

the 50 cubic centimeters of milk was added 100 cubic centimeters of 
sterile water. The flask was then put into the centrifuge machine and 
centrifuged for one hour at about 2,000 revolutions per minute. The 
milk was diluted with twice its volume of water with the idea that 
it would decrease the specific gravity of the milk and so permit of 
the easier sedimentation of the tubercle bacilli. Usually only one 
animal was inoculated from each sample, though in some cases two 
animals were used. Guinea pigs, largely those raised in the labora- 
tory, of as uniform weight as obtainable, were inoculated with 5 cubic 
centimeters of the sediment of this centrifugalized mixture of milk 
and water. The inoculation was made subcutaneously in the belly 
wall. For each guinea pig a different syringe was used. All of the 
guinea pigs, usually 8, that being the usual number of daily samples, 
inoculated on the same day were kept in the same cage, those that 
remained healthy being controls on their environment, etc. The 
guinea pigs were examined for enlarged glands after about four weeks, 
and those with enlarged glands were separated from the others so 
as to avoid the danger of infecting others if the glands broke down. 

Many of the animals inoculated died from acute infection with the 
millions of other bacteria in the milk. Autopsies were made on all 
the animals that died, but no attempt was made to determine the 
causal organisms other than the tubercle bacillus. 

Those guinea pigs which did not die in at least two months were 
chloroformed, after having been tested with tuberculin, and careful 
autopsies were made on each animal. Smears, cultures, and sections 
were made from the various organs of the animals that showed any 
change from the normal. The smears were stained with carbol- 
fuchsin and examined for acid-fast bacilli. Cultures were made on 
glycerinized potato and glycerin-agar. In no instance did any of the 
cultures show a quick-growing acid-fast organism resembling in any 
way Rabinowitch's butter bacillus. The sections were stained with 
carbol-fuchsin for tubercle bacilli, and also with hsemalum and eosine 
for histological appearances. The above details were carried out with 
few exceptions in all of the animals that gave a positive result. 

It occurred to me that those animals which had tuberculosis might 
be differentiated from those with other infections by giving all of 
the guinea pigs alive at the end of two months a sufficient dose of 
tuberculin to cause the death of the tuberculous animals in less than 
twenty-four hours. Several preliminary tests on known tubercular 
animals showed that 2 cubic centimeters of crude tuberculin given 
subcutaneously would almost invariably cause the death of such a 
guinea pig in from six to eighteen hours. As high as 7 cubic centi- 
meters of the same tuberculin given to a healthy pig caused only a 
temporary discomfort, passing off in a few hours. A rather hasty 



184 

search of the literature failed to show that this idea of giving an 
amount of tuberculin sufficient to cause the death of a tubercular 
animal as a means of differentiating true tuberculosis from infection 
with other acid- fast organisms had ever been used by previous work- 
ers. The febrile reaction in a sick guinea pig on account of the great 
variation in the temperature of the animal from handling, etc., is too 
variable a factor, and a more definite reaction, such as the death of 
the animal, is necessary. The technic was as follows: All of the 
animals, in lots of about 30, were given early in the morning 2 cubic 
centimeters of the tuberculin subcutaneously ; they were closely 
watched and as soon as an animal appeared sick it was placed aside; 
as soon after death as possible the animal was autopsied; smears, 
cultures, and sections were made. Of all the guinea pigs, about 250, 
that received the tuberculin, no animal that did not have tuberculosis 
died. Two or three that had slight lesions did not die, but became 
sick. It was noted that all of the animals died whose lesions had 
caseated. The reaction, I think, was of distinct service in eliminat- 
ing infections with other acid-fast organisms. The suggestion is 
made that with some modification the procedure may have a distinct 
place as an aid in differentiating true tuberculosis from infections 
with other acid-fast organisms which produce tubercular-like lesions. 

Samples of milk were examined from 104 different dairies; 10 
samples from 7 hospitals and asylums are also included in this num- 
ber, they being charged also to the dairy supplying the milk. 

The following tables show the laboratory number of the dairy, 
where collected, date of collection, whether the guinea pig inoculated 
died or was killed, interval between inoculation and death, and results 
of the autopsy. 

It is interesting to note that where 2 guinea pigs were inoculated 
with the same sample of milk, in two instances both animals showed 
tuberculosis and in two instances only one was positive : 

TABLE No. 1. 



03 




Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


be bo 

6 


Pres- 
ent. 


Ab- 
sent. 


44 




July 22 
Aug. 5 
Aug. 19 
....do... 


Wagon 


No. 1.. . 
....do.. . 


Died... 
....do. . 

Killed . 

Died... 

Killed . 
....do. . 


20 
2 

72 

4 

101 

86 

27 
63 


No evidence of tubercle. 






132 








?30 


do 


....do... 


Negative 






?31 


do 


do ... 








14 




July 15 
July 3n 

....do... 




No. 2. .. 
....do... 








inn 


Providence Hos- 
pital. 
do 


do 






101 


do 


Died... 
Killed . 








329 




Aug. 30 


do 


....do... 


Negative 







185 



TABLE No. 1— Continued. 



03 

® 

c 

tJO bio 


1 

3 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


6 
5? 


Pres- 
ent. 


Ab- 
sent. 


330 




Aug. 30 


Providence Hos- 


No. 2 . . . 


Killed . 


63 


Negative 












pital. 














281 




Aug. 26 
.do ... 




No. 3... 


....do.. 


61 


do 






282 




do 


....do... 
No. 4. .. 


....do. . 
....do.. 


61 

88 


do 






114 




Aug. 1 


do 


do 






299 




Aug. 27 


do 


....do... 


Died... 


5 








300 




do . 


.. ..do... 


do ... 


Killed . 
Died... 


95 

2 








?, 




July 12 
Aug. 7 
....do... 




No. 5.. . 








Iffi 






....do... 


....do. . 


8 








156 




do 


....do... 


Killed . 


82 


Negative 






61 




July 24 


do 


No. 6.. . 


....do. . 


93 


do 






86 




July 29 
Aug. 22 




....do... 


....do. . 


90 


do 






256 




do 


....do... 


....do. . 


70 


.....do 






143 




Aug. 6 


do 


No. 7... 


....do. . 


84 


do 






17 




July 16 


do 


No. 8... 


....do.. 


100 


do 






122 




Aug. 2 


do 


....do... 


....do.. 


87 


do 






7 




July 12 




No. 9.. . 


....do. . 


104 


do 






48 




July 22 

Aug. 14 
....do... 




....do... 


Died... 
....do. . 


21 
57 


No evidence of tubercle. 
do 






195 


Dairy 


....do... 






196 




do 


....do... 


Killed . 


77 








303 




Aug. 28 


do 


....do... 


....do.. 


65 


do 






163 




Aug. 8 
Aug. 20 


do 


No. 10... 
....do... 


Died... 

....do. . 


81 

57 


do 






239 


No evidence of tubercle. 






51 




July 23 
July 24 
July 25 
July 26 


Wagon 


No. 11.. 


Killed.. 


94 








64 




Dairy 


do... 


...do... 


94 


do 






68 




Wagon 


....do... 


...do... 


92 


do 






78 




Children's Hos- 
pital. 


....do... 


Died... 


3 
















85 




....do... 


do 


....do... 


Killed.. 


92 


Negative 






119 




Aug. 1 


Columbia Hos- 


....do... 


Died... 


1£ 














pital. 














123 




Aug. 2 


do 


....do... 


Killed., 


77 








131 




Aug. 5 
Aug. 19 
July 17 
Aug. 7 


Wagon 


....do... 


Died . . . 


72 








226 




do 


do... 


Killed.. 








27 






No. 12... 


Died 


19 








151 




Dairy 


No. 13... 


Killed.. 


83 








97 




July 30 




No. 14... 


...do... 


88 


do 






105 




July 31 
Aug. 7 
July 29 


Wagon 


No. 15... 


do .. 


89 


do 






146 




do 


....do... 


Died... 
Killed.. 


4 
89 








93 


Dairy 


No. 16... 


Inguinal and retroperi- 
toneal glands caseous; 


+ 


































mediastinal glands 




















enlarged; spleen en- 




















larged and studded 




















with tubercles; liver 




















and lung numerous 




















tubercular foci; sec- 




















tions show histolog- 




















ical tubercles and tu- 




















bercle bacilli. 






41 




July 19 




No. 17... 


...do... 


98 


Negative 







186 

TABLE No. 1— Continued. 



c3 
§ 

3 . 

t>0 bo 


3 


Date or 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


■gp. 

6 


Pres- 
ent. 


Ab- 
sent. 


57 




July 23 
Aug. 6 
Aug. 20 




No. 18... 


Killed . 


93 








144 






do. .. 


do .. 


83 


do 






237 




Wagon 


....do... 


...do... 


69 


Inguinal and retroper- 
itoneal glands en- 


+ 




































larged and caseous; 




















spleen and liver en- 




















larged and studded 




















with tubercles; lungs 




















contain tubercular 




















foci; sections show 




















histological tubercles 




















and tubercle bacilli. 






22 




July 16 




No. 19... 


Died... 


66 


No evidence of tubercle. 






76 




July 25 
Aug. 13 
Aug. 30 
July 17 




do... 


Killed.. 


92 








191 




do 


.. do. .. 


Died... 
Killed.. 


3 
63 








323 


.. .do 


do... 








25 






No. 20... 


...do... 


100 


do 






70 




July 25 
July 29 
Aug. 12 
Aug. 23 

July 16 




. do . . . 


...do... 


93 


do . 






88 






do... 


Died 


33 








179 






. do . . . 


Killed.. 


68 








274 






do. .. 


...do... 


69 


do 






20 






No. 21... 


....do.. 


100 


do 






1W» 




Aug. 2 
Aug. 21 
Aug. 27 
....do... 


Dairy 


. .do... 


....do.. 


97 


do 






?47 




do 


do... 


Died... 


li 

65 


.do 






W7 






do 


Killed. 


do 






?<W- 




do 

do 


do... 


....do.. 


65 
40 


do 

No evidence of tubercle. 






321 




Aug. 30 


....do... 


Died... 




39 




July 19 


do 


No. 22 . . 


Killed.. 


98 








102 




July 30 


do 


....do... 


....do.. 


88 


do 






188 




Aug. 13 
July 31 


.. ..do 


do . 


Died... 


20 








108 




do 


No. 23 . . 


Killed.. 


89 








21 




July 16 
Aug. 2 
Aug. 9 
Aug. 21 




No. 24 . . 
do 


....do.. 
...do . 


100 

87 


.....do 






m 




do 






166 




Dairy 


....do... 


....do.. 


81 


do 






248 




.....do 


....do... 


Died... 


2 








325 




Aug. 30 
....do... 




do . 


. . do . 


41 








326 




do 


....do... 


....do.. 


2 

89 








107 




July 31 




No. 25 . . 


Killed.. 








?m 




Aug. 22 
Aug. 26 




.do . . 


do . 


70 


do. 






279 




do 


....do... 


....do.. 


66 


do 






169 




Aug. 9 
July 15 


Wagon 


No. 26 . . 


....do.. 


80 


do 






10 




do 


No. 27.. 


Died... 


5 








S? 




July 23 
do 


do. 


. .do 


Killed 


94 








53 




do 

do 


do 


do 


93 
83 


do 






145 




Aug. 7 
Aug. 22 


do .. 


do.. 


do... 






263 




do 


....do... 


....do.. 


83 


do 






28 




July 17 




No. 28.. 


Died... 


4 


do 






73 




July 25 




....do... 


Killed.. 


93 


do 






74 




....do.. 




do 


Died 


35 








153 




Aug. 7 
Aug. 29 




... do... 


Killed.. 


83 








319 




do 


....do... 


....do... 


63 


do 







187 

TABLE No. 1— Continued. 



1 

be bo 

•g'S 
d 


9 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


Pres- 
ent. 


Ab- 
sent. 


3?o 




Aug. 29 
July 19 
July 31 
Aug. 22 
July 18 
Aug. 22 




No. 28.. 


Killed. . 


63 








40 






No. 29.. 


....do.. 


98 


do 






106 






....do... 


..do.. 


89 


do 






?61 






do... 


do. . 


70 


do . 






31 




Wagon 


No. 30.. 


....do.. 


99 


do 






258 




do 


....do... 


....do.. 


70 


do 






98 




July 30 




No. 31 . . 


....do.. 


82 


do 






1? 




July 15 
July 24 
Aug. 12 
July 17 




No. 32.. 
....do... 


....do.. 
Died... 


101 

n 


do 






67 










178 






. . do... 


Killed.. 


83 








29 






No. 33.. 


Died... 


3 








71 




July 25 




....do... 


Killed.. 


93 


Inguinal, axillary and 


+ 


















retroperitoneal 




















glands caseous ; 




















spleen enlarged, stud- 




















ded with tubercles; 




















liver and lung con- 




















tained many tuber- 




















cles; sections show 




















histological tubercles 




















and tubercle bacilli. 






T> 




...do... 




....do... 


....do.. 


93 


Negative 






171 




Aug. 9 


Dairy 


....do... 


Died... 


24 


No evidence of tubercle. 






?3? 




Aug. 19 
....do... 


do 


....do... 


....do.. 


4 








?33 




do 


....do... 


....do.. 


2 

88 








111 




Aug. 1 
Aug. 15 
Aug. 29 
Aug. 2 
Aug. 20 


Wagon 


No. 34... 


Killed 








?11 




Dairy 


do ... 


do.. 


76 


do... 


i 




811 






do. .. 


do 


63 


...do 






1?1 




. .do 


No. 35... 


.. do . 


87 


.do 






238 




do 


....do... 


....do.. 


70 


do 






260 




Aug. 22 


do 


No. 36.. 


....do.. 


70 


do 






?16 




Aug. 16 


Dairy 


No. 37 . . 


....do.. 


76 


do 






113 




Aug. 1 
Aug 6 
Aug. 19 
Aug. 27 
July 15 


Wagon 


No. 38 . . 


....do.. 


88 


do 






14? 




do 


....do. 


....do.. 


84 
14 
65 


do.... 






??9 


do 


do. .. 


Died . . . 
Killed.. 








296 


do 


....do... 








15 




do 


No. 39 . . 


....do.. 


101 


do 






94 




July 29 
Aug. 19 
....do... 


Dairy 


....do... 


Died... 


5 








??3 




Wagon 


....do... 


Killed.. 


73 








??4 




. .do 


do... 


Died . . . 
Killed . 


11 
61 








283 




Aug. 26 
do. 


Dairy 


....do... 








284 




do 

do 


do... 


....do.. 


61 

84 


do 

do 






138 




Aug. 6 


No. 40.. 


....do.. 




315 




Aug. 29 


do 




....do.. 


63 


do 






3? 




July 18 
July 24 
July 26 
Aug. 12 




No. 41 . . 
do. .. 


....do.. 
do 


99 
93 


do 






66 




. .do. 






79 






.do . 


. do 


92 


.do 






174 




do 


....do... 


Died... 


1£ 








?34 




Aug. 20 


.....do 


do. 


Killed 


71 








235 




...do... 


do 


do.. . 


do 


71 
76 


do 

do 






207 




Aug. 15 


Dairy 


No. 42 . . 


....do.. 




24 




July 17 




No. 43 . . 


....do.. 


100 


do 







1.88 

TABLE No. 1— Continued. 



c3 
<D 


4^ 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


bCbc 

6 


Pres- 
ent. 


Ab- 
sent. 


128 




Aug. 5 


Dairy 


No. 4, . . 


Killed . 


84 








295 




Aug. 27 


Wagon 


....do... 


....do 


65 


do 






23 




July 17 


do 


No. 44 . . 


....do.. 


100 


do 






177 




Aug. 12 
Aug. 21 


do 


....do. 


Died . . . 
Killed . 


70 
71 


do 






244 


do 


....do... 


do 






245 




....do... 


Georgetown 
Hospital. 


do . 


do 


69 


do 
























?A(\ 




do. .. 


do 


. do 


do 


69 
62 


. .do 






m 




Aug. 30 
July 12 
July 26 
Aug. 12 


....do... 


. .do 


do 






6 






No. 45 . . 
....do... 


....do.. 
Died... 
. .do 


104 
11 

If 

42 


do 






83 




do 






172 




....do. . 


do 






173 




....do. .. 


do 


....do... 


Killed . 


Inguinal glands caseous ; 


-~ 


















axillary and medias- 




















tinal glands enlarged; 




















spleen enlarged and 




















studded with tuber- 




















cles; few foci in liver; 




















sections show histo- 














• 






logical tubercles and 
tubercle bacilli. 






26,5 




Aug. 23 
....do... 


do 

do 


....do... 
..do 


Died... 
do 


4 
62 








266 


Inguinal, axillary and 
retroperitoneal 






































glands enlarged and 




















caseous; spleen and 




















liver enlarged and 




















studded with tuber- 




















cles; lungs contain 




















many tubercle foci; 




















sections show histo- 




















logical tubercles and 




















tubercle bacilli. 






267 




....do... 


do 


...do .. 


Killed 


68 


Inguinal, retroperito- 
neal and mediastinal 


+ 




























\ 






glands enlarged and 




















caseous; liver and 




















spleen enlarged and 




















studded with tuber- 




















cles; sections show 




















histological tubercles 




















and tubercle bacilli. 






159 




Aug. 9 




No. 46 . 


do 


82 


Inguinal glands en- 
larged; spleen greatly 


+ 


































enlarged, contains nu- 




















merous tubercles; few 




















tubercles in liver; sec- 




















tions show histolog- 




















ical tubercles. 






268 




Aug. 23 


do 




....do.. 


69 


Negative 






75 




July 25 
Aug. 27 




No. 47 . . 
....do... 


Died... 
Killed . 


17 
65 


No evidence of tubercle. 
Negative 






291 


Wagon 







189 

TABLE No. 1— Continued. 



1 


bp 

'5 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


Ml bC 

d 
8 


Pres- 
ent. 


Ab- 
sent. 


?m 




Aug. 27 
Aug. 2 




No. 47 . . 


Killed . 


65 








120 




do 


No. 48 . . 


....do.. 


87 


do 






4 




July 12 
Aug. 16 
Aug. 28 
July 16 




No. 49... 
....do... 


....do... 
....do... 


104 
75 


do 






??? 




do 






307 






. do.... 


...do... 


64 


do 






18 




do 


No. 50... 


....do... 


96 


do 






236 




Aug. 20 


do 


....do.... 


....do... 


71 


do 






168 




Aug. 9 


do 


No. 51... 


....do... 


81 


do 






324 




Aug. 30 


do 


....do.... 


....do... 


62 


do 






77 




July 25 
Aug. 12 


do 


No. 52.. 


Died. 


3 








180 




do 


....do.... 


....do... 


3 








181 




Aug.. 12 
July 22 


do 


do.... 


Killed.. 


71 








43 






..No. 53.. 


Died... 


22 


No evidence of tubercle. 






65 




July 23 




....do.... 


Killed.. 


93 


Negative 






89 




July 29 
Aug. 7 
Aug. 12 




do. . 


do... 


90 


do... 






159 






do. . 


do... 


83 


...do... 






18? 




Garfield Hospi- 
tal. 


No. 54. 


do... 


83 


.do 






















183 




....do.... 
Aug. 13 


do 

do 


....do.... 
....do.... 


....do... 
....do... 


83 

78 


do 






192 


do 




46 




July 22 




No. 55... 


Died... 


4 








149 




Aug. 7 
....do.... 




do... 


....do... 


1* 
83 








1.50 




do 


do 


Killed.. 








270 




Aug. 23 


do 


....do... 


....do... 


69 


do 






271 




do... 


do 


....do... 


....do... 


69 


Anterior mediastinal 
glands enlarged and 
caseous; liver studded 
with numerous tuber- 
cles ; tubercle bacilli 
found in smears. 


+ 




80 




July 26 
Aug. 23 
Aug. 9 




No. 56. . 


do. . 


92 








?,73 






do 


do . 


69 


..do 






165 




Wagon 


No. 57... 


....do... 


81 


do 






54 




July 23 


do 


No. 58 . . 


....do.. 


94 


do 






251 




Aug. 21 


do 


....do... 


....do.. 


71 


do 






as 




July 24 
Aug. 15 
July 29 
Aug. 27 




No. 59 


do 


93 


. ..do 






?m 






No. 60 


do 


76 


do 






90 




Wagon 


No. 61.. 


....do.. 


89 


do 






293 




do 


....do... 


....do.. 


65 


do 






294 




do ... 


do 


do . 


do 


65 

77 


...do 






197 




Aug. 14 


dO : 


No. 62 . . 


....do.. 


Spleen enlarged and 


+ 


















studded with tuber- 
cles; liver contains 
tubercular foci; spleen 
sections show histo- 
logical tubercles and 
tubercle bacilli. 






164 




Aug. 9 


do.. 


No. 63 . . 


. ..do .. 


81 








167 




do 


do 


No 64 


do 


81 


do 






243 




Aug. 20 


do 


....do... 


....do.. 


71 


do 






99 




July 30 


do 


No. 65 . . 


Died . . . 


1| 








313 




Aug. 29 


do 


....do... 


Killed.. 


63 


Negative 







190 



TABLE No. 1— Continued. 



03 

'3 . 


s 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


W)bO 

•g'S 
d 


Pres- 
ent. 


Ab- 
sent. 


314 




Aug. 29 
Aug. 6 
Aug. 28 




No. 65 . . 


Died . . . 


15 








139 






No. 66 . . 


Killed.. 


84 








306 




do 


....do... 


....do.. 


64 


do 






272 




Aug. 23 


Wagon 


No. 67 . . 


....do.. 


66 


do 






36 




July 18 
July 29 
do ... 




No. 68 . . 


Died . . . 


3 








91 






...do... 


Killed.. 


89 








92 




do 

do 


....do... 


....do.. 


89 
66 


do 

do 






?85 




Aug. 26 
do ... 


do . 


do. . 




?,86 




do 

do 


....do... 


....do.. 


66 
81 


do 






170 




Aug. 9 


No. 69 . . 


....do.. 


....do 






309 




Aug. 28 
Aug. 29 


.do 


do. . 


do . . 


64 


do 






317 




do 


....do... 


Died... 


1 








328 




Aug. 30 
July 15 
Aug. 8 


do 


...do ... 


Killed . 


63 


Negative 






11 






No. 70 .. 


do .. 


101 


do 






160 




do 


....do... 


....do.. 


82 


do 






257 




Aug. 22 


do 


....do... 


Died... 


1 








199 




Aug. 14 
Aug. 6 
Aug. 16 
July 16 
July 23 




No. 71 . . 


Killed . 


76 


Negative 






137 






No. 72 . 


. .do.. 


84 


do 






7115 




do. 


do 


do .. 


75 


do 






16 




do 


No. 73 


Died 


1£ 

3 


do 






55 




do 


....do... 


....do.. 


do 






56 




....do... 


do 


....do... 


Killed . 


95 


Inguinal and retroperi- 


+ 


















toneal glands caseous; 




















spleen enlarged, stud- 




















ded with tubercles; 




















liver and lung con- 




















tained many tuber- 




















cles; sections show 




















histological tubercles 




















and tubercle bacilli. 






161 




Aug. 8 
do... 


Dairy 


....do... 


....do.. 


82 


Negative 






162 




do 


....do... 


....do.. 


82 
71 

n 

64 


do 






?40 




Aug. 20 
Aug. 27 
....do... 


do 


....do... 


....do.. 


do 






?89 




do ... 


Died 


....do 






?90 




do 


....do... 


....do.. 


Inguinal and mediasti- 
nal glands enlarged 


+ 




































and caseous; liver 




















studded with tu- 




















bercles; sections liver 




















and glands show his- 




















tological tubercle and 




















tubercle bacilli; other 




















organs lost. 






1 




July 12 
Aug. 8 
Aug. 19 
Aug. 5 




No. 74.. 


Killed . 


104 








158 






....do... 


Died . . . 


26 
84 








WIR 




. .do 


...do ... 


.do.. 








133 


Wagon 

do 


No. 75 . . 


Killed . 


Negative 






228 




Aug. 19 


....do... 


....do.. 


72 


do 






87 




July 29 
Aug. 16 
July 15 


do 


No. 76 . . 
.do. 


....do., 
.do.. 


89 
75 


do 






?,?A 




do 






13 






No. 77.. 


....do.. 


101 


do 






218 




Aug. 16 


Wagon 


....do... 


Died . . . 


U 









191 



TABLE No. 1— Continued. 



3 . 

60 bC 


^ 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


o 5 - -a 

o ® 

i 


Pres- 
ent. 


Ab- 
sent. 


202 ! 


Aug. 14 
July 18 
July 25 


Wagon 


No. 78 . . 


Killed . 


77 


Negative ' 




33 






No. 79 . . 
No. 80 . . 


Died... 

Killed . 


84 
93 


No evidence of tubercle. 
Negative 






69 


Wagon 






176 




Aug. 12 
July 12 
July 26 
Aug. 12 
Aug. 15 
do .. 


do 


....do... 


.. do 


78 


do 






s 






No. 81 . . 
....do... 


....do.. 
....do.. 


104 
92 

78 


do 






8? 




do 






175 


Dairy 


....do... 


....do; 


do 






?1? 




Sibley Hospital. 
....do.. 


....do... 


....do 


76 


do 






?13 




do ... 


.. .do 


76 
19 


do 






264 




Aug. 23 
Aug. 29 
July 22 

Aug. 5 
Aug. 13 
....do... 


Dairy 


....do... 


Died... 








31? 




Wagon 


....do... 


Killed . 


63 


Negative 






45 






No. 82 . . 
do . 


Died... 

Killed 


19 

84 








1?9 










184 




Dairy 


....do... 


....do.. 


79 


do 






185 




do 


....do... 


Died... 

Killed . 


20 
71 








241 




Aug. 20 
..do... 


do 


....do... 


Negative 






24? 




do 

do 

do 


do ... 


do . 


71 
64 

63 


do 

do 






310 




Aug. 28 
Aug. 29 
Aug. 30 
July 30 
July 18 
July 31 


....do... 


....do.. 




318 


do 


Died 




327 




do 


....do... 


Killed . 


Negative 






96 






No. 83 . 


. do 


89 


do 






34 






No. 84 


Died 


4 








103 




Orphan asylum. 


....do... 


....do.. 


81 


Inguinal, retroperito- 
neal, and mediastinal 


4- 
































glands caseous; spleen 




















enlarged, studded 




















with tubercles; liver 




















and lungs contain 




















numerous tubercle- 




















foci; sections show 




















histological tubercles 




















and tubercle bacilli. 






104 




do ... 


do. 


.do 


Killed 


89 


Inguinal and retroperi- 
toneal glands enlarg- 


4- 




































ed and caseous; spleen 




















and liver enlarged 




















and studded with tu- 




















bercles; sections show 




















histological tubercles 




















and tubercle bacilli. 






130 




Aug. 5 
Aug. 7 


Wagon 

do 


.. .do 


...do . 


83 


do 


+ 




147 




....do... 


....do.. 


83 


Negative 






186 




Aug. 13 

....do... 


Dairy 


....do.. 


Died... 


2 








187 




do 


do 


Killed . 


79 


Negative 






275 




Aug. 26 


do 


....do... 


....do.. 


66 


Inguinal and mediasti- 


+ 


















nal glands enlarged 




















and caseous; spleen 


1 
















and liver enlarged 




















and studded with tu- 




















bercles; many tuber- 




















cle bacilli in smears. 







192 

TABLE No. 1— Continued. 



§ 

3 . 
bo be 


53 


Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 
since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


o ►* 
d 


Pres- 
ent. 


Ab- 
sent. 


276 




Aug. 26 
Aug. 14 




No. 84 . . 


Died... 


16 








198 




do 


No. 85 . . 


Killed.. 


77 


Negative 






304 




Aug. 28 
Aug. 6 


do 


. .do... 


do. . 


64 


.. ..do... 






140 




do 


No. 86 . . 


....do.. 


84 


Inguinal glands en- 


+ 


















larged and caseous; 




















retroperitoneal and 




















mediastinal glands 




















enlarged; spleen and 




















liver enlarged and 




















studded with numer- 




















ous tubercles; tuber- 




















cle in liver; sections 




















show histological tu- 




















bercles. 






?06 




Aug. 15 
Aug. 28 


do 


....do... 


....do.. 


76 








305 




do 


....do... 


....do.. 


64 


do 






109 




July 31 


do 


No. 87 . . 


....do.. 


79 


do 






280 




Aug. 26 


do 


....do... 


....do.. 


66 


do 






3?,7 




Aug. 19 
Aug. 27 
....do... 




No. 88 . . 


....do.. 


73 


do 






301 




....do 


....do... 


....do.. 


65 


do 






30? 




do 

do 


....do... 


....do.. 


65 
70 


do 

do 






259 




Aug. 22 


No. 89 . . 


....do.. 




38 




July 19 


do 


No. 90 . . 


Died... 


3 








95 




July 30 
Aug. 15 
July 17 
Aug. 5 
....do... 


do 


No. 91.. 


Killed.. 


88 


Negative 






?0q 






....do... 


....do.. 


76 


do 






30 






No. 92 . . 


Died... 


5 








135 




Dairy 


....do... 


Killed.. 


84 


Negative 






136 




do 


....do... 


Died... 
Killed.. 


2 








?54 




Aug. 21 
....do... 


do 


....do... 








255 




do 


....do... 


Died... 
Killed.. 


2 
92 








84 




July 26 

Aug. 6 
Aug. 23 




No. 93 . . 


Negative 






141 




Dairy 


....do... 


....do.. 


84 


do 






269 




do 


....do... 


....do.. 


69 


do 






?03 




Aug. 14 
July 12 
July 19 
July 22 
July 23 
Aug. 5 
Aug. 8 
Aug. 14 
Aug. 16 
July 12 
Aug. 8 
Aug. 15 


Wagon 


No. 94 . . 


....do.. 


77 


do 






H 






No. 95. . . 


....do... 


104 


do 






49 






....do... 


....do. . 


98 


do 






4q 






....do.... 


Died... 


4 








58 






....do.... 


Killed.. 


94 








134 




Wagon 

...do 


....do.... 


....do... 


84 


do 






154 




..do... 


. do. . 


82 


do 






?01 




Dairy 


....do.... 


Died... 


3 








914 




do 


....do.... 


....do... 


1J 








3 






No. 96. . . 


Killed.. 


104 








157 






...do.... 


do. . 


82 


do 






210 




do 


....do.... 


....do... 


76 


do 






19 




July 16 


Wagon.. 


No. 97... 


....do... 


101 


do 






127 




Aug. 2 


do 


....do.... 


;...do... 


80 


do 






35 




July 18 
July 24 
Aug. 13 
Aug. 26 




No. 98. 


..do... 


99 


do 






60 






. do... 


Died 


3 








18Q 






. do .. 


Killed. . 


76 








277 




do 


....do.... 


Died... 


8 









193 



TABLE No. 1— Continued. 



3 




Date of 
inocu- 
lation. 


Source. 


Dairy. 


Result. 


Days 

since 
in- 
ocu- 
lated. 


Autopsy. 


Tubercle 
bacilli. 


be bo 
d 


Pres- 
ent. 


Ab- 
sent. 


278 




Aug. 26 
Aug. 2 




No. 98 . . 


Killed.. 


66 








126 




do 


No. 99... 


....do... 


87 


do 






IPO 




Aug. 13 
Aug. 21 
....do.... 


do 


do... 


Died .. 


4 








249 




do 


. do... 


. do... 


2 








250 


do 


....do.... 


....do- 


5 








47 


July 22 
Aug. 7 
Aug. 16 




No. 100. 


do . 


18 








148 




....do.... 


Killed.. 


83 


Negative 






219 


do 


....do.... 


....do... 


75 


do 






220 




....do.... 


do 


....do.... 


....do... 


75 


do 






112 




Aug. 1 
July 17 
July 24 
Aug. 1 
Aug. 13 


Wagon 


No. 101.. 


....do... 


87 


do 






26 1 




No. 102.. 
....do... 


....do.. 
....do.. 


100 
95 


do 






62 i 




do 






117 ! 




. .do . . 


Died... 


9 








193 1 


do 


....do... 


....do.. 


25 


No evidence of tubercle . 






194 


.. .do 


do. 


do 


Killed.. 


75 








59 




July 23 




No. 103.. 


....do.. 


94 


Inguinal and retroperi- 
toneal glands caseous; 


+ 




































spleen enlarged and 




















studded with tuber- 




















cles; liver showed nu- 




















merous tubercular 




















foci; sections show 




















histological tubercles 




















and tubercle bacilli. 






?00 




Aug. 14 
Aug. 28 




. do . . . 


do .. 


77 








308 




do 


....do... 


....do.. 


64 


do 






316- 




Aug. 29 


do 


....do... 


Died... 


2 








P 




July 15 




No. 104.. 


....do.. 


3 








37 




July 19 
Aug. 21 




. .do .. 


do . 








?5? 




Wagon 


....do... 


Killed.. 


71 








?53 




. . . . do . . . 


do 

do 

do 


....do... 


....do.. 


71 
67 
19 


do 






287 




Aug. 26 
....do... 


....do... 


....do.. 


do 






?88 


....do... 


Died... 

















The following table gives a summary of the above protocols. It 
shows the laboratory number of the dairy, number of samples from 
each dairy, number of samples lost by the animal dying in less than 
three weeks of other infections, number samples remaining for observa- 
tion, and total number of samples for each dairy positive for 
tuberculosis. 

The same details are shown in Table 3 for the milk collected from 
the charitable institutions. 



45276°— Bull. 56—12- 



-13 



194 



TABLE NO. 2. 



Dairy. 



Number 



10.. 
11.. 
12.. 
13.. 
14.. 
15.. 
16.. 
17.. 
18.. 
19.. 
20.. 
21.. 
22.. 
23.. 
24.. 
25.. 
26.. 
27.. 
28.. 
29.. 
30. 
31. 
32. 
33. 
34. 
35. 
36. 

37. 

38. 

39. 

40. 

41. 

42. 

43. 

44. 

45. 

46. 

47. 

48. 

49. 

50. 

51. 

52. 

53. 

54. 



Number 
samples 
lost by- 
acute death 
of guinea 
Pig- 

2 



1 



1 

2 
1 



1 





1 



1 
1 



1 




1 

1 





1 

2 





1 
1 



1 





1 



1 






1 
1 





Number 

samples 

remaining. 



Number 
samples 
positive 
for tuber- 
culosis. 



195 



TABLE NO. 2— Continued. 



Dairy. 



Number 
of samples 



Number 
samples 
lost by 
acute death 
of guinea 
Pig- 



Number 

samples 

remaining. 



Number 
samples 
positive 
for tuber- 
culosis. 



100. 
101. 
102. 
103. 
104. 



Total... 
Per cent . 



272 



223 
82 



196 



TABLE NO. 3. 



Hospital. 


Number 
of samples. 


Number 
samples 
lost by 
acute 
death of 
guinea pig. 


Number 

samples 

remaining. 


Number 
samples 
positive 
for tuber- 
culosis. 


Providence 


2 
1 
1 
2 
1 
1 
2 








1 


2 
1 

1 
2 
1 
1 
1 





Children's 





Georgetown 





Garfield 





Sibley 







a\ 


Columbia . : 









Total 


10 


1 

10 


9 
90 


1 




11.1 









a Both pigs from sample positive. 



RESUME. 



It will be seen from the above that of 272 samples of milk 49, or 18 
per cent of the samples, were lost by the animals dying in less than 
three weeks and before sufficient time had elapsed for them to develop 
tuberculosis. Attention is invited to the fact that the milk from some 
of the dairies killed acutely a high percentage of all of the animals to 
which it was given. 

Of the 272 samples 223, or 82 per cent, remained for study. 

Of the 223 that remained 15, or 6.72 per cent, contained sufficient 
tubercle bacilli to cause typical tuberculosis in the inoculated animals. 

Of the samples of milk from 104 dairies, 2 were lost by acute death 
of the animals, leaving 102 ; the milk from 11 of these 102 dairies con- 
tained tubercle bacilli. This gives a percentage of 10.7 of the dairies 
examined showing tubercle bacilli in the milk supplied to their 
customers. 

Ten samples of milk were obtained from 7 charitable institutions 
of the District ; of these 10 samples, 1 was lost by the acute death of 
the animal, leaving 9 samples from 6 institutions for study. The 
sample from 1 institution caused tuberculosis in both guinea pigs in 
which it was inoculated. 

These results showing that approximately 11 per cent of the dairies 
whose milk was examined contained tubercle bacilli virulent for 
guinea pigs do not, however, give a fair idea of the frequency of the 
presence of tubercle bacilli in the market milk of the city of Wash- 
ington. Attention has already been called to the fact that when two 
animals were inoculated with the same sample both did not always 
develop tuberculosis; this would indicate that the bacilli are so few 
in the amount inoculated that one of the animals by being a little 



197 

more resistant was able to overcome the infection. The amount in- 
oculated, less than 2 cubic centimeters of milk, is a very small portion 
of a pint bottle. The creamy layer was not inoculated and other 
workers have shown that tubercle bacilli are more frequent in this 
than in the bottom milk ; it is very probable that if more animals had 
been inoculated with the same sample and both cream and sediment 
used the percentage of positive results would have been very much 
higher. The results, however, as they were found are sufficiently 
high to emphasize the great necessity for the enactment and rigorous 
enforcement of a law requiring that all cows supplying milk to the 
District be tuberculin tested and free of tuberculosis. This test, which 
is now universally recognized as a means of determining whether an 
animal has tuberculosis, should be made by a competent veterinarian 
and those animals that respond should be disposed of in some way so 
that their milk may no longer be a source of danger to the community. 



5. THE RELATION OF GOAT'S MILK TO THE SPREAD OF 

MALTA FEVER. 



(199) 



THE RELATION OP GOATS MILK TO THE SPREAD OP 
MALTA PEVER. 



By John F. Anderson. 

Passed Assistant Surgeon and Assistant Director Hygienic Laboratory, Public 
Health and Marine-Hospital Service. 



Recently it has been shown that Malta fever is conveyed by means 
of the milk of goats infected with the specific organism of the dis- 
ease. While the disease may undoubted] y be spread by other means, 
the use of infected goat's milk in Malta is by far the most important 
factor. 

Malta fever is a specific febrile infection caused by the Micrococcus 
melitensis discovered by Bruce in 1887. The fever is of an irregular, 
recurring or undulating type; in a typical case it lasts for several 
weeks, followed by a period of a few days or weeks of a relative 
apyrexia, which is again followed by other febrile periods. 

Clinically, Malta fever is usually characterized by profuse perspi- 
ration, constipation, frequent relapses, often accompanied by pains of 
a rheumatic or neuralgic character, sometimes swelling of joints or 
orchitis. The disease is characterized by low mortality and indefinite 
duration. 

Malta fever smolders endemically on the island of Malta, at 
Gibraltar, and other places on the Mediterranean basin. At times 
the number of cases at one place constitutes an epidemic. Bruce 
believes that one attack confers a definite immunity against subse- 
quent attacks. Strangers particularly, visiting in the endemic focus, 
are liable to infection. On account of the almost invariable tend- 
ency to undulations of pyrexial intensity Malta fever is often called 
" undulating fever," a name proposed by Hughes. The disease is 
also known as Gibraltar fever, Mediterranean fever, rock fever, etc., 
depending upon the locality. 

The following is a list of places from which Malta fever has been 
reported : 

(201) 



202 

Spain — Gibraltar ; Islands of the Mediterranean — Balearic Islands, 
Corsica, Sardinia, Sicily, Malta, Gozo, Cyprus, Crete; Italy — Rome, 
Naples, Caserta, Benevento, Campobosso, Aricca, Terano, Fermo, 
Padua, Cittanova, etc.; Greece — Athens, Cephalonia; Turkey — Con- 
stantinople, Smyrna; Palestine — Jerusalem; Africa — Tunis, Algiers, 
Alexandria, Suakin, Massowah, Zanzibar, Kimberley ( ? ) , Aden ; 
India — Calcutta, Mian-Mir, Nowshera, Secunderabad, Simla, Delhi, 
Lucknow, Agra, Allahabad, Choabattia, Subatha, Assam, Swat Val- 
ley; China — Hongkong; Philippine Islands; Fiji Islands; North 
America — Mississippi Valley ( ? ) ; West Indies ( ? ) — Cuba ( ? ) , Porto 
Rico ( ? ) ; South America — Venezuela, Brazil, Montevideo. 

Malta fever is a general infection not unlike other specific bacte- 
remias, such as typhoid fever. The Micrococcus melitensis is found 
especially in the spleen and also in the blood. The inoculation of 
pure cultures of this organism into monkeys produces a prolonged 
febrile disease similar to Malta fever. There have been several in- 
stances of the inoculation of pure cultures into man, both intention- 
ally and accidentally, which were followed by the characteristic 
symptoms of the fever after an incubation period of from five to 
fifteen days. Little doubt, therefore, remains that the organism is 
the true cause of the disease. 

From the standpoint of prophylaxis it is of the first importance 
to determine the channel of infection by which the micrococcus enters 
the body. In the cases before mentioned in which the disease was 
produced by inoculating pure cultures of the Micrococcus melitensis 
into man, in one instance the culture was accidentally introduced into 
the conjunctival sac; in the others, by subcutaneous inoculation. One 
case which arose in England is supposed to have been conveyed from 
son to father by using a clinical thermometer in the mouth imme- 
diately after its use by the patient. From experimental evidence, 
therefore, it would appear that the infection of Malta fever may be 
taken in through wounds, the mucous membranes, or by food and 
drink introduced into the mouth. There is no evidence that the 
disease is directly contagious from the sick to the well. 

Malta fever occurs especially in the officers and men of the British 
army and navy stationed at Malta and Gibraltar. All authorities 
recognize the influence of unfavorable hygienic conditions as an etio- 
logical factor of the greatest importance in prophylaxis. Sex has 
no predisposing influence and every age is prone to attacks, but it 
occurs mostly between the ages of 6 and 30 years. 

In Malta the greatest incidence of the disease is in the hot, dry 
month of July. Chilling of the surface, bodily and mental depres- 
sion, etc., are quoted as incidental causes. 

The morbid process is that of a general infection and is seen espe- 
cially in the condition of the spleen, which is enlarged, soft, even 



203 

diffluent. The blood gives the usual picture of secondary anemia. 
The lymphoid elements are but slightly involved; the liver is con- 
gested and the seat of cloudy swelling, and the kidneys are sometimes 
swollen and show glomerular nephritis. 

The period of incubation appears to be from a few days to thirty 
days, usually about fifteen. 

On account of the large number of cases of Malta fever in the 
military and naval population of the island of Malta a commission 
was appointed by the admiralty, the war office, and the civil govern- 
ment of Malta in 1904 for the purpose of studying this disease with 
a view especially of determining the source of infection. This com- 
mission has issued six reports. These reports include a minute study 
of the general sanitary conditions of the island of Malta, the prev- 
alence of the disease there, the various experiments upon the viability 
of the organism under many conditions, and experimental work upon 
susceptible animals. The following data in regard to the relation of 
goat's milk to the spread of Malta fever are largely drawn from these 
reports and, in many instances, are taken verbatim from the reports. 

Until the researches of the commission the means of infection were 
not definitely known. Various theories had been suggested, such as 
the agency of biting insects, the ingestion of infected food and drink, 
the breathing of infected dust, and contacts. 

Epidemiological studies having shown that, while the consumption 
of infected milk may and probably does account for Malta fever 
among the Maltese, yet many cases occur among the military and 
naval population in Malta which can not be attributed to this cause. 
Accordingly a study of mosquitoes as possible carriers of the 
M. melitensis was begun. 

The M. melitensis was recovered four times from a total of 896 
mosquitoes dissected. Deducting from these 896 mosquitoes those 
collected where there was no case of Malta fever or where the cases 
were mostly chronic we would have 4 infected mosquitoes out of 450 
collected in presumably infected places. This result was not unex- 
pected considering the small numbers of the specific organisms found 
in the peripheral blood of Malta fever patients. The mosquitoes 
could not be infected in great numbers or the disease would be much 
more prevalent than it is at present. 

Captain Kennedy a was able experimentally to infect a monkey as 
the result of bites of mosquitoes (Culex pipiens) which had fed on 
patients suffering from Malta fever. An attempt to infect a monkey 
by bites from artificially infected mosquitoes, however, failed. 

a Reports of the commission * * * for the investigation of Mediterranean 
fever * * *. Part 4, 1906, p. 187. 



204 

In the examination of 103 cases of Malta fever for the specific 
organism the minimum quantity of blood from which a positive 
result was obtained was ^-g- cubic centimeters. This fact has an 
important bearing on the question of the possibility of the trans- 
mission of infection by biting insects such as mosquitoes. This is a 
larger amount of blood than any biting insect to be found in Malta 
can contains 

The water supply of Malta is drawn from two sources, the one for 
general use being derived from three springs which are pumped to a 
central reservoir and thence distributed, the second being rain water, 
most of the houses being provided with cisterns for the collection of 
rain water which is largely used for drinking purposes. 

The milk supply of Malta is derived almost entirely from goats, 
though there is a small number of cows on the island and condensed 
milk is used to some extent. The number of milk goats in Malta is 
probably at least 20,000. 

As showing the prevalence of the disease in Malta the following 
figures are of interest: From 1894 to 1903 there was an average of 
32 cases per 10,000 inhabitants per year in the civil population; for 
the same period in the military population the yearly average was 
25.6 per 10,000; from 1901 to 1903, for which years only figures are 
obtainable, the yearly average was 28.55 per 10,000 among the naval 
population. 

In regard to infection other than through goat's milk, Major Hor- 
rocks h concludes that so far as the experiments go it appears that 
infection can not be conveyed from infected to healthy monkeys by 
skin contact alone, all other sources of infection being excluded. In- 
fection can not be conveyed from infected to healthy monkeys by 
ecto-parasites alone. When healthy monkeys living in intimate con- 
tact with diseased monkeys, under mosquito-proof conditions, become 
infected, the infection is due to the absorption of the M. melitensis 
excreted in the urine of the diseased monkeys. 

There is no evidence that Mediterranean fever can be contracted 
by contact with cutaneous surfaces uncont animated by urine. c 

Infection can be acquired by the absorption of urine secreted by 
cases of Mediterranean fever, and this is probably one way in which 
workers in hospitals become infected. 

There is evidence to show that monkeys can be infected by dry dust 
artificially contaminated with cultures of M. melitensis isolated from 

a Reports of the commission * * * for the investigation of Mediterranean 
fever * * *. Part 3, 1905, p. 14. 

6 Reports of the commission * * * for the investigation of Mediterranean 
fever * * *. Part 4, 1906, p. 36. 

c Reports of the commission * . * * for the investigation of Mediterranean 
fever * * *. Part 4, 1906, p. 81. 



205 

the spleen of cases of Mediterranean fever. The path of absorption 
maybe through the nares, throat, respiratory passages, and alimentary 
canal. Dry dust contaminated with the urine of cases of Mediter- 
ranean fever has given rise to infection in goats, but not in mon- 
keys. The experience gained during the work performed in Malta 
during 1904-5 has convinced Horrocks that men are more susceptible 
than monkeys and goats. Shaw's work on ambulatory cases of Med- 
iterranean fever among the Maltese has also shown that opportunities 
for the creation of infected dust are plentiful in Malta. Infected 
dry dust as a cause of Mediterranean fever can not therefore be dis- 
carded. "When infection is acquired in this manner the incubation 
period is probably at least a month. 

Mediterranean fever can be acquired by the absorption of infected 
goat's milk from the alimentary canal. The incubation period in 
this case is also probably long, and may even extend to two months. 

This mode of infection probably plays a great part in the causa- 
tion of Mediterranean fever among the Maltese, who drink raw milk 
drawn at the doors of their houses. 

Horrocks found that the M. melitensis could be recovered from 
khaki cotton, khaki serge, and blankets up to the eightieth day. 
Shaw recovered it from blue serge up to the seventy-eighth day. 

The above results obtained by Horrocks upon the longevity of the 
organism upon khaki, cotton, etc.. are important as showing the pos- 
sible relation of fomites to the transmission of the disease. 

The presence of ambulatory cases of Malta fever must be taken 
into account in the spread and continuance of the disease in Malta. 
These ambulatory cases constantly pass the specific organism in their 
urine and are undoubtedly as much a source of danger to those with 
whom they come in contact as are the bacillus carriers in typhoid 
fever. 

The usual source of milk in Malta is the goat. 6 These animals 
are driven about the streets and milked at the customer's door into his 
own container. The udders, which are abnormally large, often touch 
the ground and are very liable to be soiled. There are so many herds 
that it is often difficult for a householder to tell the source of his milk 
supply. Xo regulations are in force for the effectual control of these 
vendors. 

It was first shown by Zammit c that goats could be infected by feed- 
ing them with the 3f. melitensis. Zammit informed the chairman of 

a Reports of the commission * * * * for the investigation of Mediterranean 
fever * * *. Part 4, 1906, p. 176. 

6 Reports of the commission * * * for the investigation of Mediterranean 
fever * * * Part 2, 1905, p. 11. 

c Reports of the commission * * * for the investigation of Mediterranean 
fever * * *. Part 3, 1905, p. 2. 



206 

the board that he considered goats to be susceptible to Malta fever and 
that the disease is spread to human beings by goats. 

On June 23, 1905, Maj. W. H. Horrocks wrote the chairman of the 
commission that he had discovered the M. melitensis in the milk of 
an apparently healthy goat and that he had already found it in the 
milk of five goats taken from two different herds, and that Doctor 
Zammit had found it in the blood of one of these goats. 

Preliminary notes by Major Horrocks, Captain Kennedy, and Doc- 
tor Zammit on the propagation of Malta fever by goats show that one 
or more healthy goats in every herd are excreting the M. melitensis 
in their milk and urine, and that about 50 per cent of the goats react 
to Malta fever when examined by serum agglutination tests. The 
commission states that it may be objected that no exact proof exists 
that the drinking of milk containing the M. melitensis will give rise 
to the disease in man. However, when we take into consideration the 
results of feeding and inoculation experiments on monkeys it may be 
assumed that the disease is propagated in this way. 

This is the first statement in the literature bearing upon the propa- 
gation of Malta fever by the milk of infected goats. 

With the object of ascertaining by experimental inoculation 
whether goats could be infected by M. melitensis 6 goats from 2 dif- 
ferent herds were brought and placed in the lazaretto. Doctor Zam- 
mit a before inoculation of these goats took blood from each and 
tested their serum for agglutination. He found to his surprise that 
the serum of 5 of these goats considerably diluted caused agglutina- 
tion of the M. melitensis. The reactions thus obtained suggested that 
possibly 5 of the goats were suffering from Malta fever acquired un- 
der natural conditions. The goats were said to be healthy, but were 
sold cheaply as they had given very little milk for some time. Ex- 
amination of these goats in detail resulted as follows : 

Goat No. 6: M. melitensis appears to be steadily excreted in the 
apparently normal milk of this goat. 

Goat No. 1 : M. melitensis excreted in large number in the milk and 
also in the urine of this goat. 

Goat No. 2 : M. melitensis excreted in small quantities in the nor- 
mal appearing milk of this goat; not detected in the urine. 

Goat No. 3 : M. melitensis present in large numbers in the normal 
looking milk of this goat, but not in the urine. 

Goat No. 5 : M. melitensis was found in the milk and urine. 

Captain Kennedy, E. A. M. C., visited the various herds and took 
blood from the ears of the goats. Out of 161 goats examined 84 

° Reports of the commission * * * for the investigation of Mediterra- 
nean fever * * *. Part 1, 1905, p. 84 et seq. 



207 

gave a positive agglutination test, equal to a percentage of 52 prob- 
ably infected with Mediterranean fever. 

The results obtained show that some of the goats in every herd 
examined were suffering from Mediterranean fever. The M. meliten- 
sis is present in the milk in enormous numbers when the disease has 
been present sufficiently long to cause a change in the physical char- 
acters of the fluid. It is also excreted in considerable numbers, even 
when the animals are in " full milk " and no changes have occurred 
in either the physical or chemical characters of the milk. 

The M. melitensis is also excreted in the urine of goats suffering 
from Mediterranean fever, but up to the present it has only been 
found when the disease has existed for some time and after physical 
changes have occurred in the milk. 

Shaw examined the blood of 33 cows, 10 of which gave a positive 
reaction to the M. melitensis; from the milk of 2 of these cows the 
M. melitensis was isolated. 

The manner in which animals become infected with the virus of 
Mediterranean fever is a matter of considerable interest and im- 
portance. Up to the present all the evidence available points to 
their food as being the main vehicle of infection. The feeding ex- 
periments show conclusively that monkeys and goats may thus be 
infected. Besides the very obvious way of infection of the young 
through their mothers' milk, the successful result of various feeding 
experiments with food soiled, directly and indirectly, with the urine 
of 2 ambulatory cases of Mediterranean fever, and in whose urine 
living M. melitensis was being excreted, indicated another way in 
which these animals may be infected while feeding. Goats may be 
seen any day in the streets of the chief city of the island of Malta 
feeding on filth and rubbish of every possible variety, some of it 
visibly saturated with urine, animal and human. Among the lower 
class Maltese, as above stated, workmen have been found who void 
living M. melitensis in their urine, as do a certain number of in- 
fected goats. Thus the path of this manner of infection becomes 
clear. Having satisfied their hunger in this manner, the goats lie 
down in the streets to digest their meal with their teats and udders 
often in contact with the ordure of the gutters and roads, till they 
are kicked up by the goatherd to be milked into the vessel brought 
to the doors of the adjacent houses by their occupants. It is hence 
not to be wondered at that these animals frequently suffer also from 
suppurative mastitis and give milk containing pus. In the health 
reports of the Malta government may be seen reports of outbreaks 
of illness among children directly traced to this cause by the med- 
ical officers. 



208 

With regard to cows the evidence is not so clear. Kept shut up 
in " shippens," and seldom allowed outside, they have their food 
brought to them, but as this food is composed of vegetable and 
other refuse collected from every possible source and situation, it is 
easy to understand that they can hardly escape from receiving 
infected food from time to time. 

It was interesting to note whether those goats whose blood gave 
a positive agglutination reaction would have some symptoms of 
illness, but this was not apparent except in a few cases. The quan- 
tity and quality of the milk seemed in most cases to be unaffected. 
In fact, it was often noted that the best milk-producers in the herd 
gave a positive reaction. 

Horrocks and Kennedy a thought that as a result of their observa- 
tions, judged by the serum reaction, 41 per cent of the goats in Malta 
are infected. Ten per cent of the goats supplying milk to various 
parts of Malta appear to excrete the M. melitensis in the milk. 

The excretion of the specific microbe may continue steadily for three 
months without an} r change occurring in the physical character or 
chemical composition of the milk and without the animal exhibiting 
any signs of ill health. Some infected goats may lose flesh and their 
coats become thin ; the} r may also suffer from a short hacking cough. 
A febrile condition, however, has not been observed. Goats may 
have a marked blood reaction and yet never excrete the M. meli- 
tensis in the milk. If the blood serum or milk does not agglutinate 
the M. melitensis, the specific microbe is not found in the milk. 

The excretion of the M. melitensis in the milk may be intermittent, 
appearing for a few days and then disappearing for a week or more. 
A blood reaction may exist for some weeks before the M . melitensis is 
excreted in the milk. 

Monkeys and goats can be infected b} 7 feeding with cultures of 
M. melitensis isolated from milk, and also by feeding with infected 
milk itself. The incubation period in feeding experiments appears to 
vary between three and four weeks. Monkeys infected by feeding 
sometimes suffer from a typical wave of fever and lose flesh, at other 
times they show no obvious signs of ill health, and may even gain in 
weight. 

When monkeys become infected by feeding with milk the lymphatic 
glands always contain far more colonies of the M. melitensis than the 
spleen. This fact suggests that the specific micrococci contained in 
the food are carried to the lymphatic glands and there undergo con- 
siderable multiplication. It has not yet been proved that the mesen- 
teric glands are always infected at an earlier date than the femoral 

a Reports of the commission * * * for the investigation of Mediterranean 
fever * * * Part 4, 1906, p. 68, et seq. 



209 

and axillary glands, but feeding with milk shows that this may be the 
case at times. 

It has been demonstrated that goats may become infected by feed- 
ing on dust polluted with urine from cases of Mediterranean fever. 
The excretion of M. melitensis in the milk resulting from such infec- 
tion is a late phenomenon only appearing about seventy-four days 
after the blood reaction has developed. 

In report No. 6 of the commission they state that, reviewing the 
evidence already collected by the Mediterranean Fever Commission 
in its entirety, it is fairly obvious that the infective character of the 
milk of many of the goats upon the island of Malta affords a ready 
and reasonable explanation of the means by which the disease is 
transmitted. Then, too, the evidence yielded by experiments upon 
monkeys, supported by the facts of the steamship Joshua Nicholson 
epidemic, justifies the assumption that in the ingestion of infected 
milk we have the veritable infective agency in the vast majority 
of *cases. Additional weight attaches to this view by reason of the 
declining case incidence that was associated with the compulsory sub- 
stitution (owing to the goatherds strike) of imported preserved 
milks for the fresh goat's milk by the local and military authorities. 

In report No. 6, page 70, is an account of an outbreak of Malta 
fever aboard the steamship Joshua Nicholson which conveyed a herd 
of milk goats from Malta to Antwerp in the latter part of the 
summer of 1905. These goats were collected by a representative of 
the United States Bureau of Animal Industry for shipment to the 
United States. It reads almost as if it were a planned laboratory 
experiment, and in view of the experimental work above referred to 
established almost conclusively the relation of infected goat's milk 
to the spread of Malta fever. The following account of the outbreak 
is taken verbatim from the report of the commission : 

1. HISTORY OF THE GOATS. 

Mr. Thompson, of the United States Bureau of Animal Industry, 
visited Malta in the summer of 1905, and during a stay of some 
months gradually purchased a herd of 61 milch goats (all healthy 
in appearance and good milkers, many being prize animals), and 4 
billy goats. These he shipped on board the cargo steamer Joshua 
Nicholson, on August 19, 1905, for passage to the United States 
via Antwerp. During the voyage, which lasted until September 2, 
1906, when Antwerp was reached, the goats were milking well, and 
many of the ship's company partook freely of the milk — the officers 
drinking " mixed " milk collected in a large vessel, the members of 
the crew each obtaining " whole " milk from 1 goat in his own sep- 
arate panikin. 

45276°— Bull. 56—12 14 



210 

On arrival at Antwerp the goats were at once transferred to the 
quarantine station, where they remained for the five days that 
elapsed before they were reembarked on the steamship St. Andrew 
bound for New York, and during this voyage a large quantity of 
milk was again available for consumption. New York was reached 
about September 24, and the animals were transferred to the quaran- 
tine station at Athenia, N. J., where they remained under observation. 
Subsequent bacteriological examination resulted in the recovery of 
M. melitensis first from the milk of 2 of the goats and afterwards 
from that of several more. 

2. THE INCIDENCE OF MEDITERRANEAN FEVER AMONG THOSE 
WHO PARTOOK OF THE MILK. 

(a) In the steamship Joshua Nicholson. — In addition to 4 passen- 
gers (Mr. Thompson and 3 goatherds) present on the voyage from 
Malta to Antwerp, the Joshua Nicholson carried 23 officers and men. 
Of the crew of 19, the carpenter, boatswain, and messroom steward, 
together with others (11 in all), left the ship at Antwerp; the boat- 
swain was afterwards in hospital suffering from hernia; the move- 
ments of the remainder can not be traced. Of the 12 remaining offi- 
cers and crew, 8 fell sick at intervals varying from eighteen to thirty- 
four days from the embarkation of the goats, and in the cases of 5 of 
these 8 the blood reactions leave no room for doubt that Mediter- 
ranean fever was the cause of their illness. 

The 4 members of the ship's crew who did not show any signs 
of illness were the second mate and the cabin boy, with whom the milk 
disagreed and who consequently had but very little, and 2 engineers 
(Germans) who drank the milk, it is true, but appear to have always 
boiled it. 

Of the 3 goatherds, 1 (the chief goatherd) had undoubtedly been 
infected with M. melitensis previous to July, 1906, as evidenced by 
the presence of specific agglutinins in his blood, but whether recently 
or remotely it was impossible to say ; about the 2 assistant goatherds 
no information could be obtained. 

(b) At Antwerp. — The staff of the quarantine station and many 
individuals in the neighborhood are said to have partaken of the 
milk, both raw and boiled, during the five days the goats were in- 
terned here, but no information can be obtained of the subsequent 
occurrence of cases of illness resembling Mediterranean fever. 

(c) In the steamship St. Andrew. — The steamship St. Andrew car- 
ried 30 cattlemen and 3 goatherds, and Mr. Thompson, in addition to 
a crew of 30 men. Most of these drank of the milk, but the master of 
the ship and also his owners state that none of the men suffered from 
any illness. 



211 

(d) In America. — With the exception of Mr. Thompson, who died 
in January, 1906, from " bilateral pneumonia following influenza," 
and about whose medical history, qua Mediterranean fever, no evi- 
dence can be obtained, only 1 person — a woman at the quarantine 
station — took the milk in any quantity. She, however, drank the 
mixed milk from several goats for a considerable period, and in De- 
cember, 1905, suffered from a typical attack of Mediterranean fever. 

3. THE RESULTS. 

In summarizing the result of this unpremeditated experiment sev- 
eral factors have to be considered. For instance, a certain unknown 
number of goats — more, however, than 2 — were shown to be secreting 
infective milk after their arrival in America, some three months after 
leaving Malta, but there is no direct evidence as to the number whose 
milk contained M. melitensis during the voyage in summer weather 
from Malta to Antwerp. Arguing from analogy with average 
Maltese herds, at least 6 should have been secreting infective milk. 
The goats purchased by Mr. Thompson were, however, picked ani- 
mals and heavy milkers, and as experience has shown that the goats 
yielding the most milk in any given herd are the most likely to be 
passing M. melitensis in their milk, the probability is that in this par- 
ticular herd of 60 milch goats (1 having died the day after leaving 
Malta) the milk from considerably more than 6 was heavily infected — 
an inference which receives confirmation from the fact that the 3 
officers and the steward who drank " mixed " milk each developed an 
attack of Mediterranean fever, the remaining officer and the cabin 
boy, with whom the milk disagreed and who consequently did not 
drink it, remained well. 

The members of the crew, on the other hand, each drank " whole " 
milk from a single goat, and apart from the possibilities of the milk 
being supplied on any particular occasion from an uninfected ani- 
mal, a reference to Section I (3), shows clearly the possibilities of 
a man who obtains milk, even from an infected animal, avoiding the 
ingestion of infective milk. 

Apart from such considerations, however, it suffices to state the 
net result as follows : 

Of 23 a men on board the steamship Joshua Nicholson who drank 
on one or more occasions presumably infected milk, no evidence what- 
ever is available as to 12 and no relevant information as to Mr. 
Thompson; of the remaining 10, 1 suffered from hernia only, 1 
was infected by M. melitensis at an unknown date, while 8 suffered 

a That is disregarding the 2 men who boiled the milk before drinking it, 
and the officer and cabin boy who did not drink the milk. 



212 

from febrile attacks — 5 (or 50 per cent of them) yielding conclusive 
evidence of infection by M. melitensis. 

In Report No. 5 of the commission is an article by Major Horroks 
on Mediterranean fever in Gibraltar. The facts there detailed, taken 
with the curve showing the relation of the number of goats in 

























































































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= No . of goats. Each square equals 80 goats* 
= Malta fever. " " " 40 cases. 



Gibraltar to the number of cases of Malta fever, is particularly 
interesting and suggestive. With the reduction in the number of 
goats in Gibraltar there was also a decrease in the number of cases 
of Malta fever, so that finally when the number of goats had de- 
creased to about 200 in 1905, Malta fever has practically disappeared. 



213 

Mediterranean fever, often called " rock fever," has existed in Gi- 
braltar for many years,* although the cause of the fever was not known 
until the discovery of Bruce's specific organism from fatal cases of 
Malta fever. Physicians residing in Gibraltar knew of the existence 
of a fever characterized by long duration, low mortality, and liable 
to be followed by rheumatic sequela. 

In a study of the cases of continued fever in Gibraltar from 1882 
to 1905 it was shown by Horrocks that in the year 1884 there were 
833 cases of continued fever of which 429 were probably Mediterra- 
nean. In 1885 there were 697 cases of continued fever including 341 
cases of Malta fever. In 1886 there were only 331 cases of continued 
fever and of these 158 were enteric fever. The great increase in the 
number of cases of enteric fever was attributed partly to the arrival 
of an infected regiment in Gibraltar from Egypt and to serious sani- 
tary defects in Gibraltar. In 1887 there was again a considerable 
falling off in the number of cases of Mediterranean fever and from 
that date, with slight oscillations, the curve of Mediterranean fever 
gradually declined until it reached in 1904. The rapid disappear- 
ance of febrile diseases from Gibraltar, which commenced in 1885, 
forms a marked contrast with the state of things in Malta in cor- 
responding years. It is plain that some important factor which dis- 
appeared from Gibraltar has continued to operate in Malta. 

It has been shown that the M. melitensis is excreted in the urine of 
man and goats and that animals can be infected by dust contami- 
nated with the urine of Malta fever patients ; that the micrococcus is 
excreted in the milk of infected goats, and that the consumption of 
this milk causes Malta fever in monkeys. It is evident that both the 
sanitary conditions and the possible infection of goats in Gibraltar 
must be investigated if the cause of the continued fever is to be 
discovered. 

That the improvement of the sanitary conditions played but a 
minor part in the marked decrease in the prevalence of Malta fever 
in Gibraltar is shown by the fact that the curve representing the 
presence of Malta fever among the military population rose steadily 
from 1874 to 1884, in spite of the improvement in the sanitary condi- 
tions in Gibraltar. 

Twenty years ago goats were allowed to graze on certain portions 
of the rock and passes were granted to goat keepers for this priv- 
ilege. In 1883 passes for 1,793 goats were granted. In 1886 the 
number of passes had been reduced to 1,512 ; by 1890 the passes had 
further declined to 590, and in 1892 to only 510. From 1894 to 1902 
the number of goats appears to have changed very little ; in 1904 the 

a Reports of the commission * * * for the investigation of Mediterranean 
fever * * * Part 5, 1907, p. 55. 



214 

passes were reduced to 210, and when Major Horrocks began an 
examination of the goats in 1905 he found only 254 distributed upon 
various portions of the rock. It might be urged that, though passes 
for grazing were withdrawn, the goats were still kept and housed in 
goat sheds. This, however, was not the case, as Major Horrocks as- 
certained that in the period from 1883 to 1903 about 1,100 goats had 
been sold, and those familiar with the goat trade stated that where 
passes for grazing could not be obtained the goats were not kept in 
any numbers. 

In 1905, Major Horrocks took specimens of blood from 254 goats 
found on various portions of the rock and tested the serum for ag- 
glutination. Fourteen per cent of them gave a positive reaction 
with M. melitensis. It is extremely suggestive that the decrease in 
the Malta fever in the military population was coincident with the 
decrease in the number of goats in Gibraltar. 

It appears probable that the rapid disappearance of Mediterranean 
fever from Gibraltar, which commenced in 1885, was intimately as- 
sociated with the exodus of infected goats from the rock. Improved 
sanitary conditions, especially the disconnection of waste pipes 
and house drains from sewers, may have played a part in causing the 
decrease of fever, but as the same sanitary improvements have been 
carried out in Malta without any corresponding decline of Mediter- 
ranean fever, it is fair to assume that their effect was insignificant 
compared with that produced by the removal of the infected goats. 



6. MILK SICKNESS. 



(215) 



MILK SICKNESS. 



By George W. McCoy, 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 



Definition. — Milk sickness is an acute, nonfebrile disease, probably 
of a specific nature due to the ingestion of milk, milk products, or 
the flesh of animals (usually cattle) suffering from a disease known 
as trembles. The disease in man is characterized by great depres- 
sion, persistent vomiting, obstinate constipation, and high mortality. 

Synonyms. — Endemic sick stomach, sloes or slows, milk sick, sick 
stomach, colica trementia, puking complaint, paralysis intestinalis, 
mukosma, syro. 

Historical. — Milk sickness was first noted and its association with 
trembles in cattle first defined about the beginning of the last century. 
The earliest professional account appears to have been published by 
Drake in 1809, and was based upon the observations of Dr. Thomas 
Barbee. Since that time the disease has become an important part 
of the medical history of our middle west. 

In some localities the disease was so prevalent and fatal that whole 
communities migrated from " milk-sick " sections to parts where the 
disease did not occur. 

Almost every community in some parts of the country has a tra- 
dition about outbreaks of this disease in the earlier years of the past 
century. We are told by Colonel Henry Watterson (1909) that Nancy 
Hanks, the mother of Abraham Lincoln, died from the disease in 1818 
after an illness of a week. In the words of Colonel Watterson, " The 
dread milk sickness stalked abroad, smiting equally human beings 
and cattle." 

With the advance of civilization, as forests were cleared and pas- 
tures fenced, the disease became less frequent; by the time of the 
civil war the disease was by no means common. At the present time 
it is one of the rarest of diseases. Trembles in animals is now almost 
as rare as " milk sickness " in man. According to Jordan and Har- 
ris (1908) an active focus of the disease exists in the valley of the 
Pecos River in New Mexico, where the disorder among animals has 
generally been attributed to " alkali poisoning." An outbreak oc- 
curred in Macon County, Tenn., in April and May, 1907. Small epi- 

(217) 



218 

demies are reported in some part of Tennessee every two or three 
years. The cases now occur only in the thinly settled regions, usually 
remote from lines of communication. Most frequently they are at- 
tended by a layman, known locally as a " milk-sick " doctor, who has 
a local reputation for curing the disease. The only modern scientific 
contribution to the literature of milk sickness is the work of Jordan 
and Harris. 

Milk sickness in man (and trembles in animals) was such an impor- 
tant question in the early years of the last century that several State 
legislatures offered liberal rewards for the discovery of the cause of 
the disease. In 1821 the legislature of Tennessee passed an act re- 
quiring fences to be made around certain coves in Franklin County 
" to prevent animals from eating an unknown vegetable, thereby 
imparting to their milk and flesh qualities highly deleterious." 

At the present time when the disease is rare many persons living 
in and near the endemic foci abstain from the use of milk and butter 
on account of the danger of contracting milk sickness. 

At the outset one is confronted with the difficulty that the affection 
under consideration is largely a matter of tradition. Satisfactory 
accounts of the disease are rare. Drake (1841), who is much quoted 
in all accounts of the disease, appears not to have been personally 
familiar with the malady; indeed, in his memoir he states that he 
has seen no case in man nor in the lower animals. Yandell (1852), 
who is also frequently quoted and has written much on the subject, 
makes no mention of having himself seen cases, and in his later publi- 
cations expresses grave doubt as to the existence of a specific disease 
corresponding to that described as milk sickness. In his own words : 
" Upon a review of the whole matter, the conclusion to which all the 
testimony on the subject has brought me is, that we, who have written 
upon milk sickness have been egregiously imposed upon by careless 
and incompetent observers." Many of the accounts, indeed I think I 
may safely say, the majority, are based upon hearsay evidence. 

A large number of the articles published on milk sickness were 
written wholly with the object of proving that a plant poison is the 
cause of the disease; many others, that a mineral poison is the 
causative agent. The disease has been described as a mild, almost 
trivial affair ; and again as most malignant and fatal. A few writers 
have regarded the disease as a manifestation of malarial poisoning. 
However, the mass of the testimony clearly indicates that there is a 
specific disease, known as milk sickness, always derived from a case 
of trembles in an animal. 

Distribution. — So far as known the disease has never occurred out- 
side of the United States. In this country it has been endemic in 
many of the newly settled regions, in practically all of the States 
south of New York, and as far west as Missouri and Arkansas. Ten- 



219 

nessee, Kentucky, Ohio, Indiana, and Illinois have suffered the most 
severely. At the present time cases occasionally occur in Tennessee 
and North Carolina. Cases have been reported in Illinois as late as 
1904. The recent discovery of the disease in New Mexico is the first 
indication we have of its occurrence west of the Mississippi Valley. 

In the endemic foci, the disease in the lower animals is limited to 
rather well-defined areas. Many of these areas are fenced to prevent 
the access and consequent contamination of stock. I have seen a 
number of such inclosures varying in size from an acre to several 
thousand acres. " Milksick Mountain," in White County, Tenn., is 
entirely inclosed by a fence 7 or 8 miles in length, built about fifty 
years ago; since which time the disease has been very rare in that 
locality. 

The infected areas are always wooded land, but otherwise vary 
markedly, from dark damp ravines to high dry ridges or ordinary 
level forest tracts. Seaton (1841), who wrote extensively on the sub- 
ject, claimed that the disease was found only where sandstone entered 
largely into the composition of the soil. Other writers do not agree 
with this view. 

There appears to be a very general agreement in the opinion that 
wooded land is essential for the existence of the disease and the clear- 
ing of the land suffices to remove all danger of animals acquiring 
trembles. It is said that if land be rendered harmless by clearing, 
then be permitted to produce a new growth of timber, the tract may 
again become the seat of the disease. So sharply are some milk-sick 
areas defined that farmers point out places where on one side of a 
fence animals may be pastured in perfect safety, whereas if pastured 
on the other side of the fence they are almost sure to contract trembles. 
I have been told of more than one outbreak of trembles due to chang- 
ing the fence of a pasture by a few yards so as to include some wild 
(uncleared) land. 

It has been claimed that springs and water courses have conveyed 
the cause of trembles, but it seems clear that in such cases the animals 
contract the disease in the surrounding wooded areas. 

Etiology and pathology. — Children appear to be less liable to the 
disease than adults. Nursing women are said to enjoy a relative im- 
munity (Johnson, 1866). One attack confers no immunity; in fact, 
it appears to predispose to subsequent attacks (Philips, 1877). 

The disease occurs most frequently in the spring and the fall, but 
records of cases in summer are not rare and a few are said to have oc- 
curred in winter. Drake (1841), who investigated the subject in 
Ohio, states that the disease occurred in May and June, but was more 
frequently met with in August, September, October, and November. 
The majority of writers agree with this, stating that cases are most 
frequent in the fall months, and especially when the season has been 



220 

dry. The last outbreak in Tennessee occurred in April, 1907, and the 
general impression prevails among physicians and laymen in that 
State that the disease occurs only in the spring and the autumn. 

So far as milk sickness in man is concerned about the only etiolog- 
ical fact of importance is that the disease occurs as a result of the use 
of milk, butter, cheese, or flesh from an animal suffering from trem- 
bles. Even this has been questioned. Yandell (1867) states "that 
the relation of the disease to animal products is not on an impregnable 
basis." The great mass of evidence, however, leaves little doubt but 
that the disease is practically always derived from a case of trembles. 

The favorite theory among physicians and laymen is that trembles 
is caused by a poisonous plant eaten by the animals. It is supposed 
that the poison is eliminated in the milk, or if the animal is not in 
lactation is stored up in its tissues. In support of this theory it is 
urged that the disease occurs only in seasons when animals are allowed 
to graze in the open, and only when they graze in certain special 
places that soon become known as milk sick. A number of plants, 
notably poison ivy, white snakeroot, and certain mushrooms, have 
been claimed to be the essential cause of the disease. These plants 
are all common in many localities that have never had milk sickness, 
and in no case does the claim that any one of them is the cause of the 
disease appear to be well founded. Indeed the flora of a milk-sick 
region may be identical with that of the adjacent healthy land. 

Next in popularity to the plant-poison theory of the cause of the 
disease is the mineral-poison theory. 

Seaton (1841) very vigorously maintained that milk sickness was 
a form of arsenic poisoning. Lead and cobalt have also been accused. 

I have been unable to bring about any condition in guinea pigs 
that even remotely resembles trembles by feeding experiments with 
cobalt, lead, or arsenic. When these animals finally succumbed to 
the poison their tissues were without any harmful effect on animals 
(guinea pigs) to which they were fed. 

Two facts, apparently well established, may be urged against either 
the plant or mineral poison theory. In the first place, the flesh of 
animals dead of either trembles or milk sickness will, when eaten by 
another animal, cause that animal to develop trembles and the dis- 
ease may again be reproduced by feeding the flesh of the second 
animal. It is said that this transference of infection may thus be 
carried through a long series of animals. In the second place, the 
observation has been made very frequently that, under natural con- 
ditions, it is only exposure at night or in the morning while dew is 
on the grass, that is capable of infecting an animal with trembles. 

The limitation of trembles to certain well-defined areas, and the 
fact that night exposure only appears to be dangerous, suggest the 



221 

possibility of the conveyance of the infection through an interme- 
diary host, such as arthropods or biting insects. 

A favorite theory many years ago was that the disease is produced 
by a gas or miasm rising from the earth in the affected region. The 
gas was supposed to be generated by earth or vegetation. At the 
present day, no discussion of this theory is necessary. 

Trembles was early recognized to have some of the features of in- 
fectious diseases. In 1843, Heeringen wrote " I am compelled to be- 
lieve that trembles belongs to the anthrax family." This was twelve 
years before the discovery of the anthrax bacillus. Mention is fre- 
quently made of the fact that the disease may be carried from one 
animal to another by feeding the flesh of a diseased animal. 

In 1877, Philips reports finding " spiral bacteria " in the blood of 
a typical case, and the same organism, with cocci, in the urine of the 
same case. He encountered similar organisms in the urine of other 
cases. 

Gardner (1880) reported finding in the blood of a heifer suffering 
from the trembles, organisms " that bore in size and behavior a 
striking resemblance to the form of bacteria called by naturalists 
bacilla subtilissima." He found the same organism in the water of 
a spring that had supplied a family in which milk sickness was pres- 
ent. Dogs suffering from " slows " acquired by eating the flesh of the 
heifer also had the organism in the blood. He also found the organ- 
ism in milk. 

Graff (1841) reported some very remarkable experimental work 
with trembles. He found the flesh of the animals not to differ mate- 
rially in appearance from that of sound animals. Salting meat, he 
says, does not impair its poisonous properties. The milk of a cow 
was poisonous, as shown by feeding it to dogs for eight days after she 
was removed from the infected pasture; but a test made a week later 
showed the milk to be harmless. He found small amounts of meat or 
butter sufficient to cause the disease. " One ounce of butter or cheese 
or 4 ounces of beef, either raw or boiled, administered three times a 
day, will certainly prove fatal within six days, and often earlier." 
All these experiments were upon dogs and the flesh of his experi- 
mentally killed dogs was as poisonous as the beef that conveyed the 
disease. 

Graff found that treating the flesh with dilute sulphuric acid for 
two hours did not destroy the poison; even heating had no effect. 
He says butter heated " to such a degree as to cause it to inflame lost 
none of its poisonous properties." He failed to extract the poisonous 
agent from meat by prolonged boiling. He failed in attempts to 
communicate the disease " by an inoculation with any portion of the 
body or secretions from infected animals." These experiments lack 
confirmation. 



222 

Jordan and Harris have isolated a micro-organism from the tissues 
and body fluids of animals suffering from trembles, which they have 
called U B. lactimorbi." The following is a brief abstract of their 
description of the bacterium : 

The organism is a motile rod, and appropriate staining demon- 
strates the presence of flagella. Spores are found under certain con- 
ditions. On an agar slant the growth is smooth, grayish, glossy, 
without pigment formation. There is a turbidity of broth at the 
end of twenty-four hours, and later a pellicle forms, which falls when 
the tube is agitated. Litmus milk is at first rendered alkaline, later 
it turns dirty- white, and finally may become opalescent. No multi- 
plication occurred on potato. On Lofflers blood . serum there is a 
smooth, yellowish growth. Gelatin is slowly liquefied. 

The nonsporulating cultures are killed by an exposure of five min- 
utes to a temperature of 55° C.J while the spore-bearing cultures are 
destroyed at 100° C. maintained for fifteen minutes. The disease 
has been reproduced in a rabbit by the inoculation of blood from an 
infected animal. Feeding experiments have shown that the dog and 
the calf may be infected with the organism, which may in turn be 
recovered from their tissues after death. These observers report 
having isolated the organism from several naturally infected cows 
and from one naturally infected horse, and Doctor Jordan informs 
me in a personal communication that they have also isolated it from 
a man and from sheep. 

It would appear from this work that another of the diseases, the 
cause of which has long been shrouded in doubt and mystery, has at 
last yielded its secret to laboratory investigation. 

Milk cows seldom show any symptoms so long as they are regularly 
milked, even though they are secreting milk fatal to man and to other 
animals; in a herd the steers and heifers always show symptoms 
before the cows that are giving milk. Buttermilk is generally re- 
garded as harmless. Graff thought differently, however. 

Apparently not all are equally susceptible, as it has frequently 
been noted that of several persons who partake of the poisonous milk 
or meat, some may escape, while others, usually the majority, will 
contract the disease. 

A recent outbreak which I have investigated had some of the con- 
ditions of an experiment on human beings. The record, unfortu- 
nately, is based entirely upon nonprofessional observation, but is, I 
believe, fairly accurate. In brief, it is as follows : Seven persons par- 
took of a meal, 6 of whom used milk and butter and became ill with 
characteristic symptoms of milk sickness and subsequently died. The 
only person who escaped was a woman who never used either milk or 
butter. One of the 6 was a guest and had only this one meal in this 
house. This individual sickened on the day after partaking of that 



223 

meal. The other 5 persons became ill at different times ; the last one 
about ten days after eating the meal that apparently poisoned the 
guest. A calf using the same milk sickened with " trembles " soon 
after the earliest cases in the family. The cow accused of imparting 
the disease developed " trembles " and died. The cow showed no 
symptoms until milking was neglected on account of illness in the 
family. It was believed that this cow had been on milk-sick land 
about two weeks prior to the outbreak. This outbreak seems to have 
been a typical one, the sickening of the cow only after she was no 
longer milked, the sickening of the calf at about the same time that 
some of the persons were attacked, the onset of the illness at a vary- 
ing period after the use of the suspected milk and butter, finally, the 
exemption of the only person who did not partake of the milk or 
butter, all agree with the older descriptions. As trembles and milk 
sickness are both so rare at present, an occurrence like this points 
strongly to a most intimate relation between them. 

The few recorded post-mortem examinations throw little light upon 
the nature of the disease. Home (1844) , who examined three human 
cases, found inflamed patches in the small intestine. The mesenteric 
glands were red and greatly enlarged. 

In animals, Graff found the brain " suffused with a large quantity 
of blood, which, from the amount contained within the cranium, must 
have made great pressure on every part." In one human case he 
found softening of the brain and evidence of meningitis. Graff tells 
us that this autopsy was conducted " by stealth at night in the open 
air, and by the light of a single candle." 

Barbee (1840) found the colon in man " contracted to the size of a 
common candle." The mucous membrane of the stomach was red and 
thickened in spots; the remainder presented a pale and softened ap- 
pearance. The peritoneal coat of the small intestines was inflamed. 

Jordan and Harris made a number of post-mortem examinations 
on the lower animals. They noted the odor of acetone when the body 
cavities were opened. This is interesting in view of the statement of 
most of the old writers that there is a peculiar and characteristic odor 
of the breath in milk sickness. The other findings in cattle were, 
briefly, as follows: 

Small amounts of fluid in pleural and pericardial sacs, numerous 
ecchymoses beneath the visceral pericardium. The heart muscle was 
paler than normal and when sections were examined general cloudy 
swelling was found. A general injection of the vessels o? the small 
intestine was present. The liver was always enlarged, purple red, 
sometimes with streaks of yellowish. Microscopical examination 
showed cloudy swelling and fatty degeneration of the organ. The 
gall bladder was usually full of dark-green bile. The liver tissue 
was very friable, occasionally yellowish red, and gave the appearance 



224 

of the " nutmeg " liver. The spleen and the kidneys were markedly 
congested. The mucous membrane of the small intestine was deeply 
injected and had much tenacious mucus adhering to it. In horses 
the lesions were similar to those described in cattle. The liver showed 
marked cloudy swelling and less fatty change than in cattle. There 
were small nodules embedded in the wall of the small intestine. 
These nodules were 4 or 5 millimeters in diameter and were elevated 
above the surface. They were found to originate in the lymph nodes 
embedded in the mucosa. 

Symptoms. — Philips (1877) and others thought that an interval of 
days or even weeks elapsed between the exposure on infected areas 
and the development of symptoms of trembles in cattle. Drake de- 
scribes the symptoms of trembles in animals as follows : 

The animal begins to mope and droop, and to walk slower than its fellows, to 
falter in its gait. If under these circumstances it should be driven, and attempt 
to run, the debility and stiffness of its muscles are immediately apparent. It 
fails rapidly, trembles, pants, and sometimes seems blind, as it runs against 
obstacles, but this may arise from vertigo; at length it falls down, lies on its 
side quivering, and is not, perhaps, able to rise for several hours, sometimes 
never. 

He also mentions a chronic form. 

The characteristic symptom, trembling, may always be brought out 
by exercising the suspected animal. It is related that cattle buyers 
never purchased animals from milk-sick districts until they had given 
them a run of half a mile or more to ascertain if they had trembles. 

When a cow is regularly milked no symptoms are likely to develop. 

In at least some instances a period of several days appears to inter- 
vene between the consumption of the poisoned milk or meat and the 
onset of symptoms in man. Spalding (1881) reports an outbreak 
where three days in one case and six days in another intervened be- 
tween suspending the use of the suspected milk and the onset of the 
symptoms. He also speaks of the onset in some cases as being 
" almost instantaneous when milk or beef is taken." It would appear 
that such cases, with very early onset, may be due to decomposition 
products belonging to the class of poisons usually called ptomaines. 

As judged by the description of most writers, the symptom com- 
plex in man appears to be fairly uniform. In describing it I will use 
freely the account of Way (1893). The onset is gradual, the indi- 
vidual tires easily, there is loss of appetite, in a day or two vomiting 
begins, the bowels are obstinately constipated, there is great abdom- 
inal distress, the tongue becomes large and flabby, the breath acquires 
a foul odor that is regarded as highly characteristic of the disease, 
the abdomen is scaphoid, there is marked visible pulsation of the 
abdominal aorta, the temperature is not elevated; in fact, it is gen- 
erally subnormal, there is always great thirst. The mind usually 



225 

remains clear, but in fatal cases, coma for several hours may precede 
dissolution. The average duration of cases is about one week. The 
cases referred to in the recent outbreak in Tennessee died in from 
two to ten days after the onset of symptoms. 

A common sequel of milk sickness is a lasting debility. I have 
seen a considerable number of persons who claimed that since an 
attack of the disease, they were incapacitated for hard work, especially 
in warm weather. 

The mortality is quite high. Physicians who have had a large 
experience with this disease tell me that at least half the cases will 
perish, even when carefully treated. Numerous family outbreaks 
are recorded where the mortality has been 100 per cent, as was the 
case in the last outbreak in Tennessee. 

Treatment. — The early settlers had worked out the very successful 
preventive treatment of keeping their animals from lands known to 
be dangerous, or what is better, to use for purposes of pasture in 
endemic foci, only " tame " lands ; that is, land from which the timber 
had been cut. It is even better to bring the land under cultivation, 
but this does not appear to be essential. 

With our present knowledge the treatment of the disease should 
be purely symptomatic. We have no specific remedy. Kest in bed, 
abstinence from food, stimulating enemeta, and a judicious use of 
stimulants would appear to be indicated. 

The treatment of cases in the early days was somewhat vigorous 
in accordance with the therapeutic customs of the day. Graff recom- 
mended free drawing of blood and the use of calomel not to exceed 5 
grains every two or three hours. Some advised a much more liberal 
use of calomel. Counter irritation over the abdomen was a favorite 
measure used to allay abdominal pain and vomiting. It was gener- 
ally regarded as essential to secure a free movement of the bowels, 
and when this had been accomplished the case was regarded as offer- 
ing a favorable prognosis. 

Drake (1841) considered blood letting of doubtful value, but ad- 
vised the free use of cathartics. Enemeta were frequently used. 
Philips (1877) used a purely expectant plan of treatment and urged 
against the use of strong purgatives. He used strychnine in liberal 
doses, apparently with benefit. 

BIBLIOGRAPHY. 

Allen. Illinois Med. Recorder, 1878-79, p. 88. 
Barbee. West. Jour. Med and Surg., 1840, p. 178. 
Beach. Transactions Ohio Med. Soc, 1884, p. 125. 
Beck. Chicago Clinic, Sept., 1905. 
Borland. An essay on the " Milk sickness," 1845. 

45276°— Bull. 56—12 15 



226 

Byford. Nashville Jour. Med. & Surg., 1855, p. 460. 

Candler. Am. Jour. Clinical Med., 1907, p. 914. 

Coleman. Phila. Jour, of the Med. and Phys. Sci., 1822, p. 322. 

Crookshank. Observations on the Milk Sickness, 1840. Phila. Jour, of the Med. 
and Phys. Sci., 1826, p. 252. 

Drake. Memoir on the disease called by the people the trembles, etc., 1841. 

Elder. Transactions Ind. State Med. Soc, 1874, p. 133. 

Gardner. St. Louis Med. and Surg. Jour., 1880, p. 288. 

Graff. Am. Jour. Med. Soc, 1841, p. 351. 

Heeringen. A discovery of the cause of the disease called by the people trem- 
bles or milk sickness, 1843. 

Home. Western Lancet, 1844, p. 454. 

Johnson. Atlanta Med. and Surg. Jour., 1866, p. 289. 

Jordan and Harris. Journal Am. Med. Assn., Vol. L., No. 21, 1908, p. 1665. 

Law. The Vet. Jour, and Ann. of Comp. Anat., 1877, p. 161. 

McCall. Am. Med. Recorder, 1823, p. 254. 

Mcllhenny. A Treatise on the Disease Called the Milk Sickness, 1843. 

Nagel. Nashville Jour, of Med. and Surg., 1859, p. 289. 

Palmer. Chicago Clinic, 1904, p. 267. 

Philips. Cincinnati Lancet and Observer, 1877, p. 130. 

Pusey. Louisville Med. News, 1886, p. 16. 

Schuchardt. Die Milch-Krankheit der Nord-Amerikaner in ihrer geschichtlichen. 
Entwickelung und in ihrem gegenwartigen Bestande. Janus, Amst, 1897-8, 
ii, pp. 437 ; 525. 

Seaton. A Treatise on the Disease Called by the People the Milk Sickness, 1841. 

Simon. Eclectic Med. Jour., 1888, p. 256. 

Spalding. West. Med. Reporter, 1881, p. 266. 

Way. Am. Jour. Med. Sc, 1893, p. 307. 

Wagaman. West. Jour. Med. and Surg., 1841, p. 234. 

Watterson. Cosmopolitan Magazine, March, 1909, vol. 46. 

Woodfin. North Carolina Med. Jour., 1878, p. 13. 

Yandell. Transylvania Jour, of Med., 1828, p. 309. West. Jour, of Med. and 
Surg., 1852, p. 374. Proc. Kentucky Med. Society, 1867-8, p. 88. 



7. THE RELATION OF COW'S MILK TO THE ZOO- 
PARASITIC DISEASES OF MAN. 



(227) 



THE RELATION OF COW'S MILK TO THE ZOO-PARASITIC 
DISEASES OF MAN. 



By Ch. Wardell Stiles, Ph. D., 

Chief, Division of Zoology, Hygienic Laboratory, Public Health and Marine- 
Hospital Service. 



Summary. — Theoretically, it is possible that certain infections with animal 
parasites may be contracted through the milk supply, but such possibility does 
not present any danger which is even remotely comparable with the danger of 
contracting typhoid through the milk. No animal parasite is known for which 
milk is a necessary transmitting medium or a necessary habitat in any particu- 
lar stage of the life cycle. Accordingly, the danger of contracting zoo-parasitic 
diseases through the milk supply is in general more theoretical than real, and 
can be prevented by the most elementary methods of cleanliness. 

There is no animal parasite known for man for w T hich cow's milk is 
either the necessary medium of transmission or the necessary habitat 
during any portion of its life cycle. The question of the relation of 
cow's milk to the zoo-parasitic diseases of man reduces itself therefore 
to the question as to what animal parasites of man are most likely to 
gain access to the milk accidentally during a stage of their life cycle 
which would render their transmission to man possible. 

In reference to this question the broad statement may be made that 
such possible cases would in general be due to the following causes : 

(a) Fraudulent practices on the part of persons in the milk trade 
in diluting the milk with water. 

( h ) The use of contaminated water either in such cases or in wash- 
ing the utensils with which the milk comes into contact. 

(c) Improper disposal of fecal matter. 

(d) Careless personal habits on the part of milk dealers, servants, 
etc., whereby the milk might, by coming into contact with their hands, 
become infected with stages in the life cycle of the parasites which 
would render transmission possible. 

(e) Carelessness w^hereby fecal material from various animals 
(particularly of dogs, rats, and mice) might gain access to the milk; 
and 

(/) Permitting cats or dogs to have access to the milk or to the 
dishes used for milk. 

(229) 



230 

From the foregoing it will be seen that the entire question under 
discussion is one of simple, elementary cleanliness, honesty, and pro- 
priety ; that when due regard is had for these three factors the danger 
of infection by animal parasites, through the milk supply, is elim- 
inated ; but that such danger increases in proportion as these factors 
are ignored. 

There is no evidence on record that any one of the foregoing possi- 
bilities has ever played an important role in producing any large 
number of cases of infection. Still it may be well worth while to 
refer to these possibilities briefly as contributing arguments in favor 
of a clean milk supply. 

(a and b) Water-borne parasites. — If contaminated water is used 
in washing milk cans or in fraudulently diluting milk it stands to 
reason that the contamination in question may be transmitted to the 
milk and through the latter it may be transmitted to the consumer. 
In this manner any obligatory or faculative water-borne zoo-parasitic 
infection (such as amebic dysentery, coccidiosis, possibly some forms 
of distomatosis, cysticercosis, hydatid diseases, eelworms, etc.), might 
be transmitted through the milk. The dangers involved are not suf- 
ficient to cause any sensation or alarm, but they are sufficiently real 
to present contributing arguments in favor of protecting milk from 
foul and contaminated water. 

(c) Improper disposal of fecal material. — When fecal material is 
not properly disposed of, the danger is present that the infection 
which it contains may be spread in various ways, as by flies, to the 
food, and thus it may gain access to man. The danger involved in 
reference to the animal parasites is not, in general, so great as it is 
in reference to the bacterial infections — such as typhoid, cholera, etc. ; 
for in case of the zooparasites the transmission in most of the in- 
stances in which it is theoretically possible could take place only when 
the organisms had reached a certain stage in their life cycle. For 
instance, a typhoid or a cholera stool would, a priori, be more danger- 
ous when fresh than when one to several weeks old, and its danger 
would decrease with age; from a case of amebic dysentery, hookworm 
disease, or eelworm infection, danger from a perfectly fresh stool 
would in general be nil ; gradually the stool would become infectious 
corresponding to the rapidity of the development of the infecting 
stage of the parasites in question; this infectiousness would increase 
to a maximum, according to conditions of heat and moisture, and 
then the inf ectivity would gradually decrease. If stools in an infect- 
ive condition are visited by flies or are washed into a water supply or 
are scattered in dust form, they can, according to the various con- 
ditions, form the basis of various zoo-parasitic infections, and should 
particles of such stools be accidentally carried to milk, the milk could 



231 

act as a mechanical bearer of the germs. In general, however, the 
chances of such method of infection seem rather remote, in so far as 
the animal parasites are concerned. 

(d) Personal habits of persons who handle milk. — It seems possi- 
ble that the personal habits of persons (such as milkers, servants, 
etc.), who come into more or less close contact with milk, might be a 
more appreciable element than any of the foregoing in infecting the 
milk, although even in such cases the infection in question, namely, 
by animal parasites, would be of far less importance than a typhoid 
infection. For instance, while a milker who is a typhoid " bacillus 
carrier " would be an element of grave danger to the public health, 
an infection (in that person) of pinworm, of pork tapeworm, and 
perhaps of Cochin China diarrhea, might be of some slight impor- 
tance, in reference to the possibility of their transmission through the 
milk supply ; but if that person had coccidiosis, the fat, or the broad 
tapeworm, or flukes, eelworms, or whipworms, such infections would 
be without significance, so far as the public milk supply is concerned. 

(e) Fecal material from animals. — It is not a pleasant thought 
that our milk supply may contain fecal material from various ani- 
mals, but such is unfortunately the case. Upon several occasions 
other divisions in this laboratory have submitted to the Zoological 
division for determination, sediment taken from bottled milk and 
such sediment has proved to be feces from rodents — either rats or 
mice. Now it is supposed that at least 3 intestinal parasites from 
the rats and mice are capable of developing directly in man. In the 
case of one of these parasites (dwarf tapeworms) , the usually accepted 
view is open to question, since the form in man is perhaps specifically 
distinct from the form in rodents; in the case of a second parasite 
(the trichina worm), the transmission from rat's feces to man is 
probably possible, but more theoretical than practical ; in the case of 
a- certain protozoan infection (Lamhlia) it is quite possible that a 
real, though perhaps not very frequent danger is present of its trans- 
mission through the milk supply. 

(/) Infections from dogs and cats. — Probably the greatest danger 
of the transmission of parasites from dogs and cats through the milk 
supply lies in the accidental infection with hydatids, from contamina- 
tion with canine feces, and the accidental presence, in milk, of the cat 
and dog flea, in which a larval tapeworm occurs which is transmissible 
to man. In neither case, however, is any instance of these parasites 
positively traced, so far as I know, to this method of infection, 
although such method must be admitted as theoretically possible. 



8. MORBIDITY AND MORTALITY STATISTICS AS 
INFLUENCED BY MILE. 



(233) 



MORBIDITY AND MORTALITY STATISTICS AS INFLUENCED 

BY MILK. 



By J. M. Eager, 
Assistant Surgeon-General, Public Health and Marine-Hospital Service. 



The influence of milk on morbidity and mortality furnishes a 
striking example of the potency for evil of a thing designed for the 
accomplishment of good. The food of the new-born and the most 
important aliment of the sick and the aged becomes too often a pro- 
moter of disease and an instrument of death. This malign influence 
of impure milk or milk improperly used is made evident by the 
mournful proofs of the extensive and growing statistics on the 
subject. 

QUANTITIES OF MILK CONSUMED. 

The importance of the role played by milk in the causation of 
disease is emphasized when attention is drawn to the enormous 
quantities of milk consumed. Based on the Twelfth Census of the 
United States taken in the year 1900, the milk and cream sold in 1899 
by farmers, deducting the quantities purchased by butter and cheese 
factories and condensed-milk establishments, was equivalent to about 
740,000,000 gallons of milk. This quantity of milk consumed by the 
nonfarming population in a single year was as great as the quantity 
of water supplied to the city of Washington in about ten days. The 
average quantity of milk purchased by the urban and suburban popu- 
lation of the United States is 23 gallons a year for each person. The 
consumption of milk in Philadelphia during the year 1905 was esti- 
mated at 23 gallons for each inhabitant; and in London, England, 
during the year 1892, at 11.5 gallons. 

MILK AND DISEASE. 

Health may be influenced by cow's milk either because the milk is 
physiologically unsuitable, as for infant feeding, or because it has 
become a medium of infection. Milk of inferior nutritive value can 
not be without its effect on the health of the consumer, especially when 
used as a food for babes. This effect is difficult to show statistically. 

(235) 



236' 

Its potency is nevertheless evident from a statement by J. Wicliffe 
Peck, chemist to the Hospital for Sick Children, London, that the 
average quality of milk offered for sale throughout London is so 
defective in fat and nonf atty solids that a child at six months, whose 
weight should increase about 4 ounces weekly, suffers each week a loss 
in diet of 3J ounces of fat and nonfatty solids when its ration of 
fraudulently manipulated cow's milk is based on the supposition that 
the milk is of standard quality. Such low standard milk tends to 
produce marasmus and rickets. Marasmic children present a decided 
predisposition to bronchitis and summer diarrhea and thus indirectly 
an increase of infant mortality is brought about by diluted or 
adulterated milk. 

STATISTICS OF INFANTILE MORTALITY. 

The malign effects of hand feeding of infants and the consequent 
impress made upon the mortality returns become manifest by an 
examination of vital statistics, but to gauge the exact ratio of infant 
deaths resulting from artificial feeding is very difficult. 

The reports of the United States Census Office on mortality f or.the 
year 1905 show that in the registration area with a population of 
33,757,811 there were, of 545,533 deaths at all ages from all causes, 
105,553 deaths among infants under one year of age. Diarrhea and 
enteritis caused the death of 39,399 infants in the first year of their 
life. In England and Wales all the deaths registered during the same 
year numbered 520,031 and were in the proportion of 15.2 per 1,000 
persons living. The deaths of infants under one year of age were in 
the proportion of 128 per 1,000 births in the year as compared with 
150 per 1,000, the mean proportion in the years 1895 to 1904, inclusive. 
The proportion of infant deaths in England and Wales during the 
year 1905 is the lowest then recorded, although closely approximated 
in some previous years. 

Commenting upon the official statistics of infantile mortality the 
Registrar-General of England writes: 

It has frequently been pointed out in the reports that although the general 
mortality in this country has steadily fallen in the course of the last half cen- 
tury, nevertheless infants in the first year of life have not shared in the benefit. 
About one-fifth part of the total loss of life in the first year after birth takes 
place within a week of that event, while by the end of the first month the pro- 
portion reaches one-third, and by the end of the third month it exceeds one-half. 
From the first to the fourth month diarrheal diseases steadily increase in de- 
structiveness, after which month they become gradually less fatal, although 
they still contribute seriously to the death rate throughout the first year of age. 

The rate given for the whole of England and Wales does not fairly 
represent the infant mortality of the cities of England. It was stated, 
for example, at the annual meeting in 1906 of the subscribers to the 



237 

Children's Hospital at Pendleberry that the death rate of infants 
under one year during the decade ending 1903 was 183.8 in Manchester 
and 198.3 in Salford. 

The following statistics from various countries are along the same 
lines : 



Country. 



General mortal- 
ity — Deaths to 
1,000 living; aver- 
age annual rate in 
10 years (1895-1904) 



Russia (European) . 

Chile 

Spain 

Hungary 

Ceylon 

Roumania 

Austria 

Servia 

Bulgaria 

Italy 

Jamaica 

German Empire 

Prussia 

Japan 

France 

Finland 

Switzerland 

Ireland 

Belgium 

Scotland 

England and Wales. 
The Netherlands . . . 

Denmark 

Sweden 

Norway . -. 

Western Australia.. 

Victoria 

Tasmania 

Queensland 

New South Wales. . . 

South Australia 

New Zealand 



«33.6 
28.8 
27.8 
27.3 
26.8 
26.8 
25.2 
23.9 
23.9 
22.7 
22.4 
20.8 
20.5 

&20.5 
20.4 
18.7 
18.1 
18.0 
17.8 
17.8 
17.2 
17.0 
15.8 
15.8 
15.1 
14.6 
13.3 
11.8 
11.8 
11.7 
11.5 
9.8 



Country. 



Infantile mortal- 
ity—Deaths of 
children under 1 
year to 1,000 births 
-average annual 
Rate in 10 years 
(1895-1904) . 



Chile 

Russia (European) . 

Austria 

Roumania 

Hungary 

Prussia 

Spain..! 

Jamaica 

Italy 

Ceylon 

Belgium 

France 

Servia 

Japan 

England and Wales 
The Netherlands . . . 
Western Australia.. 

Bulgaria 

Switzerland 

Finland 

Denmark 

Scotland 

New South Wales . . 

Victoria 

Ireland 

South Australia 

Queensland 

Sweden 

Tasmania 

Norway 

New Zealand 



6 326 

a 268 

C224 

d218 

216 

197 

el82 

176 

170 

169 

156 

153 

154 

a 151 

150 

147 

147 

&144 

142 

134 

127 

126 

108 

105 

103 

102 

101 

&98 

94 

90 

79 



"Average for 10 years (1892-1901). 
"Average for 10 years (1894-1903). 
c Average for 8 years (1895-1902). 



<* Average for 10 years (1890-1899). 
e Average for 5 years (1900-1904). 



Balestre and St. Joseph, in a study of mortality in early infancy 
in the urban population of France from 1892 to 1897, give a mass of 
valuable data bearing on the appalling annual toll exacted from 
the infant population of France — a loss of life which in conjunction 
with the unusually low birth rate in France has given the question 
of infantile mortality in that country a national importance. 



238 



Infantile mortality in France. 
[1892 to 1897, inclusive.] 



Place. 


Deaths at all 

ages from all 

causes. 


Deaths of in- 
fants under 1 
year per 1,000 
of all deaths at 
all ages. 


Deaths from 
diarrhea and 
gastro enteritis 
of infants un- 
der 1 year per 
1,000 deaths un- 
der 1 year from 
all causes. 


Paris, population 2,511,629 


303, 206 
322, 129 
334,032 
790,576 


145. 35 
184. 73 
167.25 
168. 13 


380. 30 


11 cities between 100,000 and 500,000 inhabitants having 


420. 49 


47 cities between 30,000 and 100,000 inhabitants having 
a combined population of 2,421,820 


350. 06 


622 cities of less than 30,000 inhabitants having a com- 
bined population of 5,892,034 


(a) 





Not recorded. 



In Paris and the cities of France having over 30,000 inhabitants 
the deaths from diarrhea by months per 1,000 infants under 1 year 
dying from all causes were as follows: 



January 212. 8 

February 211. 1 

March 224. 8 

April 254. 8 

May 303. 1 

June 426. 4 



July 587. 1 

August 606. 4 

September 537. 7 

October 431.5 

November 304. 6 

December 235. 9 



It is seen from these figures that, though the months of June, July, 
August, September, and October present the most deplorable propor- 
tion of deaths from diarrhea, this cause is not negligible in autumn 
and winter. 

In Germany, according to Behring, of every 1,000 children born 
alive 235 succumb during the first year of life. Only 510 out of 
1,000 males born attain manhood. Not more than a third of those 
reaching maturity are found to be fit for military service. These 
sad facts Behring attributes very largely to the ulterior effects of 
infection derived in infancy from milk. 

DIARRHEAL DISEASE AND MILK. 

The statistics given show how large a proportion of all deaths are 
among infants. It has been said that there is only one other period in 
life in which the chance of death is greater than it is under 1 year, 
namely, in persons over 90 years old. It is seen also that no cause is so 
prolific among children in the first year of life as disease of the diges- 
tive organs. Diarrheal diseases of infants are generally accepted to be 
due to impure food ; but there is no reason to believe that the alimen- 
tary canal of the average infant is often incapable of digesting the food 
necessary for growth and development when the food supplied is of 



239 

suitable quality and quantity. During the first year of its life a child 
consumes about 500 quarts of milk. There is ample evidence to show 
that the proportion of deaths among infants is greatly reduced when 
they receive the food nature designed for them, namely mother's milk, 
or when, as a substitute therefor, the most exact imitation is provided 
with due care to prevent its infection. There is no doubt that the 
nursing of all infants by healthy mothers would contribute immensely 
to the reduction of the infantile death rate. Observations in many 
parts of the world confirm this conclusion. 

MOTHER'S MILK AND LESSENED INFANTILE MORTALITY. 

Casper in 1825 recorded that a trustworthy traveler, von Schubert, 
says that the high death rate among young children in Norway and 
Northern Sweden in the early part of the last century was very evi- 
dently due to feeding infants with cow's milk instead, of mother's 
milk. At present, breast nursing is altogether the custom throughout 
Norway, insomuch that Borchart quoting statistics in 1883 says that 
in Norway and Scotland where suckling of infants is the rule, out 
of 100 children born 10.4 for Norway and 11.9 for Scotland die, 
whereas in Wurtemberg, where mothers as a rule are not in the habit 
of suckling their infants, 35.4 per cent perish in the first year of life. 
W. J. Tyson states that of all infants who die in England in the 
first year of life three- fourths have been fed artificially, and Doctor 
Hope, medical officer of health of Liverpool, says that according to 
his observation sanitary conditions have no marked influence on 
infant mortality, but that the methods of infant feeding are chiefly 
responsible for the high rate at which it is maintained. 

Newsholme, with a view to determining the relation of mortality 
to artificial feeding, gives a census of an infant population of 1,259 in 
10,308 houses in Brighton, England, taken in a house-to-house inspec- 
tion in the three years 1903-5, inclusive, combined with an inquiry 
into the manner of feeding of 121 babes dying of diarrhea and be- 
longing to the same social stratum as those forming the sample popu- 
lation. He concludes from these inquiries that, taking the whole of 
the first year of life, the number of deaths from epidemic diarrhea 
among breast-fed babes is not much more than one-tenth the number 
among artificially fed infants. Considering separately infants aged 
from 6 to 9 months, bearing in mind the fact that breast-fed babes 
at this age must have been breast-fed from birth, he finds that 57 
per cent of such babes were entirely and an additional 17 per cent 
partly breast-fed. Not one of the deaths at the age in question oc- 
curred among breast-fed or partially breast-fed children. 

By a similar inquiry the results obtained at Brighton were con- 
firmed in the borough of Finsbury, England, by an investigation by 



240 

Sandilands in which the method of feeding of 695 infants was investi- 
gated. It was ascertained that of 139 infants under 9 months of age 
dying of diarrhea 16 per cent only were breast fed. Of the survivors, 
69 per cent were breast-fed. 

France furnishes facts of the same import. In 1898, when diar- 
rhea made many victims among the children of Paris, it was estimated 
that the number of deaths of artificially fed infants was double that 
of the breast fed at all times during the year and that in August it 
ran up to 8 times that of the breast fed. 

Before a deputation, in 1906, of the Queensland government on the 
subject of infant life protection, Turner reported that during the 
summer months at Brisbane, Australia, more than one-half of the 
bottle-fed babes die. 

INFANTILE MORTALITY A CLASS MORTALITY. 

Harrington points out that infantile mortality is a class mortality, 
highest as a rule in cities and towns where women work in industrial 
establishments and put their children early to the bottle. In an ar- 
ticle written in 1906 he gives a table prepared from the United States 
census in which mill towns in New England are shown to have the 
greatest infantile mortality. 

Reid, as a result of a careful inquiry made in 1906, shows that the 
infantile mortality rates are in great excess in the northern artisan 
towns of Staffordshire, England, where pottery is the chief industry 
and women, both married and single, are engaged in factory labor. 
This excess is very marked where a comparison is made with the 
southern towns of the county where mining and iron-working pre- 
vail, affording practically no employment for Avomen. The general 
conditions which operate in causing a high infantile mortality pre- 
vail, it is pointed out, to an equal extent in the two populations. The 
difference in the death rate among infants in the two sections is at- 
tributed to the nature of the trades as affecting the employment of 
women away from home, with the consequent effect on the proportion 
of breast-fed and bottle-fed infants. The percentage of female mar- 
ried and widowed factory workers to the whole female population be- 
tween the ages of 15 and 50 years was studied in different localities. 
In 5 towns in which the percentage of such women so employed was 
12 or more the infantile mortality was 198 per 1,000 ; in 13 towns in 
which the percentage was under 12 and over 6 the infantile mortality 
was 156, and in 8 towns in which the percentage was under 6 the in- 
fantile mortality was 149. 

While the relation between factory labor for women and the death 
rate of young children seems well established for Staffordshire the 



241 

statistics of 1,000 towns given by the Registrar-General of England 
for 1905 do not show such a relation throughout England, to be 
intimate. 

UNNECESSARY HAND FEEDING. 

Although it might seem useless to repeat what the greatest medical 
authorities have so often asserted it is interesting nevertheless to con- 
sider to what extent hand- feeding, with its melancholy impress on 
vital statistics, is an absolute necessity. Madame Dluski, in a thesis 
delivered at the Baudelocque Clinic, Paris, expresses the opinion that 
among 100 healthy women, when the necessary conditions of alimenta- 
tion and repose are present, 99 are actually able to nurse their off- 
spring. She concludes that women, almost without exception, can 
nurse their babes ; that four-fifths of mothers can do so from the be- 
ginning of lactation; that nearly all can do so after a longer or 
shorter time, and that absolute agalactia does not exist. Yet despite 
all efforts to promote the practice of breast-feeding a great propor- 
tion of infants are uselessly bottle fed. Indeed the practice of feed- 
ing infants with the milk of animals (goats and cows) is of great 
antiquity — the Greeks and Scythians had recourse to it — but it is be- 
lieved to be greatly increasing in modern times. 

SCIENTIFIC ARTIFICIAL FEEDING AND THE MORTALITY RATE. 

In consequence of the great diffusion of the practice of artificial 
feeding for infants it is interesting to study the effect on morbidity 
and mortality statistics of a scientifically compounded artificial diet 
compared with a diet too often ignorantly or carelessly prepared. 
The statistics of the pasteurization of milk throw much light on the 
subject, 

THE STRAUS PASTEURIZED MILK DEPOTS. 

Pasteurized milk was first made available for infants in general in 
New York City in 1893, in which year Nathan Straus dispensed 
34,400 bottles of milk so prepared from one depot. In 1894 339,494 
bottles were issued, in 1895 666,622, and in 1896 666,941. In 1905 
2,668,397 bottles were dispensed and 1,016,731 glasses of pasteurized 
milk were bought at the booths in the parks of New York City. In 
1906 17 Straus stations dispensed 3,142,252 bottles of pasteurized milk 
and 1,078,405 glasses. 

Prior to the beginning of this work the death rate of children under 
5 years in New York City was over 96.2 out of every 1,000 and in 
June, July, and August the death rate of children was at the rate of 
136.4 per 1,000 per annum. With the increased use of pasteurized 
milk the death rate fell to 55 per 1,000 in 1906, and the summer death 
rate to 62.7 per 1,000. 

45276°— Bull. 56—12 16 



242 



These figures, year by year, are given in the following table, com- 
piled from the official statistics of the New York Department of 
Health : 

Population, deaths, and death rate of children under 5 years. 



Year. 


Population. 


Deaths. 


Death 
rate per 
1,000 per 
annum. 


1891 


188, 703 
194, 214 
199,885 
205,723 
212,983 
217, 071 
221,339 
225,804 
230,480 
235, 585 
242, 747 
250, 153 
257,813 
265, 738 
273,938 
282, 423 


18, 224 
18,684 
17,865 
17,558 
18,221 
16, 907 
15, 395 
15, 591 
14, 391 
15,648 
14,809 
15,019 
14,402 
16, 137 
15, 287 
15,534 


96.5 


1892 


96.2 


1893 


89.3 


1894 


85.3 


1895 


85.5 


1896 


77.9 


1897 


69.6 


1898 


69.1 


1899 


62.5 


1900 


66.4 


1901 


61.0 


1902 


60.0 


1903 


53.3 


1904 


60.7 


1905 


55.8 


1906 


55.0 







FOR THE MONTHS OF JUNE, JULY, AND AUGUST. 



1891 
1892 
1893 
1894 
1895 
1896 
1897 



1900 
1901 
1902 
1903 
1904 
1905 
1906 



188, 703 


5,945 


194, 214 


6,612 


199,886 


5,892 


205, 723 


5,788 


212,983 


6,183 


217, 071 


5,671 


221, 339 


5,401 


225,804 


5,047 


230, 480 


4,689 


235,585 


4,562 


242,747 


4,642 


250, 153 


4,389 


257,813 


4,037 


265, 738 


4,805 


273,938 


4, 892 


282, 423 


4,426 



126.4 

136.1 

117.0 

112.6 

116.1 

104.5 

97.6 

89.4 

81.4 

77.4 

76.5 

70.2 

62.6 

72.3 

71.4 

62.7 



For the purpose of comparison, the figures are confined to the orig- 
inal city of New York — now the Boroughs of Manhattan and the 
Bronx. 

At the rate of mortality of 1892, there would have been 27,169 
deaths of children under 5 years in 1906, instead of 15,534. Thus the 
apparent saving in one year was 11,635 lives, or 42.82 per cent. At 
the summer mortality rate of 1892, death would have claimed 9,743 



243 

victims in June, July, and August, 1906, instead of 4,426. Thus the 
apparent saving of lives in three months was 5,317, or 54.57 per cent. 
It must not be overlooked that in New York City, coincidently 
with the introduction of pasteurized milk, other agencies became 
operative, as for example general milk inspection by the local health 
authorities, the use of diphtheria antitoxin, the campaign of fresh 
air for children, improved tenement houses, cleaner streets, more 
parks and playgrounds, recreation piers, and other factors accom- 
panying the enlightenment in hygiene so widely spread in recent 
years, not only in New York City, but throughout the whole country. 

STATISTICS OF RANDALL'S ISLAND. 

When the infants in the care of the city of New York were fed on 
milk from a carefully selected herd pastured on the island, the death 
rate was as follows : 





Children 
treated. 


Number 

of 
deaths. 


Percent- 
age. 


1895 


1,216 
1,212 
1,181 


511 
474 
524 


42.02 


1896 


39.11 


1897 


44.36 






Total 


3,609 


1,509 


41.81 







A pasteurizing plant was installed in the early part of 1898. 
other change in diet or hygiene was made. 



No 





Children 
treated. 


Number 

of 
deaths. 


Percent- 
age. 


1898 


1,284 

1,097 

1,084 

1,028 

820 

542 

345 


255 
269 
300 
186 
181 
101 
57 


19.80 


1899 


24.52 


1900 


27.68 


1901 


18.09 


1902 


22.07 


1903 


18.63 


1904 


16.52 






Total 


6,200 


1,349 


21.75 







Had the ratio of deaths for the three years, 1895, 1896, and 1897, 
been maintained in the seven years from 1898 to 1904, the total infant 
mortality would have been 2,592, instead of 1,349, a difference of 1,243. 

STATISTICS OF MILK CHARITIES ABROAD. 

Writing of infantile mortality and the supply of humanized steril- 
ized milk, Hope states that at the Liverpool infant milk depots for 
three years ending with the year 1903, among 4,453 infants provided 



244 

with the depot milk the mortality rate was 78 per 1,000, compared 
with the following infantile mortality rate in the city of Liverpool : 



Year. 


Infantile 
mortality. 


1901 


188 
163 
152 


1902 


1903 


Average . . . 


167.6 



Harris has prepared the following comparative table showing re- 
sults of the St. Helens depot in the town of St. Helens, England : 



Year. 


Number of 

children 

on the 

books. 


Death rate 
per 1,000 

among 
children at 

depot. 


Infantile 
death rate, 
boroughof 
St. Helens. 


1899 


232 
332 
282 
200 


103 
102 
106 

82 


157 


1900 


188 


1901 


175 


1902 


167 







Lederer states that as a result of the system of pasteurization in 
practice in Vienna for the past seven years the proportion between 
the mortality rates for breast-fed and bottle-fed children which for- 
merly was 1 to 20 is in latter years between 1 to 5 and 1 to 8. It is 
observed that in Vienna the improvement in artificial diet reduces the 
mortality in the second year of life also. 

In France there are two types of organizations, the Consultation de 
Lait and the Goutte de Lait, having for their object the encourage- 
ment of breast feeding wherever possible and a supply of properly 
prepared milk to those infants for whom breast feeding is impractica- 
ble. At the Consultation de Nourissons of the Clinique Tarnier, 
Paris, the annual mortality rate during a period of about six years 
among 712 children who attended the Consultation from birth for an 
average period of nine and one-half months was 46 per 1,000. Ref- 
erence for comparative purposes to the death returns of Paris during 
the years 1898, 1899, and 1900, shows that there was a mortality of 
178 per 1,000 among infants under 1 year of age.. 

MILK AS A DIET FOR THE SICK. 

The influence of impure milk on the duration of sickness and on 
the death rate when milk is employed as an invalid diet is difficult 
to demonstrate statistically. For the sick, milk — usually uncooked 
milk — is often a principal or an exclusive article of diet. Consider- 
ing the increased susceptibility of feeble and aged persons to infection 



245 

and the diminished resistance offered by the sick, there can be no doubt 
that contamination of milk is a factor that plays a part in keeping up 
the rate of sickness and death. 

MILK AND TUBEKCULOSIS. 

The report of the United States Census Office on mortality for the 
year 1905 shows that deaths from all causes in the registration area 
were in the proportion of 1.616 per 100,000. Tuberculosis in all its 
forms caused 193.6 deaths per 100,000. Applying the same rate 
throughout the United States, it may be justly estimated that tuber- 
culosis causes over 160,000 deaths a year in the United States. 

At the International Congress on Tuberculosis held in London in 
1901, Koch made the announcement that bovine tuberculosis is trans- 
missible to the human subject to only a slight extent if at all. The 
doubt thus cast on the relation between cow's milk and tuberculosis 
has to a great extent disappeared on further investigation made by a 
host of observers, most prominent among whom is von Behring. who 
claims that milk fed to infants is the chief cause of tuberculosis in 
man. 

Schroeder and Cotton in a recent bulletin of the Bureau of Animal 
Industry conclude that the assertion that tuberculosis is a negligible 
quantity in the measures that must be taken for the preservation of 
human health is without basis and that there is no more active agent 
than the tuberculous cow for the increase of tuberculosis among ani- 
mals and its persistence among men. 

The rarity of primary intestinal tuberculosis, on which subject 
there is a discrepancy of statistics, is not in favor of the theory of 
infection by ingestion. It has been, however, repeatedly proA 7 ed that 
tubercle bacilli may pass through a mucous membrane without leav- 
ing traces at the point of entrance. Again it has been demonstrated 
by competent observers that tubercular infection may take place 
through the tonsils. Latham estimates that not less than 25 to 30 per 
cent of the cases of tuberculosis which occur in early childhood are 
due to intestinal, and therefore presumably to food, infection. Of 
deaths in 1905 from all forms of tuberculosis in the registration area 
of the United States, about 1 in 39 was among infants under 1 year 
and 1 in about 14 among children under 5 years of age. 

Ravenel writing in 1898 says : 

In northern Norway, Sweden, Lapland and Finland where reindeer con- 
tribute the bulk of farm animals, or about Hudson Bay and the islands of the 
Pacific, where there are only a few cattle, tuberculosis is far less prevalent in 
man. In Algiers the cattle are few and live for the most part in the open air 
and away from cities and it is found that tuberculosis does not increase among 
the natives. In Italy, on the other hand, where cattle are housed, Perroncito 
states that tuberculosis has become the scourge of man and beast. 



246 



Kegarding the conveyance of tuberculosis in the colder countries, 
Cobb points out that an absence of tuberculosis does not necessarily 
follow the absence of milk from the dietary. He shows on trust- 
worthy evidence that the Alaskan Indian, including the Esquimo and 
Aleut, is the victim of consumption of the lungs to a great and in- 
creasing extent, though these people do not use to any extent milk of 
any kind as an article of diet, and cow's milk not at all. Of interest 
in this connection is the report made in 1906 by the medical officer 
of health of the city of London showing that at least 8 per cent of the 
milk sold within the city limits of London is derived from animals 
affected with tuberculosis, and that of 500 cows examined after 
slaughter by the city veterinarian evidence of tuberculosis was found 

in 46.8 per cent. 

EPIDEMICS CAUSED BY MILK. 

In epidemics caused by milk (typhoid fever, scarlet fever, diph- 
theria, etc.), the mortality of the disease does not appear to differ 
from that of the same disease otherwise conveyed. The effect of milk 
epidemics on morbidity and mortality returns may be surmised by 
the frequency with which epidemics of such a character occur. 

MILK AND TYPHOID FEVER. 

Raudnitz, of Prague, states that one-fourth of the epidemics of 
typhoid fever in Austria are traceable to contaminated milk, and Mc- 
Crae records that an inquiry into the causation of 638 epidemics of 
typhoid fever showed that in 17 per cent the infection was conveyed 
by milk. The bearing of this observation on the general sick and 
death rate is obvious when it is considered that the mortality in ty- 
phoid fever, though often as low as 5 per cent in private practice, 
sometimes reaches 20 per cent. Typhoid fever causes more deaths 
than any of the other epidemic diseases. The United States census 
reports show that in 1905 there were 28.1 deaths from typhoid fever 
per 100,000 population. The death rate from typhoid fever was 
smaller in 1905 than in any of the five preceding years. The annual 
average for the registration area of the United States, 1900 to 1904 
inclusive, was higher than that for any of the countries given in the 
following table except Italy : 

Deaths from typhoid fever per 100,000 of population. 



Country. 



Registration area of United States 

England and Wales 

Scotland 

Ireland 

Germany 

Norway 



Annual 

average, 

1900 to 1904. 



33.7 
12.9 
12.7 
14.2 
8.5 
6.2 



Country. 



Sweden 

Hungary 

Belgium 

Switzerland 
Italy 



Annual 

average, 

1900 to 1904. 



12.2 
28.3 
20.2 
6.5 
37.8 



247 

SCARLET FEVER AND DIPHTHERIA. 

The number of epidemics of scarlet fever and diphtheria where the 
infection was conveyed by milk show unmistakably that the effect on 
morbidity and mortality rates thus brought about by milk must be 
considerable. While the death rate is low among patients of the 
better classes, in hospitals and among the poor it ranges from 5 to 30 
per cent, a marked variability of the death rate in different epidemics 
being a characteristic of scarlet fever. The general mortality of 
scarlet fever is shown by the following table: 

Number of deaths from scarlet fever per 100,000 population. 



Country. 


Annual 

average, 

1900 to 1904. 


Country. 


Anuual 

average, 

1900 to 1904. 


Registration area of United States 


11.8 
12.7 
10.8 
4.7 
23.7 
5.8 
8.7 


Hungary 


67.5 


The Netherlands 


2.6 




Belgium 


16.3 






3.7 




Spain 


5.9 




Italy 


4.6 


Sweden 











Diphtheria and croup caused an annual average of 33.6 deaths per 
100,000 in the registration area of the United States, 1900 to 1904. 
Among the means of transmission of diphtheria infected milk is a 
well-recognized medium. 



DISEASES OF CATTLE. 

Numerous other diseases in the transmission of which milk is a 
factor exert an effect on vital statistics. Milk sickness, a disease 
related to the affection in cattle known as the trembles, still occurs 
in certain parts of the United States. It is transmitted by milk and 
milk products as well as the flesh of diseased animals. In some of 
the Western States in early days it was a prominent disease and 
killed many of its victims. 

Foot and mouth disease in the cow has been frequently transmitted 
to human beings by the use of milk and milk derivatives. In one 
epidemic thus brought about the death rate was 8 per cent. 

ASIATIC CHOLERA. 

Milk is not infrequently a means of communicating Asiatic cholera. 
The evil efficacy of milk thus infected in its influence on morbidity 
and mortality statistics can be readily conjectured, when the desola- 
ting death record of cholera is reviewed and the almost universal use 
of milk considered. 



248 

EEFEEENCES. 

Balestre and Saint Joseph. 1901. Etude sur la mortal ite de la premiere 
enfance dans la population urbaine de la France de 1892 a 1897. Paris. 

Borchardt. 1883. Infant mortality and the milk supply. Med-Chir. Journ., 
v. 3, pp. 401-407. 

Budin, Pierre. 1905. Hygiene du Nourrisson. Paris. 

Casper, Joh. Ludw. 1825. Beitrage zur medicinischen statistik und Staatsarz- 
neikunde. Berlin. 

Census Report. 1902. Twelfth Census of the United States, taken in the year 
1900. Agriculture, Part 1, Farms, Live Stock and Animal Products. Wash- 
ington. 1907. Mortality statistics, 1905. Washington. 

Cobb, J. O. 1904. Is milk a factor in the spread of tuberculosis? N. Y. Med. 
Journ. and Phil. Med. Journ. Aug. 13, p. 304. 

Davis, J. B. 1817. A cursory inquiry into some of the principal causes of 
mortality among children, etc. London. 

Duffield, G. 1904. Milk in its pathological relations. Journ. Mich. Med. Soc, 
v. 3, pp. 70-72. Detroit. 

Fortescue-Binck, J. M. 1906. The influence of milk supply on infant mortality, 
Journ. of Royal San. Inst. p. 413. 

Freeman, R. G. 1896. Milk as an agency in the conveyance of disease. Med. 
Rec, Mar. 28. 1903. The reduction of the infant mortality in the City 
of New York and the agencies which have been instrumental in bringing it 
about. Med. News, p. 433. 

Harrington, Charles. 1906. Infantile mortality and its principal cause — dirty 
milk. Am. Journ. Med. Sc, Dec, p. 811. 

Lancet. 1906. Editorials, Mar. 31, and Apr. 28. London. 

Latham, Arthur. 1903. The diagnosis and modern treatment of pulmonary 
consumption. London. 

Lederer, Ernst J. 1907. The milk supply of Vienna. Med. Rec, June 15, p. 986. 

McCrae, Thomas. 1907. Typhoid fever. Modern Medicine. 

Medical Society of New Jersey, transactions of. Report of Committee on cows' milk. 

Miller, D. J. M. 1906. The dangers that may lurk in ordinary milk and the 
duty of the physician to educate the public and the authorities in the 
necessity of a pure milk supply. N. Y. Med. Journ. Sept. 22, p. 595. 

Newsholme, A. 1906. Domestic infection in relation to human diarrhea. 
Journ. Hyg., Apr. 

Osier, William. 1905. The principles and practice of medicine. New York 
and London. 

Raudnitz, R. W. 1907. The attitude of public health authorities on preserva- 
tion of milk by heat. Med. Rec, Sept. 7. 

Registrar-General of England and Wales. 1907. Sixty-eighth annual report of 
births, deaths, and marriages. (1905.) London. 

Reid, George. 1906. Infantile mortality and the employment of married women 
in factory labor before and after confinement. Lancet, Aug. 18. London. 

Rew, R. H. 1907. Milk supply of London. Lancet, Apr. 20, p. 1116. London. 

Sandilands, J. E. 1906. Epidemic diarrhea and bacterial content of food. 
Journ. Hyg., Jan. 

Schroeder, E. C, and Cotton, W. E. 1906. The relation of tuberculous lesions 
to the mode of infection. IJ. S'. Dept. of Agriculture, Bureau Animal In- 
dustry, Bull. No. 93. Washington. 

Stewart, A. H. 1906. Digest of medical literature. Milk from a sanitary 
standpoint. Am. Med., Feb. 17, p. 253. 

Walsham, Hugh, 1905. The channels of infection in tuberculosis, New York. 



9. ICE CREAM. 



(249) 



ICE CREAM. 



By Harvey W. Wiley, M. D., Ph. D., 
Chief of Bureau of Chemistry, Department of Agriculture. 



The use of artificially frozen dishes as an article of diet is not of 
very ancient origin. It is not the purpose of this paper to discuss 
the physiological and dietetic effects of introducing ice-cold foods into 
the stomach. There are grave objections to the practice which will 
occur to every physiologist and hygienist. Briefly I may state that 
the process of digestion in the stomach depends upon the free excre- 
tion of the peptic ferments by the glands of the inner coats of the 
stomach. The introduction of large quantities of ice-cold material 
can not fail to contract the orifices of these glands and check their 
excretory activity. 

Aside from this, however, the question of ice cream is one of grave 
importance in connection with the dairy supplies of the country, 
and particularly so because under the name of ice cream are found 
upon the markets products of the widest variation in composition, 
varying from the true ice cream to the true frozen pudding. 

It is necessary, therefore, in the discussion of the matter, if possi- 
ble, to ascertain first, what ice cream is or should be, and second, to 
study the materials from which it is made with a view to determining 
their sanitary character, and finally to determine the composition of 
the article itself as it is offered to the market. Incidentally there- 
fore the dairy which furnishes the milk and the milk which furnishes 
the cream are subjects of inquiry. These two subjects, however, have 
been carefully gone over in other papers of this series and hence any 
reference to them will be merely of an incidental character as illus- 
trating some point in connection with the particular subject at hand. 

The term " ice cream " is used in this country to cover a large 
variety of products, which in Europe are known under the general 
term of " ices." The Neapolitan ices are said to be a type of the 
European dishes. This type of ices is found in most of the cities of 
Europe, served often in very attractive packages with various adorn- 
ments or used directly without molding upon the table. The art of 
representing different kinds of fruits and flowers, animals, and other 

(251) 



252 

objects is also said to be of distinct European origin, although copied 
very largely in this country. For this reason there may be seen in 
both countries frozen products representing fruits of every descrip- 
tion and usually colored and flavored to imitate the fruits which they 
represent. Strawberries, apples, pears, lemons, oranges, pineapples, 
peaches, apricots, bananas, grapes, and nearly all other fruits are thus 
represented. Various figures of statuary, or public buildings, or ob- 
jects of art are also imitated in the form of frozen packages of this 
description. Even when milk or cream is used in the composition of 
these frozen dainties in Europe it is not the custom to call them ice 
cream. The Italian general name for these dishes is " sorbetto," the 
German is " Gefrorenes," the French " glace," and the English " ice." 
With the exception of the frozen dish called " sherbet," practically 
all the forms known in Europe under the names given are called, or 
have been called until recently in this country, " ice cream." 

In the discussion of this problem I shall first offer the investigations 
made under the auspices of the committee appointed by the District 
Commissioners to advise them in regard to the dairy products on 
sale in the District, including a study of the raw material from which 
ice cream is made and of the ice creams themselves. These studies 
have been conducted both from the chemical and bacteriological points 
of view. 

I will afterwards give a brief historical sketch of the use of the 
term ice cream and the compounds to which it has been applied. 

Next will be presented certain data respecting a proper standard 
for ice cream, a standard adopted by the United States Department 
of Agriculture under authority of an act of Congress, and the criti- 
cisms of this standard made by manufacturers and dealers in ice 
cream. 

In this way it is believed that the whole subject may be presented 
in such form as to be useful not only to the Commissioners of the 
District in any work which they may inaugurate respecting the con- 
trol of ice cream, but also to the people of the District and the people 
of the country in general. 

It is not deemed advisable to go into minute details respecting the 
bacteriological and chemical investigations. I will content myself 
therefore with presenting the tables of analytical data and with giv- 
ing a summary of the chemical and bacteriological investigations. 

SUMMARY OF CHEMICAL DATA RELATING: TO CREAM. 

The samples of cream which were purchased in the open market 
covered a period extending from January 30, 1907, to June 12, 1907, 
inclusive. (See Table III, page 300.) 

For the purpose of this investigation the analytical data reported 
referred only to the percentage of fat in the cream and to its artificial 



253 

coloring. The analyses were made in the dairy laboratory by and 
under the supervision of Mr. G. E. Patrick. 

The total number of samples examined is 132, including one double 
cream excluded from the averages. The average percentage of fat 
therein is 19.09. 

By act of Congress the legal standard of fat in cream for the 
District of Columbia is 20 per cent. The number of samples at or 
above 20 per cent is 44, or 33.58 per cent. The number of samples 
below 20 per cent of fat is 87, or 66.41 per cent. 

These data show that only one-third of the samples of cream pur- 
chased complied with the legal standard for the District. The 
standard for fat in cream, established by the Secretary of Agriculture 
under authority of Congress for the country at large in so far as 
interstate commerce is concerned is 18 per cent. The number of 
samples examined which are found at or above 18 per cent is 82, 
equivalent to 62.60 per cent of the total number. The number of 
samples below 18 per cent is 49, or 37.4 per cent of the whole number. 

The data show that as sold upon the markets of Washington during 
the time mentioned almost two-thirds of the commercial creams com- 
plied with the national standard. The total number of samples of 
the above lot which are found to contain more than 25 per cent of fat 
is 6 ; the number of samples containing less than 16 per cent is 24 ; the 
number of samples containing less than 14 per cent is 6, and the num- 
ber containing less than 13 per cent is 3, all of which are from the 
same dairy. These data show that the requirement of 18 per cent of 
fat, judged by the ordinary commercial data, is entirely just and sat- 
isfactory. Hence it follows that ice cream made from standard cream 
will easily contain 14 per cent or more of butter fat for the vanilla 
type of ice cream, and 12 or more per cent for the fruit type of ice 
cream, thus showing that the standards established are reasonable 
and just from the commercial conditions which actually exist. Of 
the total number of samples examined 15, equivalent to 11.45 per cent, 
are found to be artificially colored, thus showing that the artificial 
coloring of cream is not practiced to any great extent, and its entire 
prohibition would not in any way disturb the existing conditions of 
trade. 

SUMMARY OF THE CHEMICAL DATA RELATING TO ICE CREAM. 

The chemical analyses of the ice creams were made in the dairy 
laboratory of the Bureau of Chemistry by and under the supervision 
of Mr. G. E. Patrick, chief of that laboratory. (See Table IV, 
page 303.) 

For the purpose of this report only the fat content of the various 
samples of ice cream, the presence of gelatin, vegetable thickeners, and 



254 

coal-tar dyes are reported. The summary of the chemical data show 
the total number of samples analyzed to be 228. Judged by the stand- 
ard of 14 per cent for the ice creams of the vanilla type and 12 per 
cent of fat for the ice creams of the fruit type, it is found that there 
are at or above standard 117 samples, or 51.32 per cent, and below 
standard 111 samples, or 48.68 per cent. The average percentage of 
fat in the entire 228 samples is 12.67. Only 46, or 20.18 per cent of 
the whole number of samples, contain less than 10 per cent of fat, and 
only 25, or 10.97 per cent, contain less than 8 per cent. 

The total number of samples containing a thickener was 80, or 35.18 
per cent. In 33 samples, or 14.47 per cent, the thickener is gelatin, 
while in 47 samples, or 20.61 per cent, the thickener is a vegetable gum 
or starch. Only 2 samples are found to contain coal-tar dye. 

These samples were purchased at random from all the principal ice 
cream makers in Washington, over a period extending from about 
April 1 to August 1, 1907. 

The data are most interesting in view of the contention that the 
standard suggested for butter fat is too high, and especially in view 
of the fact that 8 per cent has been suggested by many as a proper 
standard. The chemical examination shows how devoid of commer- 
cial significance are both of the claims mentioned. Another interest- 
ing fact is that the percentage of samples containing gelatin is 
extremely small. This is of great significance as being a most 
emphatic negative answer to the contention that gelatin is necessary 
to the manufacture of ice cream, or is generally employed. The 
chemical data on the whole give no support to the contention that the 
suggested standard for ice cream is unfair. The absence of eggs, 
gelatin, starch, and other substances, which it has been said are com- 
monly used in the manufacture of ice cream, from the great majority 
of the samples is another point of great significance. In fact, the data 
show most conclusively that the term ice cream, even from a commer- 
cial point of view, is applied to a substance containing more than 14 
per cent of fat in more than 51 per cent of all the samples examined. 
It is, therefore, commercially as well as scientifically and hygienically, 
a term which should be applied to a substance of standard composi- 
tion and that standard, in so far as Washington is concerned, could 
be reached with but little variation from the usual methods of pro- 
ducing ice cream. What is true of Washington certainly should be 
true of other cities, since there is no indication that the quality of the 
creams made in Washington is any better than that of other cities. 

The only conclusion which can be derived from the study of these 
chemical data is that the term ice cream should apply generally, as 
it does in the majority of cases at the present time as indicated by 



255 

the results of these investigations, to a product made principally of 
cream and sugar, and with a natural flavor, either of an ordinary 
flavoring substance like vanilla or of fruit. Hence there appears to be 
no reason for departing from the established standard, in view of the 
data which have been secured by an examination of the commercial 
samples bought in the open market from all portions of the city. 

BACTERIOLOGICAL INVESTIGATIONS OF ICE CREAM IN THE DIS- 
TRICT OF COLUMBIA. 

[Made by or under the direction of Dr. George W. Stiles, and by or under the direction of 

Dr. M. E. Pennington.] 

In most instances the samples of ice cream received for examination 
were collected directly from the original place of manufacture. In a 
few cases, however, miscellaneous samples were taken at places other 
than those at which the product was prepared. Generally half a 
pint or a 10-cent box furnished a sufficient quantity to make the 
chemical, microscopical, and bacteriological examinations. The 10- 
cent box, to which reference is made, was the pasteboard carton 
almost universally used as a container for ice cream when sold in 
small quantities, and for this reason it was much preferred as a 
carrier of the samples to be investigated. When these cartons were 
not available well-cleansed bottles or new paper boxes were used 
instead. 

Upon arriving at the laboratory, samples for bacteriological ex- 
amination were removed at once from the frozen interior by means of 
sterile spoons and placed in sterile dishes to melt. Generally within 
eight to ten minutes a sufficient liquefaction had occurred to enable 
the experimenter to remove enough material to make the bacteriolog- 
ical examination. 

The enormous number of organisms which are found in cream, 
milk, and ice cream, necessitates high dilutions to make possible the 
quantitative determination of the organisms present. For the mak- 
ing of these, and the counting of the colonies Avhich developed, the 
technique pursued may be stated briefly as follows: The quantities 
were measured in 1 cubic centimeter pipettes, graduated in 0.01 
of a cubic centimeter, and 10 cubic centimeter pipettes graduated 
in 0.1 of a cubic centimeter. They were sterilized by heat and kept 
in bacteria-proof metal cases. 

In order to make the necessary dilutions Erlenmeyer flasks of about 
500 cubic centimeters and 100 cubic centimeters capacity, respectively, 
were used. To the former were added 99 cubic centimeters of sterile 
water and to the latter 9 cubic centimeters. To the flask containing 
99 cubic centimeters there was added 1 cubic centimeter of the sample 



256 

to be examined, thus making a dilution of 1 to 100. From it 1 cubic 
centimeter was removed and added to the second flask containing 9 
cubic centimeters, making a second dilution of 1 to 1,000. By a con- 
tinuance of this method, namely, the removal of 1 cubic centimeter 
and its addition to the fresh flask containing 9 cubic centimeters of 
pure water, the dilutions may be run as high as desired. For the 
routine of this work dilutions of 1 to 1,000; 1 to 10,000; 1 to 100,000, 
and 1 to 1,000,000, were adopted. 

The sowing of the organisms on the nutrient jelly was made by the 
removal of 1 cubic centimeter from the flask containing the desired 
dilution and its transference to a sterile petri plate, into which was 
immediately poured the melted medium and the organisms evenly 
distributed by shaking with a rotary motion. Duplicate plates were 
made in all cases and 2 per cent lactose agar was selected as the 
nutrient medium affording most satisfactory results. All the plates 
for this investigation were grown at a temperature of 30° C. for a 
period of three days, after which the colonies when numerous were 
counted by means of a Stewart counting chamber or when but few 
by the naked eye alone. 

The presence of gas-producing organisms was determined in this 
investigation by adding 1 cubic centimeter of the 1 to 100 dilution to 
sterilized 2 per cent dextrose fermentation tubes and incubating at 
30° C. for three days. When gas formation took place the quantity 
was estimated by the ruled scale method, as described by Frost in his 
Laboratory Manual. 

An endeavor was made to determine systematically the presence 
and approximate number of streptococci in each sample of ice cream, 
cream and milk, which has been examined recently by this Depart- 
ment. For this purpose 15 cubic centimeters were centrifugalized 
with an electric centrifuge for a period of fifteen to twenty minutes, 
and from the sediment were made several smears which were stained 
with methylene blue. Such a procedure yielded results with milk and 
cream alone, but when in the form of ice cream, especially those with 
fruit or chocolate flavors, the debris seemed to interfere to such an 
extent that satisfactory results were not always obtained. With the 
vanilla flavors the results were better, but even in such cases they were 
exceedingly rough. Hence there are a number of blanks in the tables 
and summaries of this work dealing with the presence in ice cream of 
streptococci, and the determination of the number of leucocytes per 
cubic centimeter in ice cream was made in but a few cases. 

Between October 13, 1906, and July 29, 1907, 263 samples of ice 
cream, collected in the City of Washington, were investigated as above 
outlined. That the bacterial flora in the majority of these ice creams 



257 

was numerically enormous may be gleaned from the following sum- 
mary : 

Samples showing — 

Less than 10,000 organisms per cubic centimeter 

From 10,000 to 50,000 organisms per cubic centimeter 

From 50,000 to 100,000 organisms per cubic centimeter 

From 100,000 to 250,000 organisms per cubic centimeter 2 

From 250,000 to 500,000 organisms per cubic centimeter 3 

From 500,000 to 1,000,000 organisms per cubic centimeter 14 

From 1,000,000 to 2,000,000 organisms per cubic centimeter 23 

From 2,000,000 to 5,000,000 organisms per cubic centimeter 34 

From 5,000,000 to 10,000,000 organisms per cubic centimeter 50 

From 10,000,000 to 25,000,000 organisms per cubic centimeter 64 

From 25,000,000 to 50,000,000 organisms per cubic centimeter 42 

From 50,000,000 to 100,000,000 organisms per cubic centimeter 15 

Above 100,000,000 organisms per cubic centimeter 16 

A study of the individual results from which the above summary 
was made shows that the average number of organisms per cubic cen- 
timeter is 26,612,371. The maximum count obtained was 365,000,000, 
the minimum 137,500 per cubic centimeter. Of the total number of 
samples, 71.1 per cent showed the presence of gas-producing organ- 
isms when 2 per cent dextrose fermentation tubes were inoculated 
with 0.01 cubic centimeter of the sample. 

Reports on the presence or absence of streptococci have been made 
on 115 of the above samples; 38.3 per cent of this number showed the 
presence of the organism, and 61.7 per cent of the samples examined 
failed to show it when tested by the method above described. 

During the course of this investigation 53 manufactories of ice 
cream in Washington, large and small, have been visited in order to 
determine the sanitary conditions prevailing where this food product 
is manufactured. In 62.2 per cent of these places the ice cream is 
made in the basement or cellar. In nearly all cases they are improp- 
erly constructed to meet the demand of sanitary conditions. The ceil- 
ings are low and generally show a gross collection of filth and cob- 
webs on the rough joints overhead. Occasionally a cellar is finished 
Avith a metal ceiling or plaster, but even when such improvements are 
noticed the absence of natural proper light or ventilation generally 
makes the cellar basement in Washington an unfit place for the man- 
ufacture or preparation of ice cream. Many of the buildings are of 
old-time construction and were not originally designed for the pres- 
ent-day purposes. With such construction as they show it is practi- 
cally impossible to keep the average basement or cellar in a proper 
and fit condition for the handling of milk, cream, and milk products, 
no matter how honest and thorough may be the attempts of the 
tenants to do so. , 

45276°— Bull. 56—12 17 



258 



In many cases the tenants have much to contend with and report 
that their landlords are wholly unwilling to make alterations or neces- 
sary improvements, and if such are made it must be done entirely at 
the expense of the tenant. Sometimes, however, the fault does not lie 
exclusively with the landlord. Very frequently the basement in these 
establishments is used not only for the manufacture of ice cream and 
frozen dainties but also as a storage room for all the old waste which 
may have accumulated for years past — old broken furniture, scraps of 
metal, cast-off clothing, broken boxes, barrels, moth-eaten rugs, mat- 
ting — in fact one may find just such worthless stuff as generally col- 
lects about the dwelling house in the course of time. Such articles 
must of course pollute, and most dangerously, any food products 
which are brought into their proximity, and the nature of the bac- 
terial flora found in the foodstuffs manufactured in these insanitary 
surroundings fully bear out the truth of the above statement. 

While the premises are themselves of insanitary construction an 
immense benefit would accrue to the consumers of ice creams, char- 
lotte russes, cream puffs, custards, etc., if a general house cleaning on 
the part of the tenants were demanded and enforced. 

An analysis of the individual findings in the 53 places visited and 
the classification, so far as possible, on the basis of " clean, dirty, fair, 
and filthy " shows the following results : 



Clean. 


Fair. 


Dirty. 


Filthy. 


3 
«5.6 


16 
a 30.1 


19 
a 35. 8 


9 
a 16. 9 



a Per cent . 

While undoubtedly the insanitary conditions prevailing in and 
about the ice cream manufactories of Washington must influence the 
wholesomeness of the product from the bacteriological point of view, 
it is not entirely responsible for the great number of organisms which 
are ordinarily found in such foods. As previously stated, the cream 
and milk supply of the city has been investigated by the Bureau of 
Chemistry, and although the detailed results will not be reported here, 
it is advisable to consider briefly the findings of the bacteriological 
examination of 130 samples of cream collected in the city of Wash- 
ington from February 1 to July 27, 1907. 

Samples showing — 

Less than 10,000 organisms per cubic centimeter 

From 10,000 to 50,000 organisms per cubic centimeter 3 

From 50,000 to 100,000 organisms per cubic centimeter 6 

From 100,000 to 250,000 organisms per cubic centimeter 20 

From 250,000 to 500,000 organisms per cubic centimeter 19 

From 500,000 to 1,000,000 organisms per cubic centimeter 15 



259 

Samples showing — 

From 1,000,000 to 2,000,000 organisms per cubic centimeter 13 

From 2,000,000 to 5,000,000 organisms per cubic centimeter 11 

From 5,000,000 to 10,000,000 organisms per cubic centimeter 10 

From 10,000,000 to 25,000,000 organisms per cubic centimeter 11 

From 25,000,000 to 50,000,000 organisms per cubic centimeter 10 

From 50,000,000 to 100,000,000 organisms per cubic centimeter 7 

100,000,000 or above organisms per cubic centimeter 2 

The preceding summary indicates but too plainly the source of the 
majority of the organisms in ice cream. Not a single sample showed 
less than 10,000 organisms per cubic centimeter and only 3 Avere less 
than 50,000, while 14, or 10.8 per cent, were between 10,000,000 and 
25,000,000. The average number of organisms for all the samples 
examined was 12,130,080 per cubic centimeter. The maximum count 
was 309,000,000 and the minimum was 12,000 per cubic centimeter. 
An examination of these creams for the presence of fermenting or- 
ganisms showed that when 2 per cent dextrose fermentation tubes 
were inoculated with 0.01 cubic centimeter 51.53 per cent of the 
samples developed gas. 

Between January 12 and July 2, 1907, a bacteriological examina- 
tion was made of 381 samples of milk collected in the city of 
Washington. The quantitative bacteriological findings are appended : 

Samples showing — 

Less than 10,000 organisms per cubic centimeter 12 

From 10,000 to 50,000 organisms per cubic centimeter 59 

From 50,000 to 100,000 organisms per cubic centimeter 65 

From 100,000 to 250,000 organisms per cubic centimeter 70 

From 250,000 to 500,000 organisms per cubic centimeter 40 

From 500,000 to 1,000,000 organisms per cubic centimeter 23 

From 1,000,000 to 2,000,000 organisms per cubic centimeter 25 

From 2,000,000 to 5,000,000 organisms per cubic centimeter 38 

From 5,000,000 to 25,000,000 organisms per cubic centimeter 26 

From 10,000,000 to 50,000,000 organisms per cubic centimeter 13 

From 25,000,000 to 100,000,000 organisms per cubic centimeter 4 

From 50,000,000 to 100,000,000 organisms per cubic centimeter 2 

Above 100,000,000 organisms per cubic centimeter 2 

It was found that the average number of organisms per cubic cen- 
timeter was 3,415,533, with a maximum count of 283,000,000 per cubic 
centimeter and a minimum of 1,000. It is of interest to note, however, 
that only 12 of the 381 samples showed a bacterial count of less than 
10,000. Thirty-seven per cent of the samples showed the presence of 
gas-producing organisms when tested according to the method 
previously given. 

The foregoing investigations would seem to clearly demonstrate 
that so far as the ice cream supply of the city of Washington is con- 
cerned there is, bacterially, a wide field for its betterment, beginning 
with the cream and milk which enter into its composition and pro- 



260 

gressing steadily through every step of its manufacture to the final 
cleansing of the hands and garments of the employees who dispense 
this easily polluted foodstuff. 

Unfortunately for the good of the country at large, and judging 
from a cursory knowledge of ice cream manufactories in general and 
the reported findings of milk and cream supplies throughout the 
country, the conditions prevailing in Washington can not be 
accepted as unique. 

A study of the commercial ice cream of Philadelphia was made in 
the Bacteriological Laboratory of the city during 1905-6. (Bacterio- 
logical Study of Commercial Ice Cream, Pennington and Walter, 
New York Medical Journal, Vol. LXXXVI, No. 22, page 1013.) The 
examination in Philadelphia covered the number of organisms pres- 
ent, an approximate count of the leucocytes, the presence of strep- 
tococci morphologically and the determination of their vegetative 
ability, the sanitary condition of the premises on which the ice cream 
was manufactured, the sanitary condition of the shop or dealer's 
warehouse from which the cream and milk were obtained, and the 
bacteriological examination both numerically and for the presence of 
living streptococci in the cream and milk which entered into the 
sample of ice cream studied. 

In so far as the cleanliness of the premises and the product is con- 
cerned the above authors make the following statements: 

Sixty different ice cream makers were visited and their premises inspected. 
What constitutes a standard of cleanliness in the production of such food- 
stuff as ice cream depends very largely upon the inspector's ideas on the sub- 
ject. The very nature of the process — the mixture of ice and salt, wooden tubs 
for freezing, fruit flavoring, etc. — makes it a difficult matter to preserve immac- 
ulate surroundings even when interiors of utensils and constituents of the ice 
creams are strictly clean. The final division of these 60 different makers' estab- 
lishments was made on the basis of four classes: (1) Clean; (2) fair; (3) 
dirty; (4) filthy. In rating them the building, drainage, opportunities for 
ventilation, conditions of walls, ceilings, windows, adjoining rooms or buildings, 
as well as the condition of the utensils, methods of cleaning, attempts at sterili- 
zation, etc., were taken into account. The results are as indicated. 

Division of 60 different establishments. 



Condition. 





Percent- 


Number 


age hav- 


of estab- 


ing strep- 


lish- 


tococci 


ments. 


in ace 




cream. 


20 


90 


26 


77 


6 


66 


8 


75 



Average 

count of 

organisms 

per cubic 

centimeter. 



Clean 
Fair.. 
Dirty. 

Filthy 



12, 460, 863 
15,857,800 
22,491,833 
29,225,714 



261 

The maximum number of organisms found was 151,200,000 per cubic centi- 
meter and the minimum was 50,000 per cubic centimeter. 

While the cleanliness of the manufactory does not, according to this inves- 
tigation, bear any constant relation to the presence of streptococci it does affect 
the cleanliness of the finished product as indicated by the total bacterial con- 
tent, a gradual rise being observed from the " clean " shops to the " filthy " ones. 
The latter were sometimes almost beyond description. For instance, sample 42 
was made in a shed adjoining both a dwelling and a stable for 8 or 10 horses. 
The workmen went from horses and stable cleaning to the ice cream shed with- 
out restraint, handling the utensils in the latter as necessity demanded, re- 
gardless of soiled clothes or hands. Ice cream cans and milk cans stood in a 
passageway common to both shop and ice cream manufactory, a part of which 
was bordered on each side by stalls for horses. The stench of this place finally 
caused complaint from the neighborhood and it was dealt with on the ground of 
a nuisance. On the other hand a large ice cream manufacturer had endeavored 
to preserve the strictest cleanliness possible. Employees engaged in ice cream 
making did no other work and each man had only certain duties or portions of 
the process assigned to him. He changed his clothing and took a bath when be- 
ginning the day's work and clean lockers and plentiful showers were provided 
to enable the fulfillment of this regulation. The utensils were cleaned with 
soda and finally placed on a steam table for sterilization. Such precautions 
resulted in the counts given in samples 27 and 48 and 49, namely, 6,535,000, 
33,120,000, and 20,550,000. 

Through the courtesy and interest of the head of this ice cream firm a bacte- 
riological study of each step in the process was made possible. The cream in 
the supply tank was first sampled, a portion was then drawn off by the employee, 
mixed with the necessary sugar (cane) for sweetening, and a sample of this 
taken for examination. After adding the vanilla and transferring to the freez- 
ing cans it was again sampled, and then the frozen product was also examined. 
In the freezing the bulk a little more than doubled. Although frozen the ice 
cream was soft enough to measure in a wide-mouthed 10 cubic centimeter pi- 
pette, and it was plated, after appropriate dilution, at once. The results of the 
frozen cream, to be comparable with those of the preceding samples, should, 
therefore, be about doubled. The plates were of agar and were grown at 20° C. 

Organisms in ice cream at each step in the process of making. 



Articles. 



On agar at 
20° C, or- 
ganisms 
per cubic 
centimeter. 



Streptococci. 



Cream from tank 

Cream and sugar , 

Cream, sugar and vanilla in freezer 
Frozen cream 



2,840,000 

7,000,000 

5, 750, 000 

a 2, 250, 000 



Present, about 25 per cent of all or- 
ganisms and in an active condition. 



a Multiplied by 2 equals 4,500,000. 

It is of interest to note in the examination of the above sample 
of ice cream that a careful pasteurization had been performed by 
the ice-cream maker immediately upon the receipt of the cream. 

The presence of streptococci in the ice cream on sale in the city of 
Philadelphia has been made the subject of special study in the article 



262 

to which reference has been made. The summary of the results states 
that — 

In 55 out of the 68 samples, or 80 per cent, streptococci were found. 

In 45 examinations, or 66 per cent, not only the finished product, but the 
milk or cream used in its manufacture were investigated. In 35 of the 45 
cases, or 77 per cent, streptococci were found in the milk or cream and in the 
ice cream as well. From 23, or 33 per cent of all examined, the streptococci 
were isolated in pure culture. They grew fairly easily. In only 3 samples 
were these organisms found in the cream alone, and where both cream and ice 
cream were examined only twice in the ice cream alone. The question of the 
original source of streptococci in ice cream is of importance from a sanitary 
standpoint. The conditions under which the mixtures are made and frozen, 
the cleansing of the utensils, etc., are such that very often almost any kind of 
bacterial infection may gain access to it. 

The usual source of streptococci in milk or cream, however, is the cow, and, 
judging from the results set forth here, it is the cream or milk entering into 
the ice cream which is the carrier of the germs. The cleanliness of the sur- 
roundings under which the ice cream is made does not seem to greatly affect 
the presence of streptococci. 

Since ice cream is a food which is so largely used by children and 
invalids whose digestive tracts are more readily open to bacterial 
infection than are those of the adult or the person in perfect health, 
the widespread presence of an organism to which so much responsi- 
bility for ill-doing is attached as appertains to the streptococcus, 
should be looked upon with suspicion and every care possible taken to 
exclude it from such food products — at least until it has been proven 
innocuous. 

There seems to be a certain class of adults who have a predispo- 
sition against ice cream and who can not ingest it without a feeling 
of discomfort and in not a few cases symptoms of severe toxic 
poisoning result, manifesting the usual course of nausea, vomiting, 
diarrhea and pains in the abdomen, with cramps and muscular 
pains, often followed for a short time by general weakness, malaise, 
loss of appetite, and headache. Where samples of ice cream asso- 
ciated with such disturbances have been examined bacteriologically 
they have often shown the presence of overwhelming numbers of 
streptococci, constituting practically a pure culture, or associated 
with organisms such as B. coli or other bacteria known to be found 
under insanitary conditions. 

Where in the routine examination of a city's milk supply the absence 
or presence of streptococci is made the subject of investigation, it has 
been found that approximately 40 per cent of the milk offered com- 
mercially contains these organisms, and in the cases of certain indi- 
vidual cities the results are much higher. According to the inves- 
tigations, already quoted by Pennington & Walter, 80 per cent of 
commercial ice cream contains these organisms. In an endeavor to 



263 

determine the reason for this high frequency, they conducted a study 
on the relative rate of growth of streptococci isolated from milk, 
in milk and cream, and find that there is a much more rapid pro- 
liferation of the organism in cream than in milk. The difference in 
the relative rate of growth is more striking, also, at the temperature 
of the refrigerator (about 12° C.) than at higher temperatures, 
which may account, at least to some extent, for the frequency with 
which this organism occurs in ice cream and also for its overwhelm- 
ing proportion there. 

It was noticed also that the thickening of cream, inoculated with 
pure cultures of streptococci and kept cool, was very marked. Its 
whipping quality greatly increased and the separation of a curd was 
extremely slow, all of which qualities are sought after by the ice- 
cream maker. 

CHANGES IN ICE CREAM DURING STORAGE. 

An important point to be considered in the study of ice cream is 
the change which takes place during the storage thereof. It is quite 
customary at the present time to make a kind of ice cream which is 
intended to be kept a long while and shipped to great distances. 
It is generally supposed that very low temperatures entirely in- 
hibit bacterial growth. That this is not always the case is shown 
by the results of the investigations which are appended. In order 
that some definite knowledge might be obtained of what actually 
takes place respecting the bacterial flora during cold storage two sets 
of investigations were instituted — one in Washington under the 
supervision of Dr. George W. Stiles, and one in Philadelphia under 
the direction of Dr. M. E. Pennington. Doctor Stiles's report is as 
follows : 

The technique used in the study of ice-cream samples kept in a frozen con- 
dition for about thirty days corresponded very closely to that used in the 
quantitative examination of the ice-cream samples heretofore described. The 
sampling, however, was of necessity somewhat modified. 

From each of four representative dealers twelve 5-cent samples were pur- 
chased, each sample being kept separate in a 5-cent paper carton, as used by 
such dealers. One dealer, however, not having the small cartons at hand 
wrapped the samples each in tissue paper and placed all of them within a new 
pasteboard box. The samples were kept in a cold-storage warehouse where the 
temperature varied from 0° to 10° above F. The graphic chart shows the 
variations in bacterial content of these four groups of samples. 

In addition to making counts of the number of organisms present, each sample 
was tested for gas-producing organisms, and from each a bacillus was isolated 
which belonged to the B. coli group. 

The initial count of sample No. 1 was 16,000,000; of No. 2, 85,000,000; of 
No. 3, 135,000,000, and of No. 4, 53,000,000. The variation from these numbers 
during the keeping of the sample will be noted in the table which follows, as 



264 

well as the decrease of gas production in some and no noticeable difference in 
others, especially No. 1, which showed gas-producing bacteria during the entire 



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period. With a decrease in the gas-producing bacteria after the first or second 
week there was also noted a marked decrease in the number of organisms, 
though in many cases these again increase. 



265 

Table showing the number of organisms and percentage of gas production in cold-storage 

ice cream. 



Group 
No. 


Serial number of sample. 


Days in 
storage. 


Bacteria per 
cubic centi- 
meter. 


Percent- 
age of 
gas. 


Percent- 
age of 
gas, du- 
plicate. 




[401 




3 

6 

9 

11 

14 

17 

20 

23 

27 

30 

34 



3 

6 

9 

11 

14 

17 

20 

23 

27 

30 

34 



3 

6 

9 

11 

14 

17 

20 

23 

27 

30 

34 



3 

6 

9 

11 

14 

17 

20 

23 

27 

30 

34 


16,000,000 

25, 000, 000 

21,000,000 

27,000,000 

18, 000, 000 

3, 000, COO 

6,000,000 

13, 000, 000 

20, 000, 000 

185, 000, 000 

8,000,000 

3, 000, 000 

85, 000, 000 

175,000,000 

38,000,000 

48, 000, 000 

18,000,000 

9, 000, 000 

9, 000, 000 

70, 000, 000 

19, 000, 000 

125, 000, 000 

10, 000, 000 

11, 000, 000 

135, 000, 000 

195, 000, 000 

138, 000, 000 

145, 000, 000 

115, 000, 000 

39,000,000 

35, 000, 000 

93, 000, 000 

97, 000, 000 

385, 000, 000 

50,000,000 

28, 000, 000 

53,000,000 

95, 000, 000 

47,000,000 

75,000,000 

54, 000, 000 

7, 000, 000 

27, 000, 000 

95,000,000 

49, 000, 000 

205, 000, 000 

30,000,000 

9,000,000 


25 
45 
30 
20 
25 
25 
30 
30 
20 
20 
15 
20 
25 

5 


30 











A 




25 
30 
20 
30 
40 

2 

9 

1 

5 

18 
18 


25 
18 
25 
10 
15 

1 

9 



1 

5 


12 


25 




429 


35 




V 

433 


30 




440 


30 




484 


25 




489 


20 


1 


542 


35 




538 


25 




546 


25 




555 


20 




564 


10 




568 


20 




(404 


25 




430 


5 




434 







441 







485 












2 




543 







539 







547 







556 







565 







569 







(403 : 


25 






20 




435 


30 




442 


40 




486 


25 




491 


8 


o 

3 


544 


10 




540 







548 


5 




557 







566 














f 402 


10 




432 


20 




436 


15 




443 


20 




487 


1 




492 





4 


545 


20 




541 







549 







558 







567 







571 


o 









266 

The experiment conducted under the direction of Doctor Penning- 
ton follows: 

While the temperature of 0° C. is ordinarily accepted as that at which bac- 
terial life is either quiescent or annihilated, the making of ice cream in a freez- 
ing mixture of ice and salt reduces the substances to a temperature of from 
— 10° C. to — 20° C. To test the action of this temperature on the very rich 
bacterial flora ordinarily occuring in commercial ice creams, samples were 
obtained from various sources and maintained for several days at a tem- 
perature varying at from — 10° C. to — 20° C. It has been found by inquiry and 
observation that ice cream may be kept by a manufactory or more likely by 
the retail dealer for a week or ten days. It is of course kept for greater 
lengths of time when provisioning ocean liners or stored for some particular 
purpose, but this is rather the exception. It was deemed advisable, therefore, 
to limit this preliminary investigation to the period which is ordinarily that 
of commerce. 

The samples of ice cream tested were purchased in open market or sent 
directly from the manufacturer, who had no knowledge of the purpose for 
which they were intended. When coming from the manufacturer they were 
packed in the usual tin ice-cream storage can, set in an ice and salt mixture. 
When purchased from restaurants, confectioners, etc., the sample was obtained 
in a sterile wide-mouthed glass jar, tightly capped, and was immediately 
packed down in ice and salt. All the samples to facilitate keeping were placed 
in a room in the cold-storage warehouse, where the temperature was slightly 
below freezing. Here they were inspected daily, ice and salt added as required, 
and samples for study removed with sterile glass spatulas. 

For the determination of the total number of organisms, approximately 
1 cubic centimeter of the cream, which was melted as promptly as possible 
after reaching the laboratory, was weighed in a tared, sterile weighing bottle, 
made up to 10 cubic centimeters with sterile water, and from this mixture 
were prepared appropriate dilutions for the counting of organisms. 

The plating was done on litmus lactose agar, half the plates of each sample 
being allowed to develop colonies at a temperature of 37° C, and the other 
half placed in the refrigerator, running from 18° C. to 20° C. It has been 
found necessary to use both these temperatures if an accurate idea is to be 
obtained of the changes undergone by organisms when submitted to continuous 
low temperatures, since there is apparently a dying off of certain groups of 
organisms in the early stages of storage, and the gradual increase of other 
organisms, which seem ultimately to thrive under what are usually conditions 
fatal to growth. 

The results obtained in the study of 8 samples of ice cream are tabulated 
as Series I, II, and III, of Table I. Series I extended over sixty-six hours; 
Seres II covered a total of one hundred and ninety-two hours, and Series III a 
total of two hundred and sixteen hours. 

As with all experiments where the bacterial flora is of as varied a character 
as that found in commercial cream, there is observed in this work a consid- 
erable variation in the behavior of different samples. Generally the tendency 
is to show a decrease for at least several days in a number of organisms 
developing at body heat, though occasionally these organisms persist and thrive 
at low temperatures. The organisms, developing at the temperature of the 
refrigerator show usually a period of decrease which may last several days, to 
be followed later by a very pronounced rise. Sometimes the killing off of the 
organisms is very slight, their numbers remaining almost stationary or making 
a continuous upward curve. 



267 



The experiments cited are too few to permit of formulating definite conclu- 
sions and it must not be forgotten that, purchased as they were — in open! 
market— their histories unknown, there may have occurred a considerable part 
of the bacteriological cycle before the specimens were investigated. The results 
given simply show what may happen to commercial ice cream if kept for from 
three to ten days. 

Two experiments have been made to test the action of freezing and thawing. 
For this work cream was obtained from a milk dealer, sweetened and flavored 
with vanilla in the laboratory, and frozen in a small hand freezer, which had 
been cleansed simply with hot water. After freezing the product was packed 
down in an ice-salt mixture ami allowed to stand until the cream had thor- 
oughly melted, though the temperature was still considerably below that of the 
surrounding atmosphere. It was then refrozen and again allowed to stand for 
some hours. At each step the bacterial count was made and recorded, as seen 
in Table II. Experiments of this character are of interest, not only for the trac- 
ing of decrease in numbers, but also as a possible source of information regard- 
ing the many cases of ice-cream poisoning blamed upon stale ice cream, and 
particularly that which had been melted and refrozen. 

Table I. — Growth of bacteria in ice cream at the temperature of ice and salt 
{-n°C. = -5.8°F.). 

SERIES I. 



Source of ice cream. 



Total number of organisms in- 



1 gram of 
fresh ice 
cream. 



1 gram after 
18 hours. 



1 gram after 
42 hours. 



1 gram after 
66 hours. 



No. 1— Manufacturer, sample sent directly 
from factory, 

No. 2— Manufacturer, sample sent directly 
from factory 

No. 3— Manufacturer, sample sent directly 
from factory 



a 811, 249 
52,523,886 
a 4, 142, 068 
69,521,995 
a 3, 375, 527 
69,493,670 



a 1,010, 509 
61,010,509 
a 2, 552, 676 
61,495,066 
"4,173,622 
6936,065 



a 3, 349, 733 
6 628,074 

a 2, 603, 421 
6464,000 

a 1, 055, 966 
6 422,386 



a 4, 405, 286 
61,664,218 
a 4, 550, 050 
6 3, 993, 933 
a 4, 264, 870 
616,835,016 



SERIES II. 





Total number of organisms in— 


Source of ice cream. 


1 gram of 
fresh ice 
cream. 


1 gram after 
24 hours. 


1 gram after 
48 hours. 


1 gram after 
96 hours. 


1 gram after 
192 hours. 


No. 4— Low-grade confectioner . 

No. 5— Wholesale milk com- 
pany and dairy lunch 


f a 564, 381 
i 61,097,408 
f al, 006, 904 
1 65,418,105 


a 164, 000 

6201,786 

a 1,489, 361 

6 2, 765, 957 


a 140, 814 
61,804,180 
a 1,171, 613 
62,454,809 


a 149, 812 
6 2,536,315 

a 816, 405 
6 3,936,242 


a61,312 

61,021,867 
a 236, 709 










SERIES III. 










Total number of organisms in — 


Source of ice cream. 


1 gram of 
fresh ice 
cream. 


1 gram after 
24 hours. 


1 gram after 
48 hours. 


1 gram after 
72 hours. 


1 gram after 
120 hours. 


1 gram after 
216 hours. 


No. 6 — Cheap restaurant 
Avhich buys from manu- 
facturer of sample No. 1. 

No. 7 — Small bakery, prem- 
ises clean 

No. 8— Market-house lunch 
counter, ice cream made 


1 a 2, 668,777 
1 6 6,219,608 

fa 12, 460, 196 
[629,558,355 

a 510, 673 
I 6 714, 942 


a 298, 804 
61,090,637 

a 3, 231, 017 
62,670,974 

a 1,256, 645 
62,319,961 


a 709, 442 
6 855, 503 

a 4, 019, 523 
6 8,010,335 

a 1,424, 936 
6 1, 323, 155 


a 690, 000 
6 1, 189, 296 

a 12, 735, 849 
6 2,452,830 

a 776, 196 
6 217, 335 


a 292, 839 
6 2,352,163 

a 8, 052, 455 
6 2,300,701 

a 476, 338 
61,449,725 


a 153, 351 
6 946, 611 

a 644, 329 
6 5,257,731 

a 219, 499 
61,005,615 







a 37° C. 



6 18° to 20° C. 



268 



Table II. — Bacterial groivth in Ice cream thawed and refrozen. 





Total number of organisms in — 


Source of ice cream. 


1 gram of 
cream. 


1 gram of ice 
cream. 


1 gram of 
melted ice 

cream 14 
hours after 

freezing. 


1 gram of re- 
frozen cream. 


1 gram of ioe 

cream 7 
hours after 
refreezing. 


Experiment 1— Home-made, va- 


f al, 142, 640 
1 61,158,886 


a 274, 254 
6351,219 


a 57, 090 
6331,125 


a 32, 829 
6306,412 


a 28, 774 
632,696 






Total number of organisms in— 


Source of ice cream. 


1 gram of 
cream. 


1 gram of ice 
cream. 


1 gram of 
melted ice 

cream 23 
hours after 

freezing. 


1 gram of re- 
frozen cream. 


1 gram of ice 

cream 5 
hours after 
refreezing. 


Experiment 2— Home-made, va- 
nilla 


f a 2, 926, 421 
{ 67,525,125 


al, 144, 016 

63,874,896 


a 897, 867 
62,244,668 


a 614, 463 
6732,629 


al, 541, 501 







a 37° C. 



618° to 20° C. 



All of the samples which have been studied for cold storage his- 
tory were examined also for the presence of streptococci. The re- 
sults are indicated in the following list : 



Num- 
ber. 


Streptococci. 


Num- 
ber. 


Streptococci. 


1 
2 
3 
4 


Not found. 

Present — short chains — numerous. 
Present — long chains — very numerous. 
Present — short chains— few. 


5 
6 

7 
8 


Present— short chains — few. 
Present— long chains— numerous. 
Not found. 
Not found. 



Eighty-two and five-tenths per cent showed the presence of the 
organism. 

The method for the detection of streptococci in ice cream was as 
follows: The melted sample was centrifuged for half an hour in a 
Stewart lactocrite driven by a small motor of such power that the 
speed was approximately 3,000 revolutions per minute. This appa- 
ratus, which consists of a flat aluminum pan holding 20 tubes of 1 
cubic centimeter capacity and stoppered at the outer end with a spe- 
cially constructed rubber plug, causes the sediment not only to be 
thrown to the end of the tube but drives it against the rubber plug 
with such force it is almost quantitatively adherent to the plug. 
Accordingly, if one carefully removes the rubber stopper and by rub- 
bing on a glass slide and over an area of known surface attaches the 
sediment, one can obtain, on staining and examining the film micro- 
scopically, an approximation of the number of organisms and leu- 
cocytes in 1 cubic centimeter of the liquid. 



269 

Because of the debris in ice cream, which ordinarily renders the 
usual method of centrifuging milk and cream samples quite imprac- 
ticable, the above method was resorted to and, so far as the detection 
of the presence of streptococci was concerned, it was found eminently 
satisfactory. 

THE SIGNIFICANCE OF A PURE ICE CREAM SUPPLY IN RELATION 
TO PUBLIC HEALTH. 

A study of the literature dealing with diseases traced to the eat- 
ing of ice cream shows that not only are isolated cases more or less 
severe, even sometimes resulting in death, fairly numerous, but wide- 
spread epidemics have been caused by the toxicity of the substance. 
Such diseases are, of course, of gastro-intestinal origin. Among 
these epidemics is one of typhoid fever described by Dr. George Tur- 
ner, occurring at Depford in 1891, which was apparently caused by 
ice cream. 

Another epidemic of this disease occurred in Liverpool in 1897 
to Avhich 27 cases were traced. 

In 1902, in the city of London, 18 cases of typhoid fever were 
traced by the health officer of Finsbury (see report of health of Fins- 
bury, 1902, page 67) to ice cream as the source of infection. 

More commonly, however, the illness caused by ice cream has the 
symptoms of colic, headache, diarrhea, and depression rather than a 
specific typhoid infection. " Such an outbreak occurred in Birming- 
ham during the summer of 1905 (Thresh & Porter, Preservatives in 
Foods and Food Examination, page 280) and was investigated by 
Dr. Eobertson, the city medical officer of health. Out of 250 con- 
sumers served 52 cases of illness occurred, 4 only of the patients being 
over 14 years of age. The interval which elapsed between the eating 
of the ice cream and the onset of the illness varied from half an 
hour to eight and a half hours. All the persons suffered from diar- 
rhea and collapse. No irritant poison was discoverable by chemical 
analysis. Professor Leith examined the ice cream bacteriologically 
and found therein a bacillus of the colon group capable of causing 
the death of guinea pigs. From an examination of the premises in 
which the ice cream was manufactured it appeared probable that it 
had become contaminated while standing in the cooling shed after 
boiling and before freezing. Opposite this shed there were 3 water- 
closets in an extremely filthy condition, and possibly organisms of 
excremental origin had fallen upon one of the buckets of the cream 
while it was in a warm condition. These would rapidly multiply and 
may have produced toxins or ptomaines. Neither the bacilli nor their 
poisonous products would be affected by the subsequent freezing." 



270 

In the discussion of ice cream in " Bacteriology and Public 
Health," by George Newman, he states that a " small outbreak oc- 
curred in the city of London, affecting 16 telegraph boys. The 
symptoms were colic and diffuse abdominal pains, headache, vomit- 
ing, diarrhea, and nervous depression. Dr. Collingridge's inquiry 
resulted in the following conclusions : 

(1) That in a number of cases # of illness occurring among young persons of 
a susceptible age the symptoms were strictly identical and were characteris- 
tic of poisoning by ingestion of toxic material. 

(2) That the cases reported followed the ingestion of ice creams. 

(3) That ice creams subsequently obtained at shops frequented by the pa- 
tients contained bacilli of a virulent character. 

(4) That the symptoms observed were those generally following the inges- 
tion of material containing such bacilli. 

(5) That where pathogenic bacilli were found, the ices had been manufac- 
tured under insanitary conditions. The majority of the manufacturers are 
aliens, and although the premises may be kept in a fairly sanitary condition, 
their personal habits unfortunately leave much to be desired where the prepar- 
ation of food is concerned." 

Dr. Klein examined 24 samples of ice cream from the same locality 
and found 13, or 54 per cent, to be poisonous to guinea pigs. 

In July of 1904 the medical officer of health of Battersea (Report 
of 1904, Public Health Committee of the London County Council) 
reported an outbreak of illness among the people who had eaten ice 
cream purchased at a particular shop. As usual in such toxemias 
the symptoms included abdominal pain, diarrhea, and collapse. 
The ice cream causing these poisonings had all been eaten and there- 
fore could not be examined, but an inspection of the premises showed 
very filthy conditions and in all probability the contamination of 
the cream was due to a dust bin in the immediate proximity of the 
shelf on which the ice-cream vessels were stored. 

Owing to outbreaks of this nature the London County Council 
(general powers act, 1902, sees. 42-45) has given powers for control- 
ling this trade : 

(a) Ice cream must be made and stored in sanitary premises. 

(6) It must not be made or stored in living rooms. 

(c) Strict precautions must be taken as to protection from contamination. 

(d) Cases of infectious disease must be reported. 

(e) The name and address of the maker must appear on street barrows. 

These regulations are new for London, though they have practi- 
cally been in existence in Glasgow since 1905, and in Liverpool since 
1898. 

That such powers are enforced by the officials having the public 
health of London in charge is demonstrated by the report, for ex- 
ample, of the sanitary conditions relating to the city of Westminster 



271 

for the year 1903. (Francis J. Allan, medical officer of health for 
the city of Westminster.) 

Premises where ice creams are manufactured or sold were frequently in- 
spected during the year; there were 108 premises other than hotels and 
restaurants where ice cream is manufactured and sold. Proceedings were 
taken against Pietro Necchi, 36, Berwick street, under the London County 
Council general powers act, 1902, for manufacturing ice cream in a room used 
as a sleeping room, and he was fined £2 and £2 2s. costs. 

Every itinerant vendor of ice cream, etc., is required to exhibit the name 
and address of the manufacturer on his barrow. One man was cautioned under 
this section. Lists of such vendors were prepared in several boroughs, and 
the medical officers of health gave one another information with regard to the 
places where the ice cream is made. There were 18 persons selling it in the 
city during the year, of these several resided in the city (of Westminster), 
the others came from Finsbury (4), Holborn (3), Chelsea (3), and Lambeth 
(1). In one case the medical officer of Chelsea informed me that the place 
in which the mixture was prepared was dilapidated, with water-closet ob- 
structed, and defective paving of scullery. In another (in Holborn) pro- 
ceedings were taken for making ice cream in a living and sleeping room. 

The significance of the streptococci as a disease-producing organ- 
ism in ice cream has been briefly discussed in the section of this 
report devoted to bacteriological findings of ice cream in the city of 
Washington, and to that section the reader is referred. Aside from 
the invasion of the organism by living pathogenic bacteria, and the 
characteristic symptoms following such invasion, there must not be 
forgotten the causation of illness by products of the bacteria them- 
selves — even though they as living cells may have been eliminated 
either by boiling, freezing, or the use of chemical preservatives. It 
is commonly supposed that the manipulation through Avhich the 
mixtures for ice creams are apt to go, namely, pasteurization or 
scalding of at least a portion of the ingredients would tend to lessen 
the actual number of organisms present and to kill those which are 
commonly considered to be pathogenic. So far as the lessening of 
the number of organisms is concerned, the investigations embodied 
in this report offer an emphatic denial; and the heat or cold to 
which the mixture is exposed would be absolutely without effect 
upon the toxins or ptomaines produced by the organisms even should 
the latter be killed. 

Indeed, it may be very seriously questioned whether preliminary 
heating of the milk products going into the compounds known as 
" ice cream " is not actually deleterious and responsible, to some 
extent, at least, for such cases of poisoning as are included under 
the popular term of " tyrotoxicon." It has been definitely established 
that the scalding or commercial pasteurization of milk and cream 
of the usual commercial quality tends to kill off the organisms pro- 
ducing lactic acid and naturally causing the milk to curd, but leaves 



272 

behind the organisms more resistent to heating and which are apt 
to be those forming, as part of their excreted product, alkaline sub- 
stances, which — as the acid forming organisms are not there to 
give them combat — increase to such an extent that the reaction of 
the milk itself becomes distinctly alkaline. 

Ptomaines are chemical substances built on the ammonia type and 
are most commonly produced by bacteria coincidental with an alka- 
line reaction, or in a medium which has previously been made alka- 
line in reaction. Any condition therefore which produces in milk 
or its products circumstances favorable to the production of pto- 
maines is undesirable. The fact that the great majority of reported 
cases of ice cream poisoning are to be traced to the use of cheap grades 
of material would tend to confirm the foregoing supposition, since 
these cheaper grades of ice creams are commonly made of milk, eggs, 
gelatin, and such thickeners as require heating in order to produce 
the desired result. 

The use of condensed milk in cheap grades of ice cream is by no 
means uncommon. Indeed, with the increased activity of the con- 
densed-milk agent and the increased demand — particularly in large 
cities — for fresh milk, the practice is growing more and more popu- 
lar, and such condensed milks and those substances known as " evap- 
orated creams," which are only whole milks concentrated, are far 
too apt to usurp the place of true cream in the manufacture of ice 
creams. 

The contention has been raised by the makers of ice creams that the 
proposed Federal standard of butter fats is too high to be healthful 
and that an ice cream containing the amount of cream required by 
the Federal law can not be digested by many people. They assert, 
however, that an ice cream containing milk, eggs, and sugar, with 
such a thickener as cornstarch or gelatin, can be digested by, and is 
grateful to, those with whom the true ice cream does not agree. It 
is widely known, however, among those who have had experience in 
the feeding of invalids, convalescents, and persons having impaired 
digestive organs, that the unification of 3 of our most concentrated 
foods — such as milk, eggs, and cane sugar — produces a combination 
which is difficult of digestion and the feeding of it is often impossible. 
In such cases the patient can assimilate either of the ingredients 
separately, or any two in combination, but the third concentrated 
food when mixed with the other two is more than the organs can 
metabolize. 

Such being the case it would seem doubly desirable from the stand- 
point of the physician and the hygienist that there should be on the 
market a standard preparation consisting exclusively of cream, sugar, 
and flavoring, and of a definite fat content, that he may know what 
is being fed to his patient. 



273 

The correct labeling of the frozen mixtures sold at retail would 
also enable the person, who by experience has found that pure cream 
ice cream is or is not suited to his digestive organs, to obtain that 
which does agree with him. 

Not only is the chemical composition and the bacteriological de- 
composition of ice creams Avidely discussed in the literature from the 
standpoint of food value and desirability, but there comes from Italy 
an article by Baldoni, in the " Riforma Medica " for 1907, in which 
he attributes much of the digestive disturbance in Rome during the 
summer time to the contamination of ices by tin and lead, which are 
scraped off the inside of the freezing can by the mechanical action of 
the dasher. Baldoni has not only proven the presence of these metals 
in ices in a dissolved condition, but by careful filtration he has iso- 
lated macroscopic particles of both lead and tin. 

The container of ices, etc., commercially, is a metal cylinder, in 
which products having various fruit flavors are stored for consider- 
able lengths of time. In some cases the material melts, warms up 
very thoroughly, and is again frozen. It is perfectly possible that a 
mechanical distribution of particles of metal throughout the mass, 
and the long-continued action of fruit juices on these small particles 
as well as on the surface of the container, result in the accumulation 
in the food stuff itself of very appreciable quantities of metallic salts. 

DEFINITIONS AND DESCRIPTIONS OF ICES IN TRADE AND OTHER 

BOOKS. 

In an anonymous work entitled, " Ice Cream and Cakes," by an 
American, published by Chas. Scribner & Sons, in New York in 1901, 
the materials for making ice cream are described as follows : " Cream, 
sugar, eggs, flavors in variety, fruits and their juices, ice and snow, 
salt. Cream is classified by the author as single, double, and butter 
cream. Single cream is that which is skimmed from milk twelve 
hours after milking, double cream twenty-four hours after milking, 
and butter cream thirty-six hours after milking. No mention is 
made by this author of cream which is separated mechanically and 
which practice is now more frequently used for ice cream perhaps 
than any other. The author states that for making ice cream only 
the double cream of entire purity should be used and as soon after 
skimming as possible. On page 15 the author says : 

Milk should not be used, either wholly or in part, in place of cream. Its 
watery portion freezes into coarse crystals that give a snowy, mushy taste to 
the ice cream, which even the use of eggs does not correct, and causes it to 
melt much more rapidly than when made of pure cream. 

To prevent this and give the appearance of genuine ice cream some makers 
put in gelatin, to keep it firm, as they say. But its taste betrays it; neither 
45276°— Bull. 56—12 18 



274 

gelatin, tapioca, cornstarch, arrowroot, or any other makeshift will compensate 
for the absence of pure cream. 

The use of milk should be discountenanced by all who would have and enjoy 
ice cream of the best quality. In truth, when made of milk and eggs and not 
cream the product is frozen milk custard. 

By the same author the American type of ice cream is called " Phil- 
adelphia," and the following statement is made : 

Perhaps in no place in America can the Philadelphia ice creams be found of 
higher quality than at a first-class confectioner's in the City of Brotherly Love. 
Certainly nowhere else can the chief material, pure cream, be obtained of 
greater richness and more delicious flavor. 

This is somewhat misleading, since there are doubtless hundreds of 
places in the United States where just as good cream with just as fine 
flavor can be found as in Philadelphia. 

The American anonymous author above mentioned recommends the 
use of eggs in that variety of ice cream known as " Neapolitan " 
which, however, in its own country is not called a cream. He states 
that the Neapolitan ice creams do not differ from the Philadelphia 
creams except in the use of eggs in their composition. Types of Ne- 
apolitan ices are made according to the formulas given in the book; 
the most popular one is called vanilla, No. 53 — which is made of 2 
quarts of cream, 12 eggs, 1J pounds sugar, and 1-J ounces of a mixture 
of 1 pound of sugar with 1 ounce of finely powdered Mexican vanilla 
bean. In regard to the Philadelphia ice creams the author says, on 
page 60: 

Although some of the best confectioners in the Quaker City make their 
creams somewhat after the Neapolitan method, in proportions varying from 6 
to 1 egg for 1 quart of cream, some using the whole egg, others the yolk only, 
yet the plain creams without eggs for which that city has long been famous 
have become so generally known by its name that the title is here retained as 
their proper and distinctive designation. There is no other name for them. 

The question of the relative qualities of the Neapolitan and Philadelphia 
creams is one of either education, taste, or comfort. Those who are fond of 
eggs and custards will prefer the former ; those who are partial to pure cream, 
as well as those with whom eggs do not agree, will choose the latter. 

A typical formula for the vanilla cream is also given on page 60 as 
follows : 

Three quarts of cream, li pounds of sugar, and 1| ounces of the mixture of 
sugar with finely powdered Mexican vanilla bean, above described. 

Following this recipe are given recipes for chocolate, chocolate cara- 
mel, coffee, white coffee, caramel, pistachio, almond pistachio, almond, 
sweet almond, burnt almond, orgeat, filbert, burnt filbert, hazelnut, 
walnut, chestnut, lemon, orange, pineapple, banana, strawberry, 
raspberry, peach, apricot, nectarine, plum, cherry, apple, currant, and 
grape. In none of these are any components admitted except the 
cream and sugar, save the proper flavoring matters derived exclu- 



275 

sively from the substances mentioned. This classification is by far 
the most rational and satisfactory of any that I have been able to find 
in other authors. Nearly all the other authors admit indiscriminately 
to the name of ice cream all the various compounds which have been 
described. 

Among other authorities of this kind I may mention " Mrs. Lin- 
coln's Boston Cook Book," Roberts Bros., edition of 1897. This author 
gives the formula for Philadelphia ice cream and Neapolitan ice 
cream exactly in harmony with the author just quoted. The follow- 
ing naive statement is made on page 363 : 

If cream can not be obtained beat the whites of the eggs till foamy, and add 
them just before freezing. No matter how many eggs are used, a little cream, if 
not more than half a cupful, is a decided improvement to all ice creams. It is 
better to make sherbet or fruit and water ices than an inferior quality of ice 
cream with milk. Ice creams are richer and mold better when made with 
gelatin, but care must be taken to flavor highly to disguise the taste of the 
gelatin. 

In "Mrs. Rorer's New Cook Book," edition of 1903, it is stated, 
page 600 : 

To make good ice cream it is first necessary to have a good quality of cream. 
Scald half the cream to prevent excessive swelling. Where fruits are used they 
must be mashed and added after the cream is frozen. 

The formula for peach ice cream admits only cream, the fruit, and 
granulated sugar. The same is true of strawberry ice cream and rasp- 
berry ice cream. In chocolate ice cream as much milk is admitted as 
there is of cream. For vanilla ice cream nothing is admitted except 
cream, vanilla bean, and sugar. It is seen, therefore, that Mrs. Rorer 
upon the whole, with one exception, admits nothing but cream, flavor, 
and sugar into her products. 

Mrs. Mary J. Lincoln and Anna Barrows, in a work entitled " The 
Home Science Cook Book," describe ice creams and other frozen 
desserts on page 186 and following. The general name of frozen 
desserts is given to the whole class. The authors say : 

So many names are given to different frozen desserts that a few words of 
explanation are needed. 

ICE CREAM. 

This consists mainly ©r entirely of cream and takes a specific name from 
the substance used for flavoring. 

FROZEN PUDDING. 

Ice cream or custard, highly flavored, and containing preserved fruits and 
nuts becomes frozen pudding. 

In "Mary Ronald's Century Cook Book," edition of 1897, the 
author includes, p. 488, under the term " Frozen Desserts," ice creams, 



276 

water ices, parfaits, mousses, frozen fruits, punches, and sherbets. 
Ice creams are classified as follows : 

Philadelphia ice creams are cream sweetened, flavored, and stirred while 
freezing. 

French ice creams are custards of different degrees of richness stirred while 
freezing." 

Then follow the definitions of parfaits, bisques, and mousses, which 
are described as whipped cream with or without eggs, frozen without 
stirring. The author adds: 

These creams, in different degrees of richness and with different flavorings, 
give an infinite variety, and their combinations and forms of molding give all 
the fancy ices. 

Mrs. Ronald does not mention gelatin as a constituent of either 
straight ice creams or of any of the frozen custards or desserts which 
she describes. 

In " Paul Richard's Pastry Book." page 78, is found the follow- 
ing: 

The best and richest ice creams are made from double cream, with the 
addition of yolks of eggs, sugar, and flavorings, while some of the cheapest 
commercial creams are made from milk only, without eggs, and are thickened 
with gelatin, corn starch, arrowroot, sago, and other preparations. The rich 
creams which contain eggs and cream frozen in patent freezers are also termed 
New York creams, and the lighter creams, made from the best cream and with- 
out eggs, Philadelphia creams. 

On page 82 it is stated that the name Philadelphia ice cream 
" is generally applied to ice creams made with pure cream and with- 
out any eggs, although some makers use about 5 eggs to each gallon 
of cream, with 2 pounds of sugar." 

Under the head of commercial ice creams the author says : 

Where quantity is more required than quality ice creams are made from 
plain cream, half milk and half cream, and of milk only. Starch, arrowroot, 
and sago flour in proportion from 3 to 6 ounces to each gallon is boiled into 
a smooth batter with a part of the milk and the sugar, strained, cooled, and 
frozen. Gelatin should be soaked and dissolved in warm milk but not boiled, 
as this would cause the milk to curdle. About 1J to 2 ounces of gelatin are 
used for 1 gallon of cream and milk. Another thickener for ice creams is 
used cold. The preparation is known to the trade as cream-thick ; it is some- 
thing like a dry milk powder. The thickener is mixed with the sugar to be 
used, the cold milk or cream added gradually. As soon as the sugar is dis- 
solved the cream is ready to be frozen. 

Caterers' standard ice cream, best quality, according to Paul Rich- 
ards, is made after the following recipe : 

1 gallon double cream, flavor, If pounds sugar. The cream is made by the 
cold process and is used by the best caterers as a standard preparation from 
which are made many of the fancy creams, fruit, and nut creams. 



277 

In the " Ice Cream and Candy Makers' Factory Guide," edition 
of 1907, are found the following notes on page 4 : 

Scalding milk or cream means to bring it to the steaming point over hot 
water; never allow the material to boil. 

When part milk is used the cream may be whipped before freezing. 

If eggs are used cook them with the milk or cream. 

Well beaten white of egg added to a frozen sherbet makes it creamy and 
smooth; added to any of the creams will make it smoother and lighter. 

Good ice cream can be made without cream (part 5). 

The Philadelphia, or eggless, cream is best if fruits are to be added. 

Cream two or three days old is better than cream one day old. 

Scalded cream gives greater " body " and when frozen will have a fine grain. 

Ices made with too much sugar are hard to freeze and sometimes " ropy ;" if 
too little sugar is used they will be coarse and rough. 

Sour fruits should be added to the cream after it is frozen. 

Raspberries, lemons, and orange* make better water ices than ice creams. 

On page 5, the author quotes the national standards for ice cream 
and adds the following comment: 

It is generally thought that the standard has been set too high, but it is the 
law, and is in the right direction, as it protects the public against misrepresenta- 
tions, and against harmful ingredients ; besides it does not prohibit the ship- 
ment of creams that differ from the standard, but it simply requires the 
shipper to designate the actual quality by a label. 

On page 8, in describing the ice creams known as " Philadelphia," 
the author says : 

Includes all the various creams made of pure cream, without eggs. 

Part 7 of this work is devoted to " commercial " ice cream. The 
first formula given is that of " fortuna " cream, of which it is stated 
that this formula made a fortune for its originator. It is as follows : 

4 gallons 20 per cent cream, 1 gallon condensed milk, 1 gallon fresh milk. 
4 ounces gelatin, 7 pounds granulated sugar, 3 ounces vanilla extract. 

Chicago " picnic " ice cream is made as follows : 

14 quarts condensed milk, 10 quarts fresh milk, 8 pounds granulated sugar, 
8 ounces gelatin, 4 ounces vanilla. 

The " economy " formula for ice cream is as follows : 

9 gallons fresh milk, 10 pounds granulated sugar, 10 ounces gelatin, 4 ounces 
cornstarch, 4 ounces vanilla extract. 

The author says, after describing how the materials are mixed to- 
gether : 

It is now ready to freeze and when frozen will be smooth and fine grained 
and appear as if made from cream. It will never be blue and coarse, cheap 
looking, and cheap tasting, like milk mixtures generally. 



278 

The " Chicago " formula for ice cream is as follows : 

4i gallons cream, 1 gallon condensed milk, 7 pounds granulated sugar, 6 
ounces gelatin, 4 ounces vanilla extract. 

After describing the method of mixing and freezing the author 

says: 

Six gallons of this mixture will make 10 gallons of high-grade ice cream, 
rich and smooth. The cream should be several days old. 

Trade journals devoted to confectionery and ice-cream making 
have had much to say during the past two or three years respecting 
ice cream and the method of its manufacture. 

In the Confectioners' Journal of May, 1907, page 94, the editor 
says: 

Now for the ice cream and soda water. Use only the very best materials, 
and don't make the great mistake of thinking that this and that will do, but 
resolve that only the very best is just " good enough " and a good business with 
a fair profit will be the reward. As cream is the most important ingredient in 
the manufacture of ice cream, we wish to say a few words about the same be- 
fore we go into details of the manufacture of the ice cream. Cream is classi- 
fied as follows : Single, double, and butter cream. Single cream is that which 
is skimmed from milk twelve hours after milking, a " double " cream is allowed 
to stand twenty-four hours before it is skimmed, while butter cream — which 
does not come into consideration in this article — stands thirty-six hours before 
skimming. 

Gelatin is not mentioned by the editor as a component of ice cream ; 
he says, however, in speaking of water ices : 

In order to smooth water ice the addition of raw egg white is best, although 
glucose and gelatin are often used instead. 

In the same journal of June, 1907, on page 90, various formulas 
are given for making different kinds of ice cream and ices. The 
recipes given for ice cream contain no ingredients except cream and 
sugar and the flavor. The recipes given are for grape, banana, 
bisque, pistachio, peach, apricot, filbert, roasted filbert, walnut, pine- 
apple, cherry, and cocoanut ice creams. The formula for Neapolitan 
ice cream, however, includes the customary quantity of eggs. In 
"Answers to correspondents," on page 94, in describing ice cream to 
" N. M.," the Journal says : 

For 1 quart of evaporated cream use 2 quarts of milk, then add 11 pounds of 
sugar, stir, strain, and freeze. You may dilute the cream with 1 pint of water, 
but as this will make an inferior article we can not recommend it. 

In this connection it may be stated that the trade name " evaporated 
cream " is simply a name for condensed milk. Therefore the ice 
cream which the Journal recommends to " N. M." is not at all like 
that which it described in the editorial article. 



279 

In the same journal for August, 1907, are given additional formulas 
for ice cream. In speaking of Neapolitan ice cream the following 
language is used : 

This is no special cream ; it merely consists of 4 different flavors packed in 
layers into brick molds and cut into slices when served. The first layer being 
orange or lemon water ice, next strawberry ice cream, then chocolate, and lastly 
vanilla ice cream. 

This is quite a different compound from the formula for Neapolitan 
ice cream previously referred to in this same journal. 

In the same journal for September, 1907, page 101, is a description 
of u elk " ice cream, which is made as follows : 

Place 10 yolks of eggs into a farina boiler, add 2 vanilla beans, split in 
halves, set on a very slow fire, and beat the yolks until they form a thick body ; 
remove the boiler from the fire and beat until cold. Now make Italian meringue 
of 4 whites of eggs and 9 ounces of sugar, add this to the beaten yolks, and 
when the composition is entirely cold, add 1 strong pint of whipped cream. 
When the composition is well mixed, add 8 ounces of preserved fruits cut into 
small dice and soaked in good maraschino, and last, 2- ounces of finely crushed 
macaroons. 

It would be a little difficult if this were a puzzle to find the cream 
in the mixture. 

The same journal, page 24, gives a recipe for maple ice cream. It 
April, 1907, in response to a query asking for the formula of New 
York ice cream, makes the following statement : 

There are almost as many formulas for New York ice cream as there are for 
plain vanilla ice cream, different makers having widely different notions as to 
the proper ingredients and method for New York ice cream. 

Following this was a number of recipes for making a substance 
called " New York ice cream," each of them differing in essential par- 
ticulars from the others. 

The same journal, page 24, gives a recipe for maple ice cream. It 
is made of — 

1 quart maple syrup, 1 pound granulated sugar, 12 eggs, 2 quarts sweet 
cream, 20 per cent vanilla. Boil sirup and sugar and pour in a thin stream 
over the beaten eggs, whisking briskly. 

The editorial comment on the formula, which is furnished to Harris 
Brothers, Jamestown, N. Y., is as follows: 

It would seem that this mixture ought to make nearer 6 quarts than 4 (unless 
the machine is turned at slow speed) and still be very smooth and full bodied. 
The proportion of sweetening ingredients is abnormal. Cutting the sugar in 
half would improve the product. The milk fat contained is approximately 9.5 
per cent. 

It is evident that not only may ice cream, as commonly understood, 
be made of anything, but the journalistic advice is to swell it so as 



280 

to increase its bulk. This is interesting inasmuch as ice cream is 
bought by measure and not by weight. 

A " pure-food ice cream," the newest variety to which my attention 
has been called, is described in the June number of the Ice Cream 
Trade Journal, page 18. It is as follows : 

Sweet cream 5 quarts, cooked down to 1 gallon, being careful not to scorch 
it. It is cooled quickly in ice and stored until cold. This will raise the test 
of your cream and will give body to your ice cream. Formula is as follows : 

4* gallons, 20 per cent cream, 1 gallon condensed cream (your own make), 11 
pounds sugar, 3 ounces of best gelatin, 3 ounces of vanilla. 

The maker of the recipe adds : 

This ought to make 10 gallons of as high-grade ice cream as it is possible to 
make for smoothness, good body, and elegant flavor. All ice cream requires 
something to make it smooth and keep it so. If a State prohibits gelatin, would 
it permit the use of rennet? They allow it to be used in cheese, so how could 
they object to it in ice cream? About 6 tablespoonfuls would answer. 

The editor of the Journal makes the following comment: 

We can see no reason why anyone should object to the proper use of rennet 
in the manufacture of ice cream, but the fact remains that under a legal stand- 
ard for ice cream that failed to mention rennet as an admissible ingredient its 
use could not be permitted. 

The editor of the Ice Cream Trade Journal in the issue of August, 
1907, page 24, makes the following statement: 

SILLY ACTION PROPOSED. 

From many different parts of the country come reports that some ice cream 
manufacturers are preparing to change the name of ice cream in order to com- 
ply with or to evade the law, as you please. If manufacturers are making ice 
cream there is no occasion to change its name; if what they are making is not 
ice cream then it is not ice cream that is to be given a new or a changed name. 

There should be no change in the name of ice cream. What there should be 
is the stiffest kind of a fight, even in the face of dire threats emanating from 
Washington and divers State food-control camps, to retain the name " ice 
cream " for every kind and quality of product justly entitled to bear it by rea- 
son of having borne it since the time when the name came into common use as 
the common name of a class or group of ices differing from that class or group 
known by the common name of water ices. 

In the Ice Cream Trade Journal for September, 1907, in answer to 
the question " What is your best formula for French ice cream," the 
editor says : 

It is rather difficult to offer a best formula for French ice cream. Below 
we give two formulas, the second of which is similar to what is called Delmonico 
ice cream, except that the proportion of mix to finished product is greater. 

First formula, for 10 quarts : 24 whole eggs, 4 pounds sugar, 6 quarts cream, 
vanilla. 

Second formula, for 10 quarts : 3 quarts cream, 3 quarts milk, 2\ pounds 
sugar, 18 egg yolks, vanilla. 



281 

Really the chief difference between French ice cream and an American cream 
containing eggs is that it is much more solid and somewhat smoother because 
of its closer grain, and this is due to its being frozen in such manner that there 
is not much increase in bulk. 

The Ice Cream Trade Journal of October, 1907, contains a number 
of English formulas, submitted for the purpose of showing that 
English cream ice and American ice cream are similar products. 
Then follow 7 recipes for making different kinds of ice cream. All 
of these recipes contain eggs, but none of them gelatin or any other 
stiff ener. 

A small pamphlet entitled " Hand Book on Ice Cream," by Adolph 
Kramer, published by the Sioux Publishing Company and received 
at the Department of Agriculture on July 5, 1907, gives interesting 
information from the trade standpoint. The pamphlet is only 12 
pages of a single column each, and is sold for $5 a copy. On the front 
page occurs the following statement : 

This little booklet tells you how to manufacture a prime ice cream at 30 
cents per gallon equal to a full cream and perfectly healthful ; formulas for 
fancy creams, fruit ices, fruit frosts, sherbets, whipped cream, etc. This book- 
let is worth $100 to you. 

On page 3 occurs the following language : 

Ice cream at 10 cents per gallon sounds good to you, doesn't it? Of course it 
does. * * * Ice cream has been made and used in this country for over one 
hundred and ten years and it has increased in popularity every day since and 
will continue to do so. The Italians claim the honor of first presenting ice in 
solid form, and for that reason it is presumable that the name " Neapolitan " 
as applied to ice cream will never become obsolete. The name " Neapolitan " 
is applied to custard cream in general. It is also used to designate a fancy 
cream. The day for using a straight cream, testing from 25 per cent to 30 per 
cent of butter fat, has gone by and should go by, though some manufacturers 
claim they axe using 20 per cent butter fat test and producing all cream and 
that their trade is constantly increasing. However that may be a full cream is 
too rich for the ordinary person's stomach. Manufacturers should aim to pro- 
duce an ice cream that any person with a weak stomach should be able to eat all 
he wants without fear of being made sick, and such a cream is just as pleasing 
to the taste and just as healthful and far more satisfactory than a straight 
cream, not taking into consideration the extra profit for the manufacturer. The 
author has analyzed a large number of the preparations on the market which is 
used to improve and lessen the cost of ice cream, and when you have read this 
little booklet through you will be able to use your own preparations without 
paying someone else 1,000 per cent profit, like some of them on the market. 
Dextrine ! Dextrine ! Dextrine flour is one of the principal ingredients that 
does the trick. Now, this article is perfectly healthful and will give good satis- 
faction. It doubles the quantity, saves one-half the labor, saves one-half of the 
ice, and saves one-half of the salt, it keeps them twice as long, it will not sepa- 
rate, and will not ice. By its use whipped cream can be made of 25 per cent 
cream in half the time and stand twice as long as 50 per cent without it. It will 
make good ice cream from pure milk. 



282 

Then follow directions for making all forms of cream. On page 
9 is the formula for ice cream at 10 cents per gallon, which is as 
follows : 

It is possible to produce a good ice cream for 10 cents, figuring milk as 14 
cents per gallon. Here is the formula : 

Powdered gelatin 7 pounds, dextrine flour 3 pounds, mix thoroughly. * * * 
A powdered gelatin good enough for this may be bought for 20 cents per 
pound at the factory, and dextrine flour for 3 cents per pound. Dextrine may 
be bought from any glucose refinery. 

One pound of the above mixture at 15 cents and 5 gallons of milk 
at 14 cents a gallon are the directions given for the final process. 

The evidence cited shows that the products which have been sold as 
" ice cream " for many years in this country may be of almost any 
possible composition. We have found recommended for use in its 
composition, milk, skimmed milk, condensed milk, evaporated milk, 
vegetable gums, starch, dextrine, flour, eggs, gelatin, and other sub- 
stances. A formula has been offered for making ice cream that costs 
not more than 10 cents per gallon. It is evident that many of 
these substances are used simply because they are cheap and add 
bulk to the mixture and without any regard to their relations to 
health and digestion. So-called ice cream, having a definite name, it 
has been shown by the trade journals, is made up according to a half 
dozen formulas, so that it is impossible to state what an ice cream 
called by a definite name is. There is no uniformity followed in its 
manufacture, the sole object seeming to be to make it as cheap as 
possible and still secure a market therefor. It is evident from the 
authorities that the consumer is not given any kind of information 
at all when he purchases a substance known as ice cream, except per- 
haps that it is frozen. Even this does not seem at all times to be 
necessary, since ice cream has been offered and guaranteed to stand up 
for hours after it has been removed from the freezing machine. 

Having given in the preceding pages a summary of the authorities 
respecting the composition of ice cream, it is possible now to have 
a clear vision of the significance of this term in commerce before 
the advent of the food and drugs act. A study of the data will show 
in the first place that the frozen custard, which is said to have had 
its origin at Naples and which in this country has been known 
as Neapolitan ice cream, never was known in the country of its origin 
as ice cream, but by other terms entirely different in signification. 
In general, it may be said that the term ice cream is not used in any 
of the European countries, nor has it ever been used with the possible 
exception of its occurrence of late years in English menus, due to 
the crowd of Americans who visit England every year, especially 
during the summer season. The claim therefore that any kind of 
a pudding, or mixture of any description, has from the first been 
called ice cream does not appear to be sustained by the evidence. 



283 

In regard to the American custom, it appears plainly from the 
authorities quoted that there has always been made in this country a 
genuine ice cream composed solely of rich cream, sugar and harmless 
flavor, and this substance has been recognized and sold as ice cream 
from the very first. It has very often been designated in this country 
as Philadelphia ice cream, and this prefix indicated, at least to the 
trade, the character of the goods. The term " Philadelphia ice 
cream," however, would carry no meaning to the consumer except 
one of a geographical signification. The claim therefore which has 
been made that real ice cream has not always been made and sold 
in the United States does not appear to be verified by the authorities 
which have been cited. It is only fair to presume that Philadelphia 
is not the only town in which such ice cream has been made, but that 
it has been made very generally in all parts of the country. Hence 
it appears as established beyond any reasonable doubt that a real and 
genuine ice cream has always been an article of commerce. 

The claim that has been made that the people do not want genuine 
ice cream must be considered from two points of view. If by this 
is meant that the people in general want an ice cream as cheap as it 
can be bought, then the claim may be regarded as a fact. If, on the 
other hand, it is meant that consumers do not like the taste of genuine 
ice cream, there seems to be no evidence whatever in the way of its 
verification. Experience has shown that not only do the people, as 
a rule, like genuine ice cream, but they prefer it to any kind of frozen 
custard which may masquerade under the name of ice cream. The 
claim which has been made that genuine ice cream is not wholesome 
also lacks any kind of evidence. The fact that physicians prescribe 
genuine ice cream for invalids is an indication that it is regarded by 
the medical profession as a wholesome article of diet. It is undoubt- 
edly true that on account of its richness in butter fat genuine ice 
cream is an article of diet which should be consumed in some modera- 
tion, not only by the sick but also by the well. There is no evidence 
whatever to show that genuine ice cream is unwholesome in any 
degree except it may be contraindicated in certain diseased conditions 
of the stomach or digestive organs, or may be eaten in excessive quan- 
tities. These facts, however, can not in any sense be cited as evi- 
dence of unwholesomeness. On the contrary, it may be said with 
full assurance of verification that the average consumer prefers the 
genuine ice cream to any of the mixtures which may be substituted 
therefor. It is recommended by its organoleptic properties as supe- 
rior to the mixtures containing various added substances, used chiefly 
to give bulk or firmness to the mass. From the point of view of the 
general consumer the genuine ice cream is to be preferred for pala- 
tability to any of its substitutes. 



284 



ICE CREAM STANDARD. 

The standard for ice cream was suggested by the committee on 
standards after a long and careful study of the composition of ice 
cream, and the general character thereof, the meaning of the term, 
and the desirability of having it under the food law express some 
definite meaning. The form in which it was finally established is 
found in circular No. 19, of the Office of the Secretary of Agriculture, 
issued June 26, 1906, page 7. The standards read as follows: 

1. Ice cream is a frozen product made from cream and sugar, with or with- 
out a natural flavoring, and contains not less than 14 per cent of milk fat. 

2. Fruit ice cream is a frozen product made from cream, sugar, and sound, 
clean, mature fruits, and contains not less than 12 per cent of milk fat. 

3. Nut ice cream is a frozen product made from cream, sugar, and sound, 
nonrancid nuts, and contains not less than 12 per cent of milk fat. 

No standards were made for other varieties of ice cream. 

Before these standards were issued full opportunity was given 
to the trade to discuss the tentative standards which had been pro- 
posed and on which criticism and advice were asked. All this evi- 
dence was considered carefully by the committee before the final 
publication was authorized by the Secretary of Agriculture. Some 
of it was favorable to the creation of a standard and some opposed 
thereto. In order that the subject may be fairly presented, excerpts 
from this evidence are submitted. I give first the remarks made be- 
fore the standards committee at its meeting in Louisville in Decem- 
ber, 1906, by Mr. Samuel E. Kennedy, Pennsylvania, and then of 
others representing different views: 

Ice cream was originally invented by Florin in the city of Naples in sunny 
Italy about a century and a half ago and to-day it is still made and sold in 
Florin's cafe by his lineal descendants. It was composed of honey, fresh eggs, 
and sweet cream, which was frozen in long cylindrical shapes of various colors 
and served in a wine glass. * * * 

The agitation produced by the passage of the pure-food law, establishing a 
standard for ice cream has occasioned greater interest than anything heretofore 
known to the trade and all with one accord have begun to query and question 
" where are we at," and what will we do for a thickener and what formula or 
" mix " shall we adopt to comply with the new law which goes into effect upon 
January 1, 1907. 

The law defines ice cream to be composed of cream, sugar, flavor, nuts, and 
fruit; and the commission created under the law has set the standard at 14 
per cent butter fats for vanilla and chocolate ice cream and 12 per cent for 
fruits and nut ice cream. 

It has become the custom for several years past for the trade to use gelatin 
and refined glue under various proprietary names to " body up," and " thicken " 
and adulterate for the purpose, ostensibly of improving the product, with any- 
where from li ounces to 7 ounces of this product of the vat from abattoirs, 
consisting of horns, hoofs, pieces and scraps of skin, hides, shin bones, and 



285 

other unwholesome matter from our own and South American slaughterhouses. 
The respectable manufacturers or makers of ice cream did not use gelatin or 
other thickeners for the purpose of cheapening their product, but for the pur- 
pose of producing the velvet smoothness so much admired, and also for the 
purpose of insulating the frozen watery or aqueous portion of the cream and 
preventing it from swimming or turning into " soup," upon the slightest ex- 
posure. To avoid this dilemma, the cream had in the past been reenforced or 
''bodied up" by making custard (hot or cold), the old and ancient practice 
of adding fresh eggs and heating gently to form a custard or by adding corn- 
starch, arrowroot, potato starch, gum arabic, or tragacanth, ground gelatin, 
tapioca, etc., some of these not requiring heat to form a mucilaginous body in 
the cream, aided in keeping the ice cream firm. 

The use of same is now prohibited under the new law under a penalty that 
will prevent even the lawless from risking its execution. There is some hard- 
ship to the commercial ice cream in the double standard. Ice cream as ordi- 
narily made is run up in 10-gallon batches from 5| to 6 gallons " mixes," and 
after being " doubled " and " frozen," and then flavored, and rerun long enough 
to diffuse the fruit, extracts, nuts, coloring, etc., evenly and uniformly through- 
out the mass, it is then packed in " packers," or suitable tins to suit the cus- 
tomers' orders and hardened ready for sale, shipment, and delivery. 

Now, by this method it is quite impracticable to the ordinary manufacturer 
to make exactly the quality of the two standards, for instance, lemon and 
vanilla are flavored almost identically by the same quantity of extract, but 
the one under the law may contain 12 per cent butter fat and the other must 
contain 14 per cent, while chocolate ice cream, which is enriched by at least 
1 pound of cocoa butter fat, can be the same as vanilla. 

I would therefore respectfully ask the committee upon food standards to 
make a uniform standard of the lower quantity named, viz, 12 per cent and re- 
quire all ice cream to be made of that quality or above it. 

In making " runs " of " fruit " ice creams it is the practice to dip off a gallon 
of cream after being " run up " or " doubled " and fill in a gallon of crushed or 
macerated fruit, and thus the standard is involved, and there is a risk of an 
honest manufacturer disturbing the percentage, as ice cream in the soft state is 
difficult to measure with a dipper. 

Next the variation of the cream supplied to the manufacturer is beyond his 
control and would necessitate his calling in the chemist as a daily assistant 
to keep the milk dealer and creamery man up to his contract. 

The reputation of ice cream as a delicacy and a food for the sick was not 
achieved by the large manufacturers who now are the largest " calamity howl- 
ers " over the hardships of the new law, but by the small confectioners who 
made a neighborhood reputation, * * * but as ice cream became more and 
more popular, the machinery supply man began to manufacture machines for the 
trade, the long cherished secrets and formulas slipped into other hands and 
books of recipes were published. Then came the steam ice cream factory with 
its dirt and slop — dark, damp, noisome, underground, or above ground, in some 
stable or shed — the whirring and buzzing work went on and fierce competition 
drove down prices, and along came the " devil with his glue bags," tempting 
with his arguments, a " bigger yield," " less ice," " more velvety smoothness," 
" fast runs," " saving coal and ice," " nonmelting quality," use " more milk " 
" less cream," until after while " glue and water " began to play an important 
part in the largest establishments run by steam and electricity. 

There has grown into general use the last thirty or more years among the 
more respectable ice cream makers, the addition of a gallon of so-called heavy 



286 

evaporated cream or plain superheated condensed milk (unsweetened) to each 
4 or 5 gallons of 20 to 22 per cent cream. 

This was a pure whole milk concentrated " in vacuo " to about three to four 
times the thickness of the richest milk and served as a thickener without being 
foreign to the dairy or the cow ; this avoided the necessity for using thickeners, 
starches, cornstarch, potato starch, arrowroot starch, gums, gum tragacanth, 
Senegal, Arabic, etc., and made a beautiful smooth velvet-like product and 
double as much as cream alone would do. It had the advantage of purity, 
wholesomeness, digestibility, and cost about the same as cream. It would 
prevent the cream from swimming when dished up, or when transported long 
distances to customers who lived out of town in the summer time; but this 
formula was only used by the best family ice cream purveyors, as " glue was 
cheaper;" the "lordly mushroom" compounders could not afford to drop the 
large doses of water glue that enabled them to work up into "the only abso- 
lutely pure ice cream." 

The term cream should be also understood under the new pure-food law by 
the ice cream trade. 

The standard for cream calls for not less than 18 per cent of butter 
fat, and it is liberal in several respects, as it does not designate hand- 
skimmed cream, pasteurized cream, separator cream, centrifugal cream solidified 
cream, or evaporated cream, if they come up to the standard of not less 
than 18 per cent butter fat. This will be a great help to the ice-cream 
solidified cream, or evaporated cream, if they come up to the standard of not 
less than 18 per cent butter fat. This will be a great help to the ice-cream 
maker, for so long as he uses this or a higher standard he will be sure of com- 
ing up to the standard required by law. Some provisions should be provided 
under the law to suppress some grades of frozen mixtures now upon the mar- 
ket posing as cheap ice cream which do not contain cream, evaporated cream, 
whole milk, or a trace thereof, and which are sold to children who have only 
a few pennies to spend and want as much for their little sum as possible. 
While I recognize that frozen custard, frozen junket, and frozen jellies can be 
made clean and wholesome, I think it is but right that poor men's children 
should be safeguarded, and I hope that the pure-food commission and the com- 
mittee upon food standards will make a low standard as well as a higher one 
and will interest the Department in the subject so that the popular cheap 
frozen products within the reach of the humblest citizen may be safeguarded 
by the august eye of the law and be subject to the intelligent scrutiny of the 
chemical inspection of the Department. 

It is my opinion that all the trade are desirous of living up willingly to the 
standards, and in fact they see the beginning of better trade conditions and 
higher prices as a result. While it has placed them in a quandary as to how to 
proceed in the premises, as the instructions thus far have been quite meager, 
nevertheless I am confident they will be glad to accept the new standard. It 
would however materially assist if the Department would in due course issue 
a bulletin which would give instructions as far as deemed advisable by your 
Department. 

CRITICISM OF E. G. ECKERT AND OTHERS. 

Dr. E. G. Eckert, Secretary of the Ice Cream Manufacturers' 
Association of Pennsylvania, made the following statement at the 
national convention of ice-cream makers held in Chicago in Feb- 



287 

ruary, 1907. The account is taken from the Ice Cream Trade Jour- 
nal of February-March, 1907 : 

Pennsylvania is the Keystone State and seems to take the initiative in most 
things political. We do not have a Matthew Stanley Quay any longer, but we 
have some people who have learned politics from Matthew Stanley * * *. 
We are free-born citizens and we do not propose to have any commissioner of 
agriculture or his coterie of associates tell us what to do as against that which 
has been done for one hundred and fifty years. We had with us at Harrisburg 
Senator Tustin, chairman of this committee, who assured us that he recog- 
nized that there was an injustice being done to a manufacturing industry 
which ought not to be tolerated. We are untiring in our efforts to bring about 
the passage of a pure-food law which will benefit the public without injuring 
manufacturers and dealers. We do not want a law that makes standards. I 
am not in favor of any standard. When you ask for 1 per cent or 2 per cent or 
8 per cent of butter fat in ice cream, you are asking for an arbitrary standard. 
We are Americans. Our standard is as high as the heavens, and whatever 
people want and are willing to pay for give them. * * * You must get your 
State association organized and prevent the insertion in the agricultural bill in 
the Senate of a provision for standards. 

Mr. Thos. E. Lannen, a lawyer, also addressed the convention on 
the subject of standards. During the address he said : 

" My only suggestion at the present time on this standard for ice cream would 
be to adopt a standard which will permit you to conduct your business as you 
have been doing it in the past, and if there is any practice going on in your 
industry which is illegal and which in the minds of the majority of the men 
present here to-day should not be permitted then you should draft such a stand- 
ard as will stamp out that practice." 

Mr. N. Lowenstein, Secretary of the Sethness Company, of Chicago, 
in the course of his address respecting the standards for ice cream, 
said: 

" In answer to a telegram which I sent to the two Senators from Illinois 
I have a reply from one of them, reading as follows : ' Your telegram of re- 
cent date is at hand, and contents noted. Your suggestion relating to the pro- 
posed provision regarding food standards in the agricultural bill shall receive 
due consideration I can assure you.' " 

It may be said in passing that the ice cream makers were not the 
only persons who endeavored to have the authority to fix food stand- 
ards abolished. There are many other manufacturing interests which 
object to any standard whatever being set for their products. The 
standard, however, for ice cream to which objection was made was 
established long before the authority to establish standards was with- 
drawn. Continuing, Mr. Lowenstein said, speaking of the authority 
to fix standards: 

" Certain interests endeavored to have this same provision inserted in the 
agricultural appropriation bill of 1904, 1905, 1906, and again this year, and in 
each instance it was ruled out on a point of order as irregular legislation. 



288 

Efforts were made to have this objectionable provision reinserted in the Senate 
bill and a great many food manufacturers and organizations immediately com- 
municated with their Senators requesting that no one be given arbitrary power 
to fix food standards under the agricultural appropriation bill." 

Mr. Jackson, of Sterling, 111., said in the same Journal : 

My formula consists of milk, cream, condensed milk, and gelatin, and I 
worked that out by days of experimenting. * * * The result is I manu- 
facture 40,000 gallons of ice cream every year and I never have a complaint. 
I ship it from Sterling up to Dixon and to Freeport and over to Galena and 
down to El Paso, even down to Wheaton, a suburb of Chicago. One of my cus- 
tomers is the best drug store in Wheaton. The smallest children eat our ice 
cream in quantities. My youngest child was fed ice cream before he was 
through nursing. He is three years old now and gets from 2 to 3 dishes of it 
in hot weather, 4 or 5 if he wants them. The doctor's bill for my entire family 
is not over $5 a year. 

Extracts from the remarks of Mr. Chisholm read as follows : 

I believe in giving the people what they want. We have in our place gentle- 
men who make what they call a pure cream, cream that they do not use any 
gelatin or anything of the kind in. We have held customers against men who 
claim to make a pure cream of 14 per cent without any gelatin. People de- 
mand a cream that is not so rich as 14 per cent. I would like to speak a word 
in regard to what the gentleman from Sterling said about the question of cream. 
He seems to think that if we adopt that 14 per cent standard we shall decrease 
the amount of ice cream used. We very likely would. Suppose we decreased it 
25 per cent we would still have to increase the amount of cream we use in 
order to make that amount of ice cream, according to my way of figuring. 
Where are we going to get that cream ? It will not put the cream .back to the 
creamery ; we shall have to put up the price more than 20 per cent over what the 
creamery now pays, as he says he has been doing. In order to get the cream 
we shall have to take it away from the creamery and pure butter will go up. 
Suppose it does not decrease the amount of ice cream that we sell 25 per cent. 
If we are now making, say 7 per cent, take that as an illustration, if we go to 
making 14 per cent it takes twice as much cream as it does now. Where are 
we going to get it? It not only increases the price of cream we sell by the value 
of the extra cream used but all the cream we have to buy will cost us more 
money and we shall have to increase our price more than in proportion to the 
increase in butter fat. 

Mr. Woodhull called attention to the fight the ice cream makers are 
making against the standards. He said: 

We sent out some telegrams to-day that we would like to have ratified and 
made official by the association and spread on the record. We took it upon 
ourselves to send these telegrams, knowing that they should have been sent 
as soon as possible so we would not have to wait until evening. We have a 
telegram to the Hon. E. D. Crumpacker, who so brilliantly, earnestly, and sue- 



289 

cessfully took a stand in the House against irregular legislation being incor- 
porated in the agricultural appropriation bill : 

" The Hon. E. D. Crumpacker, 

" Washington, D. C. 
" The National Association of Ice Cream Manufacturers, in convention 
assembled, desires to thank you for your inestimable services through which 
you brought about the exclusion of the irregular legislation in the House appro- 
priation bill, thereby preventing the one-man power from destroying their 
industry. 

" J. H. Frank, President." 

President Frank : Gentlemen, Mr. Crumpacker is a Congressman from Indi- 
ana and he will do the right thing. Are you ready for the question? 

The motion was then put and unanimously adopted. Another telegram was 
sent to 
" Senator Proctor, 

" Chairman Committee on Agriculture, 
" Senate Chamber, Washington, D. C. 
" The Illinois Association of Ice Cream Manufacturers, in convention as- 
sembled, earnestly requests that you do not allow reinstatement in agricultural 
appropriation bill of parts stricken out in the House from bureau of chemistry 
section. 

(Signed) "Illinois Association of Ice Cream Manufacturers, 
" R. A. Woodhull, President" 

Mr. McCrea said : 

" The man who goes out into the field to compete for business and sells 
frozen water for ice cream is not a success, and you know it as well as I know 
it." 

President Frank : 

" They come pretty near doing it sometimes." 

After much discussion a rising vote was taken as to whether the 
convention should recommend to the commission a 14 per cent butter- 
fat standard, an 8 per cent butter- fat standard, or no standard at all, 
and the last proposition was carried by an overwhelming majority. 

The above quotations from the proceedings of the Ice Cream 
Convention are given to show that the product which is sold as ice. 
cream, or at least was sold as ice cream before the enactment of the 
food law, has no definite composition. No one can have any idea, as 
is shown by the statements made by the makers themselves, what the 
substance purchased as ice cream really is. As the President of the 
Association very aptly remarked, " Some of the members evidently 
were selling frozen water as ice cream, or nearly so." 

In The Ice Cream Trade Journal, October, 1906, page 23, there is 
an editorial article on " Butter Fat in Fine Ice Cream." This article 
states that the late Charles Ranhofer, who was for many years chef of 
Delmonico's, in his work entitled " The Epicurean," published in 
1894, devotes 50 pages to ice creams and ices. In quantity of butter 
45276°— Bull. 56—12 19 



290 

fat the plain creams which he describes are as a rule richer than his 
fancy creams. The editor says : 

Under the head of " Vanilla Ice Creams " you will find instructions for mak- 
ing 9 kinds. One, a fancy ice cream, contains no milk or cream whatever. One 
is similar to New York ice cream, or frozen custard, and has a butter-fat con- 
tent of about 2 per cent. Four others roughly calculated are well under 10 per 
cent of butter fat. One shows 11 per cent, one 14, and one 17. * * * We 
find that the butter-fat content is low in the majority of ice creams. True a 
few formulas show a high percentage of butter fat in the mixture, but, on the 
other hand, we find a number of formulas for ice cream that do not call for 
any cream and we have drawn attention to one that leaves out milk as well as 
cream. It is evident that a quality standard for ice cream specifying a mini- 
mum butter-fat content, unless that minimum is low, would prevent the sale of 
many fancy frozen dainties that were sold as ice cream before hokey pokey was 
invented. * * * For anyone to say that the term " ice cream " covers less 
to-day than it covered fifty years ago is absurd; therefore a standard that 
requires 6 out of 10 ice creams to be sold under another name is absurd. There's 
an old saying — not wholly untrue — that the law is an ass, but is it necessary 
in order to prevent fraud for those charged with the enforcement of the law to 
be absurd? Ice cream is a compound in which (except in rare cases) the 
principal ingredients are milk products, but if one reduces the butter-fat con- 
stituent in his compound or eliminates it and substitutes something equally 
wholesome and nourishing who shall say that he has not made ice cream as 
good as or even better than ice cream containing a specified percentage of butter 
fat? While we do not believe that a standard specifying the butter-fat content 
in ice cream is necessary to prevent fraud the establishment of a reasonable 
standard would prevent the sale of cheap frozen compounds unless they were 
plainly labeled to indicate their character, and this we believe would necessarily 
preclude their being served in individual portions, as in restaurants and at soda 
fountains. But what is a reasonable standard? Certainly not a standard 
that fixes the minimum butter-fat content above 8 per cent nor a standard that 
does not admit of the substitution of fresh eggs for butter fat pound for pound. 

The Kymo Company, manufacturers of food preparations, of Little 
Falls, N. Y., under date of February 25, 1907, submitted a protest 
against the standards for ice cream. The reasons for demanding a 
change are as follows: 

Inclosed, we hand you an amendment to the national definition for ice cream 
as given in circular No. 19. To our amendment we have appended an argument 
setting forth briefly numerous reasons why the present national definition 
should be repealed or amended to agree with our definition. You will find a 
recapitulation of our reasons on the last two pages of the inclosed argument. 

Because the States show a disposition to adopt the national standards we 
deem it very important that these be as nearly right and just as it is possible to 
make them. If they are not just and right those States that accept them will 
be led into errors that will in some cases result in hardships to its citizens. On 
the other hand, those States that refuse to accept the faulty standards will 
not be in full accord with those that do, nor with the National Government in 
the very important work of suppressing the traffic in adulterated and harmful 
foods and drugs. 

If the Agricultural Department or those in control of the matter of standards 
insist upon unreasonable standards like that for ice cream, will not the public 



291 

generally, especially the manufacturing element, combine with more sordid 
interests to bring about the abridgment or extinguishment of the power and 
authority to make standards? 

Believing that the national definition for ice cream is very faulty and will 
work untold hardships to manufacturers and consumers alike, especially if 
adopted by the States, we respectfully submit our definition and argument. 

The definition proposed by the Kymo Company is as follows: 

Ice cream. — Ice cream is a frozen product made from cream or milk, fresh 
or condensed, and sugar, with or without a natural flavoring and with or with- 
out the addition of other harmless vegetable and animal ingredients or products. 

The company also says: 

The term ice cream as now used is not a misnomer nor is it misunderstood by 
the consumer. This name is established in the minds of the manufacturer and 
consumer alike as that of an article that is made from recipes or formulas that 
vary greatly as to their ingredients. The consumer thus makes or purchases 
ice cream of a kind or quality that accords with his taste or means. There is 
no evidence of dissatisfaction on his part with the present popular definition or 
with the present product, therefore there is no cause for a new definition or for 
legislation along this line on the grounds that the public is being deceived or 
imposed upon by the sale of adulterated or misbranded ice cream. 

The term ice cream, in the minds of the consumer and the manufacturer, 
does not indicate that the frozen product is made from any particular amount 
or proportion of milk fat. To those who are conversant with the art of manu- 
facturing ice cream, including the confectioner, baker, caterer, and house- 
wife, the name suggests a variety of ingredients, and the quality of the arti- 
cle is not based on the amount of milk fat contained. * * * 

From the foregoing, it is obvious that to protect the public it is not neces- 
sary to restrict the term " ice cream " to frozen cream, sugar, and flavoring, 
as this is not the popular definition and is not what the consumer makes when 
he manufactures his own product. To the consumer and manufacturer alike 
ice cream made according to the Agricultural Department's definition is a new 
product under an old and familiar name. 

We believe that most doctors will agree that 14 per cent of milk fat in ice 
cream is a larger proportion than is good for the average individual. This 
is particularly true during warm weather, when ice cream is consumed most 
liberally. As regards healthfulness, whether taken as a food or as a cooling 
confection or delicacy, we believe that a pure milk ice cream is preferable to 
one made from pure cream, just as much so as milk is better than cream for 
the average individual to drink. 

The Kymo Company also makes the following statement regard- 
ing the determination of the percentage of fat : 

In all that we have seen or heard on the subject of how to figure the per- 
centage of fat in ice cream the basis has been the relation of the milk fat to 
the entire weight of the raw materials. On this basis it has been estimated 
that cream testing 17 per cent will produce ice cream showing 14 per cent of 
milk fat. If this figuring is accepted ice cream made in a slow-speed power 
freezer will cost nearly double as much as that made from the same materials 
in a freezer that whips the materials into double its original volume. Does 
this not look like discrimination in favor of the man with the high-speed 
freezer? 



292 

The company also makes the following observations upon the very 
common practice at the present day of practically doubling the vol- 
ume of ice cream. As ice cream is chiefly sold by volume it is evident 
that any process which will make out of a given amount of materials 
double the volume must be a source of profit to the manufacturer. 
Just what benefit this expansion of volume is to the consumer does 
not plainly appear: 

As is well known, most wholesale manufacturers make 40 quarts of ice cream 
from 20 quarts of materials. What is to prevent the manufacturer from still 
further diluting with air his 17 per cent milk fat cream if the test for the milk 
fat is on the basis of the weight or volume of the raw materials or of the melted 
product ? 

If we must have a milk -fat standard let it be one that will result in uni- 
formity in the finished product under all processes of manufacturing and that 
will not give the man with the fastest freezer a practical monopoly. If the 
Department must have a standard let it be one that will not tempt the manufac- 
turer to neutralize the increased cost of his raw materials by increased expan- 
sion. 

The force of the above argument is not apparent. Inasmuch as the 
percentage, unless otherwise stated, is always a percentage on weight 
it does not make any difference in the estimation of the percentage 
whether the materials have been expanded to 2, 3, 4, or 5 volumes. 
The relative weight of fat to the materials is not changed by the pro- 
cess of expansion, since the air which is used in the expansion is prac- 
tically so light as to add nothing of any consequence to the weight of 
the expanded article. 

Great stress is laid by the Kymo Company upon the fact that ice 
cream which contains 14 per cent butter fat is a new product not 
known hitherto to the trade. The company says : 

In view of the facts related in the foregoing, we suggest that if the Govern- 
ment or the Agricultural Department requires a name for the product of its 
definition it either select a specific name that will not interfere with established 
trade conditions or let the term ice cream apply generically as it does to other 
frozen confections. As a specific name for the Department's new product we 
might suggest the following: "Pure cream ice cream, cream ice cream, cream 
ice, iced cream, or frozen cream." The term cream, however, would not have 
the same significance in the Department's 3 definitions because of the variation 
in the milk fat in those definitions. 

Apparently a more just construction of the requirements would be 
to require a definite name for the variations instead of for the pure 
article, thus introducing the names " Milk ice cream, skimmed milk 
ice cream, condensed milk ice cream, evaporated milk ice cream, 
gelatin ice cream, egg ice cream, coal tar dye ice cream," etc. 

Summarizing, the company closes its remarks as follows : 

We believe that we have shown conclusively — 

First. That there is no need of a new definition or standard for ice cream. 



293 

Second. That ice cream as made by present processes is noninjurious to 
health and satisfactory in quality to the consumer. 

Third. That the manufacturer and consumer are at one in their respective 
understandings of the term as now used. 

Fourth. That the present process of manufacturing, including the formulae, 
accords with the accepted meaning of the term in our standard dictionaries, 
also with its history. 

Fifth. That it is not misbranding to apply the term ice cream to the usual 
frozen products by that name. 

Sixth. That cream is not a specific term used only as a name for the fatty 
part of milk, this being one of several applications of the word. 

Seventh. That Article f of Regulation 12, Section 8, does not apply to ice 
cream, as the name of this article is not derived from one of its constituents but 
from its own qualities as a product. 

Eighth. That the process to which the Agricultural Department proposes to 
apply the term is not the ice cream of commerce or the home, but a new product. 

Ninth. That no definition fixing a standard of milk fat is practicable or 
desirable. 

Tenth. That the term ice cream has become a valuable trade name, the 
establishment of which, by advertising and other means, has required the ex- 
penditure of large sums. 

Eleventh. That, without good cause, the Government has no right to con- 
demn the term ice cream for application exclusively to another product. 

Twelfth. That, as a model for general acceptance by the States, the Depart- 
ment's definition should be amended in accordance with our definition. 

Under the heading " Trade Customs," the Lancet makes some very 
proper comments as to the dishonest practices of which many vendors 
and manufacturers are guilty under the convenient designation of 
u trade customs." Our contemporary observes that the term " trade 
customs " in some quarters appears to be the modern synonym for 
malpractices. 

So many defendants shelter themselves, or attempt to shelter themselves, 
behind the plea of trade custom that it would be interesting to have a list of 
" trade customs "• published. 

The public have a right to know what trade customs are. We doubt very 
much if the public know quite as much about them as the trade. Police court 
proceedings enlighten us considerably at times, but there are so many " trade 
customs " that we plead for a glossary of them. We fancy that we should be 
fairly safe in saying that such a compilation would open our eyes to a string 
of petty practices designed more or less to cheat the purchasing public; trade 
customs in fact, which, though approved by the trade, are, strictly speaking, 
illegal transactions. We should like to see appointed a royal commission on 
" trade customs." The selection of the commissioners, who, of course, would be 
authorities on the subject, would be interesting, and the evidence of the wit- 
nesses would at least be amusing if not instructive. The final report would 
have the word " swindle " written in every one of its conclusions — that is to 
say if the commissioners honestly set about their business. These may be 
strong words, but day by day we read in police court proceedings how indict- 
ment after indictment is met by the sickening excuse of " trade customs." 
Brown paper is found in the soles of boots ; it is a trade custom. Silk containing 



294 

cotton is sold as pure silk ; it is a common practice of the trade and therefore a 
justifiable one because the trade recognizes it. It is also at times the trade 
custom to call an article brandy which is not brandy, soda water which is not 
soda water, butter which is not butter, and so on ad Infinitum. In fine, it will 
be found that " trade customs," as a rule, do not call a spade a spade and things 
are not what they seem. The term " trade customs " is a cloak, is not in many 
instances honest, and in an equal number of instances exists to evade the law. 
The law should recognize no trade custom which is not straight dealing. 

The British Food Journal has repeatedly called attention to this 
matter and has indicated the absurdity of the " trade custom " ex- 
cuse. Some of the most insidious forms of swindling are recognized 
and practiced by certain trades under the description of trade cus- 
toms upon which the light of the police court never shines. Those 
'firms who are guilty of such malpractices can well afford to take the 
remote chance of being found out and of having to pay a small fine 
because they find their course of procedure exceedingly remunerative. 
There seems to be an ingrained desire in certain individuals to cheat 
their neighbors and compete by fraud. 

The Horton Ice Cream Company has made the following represen- 
tations respecting the standard: 

Ice cream is a frozen product made from cream and sugar, with or without 
a natural flavor, and contains not less than 14 per cent of butter fat. 

This is the official definition of ice cream according to U. S. Circular No. 19, 
Department of Agriculture. 

If the above is a correct definition of ice cream then for the past fifty years 
and over there has been little or none made and sold. 

Cookbooks dating from 1853 do not describe ice cream in this way and it has 
not been according to American custom to make it in this manner. 

If the authorities will consult the leading and standard cookbooks published 
in this country they will find various ways of making ice cream, and why should 
a law be made where there can be only one way of making it and then only a 
product showing 14 per cent. 

If this standard should be adopted by this State and the United States it 
would fail to bring about the desired effect for the reason that ice cream has 
not been made to show 14 per cent generally, and instead of dealers endeavor- 
ing to comply with the standard ice cream, or what used to be called ice cream, 
would be sold under a new name and in time the term would become obsolete. 
It is no guesswork but a fact that the dealer who attempted to sell standard 14 
per cent goods would not be able to compete with the man who sells what was 
formerly known as ice cream under a new name, either in price or quality, and 
the practical ice cream man knows it. 

There is a market for a frozen product showing less than 14 per cent butter 
fat made with or without eggs, and with or without gelatin, and with or with- 
out condensed milk, and with or without flavor, and time will show it, for 
to-day the leading hotels make an ice cream with eggs and they will not dis- 
continue making this product should they be obliged to change the name, and 
it will be found that this style of ice cream is made by the best men in the 
business and the per cent of butter fat would be found to be about 8 per cent. 

Make a liberal interpretation of the law, say " Ice cream is a frozen product 
made of cream and sugar, with or without milk, condensed milk, gelatin, flavor, 
or eggs, and contains not less than 8 per cent of butter fat," and dealers will 



295 

use their best endeavors to live up to it and see that others do, but if the pro- 
posed standard be adopted dealers can make such fine goods under a different 
name that are equally if not more delicious that ice cream in not many years 
would only be a name. 

These standard cookbooks are not nor were they published to instruct manu- 
facturers how to make their goods, but that housewives might know how to 
make the best of everything, and not with a view of seeing how cheap every- 
thing could be prepared to put before their families. 

Gelatin is just as important an ingredient of ice cream as sugar, for without 
it ice cream could not be sold commercially for the reason that it would get 
icy and not fit to use. 

A very interesting chapter on ice cream is contained in " The Epi- 
curean," by Chas. Ranhofer, chef of Delmonicos, previously quoted. 
In the preface the author says : 

In publishing this work I have endeavored to fill a much-needed want, namely, 
the best and most effectual manner of preparing healthy and nutritious food. 

This edition contains innumerable recipes which I have simplified and ex- 
plained in a comprehensive manner so as to best meet the wants of all. It 
suggests, also, many useful and important hints to those about entering the 
profession. 

Recipe 3451 describes fresh- fruit ice creams which are to be made 
without eggs or cooking. The mixture which is used for the process 
is composed of 3 pints of cream, a pint of milk and a quart of the 
juice of the fruit. Peach ice cream is described as made with two- 
thirds of cream and one-third of the fruit pulp. 

The most important point which is brought out by Mr. Ranhofer 
is the fact that he never uses the words " ice cream " alone to repre- 
sent any of the mixtures which are usually sold under that name. I 
will quote some of the terms which he uses : 

Ice cream al la Cialdini ; Andalusian ice cream chocolate and cocoa ice cream ; 
cinnamon, ginger, or pumpernickel rye bread ice cream ; fresh fruit ice cream ; 
nougat ice cream or nougat Nepolitan cream ; pistachio ice cream ; burnt 
almond ice cream and with angelica ; rice ice cream ; rice ice cream with citron, 
garnished with truffles; Italian meringue; virgin cream with orange flower 
water and noyau; ice cream with almonds; ice cream with eggs and black 
coffee ; ice cream with roasted or boiled chestnuts, etc. 

In all these mixtures into which any extraneous bodies are added 
Mr. Ranhofer is careful to give the name so as to distinguish it from 
the plain term of ice cream. Thus no false idea is conveyed to the 
purchaser respecting its quality or composition. 

THE QUANTITY OF BUTTER FAT IN ICE CREAM. 

The data which have been cited indicate that there is no tendency 
in the trade to secure any uniform quantity or standard of butter fat 
in ice creams. The authorities show that an ice cream may have from 
a mere trace of butter fat up to 17 or 20 per cent. The consumer, 
therefore, has no indication in buying a so-called ice cream of the 
quantity of cream or butter fat which he is about to secure, nor would 
a physician in ordering ice cream for a patient have any information 



296 

of the character of the food that the patient was going to eat ; assum- 
ing that he is getting a genuine ice cream, he may be giving an inva- 
lid a lot of wholly indigestible materials which his stomach in its 
weakened condition would be utterly unable to digest. 

The claim that the manufacture of genuine ice cream will make it 
too expensive for common use does not seem to be based on any reli- 
able data. That real cream sells for more than an imitation and that 
it should sell for more no one will deny. If a man buys two volumes 
of a mixture containing 8 per cent of butter fat as ice cream, he may 
pay no more for it than a man who buys one volume of real ice cream. 
The answer to the question of increased cost would very properly be 
diminished volume. It would surely be advantageous to the con- 
sumer if he put into his stomach a less volume of the frozen mixture 
than he usually does when he buys an ice cream of commerce in which 
water is the chief constituent. 

The claim that the dairies of the country would be unable to fur- 
nish cream for making genuine ice cream is wholly unfounded. The 
dairies of the country are interested as well as the sanitarians in hav- 
ing ice cream pure and true to the name. They will be able to supply 
the legitimate demand for the cream of which the article is made. 

The protests against the standard for butter fat fixed by the Secre- 
tary of Agriculture under authority of Congress, in so far as the 
briefs and arguments which have been offered are concerned, seem to 
be wholly without merit. The same protests were made against 
fixing a legal standard of fat in milk, against the elimination of the 
quantity of water in butter, against the requirements for purity of 
almost every food product. Whenever an attempt is made to fix a 
standard of purity for a food product, all the people who are engaged 
in making a debased article of that kind enter the same kind of a 
plea. There seems to be no basis for a protest of this kind. There 
is no ethical or legal reason why the purchaser of ice cream should 
not have some definite idea of what he is getting. The conditions 
which obtained before the passage of the food and drugs act can not 
be urged in extenuation of their continuance under the pure-food 
act. If this were so there would not be a single abuse which the pure- 
food law was intended to remedy which would not be continued. 
Granted for the moment, as is shown by the data cited, that the term 
ice cream before the enactment of the food law and the establish- 
ment of the standard did not mean anything. Let it be accorded 
that it meant any kind of mixture simulating cream which the com- 
pounder saw fit to make, provided it was sweet enough and flavored 
enough to find a purchaser. These facts do not alter the relations of 
the ice cream to the consumer under the food and drugs act and the 
standards made in harmony with the act of Congress. It is evident 
that under that act every name of a food product was intended to rep- 



297 

resent a certain kind of product and this kind of product is defined 
and established by the standard. Therefore the protests against the 
standard as being too high and oppressive to the consumer and 
impossible of observation by the manufacturer have no basis of fact 
on which to stand. 

A careful study of all the evidence which has been submitted and 
of the authorities leads to the conclusion that ice cream should be 
made of cream, that no other ingredient should be used except the 
sugar and the flavor or fruit, that it should contain not less than 14 
per cent of butter fat where concentrated flavors are used and not 
less than 12 per cent where fruits are used, and with such a defini- 
tion and standard each consumer will know exactly what he buys 
and each manufacturer will know exactly what he shall make. If it 
be desirable to make other frozen puddings, custards, dainties, 
desserts, etc., at the will of the manufacturer, neither the law nor 
the standard raises any objections thereto, but these products should 
be delivered to the consumer under their proper names and not bear 
the name of a standard product on which the physician and the con- 
sumer both rely. 

GENERAL CONCLUSIONS. 

From a careful study of the data which have been collected it is 
evident the following conclusions may be drawn : 

First. The sanitary conditions of many of the localities where ice 
cream is manufactured in the District of Columbia are not at all 
satisfactory. Eadical improvements in such localities are necessary 
to secure purity and freedom from contamination. It is a recognized 
fact that many cases of violent poisoning which arise from eating 
cream or ice cream are due to insanitary conditions surrounding the 
dairy or ice cream factory, the storage for an improper length of time 
of these products, and the contamination which they suffer by reason 
of insanitary conditions by infection from preexisting poisonous 
bodies. The development of ptomaine poisoning in cream and ice 
cream is entirely prevented by using a fresh sanitary raw product, 
manufacturing it in perfectly clean surroundings, and disposing of 
it within a reasonable length of time after manufacture. 

Second. The average percentage of fat in the cream sold com- 
mercially in the District of Columbia is slightly less than that re- 
quired by the statute governing the sale of cream in the District of 
Columbia. It is, however, well within the standard established for 
cream in general by the Secretary of Agriculture. As long as the 
Act of Congress relating to the standard of cream in the District of 
Columbia is on the statute books the dealers should comply with its 
provisions and cream containing less than 20 per cent of butter fat 
should not be sold in the District. 



298 

Third. The bacteriological examination of cream and ice cream in 
the District of Columbia shows that much of it contains a number of 
bacteria which is far in excess of that which should be found in pure 
uncontaminated fresh materials. This enormous bacterial flora is 
due to two causes, namely, insanitary conditions of the dairy and 
factory, and long keeping of the product. From this point of view, 
therefore, a very large percentage of both cream and ice cream sold 
in the District of Columbia is highly objectionable. 

In regard to its content of butter fat the ice cream sold in the 
District of Columbia over the period of time mentioned is fairly 
satisfactory. A very large percentage of all the samples contained 
more than the 14 per cent of butter fat required for the vanilla type 
of ice cream and more than 12 per cent of the butter fat required for 
the fruit type. The establishment of these standards is not sub- 
versive to commercial conditions as they existed at the time examina- 
tions were made. These standards will, therefore, be regarded not 
only as reasonable, but as commercially practicable. 

Fourth. The use of thickeners in the production of ice cream in 
the District of Columbia does not appear to be generally practiced. 
There are many objections to the use of thickeners, the chief of 
which is that it enables an ice cream to be kept a longer period than 
it should be. A confection of the character of ice cream is intended 
for immediate consumption and not for cold storage or long keeping. 
The ice cream industry is essentially a local industry throughout the 
country and there is no commercial necessity of transporting ice 
cream for long distances nor of storing it on board ship, or in other 
localities for a great length of time. The sooner ice cream can be 
consumed after it is made the better. Another objection to the 
thickener is that it aids in the expansion of the volume of cream 
to proportions entirely beyond the actual amount of nourishment 
represented; so that, as has been shown in the evidence, from one 
quart of material two quarts of the product may be produced. Inas- 
much as ice cream is sold quite exclusively by volume and not by 
weight, this expansion can only be regarded as a deception practiced 
upon the consumer. The use of thickeners of any kind in the manu- 
facture of ice cream is not a commercial necessity. When used the 
thickener should be wholesome and unobjectionable from a food 
point of view, and the fact that it has been employed should be 
plainly stated on the label. 

Fifth. The manufacture of frozen dainties containing more or less 
cream is a legitimate industry, provided all the materials used are 
pure and wholesome and no false name or appellation is given to the 
product. A great many products which have been made and sold as 
ice cream belong to this category. Inasmuch as ice cream is pre- 
scribed frequently by physicians for invalids and convalescents, and 
inasmuch as it is largely eaten by children and others whose stomachs 



299 

have not full vigor, a definite idea of its composition is necessary 
to prevent injury and abuse. Hence the term ice cream should be 
reserved solely for the frozen product consisting of pure, fresh cream, 
sugar, and a flavor, while appropriate names should be given to 
other frozen dainties in which more or less cream may enter. The 
use of milk, skimmed milk, and condensed milk in the manufacture 
of ice cream does not appear to be advisable or necessary. These sub- 
stances, when wholesome and pure, are food products of value and 
their use under appropriate appellations is unobjectionable. Con- 
densed milk diluted to its original volume would not be allowed to be 
sold as fresh milk under the laws of any of the States or munici- 
palities controlling the milk supply. There seems to be no ethical 
reason why such products should be permitted to be sold under the 
name of ice cream. They should be offered to the public under appel- 
lations which disclose their real character. 

Sixth. The additional regulations which would secure for the Dis- 
trict of Columbia a supply of ice cream of unobjectionable quality 
should look to the restrictions of the materials used to the pure fresh 
articles. They should require that the butter fat should have a defi- 
nite percentage corresponding to the established standards of 12 and 
14 per cent respectively for the two different types of ice cream. 
They should protect the consumer against an undue expansion of the 
ice cream during the process of manufacture so as to make it occupy 
a volume far larger than is normal. They should restrict the time of 
storage of ice cream to the limit of ordinary needs of consumption. 
They should secure absolute cleanliness and neatness in the dairy and 
in the factory where the ice cream is made. They should exclude 
from ice cream colors not authorized to be put in foods by the rules 
and regulations of the food and drugs act. They should exclude from 
sale ice cream containing a bacterial flora of the enormous proportions 
exhibited by some of the samples which have been examined. By the 
adoption of these sanitary regulations an ice cream of standard qual- 
ity can be offered to the consumers of the District of Columbia, so 
that anyone purchasing the article may know definitely the character 
of the material he is buying, the amount which he gets, and may be 
assured of the freshness and purity of its raw materials and freedom 
from infection during process of manufacture and the time it is kept 
in storage. 

Seventh. The subject of the pasteurization of milk which is to be 
used for making ice cream is an important one and should receive 
careful attention. The data show that cream usually carries a much 
larger number of organisms than milk. This is probably due chiefly 
to the fact that the bacteria seem to stick with greater tenacity to the 
globules of fat than they do to the other parts of the milk. Cream is 



300 

also often kept longer before being used than milk. The pasteuriza- 
tion, to be effective, should be a thorough one, and the cream pasteur- 
ized should be held at the pasteurizing temperature for not less than 
twenty or twenty-five minutes to insure completion. The ideal cream, 
of course, is that derived from ideal milk, handled in an ideal man- 
ner and used in the shortest possible time in its natural state. Since 
in the present condition of affairs, however, it is not possible to secure 
such cream, thorough pasteurization under competent supervision is 
highly desirable. 

Table III. — Chemical, microscopical, and bacteriological examinations of cream from 
January 30, 1907, to June 12, 1907. 



Date. 



Serial 
No. 



Fat. 



Fat 

above(+) 

or below 

(-)18 

per cent. 



Artificial 
color. 



Bacterial 
count 
per cc. 



Streptococ- 
cus. 



Gas produc- 
tion. 



Leuco- 
cytes. 



1907. 
Mar. 27 
May 1 
May 3 
Feb. 27 
Mar. 1 
Mar. 12 
May 27 
Mar. 1 
Apr. 10 
Mar. 2 
May 27 
Mar. 7 
Mar. 11 
Apr. 2 
Apr. 22 
Feb. 20 
May 22 
Mar. 14 
Mar. 25 
June 12 
May 27 
June 11 
Feb. 26 
Mar. 2 
Mar. 8 
Mar. 23 
Jan. 30 
Feb. 1 
Feb. 4 
Mar. 20 
June 11 
Mar. 6 
Do... 
Apr. 19 
May 25 
Feb. 18 
Feb. 20 



M4594 
M4824 
M4829 
M4447 
M4452 
M4511 
M4952 
M4454 
M4680 
M 4459 
M4956 
M4480 
M4495 
M4634 
M4766 
a M 4391 
M 4912 
M4520 
M4579 

B.C. 31 
M4959 

B. C 23 
M 4434 
M 4462 
M 4484 
M4565 
M4328 
M4330 
M4339 
M4548 

B.C. 19 
M4471 
M4472 
M4747 
M4951 
M4381 
M4387 



Per ct. 
18.76 
22.27 
23.16 
16.60 
18.68 
17.67 
18.88 
22.00 
13.10 
15.07 
21.38 
30.00 
21.00 
21.82 
18.32 
42.43 
27.77 
19.19 
18.77 
20.55 
16.31 
24.92 
20.55 
20.82 
19.13 
18.56 
12.60 
12.90 
12.60 
22.31 
21.66 
22.75 
21.95 
15.42 
20.08 
17.58 
16.81 



Colored . . . 
....do.... 
....do.... 



145,000 

15,250,000 

1,050,000 

57, 600 

294,330 

395,000 

52,500,000 

1,175,000 

1,987,500 

458,330 

29,500,000 

2,833,000 

862,500 

113,000 

12,500,000 

1,610,000 

78,300 

161,000 

323,750 

29,500,000 

6,825,000 

15,500,000 

192, 500 

271, 660 

200,000 

8,375,000 

171,830 

938,300 

354,800 

136,000 

155,000,000 

245,830 

288, 300 

99,000 

25,600 

8,050,000 

296, 660 



No 


No 


do 


do 


do 

Few 

do 


Bubble 

1 percent... 
No 


do 


do... 


No 


10 per cent.. 
No 


Few 


do 

Few 


1 percent... 
No 


Many 

do 

do 

No 


10 per cent. . 

2 per cent. . . 
12 per cent. . 

3 percent... 


do 

Few 


5 percent... 
do 


No 


No 


do 


do 


do 


do 


Few 

No 


2 percent... 
10 per cent.. 
2 percent... 
No 


do 

do 


Few 


5 per cent... 

No.. . 


.do .. 


do 


do 




Not det 


Few 


do 


do 

do 


do 

No 


Many 

Few 


10 per cent.. 
do 


do 


No 


No 


Bubble 


do 

do 


15 per cent.. 
No 


Few 


do 



90, 600 

121,900 

223, 100 

1,672,300 

1,057,200 

703,300 

486,200 

1,811,500 

386,300 

21,900 

22,600 

78,600 

33,300 

16,000 

57,900 

22,600 

46,600 

35,300 

59,300 

60,600 

79,300 

258,900 

228, 400 

77,200 

57, 300 

337, 500 

465, 400. 

403,000 

978, 300 

1, 226, 000 

113, 200 

111, 900 

43,300 

56,600 

159, 100 

318,300 



a Double cream excluded from average. 



6 Cloudy, impossible to count. 



301 

Table III. — Chemical, microscopical, and bacteriological examinations of cream from 
January 30, 1907, to June 12, 1907— Continued. 



Serial 
No. 


Fat. 




Per ct. 


M4804 


16.95 


B. C. 33 


18.19 


M4383 


19.45 


M4393 


20.42 


M4616 


19.17 


M4822 


17.20 


M4979 


17.58 


M4716 


16.63 


M4780 


18.33 


M4930 


17.43 


M4540 


19.94 


M4777 


41.75 


M4448 


18.25 


M4567 


19.06 


M4581 


18.02 


M4666 


20.50 


M4813 


23.80 


M4500 


14.04 


M4799 


24.16 


M4531 


20.96 


M4554 


18.97 


M4721 


23.17 


B.C. 34 


20.06 


M4498 


18.02 


M4502 


17.95 


M4512 


18.21 


M4559 


19.16 


M4528 


19.18 


M4543 


20.92 


M4628 


21.50 


M4806 


14.91 


M4827 


23.56 


M4593 


15.90 


M 4536 


16.18 


M4949 


22.33 


M4524 


16.95 


M4533 


16.84 


M4575 


17.46 


M4429 


17.00 


M4446 


15.97 


M4758 


15.84 


M4928 


18.08 


M4366 


15.25 


M4487 


17.00 


M4629 


17.19 


M4768 


20.02 


M4976 


18.38 


M4426 


18.02 


M4464 


23.70 



Fat 
above 

(+) or 
below 
(-)18 

per cent. 



Artificial 
color. 



Bacterial 
count 
per cc. 



Streptococ- 
cus. 



Gas produc- 
tion. 



Leuco- 
cytes. 



753, 300 



Free. 



Colored.. 



46,166,000 

4,400,000 

4,825,000 

320,800 

9,250,000 

9,750,000 

425, 000 

575,000 

28,900,000 

1,375,000 

2,066,600 

70,400,000 

161,000 

2,087,500 

30,500,000 

180,000 

309,000,000 

516,000 

3,350,000 

29,000,000 

1,177,500 

359,960 

350,830 

397,500 

P) 

90,000 

12,000 

593,000 

59,500,000 

700, 000 

5,400,000 

54,000,000 

151,600 

1,450,000 

1,520,800 

755,860 

180,000 

208,000 

61,000 

625,000 

21,216,000 

275,000 

537,500 

17,500,000 

26,000,000 

350,830 

1,183,000 



No 



No 

Many 

.....do 

Few 

No , 

do 

Few 

No 

Many 

No 

Many 

Few 

Many 

do 

Few.. 

No 

Few 

No 

do 

do 

Few 

do 

No 

Many 

No , 

Few 

No 

Few 

No , 

do 

Many 

Few 

No , 

do 

Many 

Few 

No , 

Very many 

No 

do 

Numerous . . 

Many 

No 

.....do 

do 

do 

Few 



No 

do 

do 

do 

do 

27 per cent.. 
25 per cent.. 
4 percent... 
No 

1 percent... 

17 percent.. 

No 

Bubble 

40 per cent.. 

2 per cent . . . 
No 

3 per cent... 
No 

do 

do 

do...... 

Bubble 

No 

do 

do 

do 

do 

10 percent.. 

Bubble 

No 

do 

do 

25 per cent.. 

No 

do 

Bubble 

No 

12 per cent.. 
10 per cent.. 
6 percent... 

18 percent.. 

3 per cent... 

4 per cent. . . 
3 per cent... 
25 per cent.. 
15 per cent.. 
8 percent... 



126, 500 

127, 900 

654, 000 

113, 900 

3, 565, 300 

968, 400 

2, 186, 600 

1,837,300 

4,082,600 

2, 534, 600 

130,500 

70,600 

156, 100 

121,200 

309,000 

219, 100 

57,300 

1,262,000 

(a) 

41,300 

44, 600 

6,000 

29,300 

57,300 

23,900 

75,900 

57,900 

39,300 

35,300 

1,374,000 

1, 356, 600 

1,094,600 

36,600 

73,200 

22,600 

32, 600 

217, 100 

145,800 

148,600 

58,900 

163,800 

180, 500 

361,800 

561,400 

2,237,300 

321,000 

583,400 

2,446,000 

1,796,800 



a Too badly coagulated to count. 



Not determined. 



302 

Table III. — Chemical, microscopical, and bacteriological examinations of cream from 
January 30, 1907, to June 12, 1907— Continued. 



Date. 



1907. 
Feb. 15 
Feb. 20 
Mar. 13 
May 27 
Feb. 15 
Mar. 12 
Mar. 19 
May 18 
May 25 
Feb. 6 
Do... 
Feb. 8 
Feb. 9 
Feb. 20 
Apr. 24 
May 24 
Feb. 20 
Mar. 1 
Mar. 15 
June 12 
Feb. 26 
Apr. 20 
May 28 
Feb. 4 
Feb. 5 
Feb. 6 
Mar. 5 
Mar. 6 
Mar. 9 
Mar. 13 
Apr. 3 
May 27 
Feb. 16 
Feb. 18 
Feb. 20 
Apr. 15 
May 27 
Feb. 20 
Apr. 1 
Feb. 26 
Apr. 8 
Apr. 16 
May 28 
Mar. 27 
Apr. 3 
May 1 
May 29 



Serial 
No. 



M4372 
M4388 
M4514 
M4958 
M4371 
M4509 
M4538 
M4907 
M4948 
M4345 
M4346 
M4350 
M4360 
M4392 
M4784 
M4926 
M4389 
M4451 
M4525 
B. C. 32 
M4428 
M4760 
M4965 
M4337 
M4342 
M4348 
M4465 
M4469 
M4492 
M4517 
M4643 
M4954 
M4377 
M4382 
M4394 
M4723 
M4957 
M4390 
M4624 
M4430 
M4673 
M4729 
M4964 
M4596 
M4639 
M4819 
M4977 



Fat. 



Per ct. 
15.40 
17.29 
17.91 
13.62 
15.25 
20.10 
18.00 
18.10 



Fat 
above 
(+) or 
below 
(-)18 
per cent, 



Artificial 
color. 



Bacterial 
count 
per cc. 



Colored . 
...do... 
...do... 
...do... 
...do... 
...do... 
...do... 



Colored . 
....do.. 
....do.. 
....do.. 



1, 408, 330 

159, 330 

175,000 

20,500,000 

1,888,330 

200, 000 

6,675,000 

40,500,000 

18,000,000 

262,000 

631, 660 

260,000 

222, 660 

150,160 

2,825,000 

1,300,000 

16,966,000 

43, 600, 000 

87,000 



Streptococ- 
cus. 



2, 123, 300 

50,500,000 

11,150,000 

560, 330 

930,000 

9,116,000 

2,041,600 

2,841,600 

1,070,830 

543, 300 

4,300,000 

26, 500, 000 

262, 330 

202, 350 

269, 330 

126, 600 

11,500,000 

14,933,000 

14,000,000 

16, 966, 000 

7,250,000 

725,000 

15, 500, 000 

5,800,000 

27,000 

61,500,000 

64,000,000 



Many 

Few 

do... 

No 

Many 

No 

Many 

No 

Few 

No 

Few 

do... 

Very few 

No 

do... 

do... 

Many 

....do... 
No 



Gas produc- 
tion. 



Very many 

Few 

No 

Many 

Numerous. 

Few 

Many 

do 

Few 

Many 

No.: 

Few 

No 

do 

do 

do 

do 

Very few . . . 

Many 

do 

Few 

No 

do 

Few 

No 

do 

Few 



12 percent. 
No 

do 

40 per cent. 
4 per cent.. 

No 

do 

3 per cent.. 
20 per cent. 
12 percent. 
2 percent.. 

No 

do 

do 

do 

8 percent.. 

No 

17 per cent. 
No 



2 percent.. 
No 

45 per cent . 
Notdet.... 
12 percent. 
40 per cent. 
15 per cent. 
10 per cent. 

No 

do 

do 

28 percent. 

No 

....do 

....do 

4 per cent.. 
12 per cent . 

3 per cent.. 

No 

4 per cent.. 

5 per cent.. 
3 per cent. . 
30 per cent. 
5 per cent.. 

No 

15 per cent. 
20 percent. 



303 



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10. THE CHEMISTRY OF MILK. 



(313) 



THE CHEMISTRY OF MILK. 



By Joseph H. Kastle, Chief Division of Chemistry ; and Norman Roberts, 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 



PREFACE. 



In the following pages the attempt has been made to present suc- 
cinctly and yet sufficiently comprehensively for a thorough under- 
standing of the subject what is known to-day regarding the chemistry 
of milk, and to give the results of the analyses of the Washington 
milk supply, made in the division of chemistry of the hygienic labora- 
tory during a period of twelve weeks extending through July, August, 
and September, 1907. 

Part I of this communication deals with the chemical composition 
and general characteristics of milk. 

Part II deals with the chemical changes occurring in milk. Under 
this head are included changes in the composition of milk brought 
about, (1) by the action of heat and acids, (2) by the action of the 
enzymes of milk, (3) by the action of the digestive ferments, (4) 
by the action of bacteria and other micro-organisms, including the 
lactic acid fermentation and the abnormal fermentations of milk. 
Under this last section a few pages are also devoted to the subject of 
poisoning by milk, galactotoxismus. Under section 1 the destructive 
effect of heat on the milk enzymes is also considered. 

Part III is devoted to the consideration of legal standards govern- 
ing the sale of milk in various localities. 

Part IV is devoted to the subject of milk adulteration, by skim- 
ming, watering, and the addition of foreign substances, including 
artificial coloring matters and milk preservatives. Some attention 
has been paid to the effect of artificial coloring matters and preserva- 
tives on the health of man. 

Part V is devoted to the general consideration of the Washington 
milk supply. Under this head will be found, (1) a brief outline of 
the methods employed in milk analysis, (2) the results of our analyses 
of the Washington milk supply, (3) conclusions regarding the general 
character of the Washington milk supply. 

(315) 



316 

In the preparation of this communication we have drawn freely 
from the writings of numerous authors on the subjects herein con- 
sidered. In every instance the attempt has been made to give due 
credit to all concerned and no special credit is claimed for any orig- 
inality in the treatment of any of the subjects herein presented. 
Free use has been made of many treatises and works on the subject 
of milk and milk analysis and of many original articles and mono- 
graphs treating of the composition of milk, the rennin coagulation, 
the milk ferments, the use of coloring matters and preservatives and 
their possible injurious effects. For all of these due acknowledg- 
ment is hereby made. To Conn, "Agricultural Bacteriology," Phila- 
delphia, 1901, we are especially indebted for much on the subject of 
the abnormal fermentations of milk. To Leach, " Food Inspection 
and Analysis," New York, 1907, and to Van Slyke, "Modern Methods 
of Testing Milk and Milk Products," New York and London, 1907, 
for methods pertaining to milk analysis, and for valuable data on the 
composition of milk and milk adulteration. To the health office of 
the District of Columbia we are indebted for much assistance during 
the progress of the work, and to Prof. Victor C. Vaughan, of the 
University of Michigan, for private information relative to recent 
progress in the field of milk poisons. 

PART I.— THE COMPOSITION AND GENERAL CHARACTERISTICS OE 

MILK. 

Milk is the specific secretion of the mammary glands. a The milk 
of a number of animals has been and is still very extensively used 
as food by man. The milk of different animals shows a general 
agreement in physical properties and composition, containing essen- 
tially the same ingredients but exhibiting differences in the amounts 
of the several constituents. Of all the different kinds of milk, that 
of the cow is the most universally used, and in what follows, unless 
expressly stated to the contrary, it will be understood that cow's milk 
is meant whenever the term " milk " is employed. 

In the perfectly fresh state, milk is a yellowish-white, opaque fluid. 
When allowed to stand undisturbed for some time it separates into 
two distinct layers. The upper, lighter layer, occupying a smaller 
volume than the lower, heavier layer, is what is called " cream," and 
consists largely of globules of fat. The lower, heavier layer, white 

a Ordinarily milk is secreted by the female mammal only, and only after par- 
turition. In some instances, however, the mammae of newborn children, males 
as well as females, also secrete small amounts of a milk-like fluid known as 
witch's milk; and still more rarely milk is said to have been secreted by the 
mammary glands of the adult human male. Fluids resembling milk are also 
formed in certain pathological conditions. All of these instances are, however, 
more or less rare and warrant no further consideration in this connection. Milk- 
like secretions of vegetable origin are also not considered in this communication. 



317 

or bluish white in color, is when separated known as " skim milk." 
On account of changes due to the growth and action of micro-organ- 
isms the color of the milk may be altered; for example, it has been 
found under certain conditions to become red, blue, yellow, etc. As 
is well known, milk when fresh possesses a distinctly sweet taste and 
a characteristic odor. It is heavier than water, the specific gravity 
of cow's milk ranging from 1.027 to 1.035. It freezes at a tempera- 
ture somewhat lower than the freezing point of water — according to 
Beckmann (1), at —0.554° C. Atkins (2) has also found the freez- 
ing point of milk to be practically constant, viz, —0.55° C., the varia- 
tions from this mean value rarely exceeding 0.03° C. 

On account of the presence of dissolved salts of various kinds, milk 
conducts the electric current. Koeppe (3) found the electrical con- 
ductivity of cow's milk to be 43.8. 10- 4 and that of human milk to be 
22.6. 10- 4 . He concludes therefore that in cow's milk 0.072 and in 
human milk 0.04 grammolecules (Molen) exist in the ionic condition, 
or, in other words, that in cow's milk 58 per cent and in human milk 
26 per cent of the molecules are dissociated. 

The specific heat of milk has been determined by Fleischmann (4). 
For milk containing 3.17 per cent of fat he finds the specific heat to 
be 0.9457. This same author also determined the coefficient of 
expansion of milk by heat and found it between 5° and 15° C. to be 
greater than that of water. According to Fleischmann (5) milk 
shows no maximum of density above 1° C. 

The viscosity of milk has been determined by Soxhlet (6) using a 
Reischauer viscosimeter. The following are the ratios of the inter- 
vals required for the delivery of the same volume of water and milk 
at different temperatures: 



Temperature. 


Ratio of 

water 

to milk. 


Temperature. 


Ratio of 

water 

to milk. 


0° c 


100 : 221.1 
100 : 207.7 
100 : 190.6 
100 : 188.7 


20° C 


100 : 211.7 


5° C 


25° C 


100 : 175.9 


10° c 


30° C 


100:169.0 


15° C 











The microscopic examination of milk reveals the presence of great 
numbers of fat globules, and according to Cohn (7) and also Savage 
(8) the presence also of leucocytes and streptococci derived from the 
udder of the cow. (For further information on this subject see 
article 13 of this bulletin, " The significance of leucocytes and strep- 
tococci in milk," by W. W. Miller.) 

Lawrence (79) has recently observed an instance of the appearance 
of typhoid bacilli in the milk of a nursing woman ill with typhoid 
fever. 



318 

With the higher powers of the microscope various forms of bacteria 
can be distinguished, some of which at least play an important part 
in the changes which take place when milk is kept for some time at 
ordinary temperatures. The perfectly fresh milk of carnivorous 
animals is as a rule acid in reaction. According to Leach (9) the 
acidity of fresh milk is due to carbon dioxide and acid phosphates, 
and according to Richmond (10) to mono- and di-phosphates. 
Human milk and that of herbivora is slightly alkaline and cow's 
milk has been described as amphoteric; that is, it is alkaline to red 
litmus, acid to blue litmus. Vogel (11) states that he has never yet 
found perfectly freshly drawn cow's milk to show a decidedly alka- 
line reaction to litmus. In the greater number of instances the reac- 
tion of freshly drawn milk was either neutral or transiently acid. On 
standing exposed to the air for some time all forms of milk become 
more or less acid in reaction in consequence of the conversion of milk 
sugar into lactic and other acids by the action of various micro-organ- 
isms, until finally considerable amounts of acid are produced, which 
are responsible for the souring and curdling of the milk ordinarily 
observed. 

For further information relative to the reaction of human and 
cow's milk and for a theoretical explanation of the acidity and 
alkalinity shown by these milks, see Courant, pp. 349-350. 

Milk consists chiefly of water. In addition to this it contains fat, 
•lactose, several proteids (see Halliburton (12)), such as caseinogen, 
lactalbumin, lactoglobulin, opalisin, and lactomucin, and a number of 
salts. It also contains certain dissolved gases, such as oxygen, nitro- 
gen, and carbon dioxide. The oxygen and nitrogen are carried into 
the milk mechanically in the process of milking. Carbon dioxide is 
present in milk to the extent of 3 or 4 per cent by volume and partly 
escapes into the air when milk is drawn from the udder. Besides the 
substances already mentioned still others have been found in milk 
in small quantities. Among these may be mentioned lecithin (13), 
cholesterol (14), citric acid (15), lactosin, a new carbohydrate 
(16), and orotic acid (17). This substance has the composition 
C 5 H 4 4 N 2 .H 2 0, and is believed by its discoverers to have the con- 
stitution : 

NH.CH 2 .CO NH. CO.CH 2 

CO< | orCO< | 

NH.CO.CO NH.CO.CO. 

Sherman, Berg, Cohen, and Whitman (18) found small amounts of 
ammonia in fresh milk. According to Trillat and Sauton (19) the 
presence of ammonia in fresh milk is usually indicative of contamina- 
tion. According to Schondorf (20) human milk contains small 
amounts of urea. Jolles (21) and others have called attention to 
the relatively large amounts of iron which woman's milk normally 



319 

contains, and to its influence on the health of the child. Camerer 
(22) found 21 milligrams of iron oxid in 100 cubic centimeters of 
human milk from the third to the twelfth day of lactation. Accord- 
ing to Jolles and Fried jung (23) the quantity of iron in human milk 
decreases with bad environment and poor condition of the mother. 

In certain diseased conditions milk may contain still other sub- 
stances not ordinarily present in the milk of healthy animals. For 
example, Van der Marck (24) has detected bile in the milk of a 
woman who had developed jaundice after confinement, and Des- 
moulieres and Gautrelet (25) have found that the so-called lipo- 
chrome of cow's milk consists almost entirely of urobilin. Still other 
substances are sometimes acquired by milk either from the food of 
the animal or from its environment after its removal from the animal. 
Bordas and Touplain (26) have shown for example that milk rapidly 
absorbs certain odoriferous substances from the air, and Dombrowski 
(27) has shown that the odor and flavor of certain seeds and plants 
are imparted to the milk by feeding with these substances. An 
excellent example of this is furnished in the case of garlic. Ac- 
cording to Rosemann (28) alcohol passes into the milk when admin- 
stered to an animal in large amounts. Similarly Teichert (29) ob- 
served that the milk of cows fed 90 per cent " slump " contained fusel 
oil and that calves fed with such milk died. According to Bechamp 
(30) even freshly drawn milk contains recognizable amounts of 
alcohol and acetic acid. Golding and Feilmann (31) detected copper 
in a certain milk supply, and have shown that in the presence of air 
milk has the power of dissolving small quantities of this metal. 

In addition to the substances already mentioned, normal milk con- 
tains a number of enzymes, such as diastase (amylase), galactase, 
lipase, catalase, peroxidase, reductase, etc. The presence of these 
ferments serves to distinguish raw from boiled milk. According to 
Marfan and Gillet (32) milk is not an inactive fluid, but possesses 
certain properties peculiar to living substances. According to these 
authors it contains ferments and gives Bordet's reaction (see p. 335), 
which reaction is not shown by dead material. It also shows Moro's 
reaction (see p. 335). These specific ferments of milk and its char- 
acteristic biochemical reactions will be considered at length under 
milk enzymes (see pp. 335 to 342). 

Woodhead and Mitchell (33) have recently shown that milk also 
contains opsonins in even greater quantity than blood serum. It 
also contains alexins and bactericidal substances. According to 
Brieger (34) and his coworkers, the milk of animals immunized 
against diphtheria and tetanus contains antitoxins. 

A very good idea of the quantities of the several more important 
substances contained in milk may be obtained from the following 
schemes compiled by Lucius L. Van Slyke (35) and S. M. Babcock 
(36): 



320 







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321 

According to Farmers' Bulletin No. 29, United States Department 
of Agriculture (37), 1895, cow's milk has the following composition: 

Per cent. 

Water =87 87. o 

iFat =3. 6 3. 6 

Solids not fat =9.4p^ em : ?'? 

I Albumin 0.7 

~J Milk sugar 4.7 

13 -°Ush 0.7 

100.0 

Van Slyke (38) gives the following average analysis of cow's milk: 





Water. 


Total 
solids. 


Fat. 


Casein. 


Albu- 
min. 


Sugar. 


Ash. 


Average of 5,552 American analyses compiled by- 


87.1 
87.4 


12.9 
12.6 


3.9 
3.75 


2.5 
2.45 


0.7 
0.7 


5.1 
5.0 


0.7 


Average cbeese-factory milk for the season (May 


0.7 







The following compilation, according to Leach (39) from Koenig's 
Chemie der menschlichen Nahrungs- und Genussmittel, gives a very 
good idea of the composition of human milk and that of a number of 
different animals: 



Num- 
ber of 
analy- 
ses. 



800 



200 



32 



Kind of milk. 



Cow's milk: 

Minimum . 
, Maximum . 

Mean 

Human milk: 

Minimum . 

Maximum . 

Mean 

Goat's milk: 

Minimum . 

Maximum . 

Mean 

Ewe's milk: 

Minimum . 

Maximum . 

Mean 

Mare's milk: 

Mean 

Ass's milk: 

Mean 



Specific 
gravity. 



1. 0264 
1.0370 
1.0315 

1. 0270 
1. 0320 



1. 0280 
1.0360 
1. 0305 

1. 0298 
1. 0385 
1.0341 

1.0347 

1. 0360 



Water. 



80.32 
90.32 

87.27 

81.09 
91.40 
87.41 

82.02 
90.16 

85.71 

74.47 
87.02 
80.82 

90.78 

89.64 



Casein. 



1.79 
6.29 
3.02 

0.18 
1.96 
1.03 

2.44 
3.94 
3.20 

3.59 
5.69 
4.97 

1.24 

0.67 



Albu- 
min. 



0.25 
1.44 
0.53 

0.32 
2.36 
1.26 

0.78 
2.01 
1.09 

0.83 

1.77 
1.55 

0.75 

1.55 



Total 
proteids. 



2.07 
6.40 
3.55 

0.69 
4.70 
2.29 



I. '29 



6.52 
1.99 
2.22 



Fat. 



1.67 

6.47 
3.64 

1.43 
6.83 

3.78 

3.10 
7.55 
4.78 

2.81 
9.80 
6.86 

1.21 

1.64 



Milk 
sugar. 



2.11 

6.12 

4.88 

3.88 
8.34 
6.21 

3.26 
5.77 
4.46 

2.76 
7.95 
4.91 

5.67 

5.99 



Ash. 



0.35 
1.21 
0.71 

0.12 
1.90 
0.31 

0.39 
1.06 
0.76 

0.13 
1.72 
0.89 

0.35 

0.51 



45276°— Bull. 56—12- 



-21 



322 

Bunge (40) gives the following table showing the results of analy- 
ses of the milks of a number of different animals : 
One hundred parts of milk contain — 





Human. 


Dog. 


Cat. 


Rab- 
bit. 


Guinea 
Pig- 


Sow. 


Ele- 




I. 


II. 


III. 


phant. 






1.2 
0.5 
1.7 
3.8 
6.0 
0.2 


1.5 
3.3 
6.5 
0.3 


5.2 
1.9 
7.1 
12.5 
3.5 
1.3 


3.1 
6.4 
9.5 
3.3 
4.9 
0.6 
























1.7 
3.1 
5.9 
0.2 


15.5 

10.5 

2.0 

2.6 


11.2 

45.8 

1.3 

0.6 


5.9 
6.9 
3.8 
1.1 


3.1 


Fat 


19.6 




8.8 


Ash 


0.7 








Horse. 


Ass. 


Cow. 


Goat. 


Sheep. 


Rein- 
deer. 


Camel. 


Llama. 


Por- 
poise. 


Casein 


1.2 
0.8 
2.0 


0.7 
1.6 
2.2 
1.6 
6.0 
0.5 


3.0 
0.5 
3.5 
3.7 
4.9 
0.7 


3.2 
1.1 
4.3 
4.8 
4.5 
0.8 


5.0 
1.6 
6.5 
6.9 
4.9 
0.9 


8.4 
2.0 
10.4 
17.1 
2.8 
1.5 




3.0 
0.9 
3.9 
3.2 
5.6 
0.8 










Total proteids 


4.0 
3.1 
5.6 

0.8 


a 7. 6 


Faf 

Sugar 

Ash 


1.2 

5.7 
0.4 


43.8 
0.5 



a Proteids and sugar of milk. 

He calls attention to the extreme variability in the composition 
of the milk of different animals. The large amount of fat contained 
in some of these milks is certainly very striking. On the other hand, 
the milks of most of these species show a reasonable similarity so 
far as the amounts of the several constituents are concerned. 

H. Droop Richmond (41) has made a very large number of analy- 
ses of milks sold in England. As a rule he found the average com- 
position of the milks produced in that country to be considerably in 
excess of the legal requirements. The following table will give some 
idea of the results of his analyses for a number of years : 



Year. 


Number 
of milks 
analyzed. 


Total 
solids. 


Fat. 


Year. 


Number 
of milks 
analyzed. 


Total 
solids. 


Fat. 


1900 


13, 798 
13, 936 

12, 914 
15, 313 


12.57 
12.63 
12.73 
12.78 


3.64 
3.72 

3.82 
3.83 


1904 


15, 910 
14,828 


12.68 
12.70 
12.64 


3.74 


1901 


1905 


3.73 


1902 


1906 


3.71 


1903 













This author (42) also gives a single analysis of woman's milk and 
that of a she ass, which are worthy of record in this connection : 



Kind of milk. 


Total 
solids. 


Fat. 


Sugar. 


Proteids. 


Ash. 


Solids 
not fat. 


Acidity. 




10.27 
13.97 


1.45 
5.61 


5.65 
6.98 


2.09 
1.27 


0.54 
0.18 


(8. 82) 
8.36 


0.54 


Woman's milk 









323 

Billitz (43) gives the following results of the analyses of 187,610 
specimens of milk produced in Lombardy during the years 1892 to 
1902: 

Specific gravity 1. 0315 

Fat— 3. 55 

Solids not fat 8.81 

The poorest milk from a herd of 50 cows gave the following 
numbers : 

Specific gravity 1. 0306 

Fat 2. 70 

Solids not fat " 8.45 

The richest milk from a herd of 80 cows gave the following : 

Specific gravity 1. 0326 

Fat 4. 10 

Solids not fat 9.23 

These figures suffice to give an idea of the average composition of 

milk. 

On the other hand cow's milk is liable to extreme variations in 

composition. For example, Cook and Hills (44) have recorded the 

following analysis of the milk of a Jersey cow just before she went 

dry: 

Total solids 28. 43 

Fat 14. 67 

Solids not fat 13.76 

Casein and albumin 9.98 

Milk sugar 2.33 

Ash 1. 44 

This milk is remarkable for the large amounts of fat, proteid, and 
ash, and for the small amount of milk sugar. According to these 
authors there seems to be no other record of a milk showing more 
fat than solids not fat. On the other hand Wanters (45) has recorded 
analyses of several milks showing very small amounts of fat and 
nonfatty solids: 



Fat. 



Solids not fat. 



(a) 
(6) 



1. 319 to 2. 575 
1.250 to 2. 965 



5. 031 to 7. 635 
6.19 to8.0S5 



The ash of these milks was abnormally high. 

Janke (46) also reports the results of analyses of certain samples 
of milk supplied the city of Bremen. The samples were taken in 
the presence of a police officer and are remarkable for the small 



324 

amounts of total solids and fat which they contained. His results 
are as follows: 



Total 
solids. 



Fat. 



(a). 

(6) 
(c). 



7.71 
6.80 
8.23 



0.868 
.633 
.416 



Out of another lot of 103 samples analyzed by this chemist (47), 
the poorest milk had a specific gravity of 1.0275 and contained 9.04 
per cent total solids and 1.60 per cent of fat. 

The composition and also the yield of milk have been found to 
vary with the seasons of the year, with the character of the food, 
with the condition of the animal, and also whether it is fatigued or 
at work or at rest. It is also subject to some diurnal variation 
(Richmond (48)). It is also influenced by the addition of certain 
stimulants and nitrogenous compounds to the food. It also varies 
in composition during the course of lactation and also at different 
stages of the same milking. Sherman (49) has shown by monthly 
analyses extending over two years on a herd of 600 cows that the 
per cent of proteids in milk and likewise the fat varies with the 
season, being higher in autumn and winter than in the spring or 
summer. On the other hand the percentage of lactose remains prac- 
tically constant throughout the year. Richmond (50) also found 
the lowest percentage of fat in May and June and the highest during 
the winter months. On the other hand he found that the geology 
of the region over which the herd grazed exerted but little influence 
on the composition of the milk. 

Concerning the effect of food on the composition of milk, there 
seems to be a good deal of difference of opinion among different in- 
vestigators, some holding that the character of the food exerts a 
great influence on the character of the milk, others maintaining that 
this influence is but slight if any. According to Albert and 
Maercker (51) rations rich in fat cause a decided increase in the fat 
of the milk. If this however be continued for long intervals the 
fat falls to its original amount with the poorer rations. Rhodin (52) 
found that emulsified oils cause an increase in the amount of fat, 
followed by a return to the normal amount. These observations 
were confirmed by Bartlet (53). 

Gogitidse (54) found that by feeding sheep with linseed oil the fat 
of the milk could be made to contain as much as 33 per cent of lin- 
seed fat. Hills (55) observed that the addition of cotton seed, maize, 
or linseed oils to the food of cattle tends to increase the yield of milk 
per unit of dry matter fed. With cotton-seed oil there seemed to be a 



325 

fairly permanent increase of 0.2 to 0.3 per cent of fat in the milk. 
On the other hand maize and linseed oils, when given as a regular 
diet, while causing a marked increase in the fat at first, seemed to 
lower the percentage of fat in the later stages of the experiment. 
Essentially similar results have been obtained by V. Henriques and 
Hansen (56). Sebelien (57) has found that the effect of feeding 
whale meal was to increase the yield of milk 6 per cent during the 
period when it was given. There was no after effect. The absolute 
amount of fat was increased during the first period of whale-meal 
feeding, but sank during the last period to the amount produced in 
the preliminary period. The percentage of fat was not altered by the 
whale meal when this was given as additional food, but was lowered 
when an extra quantity of it was given. Wing (58) found that the 
addition of fat to the fodder neither increased the quantity of milk 
nor the amount of fat which it contained. Morgen, Beger, Finger- 
ling, Doll, Hancke, Sieglin, and Zielstorff (59) working together, have 
shown as the result of an extensive series of investigations on the 
effect of foods and food fat on the production of milk and milk fat in 
sheep and goats that food almost free from fat maintained the ani- 
mals in healthy condition and increased the live weight of the 
animal, but that such foods were unsuitable for milk production. Food 
fat in small quantities, 0.5 to 1 gram weight per kilo of the animal 
was found to promote the production of milk fat. They proved fur- 
ther that so far as their effect on milk production and the increase of 
fat in milk is concerned, stimulants are only desirable in certain cases. 
These investigations have been further extended by these observers 
working together or alone. For example, Morgen, Beger, and Fin- 
gerling (60), as the result of studies extending over six years, have 
reached the conclusion that of all foods, fat alone exerts a specific 
action on the production of milk fat, proteids and carbohydrates 
exerting no such action, and that within certain limits fat is the most 
suitable of all foods for milk-fat production. In this same con- 
nection, Finger ling (61) has shown that the replacement of food 
deficient in fat (barley meal) by one containing more fat (rice meal) 
increased both the absolute amount and the percentage of fat in the 
milk. From a study of the influence of stimulants on the consump- 
tion and digestibility of food and the secretion of milk he (62) has also 
arrived at the conclusion that when added to foods entirely free from 
stimulants the effect of the stimulant is to increase the consumption 
of food and the yield of milk and milk constituents. When how- 
ever stimulants are added to foodstuffs already containing such sub- 
stances they are without effect on the yield of milk. He concluded 
therefore that they are of use only in special cases, as, for example, 
when cattle are fed with hay. In such cases the addition of such 
materials to the food as fenugreek, anise, and caraway seed is to be 



326 

recommended. According to Temesvary (63) beer increases the 
amount of milk fat. Morgen, Beger, and Fingerling (64) have also 
investigated the influence of fat and other substances on milk produc- 
tion when fed in connection with a scanty basal meal. They have 
observed an increase in the yield of milk and an increase in the per- 
centage of fat amounting to 0.14 per cent when such quantities of fat 
were added to the food. The addition of large quantities of fat to the 
food caused a further increase in the yield of milk, but was found to 
vary in its effect on milk-fat production, sometimes causing an in- 
crease, sometimes a decrease. Caspari (65) has shown that iodized 
fats appear in the milk even though the food be poor in fats and 
rich in carbohydrates. He therefore concludes that some of the 
fat of milk comes from the fat of the food. Later (66) he showed 
that when iodocasein and iodoalbumin are fed to an animal no traces 
of iodized fats appear in the milk. On the other hand there are 
those who hold that the addition of fat to food does not increase the 
quantity of fat in milk and that there is no direct migration at least 
of the fat of the food to the milk. Such a conclusion was arrived at 
by Einecke (67) from his experiments with goats. With liberal com- 
prehensive rations the yield of milk and fat depends, according to 
this observer, on the individuality of the animal. The milk from 
cows grazing off the poor, dried-up grass on the plateau of Setif, in 
Algeria, has been compared by Malmejac (68) with that of cows fed 
on rich forage with the following results : 





Poor dry grass. 


Rich forage. 




11. 62 to 14. 25 
3. 33 to 3.50 
3. 13 to 4.46 
4. 53 to 5.64 
0.60 to 0.90 


13. 76 to 14. 90 


Fat 


4. 05 to 4.90 


Lactose 


3. 33 to 4.54 


Proteids 


4. 47 to 5.55 


Ash 


0.82 to 0.93 







Except for the proteids, the differences in composition are obviously 
in favor of the milk produced on the richer diet. Woll (69) ob- 
served that as a food for milch cows silage increases the yield of milk 
and butter 3 per cent over that produced with maize fodder when the 
area of land required to produce the two foods is taken into account. 
Some studies have also been made of the effects of certain definite 
nitrogen and phosphorus compounds on the production of milk and 
milk fat. Morgen, Berger, and Fingerling (60) have investigated the 
effect of adding lecithin to food. This substance seemed to increase 
the yield of milk and also the live weight of the animal. It was 
found, however, to be favorable to the production of milk fat only 
when it was fed in conjunction with other foods deficient in fat. 
Pfeiffer, Einecke, and Schneider (70) have shown that asparagin 



327 

when substituted for proteids, along with cane sugar, caused no dimi- 
nution in the yield of milk, in fact in some instances it seemed to 
cause an increase, but the amount and percentage of fat in milk was 
diminished. The feeding of this compound also acted unfavorably 
on the increase in live weight, and caused a reduction in the percent- 
age of proteids and dry matter in the milk. Morgen, Beger, and 
Westhauser (71) have reached the conclusion that amino compounds 
can not take the place of proteids in milk production, but that they 
exert a greater effect than carbohydrates. 

It has been observed that the actual yield of milk diminishes in 
the later period of lactation. According to Trunz (72), however, 
the specific gravity of the milk, and most of the solids, including the 
proteids, are relatively increased, while the proportion of albumin 
to casein remains remarkably constant throughout the entire period 
of lactation. This same investigator (73) has also made an exhaust- 
ive study of the mineral constituents of cow's milk and their varia- 
tion during the period of lactation with the result that he has found 
considerable variation in the ash contents during the lactation 
period and that the total quantity of ash varies from time to time 
throughout the period, being as a rule less during the spring and 
summer months than during the autumn and winter months. 

Hardy (74) claims to have shown that the milk of a given cow 
varies in composition at the different stages of milking. Thus 
taking the milk in quantities of one-half liter at a time the milk of 
one cow gave the following successive numbers for fat: 2.2, 2.9, 3.5, 
3.75, 3.8, and 4.65 per cent. The solids rose from 10.52 to 12.70 
and the ash from 0.74 to 0.75 per cent, The composition of the milk 
serum was found to remain the same throughout the milking. 

On the other hand Ackermann (75) claims that the conclusion that 
the fat in milk increases regularly during the process of milking, as 
this is ordinarily carried out, is incorrect. He has found, however, 
that by milking the teats singly or in pairs the fat did show an in- 
crease up to a maximum at the end of the milking and that on draw- 
ing the milk from the second pair of teats the quantity of fat was 
slightly more at the commencement than that given by the first pair 
and rose at the end of the milking to a higher maximum. The in- 
crease is probably due to a mechanical or physiological stimulus. 

The effect of work and fatigue on the quantity and quality of the 
milk has also been studied by several observers. Hills's (76) results 
would seem to show that there is a slight falling off in the quantity 
of milk produced as a result of fatigue, 122.5 pounds against 131.4 
pounds after rest. The total solids and the fat were found to be 
slightly higher during the period of fatigue than after rest. Dornic 
(77) also has shown that the yield of milk is diminished slightly as 
the result of work. The dry matter and the amount of acid were 



328 

slightly increased. It was further observed by this investigator 
that work exerts a harmful influence on the quality of the milk, 
especially on its keeping qualities. For example it was found in 
the case of a certain cow that ordinarily her milk curdled when the 
acidity reached 70°-75°, whereas the milk of the same cow when 
fatigued by work, curdled when the acidity reached 45°. Accord- 
ing to Moerman (78) also, work lessens the amount of milk secreted 
and raises the proportion of solids. The differences, however, in 
the quantity and quality of the milk in all of these investigations 
were only slight, indeed in some instances the results obtained were 
not very definite. 

PART II.— CHANGES IN THE COMPOSITION OE MILK. 

On account of the milk sugar and proteids which milk contains, it 
is an exceedingly unstable liquid. When first drawn from the cow, it 
has a characteristic odor and a sweet taste. Even in the perfectly 
fresh state, it reacts acid to phenolphthalein. The acidity of fresh 
milk is due primarily to carbonic acid and acid phosphates and also 
in part to dicalcium caseinogenate. According to Thorner (1) the 
acidity of fresh milk varies between 12 and 16 degrees. According to 
Richmond (2) it has an acidity of 20 degrees. On standing exposed 
to the air for some time it gradually loses its sweet taste. The sugar 
of milk is gradually transformed into lactic acid through the action 
of bacteria. The milk becomes sour to the taste and ultimately clots 
or curdles as the result of the precipitation of the caseinogen by the 
combined action of acids and soluble calcium salts. Stokes (3) gives 
figures and tests to show that milk having an average acidity of 44 
degrees, corresponding to 0.396 per cent of lactic acid, tastes sour. 
According to Richmond (2) milk tastes sour when the acidity reaches 
45 degrees, corresponding to 0.405 per cent lactic acid, and when it 
has an acidity of 85 degrees, equivalent to 0.765 per cent of lactic 
acid, it curdles at ordinary temperatures. 

Under certain conditions, milk may also develop rancid and cheesy 
odors which render it quite disagreeable. 

The principal changes occurring in milk are those produced by — 

(1) The action of heat and acids. 

(2) The action of milk enzymes. 

(3) The action of the digestive enzymes. 

(4) Bacteria and various other micro-organisms. 

Part II. — (1) Changes in Milk Produced by the Action of Heat and Acids. 

When milk is heated a film or skin forms on the surface, which, 
according to Jamison and Hertz (4) , is due to the drying and coagu- 
lation of a part of the proteids which the milk contains. They 
have shown that such a skin may be formed on the surface of any 



329 

albuminous solution containing fat or paraffin. Rettger (5) also 
has arrived at the conclusion that its formation is dependent on the 
presence of proteid. This proteid is caseinogen. Surface evapora- 
tion and the presence of fat facilitate its formation although neither 
is absolutely essential. According to Harris (6), also, the scum of 
boiling milk consists very largely of caseinogen. It is also well 
known that certain changes occur in the odor and taste of milk as 
the result of boiling. These changes seem to be due to the partial 
decomposition of certain of the proteids with the liberation of a 
volatile sulphide, probably hydrogen sulphide. That such is the case 
has been proven by Rettger (7) , and also by Franz Utz (8) . Accord- 
ing to the former, when milk is heated to 85° C., a volatile substance, 
probably hydrogen sulphide, is liberated. The amount of this, 
though small, suffices to blacken lead acetate paper and to decolorize 
dilute solutions of potassium permanganate. He found that alkalis 
and alkali phosphates accelerate the formation of the sulphide, 
whereas acids and acid phosphates retard this change. According 
to this author this change is believed to indicate proteid decomposi- 
tion, and may partly account for what some observers describe as 
the injurious effect of heating milk. These observations have been 
confirmed by Utz (8), who was able to recognize the hydrogen 
sulphide resulting from the boiling of milk by lead acetate paper 
and also by Ganassini's reagent 

When milk is boiled there seems also to be a partial fixation of the 
calcium salts which it ordinarily contains. These are probably par- 
tially precipitated in the form of tricalcium phosphate. This would 
account for the fact that the coagulation of milk by rennin takes 
place more slowly in boiled milk than in unboiled milk. (See p. 332.) 
In this connection Wassermann and Schtitze (9) have pointed out 
that cooked milk is not coagulated by lactoserum. According to 
P. T. Muller (10) the fact that cooked milk can not be coagulated by 
lactoserum is in some way associated with a diminution in the quan- 
tity of soluble calcium salts contained in the milk, this diminution 
having been caused by the action of heat. On the other hand, both 
Moro and Muller (10) have observed that certain milks do not show 
any diminution in coagulability by lactoserum after boiling. Ac- 
cording to Muller (10) this is to be attributed to the large amount 
of soluble calcium salts present in the milk of certain particular 
localities, and in this connection he has observed that the coagula- 
bility by lactoserum may be restored to boiled milk by the addition 
of soluble calcium salts. 

Hammarsten observed that milk curdles when it is heated to 130° 
to 150° C. (see p. 344). Cazeneuve and Haddon (11) observed that 
milk which had been coagulated at 130° C. became very acid. Ac- 



330 

cording to these observers it then contained formic acid. They also 
reached the conclusion that the discoloration and coagulation of 
milk by heat is due to the oxidation of lactose in the presence of the 
alkaline salts of the milk, one product of the oxidation consisting of 
formic acid, which, like other acids, precipitates the caseinogen. 
The latter undergoes no further change except that it is discolored 
by the products of the decomposition of lactose. 

Bruno Bardach (12) has also studied the coagulation of milk by 
heat. He found that about twelve hours' heating at 100° C. was 
required in order to coagulate perfectly fresh milk, whereas at 150° 
C. it coagulates in three minutes, and at 130° C. in one hour. He 
found only the merest traces of formic acid to be formed at 130° C. 
He concludes from his study of the subject that the coagulation of 
milk by heat is a complex process; that it is brought about by the 
action at the high temperature of the small quantities of acid which 
are formed from the lactose, and which ordinarily are powerless to 
coagulate the original unchanged casein (caseinogen), and that it is 
only after the casein (caseinogen) has been changed by the action of 
heat that such small amounts of acid can cause its coagulation. 

The part played by calcium salts in the acid coagulation of milk 
has been studied by Loevenhart ( 13 ) . According to this author the 
very small quantities of acid required to effect the coagulation of 
milk at temperatures at or below boiling accomplish this change by 
rendering the calcium salts normally present in milk available for 
the coagulation of the caseinogen. Therefore the temperature at 
which a given specimen of slightly sour milk will coagulate on heat- 
ing depends partly upon the degree of acidity and also upon the 
nature and amount of the calcium salts present in the milk. 

Von Soxhlet (14) has also recently investigated the coagulation 
which occurs on boiling faintly acid milk. He observed that at the 
commencement of the souring of milk boiling causes a coagulum 
to form. This occurs when only one-eighth of the amount of acid 
necessary to produce coagulation at ordinary temperatures is present. 
It depends, according to this author, on the formation of an insoluble 
compound of caseinogen with soluble calcium salts, the acid first 
produced forming monocalcium phosphate from the dicalcium phos- 
phate present in the fresh milk. 

The fact that milk occasionally curdles in the pasteurizing appa- 
ratus during pasteurization makes the accumulation of data bearing 
on this particular phase of the subject a matter of considerable im- 
portance. During our recent investigations of the Washington milk 
supply we incidentally made a number of observations on the coagu- 
lation of slightly sour milk at or below boiling. The results of these 
observations, aranged in the order of diminishing acidity, are given 
in the following table : 



331 



No. of 
sample. 


Acidity 

(per cent). 


Temperature 
(°C). 


Time of 

heating 

(minutes). 


Curdled 

= +; not 

curdled = — . 


1 


0.711 


65 


*o 


+ 


2 


.594 


65 


1 


+ 


3 


.576 


65 


2 


+ 


4 


.567 


65 


1 


+ 


5 


.554 


60 


2 


+ 


6 


.531 


65-67 


2 


+ 


7 


.513 


65 


2 


+ 


8 


.478 


60 


5 


+ 


9 


.450 


65 


If 


+ 


10 


.441 


66 


1 


+ 


11 


.387 


65 


5 


+ 


12 


.351 


65-67 


2 


+ 


13 


.351 


65 


5 


+ 


14 


.351 


65 


5 


+ 


15 


.342 


78.5 


2 


+ 


16 


.342 


66 


5 


- 


17 


.315 


70 


10 


+ 


18 


.315 


70 


5 


- 


19 


.315 


65 


5 


- 


20 


.306 


75 


3 


+ 


21 


.306 


65 


5 


- 


22 


.288 


70 


5 


*— 


23 


.261 


65-74 


5 


- 


24 


.252 


100 


1 


- 


25 


.252 


70 


5 


- 


26 


.243 


100 


1 


- 


27 


.243 


72-74 


10 


- 


28 


.243 


65 


10 


- 


29 


.234 


65 


5 


- 


30 


.225 


65-67 


2 


+ 


31 


.198 


65 


5 


- 


32 


.180 


65 


5 


- 



* Immediately. 

It will be seen from our results that of those samples of milk 
which coagulated on heating, sample 30 contained the smallest 
amount of acid at the time of coagulation, viz, 0.225 per cent. This 
sample curdled in two minutes at 65°-67° C. It will be observed 
that milks containing from 0.306 to 0.315 per cent of acid curdled 
at temperatures varying from 65°-78.5° C., in from two to ten min- 
utes, and that as a general rule those milks are most easily coagulated 
by heat which have the highest acidity. On the other hand, while 
one of the samples having an acidity of only 0.225 per cent curdled 
at 65°-67° C, in two minutes, another sample containing 0.243 per 
cent of acid did not curdle even on boiling. Thorner (15) found 
the acidity necessary to coagulate milk on heating to be 0.207 per cent. 
On the other hand, Rideal (16) found the amount of acid required 
to effect the coagulation to be somewhat higher than this. According 
to him the tendency to coagulate is not very marked even when the 



332 

acidity is as high as 0.23 per cent. Rideal's observations agree very 
nearly with our own. 

According to Stokes (3) milk which has an acidity somewhat less 
than 0.3 per cent of lactic acid will coagulate on boiling. He records 
the fact, however, that 3 samples of milk containing as much as 
0.54 per cent of lactic acid did not coagulate on boiling. 

Richmond (2) has been able to confirm Stokes's results almost 
absolutely. He found fresh milk to have an acidity of 20 degrees, 
corresponding to 0.18 per cent lactic acid. According to him milk 
curdles on boiling when it has an acidity of 33 degrees, corresponding 
to 0.297 per cent of lactic acid. 

Re vis and Payne (17) have shown that at the moment when the 
caseinogen is precipitated the calcium triphosphate has been elim- 
inated, and that the combination of caseinogen with lactic acid has 
reached a maximum. 

It is evident therefore from our results and those obtained by 
other observers that the coagulation of milk is dependent on several 
factors, among which are: time, temperature, degree of acidity, 
quantity and nature of the calcium salts, etc.; and that in order 
to avoid accidents resulting from curdling in the pasteurization of 
milk the only safe rule to follow is to determine the effect of heat 
on small samples of the milk which it is proposed to pasteurize, or 
better still, to pasteurize the milk as soon as it is drawn from the cow. 

Another important change in milk effected by heat is the destruc- 
tion of the bacteria and other micro-organisms normally present in 
fresh milk, including of course those pathogenic forms which fre- 
quently gain access to milk and cause the spread of infections through 
this medium or which give rise directly to highly poisonous sub- 
stances. For obvious reasons therefore this phase of the subject, 
namely, the pasteurization of milk, has received a great deal of 
attention during recent years at the hands of dairymen and sanita- 
rians. It is foreign to the immediate scope of this communication, 
however, to enter upon a discussion of this subject. Suffice it to 
say in this connection that pasteurization either checks or hinders 
those changes which occur in milk as the result of the life and growth 
therein of micro-organisms, and affords more or less adequate pro- 
tection against the spread of microbic diseases through the medium 
of milk. According to Pasteur (18) milk can be sterilized by heating 
it to about 110° C. and Duclaux kept milk five years by heating it to 
120° C. and preserving it in vessels which had been exhausted of air. 

Effect of Heat on Milk Enzymes. 

Another less obvious change in milk which is brought about by 
the action of heat is the destruction of the enzymes normally present 
in fresh milk. Like all enzymes those contained in fresh milk are 



333 

destroyed by boiling or by heating the milk above certain tempera- 
tures. On account of the important bearing which the thermal death 
point of milk ferments may have on the pasteurization of milk the 
following data relative to this subject are here submitted: 

Galactase. — According to Babcock and Russell (19), the destruc- 
tion temperature of galactase, the proteolytic enzyme of milk, is 
somewhat higher than the thermal death point of trypsin. So far 
as its proteolytic activity is concerned, these observers found it 
to be weakened by heating for ten minutes at 76°-80° C. That 
such is the case may be seen from the following table, in which is 
shown the percentage of soluble nitrogen present at the end of fifty- 
three days in milks which had been heated for ten minutes at the 
temperature indicated. 

TABLE i. 



Temperature to 
which the ga- 
lactase was 
heated for 10 
minutes before 
being allowed 
to act on the 
milk. 


Per cent of 
soluble nitro- 
gen after 
53 days at 
37° C.« 


78—80° C. 
76 
71 
65 
60 


0.05 
.05 
.12 
.20 
.20 



a The soluble nitrogen originally present in the milk used in these experiments was found 
to be 0.05 per cent. 

Similar tests were made upon the proteolytic activity of galactase 
towards gelatin, using Fermi's (20) method. Equal amounts of the 
galactase solution were poured over the surface of carbolized gelatin 
contained in test tubes and kept under observation seven weeks. 
The results of this series of experiments is given in Table II. 



L + 



TABLE II. 

=rapid digestion ; + =digestion by galactase ; 



no digestion.] 





Temperature (°C). 


Reaction of the galactase solu- 
tion. 




Alkaline. 


Neutral. 


Acid. 




N/10. 


N/20. 


N/10. 


65 . 


+ 


+ + 


+ + 




70 




75 




80 




Control 


+ 







334 



Hence so far as its power to digest gelatin is concerned the activity 
of galactase is destroyed in alkaline solution by ten minutes' expo- 
sure to temperatures of 65° C. in neutral solutions at 70° C. and in 
acid solutions at a temperature of 65° C. 

Babcock and Russell (19) have also employed the power on the 
part of galactase to accelerate oxidations by hydrogen peroxide as a 
test for the presence of the ferment, and have made use of this test 
as a means of determining the destruction temperature of galactase. 
This we now know is merely a test and measure of the peroxidase 
activity of the solution and not a test or measure of the activity 
of galactase at all. Indeed, as has been shown subsequently to the 
work of Babcock and Russell on this subject, galactase as prepared 
from separator slime is not a pure enzyme, but a mixture of enzymes. 
Thus Wender (21) points out that the galactase of Babcock and 
Russell consists of milk trypsin or galactase proper, milk catalase, 
and milk peroxidase. According to Wender, the trypsin of milk 
becomes inactive at 76° C. 

The use of V. Storch's tests (see p. 333), viz, with an iodide and 
starch or p-phenylene-diamine and a few drops of hydrogen peroxide 
as a means of determining the effect of high temperature on the 
activity of galactase, as employed by Babcock and Russell, is there- 
fore chiefly interesting as throwing light on the stability of milk 
peroxidase under the conditions employed in their work. Their 
results are given in Table III. 

TABLE III. 
[ + =color reaction; X=doubtful reaction; — =no color reaction.] 







Alkaline. 






Temperature (°C). 


Time. 




Neutral 
to litmus. 


Acid 


N/10. 


N/25. 


N/10. 




( 10 


+ 


+ 


+ 


+ 


65 


I 30 


+ 


+ 


+ 


+ 




1 60 


+ 


+ 


+ 


X 




| 10 


+ 


+ 


+ 


+ 


70 


30 


+ 


+ 


+ 


X 




| 60 


+ 


+ 


+ 


' - 




1 10 


+ 


+ 


+ 


X 


75 


I 30 


+ 


+ 


+ 






I 60 


+ 


+ 


+ 


- 




f 10 


+ 


+ 


+ 


- 


80 


J 30 


+ 


+ 


X 


_ 




{ 60 


X 






- 



Babcock and Russell (19) conclude therefore from their experi- 
ments that galactase is more stable in alkaline or neutral solution, and 
that it shows a close resemblance to trypsin, but is les$ sensitive to 
acids than the latter ferment The heat boundary of its activity is 



335 

influenced by the chemical reaction of the solution in which it is 
present, being lower in acid than in neutral or alkaline solution. 
When galactase that has been heated to 70° C. for ten minutes is 
added to milk, the digestion is slowed, and heating to 76° C. for ten 
minutes entirely destroys its digestive powers. In the Fermi (19) 
gelatin tests no digestion took place with specimens of the ferment 
that had been heated to 65° C., whereas with the unheated controls, 
the gelatin liquefied. 

Von Freudenreich (22) has confirmed the observations of Babcock 
and Russell on galactase. According to this observer a temperature 
of 75° C. for half an hour causes a falling off in the proteolytic 
activity of this enzyme. On the other hand, he found an exposure 
to 60° C. for half an hour to scarcely weaken it to a noticeable degree. 
According to Hippius (23) the proteolytic ferments of milk can 
withstand an exposure to 60° C. for one hour and an exposure to 
65° C. for half an hour. 

Milk amylase, according to this author, can withstand a tempera- 
ture of 60° for one hour, but is destroyed by heating above 75° C. 

Milk lipase. — Gillet (24) has found that milk lipase is destroyed 
at 65° C. According to Hippius (23) the lipase of woman's milk can 
withstand a temperature of 60° for one hour and a short exposure to 
62°, but is weakened at 63° C, and is destroyed at 64° C. 

The salol-splitting ferment (Nobecourt and Merklen) is, according 
to Hippius (23), destroyed above 65° C. However, the existence of 
this ferment is doubtful. (See p. 344.) 

Hougardy (25) has found that the activity of lactokinase is greatly 
enfeebled by heating for twenty minutes at 75° C. and practically 
destroyed by heating for half an hour at this temperature. 

The oxidizing ferments of milk. — While our knowledge of the solu- 
ble ferments is of too recent date for an exact understanding of their 
significance and powers of resistance, the well-known reactions of 
the oxidases have furnished us with a useful criterion for distin- 
guishing between raw (living) and heated milk (Zelinski 26). 

According to Marfan (see Zelinski (26)) the oxidases of milk are 
destroyed at 79° C. According to Hippius (23) they can withstand 
a temperature of 60° C. to 65° C, but are destroyed by a short 
exposure to 76° C. 

Peroxidases. — According to Wender (21) the peroxidase of milk 
becomes inactive at 83° C. According to Schardinger (27), using 
methylene blue as a reagent, the critical temperature of the milk 
peroxidases is 80° C. With Arnold's guaiacum reagent milks heated 
to 80°, according to Ostertag, failed to show the reaction (see Glage 
(28)). Franz Utz (29), using Schaffer's (30) reagent, found that 
milk heated for a short time at 90° C. or a long time at 70° C. failed 



336 

to show any reaction. Eullmann (31) gives the following data bear- 
ing on the stability of the peroxidases of milk, as shown by Storch's 
p-phenylene-diamine reagent : 



Raw milk, not heated. ] 

Milk heated one hour, 68°-69° C. } Deep S reenish blue at once - 



1. Raw milk, not heated 
2, 

3. Milk heated one-half hour, 72° C. 

4. Milk heated one-half hour, 90° C. I No coloration after ten minutes. 

5. Milk boiled one-half hour. 

V. Storch (32), employing his own reagent, found that exposure of 
the milk to a temperature of 75° C. for two minutes prevented the 
reaction. Freeman (33), working with Storch's reagent, found a 
temperature of 78° C. to destroy the peroxidase of milk. Du Eoi and 
Kohler (34) have employed hydrogen peroxide and the potassium- 
iodide-starch reagent and have found 80° C. to be the limit of the 
reaction. Weber (35) recommends Arnold's (36) reagent (guaiacum 
in acetone), and finds the temperature limit of the reaction to be 
about 80° C. Franz Utz (37), using a solution of ursol D, finds that 
milks which have been heated to 80° or above fail to give the peroxi- 
dase reaction. According to Eullmann (38) practically all bacteria 
are destroyed in cow's milk by heating it for one hour to 68°-69° C. ; 
whereas, using p-phenylene-diamine Irydrochloride, which he found 
to be the most delicate reagent for the peroxidase, he found that the 
latter was not destroyed unless the temperature exceeded 70° C. 
According to Van Itallie (39) the peroxidases of milk are not de- 
stroyed below 80° C, and milk sold as pasteurized milk gave the test 
with paraphenylene diamine and hydrogen peroxides Bruere (40) 
observed that milk which had been pasteurized at 80° C, or boiled, 
failed to show the peroxidase reaction with the gnaiacol reagent. 
Dupouy (41), using freshly prepared paraphenylene-diamine and 
hydrogen peroxide, found that unheated milks gave a blue color, 
whereas those heated above 79° C. gave no color with this reagent. 

Douglas (42), using ortol as a reagent, found that heating for five 
minutes at 75° C, or one minute at 80° C, destroys the peroxidase 
of milk. Marfan and Gillet (43), using guaiacol as a reagent for the 
peroxidases in milk, found the ferments still active at 70° C. They 
were weakened at 75° C, however, and were destroyed at 78° C. to 
79° C. Macadie (44) found that nearly all photographic developers, 
together with small amounts of hydrogen peroxide, give characteristic 
color reactions with milk which has not been heated above 75° C. 
Wilkinson and Peters (45), using benzidine and hydrogen peroxide, 
failed to obtain the peroxidase reaction with milks which had been 
heated to 78° C. or higher. 

° We have also found pasteurized milk to show the peroxidase reaction, with 
guaiacum, p-phenylene-diamine and also with phenolphthalin. 



337 

Using an acetone solution of guaiacum (purified according to 
Portier (46) and dilute hydrogen peroxide) we made the following 
observations on the resistance of the milk peroxidases to heat : 



Temperature 
(°C). 


Time of 


exposure. 


Color with reagent. 


70 


5 minutes 


Dark blue. 


70 




Do. 


72 




Do. 


70 




Dark blue; slow in developing. 


70 


60 minutes 


60 






60 


30 minutes 


Do. 


60 




Dark blue; somewhat slow in developing. 







It is evident, therefore, that while short exposures of milk to a 
temperature of 60° C. are apparently without effect on the activity 
of the peroxidases, an hour's exposure to this temperature renders 
them somewhat less active than in unheated milk, and an exposure 
of one hour to a temperature of 70° C. destroys them. 

It was also observed that milk just brought to 75° C. and 80° C. no 
longer gives the blue color with the guaiacum reagent. An examina- 
tion of curdled milk with this reagent revealed the presence of the 
peroxidase chiefly in the whey and apparently in unaltered condition 
so far as activity is concerned. 

[Since the foregoing was written the whole subject of the peroxi- 
dase reaction of milk has been thoroughly investigated by Kastle 
and Porch (47). These observers succeeded in showing, first, that 
the power of milk to induce the oxidation of phenolphthalin and 
other leuco-compounds by hydrogen peroxide is greatly intensified 
by certain substances of the phenol type ; and that by the use of these 
peroxidase-accelerators, phenolphthalin, guaiacum, and parapheny- 
lene- diamine can all be used to advantage and with certainty as per- 
oxidase reagents for milk; second, that the fresh milks of different 
cows of the same herd exhibit considerable differences in peroxidase 
activity ; third, that by means of the peroxidase reaction thus modi- 
fied it is possible to distinguish between raw and cooked milk or 
between raw milk and that which has been sterilized at a temperature 
of 70° C. or higher for short intervals, and that while milks which 
have been heated to 70° C. for one hour, or to 75° C. for twenty 
minutes, no longer show the peroxidase reaction, this reaction is not 
diminished in intensity, but, if anything, somewhat increased, by 
heating the milk to 60° C. for twenty minutes. It is evident, there- 
fore, that the pasteurization of milk at 60° C. for twenty minutes, 
as recommended by Rosenau, does not destroy the biological proper- 
ties of milk, at least so far as we are able to judge from the per- 
oxidase reaction.] 

45276°— Bull. 56—12 22 



338 

Catalase. — Less is known concerning milk catalase than is known 
of the peroxidases. It would seem, however, that it is perhaps more 
sensitive to heat than the peroxidases. Van Itallie (48) has shown 
that cow's milk is unable to decompose hydrogen peroxide after an 
exposure of one-half hour to 63° C. On the other hand, human milk 
still retains this power after a similar exposure. According to Jolles 
(49), heating to 75° C. destroys the catalases of woman's milk com- 
pletely. Wender (21) observed that catalase prepared from separa- 
tor slime (see galactase) becomes inactive at 80° C. 

Other biological properties. — According to Hippius (23) the bac- 
tericidal power of milk is retained even after long heating at 60°-65° 
C., but is weakened by a short exposure to 85° C, whereas according 
to Behring (50) this property of milk is lost after an hour's heating 
to 60° C 

The alexins of milk, according to Behring, are affected by heat in 
exactly the same way and to the same extent as the antibacterial sub- 
stances. Lane-Claypon (51) has shown that on adding blood 
corpuscles to milk the cream picks them up and carries them to the 
top, and that this property of milk is destroyed by heating it to 70° 
C. for a few minutes. It is evident, therefore, from these considera- 
tions, that the thermal death point of the milk ferments is dependent 
on a number of conditions besides the temperature itself. Chief 
among these are time and the reaction of the medium. As a rule, 
the soluble ferments can withstand somewhat higher temperatures in 
neutral or slightly alkaline solution than in acid solution. Acidity 
and temperature naturally augment the destructive powers of each 
other toward the enzymes. This accounts for the apparent dis- 
crepancies existing among such observations. In general, it may be 
said, however, that the milk ferments, most of them at least, can 
withstand a temperature ranging from 60°-65° C. for some time, 
without material injury. Between 65° C. and 70° C. most of them 
are weakened in their activities, and between 70° C. and 80° C. all 
of them are destroyed, even after relatively short exposures. 

According to Raudnitz (52) all the ferments of milk are destroyed 
between 75° C. and 90° C. (See also Tjaden, Koske, and Hertel (53), 
and also E. Weber (54), for further information bearing on this 
point.) 

The digestibility of raw and heated milk. — In this connection the 
effect of heat on the digestibility of milk proteids has been the sub- 
ject of considerable investigation. According to Kerr (55) milk is to 
be looked upon as consisting of living cells suspended in serum, the 
former consisting of fat cells and nucleated cells of the nature of 
white blood corpuscles. (As a matter of fact it has been definitely 
proven that leucocytes do actually occur in milk — see p. 491.) Ac- 
cording to Kerr, when milk is ingested, these living elements are at 



339 

once absorbed without any preliminary digestion, and are utilized 
directly in the building up of the tissues. The effect of boiling there- 
fore is obviously to kill all of the living cells of the milk, and to coagu- 
late certain of the albuminoid constituents. The result of the boiling 
therefore is that all of the constituents of the milk must be digested 
before they can be absorbed into the system. Hence there is a dis- 
tinct loss of utility in the milk as the result of boiling. He goes on 
to say further that it has been observed by many medical practi- 
tioners that there is a very distinctly lowered vitality among infants 
which are fed on boiled milk, the process of absorption being delayed 
and the quantity of milk required for the nourishment of the child 
being greater than when fresh milk is used. 

While this is doubtless an extreme view to take of the matter, there 
are quite a number of observers who believe that the proteids of milk 
are considerably altered by boiling. Thus according to Hallibur- 
ton (56) the milk proteids are rendered somewhat more difficult of 
digestion as the result of heating. Eubner (57) has observed that 
even a short heating at 100° C. coagulates the lactalbumin, an obser- 
vation which has been confirmed by Middleton (58). De Jager (59) 
has also arrived at the conclusion that the digestibility of milk dimin- 
ishes with cooking, and also that caseinogen is more readily digestible 
than casein and that infants stand raw milk better than cooked. 

In this connection it has been observed by Lorcher (60) that 
cooked milk coagulates with rennin more slowly than uncooked milk. 
This effect is noted even at temperatures of 80°-90° C. This is 
shown by the following : 

Ten cubic centimeters of milk was heated to the following tem- 
peratures for five minutes, then cooled to 35° C., and 0.5 cubic centi- 
meter of rennin solution added, and the time required for coagulation 
noted. The following results were obtained : 





Temperature (°C). 


; Time re- 
I quired for 
' coagulation 
1 (minutes). 




Temperature (°C). 


Time re- 
quired for 
coagulation 
(minutes). 


50... 
60... 
70... 




4| 

u 

4 S 


80.... 
90.... 
100.. 




H 
81 

9^ 



The probable explanation of the retardation of the rennin coagula- 
tion resulting from the heating of milk is that the calcium salts are 
partly rendered insoluble, probably through conversion into trical- 
cium phosphate, so that even the mineral constituents of milk seem 
to be somewhat altered by boiling. 

On the other hand there are those, among them Forbes-Ross (61), 
who contend that heat exerts no deleterious effect on the digestibility 
of milk, and that the feeding of infants with boiled milk is not in 



340 



any way responsible for scurvy or rickets, but in reality is a wise 
precaution against infantile diarrhea and other bacterial diseases. 
Similarly Tjaden, Koske, and Hertel (53) claim that by rapidly 
heating the milk to 90° C, with constant shaking, the chemical and 
physical properties of the milk are in no wise altered nor is the value 
of the milk as a food in any way impaired. 

These fundamental differences of opinion regarding the effect of 
heat on the digestibility of milk can therefore only be settled by 
further investigations along this line. 

By way of comparison there are given in the subjoined table cer- 
tain data pertaining to the destruction by heat of enzymes in general. 

This table has been compiled from observations recorded by Green 
(62), Oppenheimer (63), and others. 



Name of ferment. 


Temperature at which 
destroyed (°C). 


Name of ferment. 


Temperature at which 
destroyed (°C). 




Weakened at 70. 
80, weakened at 70. 
60. 
75. 
80. 

65-70, slowly at 58. 
70. 

65 (slowly). 

70, very slowly at 45-50. 
60-63. 

72(Hanriot), 65-70 
( Kastle & Loe venhart ) . 


Maltase 


55. 




Myrosin 


81-85. 






72. 






82.5. 






55-57. 


Diastase (saliva) 


Rennin 


70, neutral; 63, faintly 






64. 




Trypsin 


75-80. 






70 (Schmidt). 
55. 


» 








75-80. 









P. T. Miiller (64) gives the following data bearing on the subject of 
the resistance of the several ferments to heat: Hemodiastase (Hahn) 
is not destroyed at 55° C. It is weakened by heating to 66° C. for 
half an hour and at 65°-70° C. is destroyed. Parachymosin (Bang) 
withstands a temperature of 75° C. for some time. Papain is weak- 
ened -at 75° C. and destroyed at 82.5° C. The oxidizing ferments 
(Abelous and Biarnes) increase in activity from 0° C. to 60° C. At 
80° C. they are still active and are first destroyed at 100° C. Lacto- 
serum (P. T. Miiller) is rendered inactive by heating for half an 
hour, at 70°-75° C. So far then as the influence of temperature on 
their activity is concerned it is evident that the milk enzymes are 
much like enzymes from other sources. Indeed they are all very 
much alike and all of this great group of substances stand in such 
intimate and close relation to the vital activities of the cell that all 
of those conditions and influences which tend to destroy the one tend 
also to destroy the other. (See also Kastle (65) " On the Vital 
Activity of the Enzymes.") All of the bacteria of milk can not be 
destroyed therefore without at least diminishing the activity of the 
milk enzymes or perhaps destroying them altogether and the enzymes 
can not be destroyed without rendering the milk sterile. 



341 

Similar conclusions have been reached by Marfan (66). According 
to this author the enzymes in general can not withstand a tempera- 
ture higher than 70° C., so that by heating milk to deprive it of its 
bacteria, we also deprive it of those ferments which probably exer- 
cise a favorable influence on nutrition. He is of the opinion, how- 
ever, that this is not sufficient ground for doing away with the prac- 
tice of sterilizing milk by heat. In this connection Rosenau has 
recently made the important observation that the pathogenic 
bacteria commonly found in milk are either killed or rendered inert 
by exposure to 60° C. for twenty minutes, see Hyg. Lab. Bull. No. 42. 

Bokorny (67) has also pointed out that between protoplasm and 
the enzymes there are certain striking similarities. Toward temper- 
ature, he says, it has long been known that the enzymes conduct 
themselves like protoplasm. His table, setting forth these analo- 
gies so far as the influence of temperature and light are concerned, 
is given in the following : 



Name of protoplasm or enzyme. 



Action of temperature, light, etc. 



Protoplasm of bacteria and fungi . 



Lower plants and animals. 



Zymase (yeast) 

Maltase or glucase 

Invertase (from yeast) 

Diastase (of malt) 

Emulsin 

Myrosin 

Pepsin (from the stomach) 

Trypsin (from pancreas) . . 

Papain (vegetable trypsin) 

Rennin 

Catalase (Loew) 

Laccase (Bertrand) 



Nageli found the spores of bacillus subtilis could be heated 11 
hours in boiling water without showing the slightest damage. 
In the vegetative state this organism is largely destroyed by 
heating to 55°-60° C. 

Light tends to destroy many bacteria. 

Direct sunlight destroys by long exposure. 

A temperature of 25°-30° C best for the development of yeast. 

Young vegetative yeast-cells are killed at 50°-60°C, spores at 
60°-65° C. In the dry state yeast withstands 125° C. 

Spirogyra killed in water at 45°-50°.a Many algae live in the 
Carlsbad thermal springs, temperature- 53° C. Some forms of 
algse have been found in thermal springs having a temperature 
of 85° C 

Salt-water amcebas are killed at 35° O; fresh- water amcebas at 
40°-45° C 

Strong light is harmful. 

Optimum temperature, 25° C; loses activity at 0° C and is de- 
stroyed at 53° C 

Yeast maltase destroyed at 55° C. Maize maltase acts best at 35° C 

Quickly destroyed when moist at 70°C, and at 50°C. when heated a 
a long time. Optimum temperature, 31° C; according to Kjel- 
dahl, 52°-56° C 

Moist heat kills at 75° C, after short exposure. Dry diastase stands 
100° C. and over. Optimum temperature, 50°-55° C. 

Sunlight kills it. 

Optimum temperature, 45°-50° C; destroyed at 70° C. In dry 
state stands 100° C. for hours. 

Inactive at 0° C; thermal death-point, 85° C 

In 0.2 per cent hydrochloric acid, optimum temperature, 35°-40° 
C Death-temperature, 56°-60° C. Dry, stands 160° O for a 
short time. 

Optimum temperature, 40° O; death-temperature, 69°-70° C. In 
dry state can be heated to 160° C without harm. 



Killed at 75° C. Dry, stands 100° C 
Higher than 70° C. kills quickly. 



Optimum temperature, 40° C. 

Optimum temperature, 40° C. 

Death-temperature, 72°-75° C. 

Optimum temperature, 20° C. Destroyed at 60°-63° C. ( Yoshida). 
Destroyed at 70° .C. (Bertrand). 



° The water-plant Hottonia shows a maximum assimilation of carbon dioxide at 31° C. 
This is only one-fourth as strong at 50° C, and at 56° C. it ceases altogether. 



342 

Part II. — (2) Changes in the Composition of Milk Produced by the Milk 

Enzymes. 

According to Marfan (1), milk is not an inactive fluid, but pos- 
sesses properties which are more or less characteristic of living tissues. 
For example, it gives Bordet's reaction, namely, that when the milk of 
one species of animal is repeatedly injected into the blood of an 
animal of different species the blood serum of the animal so treated 
gradually acquires the power of coagulating milk in much the same 
way as rennin. (See P. T. Miiller (2) " Vergleichende Studien Ueber 
die Gerinnung des Kaseins Durch Lab und Lactoserum.") Human 
milk is said by Moro (3) to have the power of coagulating hydrocele 
fluid, whereas cow's milk does not give this reaction. 

As already indicated on page 313, milk contains a number of soluble 
ferments, such as diastase (amylase), galactase, lipase, lactokinase, 
peroxidase, reductase, and catalase. 

In the present state of our knowledge we know very little of the 
actual functions of the milk ferments. According to Marfan (1), it 
is probable that the milk ferments act as stimulants and regulators 
of nutrition and that they are identical in function with the enzymes 
elaborated by the various tissues and are intended to compensate 
for the deficiency of the internal secretions of the new-born. Accord- 
ing to this author the presence of specific ferments in the milk of 
a particular animal species probably explains the value of natural 
over artificial milk feeding. 

Engel (4), in discussing Moro's work on the influence of the milk 
ferments on nutrition, arrives at the conclusion that while these 
ferments are apparently characteristic for the milk of any partic- 
ular animal species, we can not yet come to any definite conclu- 
sions respecting their influence on animal nutrition. He calls atten- 
tion to the fact that Moro's curves showing the increase in weight of 
two sucklings both fed by the bottle, one on fresh and the other on 
boiled human milk, showed but little differences. Both curves 
showed that both children thrived less well during the second period. 
Concerning the function of the milk ferments see also Moro (5). 

On the other hand certain of these ferments bring about changes 
in the composition of milk which require some consideration in this 
connection. The following are the principal facts of interest con- 
cerning the soluble ferments found in milk and the changes which 
they effect in the composition thereof, except for what has been given 
already on this subject. 

Diastase {amylase) of milk. — In 1883 Bechamp (6) isolated from 
human milk an enzyme which liquefies starch and converts it into 
sugar as readily as diastase. According to this author this ferment 
was obtained from successive portions of milk as soon as drawn from 



343 

the teat, and hence is a product of the milk gland itself, and not 
formed by the action of milk stagnated in the gland. Attempts 
to isolate this ferment from cow's milk by Moro (5) and by Van 
der Yelde and Landtsheer (7) have not proven successful. That a 
diastatic ferment does not occur in cow's milk has also been con- 
firmed by Kastle. At present nothing definite is known regarding 
the function of this enzyme in human milk, and so far as we know 
it is not responsible for any alteration in the composition of any con- 
stituent of the milk itself. 

Galactase. — This proteolytic ferment was first recognized by Bab- 
cock and Kussell (8) in 1897, and has been found by these observers 
in the milk of the cow, woman, sheep, goat, pig, horse, and half- 
breed buffalo. By the methods ordinarity employed in the prepara- 
tion of enzymes, these authors succeeded in preparing from the fresh 
centrifuge slime of milk that had been kept continuously in contact 
with chemical antiseptics aqueous extracts possessing proteolytic 
properties to a marked degree. These extracts were also observed 
to have the power of curdling fresh milk, similarly to rennin, and 
also of rapidly decomposing hydrogen peroxide. Galactase has been 
found to be similar to trypsin in its action on proteids, converting 
them into proteoses and peptones and finally into amino-acids. Like 
trypsin it has been found to be most active in solutions that are 
slightly alkaline to litmus, and like all ferments it is easily destroyed 
by heat. 

Some idea of the changes produced in milk by the action of this 
enzyme may be formed from the results of analyses made by Bab- 
cock and Russell of milks that were allowed to stand for various 
intervals of time in the presence of an antiseptic to prevent the 
growth of bacteria. These results are given in the following table: 



Description of milk. 



Per cent of 

proteids in 

soluble 

form. 



Average of fresh whole milks analyzed 

Average of whole milks, 20-25 days old 

Average of centrifugal skim milks (fresh) 

Average of centrifugal skim milks, 8-12 months old. 
Maximum found in skim milk 



21.07 
38.27 
25.26 
73.30 
91.18 



The proof of the enzymic nature of these changes is shown by the 
stability of milk heated to a sufficiently high temperature to destroy 
such ferments, and by the fact that fresh milks when preserved with 
powerful antiseptics, such as mercuric chloride, formalin, etc., un- 
dergo no change even though they be kept for indefinite periods of 
time. 



344 

These observations on galactase have been fully confirmed by Von 
Freudenreich (9) and other investigators (10). Wender (11) has 
shown, however, that galactase as ordinarily prepared from separator 
slime, according to Babcock and Kussell's method, in reality consists 
of at least three distinct enzymes, viz, gallactase proper, peroxidase, 
and catalase. Ordinarily galactase by itself acts too slowly to cause 
any material change in the proteids of milk in the short intervals 
which usually elapse between the withdrawal of the milk from the 
animal and its consumption as food. It is claimed by Babcock and 
Russell, however, that this enzyme probably assists in those changes 
which ordinarily take place in the ripening of cheese. It is also 
claimed by Snyder (12) that when milk is used in a mixed diet the 
proteids have been found to be from 4 to 5 per cent more digestible 
than when milk is omitted from the diet. This increased digestibility 
he claims is due to the milk enzymes. In this connection, it is of 
interest to note that Hougardy (13) has recently shown that cow's 
milk contains a ferment or a kinase similar to enterokinase. The 
author proposes to call this ferment lactokinase. This lactokinase 
has been found to accelerate the digestion of proteids by pancreatic 
juice and loses its power to facilitate this change at 73° to 75° C. 

Lipase. — Marfan and Gillet (14) found a lipase in milk capable of 
hydrolyzing monobutyrin. Human milk exhibits this property to a 
higher degree than cow's milk. The former was found to have a 
lipolytic activity of 20-30 on Hanriot's scale, while cow's milk shows 
an activity of only 6-8. Gillet (15) has shown that the milk of differ- 
ent animals contains the lipolytic ferment. This ferment withstands 
cold, but is destroyed by heating to 65° C. It is nondialyzable and is 
held back by the porcelain filter. It probably hydrolyzes the higher 
fats of milk at least to some extent and may possibly account for a 
small part of the acidity of sour milk. 

In this connection Rogers (16) has observed that this ferment is 
present in butter and on standing increases its acidity. 

The so-called " salol- splitting ferment." — Nobecourt and Merk- 
len (17) observed that human and ass's milks have the power of hy- 
drolyzing salol (phenyl salicylate). For a time this hydrolysis was 
believed to be accomplished by an enzyme, to which the name of " the 
salol-splitting enzyme " was given. It was afterwards shown, how- 
ever, by Desmoulieres (18) and also by Miele and Willem (19) that 
no such ferment exists in milk and that this decomposition of salol is 
in reality a saponification brought about by the alkali present in cer- 
tain milks, and that only those milks having an alkaline reaction are 
capable of effecting this decomposition, so that this probably disposes 
of this subject. 

The oxidizing ferments of milk. — Milk contains no true oxidases or 
oxidizing ferments proper. It does decompose hydrogen peroxide, 



345 

however, and in the presence of small amounts of hydrogen peroxide 
or ozonized oil of turpentine it has the power of effecting the oxida- 
tion of a considerable number of easily oxidizable substances. In 
other words, milk contains catalase and peroxidase. These have 
been referred to in the literature by these names ; and also more or less 
indiscriminately by certain writers as the oxidizing ferments of milk 
or superoxidases, and also by some as the indirect oxidases. 

Catalase. — From what is known of the wide distribution of the 
catalases among living things and plant and animal secretions it 
seems probable, although it can not be said to be known absolutely 
at present, that the fresh milk of all animals has the power of decom- 
posing hydrogen peroxide more or less easily. Jolles (20) has 
pointed out that human milk decomposes five or six times as much 
hydrogen peroxide in the same length of time and under the same 
conditions as cow's milk. This author is inclined to attach consid- 
erable importance to this reaction, and recently Von der Velden (21) 
also lays emphasis on the fact that the presence of catalase in human 
milk serves to distinguish it from cow's milk. On the other hand, 
the fact that cow's milk can decompose hydrogen peroxide is attested 
by many observers, some of whom, among them Amberg (22), have 
called attention to the gradual disappearance of hydrogen peroxide 
in cow's milk on standing, and others, van Itallie (23) among them, 
to the fact that cow's milk loses its power to decompose hydrogen 
peroxide on heating to 63° C. Faitelowitz (24) has shown that the 
catalase of milk is associated with the fat globules. This has been 
confirmed by Reiss (25), who further points out that the catalase of 
milk is insoluble in the presence of colloids. 

In the present state of our knowledge we know very little concern- 
ing the function of catalase in living tissue and active secretions. The 
view has been advanced by Loew (26), who has made extensive 
studies in this field, that the function of catalase is to destroy any 
hydrogen peroxide that may have been formed during the respiratory 
processes in the living cell, thereby preventing the accumulation of 
this and other peroxides, all of which are more or less toxic in their 
effects, thus affording protection against a toxic product of respira- 
tion. The question whether hydrogen peroxide is formed in the res- 
piratory process in plants or animals is a much-mooted question, and 
there has been considerable difference of opinion among chemists as 
to whether hydrogen peroxide ever occurs in animal or vegetable tis- 
sues. One thing is certain, however, and that is, whether hydrogen 
peroxide occurs therein or not other complex peroxides do occur, espe- 
cially in plant tissues and exudations (see Bach's (27) investiga- 
tions), and quite recently in an investigation of remarkable interest 
and far-reaching importance, Usher and Priestley (28) have confirmed 
Erlenmeyer's (29) theory of the origin of carbohydrates in green 



346 

plants, which supposes these substances to originate from formic 
aldehyde, which in turn results from the reaction of carbon dioxide 
with water, as indicated in the following equations : 



(1) 0O,+2H,O=™»™+HA 



formic acid 

and 

(2) H 2 C0 2 +H 2 0= formi ^gg h y de +H 8 2 . 

In this reaction hydrogen peroxide is formed, and of course if 
allowed to accumulate in the cell would soon put a stop to all of its 
vital activities. According to Loew, however, the accumulation of 
hydrogen peroxide would be prevented by its decomposition, prac- 
tically as fast as formed, by the catalase. 

Quite recently Usher and Priestley (30) have succeeded in demon- 
strating the decomposition of carbon dioxide by means of chlorophyll 
within and outside of the plant and in proving the presence of formic 
acid, formic aldehyde, and hydrogen peroxide among the products 
of the decomposition. As already stated this work is of unusual 
interest, and if confirmed by subsequent investigations will go a long 
way toward bringing about an .understanding of this important 
biochemical process and will enable us to understand better the 
function of the catalases in general. Of course if hydrogen peroxide 
or similar peroxides are present in milk they must of necessity have 
a different origin from the peroxides occurring in the cells of chloro- 
plryllous plants. It is readily conceivable, however, that such 
peroxides might originate in animal tissues and secretions in other 
ways, and if, in the one case, it is established that the function of 
catalase is to destroy hydrogen peroxide and thereby prevent its 
accumulation in the cell, it will probably turn out that it has a 
similar function in milk or in whatsoever associations it is found. 

It is held by some that the catalases are not oxygen carriers, and in 
this connection Lesser (31) has shown that the decomposition of 
hydrogen peroxide by catalase does not lead to the oxidation of fat 
or carbohydrates. According to this author catalase is to be regarded 
as a substance capable of taking up oxygen and of giving it up again 
under certain circumstances. 

Peroxidases. — The idea that milk contains true oxidizing ferments 
or oxidases proper probably originated from the fact that in the 
earlier work on this subject old tinctures of guaiacum were employed 
in making the tests. As is well known, old tinctures of guaiacum 
frequently exhibit reactions which are not shown by the perfectly 
fresh tinctures (32). This has been accounted for on the supposition 
that on standing exposed to air and light substances of the nature 



347 

of peroxides are gradually formed in tinctures of guaiacum and that 
these substances react with the unchanged guaiacum in the presence 
of a peroxidase or suitable oxygen carrier, giving rise to the formation 
of guaiacum blue. On the other hand, there is abundant evidence 
at hand to show that milk contains substances capable of inducing 
the oxidation of guaiacum and other readily oxidizable substances 
by means of hydrogen peroxide or ozonized oil of turpentine. These 
substances are destroyed by boiling and are known as the peroxidases. 
A great many reagents have been proposed for the detection and 
approximate estimation of the peroxidases in milk, with the view, 
primarily, of distinguishing between fresh or raw and heated (pas- 
teurized) or boiled milk. Among these may be mentioned guaia- 
cum (33), potassium iodide, and starch (34), paraphenylene-dia- 
mine (35),ortol (36), paradiethyl-paraphenylene-diamine (3T),ursol 
(38), guaiacol (39), amidol (Leffmann) (35), phenolphthalin (40), 
benzidine (41), etc. These reagents are used in connection with 
small quantities of hydrogen peroxide or some peroxide compound 
such as the persulphates, perborates, or ozonized oil of turpentine, 
and with fresh unheated milk they all give characteristic changes of 
color which are not shown by milks which have been heated to 80° C. 
or higher. 

Whether the peroxidases of milk give rise to any changes in the 
composition of the milk can at present only be conjectured. It may 
be of course that they gradually effect the oxidation of reducing 
substances in the milk. According to some authors they gradually 
disappear when the milk turns sour. It has been our experience, 
however, that they pass practically unchanged into the whey when 
milk curdles as the result of the lactic acid fermentation. In the 
present state of our knowledge the various tests which have been pro- 
posed for the peroxidases of milk are chiefly useful in enabling us to 
form an idea of the condition of the milk, whether it has been heated 
beyond certain temperatures or not, although according to Gillet 
(15) even normal fresh milks vary in the amounts of peroxidases 
which they contain, and this has also been our own experience with 
this reaction. 

Reductases. — According to Seligmann (42) raw milk possesses re- 
ducing properties; for example, it reduces Schar dinger's (43) reagent, 
which consists of a solution of methylene blue containing small 
amounts of formaldehyde. By some authors these reducing substances 
have been regarded as ferments, reductases, by others as due to 
bacteria, and by still others they have been looked upon as identical 
with catalase, the ferment in milk which decomposes hydrogen per- 
oxide. By the use of a weak alcoholic solution of methlyene blue, 
Smidt (44) claims to have been able to distinguish between the re- 
duction brought about by bacteria and that caused by ferments. This 



348 

author has shown that the reductases of milk are different from the 
catalase and superoxidase of milk and separable from these, the latter 
being soluble in water and salt solution, the former not. In recent 
communications Seligmann (45) points out that the reductases and 
peroxidases of cow's milk are not indentical. According to this 
author all processes of reduction occurring in fresh and sour milk are 
due to the action of bacteria and not to unorganized ferments. 

Cathcart (46) has also made a study of the reduction of Schar- 
dinger's reagent by fresh milk. According to this author the reduc- 
tion of the coloring matter is due to the presence of a catalase which 
is readily destroyed by heat. Our knowledge, therefore, of the 
reductases of milk is at present very limited, and we are not as yet 
in a position to say whether they are responsible for any of the 
changes ordinarily occurring in milk. 

Part II. — (3) Changes in Milk Brought About by the Action of the Digest- 
ive Ferments — The Rennin Coagulation of Milk. 

The composition of milk is profoundly altered during the process 
of digestion through the action of the digestive ferments. In the 
stomach and intestine the fat is hydrolysed by lipase, giving rise to 
fatty acids and glycerin, the milk sugar is converted into glucose 
and galactose by lactase, and the proteids into simpler and more dis- 
fusible nitrogen compounds by the proteolytic ferments. Chief 
among these proteids is caseinogen, which, according to Lehmann and 
Hempel (1), has the following composition: 

Per cent. 

Carbon 54. 

Hydrogen 7.04 

Nitrogen 15.6 

Sulphur . 771 

Phosphorus . 847 

The following, according to Mann (2), are the principal dissocia- 
tion products which have been isolated from caseinogen by hydro- 
lytic cleavage: 

Per cent. 

Glycocoll 

Alanin . 9 

Leucin 10. 5 

Phenylalanin 3. 2 

Alpha-pyrrolidin carboxylic acid 3.2 

Glutaminic acid 10. 7 

Aspartic acid 1. 2 

Cystin .065 

Serin .43 

Oxy-alpha-pyrrolidin carboxylic acid . 25 

Tyrosin : 4. 5 

Lysin 5. 8 



349 

Per cent. 

Histidin 2.6 

Arginin 4.84 

Tryptophane 1.5 

Ammonia 1.8 

Cystein 

Amino valerianic acid 1. 

Glucosamin 

Diamino-trioxy dodecanoic acid . 75 

According to this author the absence of glycocoll and the carbo- 
hydrate radical and the relatively high ty rosin and tryptophane 
content of caseinogen render it especially readily digestible. It 
seems also to be the only native albumin which is attacked by erepsin 
(see Cohnheim (3)), and on account of its ease of hydrolysis it 
probably plays a special port in metabolism. In this connection 
Tunnicliffe (4) has shown that when total digestibility is considered 
human milk is much more digestible than any of its substitutes. 

Among the various changes brought about in the composition of 
milk through the action of the digestive ferments the most typical 
and characteristic is the rennin coagulation. Exclusive of the 
mineral matter the caseinogen is the only constituent of the milk 
involved in this change. 

It has long been known that fresh milk coagulates in the stomach 
of higher animals, and that an aqueous extract of the inner lining 
of the stomach of the calf, when added to fresh milk, causes it to 
curdle, whereby it clots or sets in the form of a solid curd. Since 
early times this fact has been turned to practical account in the 
making of cheese. The earlier explanations of the rennin coagu- 
lation of milk were based on an observation by Fremy (5) to the 
effect that rennet, or the mucous lining of the calf's stomach, has the 
power of converting milk sugar into lactic acid. According to 
Liebig (6), therefore, rennin curdles milk for the reason that it acts 
upon the milk sugar, converting it into lactic acid. The latter then 
neutralizes the alkali of the milk which holds the caseinogen in 
solution, thereby precipitating this substance as the curd. 

Soxhlet (7) also saw in the curdling of milk by rennin an analogy 
to the coagulation of milk by acids. According to him the former 
process took place much more rapidly than the latter. He held 
with Liebig that the rennin converted the sugar of milk into lactic 
acid and that this in turn converted the alkaline phosphate existing 
in the milk into an acid phosphate, which in turn precipitatel the 
casein. Hallier (8) explained the rennin coagulation of milk as due 
to the presence of micro-organisms in the stomach of the calf. The 
most important of the earlier observations on the curdling of milk 
by rennin was that made by Heintz (9), who showed that contrary 
to previous teachings on the subject the acqueous extract of the 



350 

mucosa of the calf's stomach has the power of curdling milk in both 
acid and alkaline solutions. To Hammarsten (10) and Schmidt (11), 
however, belong the credit of first showing that the rennin curdling 
of milk is accomplished by means of a soluble ferment to which they 
gave the name of " labferment " or " chymosin." This is the fer- 
ment which in English is called rennin, formerly rennet. Hammar- 
sten succeeded in showing: first, that the curdling of the milk by 
rennin is independent of the action of lactic acid; second, that the 
caseinogen (casein) of milk is not in true solution in milk but in 
colloidal suspension (gequollenen Zustande) ; third, that without 
the presence of a sufficient quantity of calcium phosphate rennin 
coagulation will not take place; fourth, that the caseinogen is so 
modified through the action of the rennin that in the presence of a 
certain quantity of a lime salt it can no longer remain in solution, but 
is precipitated as casein (Kase) or paracasein calcium phosphate; 
fifth, that as the result of the action of rennin, caseinogen (casein) 
is split into at least two new proteids, casein (der Kase) and whey- 
proteid (Molkeneiweiss). The former contains a relatively small 
quantity of calcium salts and is insoluble, the latter contains a larger 
proportion of calcium salts and is easily soluble. Finally Ham- 
marsten held it to be highly probable that the rennin coagulation 
of milk is analogous in many respects to the coagulation of fresh 
milk by heat, which occurs at 130° to 150° C, and that in this regard 
the action of rennin is similar to other fermentations. According 
to Hammarsten, therefore, the rennin coagulation of milk resolves 
itself into two distinct phases: (1) the conversion of caseinogen 
into paracasein in the presence of calcium salts, (2) the precipitation 
of paracasein from its solutions through the action of calcium salts. 
It will be observed that the second phase of the coagulation is inde- 
pendent of the action of rennin. 

These earlier researches by Hammarsten on the rennin coagulation 
of milk have been the point of departure for the greater number of 
subsequent investigations in this field, and his conclusions respecting 
this process have been the subject of a great deal of discussion. 

During recent years the rennin coagulation of milk has been studied 
by many observers. Among these may be mentioned Duclaux, Cou- 
rant, Lorcher, Fuld, Laqueur, Loevenhart, and others. As the result 
of his studies on the rennin coagulation of milk, Loevenhart (14) 

a The name caseinogen is employed throughout this communication on the 
rennin coagulation of milk in the sense in which it was first used by Hallibur- 
ton (12), namely, as signifying the proteid of milk, which, through the action a»f 
rennin in the presence of certain calcium salts, is transformed into the casein 
(paracasein) of the curd. The term paracasein was first introduced into the 
science by Schulze and Rose (13) and is used in the sense employed by Ham- 
marsten. 



351 

recognized essentially three distinct phases of the process : (1) Trans- 
formation of caseinogen into paracasein; (2) alteration or rearrange- 
ment of the mineral constituents of the milk, whereby the calcium 
salts become available for the coagulation; (3) precipitation of the 
paracasein by calcium salts. He has shown that the conversion of 
caseinogen into paracasein proceeds somewhat more rapidly than the 
rendering available of the calcium salts. According to this author 
the first two phases of the process are accomplished by the action of 
rennin, whereas the third phase, namely, the precipitation of the para- 
casein, is entirely independent of the action of the ferment. 

He also arrived at the conclusion from his study of the influence of 
salts on the coagulation of decalcified milk that the facts observed 
seemed to favor the theory that the curdling of milk depends in great 
part, though not entirely, on the rearrangement or rendering availa- 
ble of its mineral constituents. He succeeded in showing that fresh 
milk can not precipitate paracasein solutions nor can it prevent their 
precipitation by calcium chloride. Hence it would seem that the 
calcium salts of fresh milk are in some way altered through the action 
of rennin, thereby becoming capable of precipitating paracasein. 
He concludes therefore that in the rennin coagulation of milk the 
rennin has the power in some way to render available the calcium 
salts (die calcium Salze frei zu machen), since without this change 
no coagulation is possible. Similarly Briot (15) maintains that 
rennin acts less on the caseinogen than on the calcium phosphate of 
milk. While this extreme view is probably incorrect it is certain that 
the majority of chemists are agreed regarding the necessity of cal- 
cium salts for the rennin coagulation of milk. That such is the case 
is evident not only from the earlier investigations of Hammarsten 
but also from later and more exact observations by Arthus and Pages 
(16), Courant (17), Einger (18), Loevenhart (14), Edmunds (19), 
Benjamin (20), Soldner (21), Laqueur (22), and others. 

It has also been established by the work of Courant (17) that the 
reaction of milk is not altered during the rennin coagulation. 

The question still remains to be considered, How does the rennin 
act on the caseinogen and in what way is the latter altered through 
the action of the ferment? These questions have been exhaustively 
considered by Laqueur (23), who has arrived at the conclusion that 
from the slight differences between caseinogen and paracasein thus 
far made out it is impossible to arrive at an unequivocal explana- 
tion of the coagulation of milk by rennin. This author is inclined 
to believe, however, that Hammarsten's original explanation of the 
process is perhaps, all things considered, the best we have. Accord- 
ing to this explanation the rennin acts by splitting the caseinogen 
into a larger molecule, paracasein, and a smaller molecule, the whey- 
proteid (molkeneiweiss), also called hemicaseinogen albumose (Arthus 



352 



and Pages). Fuld (24) has recently suggested the name whey- 
albumose for the soluble proteid produced in the rennin coagulation 
of milk. This view also derives support from the more recent 
researches on the subject by P. T. Muller (25), who found whey- 
proteid in the milk serum only after rennin coagulation and not 
after the milk had been coagulated by acids or lactoserum. Simi- 
larly, unpublished analyses by W. Laqueur (23) and an experiment 
by Rotondi (26) also indicate the splitting off of a soluble nitroge- 
nous compound from caseinogen during the rennin coagulation of 
milk. On the other hand, according to Duclaux (27), who analyzed 
the filtrates obtained by filtering fresh milk and milk coagulated by 
rennin through a porcelain filter, the soluble nitrogen in the whey 
is not increased after rennin coagulation, nor is the composition of 
the whey altered in any way. That such is the case may be seen 
from the following results of his analyses of milk serum before and 
after coagulation by rennin: 





Experiment I. 


Experiment II. 




Normal 
milk. 


Milk coag- 
ulated by 
rennin. 


Normal 
milk. 


Milk coag- 
ulated by 
rennin. 


Lactose 


5.53 

.55 
.54 


5.53 
.57 
.52 


5.37 
.37 
.56 


5.64 




.36 




40 







Arrhenius (28) is of the opinion, however, that Duclaux's experi- 
ments on this point are not convincing, since the whey proteid might 
have been retained by the porcelain filter, especially in the presence 
of the gelatinous paracasein. 

From his researches on the laws governing rennin coagulation Fuld 
(29) also arrived at the conclusion that the transformation of case- 
inogen into paracasein is only a molecular rearrangement, partaking 
of the nature of a monomolecular process. According to this author 
the rennin coagulation of milk is only a special case of the well-known 
phenomenon of the reciprocal suspension and precipitation of col- 
loidal substances. Loevenhart (14) has also reached the conclusion 
that it is probable that caseinogen and paracasein are chemically the 
same substance, and that the observed differences existing between 
them depend upon the fact that paracasein exhibits a higher degree of 
association than caseinogen. In other words, paracasein consists of 
larger molecular aggregates than caseinogen, otherwise they are 
identical. These views are shared by other observers, among them 
Van Slyke and Hart (30) . On the other hand, Laqueur (23) , from a 
consideration of these facts and the conduct of other colloidal sub- 



353 

stances, comes to exactly the opposite conclusion, viz, that caseinogen 
is probably a higher colloid than paracasein. 

According to Laqueur (23) , the idea that paracasein is a more com- 
plex substance than caseinogen has also received support from 
Danilewski's observation that rennin gives rise to a precipitate in 
solutions of albumoses. According to the Russian investigators, by 
whom this reaction has been extensively studied, this precipitate pos- 
sesses the properties of a higher proteid. They therefore see in this 
change the synthesis of a complex substance having the nature of 
naturally occurring proteids from the products of assimilation, and 
find a ready explanation for the widespread occurrence of rennin in 
the tissues of animals and plants which are in no wise concerned with 
the digestion of milk. On the other hand, Laqueur (23) is inclined 
to question the validity of these conclusions. According to this 
author the weightiest objection that can be urged against these views 
is that at present we have no exact means of knowing whether the 
reaction resulting in the formation of these plastein substances, as 
they have been called, is really the result of rennin action and whether 
Ave have a right to ascribe to these changes the same cause as that 
which brings about the conversion of caseinogen into paracasein in 
the coagulation of milk. We know that as yet we have no means of 
operating with the pure ferment, but that in a solution of ferments 
the ferment itself often composes only a small part of the mixture, 
and in this connection it has been found that whereas one part by 
weight of the ferment solution is required to convert 48 grammes of 
albumose into plastein the same quantity of the ferment solution 
will convert from 10,000 to 100,000 grammes of caseinogen into para- 
casein. Hence, according to Laqueur (23), it would seem to be a far- 
fetched conclusion to ascribe these two changes to the same ferment. 
It is therefore a mistake, according to this author, to assign to a 
ferment so widely distributed in plants and animals as that causing 
the plastein reaction a function absolutely identical with that of the 
ferment contained in the stomach of the calf, the latter producing 
the typical rennin coagulation of milk, until it has been definitely 
established that the ferment from plants, etc., also acts on caseinogen 
in two stages, in one of which calcium salts are required, and that 
the paracasein produced in the two processes is the same in each. 
Other chemists are also of the opinion that the plastein reaction is in 
reality due to pepsin and not to rennin at all. 

As a matter of fact the chemical and physical differences between 
caseinogen and paracasein are apparently so slight and in the pres- 
ent state of our knowledge so imperfectly understood that it is im- 
possible to decide between all of these conflicting views on the rennin 

45276°— Bull. 56—12 23 



354 

coagulation of milk. Laqueur (23) takes the view, however, that 
the hypothesis that rennin causes a coagulative splitting of caseino- 
gen rests at least upon some foundation of fact, whereas the view 
that rennin exerts a synthetic action rests at present upon very 
deceptive analogies and teleological evidence. 

The more one studies the extensive literature of the rennin coagu- 
lation the more one is disposed to agree with Laqueur that in the 
present state of our knowledge it is impossible to arrive at an une- 
quivocal explanation of this complicated process. It seems, how- 
ever, to have been reasonably well established — 

(1) That, exclusive of phosphates of calcium and other soluble 
salts of calcium, caseinogen is the only substance in milk involved 
in the rennin coagulation. 

(2) That in the rennin coagulation of milk no change of reaction 
occurs; that is, no production of base or acid. In this connec- 
tion it has been pointed out by Herwerden (31) that hydrogen ions 
are not necessary for the rennin coagulation of milk or of solution 
of caseinogen containing calcium. 

(3) That in the rennin coagulation of milk two active agents are 
concerned, a soluble ferment, rennin, and calcium ions ; that is, solu- 
ble calcium salts. 

According to Hammarsten the caseinogen is resolved by rennin 
into paracasein and whey proteid. Through the action of calcium 
ions (soluble calcium salts), the former is then precipitated as the 
curd (Kase), the latter remaining in solution. According to Fuld 
and others the change of caseinogen into paracasein is a molecular 
rearrangement. According to Courant the dicalcium caseinogenate 
is so altered by rennin that by contact with soluble calcium salts a 
precipitate (the curd) is produced. According to Lovenhart the 
rennin renders the calcium salts of milk available for the coagulation 
of paracasein, which latter is formed from caseinogen also by the 
action of rennin, and which, according to this author, differs from 
caseinogen only in that it is composed of larger molecular aggregates. 
It will be observed that these several views regarding the precise 
mode of action of the rennin differ in some particulars. These dif- 
ferences can only be reconciled by further investigation. 

It has been shown by Soldner (32), Osborne (33), Courant (17), 
and others that caseinogen is an acid. According to Courant it forms 
three kinds of salts, namely, mono-, di-, and tri-caseinogenates. It 
also seems probable from Lehmann's (1) investigations that the 
caseinogen exists in fresh milk in the form of a complex calcium 
salt containing calcium phosphate. According to this author the 



355 

composition of this compound agrees reasonably well with the 
formula 

Ca 3 (POJ 2 Ca. caseinogen. 

According to Courant (IT) a solution can be obtained showing 
essentially the same alkalinity to lacmoid and the same acidity to 
phenolphthalein and conducting itself to rennin in the same manner, 
as fresh milk, by bringing together, lime water, caseinogen, and 
phosphoric acid in the quantities indicated in the following equation : 

/OH /OH 

6 Ca(OH) 2 +2 Cas-OH+ 4 H 3 P0 4 =Ca 3 (P0 4 ) 2 +2 Cas-0\ n . 
\OH \0/ Ua + 

Ca (H 2 P0 4 ) 2 +12 H 2 0. 

In other words, the mixture or compound 

/OH 

[Ca 3 (P0 4 ) 2 +2Cas-0 >Ca +Ca(H 2 P0 4 ) 2 ] 

closely approximates the condition of the caseinogen and phosphates 
as these substances exist in fresh milk. Whether these several 
substances are merely intimately mixed together or whether they 
form some loose chemical combination similar to a complex double 
salt can not be definitely determined at present. According to 
Courant, however, all of these substances are necessary to the rennin 
coagulation, namely, dicalcium caseinogenate, soluble calcium salts, 
represented in the equation by monocalcium phosphate, and also 
tricalcium phosphate. According to this author only the dicalcium 
caseinogenate is altered in the rennin coagulation of milk, this being 
converted into paracasein. According to him the role of the soluble 
salts of the alkaline earths (calcium) in this process is simply to 
diminish the solubility both of the caseinogen itself and the para- 
casein. This last notion is in harmony with certain observations by 
Ringer (18), who found that even fresh milk is coagulated by warm- 
ing Avith small amounts of calcium salts. According to this author 
three drops of a solution of calcium chloride are sufficient to curdle 
ten cubic centimeters of fresh milk at 70° to 75° C. He further 
observed that while a very slight acidity seems to favor the coagula- 
tion by calcium salts it is by no means essential to the process, since 
it can be brought about even in faintly alkaline milk. 

Finally, in the presence of soluble calcium salts the paracasein 
resulting from the action of rennin is precipitated in the form of an 
insoluble calcium salt containing calcium phosphate, either in loose 



356 

chemical combination or as an intimate mixture. In this connection 
it has been shown by Harris (34) that in the curdling of milk by 
rennin 13 per cent more calcium phosphate is used up than in the 
acid coagulation of milk. 

In this connection Courant's (17) views regarding the composition 
of milk and the manner in which the caseinogen is held therein afford 
the most satisfactory explanation of the conduct of fresh milk toward 
chemical indicators. To review this subject briefly, Courant has 
found that cow's milk and caseinogen solutions, such as that whose 
composition is given in the above equation, react alkaline to lacmoid 
and acid to phenolphthalein. The acidity of fresh cow's milk proved 
to be slightly less than that of the caseinogen solutions; the alkalin- 
ity of milk, on the other hand, was nearly twice that of the caseinogen 
solutions. He reaches the conclusion that one half of the acidity 
toward phenolphthalein as shown by cow's milk and his caseinogen 
solutions is due to the acidity of dicalcium caseinogenate, and the 
other half to monophosphates. In this calculation he purposely neg- 
lects the slight acidity of milk due to the free carbonic acid which 
it contains. The alkaline reaction toward lacmoid depends in the 
case of the caseinogen solutions partly on the dicalcium caseinogen- 
ate, which, like the salts of other weak acids, is readily hydrolyzable, 
yielding a certain amount of free base, namely, calcium hydroxide, 
and partly on the insoluble phosphates. In the case of milk the 
alkalinity toward lacmoid depends on these two factors and also on 
the presence of diphosphates. The greater alkalinity of cow's milk 
depends partly on the larger quantity of insoluble phosphates pres- 
ent, but principally on the presence of diphosphates. As has been 
repeatedly shown, human milk is more alkaline than cow's milk. 
According to Courant, however, it, like cow's milk, is also acid to 
phenolphthalein and alkaline to lacmoid. In the case of cow's milk 

he found the ratio of alkalinity to acidity to be —-^-=2.1, and in the 

1 08 
case of woman's milk ^^=3. According to this author the rela- 
tively slight acidity of woman's milk is due to the small quantity of 
caseinogen which it contains and also in all probability to the fact 
that it contains its caseinogen in the form of tricalcium caseinogenate. 
To return for a moment to the subject of the rennin coagulation of 
milk, it would seem that certain aspects of this change exhibit an 
analogy to the action of a toxin. It has been shown, for example, 
by Hammarsten and Roden (35) that normal horse serum contains 
a substance capable of inhibiting the action of rennin. In other 
words, it contains an antirennin. Similarly, by repeated injection 



357 

of small amounts of rennin into the blood of animals, Morgenroth 
(36) obtained an antirennin. According to Fuld and Spiro (37) the 
antirennin of normal horse serum prevents the coagulation of milk by 
binding the calcium ions. Arrhenius is therefore of the opinion that 
in these reactions rennin coresponds to the toxophorous group, the 
calcium ions to the haptophorous group of a toxin, and the antirennin 
to an antitoxin. 

Many additional facts concerning the rennin ferment are known. 
Like other ferments, it is affected by heat, and the rate of the rennin 
coagulation is determined both by the quantity of rennin acting and 
by the temperature. It has been shown that the ferment can with- 
stand a temperature of —180° C. without injury. At temperatures 
higher than 44° C. the ferment gradually loses its activity, and expo- 
sure to a temperature of 50° to 60° C. for a considerable time has been 
found to be more harmful- than a short exposure to a higher tempera- 
ture. The effect of temperature is also determined by conditions sur- 
rounding the ferment, whether it is moist or dry, and also by the 
reaction of the solution containing the ferment. In the dry state it 
can withstand a temperature of 100° to 140° C. Its destruction by 
heat has been found to follow the law for a monomolecular reaction. 

The influence of temperature on the rennin coagulation has been 
studied by Fuld (29). Some of his results are given in the following 
table : 



Temperature ° (C). 


Time (sec). 


k, observed. 


k, calculated. 


25. 05 


54 
32 
17 

10.2 

9 

14.7 


185 
312 
588 
980 
1,111 
680 


185 


30 


327 


35 


574 


40 


980 


44 


1,491 
2,742 


50 





(The values of k, observed equal 10,000 divided by time.) 

It will be observed that there is a good agreement between the 
observed and the calculated values up to 40° C. Above this tem- 
perature the observed values of k become smaller than the calculated 
values on account of the gradual destruction of rennin by heat. 

In 1870 Segelke and Storch (38) showed that rennin coagulates 
milk in intervals which are inversely proportional to the concentra- 
tion of the rennin solution. This conclusion has been confirmed by 
the later work of a number of observers. Thus Lorcher (39) obtained 
the following results from his measurements; 



358 



Quantity 

of rennin, 

in ec. 


Time of co- 
agulation, 
minutes. 


Product. 


0.01 
.02 






245 


490 


.03 


155 


465 


.04 


126.5 


485 


.05 


92 


460 


.06 


78 


468 


.07 


69.25 


485 


.08 


63 


504 


.09 


56 


604 


.10 


43 


430 


.20 


24.5 


490 


.30 


16 


480 


.40 


12.5 


500 


.50 


10 


500 


.60 


8.75 


525 


.70 


8.16 


561 


.80 


7.5 


600 


.90 


6.7 


603 


1.0 


6. 


600 



Eecently Madsen (40) has also investigated the effect of concen- 
tration of the rennin on the rennin coagulation, working at a tem- 
perature of 36.55° C. The following are the results of his measure- 
ments : 



Time 
(minutes). 


Rennin 
(grams). 


Product. 


4 


0.08 


0.32 


6 


.05 


.30 


9 


.033 


.30 


11 


.024 


.26 


12 


.019 


.23 


14 


.0175 


.25 


20 


.013 


.26 


25 


.01 


.25 


30 


.007 


.21 


35 


' .007 


.25- 


50 


.005 


.25 


70 


.004 


.28 


80 


.0032 


.26 


100 


.0028 


.28 


120 


.0025 


.30 


180 


. 00185 


.33 


240 


.0017 


.41 



The influence of various other factors, such as the reaction of the 
milk, the action of salts, the effect of ultraviolet rays, and the action 
of various organic substances on the rennin coagulation of milk has 
also Been the subject of numerous investigations. It is ofttimes a 
difficult matter to determine whether these various influences are 



359 

exercised toward the ferment itself or whether they react on the milk 
or participate only in the second phase of the rennin coagulation. 
The further consideration of such agents is beyond the scope of this 
communication. Before leaving the subject, however, it should be 
observed that Hillman (41) has studied the rennin coagulation of 
milk in its practical aspects. This author has found that the milk 
of fresh cows is better suited to the rennin coagulation than the milk 
of cows which are nearly dry. In his opinion this is probably to be 
explained by the diminution in the calcium content of milk during 
the period of lactation. He found, further, that the degree of acidity 
of milk in relation to the calcium content is an important factor. 
According to this author a high calcium content and high acidity 
prevail at the beginning of lactation and are usually accompanied 
by high total albumin and a high caseinogen content, all of which 
conduce to a large yield of paracasein. He also finds that the time 
of coagulation and the yield of paracasein are independent of one 
another; generally, however, a short coagulation time and a large 
yield of paracasein are associated. Strong dilution of the milk 
with water tends to diminish the yield of paracasein, whereas the 
addition of soluble calcium salts tends to increase it. 

According to this author the action or rennin consists not only in 
the splitting of caseinogen into paracasein and whey proteid, but also 
in the conversion of other milk proteids into more soluble form. He 
seems to think that under favorable conditions paracasein may be 
formed from the albumin as well as from the caseinogen. 

Paet II. — (4a) Chemical Changes in Milk Pkoduced by Bacteria and Various 

Other Micro-organisms. 

The more obvious changes in milk with which we are familiar 
are those that are brought about by bacteria and various other 
micro-organisms. Among these changes may be mentioned: The 
ordinary souring and curdling of milk, with the production of lactic 
acid as the chief product; the production in milk of various odor- 
iferous or highly flavored substances, many of a somewhat dis- 
agreeable character, good examples being met with in the ripening of 
cream and cheese; the production of colored substances which im- 
part to the milk unusual colors, such as the formation of blue milk ; 
the formation of mucilaginous, or mucin-like substances, which serve 
to impart to the milk a characteristic ropiness, known as ropy milk, 
and finally we must include under this head those bacterial changes 
in milk which result in the formation of poisonous substances, such as 
tyrotoxicon, toxins, etc. 

The lactic acid fermentation of milk. — The lactic acid fermentation 
is the commonest and best known of all the many bacterial changes 



360 

that occur in milk. The fact that on standing at ordinary tempera- 
tures milk gradually turns sour and finally curdles has been known 
ever since milk was first used as a food by man. In early times the 
acid of milk was supposed to be acetic acid, the same as is present 
in vinegar, and as has already been pointed out this acid does, accord- 
ing to Bechamp ( 1 ) , occur in even freshly drawn milk in small quan- 
tities. The substance really responsible for the souring of milk, how- 
ever, viz, lactic acid, was first discovered in milk by Scheele in 1780. 
The new acid was also studied by Berzelius, and its composition 
definitely established through the work of Mitscherlich and Liebig in 
1832. Its chemical constitution and its relation to other varieties of 
lactic acid, occurring in nature or the products of chemical synthesis, 
were first established by the labors of Strecker, Erlenmeyer, and 
Wislecenus. 

In 1847, Blondeau (2) discovered micro-organisms in sour milk, 
but attached to these no particular significance so far as the souring of 
milk is concerned. It remained for Pasteur (3), in 1857, to definitely 
and conclusively show as one of the results of his classic investigations 
on fermentation that the souring of milk is really a kind of fermenta- 
tion, which is accomplished by a peculiar kind of micro-organism, to 
which he gave the name of levure lactique (lactic yeast). His first 
communication on this subject was read to the Scientific Society of 
Lille, August, 1857, and afterwards to the French Academy in No- 
vember, 1857. Since then our knowledge of the lactic acid fermenta- 
tion has been considerably extended through the labors of Pasteur's 
students, and still later through the work of other bacteriologists and 
chemists. For example, Boutroux (4) in 1878, in continuing the in- 
vestigations of Pasteur on the souring of milk, arrived at the conclu- 
sion that the lactic acid ferment and the mycoderma aceti, which is 
concerned in the transformation of alcohol into acetic acid in vinegar 
making, are identical, but that these vary in function, depending on 
their general environment and the composition of the liquid in which 
they grow. This communication also contains a description of the 
lactic ferment and an enumeration of its morphological characteris- 
tics, which are beyond the scope of the present communication. He 
observed that the organism grew best in a nutrient medium con- 
taining, besides albuminous matter, invert-sugar or glucose. He also 
found that under these conditions the liquid can attain a maximum 
acidity of 1.5 per cent lactic acid. Larger amounts of acid than this 
checked the life and growth of the organism, and hence if it is desired 
to convert all of the sugar into lactic acid the acid must be neutralized 
with chalk or zinc carbonate as fast as formed. Under proper con- 
ditions the lactic acid organism employed by Boutroux produces lactic 
acid only. 



361 

The lactic acid fermentation of milk sugar was also investigated by 
Kichet (5), who found that when milk is kept at 40° C. it becomes 
acid and coagulates and finally attains an acidity of 1.6 per cent, 
which amount it never exceeds. He made the further interesting 
observation that if gastric juice be added to milk the casein is coagu- 
lated and finally dissolved, and in less than twenty-four hours the 
milk contains a larger quantity of lactic acid than otherwise would 
have been produced in a weeft, and after four or five days as much as 
4 per cent of lactic acid was formed. He observed that while neither a 
pure solution of lactose nor gastric juice will ferment, if the two be 
mixed fermentation takes place; and that the casein of milk after it 
has been dissolved by gastric juice also ferments, yielding lactic and 
butyric acids, besides other products of fermentation. On the other 
hand, the whey of milk obtained by coagulation with rennin never 
attains an acidity greater than 1.6 per cent of lactic acid, even after 
having been kept for six months. He found that. the lactic acid 
fermentation is increased by exposing a large surface of the milk to 
the air. The activity of the ferment increases up to 44° C, remains 
constant between 44 and 52° C., and above 52° C. diminishes in 
activity as the temperature rises. Digestive juices and peptones 
were found to aid lactic fermentation, but leucine and glycocoll 
were found to have no effect upon the process. 

The general trend of more recent investigations on the subject of 
lactic acid fermentation has been to show that the change of milk 
sugar into lactic acid takes place under the influence, either direct or 
indirect, of a whole series of micro-organisms, whose number has been 
considerably augmented by recent investigations in this field. Marp- 
mann (6), for example, during the summer of 1885 investigated the 
micro-organisms of cow's milk in the neighborhood of Goettingen 
and detected five seemingly new and different species of organisms 
which more or less strongly induce the lactic acid fermentation in 
solutions of cane sugar and also in milk. 

Leaving out of consideration the levure lactique of Pasteur, the first 
of these organisms whose morphological and biological character- 
istics seem to have been determined with sufficient accuracy is the 
Bacillus acidi lactici of Hueppe (7). It is now known that in addi- 
tion to the Bacillus acidi lactici (Hueppe) the following organisms 
can bring about the lactic acid fermentation, viz, Bacillus aerogenes, 
Bacillus coli. Bacillus lactis acidi (Leichmann and others) , Strepto- 
coccus lacticus (Kruse), Streptococcus pyogenes, Pneumonococcus A 
and Pneumonococcus B, Bacillus Delbruecki (Leichmann), Bacillus 
acidificans longissimus (Lafar), etc. 

Beyerinck (8) has also made exhaustive studies of the lactic acid 
ferments employed in the arts. This author applies the name 
Lactobacillus Delbruecki to all species of the lactic-acid ferment 



362 

which can be isolated by the gelatin-must method. These organ- 
isms, according to this author, however, are not the active agents of 
a good industrial ferment. On the other hand, from such a ferment 
he was able to isolate the Lastobacillus fermentans. This organism 
when cultivated under good conditions yields only lactic acid and no 
volatile acids. The minimum temperature of its activity he found 
to be 25° C, the optimum temperature 41°-42° C., and the maximum 
temperature 50° C. These observations furnish an interesting con- 
firmation of the earlier work of Kichet so far as the influence of 
temperature on the lactic fermentation is concerned. According 
to Beyerinck the lactic organisms studied by him can be mutually 
transformed into one another by cultivation. 

Heinemann (9) has called attention to the similarity existing 
between Bacillus acidi lactici (Hueppe #nd others) and Bacillus 
(lactis) aerogenes (Escherich) and also to the similarity of Bacillus 
lactis acidi (Leichmann and others), Streptococcus lacticus (Kruse) 
and Streptococcus pyogenes, and in a more recent communication 
(10) on the kinds of lactic acid produced by lactic acid bacteria, to 
the similarity of Streptococcus lacticus with Streptococcus pyogenes 
and of Bacillus acidi lactici with Bacillus aerogenes. It has been 
observed by this author that in the ordinary souring of milk, lactic 
acid is produced chiefly by Streptococcus lacticus and Bacillus aero- 
genes, and further, that the former organism predominates in ap- 
proximate proportion to the purity of the milk. Conn (11) also has 
shown that 95 to 100 per cent of all organisms in sour milk are of 
the Bacillus lactis acidi type (Streptococcus lacticus). 

It is now known that lactose (sugar of milk) is not directly fer- 
mentable, but must first be converted into the simpler sugars glucose 
and galactose. It has been shown by a number of investigators that 
many yeasts and bacteria produce an enzyme which is capable of 
effecting this hydrolysis, and Hirschfeld (12) has shown that in the 
souring of milk the lactic acid bacteria accomplish the inversion of 
lactose, and that this change takes place most rapidly in the first 
thirteen to twenty- four hours after the introduction of the organisms 
into the milk, the relative amounts of lactose inverted being: First 
day, 0.16 ; second day, 0.23 ; third day, 0.29. Finally in this connec- 
tion it has been shown by Buchner and Meisenheimer (13), and inde- 
pendently by Herzog (14), that an enzyme can be extracted from 
certain of the lactic-acid-forming bacteria, which in the absence of 
organisms is able to transform lactose and cane sugar into lactic acid. 
Buchner and Meisenheimer extracted the ferment from Bacillus Del- 
bruecki (Leichmann), whereas in his experiments Herzog employed 
the Bacterium acidi lactici. On the other hand Beyerinck (8) is of 
the opinion that the production of lactic acid by the lactic acid 
bacteria is not a mere enzymic function, but a catabolic process. 



363 

The kinds of lactic acid produced in milk by the lactic acid bac- 
teria. — As is well known, 4 isomers of lactic acid exist. Three of 
these are stereo-isomers of alpha- oxy-propionic acid or ethylidine 
lactic acid, the chemical structure of which is represented by the 
formula 

CH 3 .CHOH.COOH. 

This compound, as indicated by the above formula, contains one 
asymmetric carbon atom, viz, the central one, and hence two optically 
active forms of lactic acid and one optically inactive form composed 
of equimolecular proportions of the two active varieties are possible 
and all three are known to exist. Aqueous solutions of one of these 
forms of lactic acid rotates the plane of polarization to the right, the 
second active variety rotates it to the left, and the third inactive 
form has no effect on the plane of polarization. Hence the first 
acid is called dextrolactic acid, and is designated as the d-lactic acid 
or simply d-acid; the second is called laevo-lactic acid and is desig- 
nated as 1-lactic acid or 1-acid ; and the third lactic acid of the above 
formula is called inactive or racemoid lactic acid and is designated 
(d + 1) lactic acid or sometimes r-acid. 

The fourth isomer of lactic acid has an altogether different chemical 
constitution from the other three forms of the acid and is known to 
chemists as beta-oxypropionic acid, hydracrylic acid, or ethylene 
lactic acid. It has the chemical structure represented by the formula 

CH 2 OH.CH 2 .COOH. 

This acid contains no asymetric carbon atom. It therefore ex- 
hibits no optical activity and only one form of it is known. This 
is not a product of the lactic acid fermentation, and hence does not 
further concern us in this connection. In the changes occurring in 
the fermentation of milk we are concerned with only the first 3 forms 
of the acid, viz, with the optical isomers of alpha-oxy propionic acid. 
Formerly it was generally accepted as pretty well established that the 
lactic acid produced in the souring of milk consisted mainly, if not 
entirely, of the r-acid. Indeed, ordinary lactic acid, viz, the r-acid, 
was frequently spoken of as fermentation " Gahrungs '.' lactic acid. 
In 1895, however, it was shown by Gunther and Thierf elder (15) 
that the lactic acid present in milk which has soured spontaneously 
does not always consist entirely of inactive lactic acid. They showed, 
in fact, that while the inactive acid was present in naturally sour milk 
there was often a preponderance of the dextro-rotatory acid. Fur- 
ther, the Bacillus lactis acidi (Streptococcus lacticus, Kruse) in pure 
lactose was found invariably to produce the d-acid. 

In this connection Gadamer (16) has observed that commercial 
lactic acid is either inactive or dextro rotatory. 



364 

Quite recently Heinemann (10) has made an exhaustive study of 
the kinds of lactic acid produced in milk by the lactic acid bacteria. 
The following are his conclusions : 

1. Milk naturally soured at room temperature contains chiefly d-acid. Milk 
soured at 37° C. contains chiefly r-acid with 1-acid in excess if allowed to stand 
several days. 

2. Streptococcus lacticus and Streptococcus pyogenes produce the same kind 
of lactic acid, i. e., d-acid. B. aerogenes from milk (B. acidi lactici) and the 
ordinary laboratory strain of B. (lactis) aerogenes (Escherich) produce the 
same kind of lactic acid, i. e., 1-acid. 

3. The lactic acid produced in naturally soured milk varies : 

(a) According to the relative numbers of Streptococcus lacticus and B. 
aerogenes present, the higher the number of B. aerogenes the more I-acid is 
produced. 

( &) According to the temperature at which the fermentation takes place, other 
conditions being equal, at 37° C. relatively more 1-acid is formed than at room 
temperature. 

(c) According to the length of time the fermentation has lasted, the longer 
the time the more 1-acid is formed. 

4. In " certified " milk, d-acid only was present at room temperature for nine 
days, while both d-acid and 1-acid were present in milk of poorer quality after 
one to four days. At 37° C. 1-acid was apparent after six days in " certified " 
milk and on the second day in other milk. It seems as if the purer the milk 
the longer the excess of d-acid persists. 

5. Racemic lactic acid is the result of the formation of pure d-acid and pure 
1-acid by at least 2 different species of micro-organisms. Racemic lactic acid is 
not known to be the product of one species only. 

6. Since it is known that B. aerogenes forms other acids besides lactic acid, 
often in appreciable amounts, while Streptococcus lacticus produces almost pure 
d-acid, the presence of d-acid may be taken as indicating desirable conditions 
for dairy work, because this shows the absence of the fermentation products of 
B. aerogenes, i. e., volatile acids, gas, and ethyl alcohol. 

According to Clafflin (17) in the lactic acid fermentation as carried 
out in the manufacture of the acid, in which process the acid pro- 
duced is neutralized by chalk practically as fast as formed (or at 
least never allowed to exceed 0.02 to 0.5 per cent by weight of the 
solution), 98 per cent of the sugar is converted into lactic acid in 
three to six days through the action of a pure culture of Bacillus 
acidi lactici. On the other hand, in the ordinary souring of milk, in 
which case of course no pains are taken to neutralize the acid as it 
accumulates in the liquid, smaller amounts of lactic acid are formed 
and much less than the total quantity of lactose present is changed. 
Thus we have seen from the earlier observations of Boutroux and 
Bichet that the lactic acid never exceeds 1.6 per cent by weight of 
the liquid undergoing fermentation, and according to recent observa- 
tions by Blumenthal and Wolff (18), milk which has been kept four 
years may still contain 50 per cent of its original lactose unchanged. 

It has also been found by Haacke (19) that the amount of lactic 
acid produced in the lactic fermentation never exceeds one-third of 



365 

the amount of sugar decomposed and that the quantity of acid present 
at any one time during the time of the fermentation is not strictly 
proportional to the amount of sugar decomposed, for the reason that 
a part of the lactic acid resulting from the decomposition of the 
sugar is in all probability decomposed into other substances. Accord- 
ing to this observer, 1,000 lactic bacilli decomposed in one hour an 
amount of sugar varying according to conditions from 0.00001 to 
0.008 milligram. 

The changes brought about in milk by micro-organisms are by no 
means confined to the production of lactic acid. In fact, as we have 
already seen, it is only by working with pure cultures of certain of 
the lactic acid organisms, such as the Streptococcus lacticus, etc., 
under proper conditions, that lactic acid alone is produced, and in 
the souring of milk, as this ordinarly takes place, a great many sub- 
stances besides lactic acid are produced in larger or smaller amounts. 
Among these may be mentioned acetic, butyric, and succinic acids, 
alcohol and gaseous substances, such as hydrogen and carbon dioxide. 
In addition to these substances may be mentioned the production 
of small amounts of substances having characteristic odors usually 
of a disagreeable character. 

It would seem from the recent work of Tissier and Gasching (20), 
carried on in Professor Metschnikoif's laboratory, that in the souring 
of milk, as this usually takes place, we have a more or less regular and 
definite sequence of changes, due to the growth and development in the 
milk of various species of micro-organisms which were always found 
by these observers to be present in the milk as it left the dairy. In 
the samples examined by them they found constantly bacteria and 
fungi. According to these authors the bacteria present in milk are 
divisible into two groups: 

First. Mixed ferments, including the proteolytic mixed, such as 
Staphylococcus, rather rare, and the peptolytic mixed, such as En- 
terococci, B. coli, B. acidi paralactici, and B. lactopropylbutyricus. 

Second. The simple ferments, including the simple proteolytic, such 
as Mesentericus, Subtilis, B. putrificus, and Proteus vulgaris; the 
simple peptolytic, such as Proteus Zukeri and B. foecalis alcaligenes. 

The fungi are oidium lactis, rhizopus nigricans, and in one case a 
lactose yeast. 

In sterilized milk these authors have found these organisms to pro- 
duce the following changes: 

The mixed ferments accomplish two principal fermentations in 
milk, the lactic and the butyric fermentations. The lactic fermenta- 
tion is brought about by enterococcus, less actively by B. coli and 
most actively and vigorously by B. acidi paralactici, which possesses 
a high order of resistance. It produces chiefly dextrolactic acid. 
The butyric fermentation is accomplished by only one species, viz, 



366 

B. lactopropylbutyricus, which in order of sequence follows in the 
wake of the lactic fermentation. It is only dependent on it indi- 
rectly, however, since for the growth and development of this organ- 
ism in milk neither lactic acid nor lactates are required, but a hexose 
which is formed from lactose by the bacteria immediately preceding 
the growth of the butyric ferment. Thus the butyric ferment 
depends only indirectly for its action on the lactic acid fermentation. 

The simple ferments of milk have been found to peptonize and 
destroy the casein, but in symbiosis with the mixed ferments they 
are rapidly arrested in their action by the acid reaction of the medium 
and become powerless to effect those changes in milk which they 
ordinarily can accomplish. For the completion of these changes, 
therefore, the intervention of higher organisms is necessary. These 
are accomplished by the milk fungi, oidium lactis, and rhizopus 
nigricans. 

The progress of the souring of milk has been found by these 
observers to be always the same. The mixed ferments develop rap- 
idly, aided by the simultaneous action of the simple ferments. En- 
terococcus has been found to be the species predominantly producing 
inactive lactic acid, valerianic acid, and also always acetic acid. 
B. coli follows in its action, producing laevo lactic acid. Together 
these two organisms give an acidity to milk equivalent to 1.47 to 2 per 
cent of sulphuric acid. This degree of acidity arrests the action of 
the proteolytic ferments and brings on the coagulation or curdling 
of the milk. The B. acidi paralactici continues the destruction of 
the lactose, however, and gives rise to the true lactic acid fermentation, 
producing always dextrolactic acid. The medium having become 
favorable for its growth and development, the Bacillus lactopropyl- 
butyricus sets up its characteristic fermentation, producing always 
inactive lactic and also propionic and butyric acids until a total 
acidity of 4 to 6 per cent in terms of sulphuric acid is reached. This 
degree of acidity arrests all bacterial action. The fungi, oidium lactis, 
and rhizopus nigricans then intervene, however, and by oxidizing the 
organic acids and lactose and by effecting a further destruction of the 
casein again favor the growth and multiplication of those organisms 
whose development has been momentarily checked. It also appears 
from the work of Tissier and Gasching that the simple ferments alone 
can bring about the decomposition of the casein and its ultimate deriv- 
atives. They have further observed that the bacteria ordinarily con- 
cerned in the souring of milk are not in any way directly responsible 
for the digestive disturbances which occasionally result from the use 
of milk as a food. Under certain conditions, however, they may act 
as predisposing causes, but the accidents of botulism are due, accord- 
ing to these authors, to special species of organisms differing from 
those which are ordinarily concerned in the souring of milk. 



367 

Quite recently Beyerinck (21) has again discussed the lactic fer- 
mentation of milk. He has found that temperature and oxygen 
pressure determine the nature of the autofermentation of milk. At 
temperatures below 40° C. the fermentation brought about by B. 
coli is replaced by a butyric acid fermentation, which, after lasting 
some time, is succeeded by a lactic acid fermentation. In good milk, 
even at 40° C., at which temperature gas-producing bacteria develop 
most rapidly, no gas is produced. This fact therefore forms the 
basis of a dairy test for judging of the purity of milk. He recog- 
nizes three forms of lactic acid fermentation depending on the tem- 
perature. At very low temperatures there occurs the slimy lactic acid 
fermentation, which, according to this author, is due to the smaller 
cell walls of the organism. At medium temperatures the common 
lactic acid fermentation predominates, this being caused by the lacto- 
coccus and at higher temperatures the lactic acid fermentation 
caused by the lactobacillus. Methods for isolating these organisms 
from milk are given, and also their morphological characteristics 
and their zymotic reactions. He, like other observers, has found the 
lactic acid ferment to be very variable. 

Eeference has already been made to the fact that the lactic acid 
fermentation of milk is used commercially in the manufacture of 
lactic acid. The lactic acid fermentation of milk is also turned to 
practical account in the manufacture of cheese. It has been shown 
by Epstein (22) that the ripening of cheese is due largely to the 
action of organisms which induce the lactic acid fermentation. 
Each particular kind of cheese is produced by the agency of special 
organisms which act chemically by means of enzymes and give rise 
to the peculiar odor and flavor of the cheese. These organisms are 
chosen both with regard to their power to induce the lactic acid fer- 
mentation and also with regard to the peculiar kind of cheese desired. 
Similar views regarding the ripening of cheese are held by Von 
Freudenreich (23). According to this author the lactic acid bacteria 
play the preponderating if not the exclusive role in the ripening of 
Emmenthaler cheese. Similarly Boekhaut and de Vries (24) have 
shown that cheese which does not contain the lactic acid bacteria 
does not ripen. On the other hand Chodat and Ho f man-Bang (25) 
are of the opinion that the importance of the lactic acid bacteria in 
the ripening of cheese has been overestimated, and attribute the 
greater number of the changes occurring in this process to another 
organism — namely, tyrothrix. 

In this connection it is interesting to note that Van Slyke (26) 
found that when only rennet is allowed to act on milk no cheese 
flavor is developed. 



368 

Abnormal fermentations of milk. — Under ordinary circumstances 
milk usually undergoes the lactic acid fermentation. It turns sour 
and curdles and the production of lactic acid puts a stop, tempora- 
rily at least, to all other bacterial changes. Hence in normal milk 
it is only rarely that fermentation other than souring occurs. Under 
certain conditions, however, the milk becomes infected with a great 
variety of micro-organisms and various changes in its composition 
are brought about. By some authorities these have been called 
abnormal fermentations. As a result of these fermentations, altera- 
tions take place in the color, odor, and taste of the milk, and in some 
instances highly poisonous substances are produced. In this con- 
nection Burri and Dueggeli (27) have recently had occasion to exam- 
ine four samples of milk in which such alterations had occurred. 
According to these authors sample (1) had the peculiarly disagree- 
able odor of Limburger cheese, sample (2) the odor of dogs, sample 
(3) a bitter taste, and sample (4) the odor and taste of Schabzieger 
cheese. These peculiar odors and tastes were found to be due to 
specific bacteria, which were isolated and their morphological char- 
acteristics determined by these authors. 

Blue milk. — Under certain conditions a blue pigment may develop 
in milk as a result of peculiar changes set up by certain micro-organ- 
isms. While such milk is apparently harmless, it results from outside 
contamination and rarely if ever occurs in well-kept dairies. In one 
instance its production has been traced to some source of filth or un- 
cleanliness and in some instances to a single cow. Its occurrence may 
be prevented by the adoption of cleanly methods and in case it has 
been traced to any particular cow by washing the cow's teats with a 
little weak acetic acid. It is of interest to note that blue milk is the 
first dairy infection definitely traced to bacteria. As early as 1841 
Fuchs (28) traced the production of blue milk to the growth of a 
micro-organism. By using Koch's gelatin method Hueppe and Eng- 
ling (29) succeeded in isolating the organism which produces blue 
milk. It was found by these authors to produce different colors when 
grown on different media, but in solutions containing ammonium 
lactate it was always found to produce a sky-blue color. Milk in- 
fected with this organism was always found to be alkaline, but the 
blue color only appears when the milk turns sour, as the result of 
lactic-acid fermentation, or when acid is added to the milk. J. Reiset 
(30) observed that in dairies of some- localities a blue mold forms on 
the surface of cow's milk which has been allowed to stand. It has 
also been observed on the milk of ewes and goats. This mold was 
found to consist of mycelia containing immobile bacteria. The mold 
was found to grow only on milk having a distinctly acid reaction. 



369 

The chemical nature of the blue pigment was not determined. The 
organism ordinarily responsible for the production of blue milk is 
known as Bacillus cyano genes. When grown in fresh milk the effect 
produced by this organism is very striking. During the first few 
hours however no change is noticeable. A certain amount of lactic 
acid seems to be necessary for the formation of the blue substance 
resulting from the growth of this organism. As the milk turns sour 
therefore blue patches appear, until finally these may be distributed 
throughout the whole of the milk, in such cases imparting to it a sky- 
blue color. Still other organisms besides B. cyano genes seem to have 
the power of producing blue substances in milk. 

Red milk. — According to Conn (31), red milk is by no means un- 
common in the dairy. Ordinarily, however, the red color of such 
milk does not result from the growth of bacteria, but is due to the 
presence of blood in the milk resulting from injuries to the udder. 
Sometimes it results from the feeding of the cow on plants containing 
red pigment, such as the madder plant, etc.; more rarely from a 
peculiar fermentation induced by bacteria. Among the organisms 
known to produce this change in milk may be mentioned Bacillus 
erythrogenes, B. prodigiosus, and a sarcina. The production of red 
milk through the agency of bacteria is without practical significance. 

Other color changes in milk. — Still other changes have been found 
to occur in milk and practically all of the pigment- forming bacteria 
will develop their characteristic pigments in milk in the event that 
they gain access thereto. According to Conn (31) orange-colored 
milk, green milk, yellow milk, amber- colored milk, indigo milk, 
chocolate-colored milk, and black milk have all been described by 
bacteriologists. In all cases the pigment has been found to have 
been produced by bacteria. These have been isolated and their mor- 
phological characteristics determined. Ordinarily they are not nor- 
mal infections, and hence are of no practical importance in dairying. 

Slimy or ropy milk. — Under certain conditions, slimy, mucilagin- 
ous substances are produced in milk through the growth of certain 
organisms which impart to the milk a characteristic sliminess or 
ropiness. Milk possessing such properties is known as slimy or ropy 
milk. It often can be drawn out into long threads of exceeding 
fineness. For example, slimy milk has been obtained of such vis- 
cosity that it could be drawn out into threads 10 feet in length and 
of such fineness as to be scarcely visible. In certain countries slimy 
milk is esteemed a delicacy, and special methods have been de- 
vised for its preparation. Such is the case in Norway, where it is 
called by the natives " taetamoelk." In Holland also a special fer- 

45276°— Bull. 56—12 24 



370 

ment is employed in the manufacture of Edam cheese, which has the 
power of rendering the milk slimy. The cheese made from such 
milk is said to ripen more rapidly and more evenly than cheese made 
without the use of this particular organism. This peculiar change 
in the consistency of milk has also been found to be due to bacteria 
and ordinarily, as it occasionally occurs in the dairy, is a source of 
great trouble and annoyance. Many bacteria seem to have the power 
of producing a slime in milk under suitable conditions. Ordinarily, 
however, this change is accomplished by one or two bacteria having 
a wide distribution in nature. Of these B. lactis viscosus (Adametz) 
seems to be the commonest organism of the kind found in Europe, 
and a similar organism, probably the same species, occurs in this 
country. It is a very hardy organism, and finds its way into the 
milk through the water supply of the dairy. From such a source the 
infection may become widely diffused and difficult to trace. How- 
ever, it is an infection which, no matter how troublesome, can be 
eradicated through cleanliness, although in certain instances it may 
be necessary to resort to disinfectants. Among other organisms pro- 
ducing sliminess in milk may be mentioned Micrococcus freuden- 
reichii and two forms of streptococci, one the source of the slimy 
ferment in Holland, the latter present on the leaves of Pinguicula, 
the latter being employed in Norway as the source of the ferment; 
and as pointed out by Beyerinck sliminess in milk may be produced 
by certain of the lactic-acid bacteria, especially by those growing at 
low temperatures. Slimy milk also results from a diseased condition 
of the mammary gland and is a common characteristic of garget. 
Nothing is known of the chemical nature of the substances causing 
the sliminess of milk. 

Bitter milk. — Freshly drawn milk has sometimes a bitter taste; in 
other instances it acquires such a taste on standing a few hours. 
The bitter taste of freshly drawn milk is sometimes due to the passage 
of bitter substances into the milk from the food of the cow, such as 
lupines. It may also be produced during the last stages of lactation. 
In those cases in which the bitter taste develops only after standing 
the cause thereof is to be sought in changes in the composition of the 
milk due to the action of certain organisms. A considerable num- 
ber of organisms seem to possess the power of producing a bitter 
taste in milk; some of them after a short interval, others only after 
a longer one. Only the former are of any practical significance in 
the dairy, and among these may be mentioned a micrococcus, a cut 
of which is shown by Conn, and a bacillus described by Weigmann, 
both of which have the power of ruining the taste of freshly drawn 
milk in a few hours. The source of these organisms is difficult to 
trace. In one case cited by Conn the organism giving rise to this 
abnormal fermentation was traced to the milk ducts of a single cow. 



371 

According to Trillat and Sauton (32), bitter milk contains alde- 
hydes and ammonia, and results from the simultaneous inoculation 
of fresh milk with a yeast producing aldehydes, and an ammonia- 
forming bacillus, B. Fliigge, V. 

The alkaline fermentation of milk. — It has been observed that 
boiled milk never turns sour by spontaneous fermentation. On the 
other hand, when boiled milk is allowed to stand at ordinary tem- 
peratures it gradually acquires an alkaline reaction, ofttimes a bit- 
ter taste, and finally curdles, yielding a soft, slimy curd. On further 
standing this curd gradually dissolves to form a somewhat clear 
liquid, and if the fermentation be allowed to proceed for a sufficient 
length of time a semitransparent liquid is obtained, having no resem- 
blance to milk. As with the other fermentations of milk, a number 
of organisms are capable of causing the alkaline fermentation of milk, 
and a considerable number of substances are produced as the result 
of these changes. Among the substances found in milk which has 
undergone the alkaline fermentation may be mentioned the peptones, 
which are believed to be responsible for the bitter taste, leucin, tyrosin, 
and ammonia, which latter imparts to the liquid the characteristic 
alkaline reaction. Butyric acid is also formed in this fermentation. 
This, however, is at once neutralized by the ammonia present, and 
exists in the liquid in the form of ammonium butyrate. 

Alcoholic fermentation of milk. — Among the abnormal fermenta- 
tions of milk may be mentioned the alcoholic fermentation, which is 
accomplished by certain yeasts, aided in their action by certain 
species of bacteria. While the alcoholic fermentation of milk is ab- 
normal in the sense that it never occurs in milk spontaneously, but 
must be induced by direct inoculation with certain ferments, it is 
employed in the production of certain milk beverages, such as kou- 
miss and kefir, etc., which in certain countries are highly esteemed as 
articles of diet, and have in recent years come into more or less gen- 
eral use as food for invalids, etc. Koumiss, originally made by the 
alcoholic fermentation of mare's milk, is now made from cow's milk 
by the addition of eane sugar and yeast. The first action of the fer- 
ments is to hydrolyze the polysaccharides (cane sugar and lactose), 
producing the simpler sugars, glucose, levulose, and galactose, all of 
which are fermentable by yeast. Two changes then occur, the alco- 
holic fermentation, resulting in the production of alcohol and carbon 
dioxide, and the ordinary lactic acid fermentation, resulting in the 
production of lactic acid. Kefir, a similar beverage, originating in 
the Caucasus, is also made from milk by an alcoholic fermentation. 
The fermentation is carried out in leather bottles, and is started by 
means of " kefir grains," concerning whose origin but little is known. 
During the fermentation thus induced a considerable quantity of the 
ferment is produced, which is removed and dried in the sun, and thus 



372 

new supplies of the kefir grains obtained. Struve (33) gives the fol- 
lowing proximate chemical analysis of kefir grains dried at 100° C. : 

Per cent. 

Water 11. 21 

Fat 3.99 

Soluble peptone-like substances 10. 98 

Proteids soluble in ammonia : 10. 32 

Proteids soluble in caustic potash 30. 39 

Insoluble residue 33. 11 



100. 00 
The whole of the active matter of the ferment was contained in 
the insoluble residue. A microscopic examination of this showed it 
to consist of a mixture of yeast cells with Bacterium dispora Gau- 
casica (Kern). In a few specimens leptothrix and oidium lactis were 
also present. According to this author, the yeast cells, which have 
been somewhat modified by their growth in leather bottles, are alone 
responsible for the peculiar kefir fermentation. 

According to Vieth (34) milk sugar ordinarily does not readily 
undergo alcoholic fermentation with yeast. With kefir grains, how- 
ever, a rapid alcoholic and lactic fermentation takes place. Accord- 
ing to this author also the ferment of the grains consists of the 
Bacillus dispora Caucasica (Kern) and a modified form of the ordi- 
nary yeast, Saccharomyces cerevisim. According to von Freudenreich 
(35) the grains contain at least two species of bacteria and one species 
of yeast, which acting together produce the kefir fermentation. The 
bacteria effect the inversion of the milk sugar, after which a portion 
of the simpler sugar is converted into alcohol by the action of the 
yeast and another portion into lactic acid by the further action of the 
bacteria. The milk is curdled during this fermentation. 

According to Martinand (36) milk undergoes alcoholic fermenta- 
tion with a great many species of yeasts, especially if glucose and 
maltose be added, and coagulation of the milk occurs under these 
conditions even in the absence of acid. 

Part II. — (4b) Milk Poisoning — Galactotoxismus. 

Of all foods milk is probably the most subject- to contamination 
and change. Of the various forms of contamination to which it is 
liable the commonest is, as we have already seen, that which results 
from the introduction into the milk of lactic-acid-producing bac- 
teria from various sources. These organisms accomplish those 
changes which are familiar to us in the ordinary souring of milk. 
While according to Stoakley (1) buttermilk is sometimes responsi- 
ble for acute milk poisoning, it is the general opinion that sour 
milk but rarely gives rise to troubles of this character. Indeed, by 
a number of medical authorities sour milk is regarded as a very 



373 

healthful beverage, by reason of the fact that the lactic-acid-pro- 
ducing bacteria tend by their growth in the intestine to lessen intes- 
tinal putrefaction, thereby diminishing the tendency to autoin- 
toxications from substances resulting from the growth of the bac- 
terial flora normally present in the intestine. One the other hand, 
it not infrequently happens that fresh milk becomes contaminated 
with toxic substances, or with toxicogenic bacteria, in which event 
the milk may give rise to acute intoxications. The subject of milk 
poisoning has been chiefly studied by Vaughan and his associates, 
and to him we owe the term Galactotoxismus. In spite of all that 
has been done, however, the subject of milk poisoning is as yet but 
very imperfectly understood. Chiefly through the labors of Vaughan 
(2) and his coworkers, together with observations by Sonnenberger 
(3), Le Blanc (4), Baird (5), and others, it is now known that milk 
may acquire poisonous properties and become dangerous to health 
in essentially five distinct ways: 

First. It may absorb metallic poisons from metallic vessels in 
which it has been allowed to stand. Attention has already been 
called to the fact that Golding and Feilmann (6) found copper in 
milk which had stood in contact with a broken copper coil. In this 
connection Baird (5) attributed an outbreak of milk poisoning to 
the preservation of milk in metal vessels, and pointed out that the 
substitution of earthenware vessels brought about a cessation of the 
trouble. Sonnenberger (3) has also observed that milk allowed to 
sour in vessels of copper, zinc, etc., is apt to contain soluble, poisonous 
salts of these metals. 

Second. Through the elimination of poisonous drugs from the 
mother through the milk. As Sonnenberger (3) has pointed out, 
many drugs administered by the mouth appear in large quantity in 
the milk. Among such he cites ether, arsenic, alcohol, lead, col- 
chicum, euphorbin, iodine, morphine, salicylic acid, hemlock, mercury, 
turpentine, antimony, veratrine, and a great variety of salts. He 
calls attention to the fact that all such milks are dangerous to children 
and young animals, and recommends that milk from cows receiving 
active drugs should not be allowed to be sold. 

The excretion of drugs in the milk of nursing women has recently 
been made the subject of an exhaustive investigation by Bucura (7). 
According to this author, the number of drugs which have been found 
in human milk with certainty, following their administration to the 
mother, are very few. He himself investigated the excretion of 
forty of the drugs most commonly used on women during and after 
childbirth, and of these he found that only five or six could be recog- 
nized in the milk with certainty. These were aspirin, iodine, calomel 
(when taken internally), arsenious acid, potassium bromide, and 
probably also urotropin. From his own work and that of others, he 



374 

gives the following list of drugs as having been found with certainty 
after their administration to the nursing mother : Iodine ( following 
the external application of tincture of iodine or iodoform and the 
internal administration of iodides and iodothyrine) , salicylic acid 
and salicylates, ether, mercury (following the use of mercury sup- 
positories or after the interal administration of calomel) , antipyrine, 
aspirin, arsenic, and bromides. A complete bibliography of the sub- 
ject of the excretion of drugs in milk is given at the end of Bucura's 
article. 

More recently Van Itallie (23) has found that after the injection 
of pilocarpine, physostigmine, morphine, arsenious acid, fluorescein, 
phenolphthalein and other drugs, tests for their presence in the milk 
were negative, while a trace of arsenic was found following the 
administration of Fowler's solution. Reijst-Scheffer (24) fed sodium 
iodide in solution to cows and determined the amount of iodine in 
the milk colorimetrically, with the following results: Iodine in the 
whole milk, 0.00178 to 0.00372 per cent; in the casein, 0.00012 to 
0.00008 per cent; in the urine, 0.03 to 0.08 per cent. The milk fat 
contained no iodine. 

Third. Through the elimination in the milk of poisonous sub- 
stances contained in the food of cattle, especially the vegetable 
poisons of certain weeds which compose part of the diet of milch 
cows in many localities. According to Sonnenberger (ibid.) dele- 
terious cattle feed is very common. Clover fields around Worms 
(Germany), for example, have been found to contain 30 to 40 species 
of more or less poisonous plants, 15 of which are very poisonous. 
According to this author, these poisons pass into the milk if such 
plants are eaten by the cows; and these poisonous substances are 
not destroyed by boiling the milk. He found in harmony with these 
ideas that the season for infantile diarrheas around Worms corre- 
sponds not with the hot season, but with the season most favorable 
to the growth of weeds, viz, a cold, wet summer. According to 
Sonnenberger, the feeding of milch cows with vegetable refuse, such 
as potato tops, rotten apples, moldy hay, etc., tends also to poison 
the milk. 

Fourth. It has been demonstrated that milk may acquire toxic 
properties as a result of a diseased condition of the mother. Accord- 
ing to Michelazzi (See Le Blanc (4) ), the milk of a tuberculous 
animal contains a tuberculous poison, which is not entirely destroyed 
by heating to 100° C, and that the milk of such animal, when steri- 
lized at 100° C, causes a slow, chronic intoxication, and that the 
milk of a tuberculous mother is toxic to the children. Le Blanc has 
pointed out that the milk of cows in heat (les v aches taurelieres) 
has a strong, cheesy smell, and a salty, bitter taste. It alters rapidly 
even when kept in sterile tubes, and causes gastro-intestinal disturb- 



375 

ances in young animals. The toxic effect of the milk and milk prod- 
ucts of " nymphomanous " cows is even more marked. 

Lawrence (reference 79, Part I) has also recently observed the 
passage of typhoid bacilli into the milk of a nursing woman ill with 
typhoid fever. 

Fifth. As shown by Yaughan and others (2), highly toxic sub- 
stances are produced in milk by bacteria. The earlier investigations 
on the subject of bacterial poisons in milk and milk products were 
confined almost entirely to poisonous cheese, the poisonous properties 
of which were formerly ascribed to various fatty acids. In 1852, 
however, Schlossberger (see Yaughan & Novy, ibid.), from experi- 
ments with pure fatty acids, demonstrated that these substances are 
not sufficiently toxic to account for the highly toxic nature of poison- 
ous cheese. In 1883 and 1884 an epidemic of cheese poisoning 
occurred in Michigan, which led Yaughan and his students to an 
exhaustive investigation of the subject. The outcome of these studies 
was the isolation from poisonous cheese, in 1884, of a crystalline 
substance, to which Yaughan gave the name of tyrotoxicon, and 
which was believed by him to be a diazo derivative of benzene. 
Chemically it was found to be very unstable, its aqueous solution 
decomposing when heated to 90° C. Tyrotoxicon has since been 
isolated, in many instances, from poisonous cheese by other investi- 
gators. It has also been detected in poisonous milk. In 1886 New- 
ton and Wallace (8) found the poison in a milk supply at Long 
Branch which had seriously affected a number of persons. In 1887 
Firth (9), an English army surgeon, isolated it from the milk which 
had poisoned the soldiers of a garrison in India where he was sta- 
tioned, and in the same year Yaughan (10) investigated a number 
of cases of violent milk poisoning occurring at Milan, three of which 
had resulted fatally. Fresh milk, inoculated with the vomit, stomach 
contents, or an aqueous extract of the intestines, gave, after standing 
twenty-four hours at 25°-30° C, a sufficient amount of tyrotoxicon 
to enable these investigators to recognize nitrogen and phenol among 
the products of its decomposition, the latter being recognized by 
precipitation with bromine water and by other well-known tests. In 
these cases the coroner's jury, before whom this evidence was submitted, 
rendered a verdict of death from poisoning by tyrotoxicon. Camman 
(11) reported 23 cases of milk poisoning attributed to tyrotoxicon, 
and Kinnicutt (12) isolated the poison from milk which had stood 
in unclean vessels for some time. Yaughan and Novy (13) and 
others found tyrotoxicon in poisonous ice cream, and still others have 
obtained it from custards and other desserts prepared from milk 
or cream. Indeed it would appear from these investigations that 
any foodstuff prepared from milk is liable to contain this poison. 
In his later writings on the subject, however, Yaughan (14) takes 



376 

the view that tyrotoxicon is not the only poison in poisonous cheese 
and milk products. According to this author it is probably not pres- 
ent in all specimens of poisonous cheese, and it is probably not the 
most important poison of poisonous cheese. Others are also of this 
opinion. For example, Dokkum (15) by the methods used by 
Vaughan in the isolation of tyrotoxicon obtained from poisonous 
cheese a substance similar to curare in its action, five milligrammes 
of which killed frogs in thirty minutes. For this poison this author 
proposed the name tyrotoxin to distinguish it from tyrotoxicon. 
Nothing is known regarding its chemical composition. Lepierre (16) 
isolated a base having the composition C 16 H 2 gN 2 4 from poisonous 
cheese, which caused diarrhea in animals when administered by the 
mouth. During the course of their own investigations, Vaughan 
and Novy (IT) were unable to detect tyrotoxicon in certain samples 
of cheese known to have produced poisoning. From some of these 
samples they obtained a poisonous albumin. It gave the biuret test. 
It was found not to be a globulin nor a peptone. On the other hand, 
certain bacteria obtained from poisonous milk and cheese developed 
on culture media poisons which, according to Vaughan, are probably 
related to neurin. 

It has also been shown that milk and milk products may also con- 
tain a large number of bacteria each of which produces its peculiar 
toxin (18). This, according to Novy (19), is especially the case with 
the Enteritidis group of bacteria, which by their growth do not 
curdle the milk, but render it somewhat transparent. According to 
Vaughan, the summer diarrheas of children are not due in all cases 
to a specific micro-organism, but to the poisons elaborated in milk 
by many different bacteria. Such diseases are found almost exclu- 
sively among children that are artificially fed, and they occur chiefly 
in the hot weather, for the reason that a high temperature is essential 
to the growth and wide distribution of these toxicogenic organisms. 
To Fluegge (20) we are indebted for some of the most valuable con- 
tributions to our knowledge of the toxicogenic bacteria of milk, 
especially the peptonizing bacteria. By this author 12 such species 
were isolated and studied. Of these, 3 species were found to develop 
poisonous substances. Cultures of No. 1 in subcutaneous doses of 
0.5 cubic centimeter were found to kill mice. When milk containing 
this organism was fed to dogs similar disturbances set in in about 
one hour. Milk cultures of bacillus No. 3 produced diarrhea in 
puppies, followed in one case by death on the third day. The fil- 
tered culture of bacillus No. 7, after concentration to one-fifth of its 
original volume, caused death in mice and guinea pigs in six to twelve 
hours, and even the unconcentrated milk culture of this organism 
acted powerfully when fed to puppies. In market milk Fluegge fre- 
quently found these poisonous peptonizing bacteria in practically 



377 

pure culture. The investigation of the peptonizing bacteria of milk 
has been continued by Luebbert and also by Vaughan. According 
to Luebbert (21), these organisms are widely distributed. They 
have been found to act only on the proteids of the milk, the fat and 
milk sugar contained in the milk remaining undiminished. He also 
found the milk cultures of these organisms to be highly toxic. When 
fed on such milk, guinea pigs died after four days, and puppies after 
the fourth, fifth, and sixth day, following severe diarrheas. On the 
other hand, a full-grown dog ate of the milk freely without any bad 
effect, thus showing that age affords some protection against milk 
poisoning. Luebbert's results on the toxicogenic peptonizing bac- 
teria of milk have been confirmed by Vaughan (22). According to 
this author the organisms responsible for cholera infantum are truly 
pathogenic in that they produce a definite chemical poison, the ab- 
sorption of which is followed by the symptoms of the disease, and 
in order to explain the great susceptibility of infants to milk poison- 
ing and the comparative immunity of the adult he has advanced the 
view that the great susceptibility of children to such intoxications 
is due to the ease and readiness with which casein is absorbed by 
the mucous membrane of the intestine of children, and that the 
casein carries along with it the bacterial cells containing this poison. 
In the adult, on the other hand, the digestive powers of the stomach 
are increased and intestinal absorption modified to a corresponding 
degree. At present practically nothing is known regarding the pre- 
cise chemical nature of these bacterial poisons, and, as already pointed 
out by Novy (19), investigations pertaining to a more exact study of 
the toxicogenic micro-organisms of milk and their poisonous products 
belong to the future of medical and chemical research. I have been 
informed by Doctor Vaughan that nothing of any practical impor- 
tance has been added to our knowledge of the milk poisons during 
the last few years. 

PABT III.— CHEMICAL STANDARDS FOR THE CONTROL OF THE 

SALE OF MILK. 

For a number of years the sale of milk in various cities throughout 
the world has been regulated by law and various chemical standards 
regulating the sale of milk have been proposed, based on the results 
of large numbers of analyses of milk in various countries. I am 
indebted to L. A. Kogers, Acting Chief of the Dairy Division, Bureau 
of Animal Industry, U. S. Department of Agriculture, for the fol- 
lowing compilation of United States and State standards for milk 
and dairy products. It will be observed that this compilation was 
published in 1905. 



378 

[U. S. Department of Agriculture, Bureau of Animal Industry — Circular No. 74. D. E. 
Salmon, D. V. M., Chief of Bureau.] 

Washington, D. C, April 1, 1905, 
In the table following, prepared under the supervision of Ed. H. Webster, 
Chief of the Dairy Division, are given the standards for dairy products as pro- 
claimed by the Secretary of Agriculture and as established by law in the 
several States, so far as obtainable, and revised to date. 

The percentages stated represent miniumum standards in all cases unless 
otherwise expressed. States not named are understood to have no laws pre- 
scribing standards for dairy products. 

D. E. Salmon, 
Approved : Chief of Bureau of Animal Industry, 

James Wilson, 

Secretary of Agriculture. 

United States and State standards for dairy products, 1905. 



States. 


Milk. 


Skim 
milk. 


Cream. 


Butter. 


Cheese. 


Total 
solids. 


Solids, 
not fat. 


Fat. 


Total 
solids. 


Fat. 


Fat. 


Fat. 


United States ab 


Per cent. 
12 


Per et. 

8.5 


Per ct. 
3.25 


Per ct. 
9.25 


Per ct. 
18 

( c ) 


Per cent. 
82.5 


Full cream, 50 p. c. of the 

total solids to be fat. 
Full cream, 30 p. c. fat; 

half skim, 15 p. c; 

skim from skim milk. 

Fancy excepted. 
Full cream, 35 p. c. total 

solids to be fat; skim, 

fat less than 35 p. c. of 

total solids. 














Dist. of Columbia 




9 

8.5 
8 


3.5 

3.5 
2.5 
3 

3 
3 


9.3 


20 


83 

Not over 

12 p. c. 

water or 

5 p. c. salt 










11.5 










Idaho 




18 
el5 


82.5 

80 

80 
Maxi- 
mum 
water, 
15 p. c; 
salt,6p.c. 


Full cream, 30 p. c. fat 
(fancy excepted; skim, 
less than 30 p. c. fat; 
less than 15 p. c, sale 
prohibited. 

Whole milk, 48 p. c. total 
solids to be fat. 

Skirn, Tnim'mnTn fat 10 








Indiana 




9 












p. C. 



a See proclamation of the Secretary of Agriculture, " Standards of Purity of Food 
Products," Office of the Secretary, Circular No. 10, November 20, 1903. 

b Condensed milk, 28 per cent milk solids, of which one-fourth must be fat. 

c Cream containing thickener must be labeled. 

a Condensed milk must contain not less than 8.5 per cent fat ; evaporated cream con- 
taining less than 15 per cent fat must be labeled "An unsweetened condensed milk." 

e Coffee cream shall contain at least 15 per cent fat, and whipping cream at least 22 
per cent fat. 



379 



United States and State standards for dairy products, 1905 — Continued. 



States. 


Milk. 


Skim 
milk. 


Cream. 


Butter. 


Cheese. 


Total 
solids. 


Solids, 
not fat. 


Fat. 


Total 
solids. 


Fat. 


Fat. 


Fat. 




Per cent. 

12.5 

12 

12 

12.5 

13 

12 

12.5 
Sp. grav. 
1.029-33 

13 


Per ct. 

9.3 
9 


Per ct. 
3 
3 
3 

3.5 
3.7 
3 
3 


Per ct. 


Per ct. 
15 
15 


Per cent. 








80 


Skim, lessthanlOp. c. fat. 


















9.3 








April-September 


















Sp. grav. 
1.032-37 












3.5 


&20 


Maxi- 
mum 
water, 
16 p. c. 


Full cream, 45 p. c. total 
solids to be fat; skim, 
fat less than 45 p. c. of 
total solids. 

Full cream, from 3 p. c. 
milk fat; skim, from 
milk less than3 p.c.f at. 








11.5 




3 
3 

3.5 
3 




15 
15 












April-September 


13 

12 
12 
12 
12 

12 
12 
11.5 

12 
12 


9.5 


9 






















8.5 
9 


3 
3.25 

3 
3 

3 
3 










North Carolina d 




18 
15 


82.5 


Full cream, 50 p. c. total 
solids to be fat; skim, 
from skim milk; cream 
cheese, milk6p. c. min- 
imum fat. 


North Dakota 




Ohiod 




80 

Not over 
14 p. c. 
water. 


Full cream, 30 p. c. fat; 
skim, less than 30 p. c. 
fat. 

Full cream, 30 p. c. fat; 
half skim, 15 to 30 p. c. ; 
quarter skim, 7£ to 15 
p. c. ; skim, less than 7£ 
p. c. Fancy excepted. 

Full cream, 32 p. c. fat; 
three-fourths cream, 24 
p. c. fat; one-half 
cream, 16 p. c. fat; one- 
fourth cream, 8 p. c 
fat; skim, below 8 p. c. 
fat. Fancy, less than 
5 pounds, excepted. 


May-June 


9 
Sp. grav. 
1.038 

8 


20 


Oregon 


Pennsylvania 









a Condensed milk must contain the equivalent of 12.5 per cent of milk solids in crude 
milk of which 3.5 per cent shall be fats. 

6 No thickener allowed. 

c In New York, Ohio, and Wyoming the milk solids of condensed milk must be in quan- 
tity the equivalent of 12 per cent of milk solids in crude milk, of which solids 2.5 per cent 
shall be fat. 

d Condensed milk must contain 28 per cent milk solids and 7 per cent fat. 



380 



United States and State standards for dairy products, 1905 — Continued. 



States. 


Milk. 


Skim 
milk. 


Cream. 


Butter. 


Cheese. 


Total 
solids. 


Solids, 
not fat. 


Fat. 


Total 
solids. 


Fat. 


Fat. 


Fat. 




Per cent 
12 

12 


Per ct . 
8.5 
9.25 


Per ct. 
3 

2.5 

3 

3 

3 


Per ct. 


Per ct. 


Per cent. 
80 
Maxi- 
mum 
water, 16 
p. c; salt, 
6 p. c. 


Full cream, 30 p. c. fat; 
one-half skim, 15 p. c. 
fat; skim, 10 p. c. 


















South Dakota 


13 

12.5 

12.5 
12 




18 
20 


82.5 
83 


Full cream, 50 p. c. of the 
total solids to be fat; 
skim, fat less than 50 
p. c. 

Skim, 7 to 11 inches in 


Utah 


9 p. c. 

solids, 
not fat. 


Vermont 


diameter; minimum 
height, 9 inches. 


May and June 












Washington 


8 


3 

3 

2.4 




18 




Full cream, 30 p. c. fat; 

skim, 15 p. c. fat. 

Fancy excepted. 
Skim, 10 inches in diam- 


Wisconsin 








Wyoming a 


12 
11.5 








80 


eter, 9 inches height. 
Skim, lessthan20p.c. fat. 


May and June 





















a Condensed milk must contain 28 per cent milk solids and 7 per cent fat. 

At the Eleventh Annual Convention of the Association of State 
and National Food and Dairy Departments, held at Jamestown, July 
15-19, 1907, Mr. P. M. Harwood (1), general agent Massachusetts 
dairy bureau, read a paper entitled " Has the milk standard outlived 
its usefulness? " He called attention to the fact that on account of 
the rigid requirements regarding the composition of milk offered for 
sale in the State of Massachusetts a good many milk producers are 
being gradually driven from the business for the reason that while 
milk prices are gradually becoming higher in the cities, the farmer or 
milk producer does not receive a proportionate amount of the profit 
accruing from the increased price nor an amount sufficient to com- 
pensate him for the trouble and expense growing out of the enforce- 
ment of laws regulating the milk standard. He points out that at a 
recent discussion of the question of the milk standard before the com- 
mittee on agriculture of the Massachusetts legislature many interest- 
ing facts were brought out. It developed at these hearings that the 
standards now in force — viz, 13 per cent total solids, 3.7 per cent fat, 
and 9.3 per cent solids not fat, in winter, and 12 per cent total solids, 



381 

3 per cent fat, and 9 per cent solids not fat, in summer — are working 
a hardship on the farmers, and that indirectly they are not protecting 
the consumer ; that milk contractors and peddlers were using it to their 
pecuniary advantage, and that the prosecuting officers throughout 
the State were not rigidly enforcing the law. The author reached 
the conclusion, therefore, that either the milk standard should be 
abolished altogether and milk sold upon its merits, or, that if a 
standard is to be maintained, it should be uniform throughout the 
United States. On account of the very large amount of data on the 
chemical composition of milk at present available in State and munic- 
ipal departments and agricultural experiment stations, etc., such a 
standard could probably be equitably adjusted. Indeed, the attempt 
has been made to do so in establishing the United States milk stand- 
ard governing the sale of milk under the laws governing interstate 
commerce. This standard requires a milk to contain 3.25 per cent of 
fat and 8.5 per cent solids not fat, and, as may be seen from the tables 
of State and national milk standards given on page 378, it is lower 
than many of the State standards. According to the secretary of the 
association of State and national food and dairy departments, the 
United States standard is being made the basis of standards for all 
the States. 

In this connection it is of interest to note that certain high-class 
dairies throughout the country are prepared to furnish milk of any 
composition desired, and infants' milk according to the physician's 
prescription. 

PART IV.— ADULTERATIONS OF MILK. 

Like many other foodstuffs, milk is subject to many adulterations. 
These consist (1) in the removal of the cream (skimming) or the ad- 
dition of skim milk, (2) addition of water (watering), (3) addition 
of thickening agents, (4) the addition of coloring matters, (5) the 
addition of certain substances with the view of altering the taste 
of milk and increasing the total solids, (6) the addition of preserva- 
tives (antiseptics). The commonest forms of adulteration are skim- 
ming, watering, and the addition of artificial coloring matters and 
preservatives, the addition of thickening agents, such as chalk, 
calves' brains, starch, glycerin, etc., haA^ing almost passed out of 
vogue among farmers and dairymen. Indeed it is doubtful whether 
this (3) form of adulteration was ever practiced to any considerable 
extent (see Leach, 1). 

Shimming. — This form of milk adulteration is probably practiced 
among farmers and dairymen to a considerable extent. As its name 
indicates, it consists in the removal, by means of a separator or 
otherwise, of a part of the cream. Obviously, skimmed milk con- 
tains a smaller percentage of milk fat than normal milk, and it was 



382 

with a view of correcting and controlling this particular form of 
adulteration and watering that laws have been enacted in many 
countries and in many States throughout our own country fixing the 
amount of milk fat which a milk offered for sale should contain. 
It will be seen from the compilation of milk standards given on 
page 378 that the amount of fat required in different States varies 
from 2.4 to 3.5 per cent. All things considered, it seems reasonable 
to require that all milk offered for sale should contain at least 3.25 
per cent of fat, although it should be borne in mind, of course, that 
unadulterated milk, especially of certain breeds of cattle, sometimes 
contains less than this amount of milk fat. The color of skimmed 
milk is also more or less characteristic, tending more to dead white 
or bluish white than normal milk, which is distinctly yellowish white 
in color. 

Watering. — The addition of water to milk is probably the com- 
monest practice in milk adulteration. Obviously, this is done in 
order to increase the output of the dairy. The effect of watering is 
to alter the physical properties and chemical composition to a greater 
or less degree, depending on the quantity of water added. The addi- 
tion of water to milk has been found to lower the specific gravity 
and raise the freezing point of milk. It also lowers the index of 
refraction and probably the viscosity. It causes a diminution in the 
amount of fat, total solids, and ash. Ordinarily it is not a difficult 
matter to determine whether a given sample of milk has been watered. 
This is done by comparing its specific gravity and refractometer 
reading, together with the amounts of fat, total solids, and ash, with 
those of normal milk or with standards which have been based upon 
the results of thousands of analyses and years of experience with 
the milk of different herds of dairy cows and that produced in differ- 
ent countries. In the detection of watered milk advantage is also 
taken of the fact that natural waters frequently contain substances 
not ordinarily present in milk, such as nitrates and nitrites. If these 
substances are found in a sample of milk the chances are that water 
has been added to it. It has been proposed by Steinegger (2) to 
employ the aldehyde value as a means of detecting the addition of 
water to milk. The aldehyde value for normal milk in Soxhlet- 
Henkel degrees varies between 5.8° and 8.5° and is lowered by the 
addition of water to milk, but not by the removal of fats. According 
to Commanducci (3) the watering and skimming of milk may be 
determined by the lowering of what he proposes to call the index 
of oxidation of milk. This he determines by means of tenth-normal 
potassium permanganate in acid solution. The number of cubic 
centimeters of potassium permanganate solution required to oxidize 
1 cubic centimeter of milk is what this author calls the index of 
oxidation. This has been found to be different for the milk of differ- 



Ass 55-58 

Woman - 53-60 



383 

ent animals, but practically constant for the normal milk of any 
particular animal species. He gives the following values for the 
index of oxidation of the milk of the following animals : 

Cow 50-52 

Goat 44-46 

Sheep 43^8 

He also finds that the value of the index of oxidation of cow's 
milk diminishes with the amount of water added, and also with 
skimming. Thus the index of oxidation of cow's milk containing 50 
per cent of water was found to be 25, and that of skimmed milk 40 
to 42. 

According to Atkins (4), determinations of the freezing point and 
of the specific gravity of milk are sufficient to show whether water 
has been added or fat removed. 

The addition of water to milk is not only a fraudulent practice 
and one which as such should be condemned, but it may frequently 
be a serious menace to the public health. Atlee (5) has pointed out 
that impure water is one of the most frequent sources of milk pollu- 
tion. This pollution may occur either through the use of impure 
water for purposes of adulteration or as the result of washing the 
milk containers and utensils in polluted water. As is well known, 
milk is one of the best possible culture media for the growth of micro- 
organisms, especially for many of the pathogenic bacteria. It is 
conceivable, therefore, indeed it is a well-known fact, that the intro- 
duction of a few pathogenic organisms into milk through the addi- 
tion of impure water will under certain conditions give rise to a 
fluid containing countless numbers of such organisms. In this way 
the adulteration of milk with water may give rise to a widespread 
dissemination of various infections, especially typhoid fever, diph- 
theria, scarlet fever, etc. Aside therefore from the fraudulent aspect 
of the practice, the adulteration of milk with water, from any and 
every source, as frequently happens, becomes a matter of serious con- 
cern, and of all fraudulent and uncleanly practices resorted to in the 
handling and sale of milk this and the uncleanly methods of handling 
milk are the two which should be most vigorously combated and 
condemned. 

'Thickening agents. — As indicated above, the adulteration of milk 
through the use of thickening agents, such as chalk, calves' brains, 
glycerin, etc., has largely passed out of vog;ue. Indeed it is doubtful 
whether any of these substances were ever used to any considerable 
extent, despite traditions to the contrary. According to Van Slyke 
(6) gelatin and sucrate of lime are used to some extent to give a 
greater consistency to cream. In this connection Babcock and 
Russell have recommended the use of sucrate of lime for restoring 
the consistency of pasteurized cream. (See Leach (1), p. 156.) 



384 

Condensed unsweetened skim milk has also been employed as an adul- 
terant, with the object of increasing the consistency and raising the 
total solids of a skimmed or watered milk. 

The addition of substances with the view of altering or disguising 
the taste of milk or of increasing the total solids. — Milk is sometimes 
adulterated by the addition of certain substances intended to alter or 
disguise the taste of milk. These are sodium carbonate and bicar- 
bonate, cane sugar, and saccharine. Sodium carbonate and bicarbon- 
ate are sometimes added to sour milk with the view of neutralizing the 
lactic acid and preventing or delaying the separation of the curd. 
Cane sugar is added in order to increase the amount of total solids in 
milk impoverished by watering, and also to increase the sweet taste 
and thereby disguise any slightly sour taste which old milk may pos- 
sess. Saccharine is sometimes added to milk for the same purpose. 
It not only increases the sweet taste of milk, but probably also acts 
as a mild antiseptic. While all of these substances are probably 
harmless in the amounts in which they are employed in milk (cer- 
tainly the addition of cane sugar can ordinarily do no particular 
harm), the practice of adding these substances to milk is to be con- 
demned, mainly on the ground that they are rarely used except to 
conceal deficiencies in the quality of the milk itself, thereby enabling 
the dairyman to palm off on the consumer milk which ordinarily 
would not be found acceptable. 

Coloring matters. — Milk is sometimes adulterated by the use of 
artificial coloring matters. The principal object to be accomplished 
by the use of these colored substances is to conceal other forms of 
adulteration, such as skimming and watering, and to make the milk 
appear richer than it really is. It has been pointed out in the fore- 
going that skimming and watering cause an alteration of the color of 
milk as compared with normal milk. Generally milk that has been 
skimmed or watered is more whitish in color than milk containing 
the normal quantity of cream. In order to conceal these deficiencies 
in the color of milk so adulterated various artificial coloring matters 
are added in order to bring the milk up to the color of normal milk. 
Among the coloring matters which have been employed for this pur- 
pose are annatto, certain of the }^ellow and orange-colored azo dyes, 
caramel, etc. Generally speaking, the adulteration of milk with 
these artificial coloring matters is in itself of minor importance, in- 
asmuch as they are used in very small quantities and the coloring mat- 
ters ordinarily employed in the artificial coloring of milk have been 
found to be harmless. The fact, however, that they are employed 
mainly with a view of concealing other more dangerous adultera- 
tions, such as the addition of water to the milk, puts the addition of 
artificial coloring matters to milk in the class of dangerous adultera- 
tions. In this connection it has been pointed out by Winton (7) 



385 

that in the examination of a foodstuff for artificial colors the chemist 
ofttimes encounters the difficulty of distinguishing a harmless from 
a poisonous color. As a rule it is an easy matter to determine when 
a synthetic color is present, but very difficult ofttimes to determine 
its precise nature. Then again, as pointed out by Tolman (8), the 
coal-tar colors are frequently contaminated with powerful mineral 
poisons, such as arsenic, copper, tin, lead, and zinc, which are intro- 
duced as impurities in the process of manufacture. It has been 
established further that many of the coal-tar dyestuffs are poisonous 
and that still others not very actively poisonous are nevertheless suffi- 
ciently so to interfere with the action of the digestive ferments. 
For example, Houghton (9) found that annatto diminished the di- 
gestibility of casein and egg albumen by pepsin. For further 
information regarding the toxicity of the coal-tar dyes the following 
authorities should be consulted: T\ T eyl (10), Weber (11), Winogra- 
dow (12), Gudeman (13), Chlopin (14), and Meyer (15). 

Preservatives. — We have seen that milk is subject to many changes, 
principally those resulting from the life and growth therein of micro- 
organisms. Indeed, it is one of the most perishable of foodstuffs, and 
it is only b}^ exercising the most scrupulous cleanliness in the handling 
of it and by keeping it at low temperatures, generally below 50° F., 
that it can be preserved a sufficiently long time to be delivered to 
the consumer in a fresh condition. This has resulted in the practice 
on the part of dairymen of adding to the milk small amounts of 
various antiseptics and germicides, which are supplied to the trade 
under the general name of milk preservatives. The effect of such 
substances is to destroy or at least hinder the growth of all micro- 
organisms which the milk may contain, and thereby retard the 
souring of the milk ; and to prevent or at least delay the lactic-acid 
fermentation of milk is the principal object to be attained through 
the use of such substances. Among the various substances which 
have been employed as milk preservatives may be mentioned the 
following : 

Common salt, sodium bicarbonate, formaldehyde (solutions of 
which are supplied to the dairyman under the trade name of " Freez- 
ine"), borax and boric acid (solutions of the latter once sold under 
the name of "Aseptine"), salicylic acid, benzoic acid, hydrogen 
peroxide, certain fluorides, potassium dichromate, etc. Of these 
substances formaldehyde, boric acid and borax, and sodium bicar- 
bonate have probably been the most frequently employed as milk 
preservatives. In certain localities in Europe the addition of alkali 
chromates to milk was at one time a common practice, and Budde 
(16) has proposed a method for the sterilization of milk by the action 
of hydrogen peroxide at a moderately high temperature, viz, 52° C. 

45276°— Bull. 56—12 25 



386 

It is doubtful, however, whether the method ever found any very 
extensive application. According to Leach (IT) salicylic and benzoic 
acids are now rarely used as milk preservatives. Salicylic acid 
in quantities sufficient to preserve affects the taste of the milk. Rich- 
mond (18) found a new food preservative to consist of acid potas- 
sium fluoride, KHF 2 . 

As a general thing these substances are employed only in small 
amounts, and at present there is considerable difference of opinion 
as to what effect these various substances in the small amounts usu- 
ally present in milk and other foodstuffs exert upon the human system. 
Thus, according to Trillat (19), formaldehyde renders the casein of 
milk more or less indigestible, and a further objection to its use is 
that part of it remains unaltered in the various foodstuffs with which 
it is admixed, and being absorbed as such by the system may act 
injuriously on the digestion. On the other hand, Rideal and Foul- 
erton (20) have observed that formaldehyde at a dilution of 1: 50,000 
or 0.05 per cent of boric acid and borax will preserve milk twenty- 
four hours, and that these amounts of these substances have no 
effect on the peptic and pancreatic enzymes, while this quantity of 
boric acid greatly retards the diastatic power of saliva, the formal- 
dehyde having much less effect. Experiments with kittens, rabbits, 
and guinea pigs proved, according to these observers, that the 
amount of formaldehyde required to preserve milk has no effect on 
their proteid metabolism. Fish were not affected in six days in water 
containing 1 part of formaldehyde in 50,000 parts of water, and 
frogs stood a concentration of 1 : 20,000 without injury for two hours. 
The conclusion drawn by these writers from their investigation is 
that the quantities of these substances necessary to preserve milk 
twenty-four hours have no appreciable effect on the digestibility of 
the milk, and that in these quantities formic aldehyde and boric acid 
interfere less with the pancreatic digestion of casein than tea, claret, 
and Worcester sauce. Formaldehyde, 1 : 50,000, does not appear to 
have any injurious action upon animal tissues, or on nutrition. On 
the other hand, Otto Hehner (21) has criticized the experiments by 
Rideal and Foulerton on the ground that they were not properly con- 
trolled, and this author seems inclined to believe from the results 
obtained that these substances, in the quantities employed, were in 
reality injurious to the animal organism. T. M. Price (22), working 
in the Biochemic Division of the Bureau of Animal Industry, U. S. 
Department of Agriculture, has made a valuable contribution to this 
subject. He has studied the effect of some food preservatives on the 
action of the digestive enzymes, especially the effect of formaldehyde 
on the preservation of milk and the effect of this substance on the 
digestibility of the milk by the digestive enzymes in vitro and in the 



387 

stomach of the calf. The following are the more important conclu- 
sions which he has drawn from these investigations : 

(1) Formaldehyde in the proportion of 1:20,000 preserves the 
milk for forty-eight hours. 

(2) Formaldehyde in milk in the proportion of 1: 10,000 does not 
interfere with the digestion of the milk when it is fed to calves. 

(3) Upon feeding calves through a long period' with milk pre- 
served with formaldehyde the calves remained healthy and gained 
in weight. 

(4) Formaldehyde added to milk in the proportion of 1 : 2,500 or 
less has no effect on the activity of the fresh enzymes, rennet, pepsin, 
pancreatin, and steapsin, in vitro. 

(5) Formaldehyde added to starch in the proportion of 1 : 2,500 or 
less has no effect on the conversion of the starch into sugar by the 
enzymes ptyalin and amylopsin, in vitro. 

(6) Formaldehyde added to milk in sufficient quantity to preserve 
the milk for forty-eight hours — i. e., 1 : 20,000 — does not materially 
interfere with the action of the enzyme galactase, in vitro. 

(7) Formaldehyde added to milk in the proportion of 1:20,000 
prevents the development of the more common bacteria found in 
milk and when added in the proportion of 1 : 1,560 it kills these 
bacteria. 

(8) Formaldehyde may be added to milk in sufficient quantities 
to preserve the milk and to prevent the development of some of the 
more common bacteria — i. e., 1 : 10,000 — and still have no deleterious 
effect on the digestibility of the milk for calves. 

(9) Formaldehyde should never be fed to calves as a milk pre- 
servative stronger than 1 part of formaldehyde to 10,000 parts of 
milk. 

According to Price the results obtained by the majority of inves- 
tigators who have experimented with formaldehyde are of no value, 
inasmuch as at least the majority of them employed formaldehyde 
solutions varying in concentration from 1 : 25 to 1 : 2,000, these quan- 
tities being very much larger than the quantities of formaldehyde 
used in the preservation of milk in practice. At the close of his arti- 
cle Price gives the following bibliography of the subject : 

(1) Salkowski u. Halm, Pfluger's Archiv., Bd. LIX u. LXIII ; Moraczewski, 
Zeitschr. f. physiol. Chem., B. XX. 

(2) Babcock and Russell, Wis. Ann. Kept. Ex. Stat, Vol. XIV, 1897, p. 161. 

(3) Snyder, Minn. Ex. Stat. Bull. No. 74. 

(4) Babcock and Russell, Wis. Ann. Rept. Ex. Stat., Vol. XV, 1898, p. 17. 

(5) Van Slyke, Rept. N. Y. Ex. Stat., Vol. XX, 1901, p. 165. 

(6) Loew, Ann. Agronom., Vol, XCVIII, p. 416; Pottevin, Ann. de l'lnst. 
Pasteur, 1897, p. 807; Symons, Jour. Am. Chem. Soc, Vol. XIX, 1897, p. 724; 
Foulerton, Lancet, Vol. XI, 1899, p. 1578 ; Bliss and Novy, Jour. Ex. Med., Vol. 



388 

IV, 1899, p. 60 ; Halliburton, Brit. Med. Jour., Vol. XI, 1900, p. 1 ; Rideal and 
Foulerton, Pub. Health, 1899, p. 554. 

(7) Cripp, Analyst, Vol. XXII, 1897, p. 182; Allen, Lancet, Vol. I, 1896, p. 
1516; Ringer, Jour, of Phys., 1895, p. 425; Chittenden, Diet, and Hyg. Gaz., 
1893, p. 25 ; Mayberry and Goldsmith, Chem. Centralbl., 1898, p. 69 ; Leffmann, 
Jour. Franklin Inst., 1899, p. 103; Weber, Jour. Am. Chem. Soc, 1902, p. 4; 
Chittenden and Gies, Am. Jour. Phys., 1898, p. 1; Tunnicliffe and Rosenheim, 
Jour. Hyg., 1901, p. 168 ; Forstus, Archiv. of Hyg., Vol. XI, 1884, p. 75 ; Liebreich, 
Vierteljahrsschr. gericht. Medizin, 1900, p. 83. 

Reference has already been made to the fact that Trillat (19) found 
that formaldehyde renders the casein of milk more or less indiges- 
tible. In this same connection Pottevin (23) has observed that for- 
maldehyde retards the coagulation of milk by rennin. Further 
experiments along this line have been made by Bliss and Novy (24). 
These authors have confirmed the conclusions of Pottevin regarding 
the influence of formaldehyde on the coagulation of milk by rennin 
and have found that under the influence of formaldehyde the casein- 
ogen of milk is rapidly altered in such a way that either the rennin 
coagulation takes place only very slowly or not at all. Thus if for- 
maldehyde in the proportion of 1 : 500 be allowed to act on milk for 
a, few hours the milk is not coagulated on the addition of rennin. 
On the other hand, they observed that the rennin itself is not readily 
destroyed by formaldehyde, so that the delay or hindrance of the 
rennin coagulation of milk by formaldehyde is evidently due in some 
way to an alteration in the composition or properties of the casein- 
ogen. Similar experiments on the action of formaldehyde on the 
digestive ferments have been made by Halliburton (25) . Pie observed 
that 0.5 per cent of formaldehyde renders gastric digestion almost 
impossible, and 0.05 per cent delays it considerably. With 0.1 per 
cent formaldehyde no pancreatic digestion of fibrin occurs in twenty- 
four hours, and dilute solutions of the aldehyde delay the pancreatic 
digestion of starch. He also confirms the deleterious effects exerted 
by formaldehyde on the rennin coagulation of milk. 

Wiley and his coworkers have also studied the effect of formalde- 
hyde on the health of man. The results of this investigation, how- 
ever, have not yet been published. 

Concerning the toxic effects of boric acid and borax there is also the 
greatest difference of opinion among those who have made a study of 
the subject, and more recent investigations, despite their exhaustive 
character, have tended by no means to reconcile these opposing 
views, but if anything to accentuate them. For example, J. Neu- 
mann (26) found that only very large doses of boric acid can cause 
death by gastroenteritis or from its effects on the nervous or muscular 
systems. He therefore recommended it for the preservation of milk. 
According to Cyon (27) borax diminishes proteid metabolism, but all 
that can be learned from his work on the subject is, that metabolism 



389 

and assimilation were not seriously interfered with by borax in the 
quantities administered. Gruber (28), on the other hand, found that 
borax increases proteid metabolism and concludes that borax exerts 
no unfavorable influence on the assimilation of food. According to 
this author, no harmful effect followed a maximum dose of 20 grams. 
Forster (29), from his studies on the applicability (verwendbarkeit) 
of boric acid as a food preservative, concludes that, while boric acid is 
without influence on proteid metabolism, the continuous administra- 
tion of small amounts of it in food is not without its drawbacks so far 
as the health of the individual is concerned, and that its use as a milk 
preservative, especially in milk to be used by children, should be con- 
demned. G. T. Welch (30) records some alarming instances of poison- 
ing following the local application of large amounts of boracic acid ; 
and Chittenden (31) observed that while borax in moderate amounts 
exerts no inhibitory action on the peptic and tryptic digestion of pro- 
teids, in larger quantities it retards the proteolytic activity of both of 
these digestive fluids. Later, Chittenden and Gies (32) made an 
exhaustive study of the action of borax and boric acid on nutrition, 
with especial reference to their effect on proteid metabolism, the 
experiments being made upon full-grown dogs. They found as the 
result of these studies that small doses of boric acid, up to 3 grams per 
diem, are practically without effect upon the proteid metabolism and 
the general nutrition of the animals, and that even moderate doses of 
borax are practically without effect. Large doses of borax tend to 
retard somewhat the assimilation of proteid and fatty foods, and with 
very large doses there is a tendency to diarrhea and an increased 
excretion of mucus. Borax and boric acid in very large amounts 
(equal to 1.5 to 2 per cent of the food) are liable to produce nausea 
and vomiting. Both borax and boric acid are quickly eliminated 
from the body, almost entirely through the urine, and in none of the 
experiments were any abnormalities in the urine observed. 

Reference has already been made to the work of Rideal and Fouler- 
ton (20) on boric acid and formaldehyde as milk preservatives. In 
this connection it may be well to call attention again to their conclu- 
sions. According to these authors, (1) boric acid, 1:2,000, and 
formaldehyde, 1 : 50,000, are effective preservatives for milk for 
twenty-four hours; (2) in these quantities these substances have no 
appreciable effect on digestion or on the digestibility of foods thus 
preserved. On the other hand, according to F. J. Allen (quoted by 
Halliburton (25)), borax delays or prevents the rennin coagulation 
of milk. An excellent resume of the earlier pharmacological work 
on boric acid and borax is given by Liebreich (33). We gather from 
the data which are there presented that since its introduction into 
medicine in the seventeenth and eighteenth centuries there have been 
occasional accidents and deaths from boric- acid poisoning. In these 



390 

instances, which were comparatively rare, very large doses of boric 
acid and borax were employed, and in certain instances, at least, the 
bad results reached through the employment of these substances as 
drugs could be explained as resulting from a marked idiosyncrasy on 
the part of the patient, and in certain other instances, as pointed out 
by Liebreich, death and the bad effects following the use of these 
compounds were in all likelihood traceable to other causes. Among 
those who have observed bad effects following the administration of 
boric acid and borax may be mentioned Gowers, Evans, Molodenkow, 
Lemoine, Bruzelius, Warfwinge, Rasch, G. T. Welch, and others. 
(See Liebreich (33).) On the other hand, boric acid was early 
recognized as a mild antiseptic, and was recommended in surgery as 
a dressing for wounds by Lister, Godlee, and others. Particularly 
good results were obtained through its use by Cane, so that to-day 
the value of boric acid as a mild antiseptic wash and dressing powder 
is fully recognized and its use in these directions is extensive and far- 
reaching. It is concerning its effects on the system when taken inter- 
nally, however, that the greatest differences of opinion prevail. 
Opposed to those who have described bad effects and even death 
following the administration of boric acid and borax, we have the 
testimony of other medical authorities regarding the harmless char- 
acter of boric acid preparations. Liebreich (33) cites the cases 
described by Polli in Legendre's " Traite practique d'Antiseptique 
applique a la Therapeutique et 1'Hygiene " of a soldier who swallowed 
25 grams of boric acid without bad results. Polli cites the cases of 
eight persons who took 2 grams of boric acid in milk daily for forty- 
five days and 4 grams daily for twenty-three days without showing 
the slightest abnormal symptoms. Also the great Virchow, having 
observed his own urine to be abnormal, kept himself on an alkaline 
regimen for three months by the use of large doses of borax followed 
in the morning by Carlsbad water. The results reached are best 
given in his own words : " Ich fuhr 3 Monate lang mit meinem alka- 
lischen Regime fort, und bis auf den heutigen Tag habe ich niemals 
weder Eiter abgesondert, noch Albumen, noch Cylinder producirt; 
mein Hani ist so klar wie der einer Jungfrau." Binswanger also 
conducted a series of tests upon himself with the view of determining 
the effect of boric acid. During one day he took 18 decigrams with- 
out effect, except possibly to increase his appetite. When he took 
two doses of 3.654 grams in two hours vomiting set in, and when he 
took the third dose later in the same day he again vomited, but after 
two hours regained his normal condition. G. T. Welch quotes 
Gaucher to the effect that the fatal dose of boracic acid is 2.5 ounces, 
continued for at least ten days. On the basis of these observations 
and also certain observations on himself and from results reached in 
his study of the effects of boric acid and borax on animals, such as 



39i 

dogs, rabbits, guinea pigs, etc., Liebreich (33) enters into a somewhat 
vigorous defense of the use of boric acid and borax as food preserva- 
tives. It is his opinion that much of the opposition to the use of 
boracic preparations for such purposes grows out of prejudices 
handed down from bygone times, and he calls attention to the fact 
that in this connection undue stress has been laid upon the accidents 
resulting from the use of boric acid in surgery, and that to a consider- 
able extent the opposition to the use of boric acid and borax as food 
preservatives is founded upon conclusions drawn from imperfect 
experimental researches. To him the critical spirit of this later-day 
investigation of such subjects as food preservatives is a matter of 
regret, and in one of his communications, " Ueber Conservirung durch 
Borsaeure " (34), he inquires somewhat petulantly, "Who would 
have made the introduction of pickled meat, smoked beef, and such 
Kke dependent on a chemical or pharmacological investigation?" He 
emphasizes the fact that notwithstanding that borax and boric acid 
have been in use as food preservatives for a series of decades not a 
single case of injury to health has been observed. Lebbin (35) failed 
also to discover any harmful effect from eating meat preserved with 
boric acid, and hence points out that no objection can be urged against 
its use as a preservative. Tunnicliffe and Rosenheim (36) studied 
the influence of boric acid and borax on the general metabolism of 
three children, and arrived at the conclusion that small doses, up to 
1 gram per day, continued for some time, exert no influence on the 
proteid metabolism in healthy or delicate children. Both boric acid 
and borax were quickly eliminated from the system, and neither 
substance affected the general health or well-being of the children in 
any way. 

A second treatise by Liebreich (37) on the effect of boric acid and 
borax on the human system appeared in 1902, the object of which, 
according to the author, was to refute certain erroneous and insuffi- 
cient observations likely to encourage prejudices against the use of 
these compounds. He criticises the observations of Robinson, Kister, 
Hanford, Rose, Rost, Rubner, Mattern, Heffte, Le Bon, and others, 
on the grounds that they are based on faulty and inaccurate observa- 
tions ; that the tests and observations are not decisive, that in certain 
instances they involve contradictions; that the boric acid and borax 
were not administered with food, but were taken directly into the 
system, and that in certain instances the real cause of the disturbance 
attributed to borax and boric acid was in all probability badly pre- 
served meat ; and by way of further confuting the results reached by 
other observers regarding the toxic action of boric acid and borax he 
cites the findings of Tunnicliffe and Rosenheim, to the effect that 
children increased in weight on a diet containing borax and boracic 
acid. Liebreich is of the opinion, therefore, that practical experience 



392 

justifies the use of boric acid and borax as food preservatives. Wiley, 
Bigelow, and others (38), as the result of their study of the effect of 
boric acid and borax on man, have found that while the persons under 
experiment were in many instances made temporarily ill by the quan- 
tities of boric acid administered, at the end of the year, after the final 
after period, they appeared to be, and so expressed themselves, in 
better physical condition than when they entered on the experi- 
mental work. 

It has already been pointed out that salicylic acid and benzoic acid 
are only rarely used as milk preservatives. This is fortunate, since 
both of these substances must be looked upon as toxic, to a degree at 
least, and the former, at least, seems to be more or less cumulative 
in its toxic effects upon the system. The injurious effects resulting 
from continuous small daily doses of salicylic acid were first pointed 
out by Brouardel (39), who made a plea for its discontinuance as a 
food preservative and for more thorough and systematic examina- 
tions of preserved foodstuffs by chemists and health officers. The 
effect of salicylic acid and the salic}dates on man has also been investi- 
gated quite recently by Doctor Wiley (40) and his coworkers at the 
hygienic table. He points out in his general conclusions that there 
has been a general consensus of opinion among scientists and medical 
authorities that salicylic acid and its compounds are very harmful 
substances and that the prejudice against them is perhaps greater 
than against any other form of food preservatives. While he is still 
inclined to look upon it as a harmful substance, it is probably of less 
virulence than has heretofore been supposed. 

Attention has already been called to the use of hydrogen peroxide 
in the sterilization of milk. In its 3 per cent solution this substance 
has been employed by Budde (16) to sterilize milk at somewhat lower 
temperatures than those employed in the ordinary processes of pas- 
teurization, and attempts have also been made to remove all traces of 
the peroxide remaining in the milk after such treatment. According 
to Lakin (41), however, these attempts have not proven practicable, 
and this author therefore objects to Budde's process of sterilizing 
milk on the ground that it still contains small amounts of the un- 
changed hydrogen peroxide, and also in consequence of the injurious 
impurities which commercial solutions of hydrogen peroxide are 
liable to contain — such as boric acid and arsenic — which are present 
in the substances from which the solutions of hydrogen peroxide are 
made. He adds, however, that the consumption of milk sterilized 
by this method is not known to have produced any injurious effects. 
P. Gordan (42) has shown that the small amounts of hydrogen 
peroxide employed by Budde in his process of sterilizing milk have 
practically no sterilizing action, and that if employed in quantities 
sufficient to sterilize, it imparts a taste to the milk and renders it 



393 

unfit for human consumption. According to a number of authorities 
hydrogen peroxide is apparently harmless in its effects. Amberg 

(43) quotes the following authorities on this point: Jablin-Gonnet 

(44) fed milk containing hydrogen peroxide to young animals and 
took it himself for two months without ill effect. Eosam (45) took 
within a period of three months a quantity of hydrogen peroxide, 
in milk, corresponding to 1,800 cubic centimeters of a 3 per cent 
solution without the least injurious effect, and Vandervelde (46) 
claims to have shown that hydrogen peroxide favors the action of 
rennin, pepsin, trypsin, and galactase. 

Concerning the possibility of injurious effects resulting from the 
use of fluorides as milk preservatives, it may be said that the evidence 
now at hand goes to show that these substances are irritating poisons 
of considerable power. That such is the case may be seen from the 
following observations which have been made on their toxicity: 
Kubuteau (47) found that 0.5 gram of sodium fluoride given by 
the mouth produced sickness in dogs and 0.25 gram by mouth 
produced sickness in rabbits. When injected subcutaneously 0.25 
gram of sodium fluoride proved fatal to rabbits. Kolipinski (48), 
who successfully employed sodium fluoride in minute doses in 
epilepsy, intermittent fever, and sympathetic headache, observed that 
5 grains caused vomiting in a dog, when administered by the mouth, 
and that 3 grains injected into a dog or cat caused death in a 
few hours. The urine in such cases was found to contain small 
amounts of albumen, and to be rich in fluorine, indicating its elimi- 
nation by the kidneys. Schulz (49) found the lethal dose of sodium 
fluoride for rabbits to be 0.2 to 0.4 gram, for dogs 0.3 gram, and for 
frogs 0.005 to 0.006 gram. Heidenhain (50) found the lethal dose 
for dogs to be 0.05 to 0.1 gram per kilo body weight. Weinland (51) 
observed that a 2.1 per cent solution of sodium fluoride killed the 
mucous membrane of the throat of a frog and Gruentzner (52) found 
that at such a concentration living nerves are destroyed. Czrellitzer 
(53) found it to be an active poison for all form of cells, and for 
protoplasm generally, but states that no satisfactory explanation of 
its toxicity is yet known. Kastle and Loevenhart (54) found it 
highly toxic to lipase, the fat-splitting ferment, and quite recently 
Loevenhart and Pierce (55) have considerably extended these obser- 
vations, and have found that sodium fluoride retards the action of 
lipase when present in a solution of the ferment at the great dilution 
of one to one hundred million. 

Baldwin (56) has called attention to several cases of accidental 
poisoning by sodium fluoride, that came under his observation, in 
which an insecticide consisting of sodium fluoride was mistaken for 
baking powder and used in the making of griddlecakes. In these 
cases violent vomiting and purging followed quickly after the eating 



m 

of these cakes, which probably contained rather large amounts of the 
fluoride. These observations led the author to test the toxicity of 
sodium fluoride on himself. He found that 0.03 gram of sodium 
fluoride, eaten with bread, produced no effect. Neither did 0.09 
gram taken a little later. 0.25 gram taken on an empty stomach 
produced nausea in two minutes, which effect reached its maximum 
in twenty minutes. During this time there was an increased flow 
of saliva and retching, but no vomiting. In about two hours these 
symptoms had subsided. Luncheon was then eaten, but without 
relish. Vomiting occurred immediately after eating, and slight 
nausea continued throughout the day on which the poison was taken. 
Baldwin concludes from his observations that sodium fluoride 
belongs to the class of less violent poisons, the characteristic symp- 
toms being nausea, vomiting, and salivation. 

According to Van Slyke (57) potassium dichromate is not a very 
violent poison, though not entirely harmless. 

Concerning the physiological effects of such substances as common 
salt, sodium bicarbonate, etc., nothing need be said in this connection. 

It is evident therefore that those who have made the closest study 
of the use of preservatives in food are very much divided in their 
opinion regarding the possibility of ill effects resulting from their 
use. Indeed the whole subject of food preservatives has been dis- 
cussed from practically every standpoint, A priori, most of us would 
probably be inclined to proceed on the assumption that a substance 
which is toxic to micro-organisms is also toxic to the cells com- 
posing the tissues of man and the higher animals. In his testimony 
before the food-preservatives committee, London, Halliburton (25) 
took the stand that the use of food preservatives should be abandoned 
and methods of cold storage and transportation substituted in their 
place, upon the ground (1) that an antiseptic which is inimical to the 
life of those organisms that cause putrefaction can not be harmless 
to the vital processes of the higher animals; (2) numerous clinical 
observations have been recorded which show that dyspeptic and 
other troubles follow the use of foods which have been treated with 
preservatives ordinarily employed for such purposes, such as borax ; 
(3) even if as in the case of boric acid and borax, the poison is 
not cumulative, the continuous passage of foreign substances through 
the kidneys can not be beneficial to those organs. A similar stand 
against the use of preservatives in food has been taken by Leffmann 
(58). According to this author, the bad effects of a food preserva- 
tive may show itself in several ways: (1) It may interfere with the 
action of the digestive ferments, as has been proven in the case of 
salicylic acid; (2) it may act on the food, like formaldehyde; and (3) 
it may work a direct injury to the body as is known to be the case 
with almost all mineral preservatives. Hope (59) looks upon it as 



395 

proven beyond dispute that chemical preservatives while checking the 
putrefactive changes in food, also check the fermentative processes 
of digestion. Especially does he regard the use of preservatives in 
milk as absolutely indefensible, and points out that the experiments 
of the bacteriological department of the Thompson- Yates laborato- 
ries are sufficient in themselves to establish the dangers of this prac- 
tice, even if they stood alone. According to this author, there are 
numerous cases of injury resulting from the use of milk so preserved. 
He is therefore of the opinion that cleanliness and cold alone should 
be relied upon to insure the preservation of milk. Vaughan and 
Veenboer (60) have arrived at the conclusion that it is desirable to 
prevent the use of formaldehyde in any and all foods, and also not to 
allow the use of any preservatives in milk. They are of the opinion, 
however, that the use of one-fourth of 1 per cent of boric acid in 
cream would probably not prove harmful. The English commission 
appointed to inquire into the subject of food preservatives, upon the 
testimony and findings of seventy-eight experts, prohibited the use 
of all preservatives and coloring matters in milk, and at the Inter- 
national Congress of Hygiene, held at Brussels in 1903, resolutions 
were passed practically prohibiting the use of preservatives in all 
kinds of foods. 

On the other hand, Rideal and Foulerton (61) contend that in view 
of the exceedingly perishable nature of milk, and the fact that it fre- 
quently has to be brought long distances before reaching the con- 
sumer, the use of a preservative is not only legitimate, but distinctly 
advantageous from a hygienic standpoint, providing that the pre- 
servative is not injurious to the health of the consumer. It may be 
said finally, however, that the preponderance of medical and scientific 
opinion is decidedly against the use of preservatives in milk, not only 
on account of possible injuries, especially to young children, resulting 
from the continued use of such preservatives in small amounts, but 
also for the reason that the use of such substances, if permitted, 
would ultimately tend to carelessness and uncleanliness in the hand- 
ling of milk. Cleanliness and cold, the rigorous enforcement of the 
tuberculin test, and proper medical supervision of the dairies and 
those who handle the milk, are the prime essentials for a pure milk 
supply, and no method of sterilization or preservation is likely to 
give as good results. 

In this connection, Richmond (62) has pointed out that in hot 
summer weather milk preservatives are comparatively useless unless 
added in relatively large quantities. He also calls attention to the 
fact that when once the souring of milk containing a small amount 
of preservative begins it proceeds at an increased rate as compared 
with milk to which no preservative has been added. 



396 

An actual case of milk adulteration which came under our obser- 
vation at the Hygienic Laboratory will serve to illustrate the different 
phases of this subject. On July 23, 1907, a sample of milk was re- 
ceived from the Jamestown Exposition. According to the statement 
of the person submitting the sample, this milk was a sample of the 
milk supplied the guests at one of the tables of a hotel within the 
exposition grounds. This sample of milk gave the following num- 
bers on analysis : 

Specific gravity 1. 0213 

Fat per cent 1.7 

Total solids do 7.5 

Total solids not fat do 5.80 

Ash do . 43 

Milk sugar do 3.37 

Refractometer reading 32. 1 

It was also found to contain formaldehyde and to be artificially 
colored with an azo dye. It was also found to contain a large num- 
ber of bacteria per cubic centimeter. The results of our examination 
of this milk show that the milk was watered. The fact that it con- 
tained a large number of micro-organisms despite the addition of 
formaldehyde indicates either that proper care had not been exer- 
cised in drawing the milk from the cow or that the proper care and 
cleanliness had not been exercised in handling it, or that the attempt 
had been made to keep it for too long a time and probably at too 
high a temperature. Such milk is not only below standard so far as 
food constituents is concerned, but it is exceedingly liable to infec- 
tion, yet this was a sample of the milk probably supplied to many 
persons while they were guests at this hotel. This single instance is 
sufficient to illustrate the real significance of milk adulteration and 
its possible dangers. 

PART V.— THE WASHINGTON" MILK SUPPLY. 

So far as our experimental work on this subject is concerned, the 
principal object has been to determine the general character of the 
milk at present supplied to the consumer in Washington and the 
District of Columbia. With this in view, routine chemical analyses 
have been made of milk offered for sale by various milk dealers in 
the city of Washington and the District of Columbia, from the 5th 
of July, 1907, to the 27th of September, 1907, inclusive. So much 
has been written on the subject of the routine analysis of milk, and 
the methods at present employed are generally so well understood, 
that only a few words concerning the methods employed in this 



397 

investigation are required. For further details concerning methods 
of milk analysis, the reader is referred to the following standard 
works on this subject, viz, Modern Methods of Testing Milk and 
Milk Products, Van Slyke, New York, 1907; and Food Inspection 
and Analysis, Leach, New York, 1907. The chemical examination 
of the Washington milk supply has included the determination of 
specific gravity, total solids, fat, sugar, ash, acidity, refractometer 
reading, quantity of dirt by volume, and tests for preservatives. 
During the month of September special attention was paid to the 
examination for preservatives, and during this time the determination 
of sugar and total solids was omitted. The latter were calculated 
from the specific gravity and the percentage of fat according to Bab- 
cock's rule. The samples submitted for examination were collected 
by certain inspectors of the health office, and as soon as collected were 
put on ice and kept there until delivered at the Hygienic Laboratory, 
and until the chemical examinations were completed. As soon as 
the sample was brought into the laboratory, the acidity of the milk 
was determined on 50 cubic centimeters of the sample. The specific 
gravity and the percentage of fat and also the refractometer reading 
(the latter on the milk serum) were also determined practically as 
soon as the sample reached the laboratory, especially in those cases in 
which owing to lack of time the total solids were not determined by 
weighing, and in the event that these determinations indicated that 
any particular sample was below standard, the total solids on this 
particular sample were determined by weighing in the manner de- 
scribed in the following: 

Specific gravity. — The specific gravity of the milk was determined 
either by means of the Westphal balance or by means of the Que- 
venne lactometer. 

Total solids and ash. — The total solids and ash were determined by 
the method recommended by Leach ( 1 ) . This method consists in 
heating 5 grams of the milk on the steam bath for three hours, in 
small flat platinum dishes. At the end of this time the dishes were 
removed from the steam bath and while still hot were wiped dry 
with a piece of soft toweling. They were then allowed to cool and 
weighed. In this way we obtained the weight of the residue from 
5 grams of milk, and from this we calculated the percentage of total 
solids. The ash of the milk was then determined on the same sample 
by ignition at a low red heat, cooling and weighing the dish and its 
contents the second time. The ash left after this operation was tested 
for boric acid by the turmeric test. 



398 

Fat. — The quantity of butter fat in the milk was determined by 
the Babcock centrifugal method. This is the most rapid method 
known for the determination of fat in milk. It compares very 
favorably as to accuracy with the most exact methods now known for 
the determination of fat in milk, and it is the method ordinarily 
employed in practice for this purpose. 

Lactose. — The amount of lactose in the several samples of milk was 
determined polarimetrically after the removal of the milk proteids 
by means of an acid solution of mercuric nitrate. 

Acidity. — The acidity of the milk was determined by titrating 50 
cubic centimeters of the sample with tenth-normal sodium hydroxide, 
using phenolphthalein as the indicator. 

One cubic centimeter of tenth-normal sodium hydroxide, contain- 
ing 0.004 gram of sodium hydroxide, is equivalent to 0.009 gram of 
lactic acid. Hence each cubic centimeter of tenth-normal sodium 
hydroxide required by the 50-cubic-centimeter sample of milk is 
equivalent to 0.018 per cent of lactic acid. In order, therefore, to 
obtain the per cent of acidity of the sample we multiply the number 
of cubic centimeters of tenth-normal sodium hydroxide required for 
neutralization by 0.018. The product is the acidity of the milk in 
percentage of lactic acid. 

Thoerner (2) has suggested as a practical limit for wholesome milk 
an acidity equal to one-fifth of the volume of the milk in cubic cen- 
timeters of tenth-normal caustic soda. This would correspond to an 
acidity of 0.18 per cent of lactic acid. According to Van Slyke (3), 
the average acidity of English market milk, supposed to be 12 to 18 
hours old, is 0.18 per cent, and of German milk 0.13 to 0.18 per cent. 
According to this author, market milk should not in any case contain 
over 0.2 per cent total acidity when it reaches the consumer, and 
generally should be under 0.15 per cent. According to Tuley (4), 
the milk of swill- fed cows is hyperacid. 

Dirt. — The quantity of dirt or suspended matter in the milk may 
be estimated either gravimetrically (Renk, quoted by Ott (5)) or 
volumetrically (Van Slyke). The gravimetric method requires a 
large volume of milk and also requires considerable time. The volu- 
metric method is rapid, and only small amounts of milk are required. 
For this reason the latter method was employed. Fifteen cubic centi- 
meters of the sample was placed in a Bausch and Lomb graduated 
centrifuge tube. The samples were then centrifugalized for five 
minutes. The dirt then collects on the bottom of the tube, and the 
volume of it is read. From these readings the per cent of dirt is 
calculated. 



399 



Refractometer reading. — Milk serum has a higher index of refrac- 
tion than water. Therefore the addition of water to milk lowers the 
index of refraction of the serum The refractometer reading of the 
several samples was obtained in the following manner : One hundred 
cubic centimeters of the sample of milk is placed in a beaker. To 
this 2 cubic centimeters of 25 per cent acetic acid is added. The 
beaker is then covered with a watch glass and heated in a water bath 
at 70° C. for twenty minutes. It is then placed in ice water for ten 
minutes and filtered. The refractometer reading on the clear yellow- 
ish filtrate (milk serum) is then made with a Zeiss immersion refrac- 
tometer, at 20° C. A description of this instrument, together with all 
necessary directions for its use, is given by Leach (6). See also 
Wagner (7). Unadulterated milks give a refractometer reading 
varying between 39 and 43 on the scale of this instrument. Accord- 
ing to Leach (8), a reading below 40 with the above conditions care- 
fully observed would be suspicious of added water, though 39 might 
more safely be placed as a limit, below which milk could be declared 
fraudulently watered. 

The following data given by Leach (9) show the variations in the 
specific gravity, refractometer reading, chemical composition, etc., 
resulting from the addition to a whole milk of various amounts of 
water up to 50 per cent. 







Determinations 


on milk. 






On milk serum. 


Added 
water. 


Total 
solids. 


Water. 


Fat. 


Solids 
not fat. 


Ash. 


Specific 

gravity at 

15° C. 


Specific 

gravity at 

15° C. 


Immersion 
refrac- 
tometer 

reading at 
20° C. 


Per cent. 


Per cent 


Per cent. 


Per cent. 


Per cent. 


Per cent. 











12.65 


87.35 


4.00 


8.65 


0:65 


1.0315 


1. 0287 


42.40 


10 


11.33 


88.67 


3.50 


7.83 


.60 


1.0278 


1.0260 


39.75 


20 


10.10 


89.90 


3.10 


7.00 


.53 


1. 0252 


1.0230 


36.90 


30 


8.95 


91.05 


2.80 


6.15 


.48 


1.0211 


1.0200 


34.10 


40 


7.67 


92.33 


2.40 


5.27 


.40 


1.0192 


1.0167 


31.10 


50 


6.43 


93.57 


2.00 


4.43 


.38 


1. 0154 


1.0140 


28.45 



Coloring matters. — All of the samples of milk were examined sys- 
tematically for artificial coloring matters by the methods given by 
Leach (10). 

Preservatives. — All of the samples of milk were examined for anti- 
septics (1) by the souring test. That is, a portion of the sample 
was placed in a flask and allowed to stand overnight at room temper- 



400 

ature. If the milk turns sour in this time and curdles normally it 
was taken as an indication that antiseptics had probably not been 
added. On the other hand, if it did not curdle in this time, under 
these conditions, it was regarded as possibly containing preserva- 
tives and was systematically examined for all substances ordinarily 
employed as milk preservatives by the methods described by Leach, 
Van Slyke, and other well-known authorities on the subject. 

(2) A considerable number of the samples were tested for preserva- 
tives by Blyth's (11) method for the detection and estimation of pre- 
servatives in milk. This method is carried out in the following man- 
ner: Ten cubic centimeters of the milk is put into a clean, wide test 
tube, and into another tube for purposes of comparison and control 
are put 10 cubic centimeters of a sample of milk of known purity. To 
each tube 2 cubic centimeters of a strong aqueous solution of blue 
litmus is then added, and after plugging with cotton wool the tubes 
are sterilized by heating to 80° C. for ten minutes. The tubes are 
then removed from the sterilizer and cooled to ordinary temperature. 
Each tube is then inoculated with 0.5 cubic centimeter of a solution 
containing 0.5 cubic centimeter of sour milk and 100 cubic centimeters 
of water. After thoroughly mixing, the tubes are kept at 15° to 25° 
C. for twenty-four hours and are then examined. The tubes contain- 
ing samples of milk which contain preservatives will be colored blue 
or pink, whereas the tubes containing milks to which no preservatives 
have been added will be of the same color as the control experiment 
with normal milk, viz, white or nearly so. This test depends upon 
the fact that in the normal souring of milk the colored substances 
present in litmus are reduced by the bacteria to colorless (leuco) com- 
pounds. 

(3) All of the samples of milk without exception were tested for 
formaldehyde and boric acid by the methods described by Leach 
(12). The test for formaldehyde described by this author as the 
hydrochloric acid test is capable of readily detecting 1 part of for- 
maldehyde in 250,000 parts of sweet milk and 1 part in 50,000 in 
sour milk. It has been shown by Rideal and Foulerton (13) that at 
least 1 part of formaldehyde in 50,000 is required to preserve milk 
for twenty-four hours, so that this test is capable of detecting much 
smaller quantities of formaldehyde than is ever employed in prac- 
tice. During the month of September, during which time special 
attention was paid to the subject of preservatives in the milk, 20 
cubic centimeters of each sample of the milk was distilled and a few 
cubic centimeters of the distillate collected in a small amount of dis- 



401 

tilled water. The distillate was then tested for formaldehyde by a 
modification of the Hehner test (see Acree (14) ), which in our hands 
enabled us to detect with certainty 1 part of formaldehyde in 1,000,000 
parts of milk when a few drops of normal milk are used to supply 
the proteid required in this test. 

In Table I are given the results of our analyses. 

In Table II, column (1), are given the serial numbers of the sam- 
ples of the milks of the several dairies. These are the inspectors' 
numbers furnished by the health office of the District of Columbia. 
In column (2) are given the total number of samples analyzed from 
each dairy. In column (3), the inspectors' numbers of such samples 
as were found to be below the standard of purity now fixed for the 
District of Columbia. In column (4), the total number of samples 
found to be below this standard. In column (5) are given the in- 
spectors' numbers of the samples which were found to contain measur- 
able amounts of dirt, viz, quantities equal to or greater than 0.07 per 
cent by volume of the milk. In column (6) are given the total num- 
ber of milks from each dairy containing measurable amounts of dirt. 

It will be seen from the totals given at the end of Table II that out 
of a total of 452 samples of milk analyzed 55 were found to be below 
standard, and of these which were found to be below standard 48 
contained less than 3.5 per cent of fat and IT gave evidence of having 
been watered. In addition to the 55 samples found to be below 
standard, 4 samples gave results indicating the probability of their 
having been watered, and 2 of the samples had probably been 
skimmed. It will also be seen from Table II that out of 452 samples 
analyzed 242 contained measurable amounts of dirt, varying from 
0.07 per cent by volume of the milk to ten times this amount, viz, 0.7 
per cent by volume. Only one of the samples out of the 452 ana- 
lyzed was found to contain preservatives. This particular sample 
contained small amounts of boric acid. None of the samples con- 
tained artificial coloring matters. The following additional facts 
concerning certain of these samples are not without interest in this 
connection: Samples 148B, 235B, 240B, 241B, 280B, 297B, 1C, 2C, 
8C, 44C, 58C, and 60C were put up in bottles containing stale milk. 
Samples 48A, 196B, 203B, 216B, and 237B were put up in dirty bottles. 
Feces were found in sample HOB, grass in sample 121B, pieces of 
straw in samples 51A, 57B, 144B, 154B, 169B, 215B, and 220B. 
Pieces of hair were found in samples 49A, 77B, 147B, 181B, and 198B. 
A blue substance, probably laundry bluing, was found in sample 155B ; 
45276°— Bull. 56—12 26 



402 

and pieces of leaves in samples 121B and 196B ; and one or more dead 
flies in samples 43B, 56B, and 252B. 

Samples 28A, 4B, 29B, 51B, 91B, HOB, 132B, 154B, 179B, 189B, 
199B, 208B, 234B, 247B, 248B, 255B, 277B, 21C, and 38C were found 
to contain more than 0.18 per cent of lactic acid. 

Finally a word or two should be said as to the general import of 
these adulterations of the Washington milk supply. First, the fact 
that 48 of the samples analyzed contained less than 3.5 per cent of 
fat is not in itself a matter of serious import, for the reason that the 
milk of perfectly healthy cows frequently contains less than 3.5 per 
cent of fat, and yet no one could question the value of such milk as 
a food. Then again, we note that the requirements here in the Dis- 
trict of Columbia regarding the fat content of milk are higher than 
the United States standard controlling the composition of milk 
offered for sale under the laws governing interstate commerce. This 
in itself may indicate possibly that the requirements governing the 
percentage of fat in milk within the District of Columbia are a trifle 
too high. 

As already pointed out, the watering of milk is a practice which 
should be vigorously condemned and controlled by rigorous enforce- 
ment of the law, for the reason that such practice is not only fraudu- 
lent, but also a serious menace to the health of the community by 
reason of the fact that the milk may become infected with patho- 
genic organisms as the result of the addition of polluted water, and 
ordinarily the dairyman who waters his milk does not stop to con- 
sider the character of the water which he is adding thereto. In fact 
the degree of water pollution which might seriously contaminate and 
infect a milk supply, if the water were added to the milk, would 
probably under most circumstances be exceedingly difficult to detect. 
The only way therefore to control such a situation is simply to pre- 
vent by law the addition of water to milk in any form. According 
to Atlee (15), impure water is one of the most frequent sources 
of the pollution of milk, resulting either from the addition of water 
for purposes of adulteration or from its use for washing utensils. 
Winslow (16) is also of the opinion that water is probably the most 
dangerous adulterant of milk, for the reason that the water used by 
dairymen is frequently dirty and contaminated with pathogenic 
organisms. 

From the standpoint of public health the point of chief interest 
and of the greatest importance brought out in this investigation 
is the large number of milks sold in Washington containing meas- 
urable amounts of dirt. Two hundred and forty-two samples out 



403 

of 452, or 53.5 per cent of all the samples examined, contained 0.07 
per cent, or more, of dirt by volume of the milk. Many more of 
the samples contained traces of dirt, and comparatively few were 
absolutely clean. During the summer of 1906, of 172 samples of 
milk examined in the Division of Pathology and Bacteriology of 
the Hygienic Laboratory, 98 samples were found to contain a very 
small amount of dirt. Eight contained much dirt, and 1 contained 
(mouse?) feces. (See Bulletin 35, Hygienic Laboratory, United 
States Public Health and Marine-Hospital Service, p. 71.) All 
sanitarians are agreed that milk should contain no dirt, and by the 
use of the Gurler milk pail in milking, and by taking a few simple 
precautions in the handling and preservation of milk it can certainly 
be kept out, and a good clean milk delivered to the consumer. 

The presence of dirt in such a large percentage of the samples 
examined indicates an alarming neglect of even the simplest precau- 
tions, and probably accounts for the large number of bacteria found 
in the greater number of milks on sale in the city of Washington 
during the summer months. According to Renk (quoted by Ott (5) ) , 
cow's milk should be put on the market in such a state of purity that 
after two hours' standing a liter of the milk should show no appre- 
ciable deposit. Very few of the milks offered for sale in this city 
would conform to this requirement. 

It should be observed in this connection, however, that dirty milk 
is by no means confined to this locality. Nearly every city through- 
out the world has to contend with this problem. According to some 
authorities, the citizens of Berlin consume 300 pounds of cow dung 
in their milk daily, and the citizens of New York consume 10 tons of 
filth and refuse in the same manner; and many medical authorities, 
among them Winslow (16), assert that the question of dirt and the 
bacterial contamination of milk is of infinitely greater importance 
from the standpoint of health than a high chemical standard gov- 
erning the composition of milk, for the reason that very poor milk, 
viz, that which is low in proteids, fat, and milk sugar, is still very 
valuable as a food and contains a great deal of nutriment, provided 
that it is sufficiently clean to be consumed with safety. On the other 
hand, it is now perfectly well understood that dirty milk and milk 
bacterially contaminated is not only responsible for the high death 
rate prevailing among young children from cholera infantum, but 
that polluted milk is also responsible to a large degree for the spread 
of such infections as diphtheria, scarlet fever, typhoid fever, and 
tuberculosis, and for acute cases of milk poisoning, which are by no 
means uncommon. 



404 

It is therefore not surprising that some medical authorities (IT) 
have gone so far as to express a preference for milk containing cer- 
tain antiseptics, especially small amounts of formaldehyde, to the 
germ-laden milk ordinarily supplied the consumer in cities, and, for 
that matter, in many places in the country and even on the farm. 
The following communications on the subject of impure and dirty 
milk contain suggestions of great practical value: 

" Impure milk and its evils," J. H. Atlee, Trans. Med. Soc. Tenn. 1897, 54-61. 

" The clean-milk problem," Winslow, Northwest Medicine, Seattle, 1904, II, 
315-327. 

" Sources, effects, and prevention of dirty milk," Harrington, Amer. Jour. Pub. 
Hyg., 1904, 14, 31-55. 

" Certified milk and the general milk supply of Louisville," Tuley, Jour. Amer. 
Med. Assn., 1907, 49, 1344-1349. 

While it is more or less foreign to the general scope of this com- 
munication to discuss the economics of the milk question, it may 
not be amiss to point out that the production of clean, wholesome 
milk is largely a matter of cost and education. Medical authorities 
and practical dairymen and milk producers have alike, and more or 
less independently, arrived at the conclusion that clean, cold milk of 
a high grade of purity can not be sold to the consumer at less than 
from 8 to 10 cents a quart, and that in a number of instances where 
the production of such milk has been tried it had only a limited 
sale at 10 cents per quart, on account of the general apathy of even 
those persons well able to afford to pay this price. It is evident, 
therefore, that not only the dairyman, but also the general public, 
is in need of education regarding the necessity for a purer milk 
supply. It is also evident that a price of 8 to 10 cents a quart 
probably puts milk beyond the reach of the poorer classes. There 
are those who are of the opinion that pure high-grade milk can not 
be supplied to the poorer classes except by private philanthropy or 
municipal aid. 

The fact that the Washington milk supply is practically free from 
preservatives and artificial coloring matters is one point in its favor. 
Thus considerable toward its purification and betterment has already 
been accomplished by the health officer of the District by the strict 
enforcement of the law regulating this subject. I understand that 
the results of the analyses of the Washington milk supply made in 
the health office and the Bureau of Chemistry, U. S. Department of 
Agriculture, practically confirm the results reached in the Division 
of Chemistry of the Hygienic Laboratory regarding the freedom of 
the milk from preservatives and artificial coloring matters. 



405 



Table I. — Analyses of milk sold in Washington and the District of Columbia. 
[Hygienic Laboratory, Division of Chemistry, July 5, 1907, to September 28, 1907, inclusive.] 



No. of 
sam- 
ple. 


Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 
sugar. 


Acidity. 


Sedi- 
ment. 


Re- 

fracto- 
meter 
reading. 




1907. 




















1A 


July 5 


1.0288 


4.0 


14 11 


10.11 


0.58 










2A 


....do... 


1. 0335 


3.8 


13.89 


10.09 


.62 










3A 


.. .do . 


1. 0315 
1. 0308 
1. 0298 
1. 0327 
1.030 


3.6 
3.5 
4.0 
3.3 

4.4 


11.83 
12.50 
12.94 
12.72 
14 20 


8.23 

9.0 

8.94 

9.42 

9.8 


.637 

.62 

.60 

.66 

.65 










4A... . 


do ... 










5A... . 


. .do . . 










6A... 


.do . . 










7A 


July 6 






(a) 




8A 


....do... 


1.031 

1. 0256 

1. 0313 

1.030 

1.029 

1.032 

1.029 

1.033 

1.031 

1.031 


4 25 

4.3 

4.0 

4.0 

3.7 

3.9 

3.8 

3.8 

2.8 

3.8 


13.72 
12.88 
13.41 
12.49 
12.05 
8.97 
14 87 
13.59 
11.29 
12.54 


9.47 
8.58 
9.41 
8.49 
8.35 
5.07 
11.07 
9.79 
8.49 
8.74 


.62 
.70 
.81 
.64 
.61 
.68 
.67 
.60 
.64 
.71 






(a) 

None. 

( 6 ) 

( b ) 
None. 

( 6 ) 
(a) 
(a) 

None. 




9A 


....do... 








10A.... 


....do... 
....do... 








11A.... 








12A.... 


July 8 
do ... 


4 51 
4 90 
4.56 
4.99 
4 71 
4.68 




41.3 


13A.... 




40.5 


14A 


do . . 




39.5 


15A-... 


....do... 
....do... 




42.5 


16A.... 




41.0 


17A.... 


July 9 


0.133 


42.2 


18A.... 


....do... 


1.032 


3.15 


12.30 


9.15 


.70 


4.57 


.141 


( c ) 


41.5 


19A.... 


....do... 


1.032 


4.8 


14 10 


9.30 


.71 


4 06 


.153 


( c ) 


43.0 


20A-... 


....do... 


1.031 


4.4 


13.47 


9.07 


.65 


4 93 


.162 


( 6 ) 


41.7 


21A.... 


....do... 


1. 0315 


3.8 


12.40 


8.6 


.70 


4 70 


.155 


(a) 


41.26 


22A.... 


July 10 


1.030 


4.2 


15.13 


10.93 


.71 


4 76 


.134 


( b ) 


41.3 


23A.... 


....do... 


1.031 


4.8 


13.87 


9.07 


.68 


4 59 


.137 


(a) 


41.5 


24A.... 


....do... 


1. 0257 


3.1 


10.62 


7.52 


.57 


3.69 


.122 


( c ) 


36.5 


25A.... 


....do... 


1.030 


40 


12.68 


8.68 


.65 


4 67 


.141 


(a) 


41.5 


26A.... 


....do... 


1.031 


3.8 


12.35 


8.55 


.63 


4 69 


.130 


None. 


41.5 


27A.... 


July 11 


1. 0312 


44 


13.34 


8.94 


.73 


4 55 


.146 


( 6 ) 


42.4 


28A.... 


....do... 


1. 0294 


5.0 


13.83 


8.83 


.65 


4 61 


.185 


(a) 


42.25 


29A.... 


....do... 


1.031 


5.0 


14 35 


9.35 


.65 


4 90 


.158 


(») 


43.2 


30A.... 


....do... 


1. 0328 


46 


14 00 


9.40 


.68 


4.83 


.150 


( c ) 


43.5 


31A.... 


....do... 


1.031 


3.2 


12.31 


9.11 


.66 


4 63 


.141 


None. 


42.1 


32A.... 


July 12 


1.033 


3.6 


13.00 


9.4 


.75 


4 91 


.157 


( c ) 


43.5 


33A.... 


....do... 


1.029 


5.0 


13.30 


8.30 


.68 


3.97 


.135 


(a) 


40.0 


34A.... 


....do... 


1.031 


4 95 


12.23 


7.28 


.63 


4 46 


.137 


None. 


41.2 


35A.... 


....do... 


1.030 


3.8 


12.60 


8.8 


.60 


4 46 


.137 


( c ) 


41.0 


36A.... 


....do... 


1.034 


3.5 


12.49 


8.99 


.67 


5.05 


.140 


( b ) 


42.5 


37A 


do . 


1.031 


3.7 


12.92 


9.22 


.67 


4.90 


157 


( c ) 


41.2 


38 A.. . 


. do 


1.029 


48 


12.48 


7.68 


63 


4 74 


130 


40 5 


39A.... 


....do... 


1. 0284 


44 


13.52 


9.12 


.70 


4 85 


.131 


(») 


41.6 


40A.... 


July 13 


1.030 


3.8 


12.83 


9.03 


.67 


4 76 


.135 


0.13 


40.5 


41A.... 


....do... 


1.033 


3.0 


12.55 


9.55 


.59 


4.85 


.141 


.20 


41.2 


42A 


do . 


1.030 


3.7 


12.59 


8.89 


.58 


4 65 


141 




40 


43A.... 


....do... 


1.032 


42 


13.24 


9.04 


.62 


4 71 


.142 


.07 


41.3 


44A.... 


....do... 


1.033 


4.6 


13.64 


9.04 


.55 


4 91 


.178 


.07 


42.5 


45A.... 


July 15 


1.031 


46 


13.78 


9.18 


.67 


4 62 


.144 


Trace. 


42.25 


46A.... 


....do... 


1.033 


46 


14 37 


9.77 


.72 


4 60 


.137 


Trace. 


43.0 


47A.... 


July 15 


1.033 


4.4 


13.76 


9.36 


.65 


4.87 


.158 


.33 


40.5 


48Ad... 


....do... 


1.030 


3.1 


11.73 


8.63 


.60 


4.69 


.142 


.13 


44.0 


49A«... 


....do... 


1.033 


3.8 


13.0 


9.2 


.67 


4.93 


.149 


.06 


42.0 



Slight. 



b Very slight. 



c Considerable. 



d Full of dirt. 



e Contained hair. 



406 

Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 


Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 
sugar. 


Acidity. 


Sedi- 
ment. 


Re- 

fracto- 
meter 
reading. 


50A.... 


1907. 
July 15 


1.032 


3.0 


11.65 


8.65 


.61 


4.77 


.139 


.13 


42.0 


51A«... 


....do... 


1.032 


4.0 


13.44 


9.44 


.66 


5.40 


.148 


.13 


43.0 


52A.... 


July 16 


1.030 


3.4 


12.31 


8.91 


.71 


4.78 


.142 


Trace. 


41.25 


53A.... 


....do... 


1.031 


4.0 


12.89 


8.89 


.69 


4.61 


.139 


Trace. 


41.0 


54A.... 


....do... 


1.032 


3.8 


13.06 


9.26 


.69 


4.96 


.166 


.13 


43.0 


55A&... 


....do... 


1.031 


3.1 


12.26 


9.16 


.70 


4.46 


.137 


.20 


42.0 


56A.... 


....do... 


1.031 


4.2 


13.14 


8.94 


.67 


4.73 


.139 


.07 


42.0 


57A.... 


....do... 


1.029 


2.4 


11.81 


9.41 


.61 


4.44 


.128 


.27 


39.0 


58A.... 


....do... 


1.033 


4.6 


14.27 


9.67 


.67 


4.81 


.139 


Trace. 


42.5 


59A.... 


July 17 


1. 0285 


6.6 


12.89 


6.29 


•74 


4.66 


.15 


.07 


42.0 


60A.... 


....do... 


1.0303 


4.2 


13.28 


9.08 


.73 


4.55 


.140 


Trace. 


40.5 


61A.... 


....do... 


1. 0322 


4.2 


13.80 


9.60 


.73 


4.81 


.121 


Trace. 


41.4 


62A.... 


....do... 


1. 0312 


3.8 


13.12 


9.32 


.73 


4.50 


.138 


Trace. 


41.0 


63A.... 


....do... 


1.0312 


4.6 


12.49 


7.89 


.72 


4.28 


.137 


Trace. 


42.0 


64A.... 


....do... 


1. 0281 


4.0 


11.86 


7.86 


.62 


4.12 


.139 


.33 


38.5 


65A.... 


....do... 


1. 0323 


4.6 


14.20 


9.60 


= 71 


4.90 


.142 


.20 


43.0 


66A.... 


....do... 


1. 0303 


5.6 


14.15 


8.55 


.68 


4.74 


.135 


.13 


41.5 


67A,... 


July 18 


1.0289 


4.1 


12.37 


8.27 


.66 


4.30 


.139 


Trace. 


40.1 


68A.... 


....do... 


1.029 


3.4 


11.59 


8.19 


.67 


4.51 


.130 


Trace. 


39.4 


69A.... 


....do... 


1.0326 


4.8 


15.06 


10.26 


.71 


4.29 


.158 


.07 


43.5 


70A.... 


....do... 


1. 0275 


5.4 


13.13 


7.73 


.63 


4.31 


.126 


.20 


39.0 


71A.... 


....do... 


1. 0315 


4.2 


13.24 


9.04 


.67 


4.75 


.146 


.13 


42.2 


72A 


....do... 


1. 0297 
1. 0324 


5.8 
5.0 


14.49 
14.07 


8.69 
9.07 


.66 
.75 


4.78 
4.56 


.149 
.144 


.20 
.07 


41.2 


73A.... 


July 19 


42.0 


74A.... 


....do... 


1. 0315 


3.6 


12.34 


8.74 


.67 


4.75 


.137 


Trace. 


41.0 


75A.... 


....do... 


1. 0312 


4.3 


13.55 


9.25 


.69 


4.61 


.140 


.20 


41.1 


76A---- 


....do... 


1. 0323 


4.0 


13.16 


9.16 


.71 


4.94 


.135 


.33 


42.0 


77A.... 


....do... 


1. 0314 


3.7 


12.68 


8.98 


.66 


4.73 


.142 


.33 


40.5 


78A.... 


....do... 


1. 0263 


3.0 


10.12 


7.12 


.49 


3.77 


.177 


.07 


36.5 


79A.... 


July 22 


1. 0315 


3.2 


12.77 


9.57 


.71 


4.77 


.135 


.07 


41.3 


80A.... 


....do... 


1. 0319 


4.1 


13.02 


8.92 


.67 


4.48 


.137 


.26 


41.0 


81A.... 


....do... 


1. 0309 


4.6 


13.69 


9.09 


.65 


4.92 


.157 


Trace. 


41.7 


82A.... 


....do... 


1.032 


3.4 


12.21 


8.81 


.70 


4.94 


.137 


.13 


41.5 


83A.... 


....do... 


1. 0324 


4.3 


13.36 


9.06 


.67 


4.93 


.142 


Trace. 


42.0 


84A.... 


....do... 


1. 0313 


4.2 


12.61 


8.41 


.60 


4.63 


.146 


Trace. 


42.5 


85A.... 


....do... 


1. 0228 


9.2 


16.85 


7.65 


.52 


4.22 


.140 


.33 


39.5 


IB.... 


July 23 


1. 0314 


3.6 


11.80 


8.2 


.65 


4.59 


.137 


Trace. 


41.0 


2B.... 


....do... 


1.032 


5.6 


14.27 


8.67 


.65 


4.94 


.146 


Trace. 


43.0 


3B.... 


....do... 


1. 0278 


3.5 


12.81 


9.31 


.62 


4.18 


.121 


.07 


38.5 


4B.... 


....do... 


1. 0319 


4.6 


12.95 


8.35 


.68 


4.63 


.216 


.07 


41.5 


5B.... 


....do... 


1. 0315 


5.4 


13.59 


8.19 


.67 


4.63 


.153 


Trace. 


42.0 


6B.... 


....do... 


1.024 


8.0 


14.08 


6.08 


.58 


4.14 


.119 


Trace. 


37.8 


7B.... 


....do... 


1.029 


5.4 


12.83 


7.43 


.63 


4.68 


.169 


.13 


40.5 


8B.... 


July 24 


1. 0301 


4.5 


13.21 


8.71 


.66 


4.96 


.130 


Trace. 


41.5 


9B.... 


....do... 


1.030 


5.8 


14.50 


8.70 


.66 


4.91 


.139 


None. 


41.5 


10B.... 


....do... 


1. 0327 


3.9 


12.60 


8.70 


.67 


5.00 


.139 


None. 


42.5 


11.B- — 


....do... 


1.032 


4.8 


13.85 


9.05 


.60 


4.71 


.162 


Trace. 


42.0 


12B.... 


....do... 


1. 0315 


3.8 


12.73 


8.93 


.658 


4.79 


.139 


.13 


41.7 


13B.... 


....do... 


1. 0305 


4.4 


12.75 


8.35 


.67 


4.78 


.133 


.07 


41.0 


14B.... 


....do... 


1. 0315 


3.8 


12.59 


8.79 


.67 


4.48 


.137 


.07 


41.5 


15B 


July 24 


1. 0315 


4.3 


12.84 


8.54 


.67 


4.75 


.131 


Trace. 


41.1 


16B.... 


July 25 


1.032 
a Pieces 


4.4 
of stra^ 


12.79 
v. 


8.39 


.66 
bLarg 


4.69 
r e black 


.140 
particles. 


.33 


42.0 



407 

Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 


Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 

sugar. 


Acidity. 


Sedi- 
ment. 


Re- 

fracto- 
meter 
reading. 




1907. 




















17B.... 


July 25 


1. 0303 


7.2 


15.44 


8.24 


.69 


4.53 


.151 


.13 


41.5 


18B.... 


....do... 


1. 0313 


4.8 


12.96 


8.16 


.66 


4.90 


.138 


Trace. 


42.0 


19B.... 


....do... 


1. 0324 


5.0 


13.92 


8.92 


.67 


5.04 


.155 


.13 


42.5 


20B.... 


....do... 


1. 0285 


7.6 


15.00 


7.40 


.59 


4.82 


.133 


Trace. 


42.1 


21B.... 


....do... 


1. 0329 


5.4 


13.78 


8.38 


.68 


4.87 


.137 


.07 


41.0 


22B 


....do... 


1. 0309 

1.034 


4.8 
4.6 


12.71 
12.90 


7.91 
8.30 


.71 
.67 


4.69 
5.09 


.159 
.157 


None. 
.33 


41.2 


23B.... 


....do... 


43.0 


24B.... 


July 26 


1.0316 


3.4 


12.84 


9.44 


.70 


5.04 


.148 


.07 


42.0 


25B.... 


....do... 


1. 0316 


3.5 


12.13 


8.63 


.68 


4.88 


.137 


.07 


41.0 


26B . . . . 


....do... 


1.0277 


3.8 


11.61 


7.81 


.58 


4.20 


.119 


• .20 


39.0 


27B . . . . 


....do... 


1.0317 


4.8 


13.82 


9.02 


.67 


4.92 


.153 


Trace. 


40.0 


28B . . . . 


....do... 


1. 0299 


3.5 


11.67 


8.17 


.66 


4.49 


.155 


.07 


40.0 


29B.... 


....do... 


1.0278 


4.8 


12.30 


7.50 


.48 


4.20 


.241 


Trace. 


39.0 


30B.... 


....do... 


1.030 


3.4 


11.63 


8.23 


.61 


4.43 


.146 


Trace. 


40.0 


32B.... 


July 29 


1. 0309 


5.7 


15.68 


9.98 


.69 


4.86 


.133 


.33 


41.5 


33B.... 


....do... 


1. 0318 


3.4 


12.40 


9.00 


.70 


4.52 


.155 


.20 


41.5 


34B . . . . 


....do... 


1.0323 


4.3 


14.07 


9.77 


.73 


4.90 


.157 


.13 


42.0 


35B . . . . 


....do... 


1.0314 
1.0316 
1. 0326 


3.5 
4.2 
3.4 


12.43 
13.79 
12.78 


8.93 
9.59 
9.38 


.68 

.74 
.72 


4.63 
4.94 
5.00 


.150 
.148 
.158 


.26 
.13 
.26 


41.0 


36B . . . . 


....do... 


42.5 


37B.... 


....do... 


42.2 


38B.... 


....do... 


1.0315 


4.0 


13.20 


9.20 


.72 


4.59 


.173 


.20 


41.5 


39B.... 


....do... 


1.0327 


3.8 


13.15 


9.35 


.71 


5.06 


.158 


Trace. 


42.0 


40B.... 


July 30 


1.033 


5.0 


15.51 


10.51 


.70 


4.85 


.145 


.07 


42.2 


41B.... 


....do... 


1.0316 
1. 0312 


4.8 
4.0 


14.67 
13.40 


9.87 
9.40 


.63 
.67 


5.00 
4.66 


.144 
.167 


Trace. 
.07 


41.5 


42B.... 


....do... 


40.5 


43B a. . . 


....do... 


1. 0301 
1. 0301 


4.8 
3.5 


14.73 
13.09 


9.93 
9.59 


.65 
.68 


5.11 
4.55 


.153 
.133 


Trace. 
.70 


42.0 


44B.... 


....do... 


41.5 


46B.... 


....do... 


1. 0305 


4.4 


13.06 


8.66 


.66 


4.44 


.150 


.33 


41.0 


49B.... 


July 31 


1. 0323 


4.6 


14.38 


9.78 


.68 


5.06 


.166 


.13 


42.0 


50B.... 


....do... 


1.0306 


5.0 


13.91 


8.91 


.68 


4.86 


.141 


.07 


41.0 


51B 


....do... 


1. 0325 
1. 0306 
1. 0316 
1. 0288 


3.5 
4.0 
3.8 

4.2 


12.59 
12.78 
13.90 
12.40 


9.09 
8.78 
10.10 
8.20 


.67 
.70 

.67 
.57 


4.83 
5.03 
4.90 
4.51 


.184 
.169 
.155 
.146 


Trace. 

.07 
Trace. 

.07 


40.0 


52B . . . . 


....do... 


40.3 


53B . . . . 


....do... 


40.7 


54B . . . . 


Aug. 1 


39.0 


55B . . . . 


....do... 


1. 0306 


4.8 


13.33 


8.53 


.61 


4.74 


.131 


.07 


40.2 


56B6... 


....do... 


1.0288 


3.1 


10.81 


7.71 


.54 


4.77 


.139 


Trace. 


38.3 


57Bc... 


....do... 


1. 0298 


4.4 


12.85 


8.45 


.63 


4.72 


.131 


.20 


40.5 


58B . . . . 


....do... 


1. 0279 


5.5 


12.82 


7.32 


.63 


4.24 


.142 


Trace. 


39.1 


59B.... 


....do... 


1.0315 


3.8 


12.50 


8.70 


.62 


4.81 


.131 


.13 


41.0 


60B.... 


....do... 


1.0305 


5.3 


13.60 


8.30 


.66 


4.77 


.140 


None. 


41.0 


61B.... 


....do... 


1.030 


3.1 


11.36 


8.26 


.61 


4.60 


.133 




39.3 


62B.... 


Aug. 2 


1. 0339 


4.0 


13.29 


9.29 


.72 


4.91 


.176 


Trace. 


42.0 


63B . . . . 


....do... 


1.0316 


4.7 


13.14 


8.44 


■ .69 


4.91 


.146 


.07 


41.0 


64B . . . . 


....do... 


1. 0305 


3.8 


12.24 


8.44 


.67 


4.70 


.144 


.13 


40.1 


65B . . . . 


....do... 


1. 0306 


2.6 


10.77 


8.17 


.64 


4.47 


.158 




39.0 


66B.... 


....do... 


1. 0288 


3.6 


11.03 


7.43 


.58 


4.39 


.130 


None. 


39.0 


67B.... 


....do... 


1. 0317 


4.4 


13.01 


8.61 


.65 


4.81 


.148 


.07 


41.0 


68B.... 


....do... 


1.031 


4.0 


13.57 


9.57 


.67 


^4.72 


.146 


None. 


41.2 


69B.... 


....do... 


1.031 


4.6 


13.03 


8.43 


.69 


4.70 


.149 


Trace. 


41.5 


70B.... 


Aug. 5 


1. 0317 


3.3 


12.61 


9.31 


.70 


4.93 


.157 


.07 


41.5 


71B.... 


....do... 


1.0315 


4.5 


13.31 


8.81 


.69 


4.72 


.144 


.13 


42.0 


72B.... 


....do... 


1.0325 


4.4 


13.28 


8.88 


.70 


4.87 


.149 


Trace. 


41.5 



a Two dead flies. 



1 Dead fly. 



c Pieces of straw. 



408 

Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 


Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 
sugar. 


Acidity. 


Sedi- 
ment. 


Re- 

fracto- 
rneter 
reading. 




1907. 




















73B.... 


Aug. 5 


1. 0316 


4.0 


12.71 


8.71 


.68 


4.74 


.155 


.07 


41.0 


74B.... 


....do... 


1. 0327 


3.4 


12.38 


8.98 


.72 


4.51 


.144 


Trace. 


41.2 


75B . . . . 


....do... 


1. 0309 


4.2 


12.74 


8.54 


.63 


4.74 


.128 


Trace. 


41.0 


76B.... 


....do... 


1.031 


5.5 


14.05 


8.55 


.69 


4.70 


.137 


.07 


41.0 


77Ba .. 


....do... 


1.0319 


3.6 


12.52 


8.92 


.64 


4.77 


.164 


Trace. 


41.5 


78B . . . . 


Aug. 6 


1. 0313 


3.8 


13.43 


9.63 


.75 


5.12 


.167 


None. 


41.0 


79B.... 


....do... 


1.030 


4.2 


11.92 


7.72 


.61 


4.85 


.133 


.07 


39.0 


80B.... 


....do... 


1.0309 


5.5 


14.39 


8.89 


.64 


5.05 


.157 


.13 


42.0 


81B.... 


....do... 


1. 0269 


4.8 


11.84 


7.04 


.54 


4.20 


.117 


.13 


39.0 


82B.... 


....do... 


1. 0305 


3.6 


12.20 


8.60 


.62 


4.60 


.142 


.20 


40.0 


83B . . . . 


....do... 


1.0289 


4.0 


12.05 


8.05 


.58 


4.32 


.146 


.07 


39.0 


84B . . . . 


....do... 


1. 0269 


3.0 


10.25 


7.25 


.53 


3.95 


.130 


.13 


36.5 


85B . . . . 


....do... 


1.031 


5.2 


13.62 


8.42 


.73 


4.18 


.131 


.07 


41.0 


86B.... 


Aug. 7 


1. 0325 


4.7 


13.54 


8.84 


.64 


4.79 


.160 


.13 


41.5 


87B . . . . 


....do... 


1. 0327 


5.9 


15.31 


9.41 


.64 


5.08 


.166 


.07 


43.0 


88B . . . . 


....do... 


1. 0308 


3.7 


12.30 


8.60 


.63 


4.81 


.150 


.07 


40.3 


89B . . . . 


....do... 


1.032 


4.2 


13.00 


8.80 


.63 


4.77 


.158 


Trace. 


41.2 


90B.... 


....do... 


1. 0325 


3.8 


12.83 


9.03 


.61 


4.87 


.167 


Trace. 


42.0 


91B.... 


....do... 


1.031 


5.3 


13.67 


8.37 


.68 


4.49 


.205 


.13 


41.2 


92B.... 


....do... 


1.032 


4.3 


12.88 


8.58 


.65 


4.64 


.167 


.07 


41.5 


93B . . . . 


....do... 


1.031 


4.0 


12.45 


8.45 


.73 


4.81 


.135 


Trace. 


41.0 


94B . . . . 


Aug. 8 


1. 0313 


4.6 


13.48 


8.88 


.70 


4.66 


.149 


.07 


40.5 


95B . . . . 


....do... 


1. 0291 


4.8 


13.21 


8.41 


.58 


4.49 


.137 


Trace. 


38.5 


96B . . . . 


....do... 


1. 0322 


4.6 


13.64 


9.04 


.65 


5.01 


.159 


.13 


41.0 


97B.... 


....do... 


1. 0332 


4.2 


13.42 


9.22 


.65 


5.18 


.153 


Trace. 


42.0 


98B.... 


....do... 


1.0313 


4.3 


12.91 


8.61 


.65 


4.83 


.137 


Trace. 


41.0 


99B . . . . 


....do... 


1. 0335 


3.4 


12.30 


8.90 


.68 


4.77 


.151 


.07 


42.0 


100B... 


....do... 


1. 0305 


4.5 


13.05 


8.55 


.69 


4.70 


.151 


.13 


41.0 


101B... 


....do... 


1. 0326 


4.4 


13.04 


8.64 


.65 


5.10 


.149 


.20 


42.0 


102B... 


Aug. 9 


1. 0332 


4.4 


13.49 


9.09 


.68 


4.87 


.153 


Trace. 


42.5 


103B... 


....do... 


1. 0308 


4.2 


12.67 


8.47 


.61 


4.43 


.142 


.07 


40.0 


104B... 


....do... 


1.0319 


4.2 


13.20 


9.00 


.62 


4.32 


.149 


.07 


40.5 


105B... 


....do... 


1. 0315 


4.1 


13.12 


9.02 


.70 


4.68 


.144 


Trace. 


41.0 


106B... 


....do... 


1.031 


3.4 


12.09 


8.69 


.65 


4.74 


.155 


.07 


41.0 


107B... 


....do... 


1.031 


4.6 


13.39 


8.79 


.63 


4.74 


.148 


None. 


41.0 


108B... 


....do... 


1. 0315 


3.4 


12.95 


9.55 


.64 


4.60 


.158 


.07 


41.1 


109B... 


....do... 


1. 0301 


4.3 


11.59 


7.29 


.66 


4.28 


.130 


.07 


40.0 


HOB b . 


Aug. 12 


1. 0303 


3.8 


11.79 


7.99 


.62 


4.79 


.230 


Trace. 


40.0 


111B... 


....do... 


1. 0314 


3.8 


12.43 


8.63 


.66 


4.83 


.157 


.07 


41.0 


112B... 


....do... 


1. 0314 


3.6 


12.44 


8.84 


.62 


4.79 


.149 


.07 


40.0 


113B... 


....do... 


1.0314 


7.0 


14.92 


7.92 


.71 


4.62 


.139 


.33 


41.0 


114B... 


....do... 


1. 0253 


5.9 


14.06 


8.16 


.59 


4.20 


.131 


.20 


38.0 


115B... 


....do... 


1. 0329 


4.4 


13.29 


8.89 


.67 


4.77 


.148 


.07 


41.5 


116B... 


....do... 
....do... 


1. 0317 
1. 0327 


3.6 
4.2 


12.14 
13.41 


8.54 
9.21 


.61 
.51 


4.70 
5.16 


.158 
.167 




41.0 


117B... 


.33 


42.0 


119B... 


Aug. 13 


1. 0271 


2.9 


10.46 


7.56 


.64 


3.97 


.129 


.07 


36.5 


120B... 


....do... 


1.032 


4.0 


12.99 


8.99 


.69 


4.91 


.151 


Trace. 


40.1 


121B <- . 


....do... 


1.031 


4.1 


12.58 


8.48 


.70 


4.74 


.139 


None. 


39.5 


122B... 


....do... 


1.033 


4.6 


* 13. 74 


9.14 


.73 


4.79 


.146 


None. 


42.0 


123B... 


....do... 


1.030 


4.0 


12.71 


8.71 


.72 


4.54 


.146 


.20 


41.5 


124B... 


....do... 


1. 0312 


3.8 


13.13 


9.33 


. -75 


4.74 


.144 


.13 


41 


126B... 


....do... 


1. 0301 


4.2 


12.88 


8.68 


.71 


4.99 


.133 


None. 


41.0 




a] 


lair. 




& Containe 


d feces. 




cCo 


ntained gi 


ass. 





409 

Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 


Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 
sugar. 


Acidity. 


Sedi- 
ment. 


Re- 

fracto- 

meter 

reading. 


127B... 


1907. 

Aug. 14 


1.0298 


4.2 


12.67 


8.47 


.65 


4.64 


.158 


.13 


41.0 


128B... 


....do... 


1. 0314 


4.0 


13.04 


9.04 


.70 


4.87 


.162 


.33 


41.5 


129B... 


....do... 


1.0303 


5.0 


14.07 


9.07 


.64 


4.87 


.140 


Trace. 


41.0 


130B... 


....do... 


1.030 


3.5 


12.10 


8.60 


.66 


4.64 


.149 


.07 


40.0 


131B... 


....do... 


1. 0294 


4.8 


13.36 


8.56 


.63 


4.81 


.158 


.27 


41.0 


132B . . . 


....do... 


1. 0285 


6.8 


14.83 


8.03 


.62 


4.22 


.204 


.13 


42.0 


133B . . . 


Aug. 14 


1. 0332 


4.0 


13.39 


9.39 


.69 


4.66 


.144 


Trace. 


43.0 


134B . . . 


....do... 


1.0215 


19.0 


21.79 


2.79 


.57 


4.77 


.157 


.33 


42.5 


135B... 


Aug. 15 


1.0308 


3.6 


12.03 


8.43 


.68 


4.70 


.144 


.13 


40.0 


136B . . . 


....do... 


1. 0285 


3.6 


12.18 


8.58 


.69 


4.62 


.166 


.07 


40.2 


137B . . . 


....do... 


1.0314 


4.4 


12.24 


7.84 


.62 


4.39 


.122 


.20 


38.5 


138B... 


....do... 


1.0296 


2.6 


10.30 


7.70 


.66 


4.64 


.140 




38.0 


139B... 


....do... 


1.0315 


3.5 


12.27 


8.77 


.71 


4.60 


.140 


.33 


40.0 


140B... 


....do... 


1. 0325 


4.5 


13.27 


8.77 


.72 


4.87 


.160 




42.0 


141B... 


....do... 
....do... 


1. 0312 
1.0298 


4.4 
3.6 


13.06 
11.69 


8.63 
8.09 


.67 

.62 


4.74 
4.74 


.171 
.142 




41.8 


142B... 




40.0 


144B a . 


Aug. 16 


1. 0271 


8.7 


16.59 


7.89 


.60 


4.41 


.173 


.13 


41.0 


145B... 


....do... 


1.0327 


4.4 


13.67 


9.27 


.62 


5.23 


.166 


None. 


42.0 


146B . . . 


....do... 


1. 0327 


5.4 


14.62 


9.22 


.66 


5.23 


.142 


.26 


42.0 


147B&.. 


....do... 


1.0339 


4.0 


13.44 


9.44 


.62 


5.18 


.166 


.13 


42.2 


148B c._ 


....do... 


1. 0278 


3.6 


11.65 


8.05 


.55 


4.74 


.131 


Trace. 


41.5 


149B . . . 


....do... 


1.0308 


4.2 


12.73 


8.53 


.55 


4.91 


.142 


Trace. 


39.0 


150B . . . 


....do... 


1. 0298 


4.4 


12.78 


8.38 


.51 


4.64 


.146 


.13 


39.0 


152B . . . 


....do... 


1.0299 


4.7 


12.72 


8.02 


.54 


4.72 


.149 


.0 r < 


39.2 


153B... 


Aug. 19 


1. 0305 


3.8 


12.51 


8.71 


.65 


4.83 


.142 


.0/ 


41.2 


154Ba.. 


....do... 


1. 0293 


4.2 


12.40 


8.20 


.654 


4.54 


.248 


.13 


40.5 


155B<*.. 


....do... 


1.0314 


3.6 


12.48 


8.88 


.66 


4.74 


.144 


.13 


40.3 


156B... 


....do... 


1. 0294 


3.6 


11.88 


8.28 


.60 


4.66 


.142 


.07 


40.0 


157B... 


....do... 


1. 0305 


3.8 


12.24 


8.44 


.716 


4.72 


.133 


Trace. 


39.0 


158B... 


....do... 


1. 0286 


3.8 


11.31 


7.51 


.57 


4.41 


.135 


.07 


40.0 


159B . . . 


....do... 


1. 0315 


3.6 


12.426 


8.826 


.67 


4.72 


.148 


.13 


41.0 


160B . . . 


....do... 


1. 0315 


3.6 


12.45 


8.85 


.638 


4.91 


.151 


.07 


42.0 


161B . . . 


Aug. 20 


1.032 


3.7 


12.46 


8.76 


.66 


5.08 


.153 


.07 


41.0 


162B... 


....do... 


1.032 


4.6 


13.66 


9.06 


.70 


4.95 


.144 


.20 


41.2 


163B... 


....do... 


1.033 


4.4 


13.31 


8.91 


.694 


5.08 


.157 


.07 


42.0 


164B . . . 


....do... 


1.0315 


4.2 


13.12 


8.92 


.714 


4.97 


.149 


Trace. 


41.5 


165B . . . 


....do... 


1.032 


3.8 


12. 926 


9.126 


.716 


4.89 


.153 


.53 


41.0 


166B... 


....do... 


1.033 


4.6 


13.54 


8.94 


.66 


5.14 


.135 


.07 


42.0 


167B . . . 


....do... 


1.031 


4.2 


12.71 


8.51 


.69 


4.87 


.131 


.07 


40.8 


168B... 


....do... 


1.030 


5.3 


13.67 


8.37 


.69 


4.93 


.140 


None. 


41.0 


169B«.. 


Aug. 21 


1. 0299 


4.0 


12.70 


8.70 


.73 


4.45 


.139 


.20 


40.0 


171B... 


....do... 


1.031 


4.1 


13.15 


9.05 


.71 


4.97 


.140 


.07 


41.0 


172B... 


....do... 


1. 0325 


3.8 


13.04 


9.24 


.66 


5.16 


.149 


.13 


41.0 


173B... 


....do... 


1.031 


3.0 


12.07 


9.07 


.67 


4.70 


.139 


.40 


40.2 


174B... 


....do... 


1.031 


3.6 


12.70 


9.10 


.70 


5.03 


.151 


.07 


40.6 


175B... 


....do... 


1. 0308 


3.8 


12.58 


8.78 


.72 


4.77 


.139 


Trace. 


41.0 


176B... 


....do... 


1.0268 


5.3 


13.66 


8.36 


.53 


4.49 


.155 


Trace. 


39.0 


178B... 


Aug. 22 


1.031 


6.1 


14.88 


8.78 


.65 


5.01 


.133 


.07 


43.0 


179B... 


....do... 


1.035 


4.8 


14.27 


9.47 


.69 


5.33 


.190 


Trace. 


42.3 


180B... 


....do... 


1. 0306 


4.7 


13.11 


8.41 


.63 


4.91 


.133 


Trace. 


41.5 


181B6.. 


....do... 


1. 0316 


4.2 


12.83 


8.63 


.68 


5.12 


.173 


Trace. 


42.2 


oC( 


mtained s 


traw. b ( 


Fontaine 


d hair. 


; Stale mil 


k in bot 


tie. d 1 


31ue subst 


ance in be 


ttle. 



410 

Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 



ple 



Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


Ash. 


Milk 
sugar. 


Acidity. 


Sedi- 
ment. 


1907. 


















Aug. 22 


1.0302 


5.4 


14.13 


8.73 


.66 


4.87 


.158 


.13 


...do... 


1.0308 


4.3 


12. 474 


8.174 


.654 


4.62 


.142 


.07 


...do... 


1.0321 


4.2 


12.90 


8.70 


.69 


4.74 


.148 


.07 


...do... 


1. 0312 


3.8 


12.44 


8.64 


.69 


4.81 


.148 


.13 


Aug. 23 


1. 0336 


4.0 


13. 088 


9.088 


.72 


4.99 


.153 


Trace. 


...do... 


1.0298 


4.2 


12. 658 


8.458 


.67 


4.70 


.142 


.07 


...do... 


1. 0313 


4.0 


12.76 


8.76 


.69 


4.66 


.149 


.07 


...do... 


1. 0309 


3.8 


12.16 


8.36 


.69 


4.70 


.198 


.13 


...do... 


1.032 


4.8 


13. 634 


8.834 


.77 


4.91 


.146 


.13 


...do... 


1.0306 


4.8 


12.96 


8.16 


.70 


4.22 


.106 


.26 


Aug. 23 


1.0255 


6.0 


12.38 


6.38 


.60 


3.91 


.130 


.07 


...do... 


1. 0321 
1. 0294 


4.2 
4.6 


12.90 
12.54 


8.70 
7.94 


.67 
.67 


4.83 


.149 
.135 




Aug. 26 


.26 


...do... 


1.0325 


4.4 


13.33 


8.93 


.74 




.149 


.33 


...do... 


1.035 


5.7 


14.37 


8.67 


.70 




.160 


Trace. 


...do... 


1. 0326 


4.0 


12.91 


8.91 


.72 




.151 


.07 


...do... 


1. 0318 


5.0 


14.03 


9.03 


.70 




.135 


.08 


...do... 


1.033 


4.2 


13.59 


9.39 


.69 




.189 


Trace. 


...do... 


1.031 


5.6 


14.26 


8.66 


.57 




.165 


None. 


...do... 


1. 0314 


4.0 


12.68 


8.68 


.68 




.140 


.20 


Aug. 27 


1. 0305 


4.0 


12.63 


8.63 


.70 




.156 


.07 


...do... 


1. 0287 


3.8 


11.67 


7.87 


.66 




.120 


.33 


...do... 


1. 0315 


4.4 


13.17 


8.77 


.66 




.144 


.07 


.. .do... 


1. 0325 


3.9 


13.15 


9.25 


.71 




.171 


.13 


...do... 


1. 0305 


4.0 


12.54 


8.54 


.71 




.140 


.07 


...do... 


1. 0305 


4.0 


12.73 


8.73 


.61 




.151 


.13 


...do... 


1.0317 


5.0 


14.04 


9.04 


.76 




.182 


Trace. 


...do... 


1. 0291 


3.8 


12.01 


8.21 


.67 




.149 


.20 


Aug. 28 


1. 0294 


6.3 


13.94 


7.64 


.79 




.157 


None. 


...do... 


1. 0308 


5.0 


12.75 


7.75 


.69 




.153 


.13 


...do... 


1. 0283 


4.6 


11.78 


7.18 


.59 




.137 


Trace. 


...do... 


1.0314 


6.0 


13.99 


7.99 


.68 




.144 


None. 


...do... 


1. 0319 


4.6 


13.00 


8.40 


.71 




.146 


.07 


...do... 


1. 0304 


5.2 


12.99 


7.79 


.71 




.148 


.13 


...do... 


1. 0314 


5.6 


13.56 


7.96 


.76 




.155 


.13 


...do... 


1.0286 


4.3 


11.73 


7.43 


.63 




.155 




Aug. 29 


1.031 


4.5 


13.35 


8.85 






.149 


.07 


...do... 


1.031 
1. 0325 


3.4 
3.5 


11.92 
12.31 


8.52 
8.81 






.142 
.149 


.07 
.07 


...do... 


.73 




...do... 


1. 0307 


4.0 


12.20 


8.20 


.69 




.124 


Trace. 


...do... 


1.0295 


3.2 


11.19 


7.99 


.66 




.126 


.07 


...do... 


1. 0309 


4.0 


12.72 


8.72 


.69 




.149 


.07 


...do... 


1. 0308 


4.6 


13.49 


8.89 


.65 




.157 


Trace. 


...do... 


1. 0309 


4.9 


13.75 


8.85 


.70 




.139 


Trace. 


Aug. 30 


1.031 


4.6 


13.24 


8.64 


.72 




.156 


.07 


...do... 


1. 0294 


4.5 


12. 47 


7.97 


.66 




.125 


.07 


...do... 


1. 0315 


4.2 


12.74 


8.54 


.70 




.129 


.33 


...do... 


1.033 


4.2 


12.03 


7.83 


.68 




.149 


Trace. 


...do... 


1.030 


3.0 


11.87 


' 8.87 


.67 




.131 


.13 


...do... 


1. 0319 


3.8 


12.47 


8.67 


.69 




.135 


.07 


...do... 


1. 0334 


4.0 


13.20 


9.20 


.72 




.158 


Trace. 



Re- 

fracto- 

meter 

reading. 



182B.. 
183B.. 
184B.. 
185B.. 
186B.. 
187B.. 
188B.. 
189B.. 
190B.. 
191B.. 
192Ba.. 
193B... 
194B... 
195B... 
196B&.. 
197B... 
198B c.. 
199B... 
200B... 
201B... 
202B... 
203Bd.. 
204B... 
205B... 
206B.. 
207B . . . 
208B... 
209B... 
210B... 
211B... 
212B... 
213B... 
214B... 
215B «.. 
216B<*.. 
217B... 
218B... 
219B... 
220B/.. 
221B... 
222B... 
223B... 
224B... 
225B.. 
226B.. 
227B.. 
228B.. 
229B.. 
230B-. 
231B.. 
232B.. 



a Traces of bcric acid. 

b Dirty bottle and pieces of leaves. 



c Contained hair. 
d Dirty bottle. 



« Contained straw. 
/ Straw. 



411 



Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 



Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


1907. 










Aug. 30 


1.030 


5.0 


13.28 


8.28 


Sept. 3 


1.0323 


3.5 


12.27 


8.77 


....do... 


1. 0323 


4.1 


12.99 


8.89 


....do... 


1.0317 


4.5 


13.32 


8.82 


....do... 


1. 0308 


5.0 


13.70 


8.70 


....do... 


1. 0327 


4.4 


13.45 


9.05 


....do... 


1.0317 


4.9 


13.95 


9.05 


....do... 


1.0311 


4.4 


13.05 


8.65 


....do... 


1.0313 


4.2 


12.86 


8.66 


Sept. 4 


1. 0305 


4.7 


13.26 


8.56 


....do... 


1.0309 


4.1 


12.64 


8.54 


....do... 


1.032 


4.0 


13.05 


9.05 


....do... 


1. 0327 


4.2 


13.21 


9.01 


....do... 


1.033 


5.2 


14.39 


9.19 


....do... 


1-0315 


3.6 


12.19 


8.59 


....do... 


1.031 


3.5 


11.95 


8.45 


....do... 


1. 0327 


3.8 


12.74 


8.94 


Sept. 5 


1.0281 


3.8 


11.60 


7.80 


....do... 


1.0334 


4.0 


13.15 


9.15 


....do... 


1.029 


3.4 


11.33 


7.93 


....do... 


1.032 


3.8 


12.68 


8.88 


....do... 


1.032 


4.4 


13.40 


9.00 


....do... 


1.033 


4.8 


13.91 


9.11 


....do... 


1.031 


3.4 


11.83 


8.43 


....do... 


1.028 


3.8 


11.35 


7.55 


Sept. 6 


1.032 


3.6 


12.44 


8.84 


....do... 


1. 0325 


4.3 


13.41 


9.11 


....do... 


1. 0295 


3.4 


11.40 


8.00 


....do... 


1.0314 


4.6 


13.37 


8.77 


....do... 


1. 0326 


3.6 


12.47 


8.87 


....do... 


1. 0296 


3.9 


12.08 


8.18 


....do... 


1.0315 


4.1 


12.80 


8.70 


....do... 


1.031 


4.6 


13.27 


8.67 


Sept. 9 


1. 0323 


3.8 


12.73 


8.93 


....do... 


1.033 


3.8 


12.81 


9.01 


....do... 


1. 0335 


3.9 


13.05 


9.15 


....do... 


1. 0276 


3.6 


11.36 


7.76 


....do... 


1.032 


3.6 


12.32 


8.72 


....do... 


1. 0329 


4.0 


13.02 


9.02 


....do... 


1.033 


3.8 


12.81 


9.01 


....do... 


1.031 


4.8 


13.51 


8.71 


Sept. 10 


1. 0334 


3.0 


11.95 


8.95 


....do... 


1. 0324 


4.0 


12.90 


8.90 


....do... 


1.0325 


4.2 


13.16 


8.96 


....do... 


1. 0316 


3.5 


12.10 


8.60 


....do... 


1.0305 


3.6 


11.94 


8.34 


....do... 


1.031 


4.4 


12.55 


8.15 


....do... 


1.0333 


3.2 


12.16 


8.96 


Sept. 11 


1. 0334 


3.6 


12.57 


8.97 


....do... 


1.0325 


4.2 


13.19 


8.99 


....do... 


1.0308 


3.2 


11.77 


8.57 


....do... 


1.0323 


3.5 


12.27 


8.77 



Ash. 



Milk 
sugar. 



Acidity. 



Sedi- 
ment. 



Re- 

fracto- 

meter 

reading. 



233B . . 

234B . . 

235Ba. 

236B... 

237Bo.. 

238B... 

239B... 

240Ba.. 

241Ba.. 

242B . . . 

243B... 

244B... 

245B... 

246B... 

247B... 

248B... 

249B... 

251B... 

252B b . 

253B... 

254B... 

255B... 

256B... 

257B... 

258B... 

259B... 

260B... 

261B... 

262B... 

263B... 

264B... 

265B... 

266B... 

267B... 

268B... 

269B... 

270B... 

271B... 

272B... 

273B... 

274B.. 

275B... 

276B.. 

277B . . 

278B . . 

279B . . 

280Bc 

281B.. 

285B . . 

286B . . 

287B.. 

288B.. 



,62 



.50 



654 



132 
198 



.148 
.173 
.171 
.157 
.162 
.162 
.167 
.164 
.155 
.155 



a Stale milk in bottle. 



Dead fly. 



.178 
.135 
.173 
.135 
.162 
.228 
.144 
.140 
.124 
.162 
.142 
.142 
.135 
.144 
.136 
.128 
.140 
.153 
.178 
.148 
.131 
.141 
.149 
.160 
.149 
.164 
.157 
.409 
.151 
.139 
.146 
.149 
.164 
.160 
.142 
.180 
c Stale milk in 



Trace. 

.07 

Trace. 



.07 
.07 

Trace. 
.13 
.20 
.07 

Trace. 

Trace. 



.13 

.07 
. .07 
Trace. 
Trace. 

.07 

.07 
Trace. 
Trace. 

.07 
Trace. 

.13 
Trace. 

.60 

.13 
None. 

.07 
None. 
None. 

.13 

.20 

.13 
Trace. 
Trace. 

.07 
Trace. 
Trace. 

.07 
None. 

.07 
Trace. 
Trace. 
None. 
Trace. 

.07 
None. 
Trace. 
Trace. 
None, 
bottle. 



412 



Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



No. of 
sam- 
ple. 



Date. 



Specific 
gravity. 



Fat. 



Total 
solids. 



Solids 
not fat. 



Ash. 



Milk 
sugar. 



Acidity. 



Sedi- 
ment. 



Re- 
fracto- 
meter 
reading. 



289B.. 
290B.. 
291B.. 
293B.. 
294B.. 
295B . . 
296B.. 
297B a. 
298B.. 
299B.. 
300B.. 
301B.. 
303B.. 
304B.. 
305B.. 
306B.. 
307B.. 
308B.. 
309B.. 
310B . . 
311B.. 
312B.. 
313B.. 
314B.. 
315B.. 
316B.. 
317B.. 
318B.. 
lO... 
2Ca... 
3C... 
4C... 
5C... 
6C... 
7C... 
80 .. 
9C... 
IOC... 
11C... 
12C . . . 
13C . . . 
14C . . . 
15C . . . 
16C . . . 
18C . . . 
20C . . . 
21C . . . 
22C . . . 
23C . . . 
24C... 
25C... 
26C... 



1907. 

Sept. 11 
....do... 
....do... 
....do... 

Sept. 12 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 

Sept. 13 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 

Sept. 16 
....do... 

Sept. 16 
....do... 
....do... 
....do... 
....do... 
....do... 

Sept. 18 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 

Sept. 19 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 

Sept. 20 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 
....do... 



1. 0325 
1. 0271 

1. 0327 
1.0325 
1.033 
1. 0298 
1. 0325 
1.032 
1.0276 
1. 0275 
1.032 
1.029 
1.0325 
1.0321 
1.0311 
1.0317 

1. 0328 
1. 0279 
1.030 
1.030 
1.026 
1.031 
1.026 
1.035 
1. 0336 
1.030 
1.031 
1. 0321 
1.031 
1.0291 
1. 0281 
1. 0293 
1. 0319 
1. 0314 
1. 0308 
1.0333 
1.027 
1.0312 
1. 0298 
1.0246 
1.0296 
1.032 
1. 0295 
1. 0308 
1. 0269 
1.0319 
1.0304 
1. 0264 
1.0275 
1.0327 
1. 0307 
1.0244 



4.4 
3.0 
3.6 
4.6 
3.2 
3.5 
3.7 
4.4 
5.8 
4.0 
3.8 
3.6 
4.4 
4.0 
4.2 
3.7 
4.2 
4.8 
4.4 
3.8 
8.9 
3.8 
3.2 
2.6 
3.5 
4.2 
4.5 
5.0 
4.6 
3.8 
3.6 
5.0 
3.8 
4.4 
4.8 
3.7 
3.8 
4.7 
4.1 
3.5 
3.5 
4.1 
4.2 
5.6 
4.8 
3.5 
5.0 
3.3 
4.6 
3.8 
4.4 
3.6 



13.40 
10.92 
12.49 
13 ; 64 
12.09 
11.65 
12.56 
13.28 
13.86 
11.67 
12.56 
11.57 
13.40 
13.05 
12.81 
12.35 
13.24 
12.73 
12.78 
12.06 
17.18 
12.31 
10.21 
11.87 
12.60 
12.54 
13.15 
14.02 
13.27 
11.83 
11.34 
13.31 
12.54 
13.18 
13.46 
12.76 
11.48 
13.45 
12.37 
10.31 
11.60 
12.92 
12.32 
14.42 
12.66 
12.18 
13.60 
10.94 
12.40 
12.74 
12.96 
10.44 

a Stale 



9.00 
7.92 
8.89 
9.04 
8.89 
8.15 



8.06 
7.67 
8.76 
7.97 
9.00 
9.05 
8.61 
8.65 
9.04 
7.93 
8.38 
8.26 
8.28 
8.51 
7.01 
9.27 
9.10 
8.34 
8.65 
9.02 
8.67 
8.03 
7.74 
8.31 
8.74 
8.78 
8.66 
9.06 
7.68 
8.75 
8.27 
6.81 
8.10 
8.82 
8.12 
8.82 
7.86 
8.68 
8.60 
7.64 
7.80 
8.94 
8.56 
6.84 



514 



,04 



52 



146 
133 
148 
162 
144 
122 
139 
144 
142 
131 
147 
,136 
,129 
,157 
,148 
,149 
.151 
,128 
,151 
.157 
.144 
.139 
.119 
.115 
.167 
.137 
.135 
.160 
.149 
.122 
.122 
.113 
.175 
.135 
.131 
.166 
.115 
.133 
.140 
.104 
.130 
.149 
.139 
.126 
.137 
.146 
.181 
.124 
.131 
.158 
.142 
.099 



Trace. 
.07 
.07 

Trace. 

Trace. 
.13 
.07 
.07 

None. 
.07 

Trace. 

Trace. 

Trace. 
.13 

None. 

Trace. 

Trace. 

None. 

None. 
.07 

Trace. 

Trace. 
.07 
.07 
.07 
.07 
.13 

None. 
.07 
.07 

Trace. 
.13 

Trace. 
.07 

Trace. 

Trace. 
.07 
.07 
.07 
.07 
.07 

Trace. 
.07 
.13 
.07 
.07 
.07 

Trace. 

Trace. 

Trace. 

Trace. 

Trace. 



milk in bottle. 



413 



Table I. — Analyses of milk sold in Washington and the District of Columbia — Cont'd. 



Date. 


Specific 
gravity. 


Fat. 


Total 
solids. 


Solids 
not fat. 


1907. 










Sept. 23 


1.031 


3.4 


11.84 


8.44 


....do... 
....do... 
....do... 
....do... 


1. 0314 
1. 0323 
1.0298 
1.0257 


3.6 
4.0 
5.2 
3.2 


12.18 
12.88 
13.69 
10.28 


8.58 
8.88 
8.49 
7.08 


....do... 


1.0315 


4.8 


1418 


9.38 


....do... 


1. 0347 


4.4 


14.46 


10.06 


....do... 


1.032 


4.2 


11.84 


7.64 


Sept. 24 


1.0315 


4.2 


12.92 


8.72 


....do... 


1. 0319 


3.8 


12.54 


8.74 


....do... 


1.0309 


4.7 


13.37 


8.67 


....do... 


1.0349 


3.9 


13.41 


9.51 


....do... 


1. 0319 


4.3 


13.14 


8.84 


....do... 


1. 0284 


5.4 


13.58 


8.18 


....do... 


1. 0327 


3.5 


12.38 


8.88 


....do... 


1.032 


3.6 


12.32 


8.72 


Sept. 25 


1.033 


4.2 


13.29 


9.09 


....do... 


1. 0313 


4.2 


12.87 


8.67 


....do... 


1. 0336 


4.6 


13.92 


9.32 


....do... 


1. 0274 


4.1 


11.77 


7.67 


....do... 


1.0309 


4.2 


12.77 


8.57 


....do... 


1. 0317 


4.5 


13.33 


8.83 


....do... 


1.0297 


4.7 


13.07 


8.37 


....do... 


1.033 


4.8 


14.01 


9.21 


Sept. 26 


1.0327 


4.2 


13.22 


9.02 


....do... 


1. 0318 


4.0 


12.75 


8.75 


....do... 


1.0295 


4.0 


12.18 


8.18 


....do... 


1. 0304 


4.4 


12.88 


8.48 


....do... 


1.0288 


3.1 


10.93 


7.83 


....do... 


1. 0334 


47 


13.99 


9.29 


....do... 


1. 0303 


4.9 


13.46 


8.56 


....do... 


1.0303 


3.8 


12.15 


8.35 


Sept. 27 


1. 0329 


5.0 


14.23 


9.23 


....do... 


1.0334 


4.5 


13.76 


9.26 


....do... 


1.0314 


46 


13.38 


8.78 


....do... 


1.0334 


4.2 


13.39 


9.19 


....do... 


1.033 


4.0 


13.06 


9.06 


....do... 


1.032 


4.4 


13.28 


8.88 


....do... 


1.031 


4.9 


13.64 


8.74 


....do... 


1. 0321 


6.3 


15.59 


9.29 



Ash. 



Milk 
sugar. 



Acidity. 



.142 
.171 
.129 
.146 
.120 
.165 
.165 
.151 
.146 
.158 
.128 
.212 
.151 
.166 
.157 
.178 
.155 
.151 
.157 
.124 
.158 
.149 
.128 
.155 
.160 
.158 
.140 
.137 
.124 
.153 
.128 
.144 
.157 
.175 
.140 
.175 
.160 
.171 
.131 
.167 



Sedi- 
ment. 



Trace. 
.07 
.07 



Trace. 
.07 
.07 

Trace. 

Trace. 



.07 
None. 

.07 
None. 
None. 
Trace. 

.07 
Trace. 
None. 
None. 
Trace. 
None. 

.07 
None. 
Trace. 
Trace. 
None. 

.07 
Trace. 
None. 

.07 

.07 
Trace. 

.07 

.13 
Trace. 
Trace. 
None. 

.07 
Trace. 



Re- 

fracto- 

meter 

reading. 



o Stale milk in bottle. 



414 



Table II. — Showing Washington milks below standard, and those containing dirt, as 
previously reported to the health department. 

[The sample-numbers are those assigned by the D. C. Health Office. Each particular group of num- 
bers represents all of the samples examined from any particular dairy.] 



Sample numbers (D. C. health 
office) of milks examined. 



Total 
num- 
ber of 
milks 
exam- 
ined. 



Milks found below- 
standard. 



Total 
num- 
ber of 
milks 
below- 
stand- 
ard. 



Milks containing dirt. 



Total 
num- 
ber of 
milks 

con- 
taining 

dirt. 



27 A, 80 A, 74 B, 159 B, 36 C, 14 B. . 

50 A, 233 B, 264 B 

72 A, 37 B, 200 B, 62 C, 317 B 

57 B, 208 B, 315 B 

33A,95B 

29A,198B 

9 B, 32 B, 178 B, 246 B, 267 B, 60 C. 
42C 

41 A, 68 A, 25 B, 111 B, 161 B, 253 B, 
265 B, 273 B, 301 B, 309 B. 

84B 

38 A, 84 A, 127 B, 210 B, 15 C, 54 C. . 

10 A, 101 B, 165 B, 259 B, 1 C 

63 A 

42B 

49B,87B 

53A,64B,27C 

82 A, 90 B, 190 B, 294 B, 25 C 

21 A, 81 A, 71 B, 119 B, 167 B, 217 B, 

224 B, 231 B, 241 B, 35 C, 242 B. 
7 A, 16 B, 12 B, 73 B, 61 B, 155 B, 

277 B, 65 B, 39 C. 

91B,260B 

2 A,46C 

28A,38B 

42 A, 299 B 

11 A, 5 B, 85 B, 163 B, 41 C 

46 A, 2 B, 86 B, 185 B, 51 C 

77 A 

1 A, 58 A, 22 B, 124 B, 228 B, 303 B, 

4C. 

52B 

75A,46B,121B 

51 B, 184 B, 196 B, 293 B, 64 C 

107B 

24 B 

5 A, 64 A, 20 B, 93 B, 225 B, 312 B. . 
16 A, 81 B, 137 B, 212 B, 22 C. . . 
13 A, 83 A, 89 B, 149 B, 263 B, 24 C. 

12 A, 67 A,180B 

76 A, 50 B, 183 B, 65 C 

63 B, 164 B, 305 B, 29 C 

43B 

182B 

113 B, 306 B, 16 C, 17 B 

25A,307B 

146B,295B 



74B 

50 A 

37 B 

41 A, 68 A, 253 B 
84 B 

82 A, 294 B 

119B 

65 B, 61 B 

299 B 

24 B 

16 A, 22 C 



80 A, 14 B, 159 B 

50A 

37 B, 62 C, 317 B, 72 A. 
57B,315B 

198B 

32B,172B,267B,246B 

25 B, 41 A, 111 B, 161 
B, 253 B. 

84B 

127B,15C 

101 B, 165 B, 1C 

42B 

49B,87B 

64B,27C 

82 A, 190 B 

119 B, 167 B, 231 B, 241 

B,242B, 71 B. 
39 C, 12 B, 16 B, 73 B, 

155 B. 
91B,260B 

38B 

299 B 

85B,163B 

86B,185B . 

77 A 

124 B, 228 B, 4C 

52B 

46 B, 75 A 

184 B 

24B 

64A 

81 B, 137 B 

263B 

50 B, 183 B, 76 A 

63B 

59 C 

182B 

113 B, 16 C, 17 B 

146B,295B 



415 



Table II. — Showing Washington milks below standard, and those containing dirt, as 
previously reported to the health department. — Continued. 



Sample numbers (D. C. health 
office) of milks examined. 



Total 
num- 
ber of 
milks 
exam- 
ined. 



Milks found below 
standard. 



Total 
num- 
ber of 
milks 
below 
stand- 
ard. 



Milks containing dirt. 



Total 
num- 
ber of 
milks 

con- 
taining 

dirt. 



138 B, 56 C 

23 A, 108 B, 216 B, 223 B, 232 B, 240 
B, 247 B, 252 B, 262 B, 272 B, 278 
B, 288 B, 300 B, 304 B, 11 C, 37 C. 

39 A, 78 A, 85 A, 6 B, 76 B, 94 B, 
132 B, 144 B, 256 B, 297 B. 

37 A, 29 B, 110 B, 187 B, 53 C 

44 A, 80 B, 136 B, 213 B, 21 C 

130 B, 261 B, 298 B 

57 A, 66 B, 104 B, 172 B, 230 B, 9 C, 
47 C. 

251B,18C 

98 B, 188 B, 13 C 

78 B, 145 B, 238 B 

62B,67C. 

35 A, 27 B, 152 B, 214 B 

54 A, 6C, 162 B 

106B,229B 

19 A, 48 A, 15 B, 115 B, 271 B, 
26| C. 

23 B, 117 B, 32 C 

56B,83B, 158 B, 206 B, 270 B 

17 A, 79 A, 13 B, 35 B, 92 B 

20 A, 54 B, 142 B, 218 B, 287 B, 
311 B. 

102B,275B 

36B,204B 

280B,44C 

139B,291B 

128B,55C 

105 B, 168 B, 7 C, 49 C 

24 A, 26 B, 192 B, 313 B, 26 C, 30 C. 

44B,220B 

40 A, 40 B, 140 B, 243 B, 61 C 

9 A, 52 A, 4 B, 100 B, 166 B, 202 B, 

237 B. 

191B,314B 

8A,11B 

103B,276B 

43 A, 79 B, 221 B, 58 C 

31C 

47 A, 99 B, 179 B, 8 C, 38 C 

55 B 

26 A, 61 A, 18 B, 34 B, 59 B, 116 B, 

193 B, 45 C. 

32 A, 97 B, 154 B, 269 B 

75B,157B 



138 B, 56 C 

108 B 

78A , 

261B 

57 A, 230 B, 9 C. 

251B 

106 B 

48A,26iC 

56 B 

79 A 

287B 

275B 

24 A, 30 C, 313 B 
26 C. 

52 A 

314B 

99B 



240 B, 247 B, 252 B, 
108 B, 216 B, 11 C, 
223 B, 304 B, 37 C. 

78 A, 85 A, 76 B, 94 B, 
132 B, 144 B, 56 B, 
297 B. 

187 B,37 A 

80 B, 136B,21C, 44 A. 

130B,261B 

104 B, 172 B, 230 B, 
9 C, 57 A. 

18C 

188B,13C 

238B 



35 A, 152 B, 214 B 

6 C, 54 A, 162 B 

106B 

115 B, 271 B, 19 A, 
48 A. 

23 B, 117B,32C 

83 B, 158 B, 206 B 

79 A, 13 B, 35 B, 92 B 
54 B, 218 B 



36B,204B.. 

44 C 

139 B, 291 B. 
128 B, 55 C. 



26 B, 192 B, 313 B, 

24 A. 

44B,220B 

40 B, 61 C, 40 A 

4 B, 100 B, 166 B, 202 

B, 237 B. 
191B.314B 



103 B, 276 B 

79 B, 58 C, 43 A. 

31C 

99 B, 47 A 

55 B 

34B.59B 



154 B, 32 A. 



416 

Table II. — Showing Washington milks beloiv standard, and those containing dirt, as 
previously reported to the health department — Continued. 



Sample numbers (D. C. health 
office) of milks examined. 



18 A, 33 B, 150 B, 268 B. 



Total 
num- 
ber of 
milks 
exam- 
ined. 



59 A, 114 B, 169 B, 227 B, 308 B, 2 C. 



49A,148B 

147B,289B 

133B,281B 

134 B, 234 B 

36 A, 28 B, 112 B, 186 B, 219 B, 285 

B, 14 C. 

235B 

69 A 

41 B 

60 A, 70 B, 205 B, 245 B, 40 C 

15 A, 129 B, 211 B 

30 A, 53 B, 197 B, 63 C 

58 B, 156 B, 209 B 

27 A, 51 A, 39 B, 153 B, 199 B, 52 C. 
7 B, 131 B, 215 B, 222 B, 239 B, 248 

B, 257 B, 274 B, 290 B, 296 B, 

310 B. 

181B 

3 A, 74 A , 

14 A, 30 B, 82 B, 135 B, 189 B, 12 C, 

23 C. 

3 B, 174 B, 254 B, 279 B, 3 C 

34 A, 96 B, 141 B 

55 A,69B 

IB 



70 A, 72 B, 88 B, 120 B, 194 B, 258 B. 

316 B, 66 C, 15 A. 
31 A, 71 A, 8 B, 122 B, 195 B, 249 B, 

28 C. 

236 B 

66 A, 77 B, 176 B, 266 B, 20 C 

68 B, 123 B, 173 B, 5 C 

62 A, 10 B, 60 B, 126 B, 50 C 

6 A 65 A, 19 B, 109 B, 160 B, 33 C 

4A,21B,203B 

56 A, 67 B, 171 B, 207 B, 226 B, 

244 B, 286 B, 48 C 

57C 

45 A, 73 A, 175 B, 201 B, 255 B, 

318 B, 10 C. 

Totals 



Milks found below 
standard. 



18 A, 33 B. 



281 B. 
219 B. 



222 B, 257 B, 290 B 



30 B, 12 C. 



3B. 



55 A. 
258 B. 

31 A. 



173 B. 



Total 
num- 
ber of 
milks 
below- 
stand- 
ard. 



55 



Milks containing dirt. 



268 B, 150 B, 33 B, 

18 A. 
114 B, 169 B, 227 B, 2 

C, 59 A. 

147B 

281B 

134 B, 234 B 

28 B, 112 B, 219 B.... 

69 A 

70B,205B 

211 B 

197 B, 30 A 

156B,209B 

153 B, 51 A 

7 B, 131 B, 215 B, 222 
B,248 B, 274 B, 290 
B, 296 B, 310 B. 

181 B 

82 B, 135B,189B,12C. 

3B,174B 

96B 

55 A 

88 B, 194 B, 258 B, 316 

B, 66 C, 70 A. 
195B,28C, 71 A 

266B,20C,66A 

123 B, 173 B 

50C 

19 B, 109 B, 160 B, 65 A 
21 B, 203 B 

67 B, 171 B, 207 B, 226 
B, 56 A. 

201 B, 10C, 73 A 



REFERENCES TO THE LITERATURE. 



PART I.— THE COMPOSITION AND GENERAL CHARACTERISTICS OF 

MILK. 

(1) Beckmann, Milch-Zeit, 23, 702-703. 

(2) Atkins, Chem. News, 97, 1908, 241-242. 

(3) Koppe, Jahrb. f. Kinderheilk., 1898, 47, 389. 

(4) Fleischmarm, Jour. f. Landw., 1902, 50, 33. 

(5) Fleischmann. (See Raudnitz, Ergebniss d. Physiol., Abt. 1, 1903, p. 299.) 

(6) SoxMet, ibid., p. 300. 

(7) Conn, Zur Morphologie der Milch, Virchow's Archiv, 1900, 162, 187 to 206 

and 406 to 443. 

(8) Savage, Jour. Hygiene, 1906, 6, 123-138. 

(9) Leach, Food Inspection and Analysis, New York, 1907, p. 119. 

(10) Richmond, Analyst, 1900, 25, p. 121. 

(11) Vogel, Jour. Prakt. Chem. [2], 8, 137-144. 

(12) Halliburton, J. Physiol. (London), 1890, 11, 448^63. 

(13) Burow, Zeit. f. Physiol. Chem., 1900, 30, 495-507. 
Bordas and Raczkowski, Compt. Rend., 1902, 135, 354-355. 
Koch, Zeit. f. Physiol. Chem., 1906, 47, 327-330. 

(14) Siegfeld, Milch w. Zentr., 1906, 2, 1-5. 

(15) Uinikoff, Zeit. f. Physiol. Chem., 1900, 30, 101. (See Sieber.) 
Sieber, ibid., p. 101-112. 

Vaudin, J. Pharm., 1894, [5], 30, 464^66. 
Obermaier, Arch. Hyg, 1904, 50, 52-65. 

(16) Landolf, Biochem. Zeitschr., 1907, 4, 172-195. 

(17) Biscaro and Bolloni, Mon. Scient., (4), 19, I., 384. 

(18) Sherman, Berg, Cohen and Whitman, J. Biol. Chem., 1907, 3, 171-175. 

(19) Trillat and Sauton, Compt. Rend., 1905, 140, 1266-1268. 

(20) Schondorf, Pfltiger's Archiv, 1900, 81, 42^7. 

(21) Jolles, Arch. Exp. Path. Pharm., 1901, 46, 247-260. 

(22) Camerer, Zeit. Biol., 1905, 46, 371. 

(23) Jolles and Friedjung, Arch. Exp. Path. Pharm., 1901, 46, 247. 

(24) Van der Marck, Pharm. Weekblad, 1907, 44, 153-155. 

(25) Desmoulieres and Gautrelet, Comptes rend. Soc. Biol., 1903, 55, 632-633. 

(26) Bordas and Touplain, Compt. rend., 1906, 142, 1204-1205. 
(2J) Dombrowski, Arch. Hygien, 1904, 50, 183-191. 

(28) Rosemann, Pfluger's Archiv., 1900, 78, 466-504. 

(29) Teichert, Bied. Centr., 1902, 31, 210. 

(30) Bechamp, Compt. rend., 94, 1533-1536. 

(31) Golding and Feilmann, Jour. Soc. Chem. Ind., 1905, 24, 1285-1286. 

(32) Marfan and Gillet, Monatsschr. f. Kinderheilk., 1902, 1, 57-64. 

(33) Woodhead and Mitchell, Jour, of Path, and Bact, 1907, 11, 408-414. 

45276°— Bull. 56—12 27 (417) 



418 

(34) Briefer, Zeitsch. f. Hygien, 1893, 13, 336; and ibid., 1893, 15, 439. 

(35) Van Slyke, Modern Methods of Testing Milk and Milk Products, New York 

and London, 1907, p. 15. 

(36) See " Food Inspection and Analysis," by Albert E. Leach, New York, 1907. 

p. 90. 

(37) U. S. Department of Agriculture, Farmer's Bulletin No. 29, 1895. 

(38) Van Slyke, loc. cit., p. 15. 

(39) Leach, loc. cit., p. 91. 

(40) Bunge, Pathologic and Physiologic Chemistry, by G. Bunge, 2d English ed., 

tr. by Florence A. Starling, 1902, 104-105. 

(41) Richmond, Analyst, 1901, 26, 310-316 ; ibid., 27, 240-243 ; ibid., 29, 180-187 ; 

ibid., 30, 325-329; ibid., 31, 176-180. 

(42) Richmond, ibid., 31, 176-180. 

(43) Billitz, Milchw. Zentr., 1905, 1, 113-132. 

(44) Cook and Hills, Vermont Exp. Stat. Rep., 1891. 

(45) Wanters, Rev. Interv. Falsific, 1902, 15, 67-69. 

(46) Janke, Bied. Centr., 1880, 899-905. 

(47) Janke, ibid., 1879, 929. 

(48) Richmond, Analyst, 1902. 

(49) Sherman, Jour. Amer. Chem. Soc, 1903, 25, 132-142. 

(50) Richmond, Analyst, 1904, 29, 180-187; ibid., 31, 176-180. 

(51) Albert and Maercker, Landw. Jahrb., 1898, 27. 

(52) Rhodin, K. Land. Akad. Handl., 1888, 37, 25. 

(53) Bartlet, 14th Ann. Rep. Maine Agr. Exp. Stat., 1898, 114-117. 

(54) Gogitidse, Zeit. Biol., 1904, 45, 365. 

(55) Hills, 12th Ann. Rep. Vermont Agr. Exp. Stat., 1898-99, 269-275. 

(56) V. Henriques and Hansen, Exp. Stat. Record, 1900, 11, 674-676. 

(57) Sebelien, Landw. Versuchs Stat., 1895, 46, 259-308. 

(58) Wing, Ann. Agronom., 1896, 22, 94-95. 

(59) Morgen, Beger, Fingerling, Doll, Hancke, Sieglin, and Zielstorff, Landw. 

Versuchs Stat., 1904, 61, 1-284. 

(60) Morgen, Beger and Fingerling, ibid., 1906, 64, 93-242. 

(61) Fingerling, ibid., 1906, 64, 299^12. 

(62) Fingerling, ibid., 1905, 62, 11-180. 

(63) Temesvary, Centr. f. Med. Wissenschft, 1900, 38, 668. 

(64) Morgen, Beger and Fingerling, loc. cit., 1905, 62, 251-386. 

(65) Caspari, Archiv. Anat. u. Physiol., 1899, suppl., 267-280. 

(66) Caspari, Zeit. Biol., 46, 277-279. (See also Zeit. Biol. 1907, 49, 558-561.) 

(67) Einecke, Bied. Centr., 1904, 33, 239-245. (See also Gogitidse, Zeit. Biol. 

1906, 47, 475-486.) 

(68) Malmejac, J. Pharm., 1901, [VI] 14, 70-74. 

(69) Woll, Report Wis. Agr. Exp. Stat., 1891, 49-60. 

(70) Pfeiffer, Einecke and Schneider, Mitt. Landw. Inst. K. Univ. Breslau, 1905, 

3, 179-225. 

(71) Morgen, Beger and Westhauser, Landw. Versuchs Stat., 1907, 65, 413-440. 

(72) Trunz, Zeit. f. Physiol. Chem., 1903, 39, 380-395. 

(73) Trunz, ibid., 1903, 40, 263-310. 

(74) Hardy, Bull. Assoc. Beige Chim., 1901, 15, 228-229. 

(75) Ackermann, Milch Zeit., 1902, 31, 166-168. 

(76) Hills, 12th Ann. Rep. Vermont Agr. Exp. Stat, 1898-1899, 309. 

(77) Dornic, Milch Zeit., 1896, 331. 

(78) Moerman, Bull. Assoc. Beige Chim., 16, 147-151. 

(79) Lawrence; Boston Med. and Surg. Journ., Vol. 161, 1909, p. 152. 



419 

PART II.— (1) CHANGES IN THE COMPOSITION OF MILK PRODUCED 
BY THE ACTION OF HEAT AND ACIDS, AND EFFECT OF HEAT ON 
ENZYMES. 



(1 
(2 
(3 
(4 
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(7 
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(14 
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(16 
(17 
(18 
(19 
(20 
(21 
(22 
(23 
(24 
(25 
(26 
(27 
(28 
(29 
(30 
(31 
(32 
(33 
(34 
(35 
(36 
(37 
(38 
(39 
(40 
(41 
(42 
(43 
(44 
(45 
(46 
(47 
(48 
(49 



Thorner, Cliem. Zeit., 1891, 1108. 
Richmond, Analyst, 1900, 25, 121. 
Stokes, Analyst, 16, 122. 

Jamison and Hertz, J. Physiol., 1901, 27, 26-30. 
Rettger, Amer. J. Physiol., 1902, 7, 325^330. 
Harris, J. Anat. and Physiol., 1894, 29, 188-200. 
Rettger, Amer. J. Physiol., 1902, 6, 450^57. 
Franz Utz, Milch Zeit., 1903, 32, 354-355. 
Wassermann and Schiitze, Zeitschr. f. Hygien, 1901, 36. 
P. T. Miiller, Archiv. f. Hygien, 1902, 44, 136-137. 
Cazeneuve and Haddon, Compt. rend., 1895, 120, 1272-1273. 
Bruno Bardach, Monatshefte, 1897, 18, 199-216. 
Loevenhart, Zeit. f. Physiol. Chem., 1904, 41, 189-190. 
Yon Soxhlet, Verh v Ges. deut. Naturforsch. Aerzte, 1904, II, 151-152. 
Thorner, same as (1). 
Rideal, Lancet, 1900, I, p. 229. 
Revis and Payne, J. Hygiene, 7, 1907, 216-231. 
Pasteur, Studies on Fermentation, 1879, p. 34. 

Babcock and Russell, Centr. f. Bakt. u. Par. 1900, Abt. 2, 6, 17-22, 79-88. 
Fermi, Archiv. f. Hygien, 14, 1892, p. 19. 
Wender, Oesterr. Chem. Zeit., 6, 1-3. 

Yon Freudenreich, Centr. f. Bakt. u. Par., 1900, Abt. 2, 6, 332-338. 
Hippius, Jahrb. f. Kinderh., 1905, II, 365. 

Gillet, Journ. d. Physiol, et d. Pathol. Generate, 1903, 3, 503-518. 
Hougardy, Bull. Acad. Roy. Belg., 1906, 1888-1900. 
Zelinski, Jahrb. f. Kinderh., 1906, 63, 288-307. 
Schardinger, Zeit. Nahr. Genussm., 1902, 5, 1113-1121. 
Glage, Zeit. Fleisch. u. Milch-Hygien, 1901, 11, 162. 
Franz Utz, Pharm. Central Halle, 1901, 42-149. 
Schaffer, Schweiz. Woch. Pharm., 38, 15. 
Rullmann, Zeit. Nahr. Genussm., 1904, Heft 2. 
Y. Storch, Bied. Centr., 1898, 27, 711-714. 
Freeman, Proc. N. Y. Path. Soc, 1897-1898, p. 222. 
Du Roi and Koehler, Milch Zeit., 1902, 31, 17-18 ; and 113. 
Weber, ibid., 1902, 31, 657-659 ; and 673-676. 
Arnold and Mentzel, ibid., 1902, 31, 247. 
• Franz Utz, Chem. Zeit., 1906, 26, 1121-1122. 
Rullmann, Zeit. Nahr. Genussm., 1904, 7, 81-89. 
Yan Itallie, Pharm. Weekblad., 40, 1103-1104. 
Bruere, <J. Pharm. Chiin., 1906, [VI], 24, 488-493. 
Dupouy, These Bordeaux, 1898-1899, 80-85, No. 91. 
Douglas, Lancet, 1903, II, 23. 

Marfan and Gillet, Monatsschr. f. Kinderh., 1902, I, 57-64. 
Macadie, Pharm. J. 1907, 207. 

Wilkinson and Peters, Zeit. Nahr. u. Genussm., 16, 1908, 172-175. 
Portier, Compt. rend. Soc. Biol., 1898, 27, 453. 
Kastle and Porch. Jour. Biol. Chem., IY, 1908, 301-320. 
Yan Itallie, Proc. K. Akad. Wetensch. Amsterdam, 1906, 8, 628-630. 
Jolles, Zeit. Biol., 1903, 45, 248-260, 



420 

(50) Behring, Therapie der Gegenwart, 1904, No. 1. 

(51) Lane-Claypon, J. Pathol. Bacterid., 13, 1908, 34-37. 

(52) Raudnitz, Ergebnisse der Physiologie, 1903, Abt. 1, 322. 

(53) Tjaden, Koske and Hertel, Arb. Kais. Gesundheitsamt, 1901, 18, 219. 

(54) Weber, Zeit. f. Tiermed., 1902, 6, 419. 

(55) Kerr, Brit. Med. Jour., 1895, 52, 1491. 

(56) Halliburton, ibid., 1900, II, p. i. 

(57) Rubner, Hyg. Rundschau, 1895, No. 22, 1021-1022. 

(58) Middleton, ibid, 1901, XI, 601. 

(59) De Jager, Centr. f. Med. Wissenschaft, 1906, No. 9, p. 145. 

(60) Lorcher, Pfliig. Archiv., 1897, 99. 

(61) Forbes-Ross, Lancet, 1904, 979-980. 

(62) Green, The Soluble Ferments, Cambridge, 1899. 

(63) Oppenheimer, Die Fermente, Leipzig, 1900. 

(64) P. T. Miiller, Archiv. f. Hygien, 1902, 44, 132-133. 

(65) Kastle, Science, 1901, 765-771. 

(66) Marfan, La Presse Medicale, Paris, 1901, p. 13-16. 

(67) Bokorny, Chem. Zeit., 1900, Dec, and Pfliig. Archiv., 1901, 85, 257-270. 

PART II.— (2) CHANGES IN THE COMPOSITION OF MILK BROUGHT 
ABOUT BY THE MILK ENZYMES. 

(1) Marfan, La Presse Medicale, Paris, 1901, p. 13-16. (See also Marfan and 
Gillet, Monatschr. f. Kinderheilk., 1902, 1, 57-64.) 



(2 
(3 
(4 
(5 
(6 
(7 

(8 
(9 
(10 
(11 
(12 
(13 
(14 
(15 
(16 
(17 
(18 
(19 
(20 
(21 
(22 
(23 
(24 
(25 
(26 
(27 
(28 
(29 
(30 



P. T. Miiller, Archiv f. Hygien, 1902, 44, 126-188. 

Moro, Wien. Klin. Wochenschr., 15, 121-122. 

Engel, Deut. Aerzte Zeit., 1903, 5, 79-80. 

Moro, Jahrb. f. Kinderheilk., n. F., 1898, 47, 342-^361. 

Bechamp, Compt. rend., 96, 1508-1509. 

Van der Velde and Landtsheer, Archiv de Medicin des Enfants, 1903, 6, 

408-412. 
Babcock and Russell, Centr. f. Bakt. u. Par., Abt. 2, 1900, 6, 17-22, 79-88. 
Von Freudenreich, ibid., 332-338. 

Tice and Sherman, J. Amer. Chem. Soc, 1906, 28, 189-194. 
Wender, Oesterr. Chem. Zeit., 6, 13. 
Snyder, Bull. 74, Minn. Agr. Exp. Stat. 
Hougardy, Bull. Acad. Roy. Belg., 1906, 888-900. 
Marfan and Gillet, same as (1). 

Gillet, J. de Physiol, et d. Path, generale, 1903, 3, 513-518. 
Rogers, Centr. Bakt. u. Par., XII, 597-601. 

Nobecourt and Merklen, Compt. rend. Soc. Biol., 1901, 53, 148-149. 
Desmoulieres, J. Pharm. Chim., 1903 (VI), 17, 232-239. 
Miele and Willem, Compt. rend., 1903, 137, 135-137. 
Jolles, Zeit. Biol., 1903, 45, 248-260. 
Von der Velden, Biochem. Zeitschr., 1907, 3, 403^12. 
Amberg, J. Biol. Chem., 1, 219-228. 

Van Itallie, Proc. K. Akad. Wetensch., Amsterdam, 1906, 8, 622-630. 
Faitelowitz, Dissertation Heidelberg, 1904. 
Reiss, Zeit. Clin. Med., 56, 1-12. 
Loew, Rep. No. 68, U. S. Dept. Agric, 1901, 1-47. 
Bach and Chodat, Bied. Zent. f. Agric. Chem., 37, 1908, 168-177. 
Usher and Priestley, Proc. Roy. Soc, 77, 369-375. 
Erlenmeyer, Ber. d. deut. Chem. Ges., 1877, 10, 650-654. 
Usher and Priestley, Proc. Roy. Soc, 78, 318-327. 



421 

(31) Lesser, Zeit. Biol., 1906, 48, 1-18, and ibid., 1907, 49, 575-583. 

(32) Wender, Oesterr. Chein. Zeit, 6, 1-3. 

(33) Adam, J. Pharm. Chim., 1906, 23, 273-277. 

(34) V. Storch, Arbeit, a. d. Kaiserl. Gesundheitsamt, XVII, 1900, 110. 

(35) Lauterwald, Milch Zeit, 1903, 32, 241-242, 262-263. 
Adam, J. Pharm. Chim., 1906, 23, 273-277. 
Leffmann, Analyst, 1908, 23, 85-86. 

Tan Itallie, Pharm. Weekbl., 40, 1103-1104. 
Rullmann, Zeit. Nahr. Genussm., 1904, 7, 81-89. 
Franz Utz, Milch Zeit., 1903, 32, 417-418. 
Dupouy, These Bordeaux, 1898-1899, 80-85, No. 91. 

(36) Bellei, Centr. Bakt. u. Par., 1904, XII, 518. 

(37) Arnold and Mentzel, Zeit. Nahr. Genussm., 1903, 7, 548-549. 

(38) Franz Utz, Chem. Zeit., 1902, 26, 1121-1122, and Milch Zeit., 1903, 32, 

417-418. 

(39) Franz Utz, Milch Zeit., 1903, 32, 594-595. 
Bruere, J. Pharm. Chem., 1906 [VI], 24, 488-493. 

(40) Kastle and Porch, Jour. Biol. Chem., IV, 1908, 301-320. 

(41) Wilkinson and Peters, Zeit. Nahr. u. Genussm., 16, 1908, 172-175. 

(42) Seligmann, Zeit. Hygien u. Infectionskrankheiten, LII, Heft. 2. 

(43) Schardinger, Zeit. Nahr. Genussm., 1902, 5, 1113-1121. 

(44) Smidt, Hygienische Rundschau, 1904, 23, 1137-1143. 

(45) Seligmann, Zeit. Hygien., 52, 161-178, and ibid., 1907, 58, 1-13. 

(46) Cathcart, Jour. Hygien., 1906, 6, 300-303. 

PART II.— (3) CHANGES IN THE COMPOSITION OF MILK BROUGHT 
ABOUT BY THE DIGESTIVE FERMENTS. 



(1 
(2 
(3 
(4 

(5 
(6 

(7 
(8 

(9 
(10 

(11 
(12 
(13 
(14 
(15 
(16 
(17 
(18 
(19 
(20 
(21 
(22 



THE EENNIN COAGULATION OF MILK. 

Lehmann and Hempel, Pfliiger's Archiv., 1894, 56, 558. 

Mann, Chemistry of the Proteids, Loud., 1906, p. 70. 

Cohnheim, Zeit. Physiol. Chem., 1902, 35, 134. 

Tunnicliffe, Jour. Hygiene, 1902, 2, 445-451. 

Fremy, Ann. d. Pharm. (Liebig), 1839, 31, 188-190. 

Liebig, Plimmer, Fermentations, Lond., 1903, 110. 

Soxhlet, Jour. f. Prakt. Chem., n. F., 6, 33. 

Hallier. (See Green, The Soluble Ferments and Fermentations, Cam- 
bridge, 1899, 242.) 

Heintz, Jour. f. Prakt. Chem., n. F., 6, 374-384. 

Hammarsten, Maly's Jahresb., 1872, p. 118 ; ibid., 1874, p. 135 ; ibid., 1877, 
p. 158. 

Schmidt, Beitrage zur Kenntniss der Milch, Dorpat, 1871. 

Halliburton, J. of Physiol., 1890, 11, 448-463. 

Schultze and Rose, Landw. Vers. Stat., 31. 

Loevenhart, Zeit. f. Physiol. Chem., 1904, 41, 177-205. 

Briot, Etudes sur la pressure et l'antipressure, these de Paris, 1900. 

Arthus and Pages, Archives de Physiol., 1890, 331. 

Courant, Pfliiger's Archiv., 1891, 50, 109-165. 

Ringer, J. of Physiol., 1890, 11, 464^77. 

Edmunds, J. of Physiol., 1896, 19, 466. 

Benjamin, Virchow's Archiv., 1896, 145, 30-48. 

Soldner, Landw. Versuchs. Stat., 35, 351. 

Laqueur, Biochem. Centr., 1905-1906, IV, 334. 



422 

(23) Laqueur, Biochem. Centr., 1905-1906, IV, 333-347. 

(24) Fuld, Biochein. Zeitschr. 1907, 4, 488^99. 

(25) P. T. Mtiller, Archiv. f. Hygiene, 1902, 44, 144-150. 

(26) Rotondi. (See Laqueur, loc. cit.) 

(27) Duclaux, Traite de Microbiologic, Paris, 1899, II, 291. 

(28) Arrhenius, Inimunochemistry, N. Y., 1907, 369. 

(29) Fuld, Hofmeister's Beitrage, 1902, II, 189-194. 

(30) Van Slyke and Hart, Am. Chem. Jour., 1905, 33, 461-496. 

(31) Herwerden, Zeit. Physiol. Chem., 1907, 52, 184-206. 

(32) Soldner, Dissertation, Erlangen, 1888. 

(33) Osborne, J. of Physiol., 1901, 27, p. 398. 

(34) Harris, J. of Anat. and Physiol., Lond., 1894, 29, 188. 

(35) Hammarsten and Rhodin, Maly's Jahresb., 1887, 17, 160. 

(36) Morgenroth, Centr. f. Bakt, Abt. 1, 20, 271. 

(37) Fuld and Spiro. (See Arrhenius, Immunochemistry, 1907.) 

(38) Segelke and Storch, Ugeskrift for Landman, 1870. 

(39) Loreher. (See Duclaux, loc. cit., p. 164.) 

(40) Madsen. (See Arrhenius, loc. cit, 72.) 

(41) Hillmann, Milch Zeit., 1896, 25, p. 86. 

PART II.— (4a). CHEMICAL CHANGES IN MILK PRODUCED BY BAC- 
TERIA AND VARIOUS OTHER MICRO-ORGANISMS. 



(1 

(2 
(3 

(4 
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(27 
(28 
(29 



Bechamp, Compt. rend., 94, 1533-1536. 

Blondeau. (See Plimmer, Fermentations, N. Y. and Bombay, 1903, 61.) 
Pasteur, Annales de Chimie et de Physique, 1858 (III), 52,. 404-418. (See 
also The Life of Pasteur, by Vallery-Radot, Vol. I, pp. 108-109 and 129.) 
Boutroux, Compt. rend., 86, 605-607. 
Richet, Compt. rend., 86, 550-552; and ibid., 88, 750-751. 
Marpmann, Arch. Pharm. (3), 24, 243-256. 
Hueppe, Mitth. a. d. Kais. Gesundheitsamt, 2, 1884, 309. 
Beyerinck, Arch. Neer. Sci. Exact. Nat., 1901 (II), 6, 212-243. 
Heinemann, J. of Infect. Dis., 1906, III, 173. 
Heinemann, Jour. Biol. Chem., 1907, II, 603-612. 
Conn, 15th Ann. Rep. Storr's Agr. Exp. Stat., 1903, 92. 
Hirschfeld, Pfluger's Archiv, 47, 510-542. 

Buchner and Meisenheimer, Ber. d. deut. Chem. Ges., 1903, 36, 634. 
Herzog, Zeit. f. Physiol. Chem., 1903, 381. 
Gunther and Thierfelder, Archiv f. Hygien., 1895, 25, 164. 
Gadamer, Apoth. Zeit., 12, 642-643. 
Clafflin, Jour. Soc. Chem. Ind., 1897, 16, 516-518. 
Blumenthal and Wolff, Charite Ann., 29, 12-18. 
Haacke, Arch. Hyg, 1902, 42, 16-47. 
Tissier and Gasching, Ann. Inst. Past, 1903, 17, 540-563. 
Beyerinck, Proc. K. Akad. Wetensch. Amsterdam, 1907, 10, 17-35. 
Epstein, Arch. Hyg., 1900, 329-359. 

V. Freudenreich, Centr. Bakt., 2. Abt., 1902, 8, 735-738. 
Boekhaut and de Vries, Centr. Bakt., 1899, 304. 
Chodat and Hofman-Bang, Ann. Inst. Pasteur, 1901, 15, 36-48. 
Van Slyke, Jour. Amer. Chem. Soc, 1904, 25, 1243-1256. 
Burri and Dueggeli, Centr. f. Bakt. u. Par., 1906, Abt. II, 15, 709-722. 
Fuchs. (See Conn, Agricultural Bacteriology, Phila., 1901, p. 205.) 
Hueppe and Engling, Bied. Centr., 1885, 414-415. 



423 

(30) Reiset, Compt. rend., 96, 682-685; and 745-750. 

(31) Conn, Agricultural Bacteriology, Phila., 1901, p. 205. 

(32) Trillat and Sauton, Compt. rend., 144, 1907, 926-929. 

(33) Struve, Berichte d. deut. Cliem. Ges., 17, 1364-1368. 

(34) Vieth, Analyst, 12, 2-6. 

(35) Von Freudenreicli. See Conn, Agricultural Bacteriology. 

(36) Martinand, Compt. rend., 108, 1067-1069. 

PART II.— (4b) MILK POISONING— GALACTOTOXISMUS. 

(1) Stoakley, Virg. Med. Semiinonth., 1902, 7, 276. 

(2) Vaughan. (See Yaughan and Novy, Cellular Toxines, Phila. and N. Y., 

1902, 211-220.) 

(3) Sonnenberger, Verh. d. Gesell. f. Kinderkeilk., Wiesbaden, 1896 and 1897, 

129-145; and also Munch. Med. Wochschr., 1897, No. 13, 335-338; and 
No. 14, 363-365. 

(4) Le Blanc, Bull, de Lyon Med., 1901, 96, 586. 

(5) Baird, Yirg. Med. Semimonth, 1902, 7, 241-242. 

(6) Golding and Feilmann, Jour. Soc. Chem. Ind., 1905, 24, 1285-1286. 

(7) Bucura, Zeitsch. f. exper. Path. u. Ther. IY, 1907, 398-113. 

(8) Newton and Wallace. (See Yaughan and Novy, loc. cit., p. 215.) 

(9) Firth, ibid., p. 216. 

(10) Yaughan, ibid. 

(11) Camman, ibid., p. 218. 

(12) Kinnicut, ibid. 

(13) Yaughan and Novy, ibid., p. 219. 

(14) Vaughan and Perkins, Archiv. f. Hygien., 27. 

(15) Dokkum. (See Yaughan and Novy, loc. cit., 214.) 

(16) Lepierre, ibid., p. 323. 

(17) Vaughan and Novy, Twentieth Century Practice of Medicine, N. Y., 1898, 

XIII, p. 59. 

(18) Vaughan, Michigan State Board of Health, 1896, 397-^01. 

(19) Novy. (See Osier's Modern Medicine, Phila. and N. Y., 1907, 241-243.) 

(20) Fluegge. (See Yaughan, Twentieth Century Practice of Medicine, N. Y., 

1898, XIII, 50-52.) 

(21) Liibbert, ibid., 52-53. 

(22) Vaughan, ibid., 53-54. 

(23) Van Itallie; Pharm. Weekblad, 45, pp. 1357-1362. 

(24) Reijst-Scheffer ; Arch. Pharm., 246, pp. 595-598. 

PART III.— CHEMICAL STANDARDS FOR THE CONTROL OF THE SALE 

OF MILK. 

(1) P. M. Harwood, Amer. Food Jour., 1907, Aug., p. 33. 

PART IV.— ADULTERATIONS OF MILK. 

(1) Leach, Food Inspection and Analysis, N. Y., 1907, 133-134. 

(2) Steinegger, Zeit. Nahr. u. Genussm., 1905, 10, 659-671. 

(3) Commanducci, Rend. Acad. Sci. Fis. Mat. Napoli, 1906, (III), 12, 113-115. 

(4) Atkins, Chem. News, 97, 1908, 241-242. 

(5) Atlee, Tr. Med. Soc. Tenn., 1907, 54-61. 

(6) Van Slyke, Modern Methods of Testing Milk and Milk Products, N. Y. and 

Lond., 1907, p. 140. 



424 

(7) Winton, Conn. Agr. Exp. Stat. Rep., 1901, 179-182. 

(8) Tolman, U. S. Dept. Agr., Bur. of Chem., Bull. 65, 111-120. 

(9) Houghton, Jour. Amer. Chem. Soc, 1907, 29, 1351-1357. 

(10) Weyl, The Sanitary Relations of the Coal Tar Colors, tr. by M. Leffmann, 

Phila., 1892. 

(11) Weber, Jour. Amer. Chem. Soc, 1896, 18, 1092-1096. 

(12) Winogradow, Zeit. Nahr. u. Genussm., 1903, VI, 589-592. 

(13) Gudemann, Jour. Amer. Chem. Soe., 1905, 27, 1436-1442. 

(14) Chlopin, Zeit. Nahr. u. Genussm., 1902, 5, 241-245. 

(15) Meyer, J. Am. Chem. Soc, 1907, 29, 892-909. 

(16) Budde, Milch Zeit., 1903, No. 44, 690-691. 

(17) Leach, loc cit, p. 140. 

(18) Richmond, Analyst, 1906, 31, 176-180. 

(19) Trillat, Compt. rend., 1904, 138, 720-722. 

(20) Rideal and Foulerton, Exp. Stat. Rec, 1900, 11, 582; from Public Health, 

1899, 11, 554-568. (See also Rideal, on "The use and abuse of pre- 
servatives," Lancet, 1900, I, 228-230.) 

(21) Hehner, Exp. Stat. Rec, 1900, 11, 582-583; from Brit. Food Jour., 1899, 

1, 132. 

(22) Price, Centr. Bakt. Par., Abt. 2, 1905, 14, 65-75. 

(23) Pottevin, Ann. Inst. Pasteur, 1904, VIII, 807. 

(24) Bliss and Novy, Jour. Exp. Med., 1899, IV, 47-80. 

(25) Halliburton, Brit. Med. Jour., 1900, II, 1-2. 

(26) Neumann, Archiv. f. Exp. Path. u. Pharm., 1881, 14, 149-152. 

(27) Cyon, Compt. rend., 1878, 87, 845. 

(28) Gruber, Zeit. f. Biol., 1880, 16, 198. 

(29) Forster, Archiv. f. Hygien, 1884, 2, 75. 

(30) G. T. Welch, Med. Record, 1888, p. 531. 

(31) Chittenden, Dietet. and Hygien. Gaz., 1893, 9, 25. 

(32) Chittenden and Gies, Amer. J. Physiol., 1898, 1, 1-39. 

(33) Liebreich, Effects of Borax and Boracic Acid on the Human System, by 

Dr. Oscar Liebreich, Berlin, 1899, pp. IV. +44. 

(34) Liebreich, Berlin Klin. Wochenschr., 1887, 33, 605. 

(35) Lebbin, Die Medicinische Woche, 1901, 2, 409-410. 

(36) Tunnicliffe and Rosenheim, Jour, of Hyg., 1901, 1, 168-201. 

(37) Liebreich, Second Treatise on the Effects of Borax and Boric Acid on the 

Human System, by Dr. Oscar Liebreich, Lond., 1902, pp. VIII. +87. 

(38) Wiley and Bigelow, U. S. Dept. of Agr., Bur. of Chem., Bull. 84, Pt. I. 

Boric Acid and Borax, 1904, pp. 1-177. 

(39) Brouardel, 4th Internat. Cong. d'Hyg. et de Demographie & Geneve, II. 

p. 352, Sept. 4-9, 1882. 

(40) Wiley, Bigelow, Weber, and others, Influence of Food Preservatives and 

Artificial Colors on Digestion and Health, II, Salicyclic Acid and 
Salicyclates, U. S. Dept. of Agr., Bur. of Chem., Bull. 84, pt. II. 

(41) Lakin, Centr. f. Bakt. u. Par., 1905, 15, Abt. 2, 165-174. 

(42) P. Gordan, Centr. f. Bakt. u. Par., 1904, Abt. 2, 13, 716-728. 

(43) S. Amberg, J. of Biol. Chem., 1, 219-228. 

(44) Jablin-Gonnet, Maly's Jahresber., 1901, 313. 

(45) Rosam, Centralbl. f. Bakt, 1904, Abt. 2, 13, 716. 

(46) Van der Velde, Beitrilge zur Chem. Physiol, u. Pathol., 1904, 5, 558. 

(47) Rubuteau, Etudes Experimentales sur les Effets des Fluorures, Paris, 1867. 

(48) Kolipinski, Med. News, 1886, No. 8, 49. 

(49) Schulz, Archiv f. Exp. Pathol, u. Therap., 1899. 



425 

(50) Heidenhain, Pfluger's Archiv, 1899. 

(51) Weinland, Pfluger's Archiv, 1894, 58. 

(52) Griintzner, Pfluger's Archiv, 1893, 53. 

(53) Czrellitzer, Zur Keuutuiss des Fluornatrium, Diss. Breslau, 1895. 

(54) Kastle aud Loevenhart, Amer. Cheui. Jour., 1900, 24, 509. 

(55) Loeveuhart aud Pierce, J. of Biol. Chein., 1907, II, 397-413. 

(56) Baldwin, Jour. Am. Chem. Soc, 1899, 21, 517-521. 

(57) Van Slyke, loc. cit, p. 29. 

(58) Leffmann, Dietetic and Hyg. Gaz., 1898, 14, 171-173. 

(59) Hope, Report of the Thompson- Yates Laboratories, 1900, Pt. 1, 75-78. 

(60) Yaughan and Yeenboer, Amer. Med., 1902, III, 421-426. 

(61) Rideal and Foulerton, Public Health, 1S99, II, 554-568. 

(62) Richmond, Analyst, 1900, 25, 123-124. 

PART V.— THE WASHINGTON MILK SUPPLY. 

(1) Leach, Food Inspection and Analysis, New York, 1907. p. 130-133. 

(2) Thorner, Chem. Zeit, 1891, 1108. 

(3) Van Slyke, Modem Methods of Testing Milk and Milk Products, N. Y. and 

Loud., 1907, p. 106. 

(4) Tuley, Jour. Amer. Med. Ass'n, 1907, 49, 1344-1349. 

(5) Ott, Zeitschr. f. Fleisch u. Milch Hyg., 1896-97, 7, 214-216. 

(6) Leach, loc. cit, pp. 757-767. 

(7) Wagner, Leber quantitative Bestimmungen waiisseriger Lusunge mit dem 

Zeiss'-schen Eintauch-Refraktometer, Soudershauseu, 1903. 

(S) Leach, loc. cit, p. 767. 

(9) Leach, ibid., p. 766. 

(10) Leach, ibid., pp. 134-137. 

(11) Blyth, Analyst, 1901, 26, 148-150. 

(12) Leach, loc. cit. pp. 140 and 144. 

(13) Rideal and Foulerton, Public Health, 1899, II, 554-568. 

(14) Acree, J. of Biol. Chem., 1906. II, 145-148. 

(15) Atlee, Trans. Med. Soc. Tenn., 1897, 54-61. 

(16) Winslow, Northwestern Medicine, Seattle, 1904, II, 315-327. 

(17) Winslow, ibid., pp. 315-316. 



11. THE NUMBER OF BACTERIA IK MILK AND THE 
VALUE OF BACTERIAL COUNTS. 



(427) 



THE NUMBER OF BACTERIA IN MILK AND THE VALUE OF 
BACTERIAL COUNTS. 



By Milton J. Rosenau, 
Director, Hygienic Laboratory , Public Health and Marine- Hospital Service. 



Milk delivered in cities contains a vast number of bacteria. For 
instance, the general milk supply of Washington averaged 11,270,000 
per cubic centimeter in the summer of 1907; and 22,134,000 during 
the summer of 1906. The milk of many other cities also is exces- 
sively rich in bacteria. 

Such enormous numbers mean but little to our minds. If we 
make comparisons we find that few substances contain such myriads 
of germ life as is often found in milk. Compared with sewage, for 
instance, a fluid which is popularly and rightly supposed to teem 
with germ life, it will almost always be observed that milk when it 
is consumed is richer in bacteria by far than the sewage of our large 
cities. a 



Sewage of — 


Average for— 


Bacteria per cubic 
centimeter. 




1894 to 1901 


2,800,000 

2,000,000 to 11,000,000 

3, 500, 000 to 4,000,000 

3,034,000 

5,600,000 

2,350,000 

239,000 




1894 to 1901 




1898 




Sept. 24 to Oct. 24, 1890. . . 
16 samples, 1907 


St. Mary's, Ohio « 




16 samples, 1907 




16 samples, 1907 







a Winslow and Belcher: Changes in the bacterial flora of sewage during storage. 

6 Laws and Andrews: Report on the result of investigations of the micro-organisms of sewage. Rep. 
London Co. Council, Dec. 13, 1894. 

c Clowes, F.: Report on the bacteriological examination of London crude sewage. First Rep. Lon- 
don Co. Council, June 16, 1898. 

d State Board Health Mass., Rep. 1890, p. 35. 

« Kellerman, Pratt and Kimberly: The disinfection of sewage effluents for the protection of public 
water supplies. U. S. Bur. Plant Industry, Bull. 115, 1907. 

So far as numbers are concerned, they need not greatly alarm us, 
for we know that disease is due to agencies and conditions other 
than merely the presence of enormous numbers of bacteria. By 
universal consent, however, milk containing excessive numbers of 
bacteria is unsuitable for infant feeding. The tender mucous mem- 

a Russell, H. L. Outlines of Dairy Bacteriology, 1896. 
(429) 



430 

brane of infants is very susceptible to bacteria and their products, 
and a large proportion of the summer complaints of infants has 
been traced to the use of bacteria-laden milk. As we grow older 
it seems that the gastro-intestinal mucous membrane becomes 
comparatively immune, or resistant to bacterial action. 

If milk were a transparent fluid the enormous growth of bacteria 
found in market milk would be plainly visible to the naked eye. 
A similar amount of bacterial growth in broth, gelatine, beer, jelly, 
or other clear substance, would render such food unsightly, and it 
would be generally regarded as unfit for use on account of the evi- 
dence of fermentative and putrefactive changes. 

The number of bacteria in milk is not so important from a public 
health standpoint as the kind and nature of the bacterial products. 
But with cleanliness and the liberal use of ice the total number of 
bacteria can be kept down, and this affords a mode of protection 
against the dangerous species and their toxic products. Milk con- 
taining few bacteria will contain proportionately few or no harmful 
varieties. Most of the specific pathogenic bacteria which some- 
times contaminate milk, grow best at the body temperature and 
not at all at the low temperatures at which milk must be kept in 
order to keep the total bacterial count down. 

Park a raises the question — 

Are even these enormous numbers of bacteria in milk during hot weather actually 
harmful? Here we have only to refer to universal clinical experience, that a great 
number of children in cities sicken on the milk supplied in summer, that those put on 
milk which is sterile or contains few bacteria as a rule mend rapidly, while those kept 
on the impure milk continue ill or die. 

Our knowledge is probably as yet insufficient to state just how many bacteria must 
accumulate to make them noticeably dangerous in milk. Some varieties are un- 
doubtedly more harmful than others and we have no way of restricting the kinds that 
will fall into milk except by enforcing cleanliness. We have also to consider that 
milk is not entirely used for some twelve hours after being purchased, and that during 
all this time bacteria are rapidly multiplying, especially where, as among the poor, no 
provision for cooling it is made. Slight changes in the milk which to one child would 
be harmless would in another produce disturbances which might lead to serious dis- 
ease. A safe conclusion is that no more bacterial contamination should be allowed 
than it is practical to avoid. Any intelligent farmer can use sufficient cleanliness and 
apply sufficient cold, with almost no increase in expense, to supply milk twenty-four 
to thirty-six hours old which will not contain in each cubic centimeter over 50,000 
to 100,000 bacteria, and no milk containing more bacteria should be sold. 

Judged by the colonies that develop upon agar plates, the number 
of bacteria in milk increases every time it is handled. Separator 
milk contains more than the original milk. The same is trme of 
filtered milk. Milk strained through gauze or cotton, or filtered 

a Park, W. H.: The great bacterial contamination of the milk of cities, can it be 
lessened by the action of health authorities? Journ. Hyg., vol. 1, 1901, p. 391. 



431 

through gravel or any other device, while it looks clean, always con- 
tains more bacteria than before it has been "purified." This is due 
to the fact that, while the visible particles of dirt are held back, the 
particles of manure, dirt, and bacterial clusters are broken up. Fur- 
ther, unless the most painstaking technical precautions are taken, 
milk receives fresh bacterial contamination every time it is poured 
from one vessel to another or is handled in any other way. 

THE INITIAL CONTAMINATION OF MILK. 

Now that we know that milk freshly drawn from the udder under 
ordinary circumstances always contains bacteria, it is of practical 
importance to determine their number and kind. 

Sedgwick and Batchelder, a 1892, found that with moderate pre- 
cautions on the part of the milker the number of bacteria in fresh 
milk may not exceed 500 to 1,000 per cubic centimeter, but when 
the ordinary flaring milk pail is used, with more or less disturbance 
of the bedding and shaking of the udder, as many as 30,000 bacteria 
have been counted in one cubic centimeter. 

MacConkey, & however, finds that with ordinary care and cleanli- 
ness it is possible to obtain milk which when freshly drawn contains 
less than 1,500 organisms per cubic centimeter; and, further, that 
such milk should not contain gas-forming organisms in less than 50 
cubic centimeters. 

Comparing these results with the work of others, we find that 
Park, c 1901, found the average bacterial content of the milk from 
six separate cows examined five hours after collection to be 6,000 
per cubic centimeter, the lowest count being 400, and of 25 cows of 
which the milk was tested immediately after drawn it was 4,550. 

Burr, d 1902, also taking every reasonable precaution, found 500 
organisms per cubic centimeter in the milk of a single cow. 

Von Freudenreich,* 1902, thought it would be easy to carry out 
strict asepsis and thus obtain a bacteria-free milk; but he soon came 
to the conclusion that this was impossible. He found that milk 
always contained 250 to 300 organisms per cubic centimeter, even 

a Sedgwick, William T., and Batchelder, John L.: A bacteriological examination of 
the Boston milk supply. Boston Med. and Surg. Journ., vol. 126, 1892, p. 25-28. 

*>MacConkey: A contribution to the bacteriology of milk. Journ. of Hyg. vol. 
6, 1906, p. 385. 

c Park, William H.: The great bacterial contamination of the milk of cities, can 
it be lessened by the action of the health authorities? Journ. Hyg., vol. 1, 1901. 
p. 391. 

^Burr, Rollin H.: The source of the acid organisms of milk and cream. Cent. f. 
Bakt., 2 Abt., vol. 8, 1902, p. 236. 

«Von Freudenreich, Ed.: Milchsaurefermente und Kasereifung. Cent. f. Bakt., 
2 Abt., vol. 8, 1902, p. 674. 



432 

though the milker's hands and the teats were washed first with soft 
soap and sterile water and then with servatol soap and sterile water, 
and finally with sterile water alone and dried on a sterile towel. 
The milker's hands were smeared with lanoline and the first milk 
rejected. The bacterial content of the mixed milk of 28 cows milked 
in this way varied from 65 to 680 organisms per cubic centimeter. 

Von Freudenreich and Thoni, a 1903, from a further series of 
similar experiments conclude that freshly drawn milk, even when 
the most careful precautions are taken against contamination, always 
contains bacteria; that these are mostly cocci and that they come 
from the udder. 

Continuing his experiments, Von Freudenreich, 6 1903, states that 
he examined the udders and the milk in the udders of 15 cows, in 13 
cases immediately after slaughtering. The organisms were mostly 
cocci. B. lactis acidi was only met with once. In 3 cases the ducts 
were diseased and in these cases the diseased tissues contained fewer 
organisms than usual. B. coli was never found. He mentions that 
Boekhout and De Vries drew milk directly from the udder with a 
sterile canula and always got a growth from it. 

Lux, c 1904, examined milk drawn without aseptic precautions. 
Two hundred and sixty cow-milk and 95 goat-milk samples were 
analyzed. The average number of bacteria per cubic centimeter was 
1,395, which were mostly nonpathogenic cocci. 

Henderson/ 1904, examined seven normal udders and obtained 
growth in 76 per cent of the cultures made, the organisms being 
staphylococci, streptococci, and pseudo-diphtheria bacilli. No organ- 
isms found were pathogenic to laboratory animals. 

Willem and Miele, g 1905, obtained a milk containing 2.5 bacteria 
per cubic centimeter. The milking was done in a special place, 
which was kept as aseptic as possible. The greatest care was taken 
to insure the cows being clean. The udder and teats were washed 
before each milking with soap and boiled water or an aseptic solution. 

From the examples quoted we see that it is practically impossible 
to obtain bacteria-free milk, but that the organisms in carefully col- 
lected milk are not pathogenic to the usual laboratory animals. We 

a Von Freudenreich, Ed., and Thoni, J.: Ueber die in der normalen Milch vorkom- 
menden Bakterien und ihre Beziehungen zue dem Kasereifungsprozesse. Cent. f. 
Bakt., 2 Abt., vol. 10, 1903, p. 305. 

& Von Freudenreich, Ed.: Ueber das Vorkommen von Hakterien im Kuheuter. 
Cent. f. Bakt., 2 Abt., vol. 10, 1903, p. 401. 

c Lux, Arthur: Ueber den Gehalt der frisch gemolkenen Milch an Bakterien. Cent. 
f. Bakt., 2 Abt., vol. 11, 1903, p. 195. 

d Henderson, J.: Journ. roy. san. inst., vol. 25, 1904, p. 563. 

e Willem and Miele: Procede pour l'obtention du lait au aseptique. Compt. 
Bend, du 13 Cong, internat. d'hyg., Brux. ? 1903, vol, 3, p. 67, 



433 

may allow, then, that the presence of such organisms in reasonable 
number would not render a milk harmful to man. Lux's experi- 
ments have shown that with very ordinary care it is possible to 
obtain a milk containing on an average 1,400 bacteria per cubic 
centimeter, and it is obvious that with some trouble the number 
may be reduced. 

The work of Park," 1901, Nicolle and Petit, 6 1903, Conn and 
Esten, c 1904, Koning/ 1905, Harrison, 6 1905, and others has shown 
that if milk be rapidly cooled to 11° C. (50° F.) or below, very little, 
if any, multiplication of micro-organisms takes place for some twelve 
hours. Therefore Park's suggested average standard of not more 
than 12,000 bacteria per cubic centimeter in warm and 5,000 in cold 
weather for freshly drawn milk seems a generous standard and one 
which, with a little care, should be easily attained. 

It is necessary to note that "separator milk" must not be judged 
by the same standard as fresh milk, for Severin and Budinoff/ 1905, 
and Severing 1905, have shown that even when every possible pre- 
caution is taken against contamination, the milk issuing from the 
separator always contains many more bacteria than it did before it 
passed into the separating chamber. Severin suggests that the 
mechanical movement completes the separation of bacteria which 
were only partially divided when they entered the machine. 

Moore h concludes from a large mass of data that freshly drawn 
fore milk contains a variable but generally enormous number of 
bacteria, but only a few species, the last milk containing as compared 
with the fore milk very few micro-organisms. 

Russell * found that the mixed milk of a herd that is kept with 
any reasonable degree of cleanliness, if examined immediately after 

a Park, Wm. H.: The great bacterial contamination of the milk of cities. Can it 
be lessened by the action of health authorities? Journ. Hyg., vol. 1, 1901, p. 391. 

b Nicolle, C, and Petit, P.: Etude experimentale sur la question du lait a Rouen. 
Rev. med. de Normandia, 1903. Rev. Bull, de l'lnst. Pasteur, vol. 2, 1904, p. 552. 

c Conn, H. W., and Esten, W. M.: The effect of different temperatures in deter- 
mining the species of bacteria which grow in milk. Storrs Agric. Exper. Sta., 16th 
ann. rep., June 30, 1904, pp. 27-88. 

d Koning: Biologische und biochemische Studien uber Milch. Milchwirtschaftl. 
Centblt., vol. 1, 1905; Rev., Cent. f. Bakt., 2 Abt., vol. 14, 1905, p. 424. 

e Harrison, F. C: A comparative study of sixty-six varieties of gas-producing bac- 
teria found in milk. Cent. f. Bakt., 2 Abt,, vol. 14, 1905, p. 359. 

/Severin, S., and Budinoff, L. : Ein Beitrag zur Bakteriologie der Milch. Cent. f. 
Bakt., 2 Abt., vol. 14, 1905, p. 463. 

Severin, S.: Vermindert die Zentrifugierung die Bakterienzahl in der Milch? 
Cent. f. Bakt., 2 Abt., vol. 14, 1905, p. 605. 

& Moore: TJ. S. Bur. Animal Indus., 1895-6. 

* Russell, H. L.: Outlines of dairy bacteriology, 1896, p. 59 

45276°— Bull. 56—12 28 



434 

milking, usually will not contain more than 5,000 to 20,000 germs 
per cubic centimeter. 

I have found the milk obtained by careful methods from separate 
cows to contain the following number of bacteria per cubic centi- 
meter immediately after milking: 60, 160, 400, 400, 500, 500, 8,300. 

All these counts are evidently too low, for the reason that not all the 
bacteria produce visible colonies upon agar plates, and further each 
colony does not necessarily represent the growth from one micro- 
organism. Rosenau and McCoy have shown elsewhere (upon the 
germicidal property of milk this Bulletin, p. 447) that the bacteria 
in milk are apt to agglutinate into clusters. 

LEGAL STANDARDS. 

The first attempt to make a standard for the bacteriological con- 
tent of milk was undertaken by the New York board of health, 
which, in 1900, believed it was not necessary for any milk sold in 
New York to contain over 1,000,000 bacteria per cubic centimeter. 
It was found, however, practically impossible to enforce such a 
standard for the city of New York on account of the complexity 
and enormous volume of the milk trade of that city. The princi- 
pal difficulty was to place the responsibility when milk was found 
to contain an excessive number of bacteria, as the milk passed 
through so many hands before it was delivered to the consumer. 

Boston, on the other hand, made a strict standard of 500,000 
bacteria per cubic centimeter, which was legalized by the board of 
health June 6, 1905, in article 6, section 1, of the Regulations for 
the Sale and Care of Milk. According to Jordan, a the adoption of a 
bacteriological standard by the Boston board of health has been 
decried and the subject of scoffing, but the example of that city 
has since been followed by other municipalities, until now nearly 
20 cities are conducting bacteriological investigations of milk sup- 
plies. This outcome is fortunate, for from multiplication of work 
of this character great progress may be expected. 

Goler, 6 health officer of the city of Rochester, issued a circular 
to all milk producers supplying that city, informing them that 
thereafter 100,000 bacteria per cubic centimeter would be made a 
maximum standard. 

a Jordan, James 0.: Boston's campaign for clean milk. Journ. Am. Med. Assn., 
vol. 49, Sept. 28, 1907. 

b Goler, George W.: Municipal regulation of the milk supply. Trans. Soc. on 
Hyg. & San. Science, A. M. A., June 1907, p. 251. 



435 

Bitter a believes that no milk should be sold in cities containing 
more than 50,000 bacteria per cubic centimeter. 

Park 6 states that any intelligent farmer can use sufficient cleanli- 
ness and apply sufficient cold with almost no increase in expense to 
supply milk twenty-four to thirty-six hours old which will not con- 
tain in the maximum over 50,000 to 100,000 bacteria per cubic 
centimeter, and that no milk containing more bacteria than this 
should be used. 

The above figures apply to standards that have been set on market 
milk. So far as milk for infant feeding and other clinical purposes 
is concerned, the standard established by Coit of 10,000 bacteria per 
cubic centimeter as a maximum seems, by almost unanimous consent, 
to be the best. Some communities have adopted a second grade 
of milk known as " inspected" milk from tuberculin-tested cattle 
and obtained under cleanly conditions, and not containing over 
100,000 bacteria per cubic centimeter. 

The number of bacteria, therefore, allowable in milk depends upon 
the purposes for which it is used and varies somewhat with the 
locality. It is evidently easier to obtain milk containing fewer 
bacteria in small communities with a near-by supply and in cold 
climates, than it is in larger cities with inevitable delays in trans- 
portation or in southern latitudes. 

As a general rule it may be stated that " certified " milk should never 
exceed 10,000 bacteria per cubic centimeter, " inspected" milk not 
over 100,000, and health officers should aim to keep the general 
milk supply below the 100,000 mark. 

THE PRACTICAL VALUE OF BACTERIAL EXAMINATIONS OF MILK. 

The activities of our health officers were at first directed almost 
exclusively to the prevention of sophistication of milk, detected by 
chemical methods, to the neglect of the valuable information obtained 
from bacterial examinations. 

The addition of water to milk and the extraction of cream are 
fraudulent practices, but, as a rule, have only a secondary bearing 
upon the public health. The bacteriologic examination of milk 
gives us a clew to the cleanness of the methods employed, the tem- 
perature, and the age of the milk. The health officer who has the 
advantage of bacteriologic assistance knows that the milk of dairies 
containing excessive numbers of bacteria is dirty, old, or warm. 

a Bitter, H.: Versuche iiber das Pasteurisiren der Milch. Zeit. f. Hyg., vol. 8, 
1890, p. 240. 

& Park, William H., and Bebb, Rose A.: The great bacterial contamination of the 
milk of cities. Can it be lessened by the action of health authorities? N. Y. Univ. 
Bull. Med. ScL, vol. 1, 1901. 



436 

With a bacteriologic count as a guide it is comparatively easy to 
determine the cause of the trouble and to institute proper means to 
correct it. The enumeration of bacteria in milk is, therefore, one of the 
readiest and cheapest methods at the disposal of health officers to 
determine the general sanitary quality of the market milk supply. The 
laboratory results serve not only as a guide to direct the efforts of 
the health officer, but confirm the conclusions arrived at from an 
inspection of the dairies and dairy farms. 

While the bacteriological examination of milk has its uses, it also 
has distinct limitations. From a practical standpoint the long time 
required to obtain results is its greatest drawback. The qualitative 
determinations of the bacterial species in milk is too complex and 
difficult a method to adopt as a routine procedure. It is otherwise 
with quantitative counts. These determinations are comparatively 
easy and are of invaluable assistance to the progressive dairyman in 
controlling his methods and in discovering just which cow, what 
person, or what part of the industry is at fault when things go wrong. 

It is comparatively easy to make bacterial counts of milk, and for 
practical purposes the method may soon be learned even by one not 
skilled in bacteriologic technique. Dairymen will find it to their 
advantage to make agar plates and roughly estimate the number of 
bacteria, not only of their finished product, but from individual cows 
and during various stages in the handling of the milk. 

In fact, a number of progressive dairymen are already using bacteri- 
ologic counts of their milk in order to improve the supply. In 
Boston, Jordan tells us that in 1906, six milk firms made over 27,000 
such examinations. 

In Kochester, Goler° has obtained a reduction in the average bac- 
terial count of the milk supply of that city from 837,000 per cubic 
centimeter in 1900 to 200,000 in 1903. In 1900, 26 per cent of the 
samples examined contained over 5,000,000 bacteria per cubic centi- 
meter; in 1903 only 4 per cent contained over 5,000,000. At the time 
the city milk supply contained an average of 235,000 bacteria per 
cubic centimeter, the milk that was procured under a process of cer- 
tification and education contained but 14,000 bacteria per cubic 
centimeter for the same period. 

In Washington the bacteriological examinations made in the 
Hygienic Laboratory and submitted to the dairies by the local health 
officer have stimulated the dairymen to use more ice, with the result 
that during the summer of 1907 the average temperature of 316 
samples of milk examined was 2.3° C. lower than during the correspond- 
ed Goler, G. W.: The influence of the municipal milk supply upon the deaths of 
young children. N. Y. State Journ. Med., vol. 3, 1903, p. 493. 



437 

ing term for 1906, and the average number of bacteria per cubic 
centimeter was cut in half. Convinced of the practical advantages 
of the bacteriological control of milk, one progressive dairyman in 
Washington has employed a competent bacteriologist to assist him 
in marketing a better quality of milk. 

One great advantage accruing from the bacteriological control of 
milk is that it affords an opportunity to exclude the milk of diseased 
cows. Cows frequently suffer with diseases of the udder; in fact, 
garget or mammitis is the most common of all bovine diseases. Milk 
from inflamed udders containing pus-producing organisms (strep- 
tococci) is believed by some to be more important than the pep- 
tonizing species, about which much has been said since the work of 
Fliigge. 

Fresh milk from cows with diseased udders contains an excessive 
number of streptococci and pus cells or an excess of pus cells alone. 
So far as we know, such milk is dangerous for infant feeding. While 
not all agree with this view, nor is there any agreement concerning 
what constitutes an excessive number of streptococci and pus cells in 
milk, the facts have been put to practical use by Jordan in Boston. 
There, milk " infected" with excessive numbers of streptococci or an 
excess of pus was traced back to the cow, with the result that thirty- 
one diseased cows supplying milk to Boston in 1906 were found and 
eliminated. Most of the animals had mammitis or garget ; some had 
ulcerated teats, some had recently calved, and others were approach- 
ing the calving period, etc. a 

BACTERIAL COUNTS OF WASHINGTON MILK. 
METHODS. 

The number of bacteria found in any given sample of milk will 
vary with the methods used. It is not possible by any known 
method in bacteriology to determine the exact number of live bac- 
teria in a sample of milk. The counts obtained are always below 
the actual number present. This is due to a number of reasons. 
First of all the bacteria stick together in groups and clusters; some 
are held together by adhesive membranes in pairs, chains, or masses. 
It is therefore evident that a single colony on a plate may not rep- 
resent the growth from a single micro-organism. 

It is impossible to obtain a medium, temperature, and other condi- 
tions suitable to the requirements of all bacteria. Some grow best 
at high temperatures, others at low; some prefer acid, others alka- 
line media; some need oxygen, which is fatal to others, etc. 

a- Thirty-fifth ann. rep. city of Boston, Health Dept, 1906. 



438 

After careful consideration of the subject the following methods 
have given satisfactory results in this laboratory : a 

The samples were always collected in the original containers, 
either pint or quart bottles being purchased for our purposes. Some 
of these samples were obtained from the wagon on the street, others 
from the dairy, and still others were obtained from houses in various 
parts of the city, at once after being delivered in the usual course of 
trade. It is therefore believed that the samples examined fairly rep- 
resent the average milk obtained by the householder. The samples 
were collected early in the morning and at once placed in a metal con- 
tainer filled with cracked ice. From six to eight samples were collected 
each morning from various parts of the city, and rarely more than two 
hours elapsed from the collection of the first sample to the time it was 
received in the laboratory. The temperature was taken with a good 
thermometer at the time the sample was collected, but always from 
a different bottle, which was afterwards used for chemical purposes. 

It was noted that after the milk stood on ice for some time that 
there might be a difference of 6 to 8 degrees between the top and the 
bottom layers of the milk in a pint bottle. The milk was always 
shaken well in order to mix the cream and to help break up the bac- 
terial clumps before the bottle was opened, which was done with the 
usual bacteriologic precautions. For ordinary market milk the fol- 
lowing dilutions were made : 

1 cubic centimeter milk + 99 cubic centimeters sterile water. 

0.1 cubic centimeter of this was used for the first plate, which rep- 
resented 1:1,000. 

0.5 cubic centimeter of the first dilution was then added to 49.5 
cubic centimeters of sterile water. One cubic centimeter of this dilu- 
tion when plated represented 1:10,000, and 0.1 cubic centimeter of 
this dilution represented 1 : 100,000. 

The dilutions were vigorously shaken at least twenty-five times in 
accordance with the standard methods for water analysis in order to 
obtain uniform suspension of the bacteria. Sterile distilled water was 
used as a diluent. 

The final dilution was measured directly into a petri dish and agar 
poured at a temperature of between 40° and 45° C. in the usual way. 

After the plates were well set, they were grown at 37° C, which 
temperature appears not only to favor the maximum growth of 
bacteria ordinarily found in the milk, but has the additional advan- 
tage of favoring the kinds of bacteria belonging to the pathogenic 

a Since writing this "article the committee on standard methods of bacterial milk 
analysis have presented a preliminary report, which appeared in the American Journal 
of Public Hygiene, vol. 17, November, 1907, pp. 331-364. At the Winnipeg meeting 
of the American Public Health Association in September, 1908, the committee pre- 
sented a report of further progress, an abstract of which appeared in the American 
Journal of Public Hygiene for November, 1908, p. 425. (See also Heineman and 
Glenn's recent article on "A comparison of practical methods for determining the 
bacteriological content of milk," Journ. Infectious Diseases, vol. 5, Oct. 20, 1908, pp. 
412-420.) f 



439 



class. The plates were counted at the end of twenty-four hours, 
although by that time the maximum growth had not appeared. 
Only those colonies were counted which were visible to the naked 
eye or could be seen with a low-power magnifying glass. Three 
plates were always made from each sample, one from each dilution. 
Plates that became spoiled owing to spreading of the surface growths 
over them, irregular distribution, or excessive numbers, were dis- 
carded. The counts were always taken when possible from plates 
containing 200 or less bacteria per plate, the reading being reduced 
to round numbers. 

The composition of the media used for this work was 1.5 per cent 
agar and an acidity of + 1.5 to phenolphthalein as an indicator. 

In accordance with this method a number of samples of milk 
bought on the open market in Washington were examined in the 
Hygienic Laboratory, P. H. & M. H. S., during the summer months 
of 1906-7, the results of which appear in the following tables: 

Results of bacterial counts of market milk in Washington, 1906 and 1907. 



Name. 


Date. 


Samples obtained at— 


Tempera- 
ture of 
milk 

when ob- 
tained 
(°C). 


Number of 
bacteria 
per cubic 

centimeter. 




[July 10,1907 
July 22,1907 
Aug. 5,1907 
LAug. 19,1907 
[July 15,1907 
July 30,1907 
July 31,1907 
lAug. 30, 1907 
[July 11,1907 
lAug. 26, 1907 
J Aug. 1,1907 
lAug. 27, 1907 
{July 12,1907 
lAug. 7,1907 
[July 24,1907 
jjuly 29,1907 
I.Aug. 20, 1907 
J Aug. 30, 1906 
ljuly 13,1907 
Aug. 6, 1907 
[July 16,1907 
lAug. 2, 1907 
(July 12,1907 
Jjuly 22,1907 
[Aug. 14,1907 
lAug. 28,1907 
Aug. 6,1906 
Sept. 5,1906 
....do 




9 
10.5 

9 

6 

17 
22 
11 
23 
18.2 

7.5 
19.5 
14 

26.5 
24 
20 
20 
13 

14.5 
16 
27 
21 
19 
10 
12 

7 

18 
8 
11 
22 
20 
17 


8,000 


As 


Wagon 


69,000 




Dairy 


2, 680, 000 




do 


170, 000 
2, 240, 000 
5, 150, 000 






All 


Providence Hospital 

do 




111,000,000 




Dairy 


190, 000 
1,700,000 


Al 








1, 090, 000 
22, 500, 000 


Alt 


do 




do 


2, 400, 000 
26, 000, 000 








Dairy 


870, 000 




do 


350, 000 


Art 


Wagon 






2, 560, 000 




do 


950, 000 
18, 300, 000 


Av 


Dairy 






3, 660, 000 


B 


Wagon 






1,000,000 


Ba 


do 


2, 800, 000 




do 


880, 000 

700,000 

2, 180, 000 






Bee. 






Dairy. 


11, 700, 000 




do 


320,000 
1, 380, 000 




Wagon 




Dairy 


166, 000 


Be 


Wagon 


260, 000 




July 6, 1907 
Aug. 8, 1907 
Aug. 20, 1907 




34,000 
23, 600, 000 




Dairy 






94,000 



440 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera 

ture of 

milk 

when ob 
tained 
(°C). 



Number of 
bacteria 
per cubic 

centimeter. 



Bel. 



Ch. 



Ben 
Br. 
Bri. 

Bro 

Bu. 
Ca.. 

Car. 

Ce.. 
C... 



Aug. 13,1906 
Aug. 16,1906 
Sept. 10, 1906 
Sept. 11, 1906 
Sept. 12, 1906 
Sept. 13, 1906 
Sept. 14, 1906 
Sept. 15, 1906 
Sept. 17, 1906 
Sept. 18, 1906 
Sept. 19, 1906 
Sept. 20, 1906 
Sept. 21, 1906 
July 6,1907 
July 23,1907 
July 24,1907 
July 25,1907 
July 26,1907 

..do 

Aug. 1,1907 
Aug. 2, 1907 
Aug. 5,1907 
Aug. 19,1907 
July 17,1907 
Aug. 7,1907 
July 30,1907 
July 31,1907 
Aug. 7,1907 
July 5, 1907 
July 11,1907 
July 29,1907 
July 19,1907 
July 6, 1907 
July 23.1907 
Aug. 6, 1907 
Aug. 20,1907 
July 5, 1907 
July 16,1907 
July 25,1907 
Aug. 13,1907 
Aug. 30,1907 
Aug. 13,1906 
Aug. 16,1906 
Aug. 21,1906 
Aug. 22,1906 
Aug. 23,1906 
Aug. 24, 1906 
July 10,1907 
July 17,1907 
July 25,1907 
July 29,1907 
Aug. 1,1907 
Aug. 23,1907 



Wagon. 
Dairy.. 
Wagon. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 



Wagon 

Dairy 

Wagon 

Children's Hospital. 

do 

Columbia Hospital. 

do 

Wagon 

....do 



Dairy. 



Wagon . 
....do. 
....do. 



Dairy. 



Dairy.. 
Wagon. 
Dairy.. 



Dairy.. 
....do. 
....do. 
....do. 
....do. 
Wagon . 
....do. 
....do. 
....do. 



Dairy. 
....do. 
....do. 



11 
17 
11 
12 
17 
21 
19 
10 
12 
21 

8 
18 
14 
14 
16 
13 
11 
11 
21 
14.5 

9 
20 
18 
18 
20 

9.5 
12 

9 

9.5 
12.5 
19 
15 
13 
15 
16 
12 



8 

11 

11 
6.5 
9.5 

10 

10 

73.5 



6,200,000 

3,600,000 

5,400,000 

8,900,000 

5,200,000 

370,000 

8,700,000 

1,500,000 

9,700,000 

17,600,000 

69,600,000 

7,900,000 

20,000,000 

2,300,000 

3,520,000 

14,400,000 

730,000 

1,920,000 

2,000,000 

3,660,000 

15,000,000 

8,000,000 

3,000,000 

4,300,000 

55,000,000 

1,620,000 

150,000 

113,000 

51,000 

16,300,000 

20,000,000 

6,800,000 

33,000,000 

30,800,000 

840, 000 

6,000,000 

176,000 

101,000 

800,000 

4,000,000 

70,000 

3 

36,000 

17,000 

190, 000 

64, 000 

42,000 

7,000 

140, 000 

30,000 

25,000 

23,000 

2,000 



441 



Results of bacterial counts of market milk in Washington, 1906 and 1907— Continued. 



Name. 


Date. 


Samples obtained at— 


Tempera- 
ture of 
milk 

when ob- 
tained 
(PC.). 


Number of 
bacteria 
per cubic 

centimeter. 




/Aug. 13,1906 
Aug. 20,1906 
Aug. 28,1906 
Sept. 11, 1906 
Sept. 12, 1906 
Sept. 13, 1906 
Sept. 14, 1906 
Sept. 15, 1906 
Sept. 17,1906 
Sept. 18, 1906 
Sept. 19, 1906 
Sept. 20, 1906 
Sept. 21, 1906 
July 16,1907 
Aug. 2,1907 
Aug. 21,1907 
Aug. 27,1907 
VAug. 30,1907 
rJuly 19,1907 
ljuly 30,1907 
[Aug. 13,1907 
July 31,1907 
Sept. 6, 1906 
July 16, 1907 
Aug. 2, 1907 
Aug. 9, 1907 
Aug. 21, 1907 
Aug. 30, 1907 
[July 31, 1907 
JAug. 22, 1907 
[Aug. 26, 190" 
JAug. 3, 1906 
lAug. 9, 1907 
[July 15,1907 
■ do 




17 
15 
12 
23 
22 
20 
21 
15 
19 
22 
21 
18 
22 
21 
16 
13 
14 

8 
14 
14 
12 
17 
11 

14.5 
15 
16 
15 
15 
14 

9 
13 

21.5 
19.5 
13.5 
18 
12 

15.5 
15 

9 
15 

8.5 
17 
19 
12 
21 

14.5 
14 
11 

22.5 
24 
23 
19 


2,500,000 






44,000,000 




do 


33,000,000 






22,800,000 




do 


9,870,000 




do 


10,700,000 




.do 


7, 400, 000 




.do 


1,010,000 


Che 


do 


550,000 




.do 


11,000,000 




.do 


44, 000, 000 




do 


14, 900, 000 




do 


5, 800, 000 






30,800,000 






8,900,000 




do 


61,000,000 
1,900,000 




do 


21,000,000 




do 


208, 000 


Cla 


do 


500,000 




.do 


540, 000 


Cle 


do.., 


10, 300, 000 




Wagon 


4,860,000 






113,000 






3,200,000 


Clo 








1,600,000 




do 


4,000,000 






1,700,000 






2,500,000 




D " 


8,900,000 




do 


2,100,000 




Wagon 


12,500,000 




do 


160,000 




do 


2,280,000 




.do 


740, 000 


Cud 


lAug. 7,1907 
[Aug. 22, 1907 
[Aug. 13,1906 

Sept. 25,1906 

July 5, 1907 
jjuly 17,1907 

July 25,1907 

Aug. 7,1907 
Lug. 29,1907 

Aug. 2,1906 
[July 19,1907 

July 31,1907 
[Aug. 22,1907 
[July 8, 1907 
J July 18,1907 
[Aug. 22,1907 

July 30,1907 


do 






810, 000 




do 


2,900,000 




do. ' 


11,200,000 
380,000 




do 


5,450,000 


Du 




65,400.000 






4,000,000 






116,000 




do 


710,000 


Ec 


Wagon 


5,900,000 






1,180,000 


Ed 




4,000,000 






221,000 






33,000 


Edw 




420,000 




do 


600,000 






2,500,000 



442 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 

ture of 

milk 

when ob- 
tained 
(°C). 



Number of 
bacteria 
per cubic 

centimeter. 



Ev. 



Qle. 



Fa 

Fr 

Fy 
Ga 
Gi. 

Gl. 



Go. 



'Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
July 
July 
July 
,Aug. 
Aug. 
Aug. 
Sept. 
July 
July 
July 
Aug. 
Aug. 
Aug. 
Sept. 
July 
July 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
July 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
July 
July 
July 
Aug. 
Aug. 
July 
Aug. 
Aug. 



8,1906 
10,1906 
13, 1906 
14, 1906 
15, 1906 
16, 1906 
17, 1906 
20,1906 

22. 1906 
9,1907 

15. 1907 
24, 1907 
12, 1907 

20. 1906 
21,1906 

5. 1906 

5. 1907 
17,1907 
25,1907 

9, 1907 

19. 1907 
22, 1906 

25. 1906 
9,1907 

31,1907 

15. 1907 
29, 1907 

2. 1906 
2,1907 

20, 1907 
22, 1907 
10, 1907 
16, 1907 
1,1907 
6,1907 
19, 1907 
27, 1907 

29. 1906 
11,1907 

15. 1907 
29, 1907 
19, 1907 
26, 1907 
13, 1907 

6. 1907 
29, 1907 



Wagon. 
....do.. 
....do.. 
....do. 
....do., 
....do. 
....do. 
....do. 
Dairy. . 



Dairy. 



Dairy. 
....do. 
....do. 



Dairy . 
....do. 



Dairy 



Wagon. 

Dairy. . 

Wagon. 

....do.. 
.•...do.. 
do.. 

....do., 

....do.. 

Dairy. . 

Wagon. 

do. 

do. 

do. 

Wagon. 



Wagon. 
Dairy.. 
Wagon. 
Dairy.. 



15 
16 
15 
15 
15 
17 
16 
23 
16 

5 

14 
16 

2 
13 
15 
16 
15 

13.5 
11 
17 

8 
14 
11 

13.5 
18.5 
10.5 
15 
24 
11 
15 
19 
20 
18 

10.5 
17 
13 



20.5 
11.5 
12 
14 
8.5 
11 



Dairy. 
....do. 



9,200,000 

45,900,000 

15,600,000 

18,200,000 

8,400,000 

2,500,000 

6,800,000 

19,200,000 

28,800,000 

5,700,000 

14,400,000 

16,000,000 

2,140,000 

2,400,000 

4,300,000 

1,930,000 

1,320,000 

11,100,000 

1,600,000 

720,000 

1,500,000 

1,640,000 

2,800,000 

74,000,000 

416,000 

5,000,000 

2,000,000 

220,000 

2,900,000 

6,600,OU0 

11,500,000 

10,300,000 

170,000 

1,320,000 

123,000 

700,000 

2,100,000 

1,655,000 

4,300,000 

4,000,000 

11,800,000 

10,000,000 

29,800,000 

930,000 

6,000 

690,000 



443 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 

ture of 

milk 

when ob- 
tained 
(°C). 



Number of 
bacteria 
per cubic 

centimeter. 



Gr. 



Gy. 



Ha. 



Har. 



He. 



Hi, 



Hil. 



Ho. 



Hor. 
Hou. 
Hy.. 



Aug. 14,1906 
Aug. 15,1906 
Aug. 16,1906 
Aug. 27,1906 
July 13,1907 
July 18,1907 
July 24,1907 
July 26,1907 
Aug. 12,1907 
Aug. 20,1907 
Aug. 15,1907 
Aug. 6, 1906 
Sept. 25, 1906 
July 17,1907 
Aug. 5,1907 
Aug. 27,1907 
July 17,1907 
Aug. 12,1907 
Aug. 21,1907 

....do 

....do 

Aug. 30,1907 
Aug. 28,1906 
Aug. 31,1906 
July 12, 1907 
Aug. 12, 1907 
Aug. 23, 1907 
Aug. 8, 1907 
Aug. 23, 1907 
Aug. 7, 1906 
Aug. 20, 1906 
Aug. 21, 1906 
July 5, 1907 
July 25,1907 
Aug. 27,1907 
Aug. 3,1906 
Aug. 2,1907 
July 12,1907 
July 26,1907 
Aug. 16,1907 
Aug. 28, 1907 
July 16,1907 
Aug. 20, 1907 
Aug. 9,1907 
Aug. 30, 1907 
July 25,1907 
Aug. 12,1907 



Wagon. 
....do.. 
....do. 
Dairy.. 



Wagon. 



....do., 
Dairy.. 
Wagon. 
Dairy. . 



Dairy 

Wagon 

do 

do 

do 

Georgetown Hospital. 

do 

Wagon 

Wagon '.. 

Dairy 



Dairy.. 
....do. 
Wagon. 
....do.. 
....do. 
Dairy. . 
....do.. 
....do.. 



Wagon . 
....do. 
....do. 



Dairy. . 

do. 

Wagon. 

do. 

....do. 
....do. 
....do. 
....do. 
....do. 



20 
17 
16 
15 
14 
13 
20 
12 

18.5 
18 
6 
22 
11 



6.5 
18 
18 
19 
19 
12 
17 
14 
15 
12 
14 
16.5 

9.5 



8.5 
22 
23 
18 
17 
23 
12 
24 
21 

9 
13 

8.5 

7.5 
20 
20 
23 
19 
24 
22 



27,000, 

36, 600, 

4,000, 

11,300, 

1,560, 

2,170, 

2,000, 

2,340, 

14,100, 

2,300, 

520, 

1,800, 

2,500, 

3,500, 

1,020, 

2,200, 

2,520, 

4, 150, 

19,200, 

50,000, 

4,000, 

34, 

50, 400, 

43, 100, 

41,000, 

115, 000, 

14, 200, 

17,000, 

3,600, 

4,200, 

5,300, 

6,600, 

1, 240, 

3,280, 

1,050, 

42,000, 

243, 

2,100, 

1,040, 

4,300, 

9,700, 

4,300, 

10, 

560, 

36,800, 

7,000, 

12,000, 



000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 
000 



444 



Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 

ture of 

milk 

when ob- 
tained 
(°C). 



Number of 
bacteria 
per cubic 

centimeter. 



In. 



Ja. 



Je. 



Kl.. 

La.. 
Le.. 

Li.. 

M... 

Ma- 
Mar 

Mc. 

Me.. 
Mi.. 

Mo.. 
Mor. 



Aug. 13 
Aug. 27 
Aug. 29 
Aug. 30 
July 9 
July 22 
July 24 
July 29 
Aug. 7 
Aug. 12 
....do. 
Aug. 13 
Aug. 14 
Aug. 15 
Aug. 16 
Aug. 17 
July 22 
Aug. 7 
Aug. 23 
Aug. 28 
Sept. 11 
Sept. 12 
Sept. 13 
Sept. 14 
July 10 
July 26 : 
Aug. 23 
Aug. 9 
Aug. 22 
Aug. 28 
July 23 
Aug. 21 
Aug. 16 
Sept. 25 
July 6 
July 24 
Aug. 15 
fJuly 29 
\Aug. 27 
Aug. 14 
Aug. 9 

f do 

lAug. 20 ; 
fJuly 30 
lAug. 29 
July 13 
Aug. 6 
Aug. 15 
Aug. 28 
Aug. 23 



1906 
1906 
1906 
1906 
1907 
1907 
1907 
1907 
1907 
1907 



1906 
1906 
1906 
1906 
1906 
1907 
1907 
1907 
1906 
1906 
1906 
1906 
1906 
1907 
1907 
1907 
1907 
1906 
1906 
1907 
1907 
1906 
1906 
1907 
1907 
1907 
1907 
1907 
1907 
1907 



1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 



Dairy. . 
....do. 
Wagon. 
....do.. 



Dairy 

Garfield Hospital 

....do 

Dairy 

Wagon 

....do 

....do 

....do 



Dairy. . 
....do. 
Wagon. 
....do. 
....do. 
....do. 
....do. 



Wagon. 
Dairy.. 
Wagon . 



Wagon . 
....do., 
Dairy.. 
....do.. 



Dairy. . 
Wagon . 
....do.. 
....do. 
....do.. 
....do. 
....do.. 
....do. 
....do.. 



Dairy.. 
....do.. 
....do.. 
Wagon. 



15.5 

15 

10.5 

12 

14 

12 

18 

18 

17 

20 



18.5 

19 

21 

15 

19 

15 

14 

9 
16 
14 
16 
18 
18 

16.5 
18 

9 
16 
22 
17 
21 
20 
12 
10 
16 
17 
19 
18 
15 
18 
25 
15 
10 
21 
16 
10 
12.5 



12 



27,000,000 

23, 400, 000 

30,600,000 

53,400,000 

8,800,000 

1, 710, 000 

480,000 

1,190,000 

10,000,000 

340,000 

10,000,000 

50,400,000 

40,600,000 

5,700,000 

30, 600, 000 

4,800,000 

49,600,000 

4, 900, 000 

1, 990, 000 

65,820,000 

40,800,000 

3,900,000 

1,415,000 

24,600,000 

59, 200, 000 

4,000,000 

3,800,000 

3,800,000 

2,400,000 

5,000,000 

7,200,000 

1,500,000 

145,800,000 

3,100,000 

1,050,000 

45,000,000 

28,000 

170,000 

80,000 

2,300,000 

16,200,000 

250,000 

350,000 

280,000,000 

23,600,000 

57,400,000 

31,000,000 

27,000,000 

4,200,000 

520,000 



445 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 
ture of 
milk 

when ob- 
tained 
(°C). 


Number of 
bacteria 
per cubic 

centimeter. 


15 


550,000 


13 


11,800,000 


14 


42,000,000 


8.5 


100,000 


4.5 


1,420,000 


21 


55,200,000 


23 


40,500,000 


18 


43,800,000 


11 


3,300,000 


22 


63,000,000 


17 


34,200,000 


17 


39,000,000 


19 


132,000,000 


20 


63,600,000 


13.5 


510,000 


12 


560,000 


9 


480, 000 


8 


1,900,000 


9 


97,000 


10 


2,900,000 


12 


660,000 


17.5 


24,000,000 


14.5 


130,000 


17 


1,210,000 


10 


6,806,000 


9 


17,000,000 


8 


13,400,000 


23.5 


135,000 


21 


6,000 


14 


13,470,000 


14 


6,700,000 


18 


7,000,000 


16.5 


3,850,000 


18.5 


19,300,000 


21 


28,000,000 


16 


10,000,000 


13 


1,505,000 


11 


34,600,000 


16 


69,000,000 


10 


440,000 


11 


44,000,000 


21 


430,000 


20 


500,000 


17 


3,900,000 


12 


1,150,000 


9 


4,000,000 


24 


94,000 


23 


8,000 


25 


1,000,000 


20 


1,500,000 


10.5 


15,800,000 


23.5 


16,000,000 



Mou. 



Na. 



No. 



Ou. 



Ox. 



Pe. 



Po. 



Py- 



Qu. 



Re.. 
Rei. 
Reu. 
Ri.. 



Aug. 29 : 
Sept. 26, 
July 18 : 
July 29 : 
Aug. 26, 
Aug. 8, 
Aug. 10, 
Aug. 27, 
Sept. 8, 
Sept. 10, 
Sept. 11, 
Sept. 12, 
Sept. 13, 
Sept. 14, 
July 10, 
Aug. 9, 
Aug. 28, 
Aug. 29, 
I^Aug. 30, 
Sept. 5, 
Sept. 25, 
July 15, 
Aug. 8, 
Aug. 22, 
Aug. 30, 
Aug. 31, 
Aug. 14, 
Aug. 6, 
Aug. 16, 
Aug. 16, 
Aug. 23, 
Aug. 29, 
July 6, 
July 16, 
July 23, 
Aug. 8, 
Aug. 20, 
Aug. 27, 
(-July 12, 
Aug. 8, 
I Aug. 19, 
Aug. 5, 
Aug. 19, 
July 9, 
July 29, 
Aug. 16, 
[July 15, 
I Aug. 16, 

do.. 

Aug. 14, 
July 18, 
Aug. 3, 



Wagon 
Dairy.. 



1906 
1906 
1907 
1907 
1907 
1906 
1906 
1906 
1906 
1906 
1906 
1906 
1906 
1906 
1907 
1907 I Dairy 



Dairy.. 
....do.. 
Wagon. 
....do.. 
Dairy.. 
Wagon. 
....do.. 
....do.. 
....do.. 
....do.. 
....do. 



1907 
1907 
1907 
1906 
1906 
1907 
1907 
1907 
1906 
1906 
1907 
1907 
1907 
1906 
1906 
1906 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 



1907 
1907 
1906 



....do.. 
....do.. 
....do.. 
Wagon. 
Dairy.. 
Wagon. 
....do.. 
....do.. 
Dairy.. 
....do.. 
....do.. 
Wagon. 
....do.. 
Dairy. . 
Wagon. 
....do.. 



Wagon. 
....do. 
Dairy . . 



Wagon. 



Dairy.. 

do. 

Wagon. 
do. 



Wagon. 



Wagon. 

do. 

do. 



Wagon. 



446 



Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 




Samples obtained at- 



25 


1907 


12 


1907 


12 


1907 


26 


1907 


12 


1907 


15 


1907 


23 


1907 


29 


1907 


9, 


1907 


22, 


1907 


5, 


1907 


13 


1907 


20 


1907 


28 


1907 


29, 


1907 


30 


1907 


30 


1907 


2, 


1906 


20 


1906 


21 


1906 


22 


1906 


23 


1906 


24 


1906 


18 


1907 


31 


1907 


5 


1907 


7 


1907 


13 


1907 


26 


1907 


8, 


1907 


14 


1907 


28 


1907 


8, 


1907 


6, 


1907 


15 


1907 


28 


1907 


11 


1907 


31 


1907 


26 


1907 


1 


1907 


19 


1907 


27 


1907 


22 


1907 


5 


1907 


19 


1907 


17 


1906 


18 


1906 


19 


1906 


20 


1906 


21 


1906 


13 


1907 


30 


1907 


15 


1907 



Tempera- 
ture of 
milk 

when ob- 
tained 
(°C). 


Number of 
bacteria 
per cubic 

centimeter. 


21 


330,000 


21 


370,000 


12 


320,000 


10.5 


65,000,000 


11.5 


21,400,000 


11 


10,000,000 


10 


1, 550, 000 


14 


5,500,000 


15.5 


36,000,000 


9 


5,300,000 


12 


2,800,000 


11 


50,000,000 


9.5 


3,700,000 


11.5 


7,000,000 


5 


15,500,000 


9 


101,000 


22 


1,300,000 


24 


60,000,000 


24 


307,800,000 


23 


80,000,000 


24 


4,000,000 


24 


1,000,000 


19 


9,800,000 


10 


1,880,000 


31 


2,860,000 


15 


480,000 


18 


2,440,000 


7 


12,800,000 


7 


1,900,000 


14 


58,000,000 


8 


5,000,000 


4.5 


1,400,000 


11 


31,200,000 


10.5 


1,410,000 


7 


182,000 


6 


700,000 


11.2 


4,000,000 


8.2 


23,000,000 


7 


440,000 


24 


75,000 


20 


700,000 


20 


2,000,000 


21 


800,000 


17 


106,000 


21.5 


2,030,000 


13 


4,400,000 


16.5 


2,200,000 


20 


6,100,000 


16 


33,150,000 


14.5 


12,860,000 


16 


4,270,000 


14 


4,700,000 


5 


1,600,000 



Ro. 



Ru. 



Sh. 



Sha. 
She. 

Shu. 

Si... 

Sm. 
Smo 



Sp. 



July 

Aug. 

July 

July 

Aug. 

Aug. 

Aug. 

Aug. 

July 

July 

Aug. 

Aug. 

Aug. 

Aug. 

Aug. 

Aug. 

July 
fAug. 

Aug. 

Aug. 

Aug. 

Aug. 

Aug. 

July 

July 

Aug. 

Aug. 

Aug. 
[Aug. 

July 

Aug. 

Aug. 

July 

Aug. 

Aug. 

Aug. 

July 

July 

Aug. 
[Aug. 

Aug. 
lAug. 

Aug. 
JJuly 
lJuly 
'Sept. 

Sept. 

Sept. 

Sept. 

Sept. 

July 

July 

Aug. 



Wagon 
....do. 



Dairy 

Sibley Hospital. 

Dairy 

Wagon 



Wagon. 
Dairy.. 
....do.. 
....do.. 
....do. 
....do. 
Wagon. 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 



Orphan Asylum. 

Wagon 

....do 

Dairy 

....do 



Dairy. 
....do. 



Dairy. 
....do. 
....do. 



Dairy.. 
....do. 
Wagon . 

do. 

....do. 

do.. 

do. 

....do. 

do. 

do. 

do. 

.....do. 
do. 



Wagon. 
Dairy.. 



447 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 
ture of 
milk 
when ob- 
tained 
(°C). 



Number of 
bacteria 
per cubic 

centimeter. 



Spr. 



Spri. 



St. 



Su. 



Ta. 



Te. 



Th. 



Tr. 



Un.. 



July 31 
Aug. 6 
Aug. 24 
Aug. 27 
July 17 
Aug. 5 
Aug. 21 
Aug. 3 
[July 
July 26 
Aug. 6 
Aug. 15 
Aug. 23 
JAug. 8 
JAug. 14 
Aug. 30 : 
....do.. 
Aug. 31 
....do. 
July 12 
July 19 
July 22 
July 23 
Aug. 5 
Aug. 8 
Aug. 14 
[Aug. 16 
("July 12 
Aug. 8 
[Aug. 15 
(July 16 ; 
{Aug. 2 
Aug. 14 
Aug. 15 
Aug. 16 
Aug. 17 
Aug. 24 
July 11 
July 18 : 
July 24 
Aug. 13 
Aug. 26, 
Sept. 26 : 
Aug. 2, 
Aug. 13 
Aug. 21 
Aug. 23 
Aug. 27 
July 8 
July 22 
Aug. 7 
Aug. 16 



1906 
1906 
1906 
1906 
1907 
1907 
1907 
1906 
1907 
1907 
1907 
1907 
1907 
1906 
1907 
1906 



1906 



1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1907 
1906 
1906 
1906 
1906 
1906 
1907 
1907 
1907 
1907 
1907 
1906 
1907 
1907 
1907 
1906 
1906 
1907 
1907 
1907 
1907 



Wagon 
....do. 
Dairy. 
....do. 

Dairy. 
....do. 
Wagon 

Dairy.. 
Wagon 
Dairy. 
Wagon 
....do. 
Dairy. 
Wagon 
Dairy. 
Wagon 

Wagon 
....do. 
Dairy. 
....do. 

Dairy. 
....do. 
Wagon 
....do. 
....do. 
....do. 
....do. 
....do. 
....do. 

Wagon 
Dairy. 
....do. 
....do. 
....do. 
....do. 
....do. 

Dairy. 

Dairy. 
....do. 



20 
20 
20 
12 
23 
14 
11 
12 
13 
10 
11 
14 
8.5 
22 
15 



10 
15 
21 
11 

9.5 

7 

16.5 
13 

9 

9.5 

9.5 
15 
13 

22.5 
21 
17 
15 
24 
25 
24 
16 
11.5 
18 
10 
10 
13 
16 
23 
20 
12 
13 
13 

8 
11 



1,600,000 

9,580,000 

2,100,000 

9,000,000 

250,000 

22,000,000 

78,000,000 

260,000 

300,000 

940,000 

2,500,000 

200,000 

159,000,000 

44,400,000 

30, 000, 000 

14, 000, 000 

11,500,000 

42,000,000 

33,000,000 

2, 570, 000 

63, 000, 000 

87,500,000 

7,700,000 

650, 000 

2,000,000 

100,000,000 

42,000,000 

8,900,000 

2,050,000 

100,000,000 

640,000 

400,000 

1, 300, 000 

2, 400, 000 

4,800,000 

12,000,000 

15, 600, 000 

297,000 

57,000 

1,080,000 

100,000 

2,500,000 

420, 000 

1,190,000 

180,000 

4,200,000 

13,400,000 

28,200,000 

109,000 

182,000 

107,000 

5,000 



448 

Results of bacterial counts of market milk in Washington, 1906 and 1907 — Continued. 



Name. 



Date. 



Samples obtained at- 



Tempera- 

ture of 

milk 

when ob- 
tained 

(°C.). 



Number of 
bacteria 
per cubic 

centimeter. 



Va. 
Vi. 



Wa. 



Wal. 



Way. 



Wy. 



Average for 1906. 
Average for 1907. 



Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 
Aug. 



1, 1907 
8, 1906 
1, 1906 
2, 1906 
3, 1906 
6, 1906 
7, 1906 
8, 1906 
9, 1906 
10, 1906 
Aug. 11,1906 
Aug. 13,1906 
Aug. 14,1906 
Aug. 15,1906 
Aug. 16,1906 

....do 

Aug. 17,1906 
Aug. 20,1906 
Aug. 21, 1906 
Aug. 28, 1906 

....do 

Sept. 26, 1906 
July 19,1907 
July 24,1907 
Aug. 1,1907 
Aug. 13,1907 
Aug. 20,1906 
Aug. 21,1906 
Aug. 22,1906 
Aug. 23,1906 
Aug. 24,1906 
July 23,1907 
Aug. 14,1907 
Aug. 28,1907 
Aug. 29,1907 
Aug. 2,1906 
'July 15,1907 
July 19,1907 
Aug. 21,1907 
Aug. 26,1907 
Sept. 4,1907 
Sept. 5,1907 



Wagon. 

....do. 

do. 

do. 

do. 

....do. 

....do. 

....do. 

....do. 

do. 

do. 

do. 

do. 

do. 

do. 

do. 

do. 

do. 

do. 

do. 

....do. 

Dairy.. 



Wagon. 
Dairy.. 



Wagon. 

do.. 

do.. 

do.. 

do.. 



Dairy.. 

do.. 

do.. 

Wagon. 



Wagon. 

do.. 

do.. 

do.. 



24 
21 
18 
18 
19 
22 
21 
12 
15 
15 
16 
14 
14 
14 
19 
19 
14 
23 
18 
16 
16 
10 

9 
10.5 

4.5 

5.5 
22 
24 
23 
23 
22 

5 
11 
21 

8 
24 
15 
12 
18 

9 
17 

4 



16.5° C. 
14. 2° C. 



1,000,000 

105,000,000 

400,000 

3,200,000 

520,000 

200,000 

290,000 

156,000 

40,000 

55,000 

41,000 

48,000 

39,000 

80,000 

130,000 

134,000 

73,000 

108,000 

196,000 

86,000 

84,000 

2,100,000 

3,080,000 

340,000 

210,000 

160,000 

28,800,000 

238,000,000 

63,000,000 

119,000,000 

201,000,000 

70,500,000 

26,000,000 

2,800,000 

2,000,000 

31,800,000 

7,000,000 

6,250,000 

6,800,000 

590,000 

3,900,000 

10,300,000 



22,134,000 
11,270,000 



449 

BACTERIAL COUNTS IN OTHER CITIES. 

The great bacterial contamination of milk in other cities is given 
in order to compare with the results found in Washington. 

The statement is frequently made that the milk of American 
cities has fewer bacteria than that of European cities. The methods 
used for making bacterial counts differ, so that comparisons are dif- 
ficult to make. The larger cities have a much greater bacterial 
contamination in their general milk supply than the smaller cities 
and towns. We would expect this difference when we recall how 
much easier it is to obtain milk less than 24 hours old in villages and 
small towns. 

In comparing the following figures it must be remembered that in 
'some instances the milk is collected as it reaches the city, while 
in other instances, corresponding to our work in Washington, the 
samples were taken as they reached the consumer. Bacteria 
multiply enormously between the time the milk arrives in a city and 
the time it is delivered to the consumer. 

Von Geuns a in 1885 was the first to give us information concern- 
ing the number of bacteria contained in milk. He found 10,545 
bacteria per cubic centimeter in the so-called pasteurized milk sold 
in Amsterdam. 

Clauss, & 1889, made eight examinations of the fresh dairy milk of 
Wiirzburg in the winter of 1888-89 and found the average bacterial 
content to be between 1,000,000 and 2,000,000, the lowest count 
being 222,000 and the highest 2,300,000. The author says that 
Hohenkamp c in the summer, in Wiirzburg, found the bacterial con- 
tent to range between 1,900,000 and 7,200,000 per cubic centimeter. 

Cnof, d 1889, working with Escherich, found in the milk of Munich, 
as it came to the hands of the consumer five to six hours after the 
milking, that the bacterial content ranged between 200,000 and 
6,000,000 per cubic centimeter; a few moments after milking the 
number ranged between 60,000 and 100,000 per cubic centimeter. 

Renk,* 1891, found between 6,000,000 and 30,700,000 bacteria per 
cubic centimeter in the milk supply of Halle. Further, from a series 
of 30 tests it was found that an average of 15 milligrams of cow's 

° Von Geuns, J.: Ueber die Einwirkung des sog. " Pasteuricirens" auf die Milch. 
Arch. f. Hyg., vol. 3, 1885, p. 464. 

b Clauss, Johannes: Bacteriologische Untersuchungen der Milch im Winter 1888- 
89 in Wurzburg mit besonderer Beriicksichtigung der Milchsaure Bildenden Bac- 
terien. Inaug. disserta., Wurzburg, 1889. 38 p. 8°. 

c Hohenkamp: Arch. f. Hyg., vol. 14, p. 260. 

d Cnof: Quantitative Spaltpilzuntersuchungen in der Kuhmilch. Cent. f. Bakt., 
vol. 20, 1889, p. 553. 

e Renk: Ueber Martmilch in Halle. Munch, med. Woch., 1891. Rev. by Esche- 
rich, Cent. f. Bakt., vol. 10, 1891, p. 193. 
45276°— Bull. 56—12 29 



450 

excrement per liter was contained in the milk supply of Halle ; Leipzig, 
3.8 milligrams; Berlin, 10.3 milligrams, and Munich, 9 milligrams. 

Uhl a in 1892 showed the great fluctuation in the bacterial content 
of the milk of Giessen. In May, 1892, from 30 examinations he found 
it ranged between 83,000 and 169,600,000; in June the lowest count 
was 10,500 and the highest 13,600,000. The average in May was 
22,900,000, and the average in June was only 2,900,000. 

Sedgwick and Batchelder, 6 1892, were the first to record the bacterial 
content of milk from an American city. From a series of examina- 
tions of the milk supply of Boston and its suburbs they report as 
follows : 



City. 


Samples. 


Bacteria 
per cubic 
centimeter. 


City. 


Samples. 


Bacteria 
per cubic 
centimeter. 


Charleston 


8 
9 
10 


4,222,500 
2,778,000 
3,259,600 


Roxbury 

North End 


17 
6 

7 


1,874,300 

708, 100 

1,189,800 













These samples were taken directly from the milk wagons and 
planted at once. 

From groceries 16 samples additional were taken which averaged 
4,577,000 bacteria per cubic centimeter. 

Ten samples collected from well-to-do families averaged 1,438,000 
bacteria per cubic centimeter. 

Forty-four samples of the so-called "railroad" milk from one 
dealer averaged 500,000 per cubic centimeter. The extremes were 
5,664,000 and 2,200. 

Another set of ten samples examined on arrival in Boston averaged 
371,000 per cubic centimeter. 

Knochenstiern c in 1893 gives the results of examination of milk at 
Dorpat, Russia, between September 18 and January 25, as follows: 

Average bac- 
teria per 
cubic cent- 
imeter. 

From milkmen 10, 200, 000 

Village milk 12, 000, 000 

Market milk 25, 000, 000 

Shop milk 30, 000, 000 

a Uhl: Untersuchungen der Martmilch in Giessen. Zeit. f. Hyg., vol. 12 : 1892, p. 475. 

& Sedgwick and Batchelder: A bacteriological examination of the Boston milk sup- 
ply. Boston Med. and Surg. Journ., vol. 126, 1892, p. 25. 

c Knochenstiern, Hugo: Ueber dem Keimgehalt der Dorpater Martmilch nebst 
einigen bacteriologischen Untersuchungen von Frauenmilch. Inaug. Disserta., 
Dorpat. 1893. 51 p. 8°. 



451 

The same author gives abstracts of findings by the following 
authors : 



Author. 



Buiwid (16 examinations) 

Genus (dairy milk) 

Cunningham, D. (1891) . . . 



City. 



Warsaw 

Amsterdam 
Calcutta 



Average bacteria 
per cubic centi- 
meter. 



4,000,000 

2,500,000 

3, 400 to 3, 000, 000 



Rowland, 1895, found the average bacterial content of 25 sam- 
ples of milk in London to be 500,000 per cubic centimeters. 

Frye b in 1896 examined nine samples of milk in Buffalo as it was 
delivered to the consumer from December 28, 1895, to June 11, 1896, 
and found the bacterial content to range from 48,000 to 43,600,000 
per cubic centimeter. 

In six samples of grocery milk examined from January 26 to June 
11, 1896, the bacterial content ranged between 25,000 and 25,000,000 
per cubic centimeter. 

In seven samples of "certified milk" the bacterial content ranged 
between 4,400 and 132,700 per cubic centimeter. 

Pakes c in 1900 states that London's milk supply contains between 
3,000,000 and 4,000,000 bacteria per cubic centimeter. 

Park, d 1901, found the milk in New York City to contain, as a 
rule, excessive numbers of bacteria. During the coldest weather 
the milk in the shops averages over 300,000 bacteria per cubic centi- 
meter, during cool weather about 1,000,000, and during the hot 
weather about 5,000,000. He found the condition of the average 
city milk very different, depending upon temperature and other 
conditions. The milk as it is received in New York from the rail- 
roads averages over 5,000,000 bacteria per cubic centimeter, the 
lowest count being 52,000 and the highest 35,200,000. 

Burrage e in 1901 states that American cities appear to have better 
milk from a bacterial standpoint than European cities. In the latter, 
milk seldom contains less than 5,000,000 bacteria per cubic centi- 
meter. In the milk supply of Middletown, Conn., the number of 

o Rowland, Sidney D. : Report of 25 samples of milk examined as to their bacterial 
flora. Brit. Med. Journ., 1895, vol. 2, p. 321. 

& Frye, Maud J.: Notes upon the estimation of the number of bacteria in milk. 
Med. Rec, 1896, vol. 2, p. 442. 

c Pakes, Walter: The application of bacteriology to public health. Lancet, 1900, 
vol. 1, p. 311. 

d Park, W. H.: The great bacterial contamination of the milk of cities, can it be 
lessened by the action of health authorities? Journ. Hyg., vol. 1, 1901, r p. 391. 

e Burrage, Severance: Some sanitary aspects of milk supplies and dairying. Iowa 
Board Health, Eleventh Bien. Rep., 1901, p. 373. 



452 



bacteria was found to be comparatively low, the milk being deliv- 
ered to the consumer within a few hours after milking. The bacte- 
ria varied from 11,000 to 300,000 per cubic centimeter. 

Goler, a 1903, states that prior to 1900 the average bacterial counts 
of 86 samples of Rochester, N. Y., milk showed 837,000 per cubic 
centimeter, excluding 26 per cent of the samples which contained 
over 5,000,000 bacteria per cubic centimeter. 

Dodd, 6 1904, gives the following: 



District. 


Standard of 
shop. 


Average 
bacteria 
per cubic 
centi- 
meter. 


District. 


Standard of 
shop. 


Average 
bacteria 
per cubic 
centi- 
meter. 


City of London 


Good class 

.do 


4,800,000 
1,600,000 
4,800,000 




Good class 

do 


1,600,000 
2,300,000 
3,200,000 






do 


Do 


Poor class 









Byrnes/ 1904, speaking of milk inspection in Philadelphia, says: 
" Another branch of this subject is the almost incredible number of 
bacteria found in our milk supply, which vary from 1,600 to 21,000,000 
per cubic centimeter." 

Jordan,** 1904, found that the market milk of Chicago contained 
an average of 9,361,000 bacteria per cubic centimeter in April, 
10,071,000 in May, and 18,924,000 in June, 1904. Sixteen per cent 
of the samples examined contained over 20,000,000 bacteria per cubic 
centimeter. 

Bergey, € 1904, found as a result of the examination of ten samples 
taken at random from a large series of examinations made in July, 
1900, from milk taken at railroad depots in Philadelphia, an average 
bacterial content of 4,802,355 per cubic centimeter. The author 
gives a table showing the reported average bacterial content per cubic 
centimeter of the milk in other American cities, as follows: 

Bacteria per 
cubic cen- 
timeter. 

New York 4, 000, 000 

Boston 2, 300, 000 

Chicago 2, 350, 000 

Baltimore 4, 000, 000 

Wilmington 7, 000, 000 

a Goler, George W. : The influence of the municipal milk supply upon the deaths 
of young children. N. Y. State Journ. Med., vol. 3, 1903, p. 493. 

b Dodd, F. Lawson: The problem of the milk supply. London, 1904. 77 p. 8°. 

c Byrnes, W. J.: Annual report of the chief inspector of milk for the year 1903. 
Philadelphia Bur. Health, Ann. Rep., 1903, p. 76. 

d Analyses of Chicago Market Milk, a report by the health and sanitation co mm ittee 
of the Civic Federation of Chicago, 1904. 

« Bergey, D. H.: Sanitary supervision of the collection and marketing of milk. 
Univ. Pa. Med. Bull., vol. 17, 1904, p. 187. 



453 

He says that European market milk has been found to contain a 
greater average bacterial count, ranging from 5,000,000 to 10,000,000, 
and frequently 20,000,000 to 180,000,000. 

Proskauer, Seligmann, and Croner, a 1907, found that Danish milk 
sold in Berlin in the summer varied, in round numbers, between 
5,000,000 bacteria per cubic centimeter and innumerable quantities. 
In the winter this milk contained about 2,140,000 bacteria per cubic 
centimeter. 

The same investigators found that the market milk of Berlin 
averaged 3,500,000 bacteria per cubic centimeter in summer and 
567,000 in winter. 

Knox and Schorer, 6 1907, state that several summers ago the quality 
of the milk supplied to the working classes in Baltimore was studied 
during two successive summers at the laboratory of the Thomas 
Wilson Sanitarium. Much of the milk on sale at the small stores 
was shown to be unfit for consumption, having a high bacterial count. 

It will thus be seen that the general market milk of Washington, 
as well as that of other large American and European cities, is worthy 
the serious attention of health officers so far as excessive bacterial 
contamination is concerned. 

Addenda. — At the last meeting of the American Association of 
Medical Milk Commissions the following report of the committee on 
bacteriological standards for certified milk was adopted : 

The methods, so far as applicable, shall be those recommended by the committee 
on standard methods of bacteriological milk analysis of the laboratory section of the 
American Public Health Association. 

Bacterial counts for certified milk should be made at least once a week. 

Use agar-agar made according to the recommendation of the committee of the 
American Public Health Association containing 1.5 per cent agar and a reaction of 
+1.0 to phenolphthalein. 

Grow at 37° C. for forty-eight hours, or at 22° C. for five days, or 27° C. for three days. 

When in bottles, milk samples should be obtained in original packages and brought 
direct to the laboratory unopened. 

As soon as practicable upon arrival at the laboratory, open the bottle with aseptic 
precautions and thoroughly mix the milk either by pouring back and forth between 
the original bottle and a sterile bottle, or by agitation for two minutes. 

Make no less than two plates for each sample. 

Make a control of each lot of medium and apparatus at each testing. 

Dilute the milk in the proportion of 1 part of milk to 99 parts of sterile water; shake 
25 times and plate 1 cubic centimeter of the dilution. 

Express results in multiples of the dilution factor. 

a Proskauer, B., Seligmann, E., and Croner, Fr.: Uber die Beschaffenheit der in 
Berlin eingefuhrten danischen Milch. Ein Beitrag zur hygienischen Milchkontrolle. 
Zeit. f. Hyg., vol. 57, 1907, p. 173-247. 

& Knox, J. H. Mason, and Schorer, Edwin H.: A study of hospital and dispensary 
milk in warm weather; with special reference to pasteurization. Arch. Pediatrics, 
July, 1907. 



12. THE GERMICIDAL PROPERTY OF MILK. 



(455) 



THE GERMICIDAL PROPERTY OF MILK. 



By Milton J. Rosenau, Director Hygienic Laboratory, Public Health and 
Marine-Hospital Service; and George W. McCoy, Passed Assistant 
Surgeon, Public Health and Marine-Hospital Service. 



INTRODUCTION. 

Judged by the number of colonies that develop upon agar plates, 
the bacteria in milk first diminish then increase in number. This 
occurs only in raw milk during the first few hours after it is drawn. 
Although the bacteria seemingly decrease in number, they never dis- 
appear entirely. After this initial decrease there is a continuous and 
rapid increase until the milk contains enormous numbers. 

It was early noted that under certain conditions raw milk may keep 
longer than heated milk. In other words, the property of milk to 
restrain the growth of bacteria is destroyed by heat. 

Before this so-called " germicidal property of milk " was discovered 
it had been observed that fresh blood, or blood serum, had distinct 
powers of destroying bacteria. Further, that blood resists putrefac- 
tive and fermentative changes. It is now well known that blood, 
apart from the phagocytic action of its cells, has definite germicidal 
properties. This is due to substances in solution in the blood serum 
which have the power of clumping, killing, or dissolving the bacterial 
cells. This power of the blood is an important protection against 
bacterial invasion. Similar uses have been assigned to the " anti- 
bodies " in milk. The germicidal properties of blood are destroyed 
by heat and disappear spontaneously in a short time after it has been 
removed from the body. 

Not only the blood, but other body fluids have germicidal properties 
in varying degree, so that it was not surprising when similar powers 
were attributed to milk, especially when we consider that the fluid 
part of milk, with many of its constituents, is secreted directly from 
the blood. 

This initial power of milk to destroy bacteria or to restrain their 
multiplication is feeble and variable. The germicidal properties of 
milk have been much misunderstood, especially by dairymen, some 

(457) 



458 

of whom insist that advantage may be taken of this property for the 
preservation of milk without the use of ice. 

When we stop to consider that bacteria frequently enter the imper- 
fectly closed orifice of the teat and grow in the milk contained in 
the milk cisterns, and that they often invade the finer tubules of the 
gland structure where the milk is being freshly secreted, we must 
be convinced that the " germicidal " power of milk must be exceed- 
ingly feeble, if it exist at all. 

This property varies with the milk of different animals, and also 
in the milk of the same animal at different times. 

There, is evidence to show that the restraining action of fresh raw 
milk upon the growth of bacteria varies with the bacterial species, 
and when we inquire into the causes of the phenomenon we find that 
this is what we might expect. 

When micro-organisms are transferred to a strange medium they 
sometimes hesitate, until they become sufficiently accustomed to the 
new surroundings, before they begin to multiply. Our experiments 
show that this is by no means always the case and can not account 
for the facts now under consideration. 

We know that the serum of milk may contain " antibodies " in 
appreciable and variable quantity similar to those found in the 
blood. For instance, diphtheria, tetanus, and other antitoxins have 
been demonstrated in the milk of immunized animals. We might 
also expect small quantities of the agglutinating, bactericidal, and 
bacteriolytic substances present in blood serum to pass into the milk 
serum. Agglutinins in milk would apparently diminish the number 
of bacteria contained therein when estimated by the number of 
colonies that develop on agar plates. This might occur even though 
the number of bacteria present were actually increased. Microscopic 
examination of the bacteria in milk made at once after milking, and 
again in eight hours, demonstrates that such agglutination actually 
takes place. This is confirmed by our other technique. 

We know that milk always contains large numbers of leucocytes — 
many of them of the polymorphonuclear variety. These are known 
to be phagocytes, and we might assume that they are active in milk 
for a short time after it is drawn. In fact we have found that some 
of the leucocytes actually contain more bacteria after eight hours 
than when the milk is freshly drawn. 

If phagocytosis played a part in the diminution in the number of 
bacteria in milk, we must assume that the milk serum has opsonic 
power. ffl Our work shows that phagocytosis plays no essential role 
in the apparent reduction in the number of bacteria in fresh milk. 

a In fact Woodhead and Mitchell claim to have demonstrated opsonins in milk. 
Journ. of Path, and Bactr., vol. 11, 1906-7, p. 408. 



459 

It seems likely that the germicidal property of milk corresponds to 
a similar property of fresh blood serum. This makes it probable that 
the causes are numerous and complex. Further, it explains why the 
action is variable in different milks and in milk from the same animal 
at different times. It also gives us a clew as to why the action is to 
a certain extent specific. 

Although the germicidal property of fresh milk is feeble, it must 
be of value to the suckling. This self-evident fact emphasizes the 
importance of using fresh milk for artificial feeding. 

EXAMPLES OE THE GERMICIDAL ACTION. 

The following examples show that milk when fresh and raw actu- 
ally restrains the growth of bacteria as judged by the development 
of colonies upon agar plates. Whether the bacteria are restrained, 
destroyed, or clumped is not evident from such technique. 

This series shows the effect upon the growth of the bacteria that 
usually contaminate milk. These results show a restraining, rather 
than a germicidal action, which varies with the temperature. Actual 
reduction in numbers is more apparent from a study of our work with 
pure cultures (vide infra). 

Table No. 1. — Milk from a healthy cow (No. 1). 
[Immediately after milking contained 400 bacteria per cubic centimeter.] 





Bacteria per cubic centimeter at different 
temperatures. 


Time after milking. 


Room temper- 
ature, 16° to 
23° C 


15° C. 


37° C. 


2 hours 


430 

100 

350 

450 

500 

400 

500 

5,000 

60, 000 

366,000 

780,000 

24,200,000 

250,000,000 

330,000,000 

910,000,000 

Sour. 








450 

600 

300 

350 

300 

400 

2,000 

2,000 

1,000 

3,800 

61,000 

118,000 

3, 080, 000 

33,400,000 

192,000,000 

Innumerable. 


350 


6 hours 


2,100 

345,000 

1, 780, 000 

32,800,000 

75, 500, 000 




10 hours 




14 hours 


24 hours 


36 hours 




48 hours 




60 hours 




72 hours 








96 hours 




108 hours 




120 hours 















460 



Table No. 2. — Milk from a healthy cow (No. 1). 
[Immediately after milking contained 500 bacteria per cubic centimeter.] 





Bacteria per cubic centimeter at different 
temperatures. 


Time after milking. 


Room temper- 
ature, 26° to 
29° C. 


15° C. 


37° C. 




1,300 

700 

400 

7,800 

29, 000 

340, 000, 000 

Innumerable. 

Sour. 








900 

500 

600 

1,200 

80,000 

1,380,000 

89,000,000 

Sour. 


11,300 
38,000 


6 hours 


8 hours 


342, 000 


10 hours 


50, 000, 000 


24 hours 


Sour. 






72 hours 




96 hours 











Table No 3. — Milk from a healthy coiv (No. 1). 
[Immediately after milking contained 8,300 bacteria per cubic centimeter.] 



Time after milking. 


Bacteria per cubic centimeter at various 
temperatures. 


Room, 26° to 
29° C. 


15° C. 


37° C. 




8,000 
2,000 

6,000 






3 hours 


2,000 


2,000 








2,000 
1,000 






2,000 
1,000 
1,000 


6,000 
20, 000 




8 hours 


5,000 


166, 000 







THE EFFECT OF TEMPERATURE. 

Temperature has a decided influence upon this phenomenon. 
When the milk is kept warm (37° C.) the decrease in the number 
of colonies is striking, but of short duration. When the milk is kept 
cool (15° C.) the decrease is less marked, but more prolonged. This 
is well illustrated by the curves, Figs. 9 to 14. 

These curves were plotted from the following tables, which show 
the germicidal properties of milk for individual species of bacteria. 
The experiments were conducted as follows : 

Milk was obtained from a healthy cow, using particular care to 
prevent outside contamination. For this milk we are greatly indebted 
to Doctor Schroeder and Mr. Cotton, of the Experiment Station, 
Department of Agriculture, Bethesda, Md. 

In addition to the usual precautions, a cloth wet with bichloride 
solution was placed under the cow, permitting only the teats to pro- 



461 



ject through. The foremilk was discarded and about 10 to 15 cubic 
centimeters of the midmilk was introduced directly into sterile test 
tubes. Some of these tubes, tested soon afterwards, were found to 
be practically sterile; other contained about 60 bacteria per cubic 
centimeter. Without delay, a loopful of a pure culture of the 
organism to be tested from a 24-hour-old agar slant was placed in 
the tubes of the freshly drawn milk. Two of the tubes were con- 
taminated with each culture tested; one of them was kept at 15° C. 
and the other at 37° C. 

For a control, a similar loopful of culture was planted in a tube 
of whole milk that had been sterilized fractionally upon three suc- 
cessive days. At the intervals shown in the tables the tubes were 
shaken in order to obtain a uniform suspension, and a loopful planted 
upon agar by the plate method. Duplicate plates showed that the 
loop always took up about the same quantities. The results, how- 
ever, do not pretend to mathematical accuracy, but are sufficiently 
consistent to show any marked increase or diminution in the number 
of colonies. 

Table No. 4. — B. typhosus. 





Number of bacteria per loop — 


Milk from healthy cow (No. 2). 


At 15° C. 


At 37° C. 




In raw 

milk. 


In steril- 
ized 
milk. 


In raw 
milk. 


In steril- 
ized 
milk. 


At once, after milking 


6,720 
6,100 
5,940 
7,920 
1,860 
4,620 
3,180 
4,200 
(a) 


10,400 
10,180 
15,000 
20,000 
20,000 
11,000 
37,500 
31,000 
(a) 


6,580 

4,300 

985 

388 

62 

480 

1,800 

(a) 


4,860 
6,600 
15, 360 




4 hours later 


6 hours later 


(a) 

(a) 


8 hours later - 


10 hours later 


(a) 


12 hours later 


(a) 
(a) 


24 hours later 













a Innumerable. 

Here it was plain that there was an actual diminution in the num- 
ber of typhoid colonies from the tube kept at 37° C. during the first 
eight hours, after which multiplication began. The bacteria in the 
sterilized milk used as a control increased almost from the start. At 
15° C. the restraining effect is similar, but less pronounced and more 
prolonged. 



462 

Table No. 5. — B. dysenteriw. 





Number of bacteria per loop — 


Milk from healthy cow (No. 2). 


At 15° C. 


At37°C. 




In raw 
milk. 


In steril- 
ized 
milk. 


In raw 
milk. 


In steril- 
ized 
milk. 




2,820 
1,380 

900 
756 
890 
660 
540 
121 
109 
50 
55 


3,960 
3,800 
4,200 
4,400 
6,360 
8,040 
9,600 
15,000 
(a) 


4,680 

1,000 

720 

540 

348 

1,296 

7,200 

15,000 

(a) 


27, 000 




15, 000 




27,000 
(a) 

(a) 
(a) 

(a) 
(a) 














72 hours later 





















Innumerable. 



This shows the same phenomenon as in the case of the typhoid 
bacillus, excepting that the restraining power of the raw milk at 15° 
C. is more marked and prolonged for the dysentery bacillus. 

Table No. 6. — B. lactis wrogenes. 





Number of bacteria per loop— 


Milk from healthy cow (No. 2). 


At 15° C. 


At 37° C. 




In raw 
milk. 


In steril- 
ized 
milk. 


In raw 
milk. 


In steril- 
ized 
milk. 




19,920 
14,220 
15,120 
16, 680 
10, 980 
12,450 
9,720 
9,440 
(a) 


8,500 
9,600 

6,800 

7,560 
10, 000 
10,000 

(a) 

(a) 


16,000 
24,000 

7,750 
1,200 
418 
1,335 
4,500 
(a) 


23,000 

57,500 




4 hours later 


6 hours later 










12 hours later 




24 hours later 




48 hours later 













° Innumerable. 

This organism is one of the common causes of lactic acid fermenta- 
tion. It is practically always present in milk unless drawn with 
extraordinary precautions. It is evident that this particular sample 
of raw milk exerted the same temporary restraining influence upon 
this organism that it did upon the pathogenic species. 



463 



Table No. 7. — V. cholerw. 



Milk from healthy cow (No. 2). 



At once, after milking 

2 hours later 

4 hours later 

6 hours later 

8 hours later 

10 hours later 

12 hours later 

24 hours later 

48 hours later 

72 hours later 

96 hours later 



Number of bacteria per loop- 



At 15° C. 



In raw 
milk. 



2, 820 

740 

1,440 

1,740 

1,800 

820 

1,010 

1,440 

900 

6,700 

3,000 



In steril- 
ized 
milk. 



3,540 
7,860 
4,980 
5,100 
5,280 
7,200 
9,300 
16, 000 
(a) 



At 37° C. 



In raw 
milk. 



6,000 

6,720 

987 

1,711 

6,300 

11,880 

15, 660 

(a) 



In steril- 
ized 
milk. 



15,795 

(«) 
(a) 

(a) 
(a) 
(a) 



Innumerable. 



The milk had practically the same power of restraining the cholera 
vibrio that it had for the other bacteria tested. 

Table No. 8. — B. diphtheriw. 





Number of bacteria per loop — 


Milk from healthy cow (No. 2). 


At 15° C. 


At 37° C. 




In raw 
milk. 


In steril- 
ized 
milk. 


In raw 
milk. 


In steril- 
ized 
milk. 


At once, after milking 


270 
30 
230 
270 
330 
600 
200 
145 


160 
230 
430 
160 
300 
120 
180 
245 


470 
333 
285 
265 
275 
150 
215 


170 


2 hours later 


1,180 






6 hours later 


370 




960 


10 hours later 


2,700 


12 hours later 


3,800 


24 hours later 


8,420 


48 hours later 




(a) 











" Innumerable. 



The results obtained with the diphtheria bacillus are perhaps not 
quite so graphic as with the other organisms, partly for the reason 
that the diphtheria bacillus is not motile and it is difficult to obtain 
a uniform suspension ; and also partly for the reason that it grows so 
slowly, if at all, at 15° C. However, at 37° C. definite restraining 
action is evident in the raw milk as compared with the sterilized milk. 



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470 

RELATION TO AGGLUTINATION. 

Agglutination of bacteria in milk is somewhat difficult to demon- 
strate macroscopically. Under the microscope, in stained prepara- 
tions, the bacteria are in large and dense clusters in raw milk after 
standing eight hours at 37° C. In the boiled milk used as a control 
the bacteria under the same conditions appear singly or in very short 
chains or small clumps. In our work care was taken to break up all 
clumps in the suspensions used to inoculate both the raw and the 
boiled milk. 

Vigorous shaking also gave results that plainly proved that 
agglutination is one of the factors that cause an apparent decrease 
in the number of bacteria. 

The agglutinated bacterial clusters were broken asunder by one or 
both of the following methods, stated in each table : 

1. Vigorous shaking of the milk for about five minutes in a glass- 
stoppered cylinder. 

2. Drawing the suspension in and out a number of times through a 
capillary pipette, the end of which is broken off square and closely 
applied to the bottom of a test tube. 

Table No. 9. — Milk from healthy cow (No. 2) inoculated one and one-half hours 

after milking. 

[Organisms from 24-hour agar cultures. Controls, same milk heated to boiling.] 



Colonies per 
loop at once 
after inocu- 
lation. 



Colonies per 
loop after 8 

hours at 
37° C. mod- 
erate shak- 
ing. 



Colonies per 
loop after 8 

hours at 
37° C after 
vigorous agi- 
tation and 
mixing with 
pipette. 



B. typhosus in raw milk 

B. typhosus, control 

Staphylococcus pyogenes aureus in raw milk 

Staphylococcus pyogenes aureus, control 

B. coli in raw milk 

B. coli, control 

Original milk 

a Innumerable. 



5,620 
9,540 
4,660 
4,850 
2,600 
8,100 
17 



2,640 

obi, 000, 000 

3,810 

a b 200, 000 

9,720 

a b 1, 500, 000 

45 



9,720 



5,610 
a b 100, 000 



b About. 



Table No. 10. 



471 



-Milk from healthy cow (No. 2) inoculated one and one-half hours 
after milking. 



L Controls, same milk heated in Arnold sterilizer to 100° C. for ten minutes, 
used were from 24-hour agar cultures.] 



Organisms 



Bacteria per 
loop at once. 



Bacteria per 
loop after8 
hours at 37° 

C, tube 

moderately 

shaken. 



Bacteria per 

loop after 8 

hours at 37° 

C, culture 

vigorously 

agitated 5 

minutes and 

mixed with 

a pipette. 



B. lactis aerogenes in raw milk 

B. lactis aerogenes, control 

B. typhosus in raw milk 

B typhosus, control 

Staphylococcus pyogenes aureus in raw milk. 

Staphylococcus pyogenes aureus, control 

Original milk 



1,200 
1,200 
3,440 
2,160 
2,120 
2,660 



4,400 
(a) 

4,107 
(a) 

1,220 
30,000 



14, 000 



7,560 
2,070 



a Innumerable. 



The next experiment was designed to show whether the phenome- 
non of germicidal action could not be duplicated by the addition of 
typhoid agglutinating serum to milk that had been boiled. 



Table No. 11. — Milk from healthy cow (No. 2) planted one and one-half 'hour, 

after milking. 

[Controls, same milk boiled — 24-hours old agar culture used.] 





Bacteria 
per loop 
at once 
after in- 
oculation. 


Bacteria 
per loop 
after 2£ 
hours at 
37° C 


Bacteria 
per loop 
after 4£ 
hours at 
37° C 


Bacteria 
per loop 
after 6i 
hours at 
37° C 


Bacteria per loop after 
8£ hours at 37° C 




Moder- 
ately 
shaken. 


Mixed 

with 

pipette. 


B. typhosus in raw milk 


1,880 


1,380 


1,060 


1,480 


1,980 


12, 200 


B. typhosus in same milk 














boiled (control) 


2,120 


4,020 


a b 800, 000 


(a) 


(a) 


(a) 


B. typhosus in raw milk plus 




1 drop typhoid serum 


2,100 


2,040 


1,920 


2,360 


1,260 


a b 20, 000 


B. typhosus in boiled milk 














plus 1 drop typhoid serum. 


2,280 


2,360 


7,020 


6,480 


10, 860 


a b 60, 000 


B. typhosus in bouillon plus 














1 drop typhoid serum 


1,830 


970 


2,920 


9,180 


11, 160 


a 6 100,000 


Original milk 





1 


2 


2 


2 


46 







a Innumerable. 



6 About. 



The typhoid serum used in this experiment was a strongly agglu- 
tinating horse serum (strength over 1 : 10,000). 

It will be seen that boiled milk plus typhoid agglutinin acts much 
the same as the raw milk. The contrast in each case with the con- 
trol (boiled milk) is striking. 



472 

The fact that agglutination plays a prominent role in this phe- 
nomenon is well illustrated in this table by the fact that the bacterial 
clumps may be shaken apart. This was confirmed by the micro- 
scopic examinations of stained smears in each case. 

Table No. 12. — Milk from healthy cow (No. 2). 
[Plantings one hour after milking.] 



Bacteria 
per loop 
at once 
after in- 
oculation. 



Bacteria 
per loop 

after 

3 hours at 

37° C 



Bacteria 
per loop 

after 

5 hours at 

37° C. 



Bacteria per loop after 
7 hours at 37° C. 



Moder- 
ately 
shaken. 



Mixed 

with 

pipette. 



B. typhosus in raw milk 

B. typhosus in boiled milk 

48-hour B. coli culture in raw milk 
Original milk 



5,400 

6,400 

16,000 

2 



4,680 
5,040 
12,000 

1 



4,720 

a b 100, 000 

11,000 

2 



2,250 

a b 200, 000 

9,000 

3 



5,400 

i b 200, 000 

a b 40, 000 

112 



a Innumerable. "About. 

Table No. 13. — Milk from healthy cow (No. 2). 

L Plantings one hour after milking.] 





Bacteria 
per loop 
at once 
after in- 
oculation. 


Bacteria 
per loop 

after 

3 hours at 

37° C 


Bacteria 
per loop 

after 

5 hours at 

37° C. 


Bacteria per loop after 
7 hours at 37° C. 




Moder- 
ately 
shaken. 


Mixed 

with 

pipette. 


1 loop faeces and hay emulsion in raw milk . 
1 drop f aeces and hay emulsion in raw milk . 
5 drops faeces and hay emulsion in raw 


720 
4,860 

10,500 


660 
4,640 

7,500 


480 
6,000 

9,900 


420 
3,780 

13,000 


4,320 
9,720 

20,000 





Table No. 14. — Milk from healthy cow (No. 2) planted, one and one-half hours 

after milking. 

[Controls same milk boiled.] 



Bacteria 
per loop 
at once 
after in- 
ocula- 
tion. 



Bacteria 
per loop 
after 1\ 
hours at 
37° C 



Bacteria 
per loop 
after 4£ 
hours at 
37° C 



Bacteria 
per loop 

after 6£ 
hours at 

37° C 



Bacteria per loop 

after 8£ hours at 
37° C 



Moder- 
ately 
shaken. 



Mixed 

with 

pipette. 



1 drop cow faeces and hay suspension in 

raw milk 

1 drop cow faeces and hay suspension in 

boiled milk (control) 

4 drops cow faeces and hay suspension in 

raw milk 

4 drops cow faeces and hay suspension in 

boiled milk (control) 

Original milk 



18 
124 



26 

80 

450 

720 
2 



44 

1,260 

1,800 

3,300 
2 



5,400 



473 

The fact that bacterial clusters may be separated by shaking, etc., 
is still more convincingly demonstrated in many of the other tables 
throughout the remainder of this article. 

THE GERMICIDAL ACTION COMPARED WITH THAT OF BLOOD 

SERUM. 

For the purpose of comparison the following experiment was made 
with fresh blood serum. The blood was drawn from the jugular 
vein of a horse, defibrinated and centrifugated for fifteen minutes 
at 1,800 revolutions per minute. In this way a fresh serum free from 
fibrin and cellular elements was quickly obtained. Care was exercised 
throughout the process to avoid contamination. 

The serum was now divided into two portions: (1) Untreated, 
and (2) heated to 60° C. for twenty minutes. This temperature 
was selected as being sufficient to destroy the bacteriolytic property 
without seriously interfering with the agglutinins. 

The heated and the unheated serum was now inoculated with 
24-hour-old cultures from agar slants. The bacillary emulsion was 
first drawn in and out of a pipette in order to break up clumps. 





Bacteria per loop — 




At once 
after in- 
ocula- 
tion. 


After 2 

hours at 

37° C. 


After 4 

hours at 

37° C. 


6 hours at 37° C. 


After 24 

hours at 

37° C 




Moder- 
ately 
shaken. 


Mixed 
with a 
pipette. 


B. typhosus in fresh horse serum 

B. typhosus in fresh horse serum, heated 
to 60° C 20 minutes 


3,240 

2,700 
1,500 

2,640 


328 

2,650 

5 

3,180 


364 

7.600 


9,000 


220 

ob 70, 000 


a&100,000 


636 

o&250,000 


o&200,000 


11,000 

(a) 
5,400 

(o) 


B. lactisaerogenes in fresh horse serum. . 

B. lactis aerogenes in fresh horse serum, 

heated to 60° C. 20 minutes 





a Innumerable. 



6 About. 



It is at once evident that there is a general resemblance between 
blood serum and milk so far as this phenomenon is concerned. It is 
also plain that blood has a much quicker and stronger action than 
milk. 

The results of the bacterial counts upon agar plates were confirmed 
by microscopical examination of stained smear preparations. At 
first the organisms were well distributed throughout the serum, 
whether heated or unheated. There were no clumps of over six or 
eight individuals. 

At the end of six hours no organisms could be found under the 
miscroscope in preparations made from the unheated serum planted 
with B. lactis aerogenes. Only occasionally could the typhoid bacil- 



474 

lus be discovered in the corresponding serum at the end of six hours. 
This agrees with the number of colonies upon the agar plates. 

The heated serums gave quite a different picture under the micro- 
scope. Many organisms were found, lying singly, in small and long 
chains, and in dense clusters. This corresponded to the innumerable 
growth upon the agar plates. 

RELATION TO PHAGOCYTOSIS. 

Milk contains many leucocytes and it therefore seems reasonable 
to assume that active phagocytosis takes place in the fresh raw prod- 
uct. A priori it seemed to us that this might account for the germi- 
cidal property of milk. This assumption was apparently confirmed 
when we found that stained smear preparations showed but few if 
any bacteria in the cells in the fresh milk just after inoculation with 
bacterial cultures, while similar preparations made from the same 
milk eight hours later, kept at 37° C, showed numerous bacteria in 
some of the cells. 

The following experiments, however, demonstrate that the ger- 
micidal power of milk is independent of its cellular contents. The 
leucocyte-free milk is quite as active as the leucocyte-rich sediment 
obtained by centrifugation. 

Table No 15. 

[Milk from a healthy cow (No. 2) was centrifuged for twenty minutes at 1,500 revolutions 
per minute. Part of the supernatant fluid was passed through a Berkefeld filter and a 
clear bluish serum obtained. Five sets of tubes were inoculated with 24-hour agar 
cultures, (1) the filtered clear serum, (2) the supernatant fluid free from leucocytes, 
(3) the sediment rich in leucocytes, (4) the original whole milk, and (5) sterilized milk. 
The inoculations were made three hours after milking.] 



Bacteria 
per loop, 
at once 
after inoc- 
ulation. 



Bacteria per loop after 
8 hours at 37° C 



Shaken 

moderately 

before 

planting. 



Vigorous 
agitation 

before 
planting. 



B. typhosus in filtered milk serum 

B. typhosus in leucocyte-free supernatant fluid 

B. typhosus in leucocyte-rich sediment 

B. typhosus in whole raw milk 

B. typhosus in sterilized milk (control) 

B. lactis aerogenes in filtered milk serum 

B. lactis aerogenes in leucocyte-free supernatant fluid 

B. lactis aerogenes in leucocyte-rich sediment 

B. lactis aerogenes in whole raw milk 

B. lactis aerogenes in sterilized milk (control) 

Original milk 



22, 000 
19, 000 
32, 000 
3,500 
16,000 

33,000 
4,000 

42, 000 
5,400 

36,000 

19 



10, 000 

1,900 

3,600 

1,200 

a b 160, 000 

a b 330, 000 

2