REPORT
OF 'THE
SPECIAL MILK BOARD
OF THE
My || MASSACHUSETTS STATE DEPARTMENT OF HEALTH.
7
SUBMITTED TO THE COMMISSIONER OF HEALTH AND PuBiic
| Heatta Councit DecemBer 29, 1915.
BOSTON: 3
WRIGHT & POTTER PRINTING CO., STATE PRINTERS,
| 32 DERNE STREET.
1916.
REPORT
SPECIAL MILK BoaRD 2#2=
OF THE
MASSACHUSETTS: STATE DEPARTMENT OF HEALTH.
SUBMITTED TO THE COMMISSIONER OF HmauTH aNnD PuBLIC
Heatta Councin DreceMBER 29, 1915.
BOSTON:
WRIGHT & POTTER PRINTING CO., STATE PRINTERS,
32 DERNE STREET, |
1916.
a
mf
Lteze Pe)
erditer ,
Che Commatuuealth of Maszsachusetts.
State DEPARTMENT OF HEALTH, Boston, Dec. 29, 1915.
To the Commissioner of Health and Public Health Council.
GENTLEMEN: — The Special Board of this Department ap-
pointed to investigate the status of milk production, distribu-
-tion and inspection, and the relation thereof to the public
health of this Commonwealth, by an order of the Commissioner
of Health of March 29, 1915, has the honor to present here-
with the accompanying report.
Respectfully submitted,
EUGENE R. KELLEY, Chairman,
JOSEPH E. LAMOUREUX,
HERMANN C. LYTHGOE,
EDWARD H. WILLIAMS, Recorder,
Members of the Board.
TABLE OF CONTENTS.
PREFACE, by Allan J. ene s
INTRODUCTION, :
ABSTRACT OF REPORT,
CoNCLUSIONS,
Part I. HuisTorica,
Ave
B.
fe)
va
Hoa Hf HY Oo Pe
I.
Development of page Milk Wontroverey: ie dward H. Wallsara! Y
Earlier Investigations, by Dr. Eugene R. Kelley, A 5 ‘
1. Legislative Inquiry of 1910, : y 4
2. Special Milk Commission of 1910,
3. Boston Chamber of Commerce Taestiention of 1915,
Summary of Proposed Laws relating to Milk, by Dr. Lewis Fish, 1
Summary of Present Milk Laws, by Hermann C. Lythgoe,
T II, SraTeMENnTs oF Various INTERESTS,
Milk Contractors, compiled by Hermann C. erates,
Boston Chamber of Commerce, by John C. Orcutt, Assistant oa
tary, 4
Milk Consumers’ Tessie: by Niveon L. Bionees Council of Milk Gon:
sumer’s League, i ‘ 4
The State Grange, by on Chas. M. Gardner)
Milk and Baby Hygiene Associations, by Dr. J. Hotbone Voune,
Medical Director, Boston Milk and Baby Hygiene Association,
City of Boston Health Department, by Dr. Francis X. Mahoney,
Health Commissioner,
Massachusetts State Boarall of Nerieulture: by Wilfrid esler,
Secretary,
Massachusetts State Tanarimant of nial Tce By. Dr. estan
H. Howard, Commissioner,
Cattle Breeders’ Associations, Compiled Ay wdward H. Walltomna!
Part III. Facrs or Propuction, PRocEssina AND MARKETING,
A.
IDE
Summary of Milk Board’s Own sii Inspections,: by Dr. ews
Fish,
Compilation of Milk Gantractor! s Statements by Dr. emuene R.
Kelley and Hermann C. Lythgoe,
Observations on Past and Present Increase, Decrease: Frmceetiods
and Geographical Movements of Commercial Milk and Cream
Production in Massachusetts and Neighboring States and the
Province of Quebec in Relation to the Milk Supply of this Com-
monwealth, by Edward H. Williams,
The Commercial Pasteurization of Milk and Crean Py omer C.
Lythgoe, .
Part IV. Facts oF THE eeooee Ou s Saas OF THE Mite
A.
B.
Cc.
SUPPLY oF THIS COMMONWEALTH, by Hermann C., Lythgoe, .
Present Status of Official Supervision of the Massachusetts Milk
Supply by Federal, State and Local Authorities,
Present Status of Local Milk Inspection, }
Discussion of Present System of Dairy Inspection tena its Suntan
Value,
105
110
117
121
1 Proposed laws for 1914 summarized by E. H. Williams.
Part V. THe RELATIONSHIP BETWEEN Cow’s MiLK AND THE PUBLIC
kg
ae]
A.
B
BoP a OO
Pee OO ee
Heautu, by Dr. Eugene R. Kelley, Dr. Lewis Fish and Dr. John
S. Hitchcock, A 5 x
Introduction, by Dr. Bieone R. elie é
Milk and the Communicable Diseases,
1. Milk and Tuberculosis, by Dr. Eugene R. Kellee! :
2. Methods of Infection of Milk by Diphtheria, Scarlet Fever, Sepee
Sore Throat and Typhoid Fever, by Dr. Lewis Fish,
3. Communicable Diseases of Minor Significance or Relative Tie
frequency, in which Milk is concerned as an Agent of Transmission,
by Dr. Eugene R. Kelley, . :
4. The Evidence Available as to the Relation eortanion of Milk
as a Means of Transmission of Communicable Diseases, compared_
with Other Means of Transmission, by Dr. Hugene R. Kelley,
5. The Possible Means of preventing Communicable Disease Trans-
mission through Milk, and their Relative Practicability, by Dr.
Eugene R. Kelley,
6. Pasteurization as a Moane of ingenious iaerse Prevention, rosy
Dr. Eugene R. Kelley, f
Milk and Infant Mortality, by Dr. J ohn S. iecheaele
The Nutritional Value of Milk, by Dr. John S. Hitchcock,
t¢ VI. Grapine or Mitx, by Hermann C. Lythgoe, .
General Discussion, :
Relation between Solids and Bate in . Milk,
7 VII. EXPERIENCES OF OTHER LOCALITIES,
Report on an Investigation of the New York City Milk Gradine
System in the City of New York, by Hermann C. Lythgoe,
Report on a Special Investigation of the Efficiency of the New York
Grading System in the Producing Area, by Clarence E. Marsh,
Report on a Special Investigation of the New York Grading System
in the Producing Area, by Charles H. Hickey, :
Copy of an Article by Lucius P. Brown of the New York Gin Health
Department,
Report on Talore sue ai hered a ‘he Gouvention of the Inter
national Milk Inspectors Association, by Clarence E. Marsh,
Digest of Recent American Milk Tepislacon by Various Cities said
States, by Dr. Lewis Fish,
PAGE
126
126
128
128
135
137
138.
166
168
172
185
190
190
200
206
2°6
214
216
220
230
233
LIST OF APPENDICES.
A.— Tabulation of Answers to Questionnaire on Milk and Disease for the
Years 1909-13,
B. — Forms of Questionnaire and Tettere Le to Tiecal pends of Health,
and a List of Cities and Towns failing to reply to Question-
naire,
C. — Abstract of Milk hoctio oid saeets in laviadensttieetes froma 1906— 15,
D. — Copy of Letter sent to, and replies from, Epidemiological Authorities
of Other States relative to Milk and Disease,
E. — Influence of Pasteurization on Chemical Content of Milk,
F. — Status of Local Milk Inspection: — .
(a) Summary of Local Milk Tease int: bisueiica oy Cities ond
Towns,
(b) Summary of Local Milk iepention, ‘alphabetically,
G. — Statistics of Milk Transportation into Boston, ; )
H. — Replies to Questionnaire relative to Local Milk Inspection,
I. — Map showing Places inspected by the Milk Board,
J. — Bibliography,
K. — List of Conferences and Nobuines atid: or of Pesca atermewed
relative to the Milk Question,
PAGE
238
249
252
262
273
293
297
321
339
344
393
354
356
PREFACE.
The writer became Commissioner of Health in November,
1914, and within a week he was importuned by several factors
in the milk problem to take sides and give testimony for or
against certain proposed legislation. The milk problem in
Massachusetts had agitated the people for years, and had
degenerated into an acrimonious controversy which made it
difficult to separate easily real facts from mere assertions.
Milk problems exist everywhere, and the subject was not
new to me as a health officer, but I felt that conditions in
Massachusetts were different from other States, and that it
would be unwise and unfair to apply general knowledge of a
problem without a careful study of local conditions and their
bearing on the problem. I felt that I had a right to proceed
one year at least under existing law, and to utilize that time
in informing myself as to the dairy industry in Massachusetts.
After a year’s study, a fair impartial report with recommen-
dations could be made from facts collected by an unbiased
board. Accordingly, I appointed a Board to secure the facts
in the dairy industry in Massachusetts, with instructions to
extend their investigations to adjoining States and the Province
of Quebec. I knew that without a special appropriation this
could be done by this Department, but that it would involve
much overtime work and considerable self-sacrifice on the part
of the Board. The personnel of the Board was as follows: —
Dr. Eugene R. Kelley, Director of the Division of Communicable Dis-
eases, formerly Commissioner of Health of the State of Washington, and
a sanitarian of wide experience.
Mr. Hermann C. Lythgoe, Director of the Division of Food and Drugs,
in charge of both the inspection and laboratory work of the Department
in connection with milk, an analyst and chemist with a most thorough
knowledge of all phases of the milk problem.
Mr. Edward H. Williams, a practical farmer and dairyman, an assistant
in the Division of Sanitary Engineering of the Department, who was
>
10
selected because of his knowledge of farming conditions in the State, and
especially with those conditions related to or dependent upon the milk
industry.
As a representative of the Public Health Council, Dr. J. H. Lamoureux
was appointed, a practicing physician of high standing, an excellent sani-
tarian, and the possessor of an analytical and judicial mind.
These gentlemen worked overtime, Sundays and _ holidays,
and sacrificed vacations and other privileges, in order to carry
on the work, but returned with all the available data touching
our milk problem. With such a committee I feel sure not only
that we have the facts, but that they are presented fairly with-
out bias, and with only one object, viz.: to furnish a solution
for the milk problem and to take it out of politics and out of
controversy for all time.
REPORT OF SPECIAL MILK BOARD OF THE MASSA-
CHUSETTS STATE DEPARTMENT OF HEALTH.
INTRODUCTION.
The special Milk Board of the State Health Department
was appointed by the State Commissioner of Health on March
29, 1915. It was charged with the duty of collecting all avail-
able facts relative to the milk problem of this Commonwealth
for the guidance of the Commissioner and Public Health Coun-
cil in drafting legislation to be submitted to the General Court
if it should appear from the results of such investigation that
new legislation was desirable.
Originally it was intended to confine this investigation to the
public health aspects of milk production and distribution.
Because of the closely interwoven connection between the
economic and sanitary features of the milk problem your Board
soon found that such a procedure was impossible, and we have, .
therefore, endeavored to cover the entire problem in a com-
prehensive manner.
The report is seriously incomplete from one important stand-
point, —the total number of producing dairies personally
visited by members of your Board. We estimate that in all we
have seen possibly 2 per cent. of the producing farms supplying
milk to Massachusetts consumers. As far as possible we have
endeavored, to select typical sections, and feel that in reality we
have by this procedure obtained a much truer picture of aver-
age dairy conditions than if we had concentrated our visits in a
smaller area and possibly visited a considerably higher per-
centage of the total producing dairies. :
The report has become voluminous under our hands to a
degree neither anticipated nor desired, but the entire problem
presents so many ramifications that we felt we could not in
12
justice to the question omit any of the included subject-matter.
In fact, many bulky sections of the report are in reality very
condensed abstracts of the total data consulted.
Throughout the progress of the report your Board has been
indebted to the courteous co-operation of many officials and
private citizens. A partial list of these persons is given in
Appendix K, and we will not attempt to enumerate them all
here. . ‘
Special mention should be made, however, of the assistance
given by the personnel of the Food and Drug Division. of the
State Department of Health, including both inspectors, ana-
lysts and clerical force. To them we owe the collection of data
from local boards of health.
Two of the State district health officers, Dr. Lewis Fish and
Dr. John S. Hitcheock, have in effect served as members of
the Board. Several sections of the report have been contrib-
uted by them, and they have, in addition, carried out pains-
taking investigations into the general literature of milk and the
epidemiological records of this Department. Other district
health officers, notably Dr. Jones, have assisted your Board in
carrying out dairy inspections.
To many city and town health officials within the Common-
wealth, as well as to epidemiological authorities of other States,
and of the Federal Public Health Service, we are deeply indebted
for valuable information, suggestions and criticisms.
Special acknowledgment is due the following for careful
criticism of various finished sections of the report: —
Dr. Charles V. Chapin, Superintendent of Health of Providence,
RL
Dr. Mark W. Richardson, Former Secretary, Massachusetts State
Board of Health.
Dr. Thomas B. Shea, Director, Division of Communicable ‘Diseases,
Boston City Health Department.
Dr. A. J. Chesley, Director, Division of Preventable Diseases, Minne-
sota State Board of Health.
All of these gentlemen critically reviewed Part V. of the
report as to authenticity, fairness and reasonableness of the
epidemiological deductions: contained. therein.
13
In a similar manner, special acknowledgment is due the
following gentlemen: —
Hon. Wilfrid Wheeler, Secretary, State Board of Agriculture.
Mr. J. C. Orcutt, Assistant Secretary, Boston Chamber of Commerce.
Mr. P. M. Harwood, Agent of the State Dairy Bureau.
Hon. Chas. M. Gardner, Member of State Dairy Bureau.
Hon. William D. T. Trefry, State Tax Commissioner.
These gentlemen all contributed many facts and statistics
relative to present and past production of milk.
ABSTRACT OF REPORT OF MILK BOARD.
The progress of this investigation revealed such a mass of
facts and opinions bearing upon the. present milk problem of
Massachusetts that the inclusion of simply the most pertinent
material made this report voluminous to an extent not antici-
pated. We have therefore deemed it wise, for the benefit of
those who do not care to go into the detail of the subject, to
prepare a brief abstract of the report for inclusion at this
point. |
The report is divided into conclusions, the main body of the
report and appendices. The conclusions, which immediately
follow this abstract, cannot be further summarized. The report
proper is divided into seven parts.
PAR ee
SECTION ae
In this section it is first pointed out that there has been
friction between the producers, middlemen and transportation
interests for at least twenty years. In addition to this source of
irritation such things as overlapping laws, imposing practically
the same powers and duties upon the State Boards of Health
and Agriculture and local boards of health, overlapping and at
times contradictory systems of dairy inspections by State and
local health officials, extreme statements from all parties con-
cerned as to the relative weight of different sanitary and eco-
nomic aspects of the problem, have all contributed to the
14
development of the bitter controversial spirit that has been so
widely manifested relative to the entire subject of production
and sanitary supervision of milk in the Commonwealth during
the past six years.
SEcTION B.
Three special investigations, two legislative and one non-
official (that of the Boston Chamber of Commerce), have added
materially to the information available upon the subject, but
cannot be said to have produced any definite results except the
introduction of much proposed legislation into the General
Court.
SECTION C.
The laws proposed for the solution of the milk problem of
the Commonwealth are in general agreement in providing for
the abolition of certain features of the present system of local
control and the substitution of a central State inspection board
with plenary powers. The controversies have all arisen over
the manner in which such central board shall be appointed
and controlled.
Section D.
It is not possible to summarize this section any further.
PAR ne
In this part an attempt has been made to gather author-
itative statements from various persons and interests con-
cerned in the milk question. In general, these may be said to
fall into three groups.
Group A.— Dairy and agricultural interests, comprising the State
Grange, the State Board of Agriculture, the State Department of Animal
Industry and the cattle breeders’ associations.
Group B.— Those concerned in the business aspects of the suashe
viz., the milk dealers and the Boston Chamber of Commerce.
Group C.— Those interested in milk from the health standpoint,
viz., the Milk Consumers’ League, the Boston Department of Health
and the Milk and Baby Hygiene Associations.
The general contention of Group A is that agitation and at-
tempted legislation have had only detrimental effect on the
15
milk industry. Natural economic conditions, such as increase
in land values, increase in transportation facilities, and more
remunerative returns from other lines of agriculture have tended
to drive milk production out of the State. In addition to this
there is a general feeling that the attitude and statements of
the so-called clean milk advocates has had a positive detrimen-
tal influence on the milk business, and has hastened the’ opera-
tion of these economic conditions. This group offers no re-
medial suggestions. The cattle breeders’ associations, with the
exception of the Holstein Breeders Association, in answer to
a direct question submitted by your Board, believe that the
price of milk should be governed by the fat content. The
Grange believes that the farmers can and will produce a better
article if they receive a better price.
The general contention of Group B is that the present sys-
tem of distribution of milk cannot be greatly improved upon,
but that the competition between retail dealers is disastrous to
the financial aspects of the business, and the lack of a standard-
ized or graded product does not tend to improve the situation.
Some of this group seem to be of the opinion that official in-
spection should be centralized, and should be administered
preferably by the State Department of Health.
In some respects the members of Group C are in accord with
some of the contentions of Group B. The Health Department
of the city of Boston believes that the city is being very un-
justly practically forced to carry nearly all the expense inci-
dental to milk inspection for most of the other cities and towns
comprising greater Boston, and for this reason are strongly in
favor of this duty being transferred to some State authority.
The Massachusetts Milk Consumers’ League, to use their own
words, state: “The Association has never taken any arbitrary
position as to the form of the bill, only insisting on the central
principle that the State Department of Health should have
legal power on its own initiative in places where milk is pro-
duced or handled, to insist upon reasonable cleanliness.”
16
PARA Tins
Section A.
As this section is itself merely a summary of the conditions
noted in the various trips of inspection made by the members
of the Milk Board, it is difficult to emphasize its findings any
further, but the general impression received was, although
many individual and geographical exceptions to the rule were
found, that producing dairies in Massachusetts were, on the
whole, in very satisfactory sanitary condition, which impres-
sion is substantiated by the records of routine dairy inspec-
tions made by the State Department of Health. Typical
dairies in Maine, New Hampshire, Vermont and Quebec sup-
plying Massachusetts markets are, on the whole, somewhat
below the sanitary standards of Massachusetts dairies.
SECTION B.
This section is a portion of the summary of replies received
to a questionnaire submitted to contractors. It deals with the
phases of production and. of distribution of their milk supply
and gives a summary of their methods of dairy inspection.
SECTION C.
This section deals with the production of milk in Massa-
chusetts and neighboring States and the province of Quebec,
and its increase, decrease and geographical fluctuations. Milk
production in Massachusetts has steadily decreased while the
population has increased. In this section the following points
are discussed: variation in number of milch cattle kept in
Massachusetts from 1890 to date, supplemented by evidence of
freight statistics of the milk brought into greater Boston;
effects of the increasing cost of producing milk in Massachu- —
setts, and its comparison with the cost of milk production in
other States and Quebec; the relative importance of dairying _
to diversified farming; the fact that beside the use of milk raw
and for cooking purposes the steadily increasing consumption
of cream, butter, cheese and ice cream accounts for a large
proportion of the total milk consumed; the use of the by-
products of milk, particularly of casein in the arts and sciences,
17
and the fact that this is a relatively unappreciated but im-
portant use of cow’s milk; causes assigned by various inter-
ested parties for the decrease in milk production, the principal
ones alleged being oppressive activities of the State and local
boards of health in carrying out dairy inspection, the exag-
gerated newspaper publicity relative to milk epidemics and
alleged epidemics, constant legislative agitation, the increasing
use of evaporated, powdered and condensed milks brought in
from long distances, lower prices offered to the producer, the
development of more remunerative and less laborious forms of
agriculture, together with increasing scarcity of farm labor;
several pages are devoted to the actual cost of keeping cows
and producing milk, according to best statistics available; the
average amount of milk production per cow in Massachusetts
and neighboring States; salient points obtained by interviews
with agents of condensed, powdered and evaporated milk
companies. ;
This section closes with general comments on milk produc-
tion and the importance of producing more milk and the value
to the Commonwealth of the dairy industry.
Section D.
In this section the influence of heat upon milk is discussed.
The process of commercial pasteurization as carried out in this
State is without apparent influence upon the chemical composi-
tion of milk. Experiments made in the commercial pasteurizing
plants show that the process as applied is very efficient in
lowering the bacterial content, but owing to possible reinfec-
tion the health authorities should control the operation of these
plants.
PART IV.
Section A.
In this section is given a summary of the activities of the
various bodies engaged in the official supervision of Massachu-
setts milk, and a digest of the laws under which they work.
This work is carried on by local boards of health, the State
Department of Health, the Dairy Bureau of the State Board
of Agriculture, the State Department of Animal Industry, and
the United States Department of Agriculture. Local boards
18
of health are given authority to grant licenses, inspect dairies,
take samples for analysis, and to make and enforce rules and
regulations. In general they have unlimited powers to ade-
quately supervise and control the milk supply of their respec-
tive cities or towns. The State Department of Health and the
Dairy Bureau have power to collect samples and to enforce the
laws relative to the adulteration of milk. The State Depart-
ment of Animal Industry exercises a certain amount of control
over the health of cattle by an annual inspection made by the
local inspector of animals.
SEcTION B.
A special study has been made of the operation of local milk
inspection from which it has been ascertained that about
20 per cent. of the total population received no protection
relative to milk from their local boards of health. The balance
received some protection, but only 48 per cent: are adequately
protected. If Boston is excluded from the list, 25 per cent. of
the balance of the population receive no protection, and only
28 per cent. are adequately protected from possible dangers
. arising from the milk supply.
SECTION C.
In this section the present system of dairy inspection is dis-
cussed in relation to its sanitary value. Although in many
instances too much importance has been attached to the condi-
tion of the dairy and too little to the condition of the milk,
the dairy inspection as carried out in the past has resulted in
an improvement in our milk supply.
IPAURIE. We
Section A.
It is not possible to summarize this section any further.
Section B.
A number of the human communicable diseases are trans-
mitted through milk. Those of the most importance in Massa-
19
chusetts are tuberculosis, diphtheria, scarlet fever, septic sore
throat and typhoid fever.
~ In tuberculosis the milk may be infected by the cow pro-
ducing it or by the human beings who handle it.
In the other four diseases mentioned, except possibly in the
ease of scarlet fever, the infection does not originate in the
cow; the source is in the human handlers.
The amount of communicable disease transmission through
cow’s milk has been overestimated, but such transmission does
occur in a degree of frequency which demands public protection.
The infection of milk with human disease germs may occur
at any time between its secretion in the cow and its con-
sumption.
In addition to infection with human disease germs milk may
be otherwise polluted, or may decay to a degree that renders it
an unsafe food for human beings.
To imsure its safety as a human food two procedures of
control are necessary.
First. — By inspection of cattle, methods of production and
transportation, secure a supply that is pure, clean and fresh.
Second. — By the application of heat destroy all disease
germs that may be in it, whether they come from animal or
human sources.
There are two methods of disinfection by heat in common
use: (a) complete sterilization by boiling; (6b) partial steriliza-
tion — “pasteurization” —by heating the milk to between
140° and 150° F. for from twenty to thirty minutes.
Both of these methods are effective.
The partial sterilization — “pasteurization”’ — seems to have
fewer objectionable features, and is already established in this
country as an accepted, successful process.
To obtain the most perfect results, market milk, intended for
human consumption as milk, should be pasteurized under the
control of the health authorities.
SECTION C.
The infant mortality rate is still higher than it should be, —
higher than investigators feel is inevitable. A still undeter-
mined part of this excess is due to the quality of infant’s food
\
20
and the method of its administration. Breast milk is the
natural food for the infant. When this maternal function fails
a substitute food is required. Modified cow’s milk is the com-
mon substitute, although it has inherent qualities that make it
an imperfect food for infants. The supply for our cities must
be brought from a distance. It may become polluted at any
time between its secretion in the cow’s udder and its digestion
in the stomach of the infant. To make it reasonably safe it
should be controlled by inspection and pasteurization up to
the point of delivery at the home, and controlled after delivery
by the education of the mother in hygienic methods.
Section D.
The exceptional place of milk as the indispensable food for
infants and invalids is emphasized. The fact that milk is a
unique food in the sense of being so complete in itself that it
can sustain life alone for indefinite periods is emphasized; also
that it is in food value one of the cheapest of foods. Under
our present conditions there is a great economic waste of a
part of the milk that has in itself a high nutritious value, —
that is to say, the skimmed milk.
PAR GE Nae
Section A.
In this section the subject of grading is discussed, both from
the bacteriological standpoint and from the standpoints of per-
centage composition and of food values. The average milk
sold in Massachusetts, although considerably above the stand-
ard, is nevertheless steadily becoming more inferior in fat, the
average of which in 1909 was 4.10 per cent., and in 1915 had
been reduced to 3.82 per cent. The New York system of
bacteriological control and its application is discussed. ‘The
commercial pasteurization of milk should be under official con-
trol, which is not the case at present in Massachusetts, and if
this were done the pasteurization of dirty milk, or of milk high
in bacteria, could be prohibited. A premium should be paid
for milk low in bacteria as well as for milk high in fat.
21
- Section B.
a pecial article is inserted in this section showing the rela-
tion between the solids and fat in known purity and commer-
cial milk. It is evident from a study of the charts introduced
that commercial milk is somewhat deficient in fat. The intro-
duction of a grading system by which milk may be sold on its
fat percentage would stop this form of adulteration, which,
while too slight to be proven in a court of law, yet is sufficient
to be apparent when the averages are compared with data
obtained from milk of known purity.
PART VII:
In this part the experiences of other localities is discussed.
Section A is a special report on the New York City grading
system from investigations made in the city of New York.
Sections B and C are special reports on the efficiency of the
system in the producing area. Section D is a special article
upon this system by Lucius P. Brown, Chief of the Food Divi-
sion, New York City Department of Health. This system has
been studied to the best of our ability, visits being made to
the New York City Health Department, the New York State
Department of Health, several New York milk dealers, one
commercial chemical laboratory in New York City, to the
producing territory and to one country pasteurizing station in
Connecticut. Every definite complaint relative to the ineffi-
ciency of this system brought to our attention has been care-
fully investigated, and in all cases these complaints have been
found to be without foundation. The system is substantially
as follows: —
All milk except of a quality resembling certified milk must
be pasteurized. If the bacteria content is high before pasteur-
ization it must be labeled “Grade C, For Cooking Purposes
Only.” There are two other grades of pasteurized milk,
“Grade A Pasteurized” and “Grade B Pasteurized.”’ The
Grade A milk is obtained from better stables, and has a lower
bacteria content before pasteurization than Grade B milk.
Section E gives a report of information regarding the experience
22
of other localities gathered at the Convention of Milk and
Dairy Inspectors in Washington, D. C., from conversation
with the milk inspectors of various cities and towns of the
United States. This report cannot be further summarized.
In Section F is given an abstract of the laws and regulations
relative to milk in force in various States and municipalities in
the United States. This report is of such nature that it cannot
be further abstracted.
CONCLUSIONS.
Cow’s milk is an invaluable article of diet. :
In the interest of the public health its use as a food should
be maintained and extended.
Healthy animals and proper methods are more important
than equipment in the production of clean, wholesome milk.
Epidemics of disease have not infrequently been caused by
raw milk, but the amount of communicable disease so trans-
mitted is much less than has been often asserted.
PASTEURIZATION.
Pasteurization or sterilization is the only practical method
for insuring the safety of commercial milk.
No epidemic has ever been traced with certainty to pas-
teurized milk.
The present uncontrolled method of pasteurization does not
furnish a satisfactory safeguard to the public.
To make certain of the adequacy of the processes of steriliza-
tion or pasteurization, the responsibility therefor should rest
upon public health officials.
Employees in commercial pasteurizing plants should be sub-
jected to routine physical examination.
Pasteurization should not be allowed to be used to conceal
an inferior quality of milk.
MILK IN THE POSSESSION OF THE CONSUMER.
Fresh milk has a greater food value than other milk.
Milk, while in the possession of the consumer, should be no
less scrupulously cared for than while in the hand of the producer
or dealer.
23
(a) It should be immediately placed in a cool place and kept
there, duly protected, until used.
(b) All milk bottles received by the consumer should be
washed with soap and hot water as soon as the milk has been
removed, and should be kept clean until returned to the dealer.
(c) Milk bottles should never be used for anything but milk,
as is provided for by statute.
on
TUBERCULOSIS.
In addition to epidemic diseases, the evidence is now con-
clusive that a very considerable proportion of tuberculosis in
children is due to infection by the bovine type of tubercle
bacilli taken into the body by drinking raw milk.
Bovine tuberculosis is prevalent to a ae degree in
ordinary dairy herds.
Dairymen should attempt to eradicate tuberculosis from
their herds, not only in the interest of public health, but also
to improve the quality of their young stock.
Adequate pasteurization as effectively destroys tubercle
bacilli as it does the germs of epidemic diseases.
Mitx For Inrant FEEDING.
Cow’s milk is decidedly inferior to mother’s milk as a food
for infants, but clean cow’s milk is the best as well as the most
common substitute for mother’s milk.
Some part of our excessively high infant mortality rate is
probably due to unwholesome qualities of the cow's milk
furnished to infants. It is generally admitted, however, at
present, by children’s specialists and sanitarians, that the use
of cow’s milk regardless of quality furnishes only one among
many factors in the total causes of infant mortality.
There appear to be some grounds for concluding that in some
cities of this Commonwealth the inadequacy of the total sup-
ply of cow’s milk for infants and young children is a more
serious public health problem than any existing deficiencies in
quality.
Existine INSPECTION.
The present laws for the supervision of milk production and
distribution in Massachusetts give ample authority to the
cities and towns to protect their milk supplies in as stringent
and thorough a fashion as they may see fit.
These laws make it mandatory upon cities and towns to
carry out thorough dairy inspection in all dairies supplying
milk for their consumption.
The present system of sanitary supervision of milk by local
authorities is in the aggregate costing the people of the Com-
monwealth fully as much if not more than a complete, well-
balanced, uniform system of control.
As these laws are carried out the practical results are (1)
that the inhabitants of many cities and towns receive no pro-
tection whatsoever, and the inhabitants of many other cities
and towns receive protection at the expense of the taxpayers
in neighboring cities; (2) responsibility is divided, official
friction between cities and towns is incurred; (8) the literal
carrying out of the laws would result in an inconceivable mass
of overlapping inspections; (4) the producer not having a fixed
standard, owing to the changing and contradictory orders of
local milk inspectors, is confused and discouraged.
STaTE CONTROL.
There is no law at present providing for State control of the
milk, supply of ‘this Commonwealth relative to the public
health.
The systematic dairy inspections instituted in this State by
the State Board of Health, and subsequently carried on by
local authorities, have been productive of improved dairy condi-
tions and an improved milk supply, many producers having
taken advantage of the opportunities of obtaining valuable -
information from the inspectors.
The clean milk contests of the State Board of Agriculture
have been productive of much good among those producers
who distribute milk of their own production direct to the
consumer.
29
Milk production should be so supervised as to result in a
maximum of cleanliness and safety with a minimum of inter-
ference with the milk industry.
SALE oF Mitk. PRICES.
At the present prices, or even at considerably higher prices
than those prevailing at present, milk is one of the most
economical of foods.
There are no reasonable grounds for believing that the retail
price of milk can be lowered.
Milk should be bought and sold on its merits as determined
by its chemical and bacteriological condition rather than by
volume only. This should include higher price for higher fat
content and higher price for low bacterial content.
MASSACHUSETTS DaIRIES.
Massachusetts dairymen must produce milk of a superior
quality if they are to hold the confidence and patronage of the
consumers of the Commonwealth.
As far as statistics are available it would appear that Massa-
chuseétts dairymen produce more milk per cow than dairymen
of neighboring States and countries, and produce it under gen-
erally better conditions as to cleanliness.
“Nevertheless, milk production in Massachusetts has rapidly
decreased since 1890.
To supply the steadily increasing population of the State
with milk and cream, the large dealers of Boston and other
cities have been going to points in other States (principally
Maine, Vermont and New Hampshire) and the province of
Quebec to secure adequate supply.
The great distance of some of these points, together with
careless handling and slow transportation, tends to place a
large amount of milk on the Massachusetts market which is
less desirable than milk produced near by.
Sufficient milk to supply Massachusetts people could be pro-
duced within the borders of the State if the thousands of acres
of naturally good dairy lands now lying idle were stocked with
milch cattle.
26
The principal reason for the decline in dairying in this State
is the low price paid to producers.
Other causes are the increase in the cost of cows, grain,
building materials, labor and the improved methods demanded
by State and municipal authorities, as well as constant legis-
lative agitation for several years.
Milk can be bought at lower prices at out-of-State points
than Massachusetts farmers can produce it with profit.
Milk transportation rates are lower in proportion for long
haul than for short haul.
Massachusetts dairymen have been in general subjected to
a more rigid enforcement of dairy gules and regulations than
out-of-State producers of milk.
Massachusetts dairymen furnishing milk for near-by con-
sumption must compete with an inferior grade of milk pro-
duced out of State, which has been freed from disease germs
by pasteurization, and has been rendered macroscopically
acceptable to the consumer by clarifying processes to remove
filth originally introduced by slovenly dairy methods.
Owing to the fact that in Massachusetts there are scarcely
any country-receiving milk stations, milk produced in Massa-
chusetts must be marketed more quickly than milk produced
out of State which has been clarified and pasteurized before
being shipped.
It would be an advantageous practice if Massachusetts dairy-
men would label State-raised milk as Massachusetts Milk,
particularly if a State authority could, after examination,
permit its sale as a distinct grade of milk.
PART I. HISTORICAL.
A. DEVELOPMENT OF PRESENT MILK CONTROVERSY.
It would be hard to say when the milk business became the
subject of discussion between various interests, but probably at
a time more than twenty years ago it became a subject of bitter
controversy between producers and the so-called contractors;
dairymen claiming that they were not paid a fair price for milk,
and that the surplus system and some other features made it
an absolutely losing proposition to produce milk to be sold to
the large dealers. Complaints were numerous of the methods
employed in transportation. The many ways in which the
farmers had been, or claimed to have been, defrauded, either
by a system of discounted price for surplus milk or by the fail-
ure of dealers to pay for the milk, added to the confusion.
Efforts were made by different organizations, either of Massa-
chusetts or New England dairymen, to eliminate some of the
troubles, but it seems that they were not successful, as we hear
the same complaints to-day about the price of milk and of
transportation methods. So bitter were the controversies be-
tween the producers and the large dealers that many of the
dairymen either reduced the amount of milk production on
their places or went out of business altogether.
On the other hand, the contractors have claimed that the
price they- paid was all that was possible, when the cost of
handling and the price received by them from the consumer
were taken into consideration, and they have always claimed .
that the margin of profit was small. Many times contractors
have claimed that no satisfactory adjustment of prices could
ever be made until the consumer was willing to pay more for
milk.
The question of transportation is still under discussion.
Claims are made by different dairymen-: that under the present
system of handling milk on the railroads they cannot market
their milk to the best advantage. The railroad companies,
principally the Boston & Maine, have claimed that there was
28
no profit, and many times a loss, in the transportation of milk,
and have recently asked the Public Service Commission of
Massachusetts to consent to an increase in transportation
rates.
In recent years, beginning with 1906, when the first system-
atic dairy inspection was made by the State Board of Health,
there have been many discussions as to the right and justice
of the dairy inspection as conducted by the State or local
boards of health. Inspection methods have received a great
deal of criticism, and complaints made that the multiplicity
of inspections has tended to make the production of milk a
very unsatisfactory business. The positions taken by certain
health authorities and prominent social workers that milk was
the cause of much disease and many deaths among infants of
our large cities, and many published reports of cases of dis-
eases and deaths caused by milk-borne epidemics, have been
assailed by many dairymen as unjust and tending to harm the
business to such a degree that the business is becoming less
profitable on this account as well as on account of the activi-
ties of the inspectors. ‘The result of these controversies be-
tween producers, contractors, health authorities and organiza-
tions has been the introduction of legislative bills that have
generally served to keep up the constant agitation.
The following have taken more or less active part in the dis-
cussion of milk conditions in Massachusetts, but have seemingly
never arrived at. any definite conclusion or settlement of the
situation: The Boston Chamber of Commerce, the Grange,
State Board of Agriculture, the Department of Animal Indus-
try, Milk Consumers’ League, labor organizations, Milk and
Baby Hygiene Associations, the contractors, medical societies
and. others.
In the year 1912 efforts were made to bring together the
State Board of Health, the State Board of Agriculture, and the
executive committee of the Massachusetts State Grange and
various dairymen, so that there might be, if possible, a settle-
ment of some of the difficulties in the milk business.
The local milk inspectors have generally appeared at legisla-
tive hearings, and have taken an active part in opposing legis-
lation tending to centralize the authority of milk inspection;
29
but up to the present time there has never been any legislation
that would satisfy all of the parties concerned, and the future
must decide how this vexatious problem can be fairly adjusted.
B. EARLIER INVESTIGATIONS.
There have been three previous investigations of the milk
situation in Massachusetts carried out during the past. six
years. They are — ;
(a) The investigation into the cost of production, transporta-
tion and marketing of milk within the Commonwealth by a
joint special committee of the General Court of 1910. —
(b) The report of the special commission, consisting of the
members of the Dairy Bureau, of the State Board of Agricul-
ture and two additional members appointed by the Governor,
authorized by a resolve of the General Court of 1910.
(c) The report of the special committee on milk of the Bos-
ton Chamber of Commerce, issued in July, 1915.
Your Board has made a careful and intensive study of the
subject-matter of these three reports, and as far as they have
been available have examined the original data upon which
these reports are based.
In the case of the first report, through the courteous co-
operation of the Hon. Charles M. Gardner, a member of this
committee, your Board has had access to and has thoroughly
studied for several months past the verbatim testimony pre-
sented at the numerous hearings of this committee.
In the case of the last report, through the courtesy of the
officials of the Boston Chamber of Commerce, especially Mr.
John C. Orcutt, assistant secretary of the Chamber of Com-
merce, in charge of this investigation, your Board has had
access to practically all the facts upon which this report is
based.
In the case of the second investigation in the introduction
to that report the following sentences occur: “The first step
was to secure and place on file for reference as complete data
as were obtainable from every State which has a system of milk
inspection. This resulted in the collection of a vast amount
of information regarding milk inspection and handling. All
these data have been studied, compiled and tabulated, and put
%
30
in concise form for future reference.” Persistent and diligent
inquiry addressed to all the individual members of this Com-
mission has failed up to the present to unearth any of these data
referred to for our enlightenment. We may add parenthetically
that this striking example of how easily valuable data, com-
piled for the express purpose of having them accessible for future
reference, become completely lost to sight in a few years’ time
has been the cause, to no small degree, of your Board adopting
a radically different policy in reference to the data that we have
compiled. We feel that we might also fairly lay claim to having
accumulated at least a considerable “amount of information,” —
but we have included practically all of it, that in our opinion
has any direct value to the question under investigation, in
either the body of our report or among the appendices.
(a) Abstract of the Report of the Special Joint Milk Investi-
gating Committee of the General Court of 1910.
This committee considered themselves limited, by the terms
of the order creating the committee, in their scope of inquiry
to “an investigation of the methods and costs of said produc-
tion, transportation and marketing.”
They concluded and reported. essentially as follows: —
1. That milk on the average could not be produced in 1910
in Massachusetts at an actual cost to the producer of less than
4 cents per quart.
2. That the “control”? of producers by the “contractors”
of the metropolitan district of Boston “tends to create and
maintain a monopoly in the sale of milk, and to restrain com-
petition in the supply and price of milk.”
3. That “the cost and methods of transportation are of great
importance to the consumer as affecting not only the cost of
milk to him, but also its freshness.” They go on to condemn
the “leased car’’ system on this basis, and specifically recom-
mend repeal of certain sections of the (then) transportation
statutes, and the substitution therefor of the “flat-rate system.”
4. That there was no definite proof of any collusion between
the different “contractors” as to price and territory, but the
committee, on the contrary, express themselves satisfied that
the contractors are truly competing with each other, and also
31
that the contractors are making a fair profit on their invest-
ment. .
5, That regular and adequate sanitary inspection of market
milk is necessary in the interests of the public health.
6. That this (z.e., work of milk inspection) cannot be properly
and economically done by the health officers of the several
cities and towns. It should be done by some central authority.
To do this “requires an examination of existing laws, the en-
actment of new, and the repeal or modification of existing laws
which would consume much time.” They then recommend
that the Dairy Bureau be charged with the duty of formulating
a general bill to cover these points.
This report was signed by five of the seven members of the
committee, one member concurring in all except the recommen-
dation for further reference to the Dairy Bureau, urging the
formulation and passage of immediate corrective legislation;
one other member concurring in the minority opinion, and also
filing an opinion that the joint special committee itself should
have recommended specific legislation to “remedy the abuses
and the iniquities of the present transportation system.”
(b) Report of the Committee on Inspection of Milk of 1910.
Following the recommendations of the special joint committee
on milk of the General Court, a resolve was passed directing
_ the Dairy Bureau of the State Board of Agriculture, “together
with two additional persons to be appointed by the governor,”
to prepare a bill for the inspection of market milk in all its
stages from cow to consumer, to make such amendments as
would eliminate duplication of inspection or conflicting pro-
visions in existing laws, and to thoroughly cover the sanitary
aspects of the milk question.
The Commission held hearings, traveled to other points in
the United States, and did more or less inspecting of dairies
and milk plants, as well as examining the laboratory equipment
for milk examination of various cities, and conferring with
local health authorities.
They found existing duplication of laws and of law enforce-
ment, but rather strangely make no reference in their report to -
the large number of cities and. towns in which no real milk
o2
inspection or supervision of any kind existed (for your Board’s
investigation reveals the fact that in 1910 there was even less
supervision of milk by local authorities than at present). They
concluded that existing laws operated to the disadvantage of
Massachusetts producers as competitors with out-of-State pro-
ducers.
They recommended a State-administered uniform system of
milk inspection enforced by a special State Milk Board, which
body should have broad legislative and execytive powers.
They point out that both the sanitary and economic as-
pects of milk production demand reasonable consideration, and
urge that no system of State inspection of milk be put into
effect unless funds are available to adequately enforce it. \ —
A minority report signed by the two appointed members
agrees in the general scheme proposed, but dissents from the
recommendation for a ‘Special Milk Board, recommending in
the place of it that “the milk act and its regulations should
be administered by the State Board of Health, in a milk di-
vision established for this purpose.”
The direct result of this investigation and report has been
an annually recurring crop of proposed acts to settle the milk
questions of the Commonwealth, none of which have ever be-
come enacted. (Their provisions are discussed in the following
section.)
(c) The Boston Chamber of Commerce Report of 1915.
Recently the Boston Chamber of Commerce has made an
extended report upon an investigation into the milk situation
of New England. This report naturally and properly confines
itself largely to the “business aspects of the milk problem.”
It also takes up the entire question from a New England rather
than from a Massachusetts standpoint.
- The salient features of this report are that the milk industry
of Massachusetts is steadily shrinking, but that under certain
conditions it might be revived. This result in the opinion of
this committee might be brought about by establishing uniform
systems of grading and labeling throughout New England
(method by which same is to be accomplished not specified) ;
by development of co-operative receiving stations by the pro-
ducers; by better bookkeeping by farmers; by reform of trans-
33
portation methods; by improvements in distribution systems;
and by advertising more widely the comparative food value of
cow’s milk.
Your Board has found in many quarters of New England,
especially among producers, a deep-seated skepticism as to the
impartiality and real reason for this Boston Chamber of Com-
merce investigation. This has usually taken the form of a
direct charge that the entire investigation was undertaken and
carried through at the instigation of transportation interests.
If there be any truth in this very widespread impression, a
careful study of the report itself does not reveal any definite
internal evidence to support it.
C. SUMMARY OF PROPOSED LAWS RELATING TO MILK.
The following is a list of laws which have been proposed for
the control of the production, handling and sale of milk in the
State of Massachusetts during the past five years.
Proposed, 1910.
. To permit Boston to control its own milk situation.
. Prohibiting mixing anything with the whole, raw milk.
3. Providing for milk board of three from State Board of Health, dlinee
from Dairy Bureau, to make regulations to be enforced by local
board of health.
4. Providing State Board of Health to make regulations to be enforced
by local board of health.
5. Providing Dairy Bureau to draft bill which would wipe out con-
flicting and duplicating inspections.
6. Providing commission to investigate milk from cow to human stomach.
7. Regulating railroad rates for transportation.
8. Repealing present laws (Acts of 1906, chapter 463, Part II., sections
202 to 204) which attempt to regulate railroad rates and methods.
Ne
Proposed, 1911.
In 1911 five bills were proposed for regulation, all maiuly
identical, but differing chiefly as to who should make and who
administer the regulations.
1. State Board of Health to make and administer rules and regulations.
(House 1332.)
2. Unpaid board, three from Board of Health, three from Board of Agri-
culture; to make and administer. (House 1476.)
a4
3. Paid board, two from Board of Health, two from Board of Agri-
culture, and one chosen by these, to make regulations. Adminis-
tration in local boards of health. (House 1943.)
4. No pay mentioned. Appointed by the Governor, —two medical
men, two practical producers, one sanitarian; to make regulations.
Administration in Milk Division, State Board of Health. (House
2002.)
5. Paid board, appointed by the Governor, five members, two medical
and two producers; to make and administer regulations. (House
2054.)
The following bills were also proposed: —
1. Requiring license for all dealers without reference to amount sold
or to whom sold. (House 361.) ;
. Authorizing establishment of milk-distributing stations. (House 496.)
. Labeling milk. (House 1319.)
. Providing standard bacteria count not over 500,000. (House 1130.)
. Any city or town to issue permits. (House 350.)
cr H OO DO
. Passed, but vetoed, 1911.
House 2082, passed and vetoed by Governor Foss, was identical with
House 2002, except as follows: — .
House 2002 prohibited selling without a permit by dealers except “those
selling to others than consumers.”’ This bill prohibited selling without
a permit by dealers except “‘those selling solely to others than con-
sumers.”” (Section 4.) .
House 2002 stated: ‘‘ This bill not to be construed to make legal what
is now prohibited nor to affect present local regulations.” (Section 20.)
House 2082 added, ‘provided said municipal regulations do not conflict °
with this act nor with regulations which may be made under it.”
Proposed, 1912.
1. No pay mentioned. Five members appointed by Governor with
advice of Council,—two medical, two producers, 1 sanitarian;
to make regulations. Administration, State Board of Health.
(House 1570, Ellis.) /
2. Paid board, six members; three from State Board of Health, three
from State Board of Agriculture; to make regulations. Administra-
tion by local boards of health. (House 1571, Meaney.)
3. Giving full power to State Board of Health to make and administer
regulations on milk question. (House 1049, Withington.)
4, State Board of Health to make regulations subject to approval by
Governor and Council, and requiring publishing in advance of
approval. (House 1568, Fowler.)
30
Proposed, 1913.
i ‘Authorizing local board of health to issue permits or forbid sale.
(House 612, City of Boston.)
2. Stating many prohibitory conditions, including maximum bacteria
count of 200,000 to be administered by State Board of Health.
(House 1569, Putnam.)
3. Almost identical with House 1568, 1912, except instead of State Board
Or
of Health making and administering rules and regulations, a special
milk board of five members, appointed by the Governor and Council,
— two medical, two producers, one sanitarian, —is provided; regu-
lations to be published and then approved by Governor and Council,
then to be administered by State Board of Health. (House 393,
Bradley.)
Proposed, 1914.
. Relative to inspection of dairies and cows and of barns and other
enclosures where cows are kept for the production of milk. Except
in case of contagious disease now under jurisdiction of State Board
of Health, no other inspection shall be made than that by the Com-
missioner of Animal Industry, such inspection to be made under
such regulations as agreed upon by State Board of Health and said
Commissioner. (Senate 234, Moore.)
Relative to inspection by boards of health of milk and other articles
‘of food with right to seize unwholesome or unfit milk or food.
(House 877.)
Relative to licensing of persons, partnerships, corporations, except
the producer selling to others than consumers or not to exceed five
quarts per day to consumers, in cities or towns where a milk in-
spector is appointed. (House 588, McGrath.)
. Providing for State milk regulation board to make regulations for
production, transportation, keeping and sale of milk; five members
appointed by Governor with: advice and consent of Council, two
learned in the science of medicine or bacteriology, two practical
producers and one sanitarian. Rules and regulations to be approved
by Governor and Council and administered by State Board of
Health or other municipal boards of health. Appropriation $50,000.
(House 775, Bigelow.)
. Safeguard ie public health from dangers of milk injurious to public
health. Boards of health of any city or town authorized to exclude
milk or cream deemed to be injurious to health. Prohibiting the
bringing into the State for sale in any city or town such milk or
cream as may have been condemned. Penalty $25 to $100. (House
780.)
Terms “milk” and “pure milk” to be defined. The terms “milk”
and ‘‘pure milk” as used in section 55 of chapter 56 of the Revised
Laws to apply to cream, buttermilk or any fluid or semi-fluid product
36
of milk except evaporated, concentrated or condensed milk when
not diluted with water, which is to be employed as milk, cream or
buttermilk. In the manufacture of evaporated, concentrated or
condensed milk the use of cane sugar is permitted. (House 781.)
7. For further regulations of prosecutions in milk cases. A dealer of
milk not to be liable to prosecution unless the sample of milk which
it is charged he has sold, exchanged, delivered or had in his posses-
sion with intent to sell, exchange or deliver was taken upon his
premises or while in his possession by the inspector of milk or by the
agent of the Dairy Bureau or of the State Board of Health, and a
sealed portion thereof was given him at the time of taking. (House
934, Connor.) :
8. Regulation of sending of results of analysis of milk by inspectors.
Amending section 63 of chapter 56 of the Revised Laws so that such
inspectors shall send to persons responsible for the condition of
sample of milk the results of the analysis within three days. (House
935, Connor.)
9. Massachusetts Milk Consumers’ Association for protecting the public
health and the promotion of the milk industry of the Common-
wealth. State regulation, milk board; five men appointed by the
Governor with the advice and consent of the Council, two learned
~ in medicine or bacteriology, two men of practical experience in the
production of milk and one sanitarian. Regulations to be approved
by Governor and Council and administered by State Board of
Health and municipal boards of health under supervision of State
Board of Health. Permits from State Board of Health to sell milk.
Creation of milk division of State Board of Health, with chief of
~ division and milk inspectors not to exceed twenty in number
and such other employees as necessary. Appropriation $50,000.
(House 936.)
10. To prohibit the sale of milk and milk products produced under in-
sanitary conditions. Fine of not more than $300 or imprisonment
for sixty days, or by. both. Supreme Court to have jurisdiction in
equity upon appeal of State Board of Health or any local board of
health to enjoin sale of such milk or milk products. (House 937,
Sullivan.)
11. To exclude out-of-State milk not produced or handled under sanitary
conditions. The State Board of Health is authorized to spend for
salaries and expenses for necessary inspection of dairies, creameries,
stores and contractors’ plants, railroad cars used for the transpor-
tation of milk, and other conveyances and places outside the State
in which milk, cream or their products are stored when they are
intended for sale within this State. Appropriation $35,000. Penalty
$300 or ninety days’ imprisonment, or both.
Milk to be labeled or marked by name of State in which it was produced,
and also what artificial treatment, if any, has been employed, as
37
“Massachusetts Milk,” “ Maine Milk,” ‘‘New York Milk,” etc.;
“pasteurized,” “natural,” “modified” or ‘compound milk.” Milk
pasteurized two or more times shall be so marked. Penalty clause
not filled in. (House 1409, John J. Lydon.)
12. Amendment to law relative to inspection and sale of milk. Sample
of equal size, sealed and delivered to the person having milk sampled
at the same time when sample is taken for analysis. Results of
analysis to be sent to party within five days. Twenty-day clause
for producers. Cities of 50,000 population or over shall cause all
milk or cream sold therein to be pasteurized at 145 degrees F. for
thirty minutes. All milk inspectors, as provided by law, shall pub-
lish monthly records of analyses and names of persons from whom
samples were taken. (House 1408, Murray.)
13. Producers of milk shall be reimbursed for damages suffered from
' non-sale of milk during epidemics as a result of orders of boards of
health. (House 1520, Kimball.)
14. Every city and every town of over 6,000 population shall establish
public milk stations in charge of milk inspectors or other persons
designated by local boards of health. Distribution shall be made
for the sole purpose of benefiting persons whose personal or family
conditions make it imperative that they be entitled to the benefit
thereof, the price of the milk to be subject to the control of the
local board of health, with the right of appeal to city council or
board of selectmen. Milk to be inspected once a week at least to
. avoid danger. Business shall be conducted so that no financial loss
to distributors shall take place or to establish no offensive competi-
tion with local dealers. (House 2104, Arkwell.)
15. To authorize cities and towns to compensate certain owners of milk
at prevailing wholesale rates when owners are prevented from selling
by orders of boards of health because of presence of contagious or
communicable disease. No compensation if existence of disease is
due to negligence or fault of owner. (House 2158, Putnam.)
16. Relative to inspection by boards of health of milk and other articles
of food. Right to seize unwholesome or unfit milk or food. (House
2156.)
|
D. SUMMARY OF PRESENT MILK LAWS.
Boards of health of cities shall, and boards of health of towns
may, appoint milk inspectors, compensation determined by the
appointing boards. (Acts of 1909, chapter 405, amended by
Acts of 1910, chapter 114.)
No person in the milk business shall be appointed an in-
spector of milk. (Acts of 1910, chapter 457.)
Each inspector shall be sworn and shall publish his appoint-
38
ment for two weeks in a newspaper. (Revised Laws, chapter
56, section 51.)
Inspectors shall keep an office, and record in books the name
and place of business of all persons engaged in the sale of milk.
The board of health may employ collectors who shall be sworn.
The inspectors or collectors may enter premises and take sam-
ples of milk. They shall upon request make sealed samples,
a receipt for which must be given to the inspector. The in-
spectors shall cause such samples to be examined, and shall
keep a record of the analyses. If sealed sample is refused no |
evidence of the analysis can be introduced. (Revised Laws,
chapter 56, section 52, amended by Acts of 1909, chapter 405.)
The State Department of Health may appoint inspectors,
analysts and chemists. Inspectors have the same authority to
collect samples as is given to inspectors and collectors of milk.
(Revised Laws, chapter 75, section 5, amended by Acts of 1910,
chapter 394.)
The State Department of Health has appropriation of $17,500,
three-fifths of which must be spent for the enforcement of milk
laws. (Revised Laws, chapter 75, section 6, amended by Acts
of 1908, chapter 467; 1907, chapter 208; 1911, chapter 296.)
The Board of Agriculture at its annual meeting appoints a
general agent of the Dairy Bureau. The Dairy Bureau con-
sists of three members, one of whom is, appointed annually by
the Governor for a term of three years. The secretary of the
Board of Agriculture is the executive officer of the Bureau.
The Bureau inquires into the methods of butter and cheese
making, and enforces the laws relative to the sale of all dairy
products and their imitations. The Bureau has an appropria-
tion of $8,000 per annum. It may co-operate, but must not
interfere with the State Department of Health and with in-
spectors of milk. The agents of the Bureau have the same
authority as is given to inspectors and collectors of milk. Pen-
alty for obstruction, first offence, $100; subsequent offences,
$200, with fine payable to the Treasurer of the Commonwealth.
(Revised Laws, chapter 89, sections 5, 11, 12 and 13, amended
by Acts of 1891, chapter 412; 1892, chapter 189; 1894, chapter
280; 1895, chapter 214; 1900, chapter 368; 1905, chapter 155;
1907, chapter 401; and 1908, chapter 416.)
39
Unlawful to sell milk without a permit. Permits are issued
by local boards of health after a satisfactory inspection of the
milk and of the dairies and of the premises upon which the
milk has been handled. No charge for inspection. These in-
spections must be made by the authorized agents of the board.
The boards may require such reasonable conditions as they see
fit. Ifa permit is revoked the board of health must notify the
State Department of Health. The latter must notify other
boards of health in whose jurisdiction the milk is liable to be
sold, and must notify dealers liable to purchase the milk. , Un-
lawful to sell after receiving such notice. Permits may be
reissued by local boards of health. Penalty not more than
$100. (Acts of 1914, chapter 744, amended by Acts of 1916,
- chapter 228.)
Unlawful for any State or municipal inspector to charge for
the inspection of live stock, dairy, etc. (General Acts of 1915,
chapter 109.)
No person shall sell milk without a license. Exception: a
producer selling to dealers or not more than 20 quarts to con-
sumers. The license shall be numbered and shall contain the
name, place of business, residence, number of wagons and
names of drivers, and shall be conclusive evidence of owner-
ship. Name, place of business and license numbers must be
painted on wagons, and license must be posted in stores. Pen-
alty for operating without a license, first offence, $10 to $100;
second offence, $50 to $300; third offence, $50 and imprison-
ment for thirty to sixty days. Fee for license, 50 cents. Li-
cense remains in force until the first day of June. May be
revoked for violation of the terms of the license. If license is
revoked licensee has an appeal to the State Department of
Health, whose decision shall be final and conclusive. (Acts of
1909, chapter 443.)
Utensils used in determining fat by the Babcock or other
centrifugal methods must be approved or calibrated by the
Massachusetts Agricultural Experiment Station. Persons oper-
ating these machines must have a certificate from the experi-
ment station. Exception: persons doing such work for their own
information, not for inspection or as a basis for payment in buy-
ing or selling. Penalty, $15 to $50. (Acts of 1912, chapter 218.)
40
_ Milk which has been heated to a temperature greater than
167° F. must be labeled “Heated Milk.” Penalty, first offence,
$50 to $200; second offence, $100 to $300; subsequent offences,
$50 and imprisonment for sixty to ninety days. (Acts of 1908,
chapter 570.)
Sale, ete., prohibited of adulterated milk, or milk to which
water or any foreign substance has been added, or milk from
cows fed on the refuse of distilleries, or from sick cows, or as
pure milk, milk from which a part of the cream has been re-
moved, or skimmed milk containing less than 9.3 per cent.
solids not fat. Penalty, first offence, $50 to $200; second
offence, $100 to $300; subsequent offence, $50 and imprison-
ment for sixty to ninety days. (Revised Laws, chapter 56,
section 55.)
Sale, ete., prohibited of milk below the legal standard. Pen-
alty, first offence, not more than $50; second offence, $100 to
$200; subsequent offences, not more than $200 or not more than
ninety days. (Revised Laws, chapters 56 and 57, amended by
Acts of 1910, chapter 641.)
Producer not liable for sale of low standard milk unless low
in both solids and fat, and unless twenty days after he has
received notice of this fact a second sample is found by the
same inspector to be low in solids and fat. Furthermore, sam-
ples must be taken while in his possession or in his control by
an inspector, and a sealed sample given. (Revised Laws, chap-
ter 56, section 62, amended by Acts of 1910, chapter 641.)
Standard: solids, 12.15 per cent.; fat, 3.35 per cent. (Re-
vised Laws, chapter 56, section 56, amended by Acts of 1908,
chapter 641.) ’
Skimmed milk may be sold if labeled with the words
“Skimmed Milk” in letters 1 inch in length. (Revised Laws,
chapter 56, section 58.)
Use, etc., of counterfeit seal, or tampering with sample,
punished by fine of $100 or imprisonment three to six months.
(Revised Laws, chapter 56, section 60.)
Obstruction of inspector punished by fine of $100 to $300 or
imprisonment thirty to sixty days. (Revised Laws, chapter 56,
section 61.)
The inspectors must make complaint upon receipt of evi-
dence. (Revised Laws, chapters 56 and 64.)
41
Analyses of samples must be sent to the person from whom
sample was taken. (Revised Laws, chapters 56 and 63.)
Use of unclean containers and implements punished by fine
of not more than $50. (Acts of 1913, chapter 761.)
Placing substances other than milk and milk products and
cleaning fluids in milk cans or bottles punished by not more
than $10 for each vessel misused. Returning dirty cans to
producers punished by fine of not more than $10 for each such
vessel. (Acts of 1906, chapter 116.)
Milk dealers must not use cans not their own. Penalty, $10.
‘ (Acts of 1906, chapter 116, amended by Acts of 1908, chapter
435.)
Commissioner of Animal Industry may inspect premises
where cattle, etc., are kept. He may make and enforce regula-
tions for the sanitary condition of the premises subject to ap-
proval by the Governor and Council. State Department of
Health, Dairy Bureau and boards of health must report all
premises found to be unsanitary. Penalty for obstruction, not
more than $50 or imprisonment not more than thirty days.
(Acts of 1911, chapter 381.)
Feeding garbage collected by a city or town to milch cows
prohibited. Penalty not more than sixty days or not more
than $100. Feeding garbage collected from a city of more than
30,000 inhabitants to any animal except swine prohibited. Pen-
alty, not more than thirty days or fine not more than $50.
(Revised Laws, chapter 213, section 5.)
Medical milk commissions may be formed. The members
of the board of health may be ex offictis members. Members
shall receive no compensation. The corporation may make
agreements for the production of milk under their supervision,
but the conditions shall not fall below those imposed for cer-
tified milk by the American Association of Medical Milk Com-
missions, or below the statutory standard. Penalty for sale of
milk not conforming to the regulations, not more than $100.
(Acts of 1911, chapter 506.)
Boards of health of cities and of towns having 10,000 or more
inhabitants may establish stations for the distribution of milk
free of charge or at such charge as the board may establish.
The boards, however, must not engage in the general milk
business. (Acts of 1911, chapter 278.)
42
PART II. STATEMENTS OF VARIOUS INTERESTS.
INTRODUCTION.
It was the desire of your Board to obtain as many view-
points from as many different interests concerned in the pro-
duction and the sale of milk as possible, and therefore a num-
ber of letters were sent to different organizations.
A questionnaire of nine questions was sent to .certain of the
large milk contractors; six questions requested definite informa-
tion upon certain phases of the operation of their business, and
three were relative to their opinion of the present milk
situation. Letters were sent to cattle breeders’ associations
asking whether or not they would approve of selling milk upon
its fat percentage. A letter was sent to the State Department
of Animal Industry relative to the inspection of cattle, and
that Department was asked to give an opinion upon the health
of Massachusetts cattle at present as compared with that in
former years.
The Boston Chamber of Commerce, the State Grange, the
Milk Consumers League, the Milk and Baby Hygiene Associa-
tions, the Massachusetts State Board of Agriculture and the
Health Department of the city of Boston were all requested to
submit statements giving the viewpoints of their respective or-
ganizations relative to the milk situation in Massachusetts.
The answers, wherever possible, have been reported in full,
but in a few instances it has been necessary to make com-
pilations.
A. MILK CONTRACTORS.
A questionnaire was sent to milk contractors, a portion of
which dealt with their opinions relative to the milk situation.!
From the answers received the following has been compiled: —
Question ie Bio you consider that the present competitive system
of retail milk delivery involves an unnecessary duplication of equip-
ment and labor?
1 The balance of the answers are discussed in Part III., Section B.
43
To this question 7 answered no, 3 yes, and 1 gave no answer,
stating that he made no retail sales. One complete answer is
as follows: —
7. In large centers of population where the business is of considerable
volume that is carried on and operated by a dealer, we think that there
is little chance to improve upon the city milk delivery. A number of
years ago, when the distribution of milk was in the hands of milkmen
who ran one or two teams, there was of necessity long drives and scattered
deliveries. One can readily see the way the business is now carried on
by large dealers, —a customer moving from one section of the city to
another is simply transferred to the team delivering in that section;
but under conditions that existed as referred to above, the small milk-
men who operated one or two teams would either have to give up the
customer who moved to another part of the city, or lengthen out his ~
drive, which, of course, is a costly thing to do. We try to load up our
wagons and divide the territory so that we give one man a full day’s
work, and also try to arrange the deliveries so that one horse is all that
is necessary usually to run the team.
Question 8.—Is there a surplus or a shortage of milk at different
seasons of the year in your milk producing territory, and if so, please
state your opinion of the reason therefor.
All eleven answered yes to this question. The variation
in the amount of milk upon the market was explained by
natural causes, unavoidable causes and faults of production.
The cows are generally allowed to freshen in the springtime,
and the farmers do not attempt, as a rule, to control the flow
of milk by regulating the time of breeding.
On the other hand, the demand for milk varies with the tem-
perature. During the extremely hot days there is an enormous
demand for milk without a corresponding increase in produc-
tion. The present shortage in the hot weather is not so severe
as formerly, owing to the fact that many farmers are beginning
to arrange their herds so that more milk will be produced dur-
ing the hot weather.
One complete reply is as follows: —
8. Generally speaking, there is marked irregularity in the production
of milk, the largest quantity occurring in the months of May and June,
and the smallest in the months of October and November. Both the
excess production and the under production from the average level result
44
in heavy cost to the industry. In the case of surplus no use is available
which will yield the full cost of the milk, and in the case of shortage the
supply has to be replenished from new sources of exorbitant prices.
Notwithstanding instruction to producers as to the need of the market
for even production, and notwithstanding the application of a heavy
grade in prices, the producer, in general, persists in uneven production.
This is due, presumably, to the tradition of producing maximum amounts
on summer pasturage, and again, to the consideration that milk on most
farms is not the sole product, and the production of milk is not inten-
sively carried on.
Question 9.— Do you consider the present milk situation in Massa-
chusetts satisfactory from the dealer’s point of view? If not, would
you kindly state in your opinion what changes could or should be made
to place the business on a more satisfactory basis?
To this question seven answered no, two answered yes and
two gave no answer. The following suggestions were made: —
Increase the license fee to $50, which will prevent incom-
petent men from going into the milk business, and, further-
more, prohibit by statute any person engaging in the business
without adequate equipment. 3
Milk from uninspected sources and of doubtful origin is now
allowed to compete with Massachusetts producers. To offset
this, uniform regulations should be made, placing the enforce-
ment of dairy inspection in the control of the State Depart-
ment of Health.
Another contractor stated that multiple inspection under the
provisions of chapter 744 of the Acts of 1914 should be stopped
in favor of State Department of Health inspection. Another con-
tractor suggested lessening the legislative activity, and placing
the inspection of dairies under the control of the State Depart-
ment of Health. One contractor suggested compulsory pas-
teurization of milk in large cities under the supervision of the
State Department of Health.
Price cutting is stated to be ruinous among dealers, as is also
the practice of selling bottled milk in stores at cost. The selling
of milk on its quality by different grades would give the con- —
sumer a reliable basis for a differentiation of quility, and would
standardize competition among dealers. Another contractor
with this same idea suggested statutes permitting the sale of
standardized milk and the sale of milk on the fat basis.
45
The present conditions do not encourage milk production in
Massachusetts. Long-distance milk is cheaper and discourages
home production. The Saunders law did not handicap dealers
in getting milk, but probably has been of no benefit to Massa-
chusetts producers.
Another contractor suggested amending the laws so that
dealers may be seen on the street corners together without
danger of arrest. One complete reply is as follows: —
9. Under the law of 1914 cities and towns of the State are required
to inspect and to license dairies supplying them with milk. This results
in a multiplication of permits, to the extent that producers supplying
dealers covering greater Boston may have permits from twenty boards
of health. We believe the interests of all concerned in milk, viz., the
producer, distributor, board of health and consumer, would be more
agreeably, effectively and economically served by centralizing the in-
spection of dairies under the authority of the State.
We believe that the pasteurization of milk in the large cities of the
State should be made compulsory, and that the process should be carried
on under conditions prescribed by the State Department of Health.
We believe that the sanitary problem in milk has resolved itself chiefly
into an economic problem. Knowledge as to the sanitary measures
required for producing and handling clean and safe milk is widely dis-
seminated. What lacks is the application of this knowledge, which is
a business matter. The establishment of the sale of milk on a basis of
quality through the definition of grades would afford the consumer a
reliable basis for the differentiation of quality, would standardize compe-
tition among dealers, and would permit compensation of producers on
a basis of quality. The consumer could then have the grade of milk
desired by paying the appropriate price. We accordingly urge the es-
tablishment of grades for sale of milk in the large cities of the State.
We urge the enactment of law prescribing the sale of cream on a basis
of fat.
The present requirement of law of 9.3 per cent. solids not fat in skimmed
milk is higher than genuine milk will show. We therefore urge a change
to 8.75 per cent.
We recommend that the boards of health of the towns and cities in
greater Boston standardize their regulations controlling the delivery of
milk to homes in which an infectious disease exists. There is now con-
siderable difference in the requirements of different localities. Generally
speaking, the’ milk dealer is held responsible to the board of health for
seeing that this is done. We believe that the householder should be
made completely responsible, by such means as retaining bottles in the
household until the disease is over and until bottles have been disinfected
by the board of health or under its direction. Such a requirement would
46
be seen to cover the case of bottles bought through the stores for use in
infectious households where now, according to our understanding, they
escape supervision. The sale of milk in bottles through the stores now
constitutes a large part of the city supply.
B. BOSTON CHAMBER OF. COMMERCE. -
_ Dec. 20, 1915.
Mr. Epwarp H. Wiuiams, Room 141, State House, Boston, Mass.
Dear Mr, Wititams: — I have your letter of December 18, in which
you state that you would like to have a statement from us in regard to
the milk situation.
You already have copies of our milk report, which gives a summary
of the present conditions and our opinion as to what is necessary to
remedy some of the present difficulties. I am enclosing a leaflet which
will give you an idea of our future plans. We are just sending the third
edition of this report to the press. The fourth edition will come out
some time in February. It seems to us that the first thing to do is to ©
get a wide distribution of the report, co-operating with the various
agencies interested, in order that a large number of people interested in
the dairy industry may become acquainted with present conditions and
the suggested remedies.
Up to date, almost every agency has been looking at the suggestion
from their own point of view, forgetting the bearing that the other con-
ditions had upon their particular problem. Again, many people, in
order to accomplish certain needed reforms, are so anxious to overturn
in a few months conditions that have been growing for a period of many
years that they generally do not succeed. After securing a wide distribu-
tion of the report, we hope that a plan can be laid out by a conference
of the agencies interested, whereby the recommendations as to the par-
ticular phases of the production, transportation, inspection and distri-
bution of milk and cream can be carried out step by step.
For instance, take the grading and labeling of milk. A pamphlet
should be issued telling how grading and labeling can be really carried
out; what is necessary to be done in order to interest the people, such
as holding meetings of health officials, town and city authorities, dealers,
producers, consumers, etc.; the equipment necessary for a laboratory,
the cost of operation and cost per sample, and the cost per capita. This
should be figured out according to the population of the various munici-
palities, showing what it would cost cities of, say, 500,000 and over;
100,000 to 500,000; 50,000 to 100,000; 5,000 to 50,000; and under
5,000. These, of course, are only fictitious divisions, and it may be
found upon further study that they would have to be in different divisions.
This would give in detail how the grading and labeling of milk should
be carried out, and this is what the people need.
The same thing should be done in regard to every recommendation
47
as to country milk plants, railroad transportation, better methods of
production, distribution, etc., outlining a detailed plan of just what can
be done, providing the people wish to take some initiative.
Undoubtedly some legislation ‘will have to be secured in regard to
making the local standards more or less uniform as to milk and cream
and ice cream; the problem of the country dairy inspection; and the
granting of authority to boards of health to issue licenses for the grading
and labeling of milk. Undoubtedly your Board has looked into these
matters and is more or less familiar with the situation.
I am sure that I personally, and other members of our committee
would be very glad to have a conference with your committee any time
to discuss these three particular questions, or others pertaining to this
oft-vexed and much-perplexed problem.
i Very truly yours,
Joun C. Orcutt,
Secretary, Committee on Agriculture.
C. MILK CONSUMERS’ LEAGUE.
The Massachusetts Milk Consumers’ Association dates its organization
from 1910. It consists of over 1,800 prominent men and about 10 women,
very evenly distributed throughout the various representative districts
of the State. Its purpose is: “An association formed to unite consumers
in obtaining efficient inspection and a pure milk supply.”
The organization was evolved from three sources, namely, Dr. Charles
Harrington, former secretary of the State Board of Health, the official
legislative investigating committees of 1910 and 1911, and the health
committee of the Municipal League.
For several years prior to 1911 Dr. Harrington introduced bills in the
Legislature designed to enable the State Board of Health to enforce its
suggestions for cleanliness in the dairies supplying Massachusetts. In
1905 he appointed one State Dairy Inspector, and at his death was con-
templating extending the State inspection to out-of-State dairies.
When asked by the chairman of the health committee of the Women’s
Municipal League what they could do to help him, Dr. Harrington sug-
gested that they assist him in securing the passage of the bill which he
had introduced. Because of the continued failure to get Dr. Harrington’s
bill through, it was decided to form a State organization, which subse-
quently took the name of the Massachusetts Milk Consumers’ Associa-
tion.
On May 5, 1910, a joint committee of the Legislature was appointed
to investigate the milk problem. This committee, after expressing the
necessity for a central authority administrating a uniform inspection of
the places where the milk is produced, recommended that the Dairy
Bureau investigate the subject. Acting on this recommendation the
Legislature authorized an investigation by the Dairy Bureau consisting
48
of three members, of which Charles M. Gardner is chairman, with two
experts, Dr. Milton J. Rosenau and George H. Ellis, to complete the
commission.
This commission on Jan. 2, 1911, reported a bill to the Legislature
known as the Gardner bill. The commission unanimously found that
existing conditions were a menace to the Massachusetts milk consumers
and an unfair burden upon the Massachusetts milk producers.
It was at this stage that the Milk Consumers’ Association became
active. The Ellis bill is simply the Gardner bill with practically only
one substantial change, the details of the bills being in most cases word
for word the same.
Instead of having the mixed board both pass and administer regu-
lations, as in the Gardner bill, the Ellis bill provided that while the mixed
board should pass the regulations the administration should be in the
hands of the State Board of Health in order to preserve unity in health
administration.
There were some other changes made at the suggestion of the milk
inspectors who met at a conference called by the association for the
purpose of getting their ideas. The changes made at their request were
in the line of preserving local powers. Everything they asked for was
put into the bill.
The bill expressed the ideas of Dr. Rosenau and Mr. Ellis, the minority
members of the commission.
The efforts of the association have always had the support of the
Massachusetts Medical Society and of various local medical societies
and innumerable other State and local welfare organizations.
The association has constantly consulted experts on the subject
throughout the country, and has from time to time made changes in the
bill at the suggestion of its members and others, going as far as possible
to remove controversial phrases.
Many efforts have been made to come to a common understanding
with the Grange, the Grange usually being represented by Mr. Howard
on such occasions.
The association has never taken any arbitrary position as to the form
of the bill, only insisting on the central principle that the State Depart-—
ment of Health should have legal power on its own initiative, in places
where milk is produced or handled, to insist upon reasonable cleanliness.
In years past a great many local labor unions indorsed the bill advo-
cated by the Consumers’ Association, but this year the State branch of
the American Federation of Labor at its State convention made the fight
for clean milk legislation its own, and authorized its legislative com-
mittee to introduce what was afterwards known, and properly so, as the
labor clean milk bill. It was an entirely different bill from the Ellis
bill, but one which was heartily supported by the Massachusetts Milk
Consumers’ Association. The members of the association veted almost
unanimously on a referendum to support the labor bill.
49
After receiving the favorable report of the public health committee,
it was passed by a two-thirds vote of each house, but was vetoed by the
Governor.
The original Ellis bill was passed in the first year of the association’s
campaign, but was vetoed by Governor Foss.
D. THE STATE GRANGE.
Session of 1911, Worcester.
In view of all the aspersions cast upon the Grange and upon the farmers
because of the Ellis bill episode, and the misstatements of people whose
conduct cannot be attributed to ignorance, it seems fitting to cause this
annual session of the Massachusetts State Grange to speak clearly and
distinctly on the subject of milk inspection and concerning the Grange
attitude upon health matters in this State. There are exceptions to
every class as to every rule, but as a whole the farmers of this Com-
monwealth are as eager to sell clean, wholesome, properly handled milk
as any consumer is to buy it; they are as truly interested in the health
and life of little babies as are the philanthropists of any city. No one
in this State will more quickly condemn a filthy and disease-breeding
stable than the great mass of our farmers themselves; and in any reason-
able and common-sense undertaking to improve the health conditions of
the dairy industry they will lend instant and earnest co-operation.
They do insist, however, that those who essay to prescribe the con-
ditions of milk production must at least be able to recognize a cow stable
when they see one, and must understand that a farmer cannot produce
any kind of milk, not to mention clean milk, unless he can get something
near 100 cents for each dollar that he spends to produce that milk.
Your State master sincerely trusts that this body will in no uncertain
tones pledge its belief in and its support for such measures, wherever
their origin, as propose to continually improve health conditions in our
milk supply, by the only means that will ever prove effective, so well
expressed in the words of the Chief Executive of the Commonwealth:
“What we need is to penalize the farmer a little less and encourage him
a good deal more.”
Session of 1912, Springfield.
Confirming further our previous State Grange attitude on the whole
milk question, we may well emphasize anew our emphatic declaration
of one year ago, — that the final answer to all phases of the milk problem
will be found, and speedily found if sought, in the disposition to pay the
farmer a fair price for clean, well-handled milk, based on the belief that
milk producers of Massachusetts will make just as good milk, even up
to the certified class, as the consumers want to pay for. This, finally,
is the essence of the whole question, and points the way to the line of
_ milk education to-day most needed.
50
Session of 1913, Boston.
In all the maze of the milk situation it is exceedingly refreshing to
find some of the milk contractors making advances to the producers for
a graded scale of prices, paying according to the percentage of fat value
in the milk and the degree of cleanliness it possesses. This is highly
significant as the trend of the times, indicating what are to be the lines
of profitable milk production for the future; especially so because this
is exactly the attitude the State Grange has taken for three consecutive
years, not only by action in the annual session, but by appeal before
the Legislature, — that the farmer will produce from his cows just as
rich milk and just as clean milk as the consumer is willing to pay for;
and that in respect to cleanliness the farmer is already spending far more
in equipment and in care than the consumer does pay for. Let it be
hoped that a graded scale of milk purchasing will ultimately become
general, with an opportunity afforded the ambitious farmer, at a price
commensurate with the cost of cleanliness, to produce the most wholesome
and satisfactory milk it is possible for the combination of clean, healthy
cows and clean, honest cow owners to produce. This is the only line on
which milk progress can ever come, and that most people are coming to
see this fact is one of the most hopeful signs of the times for both milk
producers and milk consumers.
E. MILK AND BABY HYGIENE ASSOCIATIONS.:
For the purpose of acquiring information as to the work done
by the Milk and Baby Hygiene Associations, a letter of inquiry
was sent to the following associations: Society for District
Nursing, Worcester; Instructive Nursing Association, New Bed-
ford; the Lowell Guild, Lowell; Visiting Nurse Association,
Great Barrington; District Nursing Association, Fall River;
Sanitary Milk Committee, Lawrence; Infant Hygiene Associa-_
tion, Holyoke; Milk and Baby Hygiene Association, Malden;
Baby Clinic Day Nursery Association, Lynn; and Miss Helen
Dalton, Fitchburg. The letter was as follows: —
Will you kindly send me for use in this Department in its milk investi-
gation any published reports or data you-may have i in regard to the work
being done by your society?
Any information you can give us will be of great assistance.
Replies were received from several of these associations, but.
none of them had anything to offer in the way of the informa-
ol
tion asked for except the Holyoke and Boston Infant Hygiene
Associations. From the first we received their first annual re-
port published in 1914. This report is very interesting, and
contains the names of the members of the association, the by-
laws, amount of money spent on the work, and is descriptive
in a general way. The detailed statement of the Boston asso-
ciation follows: —
STATEMENT OF Dr. J. HERBERT YOUNG.
The Milk and Baby Hygiene Association of Boston was organized in
1909. The purpose of the association, as stated in the first annual report,
was — .
1. To improve the milk supply.
2. To prevent sickness and reduce mortality among infants.
3. To increase the health and vitality of children and their mothers.
The methods to be used were —
1. Encouragement of breast feeding.
2. Distribution of clean milk.
» 3. Maintenance of a first-class milk modification laboratory.
4. Maintenance of milk stations in the neediest districts.
5. Instruction of high school girls, mothers and fathers in the care of
children.
6. Supervision of the care and feeding of babies by skilled physicians
and nurses at. home and at the stations.
7. Conferences, lectures, exhibits and publications for milk consumers.
8. Co-operation with public health authorities.
9. Researches in bacteriology, biochemistry and sociology with reference
to infant mortality.
The purpose of the association remains the same; our object is to
keep well babies well. The methods used, while essentially the same,
have been changed somewhat to meet existing circumstances. It has
been our experience, as time goés on, that in our work as applied to the
individual baby, milk assumes lesser and hygiene assumes greater im-
portance. This does not mean, however, that the association does not
continue to have an active interest in all phases of the milk question
as applied to infants.
The field activities of the association are carried on from 12 milk
stations. From these stations we cared for, in 1915, 4,800 babies. Of
these babies about 50 per cent. were entirely breast fed, 30 per cent.
partially breast fed and 20 per cent. entirely bottle fed.
Bids are annually requested for the milk sold at the milk stations.
The milk at the present time is supplied by D. Whiting & Sons. This
milk is sold to the mothers at cost. Milk modified at the laboratory of
52
D. Whiting & Sons, according to three formule recommended by the
association, — certified milk, inspected whole milk and fat-free milk, —
is provided. The modifications are made from milk certified by the
Medical Milk Commission of Boston. The certified milk is certified by
the Medical Milk Commission of Boston.
The whole milk and fat-free milk is of the grade known as inspected.
This milk comes from dairies which show a score on the United States
government score card between 75 and 80 points. The cows are annually
subjected to the tuberculin test. The milk is pasteurized at a temperature
of 145° for thirty minutes.
During the month of December, 1915, 494 quarts of modified milk,
57 quarts of certified milk, 5,414 quarts of inspected whole milk and
31 quarts of fat-free milk were sold at the 12 milk stations.
While we believe that the best food for a bottle-fed baby is the freshest,
cleanest and purest cow’s milk that it is possible to procure, we believe
that the milk sold by our association, or any milk of equal grade, is a
safe food for infants.
F. CITY OF BOSTON HEALTH DEPARTMENT.
Eucene R. Keuiey, M.D., Chairman, Milk Board, State Department
of Health, State House, Boston.
Dear Doctor: — In reply to your communication of the 9th instant,
requesting an expression of my opinion on the present status of the milk
situation, I would say that this Department has always kept in mind
the sanitary aspect of this problem, never investigating the economic
or political sides, and forbidding the employees of the Department from
doing so.
Boston is expending large sums of money te improve the milk supply
of this city, and the so-called metropolitan district of Boston has been _
reaping the benefit of this inspection without expense to those cities and
towns in the district. This is manifestly unfair to Boston, but we do
not complain, as under the presen methods of inspection it cannot very
well be avoided.
In my opinion the inspection of the production, handling and trans-_
portation of milk is largely an interstate problem, as about 92 per cent.
of the milk sold in Boston comes from without the State, and should
be supervised by the Federal authorities. As the government has refused -
to assume this responsibility, owing to lack of money to carry on the
work, the duty should devolve on some central State authority, preferably
the State Department of Health.
If the State Department were to take over this work it would do away
with a great amount of duplication in inspections and issuances of permits.
You are thoroughly conversant with the present law regarding the
issuing of milk permits, so I will not go into that phase of the subject,
except to say that if a central State authority had complete supervision
53
‘over these permits it would clarify the situation wonderfully. It would
also help the producer, as he would have only one inspecting authority
to satisfy, instead of three or four, as at present.
Local authorities should have complete control over the inspection
and handling of milk within the limits of their respective cities and towns.
The law, or statute requirements as to standards, etc., places that au-
thority in their hands at present.
I believe in pasteurization of all milk, except certified milk, under
proper supervision by the local authorities of the cities and towns where
the milk is offered for sale.
Yours very truly,
F. X. MAHONEY,
Health Commissioner.
_G. MASSACHUSETTS STATE BOARD OF AGRICULTURE.
Massachusetts is peculiarly located in relation to other States of the
New England group. With only two others smaller, and surrounded by
them all, with New York on the west, it is the natural market for the
group, as next to Rhode Island it is the most densely populated State
in the United States.
Once Boston, which is now the great milk market of New England,
produced its own milk supply. Then as the city grew, and demanded
among other things fresh vegetables, the cows were pushed out to the
near-by. towns, and dairying went on until again the pressure for different
kinds of agriculture was felt, and always dairying, which was considered
a more extensive type of agriculture, depending on large pastures and
lands to grow cheap forage, was pushed further from the central base,
and Boston has had to draw its milk supply first from the 20-mile radius,
then 50, then 100, and now much of the supply comes from over 200
miles. What is true of Boston has been true in a measure of many of
the smaller cities; but many of these latter, owing to their proximity
to the farm lands, have done much to encourage the dairy industry
near by, and are, therefore, supplied with a better grade of milk than is
usually sold in the Boston market, where now a more discriminating
public is demanding that its milk supply be drawn from sources near
the consumption line, and under conditions upon which it desires to
impose restrictions which are bound to increase the cost of production,
as well as that of transportation and distribution.
Massachusetts agriculture has seen great changes in the past one
hundred years, chiefly owing to the severe competition of States more
favored than we are by climate, soil or transportation facilities for the
production and distribution of some particular crop; but in spite of the
loss of some crops and a great reduction in dairying, the State has ad-
vanced steadily in the value of its agricultural products since 1870, as
the following figures will show: —
54
ISTONS MEU UNA he 63 ass wis ia a f : Se . $24,160,881
TRL aU Hak ort 0 a EB es RN, Nr ree ER Re MB MONS (17/29 5178
PSOOR LS) ANE AYLI SLA NE a Dk Oa) ah PCa Oa
1909, . : f : c 5 : 3 : - c . 60,000,000
Market gardening, fruit growing and the production of special green-
house crops have in many instances taken the place of dairying on our
farms, and particularly so near the cities, where it has been possible to
obtain manure from city stables to conduct these operations.
With the very acute fertilizer situation our farmers’ attention is more
forcibly drawn to the general problem of keeping up soil fertility, and
were this situation to continue for long, undoubtedly it would have a
very great effect in restocking with dairy animals many of the farms of the |
State. That there is a desire on the part of many farmers to put cattle
back on the farm is apparent, and there is a decided feeling in many
sections that the cow is a necessity in our agriculture; that milk should
be treated as a by-product; that we should raise more pure-bred stock
in this State; and that all of our dairymen should raise their own stock
and not depend upon those shipped here.
With our great resources in undeveloped land, salt and fresh marshes
for growing hay, upland pastures now growing up to brush, and much
valley land still unproductive, we certainly have a chance to produce
all the milk, cream and butter that we consume. That we shall produce
it some time is apparent, but with present conditions as they are, with
our best markets flooded with milk produced in more natural dairy
sections than ours, and hauled to these markets as cheaply as ours, Massa-
chusetts’ problem is one of producing a superior article which will be
called for in our markets in preference to any other.
That the dairy problem is no new one to our people is apparent from
the following, taken from the report of the secretary of the State Board.
of Agriculture for 1884: —
The production of milk to supply our towns and cities is a branch of husbandry
that in late years has not been satisfactory; the farmers have allowed shrewd
contractors to control the supply and sale of milk, and have accepted prices lower
than the cost of production.
In a way it is to the credit of our farmers that they have gone out of
the dairy business rather than produce an article for which they did
not receive a profit; but the most vital question is a readjustment of
our agriculture, and a readjustment in which the dairy cow will play a
prominent part. Diversified agriculture is bound to become more common
with the exception of very favorable localities, in which rotation of crops,
together with animal husbandry, will be practiced, and a business built
upon quality and freshness of our products will take the place of the
now long-distance shipments which are so common in our markets.
do
H, MASSACHUSETTS STATE DEPARTMENT OF ANIMAL
INDUSTRY.
State Houssr, Boston, Sept. 15, 1915.
Dr. Eucent R. Keuury, Chairman of Milk Board, State Department —
of Health.
Dear Sir: — Your letter of September 9 at hand, and in reply will
furnish you with what information I can on the different subjects
mentioned.
On account of the prevalence of foot-and-mouth disease this past |
season the annual inspection of animals and premises by the local in-
spectors of animals throughout the State was abandoned. This animal
inspection is generally recorded during the early spring months, when
the animals are all in the barns and can be more conveniently examined,
and in order that disease which may have been influenced by the housing
of the animals during the winter months may be recognized. On account
of the danger of spreading foot-and-mouth disease by the medium of
the local inspectors of animals going from farm to farm, and also on
account of the apprehension of cattle owners of this danger of spread of
the disease, we decided that no inspection should take place this year.
The next inspection will undoubtedly be ordered some time during
the coming winter, and at the end of that inspection a much better general
opinion of conditions of animals and premises can be rendered than at
the present time.
If, upon examination of the animals on a certain premises by an in-
spector, he has reason to suspect the presence of any contagious disease,
he is ordered to quarantine such animal or animals, and send duplicate
copy of such quarantine to this office.
I am enclosing to you a blank form used by the local inspector of
animals at the time of their examination, in order that you may see the
information they are expected to return to us. A copy of their report is
left with the owner of the animal, another one retained by the inspector,
and the full record sent to this office. At the time a copy of this record
is left with the owner of the premises, such recommendations for im-
proved conditions, if any, as are necessary in the opinion of the inspector,
are brought to the attention of the owner by the inspector, and the
owner is requested to make such improvements. A later visit is made
by the local inspector, at which time, if conditions are found to be de-
cidedly improved, the report submitted to this Department above re-
ferred to credits the owner with the conditions found on the second visit,
and in most cases we find that the owners carry out the recommenda-
tions made by the inspectors.
As a result, many of the cases that under a former plan would have
been called to the attention of the district agents of our department
are satisfactorily disposed of locally, but if not so disposed of our district
56
agent is sent to the premises, and this Department’s supervision is directly
given to such premises, and frequent visits made until they are placed
in a satisfactory condition.
All cattle over six months of age coming into Massachusetts from
any point without the State, if not intended for immediate slaughter,
are according to law tuberculin tested by an agent of this Department,
unless accompanied by a certificate of test made by a man approved
by the officials of the State wherein the shipment originates. All animals
reacting to this test are destroyed.
For the Year ending Dec. 1, 1914.
Number of cattle tuberculin tested by agents of this Department or ap-
proved veterinarians outside of the State were . : i ‘ . 23,645
Released at Brighton, . : : , 3 5 y : : . 17,485
Released at other points, . ! : . s : id eid Se) OA
Released for slaughter, f d : ; i is : ‘ f 2
Condemned at Brighton, ! é k : : 2 s : A 587
Condemned at other points, ; i 4 ‘ ‘ A : é 86
Permit-to-kill warrant issued, : d i : , 4 s é 13
The above figures relate only to cattle brought into Massachusetts
from without the State.
Of the 17,411 tested at the quarantine station in Brighton 687, or 33
per cent., reacted to the tuberculin test, and only one of such reactors
failed to show lesions of tuberculosis on post-mortem examination, which
is made in every case.
The following figures show the number of neat cattle quarantined by
local inspectors of animals within the State,’for which number warrants
were issued by this Department, and disposition made of the animals: —
Massachusetts Cattle.
Total number of cattle quarantined or reported for examination during
the year, . : Q : : : ‘ : : é : BaP anetThe)
Number released, . , : 4 ‘i : 3 288
Number condemned, qelted ag aie for be ‘ : f : 880
Number condemned and killed, in process of gevelesneat: : i : , 141
Number permit to kill, paid for, . - 4 a 3 A : 63
Number permit to kill, no award, . 4 s 4 & é i 4 174
Number died in quarantine, no award, . be i f x s 36
Catile from without the State.
Number released, . ; a 3 6 F 12
Number condemned and iailed, no ete “ i 5 . 654
Number condemned and killed, no lesions found, nal fark ‘ 3 : 6
Number in process of settlement, . i 5 A 5 3 i 5 5
In addition to the 2,259 head of cattle disposed of as above, 183 cattle
and 27 swine have been reported by butchers, renderers and boards of
health as having been found tuberculous at time of slaughter, all of
which were rendered.
57
I quote you section 31, chapter 90, Revised Laws, as amended, which
restricts the use of tuberculin as a diagnostic agent: —
Tuberculin as a diagnostic agent for the detection of tuberculosis in domestic
animals shall be used only upon cattle brought into the commonwealth and upon
cattle at Brighton, Watertown, and Somerville; but it may be used as such diag-
nostic agent on any animal in any other part of the commonwealth, with the
consent in writing of the owner or person in possession thereof, and upon animals
which have been condemned as tuberculous upon physical examination by a
competent veterinary surgeon. Such tests by the usé of tuberculin shall be made
without charge to citizens of the commonwealth, and in all other caser the expense
ot such tests shall be paid by the owners ot such animals or by the person in posses-
sion thereof.
The activities of the local inspectors of animals are not limited to
their annual cattle inspection. On finding an animal which to them
seems to be probably diseased, they quarantine the same, and return a
duplicate to this office. A warrant or killing order is then made out, and
one of our district agents, or an outside veterinarian who acts as our
agent, is charged with the execution of the warrant. If, on physical
examination the animal is found to be diseased, it is condemned and
killed, and report made to this office of the lesions found on post-mortem
examination.
Following the disposal of a case of tuberculosis, the owner is required
to disinfect the premises according to our instructions, and his claim
for reimbursement for the death of the animal is not paid until report
is on file in this office that the disinfection has been satisfactorily com-
pleted. .
I am about to institute the practice of careful physical examination
of all the animals in the herd from which an animal afflicted with tuber-
culosis has been condemned by this Department. In my opinion this
will bring to notice a no inconsiderable number of diseased animals which
otherwise might have escaped notice for a greater or less period, during
which time they were acting as spreaders of the disease.
The percentage of Massachusetts cattle tested with tuberculin is
necessarily small, and it is impossible to get at the correct statistics.
This Department tests Massachusetts cattle with tuberculin only upon
voluntary request of the owner, and private tests which are made are
not in very many cases reported to this office, so that no means are at
hand for obtaining information as regards the percentage of the State’s
cattle which are tuberculin tested.
Whether or not a tuberculin test should be compulsory is a large
question, and open to a great deal of argument pro and con. Compulsory
tuberculin test was inaugurated in this State some twenty years ago,
but it was not carried very far before the farmers rose en masse against
it. Tuberculosis was then so rampant among the cattle of this State
that in many instances as high as 30 to 50 per cent. of the cattle were
destroyed as a result of the tuberculin test, and the carcasses became
a total loss.
58
In my opinion there is a gradual improvement from year to year in
the percentage of cases of tuberculosis among our cattle, and with what
improvements we make in the control of this disease I think the general
situation is found to gradually become better.
On the appearance of foot-and-mouth disease in this State last Novem-
ber the great market for milch cows, viz., Brighton Stock Yards, was
immediately closed, and remained closed until Sept. 1, 1915, when modi-
fication of the quarantine was allowed, so that there could be received at
these premises cattle from the States of Massachusetts, Maine, Vermont
and New Hampshire. Cattle from all other States in the Union are
prohibited from entering the Brighton Stock Yards unless intended
for immediate slaughter, and all cattle received from any other sections
of the country than those States mentioned are obliged to remain in >
quarantine at the point of arrival until released by an agent of this De-
partment, and at the present time this limit of quarantine is fifteen days,
so that in case the animals have picked up this infection en route, sufficient
time will elapse while in quarantine for them to show clinical symptoms,
and the disease will therefore be confined to those premises. No cattle.
are received anywhere in Massachusetts from any point other than what
is designated as “‘free area” by the United States Department of Agri-
culture. All premises on which foot-and-mouth disease existed during
the recent epidemic are still under quarantine, and animals go to and
from such premises only on permit of this Department.
Regarding the health of cattle in different sections of the State, a
larger number of cases of disease are found in the middle and eastern
sections. Very little contagious disease of any kind is found in the Cape
district, and in that portion of the State west of the Connecticut River.
As you asked for a personal opinion regarding physical examination
of animals, I would say that it is my belief that a more careful and more
frequent physical examination would certainly tend toward an improve-
ment in the health conditions as viewed from the standpoint of the
products of the animal industry, whether that product be milk or meat.
Very truly yours,
Lester H. Howarp,
Commissioner.
I. CATTLE BREEDERS’ ASSOCIATIONS.
Appended is a list of the replies from several cattle breeders’
associations in response to request for information as to their
opinion on the question of selling milk on a basis of its food
value.
Mr. Williams attended a meeting of the New England Hol-
stein Friesian Breeders’ Association, and asked for an opinion
on the matter of selling milk on a basis of its food value. The
59
members of the association would not give a frank opinion,
but two or three members said that the association had always
stood for clean, pure milk. Mr. Williams was led to believe
that they were opposed to any system whereby milk would be
sold on a basis of its food value. Several of the members made
claims that Holstein milk was a better milk for infants or in-
valids than any other, and that it was the best substitute for
mother’s milk that could be found. Professor Hills in an ad-
dress at the meeting said that he had carried on a great number
of experiments, and had come, to the conclusion that Holstein
milk was the nearest to the piasent. milk for infant feeding,
but was no better than Jersey or Guernsey milk that was re-
duced to the same amount of fat, solids, sugar, etc. Professor |
Hills said that his experiments had been carried on on a large
number of baby pigs.
No answer has been received from the American Holstein
Friesian Association in response to our letter, as the secretary
could not say how they felt in the matter, but he said he would
take it up at some future. meeting. All of the other associa-
. tions that have answered have expressed their approval of the
idea of selling milk on a basis of its food value.
As far as the Jersey breed of cattle is concerned, nothing would please
us better than to see milk universally sold in accordance with its value.
as food. (American Jersey Cattle Club, R. M. Gow, Secretary.)
There is no question about the desirability of selling milk on the basis
of its food value. Brown Swiss Breeders are in favor of a quality test
on milk. (Brown Swiss Breeders’ Association, H. C. Taylor, Secretary.)
The question has never been discussed by the Ayrshire Breeders’
Association in relation to selling milk on its food value. My personal
opinion is that milk should be sold on the food value it contains. (Ayr-
shire Breeders’ Association, C. M. Winslow, Secretary.)
I am personally a great believer in the selling of milk and dairy products
according to their value as food. Why should not the same be done as
with other commodities? (American Guernsey Cattle Club, W. H.
Caldwell, Secretary.)
I was always of the belief that all dairy products should be sold as
nearly as possible on their basis of food value. (Red Polled Cattle Club,
H. A. Martin, Secretary.) \
60
PART III. FACTS OF PRODUCTION, PROCESSING AND
MARKETING. ;
A. SUMMARY OF MILK BOARD’S OWN DAIRY INSPEC-
TIONS.
The Milk Board visited various sections of Massachusetts,
Maine, New Hampshire, Vermont, Connecticut and New York ~
and the Province of Quebec in their investigation of the milk
problem as it pertains to the State of, Massachusetts. More
than 300 dairies were investigated, and although this number
represents approximately only 2 per cent. of the total number
of dairies within the State, their location and type make them
reasonably representative of the whole. The committee started
its work in the Berkshire section of the State in April, 1915.
In May 83 dairies were investigated in the followmg towns:
Truro, North Truro, Orleans, East Orleans, Eastham, Barn-
‘stable and Sandwich. There were a total of 146 cows kept on
these dairies, producing approximately 1,429 quarts of milk per
day. The farms were on the average neat and clean. Many of
the barns were old but kept in reasonably good condition. Only
in one or two instances were they of a low standard. Cooling and
icing were done in a fairly satisfactory manner. Several farmers
state that there is no demand for winter milk, and are consider-
ing the keeping of cows only for the summer trade. The aver-
age price for milk at wholesale is 6 to 7 cents per quart, and
at retail, 10 to 12 cents per quart. Some dairies sell at the
docr for from 7 to 9 cents-per quart. Mr. P., a small producer,
wholesales at 6 cents per quart, and says that “there is no
money in the business.” Another dairyman who retails his
product says that the business pays only when milk sells at 10
cents. There were four herds in this section tuberculin tested.
Dairies were subject to local and State inspection, and no com-
plaints were heard regarding it. Fifteen dairies in ‘Truro, sup-
plying milk to Provincetown, were inspected and scored, the
old form of score card being used. For methods they averaged
61
73 of the perfect score and for cleanliness, 72. Two instances
“were noted where former inspection by the State Department
of Health had been of service. A man who owned the dairy
which gave the highest score stated that the conditions found
were due to suggestions made by the inspector of the Depart-
ment. Another who had been annoyed with moisture collecting
upon the ceiling and falling down said that upon advice of the
inspector of the State Department of Health the condition had
been removed. Conditions of the dairies in this part of the
State are rather different than those elsewhere. There are fewer
cows, and milk is as a rule delivered to consumers by the owner
of the dairy immediately after milking, and very frequently
_without cooling.
The district visited about Lynn included this city and Saugus,
Melrose, Lynnfield, Peabody and Salem. Thirteen dairies were
visited. A total of 462 cows were kept. The conditions in gen-
eral were good. Poor drainage conditions were noted in two,
and a few did not have separate milk rooms. On several dairies
only a few cows were kept principally for the purpose of pro-
ducing fertilizer. Such places were engaged in market garden-
ing, the dairy end being more or less a side line. On one of
the places the cattle were regularly inspected by veterinaries,
and the men employed subjected to physical examination by
physicians. Milk retails for from 7 to 12 cents per quart, and
wholesales at 45 to 50 cents per can in winter and from 42
to 43 cents in summer. Mr. B., who has 18 cows, says there
is no money in the business at these prices. Mr. S., having
50 cows and selling milk at 8 cents retail, says the milk busi-
ness is not so profitable as it used to be because grain and cows
cost so much. In Methuen, Bedford and Concord 9 dairies
were visited, with a total of 375 cows kept. The conditions
found were generally satisfactory. Milk from these dairies re-
tails for from 8 to 12 certs per quart. Mr. B., producing 160
quarts daily, all of which he retails at 8 cents per quart, said
that the milk should bring 9 cents per quart to make the busi-
ness a paying proposition. All these dairies and those included
in the Lynn district are subject to local and State inspection.
There appears to be no objection to such inspection; no com-
plaints were made. Mr. H., who keéps 50 head of cattle and
62
produces 300 quarts of milk daily, said that proper inspection
would be a good thing if the inspector understood the farmer’s
problem. Representatives of the committee visited the district
about Fitchburg, which included, beside the city, the towns of
Westminster and Winchendon. Eight dairies were visited upon
which were kept a total of 205 cows, producing approximately
1,509 quarts of milk daily. One of the dairies produced cream
and wholesaled in the city of Fitchburg. All the dairies visited
presented very satisfactory conditions. ‘They were subject to
frequent local inspection, which was based upon education
rather than coercion. Commendable conditions were noted on
dairies in Winchendon. Only two dairies wholesaled their milk
and one wholesaled cream. The prices received by these dairies
were 40 cents per can for milk and 50 cents per quart for
cream. Milk retails in Fitchburg for from 8 to 12 ceuts per
quart, while in Winchendon the maximum is § cents per quart.
Mr. M. of Winchendon, whose methods and equipment gave an
excellent score, 93, thinks that 10 cents per quart would be a
fair price. . |
In the Berkshire district which included Richmond, West
Stockbridge, Great Barrington, Egremont, New York State,
Stockbridge, Pittsfield and Cheshire, 15 dairies were visited,
also one creamery keeping 333 head of cattle and 33 young
stock. In many of the farms visited conditions were found to
be fairly good. Some in addition to dairy farming were en-
gaged in various side lines, such as poultry, pork raising and
summer boarders. Milk from this section is shipped into Pitts-
field, Mass., and New York. Mr. S., who operates a 100-acre
farm, retails the milk at 8 cents per quart. He says that were
it not for the fact that he and his wife do all the work he
could not stay in the business. One of the troubles he says
has been multiplicity of inspection. A Mr. C., operating a
200-acre farm, says that milk should’ bring 5 cents per quart
at the farm in order to pay. Butter produced in this section
brings at retail 35 to 40 cents per pound. Mr. M., who has
a 275-acre farm and is engaged in this business, states that
butter could not be produced for less than the prices given and
allow a living margin. The dairies are subject to local mspec-
tion. , Inspectors also come in from Pittsfield and New York
to dairies supplying milk to these places.
63
The committee visited 80 dairies in the Deerfield valley, in-
cluding the following towns: Ashfield, Buckland, Conway, Shel-
burne,. Charlemont, Heath and Whitingham, Vt.
The dairies were found to be in a very poor condition. On
a total score, 10 per cent. scored below 40 and ouly 1 per cent.
above 70. The Milk Inspection Association had recommended
that permits be refused to any dairies scoring below 50. Nearly
all the dairies use ice for cooling. The milk is kept in 40-
quart cans, and is collected every day, or every other day in
some cases, and delivered to the railroad depot, where it is
kept without being iced until placed on the train. , Some of
the farmers are obliged to cart their milk some distance and
leave it on the platform in the sun until the collector calls for
it. A number of Polish people have bought up old farms in
this region and are gradually improving them. One of these,
for example, presented dirty walls and floors, with manure
piled up to the windows. This place scored 48.7, but the use
of ice in milk house brought up the score. On another place
presenting dirty conditions the woman who was interviewed
stated that she knew the stable was in poor condition, but the
price given for milk was insufficient to compensate for making
any improvements. She also stated that the Pole who col-
lected the milk was in the habit of measuring it by means of
a stick which he wiped sometimes on a cloth, sometimes on
his overalls and sometimes on the grass. The average price
paid the farmers is $1.55 per 100 pounds, which is undoubtedly
less than the cost of production, and out of this is deducted
the cost of transportation. One farmer stated that the reason
for the low price of milk was due to the inability of the farmers
to hold together. Very few of the farmers keep more than 10
cows. They keep only a sufficient number. to enable them to
_ keep up the farm, the principal product being manure and the
by-product being milk. Inquiries relative to any systematic
inspection being made met with negative replies. The only
inspection is that casually done by the man representing the
milk contractor at the time he makes his visits to solicit milk
from the farmers. The character of some of these dairies war-
rants the statement that the contracting company is willing to
take milk from any dairy, no matter what condition it is in.
Dairies were visited by the committee in the towns of North
64
Charlestown, Claremont, Greenville, Mason, all in New Hamp-
shire, and Wethersfield, Vt. ‘Thirteen dairies were inspected
on which were kept a total of 150 cows, producing approxi-
mately 131 cans of milk per day which was shipped into the
State of Massachusetts. A few places presented fairly good
conditions, while in others various objectionable conditions pre-
vailed, such as poor barns, lack of proper milk rooms or suit-
able places to handle milk, poor methods of cooling and low
standard of cleanliness. Milk is wholesaled at 25 to 323 cents
per can. A Mr. M., producing 8 cans of milk per day, says
that the laws discourage milk production.
Seven dairies at Wethersfield, Vt., were visited, where a total
of 149 cows were kept, producing 550 quarts of milk per day,
all of which was shipped into Boston, Mass., to a milk con-
tractor. Conditions on each dairy were distinctly bad. The
place in which the cows were kept- was unfit because of filthy
and wretched drainage, poor light and ventilation and general
filthy conditions. Some of the most filthy conditions of all
were found on the milk collector’s farm, this man being em-
ployed by the contracting company to collect the milk from
the farmers and ship it to Boston. Farmers complained of
delay in collecting and shipping the milk, one farmer stating
that the milk was thirty-six hours old before it was shipped
from Claremont. The price paid the farmers for milk ranged
from 28 to 33 cents per can. One farmer preferred to sell his
milk to a local creamery. The wife of a dairyman, in his ab-
sence, stated that her husband did not consider there was any
money in the business at the price they were getting. Others
were going out of business because of the low price received.
The committee were of the opinion that milk from this region
should not be permitted to enter Massachusetts or any other
State as conditions now exist on the farms.
_ The committee visited 27 dairies in the counties of Andros-
coggin, Cumberland, Kennebec, Lincoln, Sagadahoc and Waldo,
Me.; also visited the plants of the milk contractors in this
region from which milk is shipped into Massachusetts, the prin-
cipal one of which is the Turner Center Dairying Association. —
Of the 27 dairies visited, 22 sold to this association, 4 to two
Massachusetts contractors and 1 to the Bangor Creamery. The
65
dairies supplying the Turner Center Dairying Association were
found to be in the best condition, while those supplying the
Massachusetts contractors presented nasty conditions; horse
manure was used in gutter, and milk was found cooled in tub
of water near pump in hot weather and was not cooled at all
in cold weather. The pasteurizing plants were found to be in
a very good sanitary condition, and conducted on the whole in
a satisfactory manner. The plants visited were located at Au-
burn, Wiscasset, West Benton and Unity. The pasteurizing
plant of one of the Massachusetts contractors at Unity was
in an extremely dirty condition. Pasteurization in this plant
is supposed to be carried on at a temperature between 160 to
170, and the cream is held for thirty minutes, while skimmed
milk is not held. The temperature at the time of visit regis-
tered 172.
The Turner Center Dairying Association has the total output
of between 4,200 and 4,300 farms situated in Maine. Of this
amount, 75 per cent. is sold in Massachusetts. Very little is
sold at retail in Massachusetts except in the city of Lawrence.
Mr. Bradford, manager of this association, believes that pay-
ment on a butter-fat basis has a tendency to make farmers
produce milk very high in butter fat. The price of butter fat
is fixed from time to time. They also purchase by hundred-
weight of milk, and give a bonus of 1 cent per pound of butter
fat for milk from tuberculin tested herds. Mr. Bradford
thought the average retail price for bottled milk in the larger
cities of Maine was 8 cents per quart, while in smaller places
it was as low as 6 cents per quart. The average price to the
farmer in the State of Maine, he presumed, was 33 to 43 cents
per quart.
A farmer selling to the Turner Center Dairying Association
stated that he makes a profit of at least $250 per year from
milk alone from 10 cows. Nearly all dairymen interviewed
were of the opinion that they did not lose any money on their
milk. One criticized the method of selling, as he was obliged
to take the word of the Dairy Association as to the weight and
fat contents of his milk.
All the product of the Turner Center Dairying Association
is pasteurized. Pasteurization is done at creameries in Maine.
e
66
The milk is subsequently bottled in Boston at the point of
shipment. Milk received at one of the plants of a Massachu-
setts contractor at Etna, Me., was not pasteurized. It was
received at the station, placed in cans in ice water, and shipped
on the train the following morning, arriving in Boston at 4 or
5 P.M.
The committee visited the Province of Quebec to look into
dairies shipping milk and cream into Massachusetts by way
of Newport, Vt. The business of shipping milk at this point
has gradually grown during the few years it has been in opera-
tion until at the present time an average of 250 40-quart cans ~
or jugs of milk and cream are sent out every night. In addi-
tion to this section it was learned that there were three other
distinct sections in the Province of Quebec from which milk
and cream were sent into Boston, viz., by the Passumpsic
Division of the Boston & Maine Railroad; a triangular area
with apex at St. Albans, Vt.; and a branch road north of the
Grand Trunk line, connecting with the main line running from
Montreal to. Portland, Me. It appeared to the committee that
the various milk contractors were trying to keep the milk and
cream during transit in as good condition as when received.
Two methods of cooling were in operation during transporta-
tion, — the iced car and blanketing. Inspection of one of the
contractor’s creameries located at Newport, Vt., showed that
the conditions did not compare with those existing in the same
company’s plant in Massachusetts. The price paid at Newport
station for cream is 32 cents per pound of butter fat, and for
milk, $1.60 per 100 pounds of milk. The prices are based upon
a sliding scale from month to month. Twenty-seven dairies
were inspected in this region, 13 of which shipped their milk
into Massachusetts. ‘The sanitary conditions on the various
farms compared very favorably with conditions found in dairies
located in New Hampshire, and were very much better than
those noted in the dairies visited in Vermont. At the time of
visit they were being inspected by a representative from the
United States Department of Agriculture. Through his efforts
many improvements were being made on the different farms.
A good many of the farmers in this region are engaged in rais-
ing young stock for beef, and make use of the skimmed milk
67
for this purpose. One farmer stated that he did not consider
there was much money in selling cream, but the skimmed milk
disposed of in this way helped out. The dairies in the vicinity
of Lyndonville, Vt., supplying the Lyndonville Creameries Asso-
ciation, were investigated in company with the board of health
of the city of Newton. These dairies were found to be in a
most unsanitary condition, the score for cleanliness of stable
being very low. In some instances the separators were placed
directly behind the cows in the open barn. It was also a com-
mon practice to have privies in the stables. In many instances
the milk was kept twenty-four hours in a tub of water in the
stable, the covers of the cans being generally partly removed.
From the foregoing summary we may conclude (1) that al-
though the dairies in Massachusetts as represented by those
visited, except dairies in the Deerfield valley, are reasonably
satisfactory, the conditions vary somewhat in different sections,
and (2) that dairies in New Hampshire, Vermont, Maine and
the Province of Quebec do not reach the same standards as
those in Massachusetts. A few deductions showing the differ-
ences follow: —
Dairies in Cape Cod section, while having barns that are old and
methods and equipment not as modern as are found in other sections,
are nevertheless well kept, neat and clean.
Dairies about Lynn and Methuen have somewhat better conditions
as to structure and equipment. In this section are examples of the best
conducted and equipped dairies. One of them requires regular inspection
of the cattle by veterinaries, also medical inspection of the men employed.
| Dairies about Fitchburg and Winchendon presented commendable
conditions. Dairies in Winchendon, examples of the average old farm,
have been brought up to an excellent sanitary condition, with good
separate milk rooms, proper cooling facilities and equipment for the
sterilization of milk utensils, etc., through a local system of educational
inspection. |
Dairies in the Berkshire district are not as well kept as in other sections.
A number of them engage in other lines, such as raising pork, poultry,
keeping summer boarders, etc., so that the dairy end failed to receive
the proper attention.
Dairies in the Deerfield valley presented filthy conditions. The farms
are run down and are being bought up by Polish people who are gradually
improving them. Only a few cows are kept on each of the different farms,
principally for fertilizer, the milk apparently being a by-product.
68
Dairies at Wethersfield and Lyndonville, Vt., presented the most
filthy conditions of any visited out of Massachusetts. Drainage con-
ditions were such as to render the places unfit for the housing of catile.
Facilities for the handling of milk were entirely inadequate. Nasty
methods of cooling the milk were used.
Dairies in Maine shipping to Massachusetts contractors were in much
worse condition than those supplying the local dairying association.
Horse manure was used in the gutters and careless and nasty methods
of cooling the milk prevailed, such as cooling in the tub from which
cattle drank.
Dairies in New Hampshire have poor cow barns, lack of suitable milk
rooms, crude methods of cooling the milk, and rather low standard of
cleanliness.
Dairies in the Province of Quebec presented fair conditions. Im-
provements in some were being made. They lacked suitable milk rooms
and proper facilities for cooling. Cows were housed in the cellars of the
barns because of the extreme cold in winter.
A summary of the scores of the dairies inspected on a ese
trips is given in the following table: —
69
SS ee
ge! 0° 00T
09 L9
TP 89
e& 1&1
(an G06
GT £6
0:0 00S
*e100Q | ‘Solmeq
ese | Jo “que
-I0AV Ioq
“LNOWUE A
‘H'TIIANOGNA'T
UVaN
SULYIVG FP
Té& 0° 00T Té 0° 00T 83 0° 00T 0% 0° 001 §& 0 001 Ty? 0 001 v? 0001 ‘QSBIOAV
= a2 = = = = 2 = 09 | GIT = = 09 |-29 ‘9
= 5 0¢ ot = = Tg sé 0¢ 6&6 o¢ T6 og 0°02 “g
97 9°26 e7 G Gr (a4 G 8T a 4 os £7 Tt (aa 8 18 a 0 0F : v
Gé& 9°c7 T& 099 && y && roms 8 8I G& y GT = = 9°& 9°96 =o6
6G G16 GG eit 9°% 9°66 £6 8&6 13 6 6L GG 16 = = 3
OT 97 rome 0 OF L0 GSI eT £16 = a = ae 6T 19 T
rd = S = = = 00 | e242 0°0 G61 = = = = , ‘0
*9100Q | ‘Seed “91009 ‘some || ‘ez0og | ‘sorareq || ‘e100 | ‘selsreq || ‘e100g | ‘solute || “e100g | ‘sermred || ‘e100 | ‘senred
ase |jo*quep|| ese |jo‘quep|| o8e |jo-yuep|| ese | Jo “jue ese |jo*quep|} ese | jo-yueD ese | Jo°yUeD
-IOAV ag -10AY eg -I0AY Jog -I0AV Iog -I9AV Iog | -IeAV Jeg -IOAV Iog
“LNOWUG A. eG *SHUO0G
j j *RATIVA aNV GuIHS
Pie AS, ii ae “ONIV TAL aigidaaaqd NI -dNVE] MON Ee ee ‘SaIUIVd
ea anaes a 2 ASOD NI SHINIVG 12 SaIuIvVd NI SaIUIVG i d advO GT
SHIMIVG BZ NI SHINIVG 08 SMOOVE SHIMIVG
§,aooy 40 0g
SCTIHH 40 9%
§,adooy{ 40 TT
a1qnjG fo ssaurjuna))
‘sdity, woysadsuy wo apou sasoog hing fo hununung
70
=. = = ae = = 06 9°€ TOT. £9 = = = = S = ‘ 5 * “3I-8
OL £°% = = = - VL Were - 5 = 2 = = a Zs 5 4 : - ig 5
se aa — mas = me = a <= a ~S om = _ = r= . . . . 'D -0
“quaudinbay
€0 0 00T 6 T 0° 00T VI 0°00T &¢ 0'00r ian | 0 00T 80 0°00 L@ 0°00T LG 0001 3 ‘OBBI0AY
= = og oF 0g eT om = = = = = = e 09 € ST : E : g ‘9
= = (a7 16 0% 69 = = 07 eT 5 = = = (an £9 g ; ; 4 a7
Le ger 0°¢ 97 Té 88 £€ L& = = 0€ 8'§ 06 LCL && 19 fi - : ; ‘g
0% G7 £6 % 98 0G 61 £G 0°96 VG 0°SP 14 0°16 €G 16 £3 19 ; : : : B
OT 66 eT 1°03 ot 0°96 oT 8° FI TT GCE VT GIT = = = = : Z , : ‘I
0:0 818 0°0 9°32 0°0 GLE 0°0 Bagg 00 6 1G 0°0 L149 00 6 81 00 0°06 : : : ‘0
‘900g | ‘soraveq || ‘o100g | ‘sored || ‘o100g | ‘sorareq || ‘e100g | ‘solzreqy || ‘e109g | ‘sotareq || ‘e100g | ‘sorareq || ‘e100g | ‘sorsreq || ‘o100g | ‘sored
938 |jo"yueD e3%@ |jo"4yuen e386 | jo*yuND ese |jo"yUeD 938 | jo*yUeD 988 |jo"yUED 088 |jo"yUueD 93% |jJo*Ju0Dg
-10AV og -I10AV 1og -1OAY og -1OAY ag -10AV 10g -1OAY 10g -IOAY 10g -IOA VY 19g
‘INOW A. “
‘0T=2r
72
eee
G'6P 0° 00T 40g | 0001 OT 0 '00T 0°36 0° 001 G°Og 0° 00T 89g 0 00T 6°8S 0°00 #99 O'OOT | ~ ‘ese IOAY
= 2 = aaa Pree Se = x = Ss || Sree Sar | Peers ee & e - 4g T-98
L°98 oF 6 68 9'F = = = = 0°28 GT = = = = 0°78 19 : * ‘06-08
= = TTL 97 0&2 Gs 0°02 Lé = = 0°02 8'& = = 80h 0°07 : * “08-01
0°19 es g°€9 16 0°99 Gor 19 0°96 0°€9 L°& G9 0°16 169 ocr €°99 9°92 j * ‘01-09
86S 8°07 € 6S L1& 0°&¢ GLE GPS €°&& 0+ 8°88 84S 00s 29S i 6°99 0°02 * ‘09-08
T9F 8°07 6 CP 0°0¢ 0°8P 0°SP 6 &P 66S 0'9F G1 9°67 6 61 9°87 0°6 6° 8F 19 : * ‘0S-0F
OLE 66 = = 0°88 Gs v 68 VL 0°9& 88 = oo = = = = * ‘0F-08
= = = = = S eas | HL = = = z= = = = = : * ‘08-02
0&1 £6 = = = = = = = = = = = = 5 = * ‘0-01
= = = = = — = = = = - — = - - - : a ‘OI-0
‘e100g | ‘sotmted |} ‘o100g | ‘serareq || ‘e100g | ‘serie || ‘e109g | ‘sorateq || ‘e100g | -serareq || ‘e100g “soured, ‘e100 | @ptireq || ‘e100g | ‘sored
ese | jo-yueD ese | Jo"JUe ese | Jo"4UeD ese | jo"qUeD ese | jo'yueD ese | jo°yueD ese | jo"qUED) es8@ | jo-jUueD
-I0AV og -I0AV og -I0AW 10g -IOAW 10g -IOAW Jog -I0AV Jog -IDAV og -I0AW I0g
“LNOWUS “KOVIY mah? nea ae es
saruNomn murmerastl st | unotiseton | wy canal 1 sues | om oe ‘quae || sag
SUINIVG FF §,aooy{ 40 08 ee a $,d00}] LO TI :
a
"HUONG 'IVLOT,
‘pepnpu0n — sd worsadsuy uo appu sasoogy hung fo hiunwung
73
B. COMPILATION OF MILK CONTRACTORS’ STATEMENTS.
A circular letter of inquiry was sent to the followmg milk
dealers doing business in Massachusetts: —
Alden Brothers, 1171 Tremont Street, Boston, Mass.
C. Brigham Company, 158 Massachusetts Avenue, Cambridge, Mass.
W. D. Cowls & Son, North Amherst, Mass.
Deerfoot Farm, 9 Bosworth Street, Boston, Mass.
Elm Farm Milk Company, 19 Wales Place, Dorchester, Mass.
W. A. Graustein, President, Boston Condensed Milk Company, 134
Cass Street (?), 484 Rutherford Avenue, Charlestown.
H. P. Hood & Sons, 494 Rutherford Avenue, Boston, Mass.
Manley Dairy Company, Brockton, Mass.
A. D. Perry, Worcester, Mass.
Plymouth Creamery, 268 State Street, Boston, Mass.
H. H. Prentice, Pittsfield, Mass.
J. B. Prescott, Bedford, Mass.
Tait Brothers, Springfield, Mass.
Turner Center Company, 63-69 Endicott Street, Boston, Mass.
D. Whiting & Sons, 590 Rutherford Avenue, Boston, Mass.
The letter requested information upon the following points of
_ the business: —
1. The quantity of milk and cream sold.
2. Name of Massachusetts cities and towns in which milk is sold.
3. Approximate proportion produced in individual New England
States, New York and Canada.
4. Details as to pasteurization.
5 and 6. Details as to dealers’ system of dairy inspection.
7, 8 and 9. Requests for contractors’ opinions on certain aspects of
the milk business.
The answers to these last three questions have been discussed
elsewhere. ;
A few weeks after first sending out the circular letter it was
learned by accident that one of the contractors had never re-
ceived this letter, or that it was never referred to the respon-
sible officer of the firm. A second letter was then sent by
registered mail to those who had not previously replied. This
brought several prompt responses.
Up to November 30 the following dealers have replied: —
1. Alden Bros., Boston, Mass. —
2. C. Brigham Company, Cambridge, Mass.
3. Deerfoot Farm Dairy, Boston, Mass.
74
4, A. D. Perry, Worcester, Mass.
5. Plymouth Creamery, Boston, Mass.
6. H. H. Prentice, Pittsfield, Mass.
7. J. B. Prescott, Bedford, Mass.
8. Tait Bros., Springfield, Mass.
9. Turner Center Dairying Association, Auburn, Me.
10. D. Whiting & Sons, Boston, Mass.
11. H. P. Hood & Sons, Boston, Mass.
No replies have been received from the following: —
1. W. D. Cowls, North Amherst, Mass.
a Elm Farm Milk Company, Boston, Mass. 5
. W. A. Graustein, President, Boston Condensed Milk Company,
Charlestown, Mass.
4, Manley Dairy Company, Beye Mass.
The following is a summary of the replies received: —
Question 1.— Approximately how much milk and cream per annum
do you sell? . Wholesale? Retail? |
For trade reasons most of the dealers declined to state ex-
actly how much milk or cream they now handle. Two or three
of the smaller dealers and two large contractors gave exact
figures.
The Boston contractors report that their product is sold in
Arlington, Belmont, Boston, Brookline, Brockton, Cambridge,
Chelsea, Cohasset, Everett, Hull, Malden, Marlborough, Med-
ford, Melrose, Newton, Quincy, Revere, Somerville, Southbor-
ough, Stoneham, Winchester, Winthrop, Woburn and Worcester.
Cream is also distributed in addition to the above localities
in the following places: Abington, Attleboro, Amesbury, Barn-
stable, Fall River, Foxborough, Gloucester, Hanover, New Bed-
ford, Provincetown, Maynard and Wareham.
Tait Bros. of Springfield report that their cutput is sold in
Springfield, West Springfield, Holyoke, Chicopee and Fitchburg.
Question 3. — Approximately what proportion of your milk and cream
sold in Massachusetts is produced in —
(a) Massachusetts?
(6) New Hampshire and Vermont?
(c) Maine?
(d) Connecticut?
(e) New York?
(f) Canada?
79
This question was asked in order to ascertain the amount of
milk obtained in the different States and the Dominion of
Canada, and particularly the proportion produced outside of
Massachusetts. Owing to the absence of answers to question
1, the replies to question 3 cannot be used for this purpose, as
they are expressed in percentage.
None of the cream sold by the large dealers doing business
in greater Boston is produced in Massachusetts. Most of this
cream comes from Vermont and Maine, and a small supply
from Canada. Our own investigations, however, show that one
contractor obtains a large amount of cream from Canada.
These statements, are therefore by no means conclusive.
Question 4.— How much of your milk and cream is pasteurized?
Where is it pasteurized? Type of pasteurizer?
Maximum temperature of which milk or cream is heated? Time
held? Temperature of holding?
Is any of your milk or cream re-pasteurized? If so, state location and
character of the first and final pasteurizing plant.
All the large dealers practice pasteurization except in the
case of the small amounts of certified milk sold and of milk
sold to milk peddlers. In general, the milk is pasteurized but
once, at the headquarters of the principal receiving stations of
the corporations. The holding process is used, the milk being
held for thirty minutes at a temperature of 143° to 145° F.
Some of the family cream is repasteurized. In general, a higher
temperature is used in pasteurizing cream, the dealers stating
temperatures as high as 165° F.
Questions 5 and 6.— Do you maintain a system of dairy inspection?
If so, describe the principal features of your system of dairy inspection.
To question 5, 7 answered yes and 4 answered no. The
typical system is to have the agents of the receiving stations
inspect each dairy three or four times a year, score the same
and urge the dairymen to correct insanitary conditions. No
statement is made, however, as to whether or not dairies found
dirty are excluded.
One of the largest dealers replying no to question 5, in his
reply to question 6 showed he maintained an inspection system
similar to the others, except that he did not score the dairies.
76
Several of the large firms have imaugurated features of in- -
spection which deserve special commendation; for example, one
dealer states they retain a chief inspector who is a thoroughly
experienced dairyman, a graduate of the New Hampshire State
Agricultural College, and supplement their inspection by illus-
trated lectures for the benefit of the producers on the sani-
tary and economic aspects of milk production. _ ;
Another company retains a veterinary inspector for the ex-
amination of the cattle and stables, and a bacteriologist of na-
tional reputation to supervise the bacteriological examinations.
Another dealer states that his inspector scores the farms using ~
the United States dairy score card, and he also employs the |
honor system of inspection. The producer scores his own farm,
answering monthly a list of four questions by yes or no. These
questions are relative to cooling the milk below 50° F., having
and using a milk house, whitewashing the stable, and the win-
dow and air space per cow. A cash premium is paid if these
questions are answered in the affirmative.
Another dealer appears to get into the closest co-operation
with the local boards of health. He very logically leaves it to
the board of health to first score and issue a permit to the
dairy ‘before the milk is purchased. Thereafter they utilize
their own inspector to see if the dairies keep up the original
standard set. Whenever they find a decline in these standards
the board of health is at once notified, thereby placing the
responsibility for refusing the milk on the local iene of
health, as it should be.
One corporation makes a practice of having the creamery
managers accompany the inspectors of the Health Department
on their visits to the dairies, and your Board is satisfied from
personal observation that they rigidly refuse to accept the prod-
uct of any dairy, the score of which is below the requirements
of the health authorities, until these dairies have complied with
the recommendations of the inspector.
At the central plant of this corporation occasional examina-
tions are made for bacteria and for sediment. If the milk ex-
hibits any sediment, or if the bacterial content is found to be
high, the producer is notified of this fact, and the subsequent
shipments of milk are carefully watched to ascertain whether
(7
er not the producer has complied with the suggestions made
by the company.
One contractor, evidently missing the point of the question,
rather ingenuously replied, “Yes, by our city inspector and
also by the State Bo&rd of Health.” , Another contractor
answered rather modestly, “No,” but in all probability main-
tained a system quite as efficient as his larger competitors.
He states, “Not a regular system, but I visit them if the milk
don’t suit.”
Somewhat as an offset to the very encouraging and broad-
minded policies which these contractors maintain and have
instituted for the purpose of bettering the sanitary quality of
their product, strict impartiality requires us to state that one
of the dealers, who now states that he does not repasteurize
at all, admitted under oath a few years ago that a portion of
his product was occasionally submitted to a second pasteuri-
zation.
The reports of the special investigations made by your Board
seem to indicate that the system of inspection operated by the
contractor is not as efficient in certain localities as the con-
tractor’s replies would indicate. In fact, we are forced to con-
clude that the policy of using the local collecting agent as a
dairy inspector frequently results in giving the dealers them-
selves an altogether erroneous impression of the sanitary con-
ditions pertaining to the dairies from which they obtain their
milk.
C. OBSERVATIONS ON PAST AND PRESENT INCREASE, DE-
CREASE, FLUCTUATIONS AND GEOGRAPHICAL MOVE-
MENTS OF COMMERCIAL MILK AND CREAM PRODUC-
TION IN MASSACHUSETTS AND NEIGHBORING STATES
AND THE PROVINCE OF QUEBEC IN RELATION TO THE
MILK SUPPLY OF THIS COMMONWEALTH.
A study of the production of milk in Massachusetts reveals
the fact that while there has been a constant increase in popu-
lation in this State since 1885, at which time the statistics |
quoted begin, there has been, at the same time, a decrease in
the number of milch cows kept in this State. From 1885 to
1890 there was a great increase in the number of milch cows.
According to statistics the increase was at the rate of about
78
6,400 per year, and in 1890 the highest point was reached in
the number of cattle, which was 200,658. From 1890 down
to 1914 there has been a great, although not a uniform, de-
crease, but in the five years from 1890 to 1895 the decrease
was almost as great as the increase had been in the previous
five years. From 1895 to 1897 there was a decrease, although
not as rapidly as in the previous five years. From 1897 to
1899 there was an increase in the number of cows kept, which
. in 1899 reached a total of a little more than 180,000. The
number remained approximately stationary until 1906, and
from 1906 to the present time there has been a rapid decrease
at an average rate of 4,000 cows per year. From 1890, when
the greatest number of milch cows kept in this State was
reached, until 1914 there has been an average decrease in the
number of cows of a little over 2,200 per year, so that while
there was a production of milk at the rate of one-half quart
per person in Massachusetts in 1890, in 1914 there was pro-
duced one-fifth quart per person in population.
Although the amount of milk used per person has increased
according to different authorities, for the sake of comparison
we will assume it to be the same.
Diagrams showing the comparative number of milch cows
and the population of the State of Massachusetts, also show-
ing the amount of milk brought into the city of Boston by
the steam railroads for the years 1896 to 1914, are included
in this report. The amount of milk and cream is given in mil-
lions of quarts, and there was a decided decrease from 1906
to 1911 in the amount handled on trains. From 1911 to 19138
there was almost as great an increase in the total amount
handled on the railroads as there had been a decrease in 1906
to 1911.
Another interesting diagram shows the relative amount of milk
handled by the three large railway systems coming to Boston.
One curve shows the amount of milk handled by the Boston &
Maine. There was a decrease from 1906 to 1910. From 1910
to 1911 the amount remained about the same, but from 1911
to 1913 there was a very rapid increase in the amount handled
by this railroad, which increase corresponds to the rapid in-
crease in the total amount of milk brought into Boston.
79
On the New York, New Haven & Hartford Railroad there
was an increase in the amount brought into Boston from the
NNN ct
Ma
20 200
00 200
020.000
2
;
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:
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gX
aS
kK
.3
6 §
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is)
Q
AND
NUMBER OF MILCH Cows
leeeone aS
eee peers
year 1906 to the year 1910, a decrease in 1912, and the amount
remained about constant from 1912 to 1914.
In the case of the Boston & Albany there has been a steady
decrease from the year 1906 to the year 1914. The increase in
80
the amount of milk brought into Boston by the Boston &
Maine Railroad from 1911 to 1913 corresponds with the in-
crease in the total amount of milk brought into Boston for
those years. In 1913 to 1914 there is a decrease shown in the
amount which also corresponds to the decrease in the total
amount. ‘The increase in the amount brought into Boston by
the Boston & Maine not only corresponds to the increase in
the total amount brought into Boston, but it also corresponds
with the amount of milk brought into Massachusetts from the
Province of Quebec by different Boston contractors.
It would seem from the diagram that the milk contractors
have been going farther from Massachusetts, as time goes on,
to get the milk and cream with which they are supplying the
people of this State.
A feature of the diagram is the notable decrease in ie total
amount of milk and cream coming into Boston in the years
1913 and 1914, whereas the increase in the population of Bos-
ton, or the metropolitan district, which probably receives most
of the milk and cream which is brought into Boston by the
railroads, has been at about the same rate as in previous years.
This discrepancy has been studied with a view to finding out
whether there has been a per capita decrease in the amount of
milk and cream used as stated by several parties, but it has
not been found that this is so. Neither has it been determined
that people are using more milk and cream per capita than
formerly, as has also been stated, but the amount probably
remains about the same. A part of the decrease can be ac- |
counted for by the statements of some of the milk contractors
that the surplus which formerly was shipped into Boston and
manufactured into butter and other products at the Boston
milk stations is now largely cared for out in the country, thus
relieving the factories of some of the work, and resulting in a
saving in railroad transportation. Probably the increased use
of condensed, evaporated and powdered milk accounts for some
of the decrease in the amount brought in by the railroads, as
shown by the figures obtained from the Chamber of Commerce
and agents of two of the large condensing and evaporating
firms.
A study has been made to find out to what extent condensed,
evaporated and powdered milk has taken the place of fluid milk
81
_ in manufacturing and in the homes, and these results are in-
cluded with this report.
It seems to have been the general opinion of investigators of
the past that the facts of milk production, especially from the
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cost standpoint, should receive a great deal of attention, and,
in fact, there has been a great deal of time, with attendant
expense, devoted to this side of the question in milk produc-
tion. There must have been good reasons for the study of the
- production costs when the question was a new one, but it seems
82
unnecessary to continue such work to any great extent, in view
of the fact that all sides of the question have been thoroughly
considered and the results have invariably been the same, and
so far as can be ascertained no dispute as to the statements of
cost has been made. ‘Taking into consideration the fact that
only a small percentage of the milk producers have kept item-
ized accounts that would enable them to accurately determine
the cost of producing a quart of milk, and also the fact that
conditions vary so on different farms even in the same locality,
the question is raised as to the value of any one set of ficures
being greater than another. That the figures given by different
producers who have testified at different investigations, and
who have given this Board figures on the cost of producing, do
not agree is no reason for condemning such figures, as the con-
ditions vary so much on the different farms on account of the
varied lines of agriculture carried on at these places that they
may be just as accurate and reliable in one case as in another,
and it would seem to be impossible to fix any exact price for
which milk could be produced as long as it is produced under
the many different conditions as at present. But as the cost
estimates vary so slightly, that is, generally within less than
a cent per quart, it would seem as though an approximate idea
can be obtained of the cost in the different zones.
In some cases milch cows are kept as the sole source of in-
come, and one will naturally think that in that case the lowest
cost of production would be reached, but such is not always
the fact, as in some of the cases the highest cost of ‘production
is reached. It is difficult to form an opinion as to the exact
cost of production on those farms where the dairy business is
run simply as a side line, as a part of the profits on these places
is the fertilizer that is used in producing the vegetables or
fruit, and it has been said that the value of the fertilizer varies
with the value of the crop raised, so that some people have
maintained that it was difficult to estimate the value of a cord
of manure, as in some soils the value will be much greater than
others. Stable manures have a much greater value than a com-
mercial fertilizer containing the same amount of nutritive ele-
ments when used in a soil that needs the addition of humus...
It must be a fact that the cost of producing a quart of
milk has increased in the last few years, as all of the material
83
used in the construction of buildings and the feeding of cattle
has decidedly increased. The price of cows has greatly in-
creased, and also the price of all farm labor. It has been
stated by some of the milk producers with whom we have cor-
responded that the cost of producing a quart of milk has in-
creased 15 per cent. in the last few years, and it is safe to say
that the increased cost of producing a quart of milk is greater
near the large centers of population than in the more remote
districts, owing to the fact that labor costs generally more, and
that taxes on farm lands have been increased more in propor-
tion than they have in the outlying districts.
The element of pastures enters largely into the cost of the
production of milk, because milk can be produced more cheaply
in the sections where the pastures are good than in the sections
where the pastures are poor. The dairying sections of the
states of Vermont and New Hampshire can produce milk more
cheaply for this reason than many sections of Massachusetts,
and in proportion milk can be produced more cheaply in the
Province of Quebec than in the portions of Vermont and New
Hampshire mentioned. This is due to the fact that the farther
north one goes from the city of Boston to the St. Lawrence
River in Canada the heavier soils produce more and better
pastures than the sandy soil in the eastern part of Massa-
chusetts, and also to the fact that good: pasture lands are
much cheaper in Canada than in the New England States. ©
It is a mistake to say that because farmers do not keep an
accurate set of books they do not know whether there is a
profit or loss in the production of milk. In interviewing a large
number it has been found that those who have been milk
producers for more than four or five years have a very good
idea of the cost of milk production which experience has given
them. Almost any farmer of a few years’ experience knows
how much hay or other forage his place produces; knows in a
general way how much money he is spending every month for
grain; can easily tell whether his farm has increased in pro-
duction; and, if he is dependent entirely on the dairy business,
most certainly knows whether he has more money or less than
formerly.
To give an idea of the importance of the dairy industry in
the United States, statistics from the United States Census
84.
reports are used as being the only ones available and with the
belief that these figures are approximately correct; but it
- must be understood that these figures do not show anything
as to the great importance of dairying in its connection with
other lines of agriculture, which may well be said to rely upon
the keeping of cattle for their perpetuation, and it is probable
that many agricultural products would greatly advance in
price owing to the difficulty of producing them without the
animal fertilizers produced in dairying. It has been stated by
competent judges of agricultural work that the only way in
which milk production can be carried on successfully in New
England is in combination with other lines of agriculture, and
in the future we must depend upon the farmer who produces
milk as one line of his diversified farming rather than on the
men who will keep large herds of milch cows and follow milk
production as an exclusive line.
Milk production by small farmers as a side line would
probably be much better for the consumer from a cost point of.
view, as it is extremely doubtful if a combination to raise or —
fix prices could ever be effected, and in connection with this
statement it might be well to call attention to the statements
of interested persons who have said that if it had been the
custom of New England milk producers to conduct the business
as an exclusive line rather than a side line the public long ago
would have been compelled to pay a much larger price for
dairy products. It is only because the other lines have been
more profitable than dairying that the farmers have been able
to produce milk and sell it at less than the actual cost.
Uses of Milk.
Cow’s milk and its manufactured products have many uses,
and there will always be a demand for this important article.
Probably the most important use to which milk is put is the
feeding of infants, and it seems improbable that we could ever
find a substitute for milk for this purpose that would be as
satisfactory or as efficient. Milk occupies an important place
in the daily diet of many people who either have to use it as a
portion of their food, or in some cases as their entire food on
account of physical disorders, or who find it an agreeable and
89
nutritious article of diet to be used daily in conjunction with
the more solid foods.
The use of cream has increased very fast in the last twenty
years, and is considered by many as an indispensable article
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in the daily menu. The ice-cream business has assumed, vast
proportions, and the use of cream in the manufacture of ice
cream is an important factor. Milk is used more extensively
than ever before for cooking purposes, and bakers nowadays
86
make more products containing milk than formerly. Butter is
too well known a commodity to require any comment, but
attention should be drawn to the fact that buttermilk has a
considerable market value at the present time, and its use as
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a beverage has become quite a factor in disposing of the
by-product of butter-making which formerly had little value.
Cheese is a highly important product of the dairy industry, and
its use is said to be increasing. The amount of butter and
87
cheese produced in Massachusetts is very small, and is generally
produced for home use only. f
By-products of milk ar@ used in the manufacture of different
articles to an extent that is almost incomprehensible to the
uninformed. In considering the many ways in which milk is
used, it is well to follow it from its point of production through
the many hands and operations before it reaches the consumer.
In New England, asa general thing, the whole milk is sold by
the producers to large dealers who run cars out into the pro-
ducing districts, and who either receive it at the car or at the
local receiving station, where it may be separated and the
cream shipped to the large centers and the skimmed milk used
in various ways, or the whole milk may be shipped without
any treatment except icing in a more or less efficient way. The
whole milk or the cream may or may not be pasteurized at the
receiving station or country creamery. The country shipping
point may be 300 or more miles away from the main plant.
If the receiving station is a creamery where butter is manufac-
tured, the farmers generally bring in the whole milk, although
in some cases they have separators and carry in only the cream.
The farmers who bring in whole milk buy back the skimmed
milk, The skimmed milk is used for feeding calves, hogs and
poultry. It has been said that in former years some creameries
followed the custom of either giving the skimmed milk away or
throwing it on to the ground or into streams where it would
flow away. In some parts of the country serious stream pollu-
tion has been reported in many cases where the latter method
has been adopted, but it may be that the pollution was_more
the result of materials used in washing utensils and floors than
of the skimmed milk. Of late years, where there has been a
large amount of skimmed milk at the milk stations, it has be-
come the custom to reduce the skimmed milk to milk powder
for bakers’ use, or for use in some instances in making a so-
called synthetic milk by the addition of fat and water in proper
proportions. In some instances it is made into a high protein
“feed for poultry, and to some extent is used in the manu-
facture of cold-water paint. Quite a considerable quantity of
skimmed milk is condensed for use on board ships, etc. When
skimmed milk is spoiled by age or in some other way, or where
88
there is no other method of disposing of it, the most common
procedure is to manufacture casein.
Casein is used very extensively in the paper industry, making
possible the manufacture of washable wall papers, also in the
waterproofing of paper flasks, cartons and wrapping papers.
It is used for coating paper slates and drawing papers, and as
a fixing agent for enamels and colors on papers. Casein paints
are quite extensively used, and the plasters which can be made
by the combination of casein with other substances are useful
in the decorator’s art and for making molds. Insulators for elec-
trical appliances and transparent sheets resembling celluloid and -
mica are manufactured from casein compounds, and in the dye-
ing and printing of textile fabrics it is also very useful. Casein
is used in large quantities in the manufacture of linoleums,
and, to some extent, in the compounding of medicines and
foods. ee
When we consider how important milk has become as an
article of food and in the arts and sciences, and how useful even
the poorer parts and cheaper grades can be, it would seem as
though the encouragement of the production of milk must
surely tend to increase the general prosperity of the entire
country. When we consider the enormous amount of money
involved in the dairy industry of the United States, and the
important uses to which dairy products are adapted, we are
justified in pausing for a while before declaring that certain
laws and regulations would be either beneficial or detrimental
to this great industry.
Many reasons have been assigned or suggested as having
had a direct influence on the decrease in the amount of milk
produced in the State of Massachusetts. These are quoted not
as matters of fact, but simply to record some of the ideas as
expressed by various persons. Several persons have suggested
that the past work of the State Board of Health has had a
decided influence by reason of the methods employed in prose-
cuting farmers and others for offences against the law.’
Another reason for the decrease in production is said to be
1 The critics did not take into account the fact that the State Board of Health had for years
practiced the warning system with no advantage, and the new secretary furnished the inspectors
a long list of the people who had been warned. The samples collected resulted in a large number
of prosecutions. — H. C. L.
89
the result of milk-borne epidemics being sensationally featured
by the newspapers. This publicity is said to have resulted in
a decrease in the amount of milk.consumed for at least a time.
Many producers have stated that a large part of the decrease
has been due to the feeling of unrest and insecurity on the
part of the farmers, occasioned by the constant agitation, legis-
lative and otherwise, that they have been subjected to for the
past several years, and some have said that improyements have
been delayed in many cases because dairymen were afraid that
it would not pay them to stay in the business if drastic laws
were to be passed.
Another reason is said to be the constantly increasing use of
condensed and evaporated milk by families and: the increase in
the amount of milk powders used by bakers. Probably the
increased use of milk powders and of condensed and evaporated
milk is responsible for some of the decrease in the amount of
milk brought into Boston by the different railroads in the year
1913, and also for the general decrease of about 10,000,000
gallons in the yearly amount between the years 1906 and 1914.
How much bearing the financial panics and bad _ business
conditions of .different periods may have had on the amount
- of milk produced and the amount consumed is problematical,
but we may well assume that such conditions have had their
influence.
A large number of dairymen have given the low price paid to
the producer as the principal and almost only reason for the
great decrease in production in this State. This seems to be
the most reasonable one, because many of the producers have
said that the price received for milk during the last few years
has not been sufficient to enable them to make a profit, and
that in many cases the price paid was below the cost of pro-
duction.
It has been stated by many dairymen that the production
per cow in Massachusetts has increased from 10 to 15 per cent.
in the last fifteen years, this increase having been secured by
more careful selection of cattle, breeding for production, and
because of a better knowledge of the problems of feeding.
Some have claimed that the greatér production of the Mas-
sachusetts herds over those of other States and countries
90
should have helped the dairymen in overcoming the difference
of cost in production between this State and States farther
north, where the pasture conditions are better than they
generally are in Massachusetts.
Criticisms have been made of the result of the Saunders law,
which at one time was believed would help Massachusetts
producers, but many have expressed the opinion that it has
really resulted in hurting the Massachusetts industry.
Another reason assigned as the cause of decrease in pro-
duction in the State of Massachusetts is the growing interest
taken in fruit, vegetable and poultry raising by farmers who .
were formerly engaged in dairying.
Searcity of labor at reasonable prices has also been given as
one of the reasons for the decline, and some farmers claim to
have been discouraged by the fact that the only laborer avail-
able at any price in some districts is the foreign-born laborer,
who does not understand the English language, and who
understands but little of farming conditions and work in this
country; and it is a fact that new arrivals on these shores
demand, in many cases, $30 to $35 per month and board, and
generally obtain these prices on account of the scarcity of
laborers.
An interesting feature of the business of milk production in
Massachusetts at the present time is the work being done by
the State Board of Agriculture, through its Dairy Bureau,
along the lines of the encouragement of a greater production of
milk of a high quality. For the purpose of interesting Massa-
chusetts dairymen the Legislature has appropriated money to
the State Board of Agriculture, and they have conducted for
the last three years a series of clean milk contests, which has
resulted in the production of high-class milk on places which
formerly had been somewhat indifferent to some of the neces-
sary details of clean milk production. |
The Milk Board in conducting its dairy investigations has
visited several places that have been entered in these clean
milk contests, some of which have won prizes. The winning of
a prize in these contests has meant a great deal to the winners,
as it has resulted, in some instances, in their getting a better
price for milk when they distributed their milk direct to the
consumer.
91
There are some good figures available on cost of production
of milk in Massachusetts, probably none of them better than
those of Elmer D. Howe of Marlborough, a practical dairyman,
who is a graduate and trustee of the Massachusetts Agricultural
College, and also a past master of the Massachusetts State
Grange. The figures are ee on his own herd of 40 cows.
Mr. Howe says: —
Our experiment stations agree that the average cow in milk needs,
for economical production, 25 pounds of hay or its equivalent in silage,
roots, etc., plus 8 pounds of grain. This will make the food cost per day
(with hay at $20 per ton and grain at $30 per ton) 37 cents per cow.
For 40 cows, food cost per day equals . 4 5 . $14 80
A building for housing stock and hay will average oe Gout $100 per cow;
interest on $4,000 at 5 per cent. equals per day, : ‘ : 60
Depreciation of building at 5 per cent. per year equals per ene 5 i 60
Depreciation of cows and loss in ‘uu equals per day (low esti-
mate), . . Sb Aa : 75
Taxes on ai dine a cows ‘aot on ea) per dav : I : p 20
Milking 40 cows at 20 cents per hour equals perday, . 3 : : 1 60
Grooming 40 cows equals per day, : : : 3 ‘ y : 40
Cleaning stables and feeding per day, . A 60
Wear and tear of small tools, currycombs, Eegocae) etc., Domine: service
of bull, cost of city water, veterinary fees, ice, light, etc., . 2 2 15
_ $19 80
Against this we have a credit of $2.50 per day for manure and 30 cents
_ ~per day for calves born during the year (calves at $3 each at birth), . 2 80
Net cost for 40 cows per day, é J Lay etes : oi . $17 00
For more than fifteen years we have weighed every cow’s milk both
morning and night, and our records show that our cows (and we keep
none that give less than 5,000 pounds per year) average just about 7
quarts per day. Forty cows, then, will average to produce 280 quarts
of milk per day at an average daily cost of $17, or a trifle over 6 cents
per quart.
By substituting 30 pounds of ensilage for 15 pounds of hay in the
daily ration of each cow we are able to cut the cost to about 5 cents per
quart, but the closest scrutiny will not reveal any other item where a
saving can be made.
That Mr. Howe’s figures are not too high is obvious when
we consider that he has made no account of waste in handling,
superintendence or profits beyond interest at 5 per cent.
Prof. John M. Trueman, formerly of the Connecticut Agri-
cultural College, Storrs, Conn., says: —
Cost of Feeding. 1
Silage, 4 tonsat$4, . . : : , : ! 2 ’ . $16 00
Hay, 13 tons at $16, . : s A ; 4 : : . 24 00
Grain, 14 tons at $30, : M : : i Q : 5 sit, 0)
Pasture, four months, i AG Pil ! i , : : i 8 00
Total, 4 ‘ i 5 4 4 f i } . $85 50
In years when pasture is short, and grain and silage or green fodder
must be fed all summer, the cost per year will frequently go up as high
as $100.
The total cost of keeping each cow per year, therefore, is as follows: —
Feed, H s . a : ! é i 4 : ‘ . $85 00
Bedding, . , f y 7 is e , 5 00
Keep of bull (for Herd of 25 somay A i i ; : : : SOO
Taxes on cow and barn, §. L : ‘ : : é : 1 25
Interest on money invested in cows, . \ ; g ; k : 3 75
Barn rent, , 5 i ; , : : 2 A i A 3 00
Insurance, i 4 ; : : ena Ba : STN 40
Depreciation of cow, . 4 drat aale : : ‘ i : 7 13, 00
Light, medicine, etc., ! i : : s . i 5 k 2 00
Labor, . x ‘ f 4 : } i ‘ , : Buy 3k) (HO)
Total, SSE e nis : : : : ; \ : : . $150 00
The cows thus fed and eared for included Jerseys, Guernseys, Ayr-
shires and Holsteins. Some were very good producers, others only fair.
The average for the whole lot for the five years was 6,378 pounds per
cow, which, on the basis of 2} pounds to the quart, is equal to 2,834
quarts. Although this is not a heavy yield, it is a good average for a
herd of 25 cows made up of several breeds. Jt requires extra skill and
good management to increase the yield beyond this point. When it is
remembered that the average yearly production for the New England
States is less than 2,200 quarts per cow, it will seem that a herd making
over 2,834 is doing fairly well. It is useless, therefore, to hope to de-
crease the cost of milk by much further increase in the yearly production
of the cows. Any material increase over 3,000 quarts in a large herd
comes high from the necessary weeding out of ordinary producers and
the small numbers of high producers to be found.
The cow should be credited with her calves and with the manure He
makes. We cannot allow more than $5 per year for calves, nor more
than $10 per year for manure in the barnyard. We can, therefore, credit
the cow with $15 and subtract that amount from the $150 that it cost
to keep her. This leaves $135 to be balanced by 2,834 quarts of milk,
which would require the milk to be sold at the farmer’s door for practically
4.75 cents per quart. This amount simply pays for the actual cost of
1 These figures represent the average cost of five years, 1907-11, and are somewhat too low for
1913.
93
.
the investment and labor put on the milk. It allows nothing for the
farmer’s skill as manager, nor for the extra hours he must work planning
for the improvement of his herd and the running of the business, and
nothing for the profits. He has simply received 5 per cent. on his in-
vestment and common laborer’s wages.
If he is going to improve his farm and build up a permanent agriculture
in an advancing rural community, and continue in business, he will
require 5.75 cents or more per quart to pay the bill.
Fred Rasmussen, professor of dairying, New Hampshire
Agricultural College, Durham, N. H., says: —
The last census report shows the average production of milk per cow
in Massachusetts to be 4,524 pounds, in New Hampshire 3,775 pounds,
in Vermont 3,982 pounds. No doubt the actual production in the several
States is higher than this. In the writer’s opinion a more nearly correct
estimate is between 5,000 and 5,500 pounds of milk.
To get conditions which will represent average production for Mas-
sachusetts, New Hampshire and Vermont let us take the 39 cows, of
the 26 herds! studied, producing between 5,500 and 6,000 pounds with
an average production of 5,540 pounds of milk.
- The Cost of Production.
Cost of feed,? . : f : ; : (i : s . $66 91
Labor,, . f : : : : : : f : i Nea eas:
Delivery, . 6 16
Housing, . 9 05
Depreciation, 8 83
Bedding, . 4 00
Bull, 3 79
Taxes and interest, : A 55
Ice, coal and wood for heating, 256
Veterinary service and medicine, | : 2 5 : 4 2 i 87
Tools, utensils, salt, ete., ©. : : : ¢ ‘ Suen us 53
$139 19
Credit: —
Manure, . i i R ; : i : 3 $15 00
Calf, : 4 : : 3 SAAN : : 3 00
18 00
Toray ty sea HMM n ame UMN OUAM MG tity Ales BAC AG
ie See Circular No. 8 of this series; also Bulletin No. 2, New Hampshire College and Experiment
ation.
2 Tt costs less to feed these “‘average’’ cows than it does higher producers, which accounts for
the difference in figures here given from those used in Circular No. 8.
94
Comparison of Increase in Cost of Production with Increase in
Price obtained by Farmer.
The following table gives comparison of cost of feeds and
prices received for milk, 1904 to 1912. The prices are those of
the Boston Chamber of Commerce, and records compiled by
J. B. Lindsey. The price of milk per quart to the farmer is the
‘price paid in the middle zone by one of the largest milk con-
tractors in Boston. The price paid by the consumer for milk
is the price paid for milk delivered in glass bottles for family
use in Boston.
95
0°06 ¥ 06 9°16 G16 6 66 bE
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96
- Professor Lindsey gives the following figures on the cost of
production of 131 cows from 1896 to 1911: —
Average yearly food cost per cow, . Bi Suck aie ehope eros
Net yearly fixed charges per cow (estimated), AE emo ipa te 150). 00)
Total cost percow, . Pic a eas, Shea ea ee
Average yearly yield per cow Peer ts) Ge ae RN ih ce maa Ale oO BUS 8
Average yearly yield per cow (quarts), . 2 2 02 s/s 21688
Cost of milk (100 pounds), SU TE HIE amin a MMe eae GRAN GS Jets Ae
Cost of milk (1 quart) (cents), . Ran ane f i ett 5.43
Financing the Cow.
Few people have any idea what it costs to finance the cow.
We know of no New England data upon the subject. The New
York Experiment Station at Geneva has made a study of this
question as applied to the milk supply of that city, and Bulle-
tin No. 563 says: —
Considered from the agricultural standpoint, the capitalization amounts
to $763 per cow, of which the producer furnished $680 and the retailer
$83.
In other words, it costs the milk producers supplying milk
to Geneva, N. Y., a city of about 13,000 imhabitants, $680 to
finance each cow, and it costs the distributors $83 to finance
the distribution of the milk of each cow.
The capital invested was estimated as follows: —
600 cows at $80, . , OC AEE i SB sa. es ta es
3,000 acres of land with panini Pi earch Aer IMAC RUMbR ETN a! O,04 0100)
Talpyueh avon P20 WERCACKE, Fu, Iie dapayahen Weel oe : 5 ; . 60,000
; $408,000
Capital invested in distribution, . . ines tance mmm innit Hacks 8 10) 0190)
Potalie ene Oe Mee ale ii aaa a liven eas Oy
That the Massachusetts dairyman is progressive is evidenced
by figures of milk production in Massachusetts as compared.
with the States of Vermont and New Hampshire.
Professor Rasmussen says that the average annual produc-
tion per cow in those States is as follows: —
Pounds.
Massachusetiart Siig yo i) ag RAIN cet acini 01 ge ee ere
Vermont CANE a ale GN: RN AR RRR HC ER cals NER nee
New Hampshire 00): 2) Gli iin eiMan Meir Mest GG ex a 3,775
97
Assuming that a quart of standard milk weighs 2.15 pounds,
the production in quarts per day would be —
} Quarts,
Wis sTeMUSehISa re ri Ue GR Am uta aS ge ao he | i
Vermont, ; WE I RT aR ADT ea ohne em en ese
New Hampshire, . Vy fie leg ages AA Meh Mat a ct ea ea:
These figures are interesting in view of the fact that Ver-
mont has generally been considered the dairy State of New
England. )
An interesting feature is the belief of admirers of different
thoroughbred. varieties of cattle that the breed which they ad-
mire is the best for certain purposes, which ideas are not always
substantiated by facts. Too much emphasis is laid on individ-
ual work and not enough on herd work; as, for instance, in
the Holstein breed the herd records, so far as we have them,
are in no way comparable with individual records, and it is
a mistake to think that thoroughbred herds exceed in produc-
tion, to any great extent, the good herds of grade cows; at
least, the observation of the committee has shown it thus.
That there are fads and fashions in all things is just as true
of the dairy business as of other things, and many a dairyman
owes a part of his failure in dairying to the fact that he has
been caught by a fad.
Fads in feeding cattle have followed a knowledge acquired
after patient study and research by competent persons, by
parties who have absorbed only a part of the idea and have
had the benefit of other conditions to help them out for a
while; but when the favorable elements have been removed
they found that the profits have been wiped out by wasteful
and injudicious feeding methods, also by dairymen following
ration formule used by gentlemen farmers and others in trials
for advance registry records. Such fads and heavy feeding
methods have resulted in very many cases of udder troubles
that seriously affect the quality of the milk from such cows,
both from a health standpoint and also a commercial point of
view, as well as being a deteriorating factor in the value of
. the cow.
If there has been a profit in milk production in Massachu-
setts in the last few years among those dairymen who sell
their product to the large dealers, it has been among those
98
who raise the largest proportion of the stock feed on their own
place. This class of producers, that is, the ones who raise most
of the fodder and a good part of the grain used in feeding their
herds, do not as a general thing produce as much milk or cream
as those who buy and feed generously the high concentrates
now common in the markets; but they do keep a larger part
of the gross receipts in their own pockets, and the cattle fed
in the old-fashioned way are almost invariably healthier and
remain producers longer than the highly pampered and fed
cattle. Cases of milk fever, garget and other udder troubles,
and also tuberculosis, are less prevalent in herds that have not:
been crowded.
The old-fashioned way spoken of is the one followed by many
Worcester County farmers formerly, and by a less number now,
and the ration is generally composed of hay, clover and cut
dry corn stalks for roughage, turnips and mangles for succulent
feed, and the field corn ground into what is called cob grist, —
that is, the whole ear is ground and fed as meal with some of
the wheat feeds, such as bran or mixed feed, — and by this
method of feeding, which gives a good nutritive ratio, the high-
est natural production can be obtained. Any crowding with
concentrates is unnatural, and requires the best efforts of an
expert cattle feeder to keep the herd in good shape.
Large and Small Herds.
The cost of maintaining a large herd, of cattle is less in pro-
portion in some ways and not in others, for while any large
business is done on a more economical basis than a small one
when materials are bought, still, the smaller dairies that are
run in conjunction with general farming are sometimes more
profitable in proportion, as they provide something for the
farmers to do in the winter time when other lines of his busi-
ness are at a standstill.
Condensed and Evaporated Milk and Milk Powders.
An IntTERVIEW witH Mr. W. J. Rem, Locan MANAGER FOR
, THE VAN Camp COMPANY. .
Mr. Reid says that the Van Camp Company’s business in
evaporated milk increased at least 100 per cent., perhaps 125
per cent., from 1906 to 1914, and that the business was very
99
profitable from 1906 to 1912. Since 1912 there has been no
profit in the evaporated milk business, owing to the increased
cost of everything used in the manufacture and shipping and
to the scarcity of milk. The Van Camp evaporating plants
have been running half time recently, owing to the scarcity,
and in 1910 a large plant that the company was running at
St. Albans, Vt., was discontinued, as not enough milk could be
obtained to make it profitable: Mr. Reid says that the cases
in which the evaporated milk is packed now cost 18 cents
apiece where formerly they were bought for 5 cents apiece.
The cans used in putting up the milk cost at least 40 per cent.
more than a few years ago. The labels also have increased in
price, and there has been a considerable increase in the price
paid for labor, but in spite of these increased. costs the price of
evaporated milk per case, for the year 1915 averaged $3 a
case, against a price of $3.55 per case in 1912. Mr. Reid made
the statement that his firm believed that there was no profit
in the evaporated milk business at the present time (1915), nor
would there be any until the consumers were willing to pay more
than they do. Keen competition among the manufacturers of
evaporated milk made it impossible to do anything in a general
way toward advancing prices. Mr. Reid said that the evapo-
rated milk business was the only one of their many lines where
the manufactured product did not respond to the market price
of the raw material, and said that all other lines that they
handle were advanced or lowered in price to correspond with
market conditions. For instance, their best brand of baked
beans is now selling for 20 cents per can instead of 14 cents as
formerly, and this is due to the advanced price of the raw bean.
INTERVIEW WITH Mr. Grorce Wm. BENTLEY, AGENT FOR
THE BoRDEN CoNDENSED MiLK ComPANy.
Mr. Bentley says that at the present time the condensed milk
business is not in a very satisfactory condition; that it is im-
possible for him to get enough condensed milk from the
factories to fill their regular orders; that the reason for this is
the scarcity of the raw product; and that so scarce is the fluid
milk for manufacturing into condensed milk that their com-
pany is now going into Canada for more milk and to open
manufactories. He also says that until within two years the
100
condensed milk business had increased at the rate of about
15 per cent. per year since 1906, but that it was now falling
off almost as fast as it had increased up to 1912. Part of this
decrease is due to the fact that there is a less demand, and
part to the above-mentioned shortage of the raw milk. Mr.
Bentley said that the less demand by the public might be due
to the financial conditions of the past few years, but did not
see why there should have been any idea that this was economy,
as he considered that the public was getting more for their
money when they bought milk or any of its products than in
any other line of food. Mr. Bentley very kindly offered to give
the Milk Board figures to show the amount of condensed milk
his firm had handled for several years back. These figures
have not yet been acquired by the Milk Board.
INTERVIEW with Mr. Louis W. pre Pass, In CHARGE OF
STATISTICS AT THE Boston CHAMBER OF COMMERCE.
Mr. De Pass gave the figures on the amount of condensed,
evaporated and powdered milk coming into Boston for the
years 1912, 1913 and 1914, with the amount from Jan. 1 to
Nov. 1, 1915. Mr. De Pass only began to keep these figures
in the year beginning 1912. The amounts are as follows: —
Cases. Barrels.
|
1912, . : 4 : i ‘ f dl 4 5 4 321,946 2,304
1913, . ; ‘ ; : z F : ; A 3 5 321,883 3,484
1914, . : 5 : \ : 5 : , q F 4 432,601 851
Jane dbo sNov. 1, Oday oh )e i, ge) ges et ah angen 326,474 5,145
Jan. 1 to Nov. 1, 1914, ‘ ; 4 : ! ; ; : 355,932 606
November, 1914, . i, x ' : x : : 4 3 34,253 40
December, 1914, . : 5 A j 5 : H : : 42,416 205
In the opinion of Mr. De Pass there has been a decided
increase in the amount of condensed and evaporated milk
handled for the last few years, and he did not think that the
financial conditions of the last few years had caused any
decrease in the amount of this product coming into the city of
Boston.
ion
The figures quoted are made up from the dairy returns of all
the railroads running into Boston, and are said to be accurate,
but there has been no attempt made to separate the different
kinds of milk preparations.
Comments on Milk Production.
Although considerable time has been spent in the investi-
gation of the different factors entering into the business of milk
production, it is by no means certain that enough information
has been gathered from which to draw conclusions as to the .
exact condition of milk production in Massachusetts, and it
would be unwise to make any efforts toward the regulations of
the dairy business from a health or any other standpoint until
the findings of this investigation have been carefully reviewed,
as there is a possibility that the dairy business in Massachusetts
is in danger of becoming almost entirely eliminated unless
something is done to restore confidence.
A study of the census reports shows that in all of the New
_ England States, except Rhode Island, there has been a great
decrease in the number of milch cows kept, this decrease being
most pronounced since 1890; that the consuming public of
Massachusetts has been obliged to use milk from dairies far
beyond the points where the milk supply was formerly ob-
tained; and that the distance has steadily increased and nearby
production has steadily decreased, so’ that it would appear
as though the future generations would have but a small
amount, if any, of milk from near-by points.
_ If milk is an important article of food, and if the quality is
-at all an important feature, it is evident that it becomes neces-
sary that the near-by production of milk should receive such
encouragement as can be given. Although the milk business
owes its.principal decline to strictly commercial causes, it must
be revived for more important reasons than that of commercial
interest, and one of the most important and vital reasons is
the preservation of the life and health of our people.
That milk is a necessary article of diet is admitted by all,
and its importance in the diet of infants and invalids is incal-
culable, because on the use of cow’s milk depends the lives of
many, who, from unavoidable causes, are compelled to rely on
102 -
it for varying periods of time. It is said by several authorities
that breast feeding of infants is on the decline in this country,
and if that is a fact, then we must depend more and more on
the cow to provide sustenance for those who unfortunately are
denied their natural food.
If the statistics in regard to milk prolduletion gathered during
this investigation are correct, and we believe them to be so,
then we must be approaching at a greater or less rate of speed
the time when a good quality of cow’s milk for our infants’
nourishment will become a rare and consequently high-priced
article. It therefore seems as though the complaints of the
future would be numerous in regard to the milk situation, but
along distinctly different lines than at present. If the produc-
tion of milk within a reasonable distance of the city of Boston »
shall decrease as fast in the next twenty-five years as it has
in the past twenty-five years, and the farmers in zones that are
now supplying a large part of the milk which was formerly
produced nearer Boston become convinced of the fact that milk
production is a financial failure under prevailing conditions (and .
personal interviews with many producers of those zones have
shown us that the more thoughtful ones believe this to be the
case), it is only a question of time when we will have no ade-
quate locally produced milk supply suitable for infants, invalids
or those who need it as an article of daily diet.
It has been suggested by some farmers that the best way to
remedy the financial conditions under which producers labor
at the present time, and have for some time in the past, is for
the dairymen to cease the production of milk and go into other
and more remunerative lines of agriculture, with the expecta-
tion that a shortage in the supply of milk would bring an ad-
vance in prices that would make the production of milk a pay-
ing line of agriculture. This idea, however, is probably an
erroneous one, for it is well known that those dairymen who
have given up milk production and have engaged in vegetable,
fruit or poultry raising, or other agricultural lines, have seldom
returned to dairying because it is much more exacting in regard
to hours and close application throughout a whole year than
is the. production of seasonable crops or poultry husbandry;
and. also because a return to the dairy industry means either
103
a large outlay of money at the start or a slow process of build-
ing up a herd with which to do business.
_An important reason why the dairy business should be en-
couraged is that all other lines of agriculture depend largely
on the animal fertilizers for best results in growing farm crops,
and except in a small percentage of cases farms certainly do
run down and become less productive where the animal fer-
tilizers ‘are lacking.
It is a fact that some farms have been successfully run on
commercial fertilizers and green manures, but it does not seem
probable that the method will ever become general, as it re-
quires more than the ordinary amount of scientific knowledge
of chemistry, etc., than we can expect to find among our com-
mon farmers.
Agriculture along the lines now common in our New England
States must be fostered if we are to continue to have a supply
of the native-grown fruits and vegetables that we are accus-
tomed to, and no one should dispute the statement that New
England quality in all lines of fruits and vegetables native to
these States is high.
The working classes are the ones who must bear the burden
of the high cost of living, and to them any advance in price of
any necessary article of food is of great importance, and it is
very necessary that in the study of conditions relating to the
production of milk due consideration should be given this part
of the subject.
The lack of uniformity in the price paid to producers of milk
whose output comes into the Massachusetts market is appar-
ent, and the Milk Board has found in their investigation that
the amount paid per 83-quart can varies from 25 to 56 cents
per can in different sections of New England, but as only a
small part of the total is sold for the latter price it is very dif-
ficult to say what the average price may be. The estimated
average price paid is 31 cents per 83-quart can, and the esti-
mated average price to the consumers is 9 cents per quart, or
about 75 cents per 83-quart can. Our investigation has shown
that the retail price of milk of the ordinary market quality
varies from 6 cents per quart in the town of Great Barring-
ton to 12 cents per quart in the towns on Cape Cod, where
104
the greater part of the milk is produced in the summer season
to be sold to summer residents. Certified milk seems to be
a small part of the total amount, probably less than 1 per
cent., and the prices are said to vary from 12 to 20 cents per
quart, although a small amount is sold at a higher price. It
has been ascertained that producers in the State of Maine are
paid a much better price for milk by a large concern doing the
principal business in that section than are producers in other
sections equally distant from Boston who deal with other com-
panies. There is also a lack of uniformity in deducting the
transportation charges from what is called the Boston price, .
which transportation charges vary in the different zones.
It is said that in some instances milk is transported by rail-
road twice as far for a given price as it is in others, which, of
course, must increase the unfavorable conditions surrounding
the milk industry. s
The management of the Boston & Maine Railroad has re-
cently petitioned the Massachusetts Public Service Commission
for permission to increase rates for hauling milk, but nothing
has been done along this line, as it has been claimed by some
of the interested parties that it is an interstate question, and
must be settled by the United States Interstate Commerce
Commission. ire
In one of the Boston Sunday papers of Jan. 9, 1916, a state-
ment was made that the Interstate Commerce Commission is
to make an investigation of milk transportation rates in the
New England States.
Any increase in transportation rates at this time must mean
an increased price to the consumer, as the producers cannot
stand a smaller price than they are now receiving, and the
dealers have stated that they cannot do business on a smaller
margin of profit than that which they now receive.
A study of one of the accompanying charts shows the values
of.some of the principal agricultural crops of the United States,
and also that dairy products rank high in value. When we
consider that where dairying declines other agricultural lines
suffer great loss, and where agriculture is neglected or becomes
unprofitable all business lines almost instantly respond to the
decline, and if agricultural work is profitable then all other
109
business lines are profitable, we are justified in considering that
dairying is an important industry in Massachusetts.
To give an idea of the financial importance of dairying in
Massachusetts the following figures are given: 147,000 milch
cows at an average value of $60 each equals $8,820,000; 147,000
cows yielding 53 quarts per day each at a value of 4 cents per
quart equals $33,800 per day; $33,800 per day multiplied by
365 equals $12,307,000 per year, as a rough estimate of the
value of the present milk production in Massachusetts. Using
figures of the New York Experiment Station on financing the
cow, 147,000 cows at $680 each equals $99,960,000 to finance
the cows of this State.
If we estimate the number of people employed in caring for
the milch cows of this State as 1 person per 8 cows, we have
18,375 persons daily employed in this work. These figures show
the dairy industry of Massachusetts to be important, and. al-
though it is impossible to say what the effect of the elimination
of dairying in Massachusetts would be, it would certainly have
a very depressing effect on other lines of business activity. Any
increase in the dairy industry of Massachusetts must certainly
tend toward a greater prosperity for all connected with the
agricultural interests of the Commonwealth and for those firms
or individuals who rely upon the residents of the rural districts
for their commercial success.
D. THE COMMERCIAL PASTEURIZATION OF MILK AND
CREAM.
Pasteurization is the term applied to the process of heating
a substance to a temperature sufficiently high to destroy or
greatly reduce the bacterial content without causing appreciable
chemical changes in the substance. The commercial pasteuriza-
tion of milk as generally carried out in the State of Massachu-
setts consists in heating the milk to a temperature of 145° or
150° F., and holding the heated milk at a temperature of 142°
to 144° F. for a period of from twenty to thirty-five minutes,
after which it is immediately cooled. In a few instances, how-
ever, dealers still employ the flash process of pasteurization,
by which the milk is momentarily heated at a higher tempera-
ture and is immediately cooled.
106
In the milk-pasteurization plants the milk is heated very
quickly, generally under automatic temperature control and
record, after which it is transferred to the holding chambers
which may be of the continuous or of the intermittent type.
In either case the temperature of the milk is usually recorded
as the milk leaves the chambers for the cooler. In a few in-
stances the milk is heated slowly in bulk, and held at the tem-
perature of pasteurization for the necessary time in the same
tank in which it was heated, after Walon it is cooled and. bot-
tled in the usual manner.
The sale of milk heated to a temperature greater than 167°
F. is prohibited in Massachusetts unless labeled “ Heated Milk.”
This statute is difficult of enforcement, as it is almost impos-
sible to determine by laboratory methods the exact tempera-
ture to which milk has been heated, and in order to obtain the
necessary evidence to prosecute for a violation of this law the
investigator must see the milk pasteurized, and must of his
own knowledge know the temperature to which the milk was
heated.
The first noticeable effect of heat upon milk is the production
of a cooked taste which, however, depends to a large measure
upon the temperature of heating. If the temperature is not
too high this taste will disappear in eighteen or twenty hours.
The chemical effect of heat on milk is the destruction of the
so-called enzymes, and, as the temperature is increased, the
coagulation of the albumin, and if a temperature greater than
the boiling point is reached the sugar may be caramelized.
The exact nature and significance of the enzymes present is a
matter of controversy among those scientists who are trying to
solve the problem, but a study, of the literature shows that
milk gives reactions which may be explained by the presence
of enzymes. Under this assumption it may be stated that raw
milk contains a diastase capable of hydrolizing 0.01 to 0.02
per cent. of starch, a catalase which will liberate oxygen from
hydrogen dioxide, a peroxidase which will cause hydrogen
dioxide to react with certain organic substances, thereby pro-
ducing colors, and reductases capable of reducing methylene
blue solutions to a colorless compound. These reactions are
not only influenced by the temperature to which the milk is
107
heated, but by thé length of time during which the temperature
is maintained, and also by the age of the milk. The diastase
is destroyed by commercial pasteurization, and this is also true
of the formalin-methylene blue reductase, but this. latter
reaction returns three days after pasteurization, probably the
reacting substance being reproduced by the growth of bacteria.
The peroxidase reaction is not affected by the commercial
pasteurization of milk, as shown by the work performed with
this reaction in the Food and Drug Laboratory of the Massa-
chusetts State Department of Health during the year 1913.
As the destruction of this reaction is coincident with the
coagulation of the albumin, and since the reaction may be a
function of the albumin, it follows that there is undoubtedly no
change in the milk proteins by commercial pasteurization as
now practiced. When it is considered that milk with a cooked
taste is liable to have a limited sale it is evident that the milk
dealers will endeavor to keep the temperature as low as they
possibly can and produce the required results. An added
incentive to keep the temperature of pasteurization low is the
- fact that if milk is heated to a high temperature the cream
does not rise well, and the bottle of milk will not show the
cream line by which the public judge the quality of the milk
they receive.
Proper pasteurization will cause an enormous reduction in
the bacterial content of milk, and, owing to the fact that
pathogenic bacteria are killed at a lower temperature than
most forms of lactic acid bacteria, the milk is rendered safe for
food purposes and yet, provided that the temperature is not too
high, is capable of going through the usual form of fermentation
common to raw milk, thereby giving the consumer due notice
of any undue age.
Commercial pasteurization, however, is not carried on as a
health measure, but purely for business reasons. It is for the
interest of the large milk dealer to first preserve the large
volume of milk he has on hand which he may desire to hold for
a day or two before selling, and second, to distribute a safe
milk in order to avoid possible damage suits owing to possible
epidemics of disease among his customers. The latter is
avoided by the pasteurization of the milk. Undoubtedly, old
108
milk and milk high in bacteria are pasteurized commercially,
and no doubt much pasteurized milk is reinfected with bacteria.
BACTERIA PER C.C.
“~
~ S
a = Ss S
S S 8 8
Ss S Ss S
000 0007
000°0000/
O00 00000/
0.
y
x
(EA TED 185.
FIELD SO WIN.
HEATEDEHELO-
AT ee
COOLED
. | BOTTLED
PAW
pee eas se
NI
; \
i ee
tS 3
NOILVZIANILG Gf TWIIPFTMNOD
wie
sacs! a
HEATED 145°F
=e c=
=
Stet
: SUN
Hitt nm
Biman’
The chart shows the influence of commereial pasteurization
upon the bacterial content of milk, the statistics being obtained
from the records of the New York City Department of Health.
Two sections of the chart show good conditions in the pasteuri-
‘HLT Fp IO ASIC ALID A WV
HELD SONMIN.
COOLED
|
it
WA
BOTTLED
109
zation plants, and the third section shows poor conditions
caused by contamination of the milk after pasteurization, or
high bacterial content before pasteurization. The milk in these
instances was degraded. If these conditions occur in super-
vised supplies they must be very frequent in unsupervised
supplies.
~The commercial pasteurization of milk should be under
official supervision for the following reasons: —
1. To prevent the pasteurization of milk high in bacteria.
2. To prevent the heating of milk to a temperature sufficient
to change its chemical composition.
3. To see that the pasteurization is carried out in such a
manner that the pathogenic bacteria are killed. rs
4. To see that the milk is not reinfected after pasteurization.
110
PART IV. FACTS OF THE PRESENT OFFICIAL SUPER-
VISION OF THE MILK SUPPLY OF THIS COMMON-
WEALTH.
A. PRESENT STATUS OF OFFICIAL SUPERVISION OF THE
MASSACHUSETTS MILK SUPPLY BY FEDERAL, STATE
AND LOCAL AUTHORITIES.
Local Inspection.
Local milk inspection is carried on under the provisions of
chapter 405 of the Acts of 1909, which require that the boards
of health of all cities shall, and the boards of health of towns,
or the selectmen acting as such boards, may, appoint one or
more inspectors of milk for their respective cities and towns.
Each inspector shall be sworn before entering upon the per-
formance of his official duties, and shall publish a notice of his
appointment for two weeks in a newspaper published in his
city or town, or, in the absence of such newspaper, shall post
the notice in two or more public places in such city or town.
The inspector shall keep an office, and shall record the names
and places of business of all persons engaged in the sale of
milk within his city or town.
The boards of health may appoint a collector of milk. The
inspectors or collectors may enter all places in which milk is
stored, and all carriages used for the conveyance of milk, and
may take samples for analysis. The inspector of milk shall
license the persons engaged in the sale of milk, except pro-
ducers selling milk to other than consumers or less than 20
quarts per day to consumers.
The statutes prohibit the sale of milk containing added water
or any foreign substance, or as pure milk, milk from which the
cream or any portion thereof has been removed. Skimmed
milk may be sold if labeled as such in uncondensed Gothic type
not less than 1 inch in length. The statute also prohibits the
sale of milk containing less than 12.15 per cent. total solids,
or less than 3.35 per cent. fat. There is a special provision
allowing a producer of milk to sell milk below the standard
111
until twenty days after he has received written notice from
the inspector that his milk is below the standard, both in
solids and fat. The effect of this statute is to permit the pro-
ducer to sell milk with total solids as low as 11.70 per cent.,
because such milk will invariably contain at least 3.35 per cent.
fat. This milk cannot be sold by any person except the pro-
ducer.
Chapter 744 of the Acts of 1914 provides that it is unlawful
for any person engaged in the milk business to sell or deliver
any milk without first obtaining a permit from the board of
health of the city or town where such milk is to be sold. This
permit is to be issued only after an inspection, satisfactory to
the board, of the premises upon which, and the condition under
which, the milk is produced. The boards of health are also
permitted under this act to make such reasonable rules and
regulations as they may think suitable for protecting the pub-
lic health. The duty of enforcing this portion of the act has
been placed in the hands of inspectors of milk appointed for
their respective cities or towns. If the board of health revokes
a permit they shall immediately send notice of the fact to the
State Department of Health, and the State Department of
Health must then notify the boards of health of other cities
and towns where’'this milk is liable to be sold, and any dealer
in milk who is liable to sell it, of the action of the local board
of health. After receiving such notice from the State Depart-
ment of Health it is unlawful for any dealer to sell or offer for
sale the milk from a dairy the permit of which has been re-
voked. It is the duty of the State Department of Health to
enforce this portion of this law.
A careful study of the provisions of this act will show that
if carried out as it should be there would be a needless dupli-
cation of inspection on the part of many of our cities and
towns. There is scarcely a city or town of any size in this
State in which the milk dealers’ supply is sold exclusively; for
example, the milk sold in Boston is to a large measure sold
also in Lynn, Salem, Peabody, Saugus, Melrose, Stoneham,
Medford, Malden, Winchester, Arlington, Belmont, Somerville,
‘Revere, Chelsea, Cambridge, Watertown, Waltham, Newton,
Brookline, Dedham, Milton and Quincy. The milk sold in
112
Springfield is to some extent sold also in West Springfield. The
milk sold in Hopkinton, Holliston and Hopedale is also sold in
Milford. Milk sold in Framingham is also sold in Natick, Wel-
lesley and Sherborn. Nearly the entire milk supply of Methuen
is from the same source which supplies the city of Lawrence,
and milk dealers supplying Dracut, Chelmsford and Tewksbury
also deliver milk in Lowell. Similar conditions exist an other
portions of the State, although not to such an extent as in the
vicinity of Boston. If this law was enforced as the statute
contemplates, each farmer supplying milk to these various milk
dealers would be subjected to inspection by the representatives
of the boards of health of from 6 to 15 different cities or towns,!
and in many cases, even with the little enforcement this law
has had, producers have been visited by at least three different
inspectors and have been asked to comply with three different
sets of rules and regulations. Even if the representatives of
three or four different cities or towns did not visit the same
dairies, the provisions of this act require them to make in-
spections in the same territory. For example, the milk from
dairies situated within 1 mile of each other in the Connecticut
valley goes in some instances to Greenfield, in others, to North-
ampton or to Springfield; and similarly in Cheshire the farmers
are selling in some instances to North Adams, and in others to
Pittsfield, making it necessary for inspectors of North Adams
and Pittsfield to visit the town of Cheshire and examine dairies
in that town in order to comply with the provisions of this
act. Inasmuch as the provisions of this act have been carried
out by but few localities, the needless duplication of inspection
with its attending difficulties has been limited.
State Inspection.
Stare DEeparTMENT oF Heaurn.
The State Department of Health is authorized by statute to
expend annually a sum not exceeding $17,500 for the enforce-
_ ment of the laws relative to the adulteration of food and drugs,
three-fifths of which sum, or $10,400, shall be spent for the
enforcement of the laws relative to the adulteration of milk
and milk products. Under the provisions of this act the State
1 Unless local boards of health made the employees of other boards their agents for dairy inspec-
tion.
113
Department of Health collects and examines milk, butter,
cheese, condensed milk, cream and ice cream. If any viola-
tions of the law are discovered they are carefully investigated,
and, if conditions warrant, prosecutions are made or further
investigations started, with a view to prosecuting the respon-
sible offender.
The following list shows the number of samples collected,
examined and prosecuted during the past eight years by the
State Board of Health. —
a
SAMPLES COLLECTED AND EXAMINED. PROSECUTIONS.
a
YEAR. ' 2 : E
2 q 5
Peart Menai ieee ee ie
zs = ase CN CAS rd RUNS “| 3
3 Svea Moulic: lacie i ey yp ahs
1907, . , : 2,992 87 15 19 26 = 3,139 142 5 147
1908, . F 5 3,934 54 22 38 170 - 4,218 214 5 219
1909, . : 4,611 68 22 26 171 2 4,900 171 9+} 180
1910, . 3 4 5,396 102 15 23 104 - 5,640 106 13 119
1911, _ . : Y 4,690 30 9 28 166 - 4,923 78 4 82
19125): 4 A 4,900 33 6 PAF 100 - 5,066 64 1 65
1913, . 5 ‘ 6,702 58 = 8 209 132 7,109 101 5 106
1914, . \ 3 6,008 27 3 44 284 206 6,572 52 6 58
Totals, . . | 39,238 459 92 213 | 1,230 340 | 41,567 928 48 | 1,066
The State Department of Health has no power to make rules
and regulations relative to the sanitary conditions of dairies,
but dairy inspections have been made under the general pro-
visions of the law creating the State Board of Health.. The
number of dairies inspected is given in the following table: —
pr
Number Number
YEAR. of Dairies YEAR. of Dairies
inspected. inspected.
1907, H : ‘ Z 4 Z 2,714 1912, 4 3 j Z 8 s 1,451
NGOS oer urs - Ks Fi é 2,231 GIBy, S96 : 4 H 5 5 4,493
1909, . Aaa A 4 : prea 1914, .. 4 : ; * ‘ 2,222
1910, : F 3 ‘ i u 2,053 Total, . . is M 19,004
1911, 3 3 5 : i 2,069
: ;
a
114
Datry BUREAU.
The Dairy Bureau of the State Department of Agriculture
has an annual appropriation of $8,000 for inquiry into the
methods of butter and cheese making, and for the enforcement
of the laws relating to the sale of adulterated milk and milk
products. The Dairy Bureau maintains a general agent whose
salary is provided for by a special appropriation, and several
other agents who obtain the samples and make the necessary
investigations. The chemical work is all done by private chem-
ists, being paid for at contract prices according to the number
of samples submitted. The Dairy Bureau does but very little
work relating to the adulteration of milk, but spends ‘the
largest amount of its appropriation enforcing the laws relative
to the sale of oleomargarine. The Dairy Bureau reports that
it has made no dairy inspections except those made in connec-
tion with the clean milk and other contests.
The following tables show the number of samples of milk
and milk products examined by the State Dairy Bureau during
the past eight years, and the number of prosecutions for the
sale of adulterated milk and milk products.
Samples collected and examined.
Milk Butter Cans
Year, cant, Oleoinar Cheese. ] densed | cream, | Samples.
LOOT act raren ne 192 isolate = ls teal
1O0BE NG eee, a 321 1,497 | : = geet inserts
1900s eRe ae 90 | 1,779 = - a) aa
AQTON Renu Nr ete ate 136 | 1,724 a hee plies - | 1,860
LOUTH PERT et aN 35 | 1,282 = = Ea casey
SOLO CE aR, CR Ma ae 124 | 2,042 z “ = | 2\166
MOIS RUHR ANP UU 94 | 3,458 - = 7}! 3,552
LOLA att AWW ooh TLE 51 1,816 - - SA ceiaey
‘ Totals, - 3 5 1,043 14,780 - - - 15,823
eee ee eee eee
I TT SS aE ST I LEIS SE LT a
1 About 100 analyses of cheese and condensed milk are included with the butter and oleomar-
garine figures.
115
Number of Prosecutions.
YEAR. Milk. Cream. Butter. meee Protec
1907, . : a : i ¢ 19 = 72 111 202
1908, . ; c 4 é 3 13 1 51 104 169
1909, 5 = 33 168 206
1910, 4 = 77 139 220
1911, —. a 0 a : 2 = 60 157 219
1912, .° 6 = 88 122 216
1913, 2 5 54 88 149
1914); : : 9 = 27 93 129
' Totals, . 5 ar oe : 60 6 462 982 paver
DEPARTMENT OF ANIMAL I[NDUSTRY.!
The State Department of Animal Industry has charge of the
examination of animals with respect to the presence of dis-
eased conditions. The appointment of local inspectors is similar
_to that pursued in the appointment of inspectors of slaughter-
ing. Nominations of inspectors of animals are made by the
boards of selectmen of each city and town, which nominations
must be approved by the Commissioner of Animal Industry
before the inspector is appointed. The statute provides, under
certain conditions, that a portion of the salary of these men
may be paid by the State. Inspections by these local inspectors
of animals usually take place in the spring.
If upon examination of the animals on a certain premises the
inspector has reason to suspect the presence of any contagious
disease, such animal or animals are quarantined, and the in-
spector sends duplicate copies of such quarantines to the office
of the Department of Animal Industry. A copy of the report
is left with the owner of the animal, another one retained by
the inspector, and the full record sent to the office of the De-
partment of Animal Industry. At the time a copy of this
record. is left with the owner of the premises, such recommen-
dations for improved conditions as may be necessary in the
opinion of the inspector are brought to the attention of the
1 The following résumé of the present status of animal inspection is directly compiled from a
statement submitted by Dr. Lestor H. Howard, Commissioner of Animal Industry.
116
owner by that inspector, and the owner is requested to make
such improvements. A later visit is made by the local in-
spector, at which time, if conditions are found to be decidedly
improved, the report submitted to the Department above re-
ferred to credits the owner with the conditions found on the
second visit, and in most cases it is found that the owners
carry out the recommendations made by the inspectors. .
As a result, many of the cases that under a former plan
would have been called to the attention of the District Agents
of the Department of Animal Industry are satisfactorily dis-
posed of locally, but if not so disposed of the District Agent is
sent to the premises, the supervision of the Department of
Animal Industry is directly given, and frequent visits made
until the conditions are satisfactory.
All cattle over six months of age coming into Massachusetts
from any point without the State, if not intended for immedi-
ate slaughter, are, according to law, tuberculin tested by an
agent of the Department of Animal Industry, unless accom-
panied by a certificate of test made by a man approved by
the officials of the State wherein the shipment originates. All
animals reacting to this test are destroyed. .
Federal Inspection.
The United States Department of Agriculture, Bureau of
Chemistry, has supervision over the interstate shipment of
food including milk, and over the food introduced into this
country from foreign countries. The Bureau of Chemistry has,
until recently, taken little action upon the subject of milk.
Some years ago Dr. Charles Harrington, then Secretary of the
Massachusetts State Board of Health, endeavored to induce
Dr. Harvey W. Wiley, then Chief of Bureau of Chemistry,
United. States Department of Agriculture, to prevent the ship-
ment into this State of milk from dirty dairies in New Hamp-
shire, and this the Department of Agriculture refused to. do.
Two years ago Mr. Lythgoe endeavored to have the Bureau of
Chemistry prevent the shipment of adulterated milk from
Rhode Island into Fall River. This the Federal authorities
refused to do. The United States Department of Agriculture
has authority to absolutely prohibit the importation imto this
a l7/
country of any food product which may be adulterated or mis-
branded, or the sale of which may be prohibited in the country
of its production. Under the provisions of this act the Federal
government has recently had an inspector investigating the
sanitary condition of dairies and creameries in Quebec. Action
taken by the Federal government under this section of the law
need. not be passed upon by the courts.
The Commissioner of Health of the State of Massachusetts
has been made ex officio a Federal officer for the enforcement
of the United States law relative to food samples shipped for
sale into this State, and the analyst of this Department has
been made the collaborating chemist of the United States De-
partment of Agriculture. Under the provisions of these ap-
pointments the State Department of Health of Massachusetts
is able to exercise some control over the interstate shipment of
foods, but as a rule the Federal law is difficult. of application,
and when adulterated milk from near-by cities or towns in
other States has been shipped into Massachusetts, this De-
partment has invariably succeeded in finding the producer of
the milk in the State, and obtaining samples from him at the
time of delivery to the purchaser. The interstate shipments
of milk can best be controlled through the agency of the person
buying the milk and selling the same in this State.
B. PRESENT STATUS OF LOCAL MILK INSPECTION.
The present statutes regarding local milk inspection were
drawn with the contemplation that local inspection should in
general be supreme. ‘This is particularly true with reference
to the influence of milk upon public health. Cities and towns
have power to grant or refuse licenses to milk dealers, to issue
or refuse permits to milk dealers or milk producers, and, what
is of more importance, have power to make rules and regula-
tions for the violation of which, or a refusal to comply with
which, the license or permit may be rendered void by the author-
ity by which it was issued.
In order to ascertain to what extent the local boards of
health exercised the authority the State had imposed upon
them, a questionnaire and an addressed envelope was sent to
all the local boards of health asking for information relative
118
to the character and amount of milk inspection done, the lo-
calities where the dairies supplying milk were situated, the
number of dairies from which the town obtained its milk, and
a statement of any infectious diseases occurring in the city or
town which may have been caused by milk. The analysis of
this questionnaire is given elsewhere. _
A second set of questions and a stamped envelope was sent
two months later to those boards making no reply to the first
questions. Four months later a letter was sent to those boards
from whom no reply was received, asking whether or not any
milk inspection work was done, and the name of the person.
in charge of the work. This letter brought in a few more re-
sponses, and three weeks later another letter was sent to the
balance of the cities and towns making no reply, stating that
in the absence of a reply it would be assumed that no milk
work was done. Up to Dee. 1, 1915, no replies had been re-
ceived from a number of towns with an aggregate population
of about 3,500 people, or 1 per cent. of the total population.
It was desired to obtain more exact. figures relative to the
work done by local boards of health, and as this would have
involved a larger amount. of clerical work than the Board felt -
it could request the local authorities to perform for us, the in-
spectors and analysts of the Food and Drug Division were sent
to different milk inspectors, or agents of local boards of health,
requesting permission to copy certain figures from the official
records of their respective departments. These local officials
showed every courtesy to our investigators, and gave all the
information that they possibly could.
A form was filled out for each town visited, and then the
investigator copied from the local inspectors’ books upon other
forms the name and address of each licensed milk dealer, the
number of wagons, whether or not the milk was pasteurized,
the amount of raw milk sold, the amount of pasteurized milk
sold, the name and address of the producers supplying the
dealer, and the dates and scores ‘of the dairy inspection made
during 1914 and 1915.
A card index of these various producers and dealers has been |
made, and we have at present a list of the names and addresses
of the licensed milk dealers of this State, and the producers
*
119
supplying’ them with milk, except the dealers and producers
supplying the city of Boston. A perusal of the cards shows
that with but few exceptions there is practically no duplication
of inspection, and in many instances no inspection whatsoever.
In completing these statistics the varied character of the work
done in the different cities and towns has rendered it a difficult ©
task to set forth the results obtained in a clear and concise
manner.
It has been found necessary, in order to make a proper com-
parison of the work done, to divide the cities and towns into
sixteen groups according to the character of their inspection
work. In most instances it was found necessary to subdivide
the towns in a group, for notwithstanding the fact that the
character of the work performed entitles these towns to a posi-
tion in the group, the amount of work performed was very
slight in many instances.
It was found that the replies to the questionnaire were in
many instances misleading, most of which were in favor of the
local boards making the reply. In one instance, however,
where the local board stated that no milk inspection work was
done, one of our inspectors found a milk inspector in the town
doing good work.
The fact that the local milk inspector had no records of
dairy inspection does not necessarily imply that his work as
regards actual inspection of the dairies is faulty or inefficient.
Some of the inspectors have demonstrated to us the fact that
their dairy inspection is productive of excellent results, although
they make no dairy scores and keep no records of inspection.
Many of these inspectors do not have the clerical help neces-
sary to keep records in proper shape, and therefore may con-
sider it futile to make any. In the case of death or resignation
of an inspector, however, the department in which he was em-
ployed has no records with which to ascertain the amount and
character of work performed by the inspector.
Using the 1910 population figures, 645,000 people, or 19 per
cent. of the total population, received no protection relative to
milk from their local authorities according to their own state-
ment; and if we include the 1 per cent. who have not responded
to numerous letters from the Department, the balance of 80
120
per cent., or 2,680,000, received some protection from their
local authorities; 2,102,000, or 63 per cent. of the total popula-
tion, are protected by some bacteriological work and some dairy
inspection, and 1,446,000, or 43 per cent. of the total popula-
tion, are adequately protected. The city of Boston represents
670,000 people, or 46 per cent. of the population, so protected.
Excluding Boston from these figures and recompiling, the re-
sults are as follows: 25 per cent. of the population receive no
protection, 53 per cent. are protected to some extent by: bac-
teriological examinations and by dairy inspection, and only 28
per cent. are adequately protected. By adequate protection
is meant frequent and careful inspection of dairies combined
with frequent, reliable and thorough bacteriological examina-
tions of milk.
Qualifications of Local Milk Inspectors.
While no attempt has been made to accurately summarize
the qualifications of local milk mspectors, contact with the dif-
ferent men has given quite an insight into their ability. These
men range from those of the highest ability to those of very
little ability. Some of them are physicians, some are chemists, ~
some are pharmacists, some are veterimarians, some are men
familiar with the production and sale of milk, and some are
laymen. Many of these men are qualified only to grant li-
censes, others with more ability specialize in dairy inspection,
and have materially improved the conditions under which the
local milk supply is produced and handled. Others add chem-
ical analyses to their work, and still others do bacteriological ’
work, and in general this work is performed in a creditable
manner.
Some without the necessary qualifications attempt to carry
out complex analytical operations, and in some cases may ‘have
instituted prosecutions upon incorrect analyses. One such in-
stance was brought to the attention of the State Department
of Health. The local inspector in this instance asked for in-
formation relative to the determination of nitrogen in milk by
the Kjeldahl process, upon which determination he had based a
prosecution. This inspector desired to inform himself concern-
ing the process in order to be able to answer any questions
121
which might be put to him upon cross-examination. During
the course of the conversation, it developed that the inspector
had standardized his acid solution against a known weight of
sodium hydroxide, which is never sufficiently pure for this pur-
pose. Under these circumstances there might have been a pos-
sible error as high as 20 per cent. in the determination. The
inspector in this instance was given a correct method of stand-
ardization, and found that the error was not sufficient to phone
his conclusions of the character of the sample.
In many instances the laymen among the local inspectors
have developed unusual skill in the analysis of milk, and have
become efficient and valuable public servants notwithstanding
their scientific and technical limitations. In the country dis-
tricts the inspector is generally a farmer with the viewpoint of
the producer who is selling his products. In the city the in-
spector is generally a consumer with the viewpoint of the man
who is buying milk. When these two classes of inspectors come
in contact with each other by working in the same territory
there develops a material difference of opinion. An example of
this was shown in the reports of inspections made in one town
received from two such inspectors.” The local man had in-
spected all.the dairies, and in his opinion they were in proper
shape to produce milk for sale anywhere. The inspector of a
city many miles away where the milk was sold inspected the
same dairies and excluded the milk of about 25 per cent. of
them on account of dirty premises and unsanitary conditions
of production and handling.
The salaries paid to these local inspectors are, on the whole,
inconsistent with the necessary qualifications for the positions.
Communities should realize that unless they pay the price they
cannot get the services of competent men, even if in some in-
stances competent men are serving as local inspectors of milk
without adequate compensation.
C. DISCUSSION OF PRESENT SYSTEM OF DAIRY IN-
SPECTION AND ITS SANITARY VALUE.
The system of dairy inspection carried on at present in this
country is that outlined by the United States or some similar
dairy score card, although the former is the one which is most
ae
used for the reason of uniformity in comparison. ‘This score
card allows a total of 40 per cent. for equipment and a total
of 60 per cent. for methods. Under methods 8 per cent. is
allowed for cleanliness of the cows, 6 per cent. for cleanliness
of the stable, 8 per cent. for cleanliness of the utensils, 9 per
cent. for cleanliness during milking, and 16 per cent. for the
cleanliness and care in handling of the milk. Under equipment
6 per cent. is allowed for the health of the cattle, 6 per cent.
for the location and construction of the stable, 11 per cent. for
light and ventilation, 9 per cent. for construction and character
of utensils, and 6 per cent. for the milk house. It is a-well-
known fact that clean milk can be produced in dirty stables,
provided that the milker is a clean man and cow has been
thoroughly cleaned before milking, but under ordinary circum-
stances milk obtained from dirty cattle housed in dirty stables
is liable to be dirty milk. This score card has been severely
criticized on the grounds that too much stress is laid upon
equipment and too little on methods.
A questionnaire was sent to the various food commissioners
of the different States early in the present year asking, among
other questions, whether & not the United States score card
was of any practical value in improving dairy conditions, and
what changes it would be advisable to make in order to im-
prove the card. ‘Twenty-four replies were received, all answer-
ing the first portion of the question in the affirmative. To
the second portion of the question three persons suggested
that no change need be made, but 11 others suggested changes,
the majority of which were to the effect that more value should
be given to methods and less to equipment. The character of
’ the replies were very characteristic of the personnel of the
various departments. For example, replies from health boards
only stated that more stress should be placed upon cleanli-
ness of attendants, health of cattle and medical inspection of
attendants. One, a director and chemist of an experiment sta-
tion, replied that the dairy inspections should be supplemented
by chemical and bacteriological examinations of the milk and
the water. |
It is evident by the replies received from these various food
commissioners that the score card has in their opinion resulted
123
in improved dairy conditions. It is undeniably true that if
dairy conditions are improved dairy products must of necessity
be improved.
Because of the facts that an exceptionally clean man can
produce clean milk in a dirty stable, and a dirty man cannot
produce clean milk even in a clean stable, certain opponents of
inspection of dairies or of other forms of inspection directed
towards farmers seem to advocate the theory that the proper
way to produce good, clean milk is to have dirty stables as the
first requisite. The consumer, however, is now demanding that
the factories in which his food is prepared, warehouses in which
it is kept, and the stores in which it is sold, shall be clean.
The consumer is now demanding that the dairies from which
his milk is produced shall be clean, but if he is educated to the
belief that producers of milk need not keep their premises
clean, the consumer is liable to abstain from the use of milk,
and the dairyman loses his market.
The score card, however, is of the highest educational value
to the farmer by pointing out the measures for producing clean
milk upon old premises. If a dairy farm scores very low, and
the farmer desires to produce a better article, or if he is paid
a higher price for a better article, he can easily improve the
score, and consequently the character of the milk, by improv-
ing the methods and to a slight extent the equipment.
The purchase of a small-top milk pail increases the score by 5
per cent., washing and wiping the udders before milking increases
this portion of the score to 6 per cent., removing the milk im-
mediately from the stable without pouring from the pail adds
2 per cent., cooliag immediately after milking adds 2 per cent.
more, and cooling, storing and transporting below 50° F. adds
10 per cent. to the score. This procedure increases the total
score by 25 per cent., and if the stable was dirty and the cows
were not tuberculin tested the dairyman by remedying the de-
fects may add 11 per cent. more to the score, and by building
and equipping a milk room and keeping it clean may add 5
per cent. more to the score. Thus it is apparent that if this
portion of the score card is lived up to both the quality of the
_ milk and the score of the dairy will be improved.
In order to see whether or not there was any uniformity in
t
124
the dairy scores in different parts of the country, and to ascer-
tain the mathematical difference between a clean and a dirty
dairy, the scores obtained by the Milk Board upon their various
trips were taken, computations made, and the computations
plotted in such a manner that the various scores of different
portions of the score card could be made comparable with each
other. It was found that as a general rule the dairies scored
relatively higher in methods than they did in equipment, show-
ing that the dairymen appreciated the value of good methods
in improving the product. It was found, however, that those
dairies supplying milk to the “contractors” were not in such -
good condition as those located near and sending milk to large
cities. The scores of 117 dairies supplying near-by cities, and.
the scores of 124 dairies supplying contractors, were separately —
combined and plotted, the resulting plot showing that the con-
tractor’s dairies were somewhat inferior to those supplying milk
to near-by cities. This was particularly noticeable in that por-
tion of the score relative to cleanliness of stable. Thirty-five
per cent. of the contractor’s dairies scored 0 for cleanliness of
the stable, and 15 per cent. scored only 1.3 per cent. Of the
dairies supplying near-by cities none scored 0 for cleanliness
of stable, and only 8 per cent. scored as low as 1.2 per cent.
Fifty-eight per cent. of the dairies supplying near-by cities
scored 3.5 per cent. on cleanliness of stable, but only 15 per
cent. of the contractor’s dairies reached this score. ‘The sys-
tematic inspection on the part of agents of local boards has
had an influence upon those dairies located near their re-
spective cities and: towns, resulting in improved conditions at
the dairies. ‘These conditions are due to the fact that if the
farmer is paid a sufficient price to make it profitable to pur-
chase good utensils and to keep his stable: clean he will do so.
The farmers supplying milk to the large contractors receive
on an average from 1.5 to 2 cents less per quart than the
farmer selling to a dealer delivering milk in a near-by city,
and, therefore, cannot afford to take the care of the milk and -
the stable that the dairyman does who receives more money.
Dairy inspection is of value in increasing the sanitary quality
of milk in those communities where it.is rigidly enforced, and
particularly so where milk is sold upon its sanitary value. It,
125
however, should be almost entirely educational, because it is
the milk and not the stable which is consumed, and, therefore,
the inspection and the improvement of the milk rather than
the stable should be the prime object. There is no doubt,
however, that the dairy inspection which has been carried on
in this State for the past eight years has resulted in an im-—
provement of dairy conditions and of the milk supply, and for
this reason dairy inspection is highly desirable.
126
PART V. THE RELATIONSHIP BETWEEN COW’S MILK
AND THE PUBLIC HEALTH.
A. INTRODUCTION.
The enormously diversified individual conditions under which
cow’s milk becomes an important factor in human health or
disease may be reduced to three great groups: —
I. The relationship between the use of cow’s milk, or milk
products, and certain infectious diseases of man.
II. The relationship between the use of cow’s milk as a
substitute for human milk and the death rate of infants.
III. The relationship between the use of cow’s milk, milk
products and derivatives, and the sustaining of that balance
of the processes of destruction and repair within the human
body that is commonly known as a state of health, or, in other
words, the relationship of milk to human nutrition, or the
metabolism of milk. t
The first two of these groups have one common ground in con-
trast to the third. They represent the health-menacing possi-
bilities of milk. The last represents the health and life sus-
taining properties of milk as an everyday article of diet.
Perhaps the most unfortunate thing about the entire litera-
ture of milk — about the present agitation relative to the use
of cow’s milk throughout the country — is the slight amount
of emphasis that has been placed on the value of milk as con-
trasted to the dangers of milk as an everyday article of human diet.
Milk as an incubator of infections, the limitations of the cow
as a substitute for the human mother, the connection between
dirty, stale and decomposed cow’s milk and the summer scourge
of the innocents, — all these themes have been worn thread-
bare, all have been argued to the point of exhaustion, and all
more or less conclusively proved. But the beneficent rdle
played by the maligned cow even under the most adverse con-
ditions, in stepping into the breach between life and death
when mothers fail, has received all too scanty emphasis.
127
It may even be seriously questioned whether some of the
well-intentioned popular agitation, relative to the disease-bear-
ing possibilities of milk, has done as much service to the cause
of humanity, by pointing out the existence and insisting upon.
the correcting of certain very real and serious dangers, as they
have done injury to that cause by inducing an exaggerated
fear of cow’s milk as it is produced and handled at present.
This fear, in turn, has led to attempts to substitute for cow’s
milk other materials and products that in the long run are
vastly more inimical to human health in general, and to that
portion of humanity designated as mfancy in particular.
It may be held that such statements as the foregoing are
damaging to the “clean and safe milk” cause; that any re-
sponsible. officials making such statements are placing them-
selves in the position of apologists for the cause of dirty and
disease-producing milk. Far from it. Such statements simply
indicate that the other side of the problem should receive its
fair consideration.
In the United States during the past anilidig years it has be-
come firmly established by law and by the general consensus
of public opmion that the business of producing and distribut-
‘ing cow’s milk has such extensive and direct relations to the
public health and welfare that it is justifiable, through an exer-
cise of that police power which resides in all organized govern-
ment, to interfere with the commercial processes of that busi-—
ness to an extent that is hardly approached in any other line |
of commercial enterprise. In direct proportion to the growth
of such sentiment — permitting, even demanding, this extraor-
dinary interference in the name of the public health with a
legitimate life-supporting industry — it becomes more and more
important that this police power be exercised with sanity, dis-
crimination and fairness to all concerned.
Exaggeration of the dangers of milk as they are, and an in-
sistence upon non-essential, whimsical, illogical and excessively
costly measures of alleged protection of the consumer’s milk at
the present, are never going to successfully solve the problem
of safe, clean and honest milk for the consumers in the future.
Perhaps there is no service in relation to the milk question
that is needed so much to-day as a clear, unbiased statement
128
of the relative evils and benefits of cow’s milk to the human
race as conditions are at present.
With this clearly fixed, with the excessive overstatements of
present dangers and the moral responsibility of the deliberately
dirty or careless producer, dealer and consumer equally clearly
understood, the public, who is the final arbiter in the whole
matter, can more clearly and intelligently fix and determine,
through its representatives and duly authorized agents, the
degree of refinement of methods that it considers reasonable
and essential for its own best interests, and the price that it
is willing to pay to institute such minimum standards of quality
as it may determine upon as necessary in the interests of the
_ public health and welfare.
B. MILK AND THE COMMUNICABLE DISEASES.
The more important diseases of man that milk may play an
important réle in transmitting are tuberculosis, diphtheria, scar-
let fever, typhoid fever and septic sore throat.
The question as to the connection between milk supply and
the transmission of these diseases under certain circumstances
is no longer open to debate. It has been proved beyond reason-
able doubt. The phases of the problem that are still open to
discussion are (a) how great a relative danger in the transmis-
sion of these diseases is milk as at present produced, and: (6)
what are the most reasonable, efficient and economical protec-
tive measures that can be adopted to reduce the risk of such
disease transmission through milk to a minimum?
1. Milk and Tuberculosis.
Broadly speaking, among the various human diseases that
may be transmitted by infected milk tuberculosis occupies a
- unique position. This is due to the fact that in all the other
important milk-borne diseases the infective agency is human,
and comes into play after the milk has been drawn from the
cow. In the transmission of tuberculosis it is possible that
subsequent accidental infection of milk and milk products, due
to human tubercle bacilli, may occur, but the great source of
danger as regards tuberculosis transmission Ethene milk is the
cow herself.
129
So much confusion still exists relative to the connection be-
tween animal and human tuberculosis, due to the great con-
troversy that raged in regard to it from 1901 to 1911, that
although the questions at issue are now definitely settled, it is
perhaps advisable to refer to them briefly in order to make
our present problem perfectly clear. This seems the more de-
sirable in the present report from the fact that your Board
has found several among the milk producers of this Common-
wealth who are under the serious misapprehension that good
scientific authorities still deny the transmission of tuberculosis
through milk.
Following the demonstration of the tubercle bacillus in 1882
by Koch, it was taken for granted by all the scientific world
that the two diseases, human and bovine, were identical, and
readily and mutually transferable. His later discovery of tuber-
culin in 1890, and its rapid application to dairy animals for
diagnostic purposes, quickly demonstrated that tuberculosis was
more prevalent among dairy animals than had been previously
suspected. This discovery led to a veritable epidemic of sani-
tary live-stock legislation directed against tuberculosis in cattle,
which spread over nearly all civilized countries during the 90’s.
Prominent among such laws were the “tuberculin testing and
slaughter of reactors” laws of Massachusetts.
Meanwhile, in 1896, Prof. Theobald Smith demonstrated that
the human and bovine types of the tubercle bacillus were not
identical, but possessed quite distinctive differences both in
appearance, in reactions on culture, and in their relative viru-
lence to different animals when injected experimentally.
In 1901 Koch read his famous paper in London, in which he
clearly gave the impression to all the world that there was no
relationship whatever between human and bovine tuberculosis.
It is not true, as has been often alleged, especially by some who
have sought to minimize or deny all relationship between hu-
man and bovine tuberculosis, that Koch said that the bovine
bacillus and the human bacillus were two different germs. He
simply said they were two types of the same species, a point
Prof. Theobald Smith had long before made clear. But he did
state very emphatically his opinion that the two had little in
common. To quote the words of Professor Welch of Johns
Hopkins, “Koch certainly left the impression by the conclu-
130
sions drawn from his own words that there was practically no
danger whatever of infection from bovine sources;, Koch drew
that inference without basis of facts.”
The controversy that this opinion of Koch’s immediately
aroused and the great practical importance of the subject pre-
cipitated one of the most intense investigations into the true
nature of any communicable disease that has ever been known.
The British government appointed a Royal Commission which
worked continuously for ten years upon the subject. The Ger-
man government appointed a similar commission, and these two
commissions and other investigators the world over, especially
those of the New York City Health Department in this coun-
try, carried on researches for years into every conceivable phase
of the great problem.
These researches all came to one general conclusion, which
can perhaps best be stated in the words of the British Royal
Commission in their final report in 1911. The following ques-
tions were submitted to them for investigation: —
Question 1. — As to whether the disease in animals and man is one and
the same.
Conclusion. — Whether one prefers to regard bovine tuberculosis and
the cases of tuberculosis in man, which are caused by the human type ef
bacilli, as varieties of the same disease or as independent diseases, there
can be no question that human tuberculosis is in part identical with
bovine tuberculosis. Our researches have proved that in a considerable
proportion of cases of the human disease the lesions contain, and are
caused by, bacilli which in every respect are identical with the bacilli
which are the cause of tuberculosis in cattle. In all such cases, therefore,
the (human) disease is the same disease as bovine tuberculosis.
Question 2. — Whether animals and man can be reciprocally infected.
Conclusion. — We must conclude that mammals and man can be
reciprocally infected with the disease tuberculosis.
-— Question 8.— Under what conditions, if at all, the transmission of
tuberculosis from animals to man takes place, and what are the circum-
stances favorable or unfavorable to such transmission.
Conclusion. — Whatever may be the animal source of tuberculosis in
adolescents and in adults, there can be no doubt that a considerable
proportion of the tuberculosis affecting children is of bovine origin.
And again: —
_ It may be asked in what way are children . . . most likely to obtain
a large and fatally infective dose of tubercle bacilli? . . . To this question _
131
there can be but one answer, namely, that . . . a considerable amount
of the tuberculosis of childhood is to be ascribed to infection with bacilli
of the bovine type transmitted to children in meals consisting largely of the
milk of the cow.
The fact of the existence of bovine tuberculosis infection in
human beings once demonstrated, the all-important question
from the standpoint of practical safeguarding of the milk sup-
ply of any nation, State or community is, how great a danger,
how great a menace to human life is this transmission of bovine
tubercle bacilli to man? And what are the most logical steps
to be taken to minimize or entirely eradicate this danger?
From the careful and extensive investigations of Park and
Krumwiede, of the New York City Health Department, it
would appear that at least one-third of all cases of tuberculosis
in children under five years of age are due to bovine bacilli,
and nearly as great a proportion in cases occurring in children
between five and fifteen years of age.
It would also appear that the bovine type of bacillus is prac-
‘tically never found in adult pulmonary tuberculosis or con-
sumption, but this does not necessarily mean that infection in
childhood by, the bovine tubercle bacillus has no relation to
the occurrence of adult consumption.
When consumption is excluded, the percentage of adult tuber-
culosis due to the bovine tuberculosis in the large series of
cases so exhaustively investigated rises to 7.3 per cent. Various
leading authorities, American and foreign, are in substantial
agreement that at least 5 to 7 per cent. of tuberculosis in hu-
man beings is definitely and directly of bovine origin. And
the possibility of the true percentage being still higher cannot
be denied.
In addition to these well-demonstrated dangers to the human
race from tuberculous milk, two other theories have been ad-
vanced and have received very serious attention from the
world’s best authorities on tuberculosis.
_ The first theory is based on the fact that after all, the dz-
ferences between the human and the bovine tubercle bacillus
are merely differences of type or of degree. They cannot be
‘considered as distinct, fixed species. Or, to use the apt illus-
tration of Professor Ravenel, the differences between human
132
. tubercle bacilli and bovine tubercle bacilli are analogous to the .
differences between a Jersey cow and a Holstein cow, rather
than to the differences between a cow and a horse. With this
admitted, it is entirely conceivable that bovine bacilli might
be taken into the body in childhood, and after a lapse of years,
by spontaneous breeding in human tissues, finally take on the
essential characteristics of the human bacillus in much the same
manner as a farmer may greatly change the characteristics of
his final product in any field crop by seed selection extended
over a period of years, without introducing any outside seed.
If this does actually occur, if bovine bacilli, taken into the
child’s body through milk, under the influence of a human en-
vironment, in the course of many, many generations of germ
life, approach the human bacillus type, and finally become
manifest as active tuberculosis in the adult, then, the bacilli
recovered showing human characteristics, the infection would
naturally be ascribed to human origin although in reality bo-
vine. There are some facts that tend to support this view,
but the majority of authorities are not inclined to believe in
it, although no one can yet positively deny its correctness.
The other theory has received much more favorable consid-
eration, and it is perhaps not putting it too strongly to say
that certain of its originally assumed conditions are beginning
to be quite firmly established as facts. Without going into de-
tails that would be entirely out of place here, it is enough to
say that the fundamental concept of this view is simply that
certain infections with bovine tubercle bacilli in early child-.
hood, which at the time cause very slight or no visible consti-
tutional symptoms, may be an important factor in the devel-
opment of tuberculosis later in life by rendering the person
less resistant to heavy doses of the human bacilli than he
would otherwise have been.
. Other points of great significance in the relationship of milk
to tuberculosis are: how many of our dairy cows are tuber-
culous; which ones among the tuberculous animals are dan-
gerous to the consumer of raw milk; and how relatively
frequent is the occurrence of bovine tubercle bacilli in ordinary
market milk, cream, butter, etc.
133
A complete discussion of the first point would take us too
far into the field of veterinary medicine. Suffice it to say that
while absolutely reliable figures for all the dairy cattle of any
nation or State do not exist, such authorities as Chief Melvin
‘of the Federal Bureau of Animal Industry and Professor Moore
of Cornell concur in the opinion that not less than 10 per cent.
of the dairy cows of the United States are affected with bovine
tuberculosis. M’Fadyean, an eminent British authority, esti-
mates that 30 per cent. of British cows are tuberculous. In
Massachusetts over a period of fifteen years, from 1893 to
1908, out of a total of 86,223 animals tested, 11,853 reacted
to the tuberculin test for tuberculosis, 10,760 of them were
slaughtered and 10,688, or 99.34 per cent., were found definitely
tuberculous at post-mortem examination. It is interesting to
note that although comparatively few examinations are being
made at present in this State, it seems to be quite a universal
opinion among the older milk producers interviewed that bo-
vine tuberculosis is relatively much less frequent among the
Massachusetts dairy cows than was the case twenty years ago.
These figures are enough to show the great extent of the
disease tuberculosis among dairy cattle.
The evidence is now complete showing that tubercle bacilli
are excreted in large numbers in the dung of tuberculous cows,
and that this occurs even when there is no lesion of the ani-
mal’s intestines.
It is also quite universally agreed that at I¢ast 2 per cent.
of tuberculous cows suffer from tuberculosis of the udder. In
this disease prodigious quantities of bovine tubercle bacilli pass
directly into the milk with every milking, but under present
conditions it is more than likely that even more tubercle bacilli
in the aggregate pass into the milk from the dried dung of the
tuberculous animals.
Two or three other points bearing upon the same sublect are
of great practical significance.
(a) That the clinical diagnosis of tuberculosis in cows is rec-
ognized as impracticable in all except the well-marked cases.
' (b) That extremely small amounts of milk from cows suf-
fering from udder tuberculosis are sufficient to produce tuber-
134
culosis experimentally in animals when administered by inocu-
lation.
(c) That tuberculosis can be induced with varying degrees
of readiness in various animals by feeding tuberculous milk
(i.e., milk from cows suffering from tuberculosis of the udder),
and, what is more significant, in none of the considerable series
of animals so tested by the British Royal Commission did this
occur more readily than in the anthropoid apes, their relative
susceptibility bemg much higher than that of calves.
(d) That samples of unselected raw market milk taken at
random from the city milk supplies of many European and -
American cities have been proved by the work of many in-
vestigators to contain virulent bovine tubercle bacilli in from
2 to 50 per cent. of samples taken, with an average of between
10 and 20 per cent. probably predominating.
Without going into any details, it is obvious that there are
only two conceivable general lines of action that will be prac-_
ticable in coping with the problem of minimizing or eradicating
the danger of bovine tuberculosis to the human race. They
are either the practical extermination of bovine tuberculosis,
or such universal treatment of cow’s milk as would render it
safe and inocuous from the standpoint of transmitting tuber-
culosis, even though it may originally have contained more or
less tubercle bacilli. As a practical procedure it is, of course,
necessary that both lines of action be followed.
The struggle against bovine tuberculosis among dairy herds
is a subject that does not strictly pertain to this report, inter-
esting though it would be to review some of its more salient
features. It must be admitted that up to the present time the
total progress in this line, while by no means negligible, cannot
be. considered as sufficient to give us any sound basis upon
which to base any hope of eliminating the menace of bovine
tuberculosis by this means in the near future. Certain im-
portant subsidiary measures should never be neglected, such
as careful veterinary inspection of herds to rule out tuber-
culosis of the udder, and insistence upon such standards of
dairy cleanliness in general, and of clean methods of milk-
ing in particular, as will guarantee a minimum possibility of
tubercle-infected dung finding its way into the milk. But the
135
surest, most economical and quickest method that has ever yet
been devised to bring about the end in view, namely, the per-
fect safeguarding of the milk supply as regards bovine tuber-
culosis, is through the resort to the process of pasteurization.
Pasteurization in its relation to communicable diseases in gen-.
eral will be considered later. It is sufficient to make the defi-
nite, emphatic statement here that pasteurization properly per-
formed will undoubtedly remove all danger of transmission of
- tuberculosis through milk.
2. Methods of Infection of Milk by Diphtheria, Scarlet Fever,
Septic Sore Throat and Typhoid Fever.
That milk is a most favorable medium for the growth of
specific organisms of certain infectious diseases of man has been
demonstrated by Eyre. He found that typhoid bacilli were
multiplied in healthy cow’s milk 6,000 times in twenty-four
hours, while diphtheria bacilli increased more than 1,000 times
during the same period. However, this experimental work was
done upon milk obtained under sterile conditions. Your Board
has not found any reliable data upon the amount or rate of
increase of pathogenic bacteria in unsterilized milk under or-
dinary conditions of temperature. It can be readily seen that
in the presence of the many non-virulent types of bacilli found
practically universally in raw milk, the question of determining
just how rapidly growth of disease-producing bacteria occurs is
practically insoluble. The presence of acid-forming bacteria in
milk checks their growth, but cannot be relied upon to kill any
contained typhoid bacilli (Savage). Their viability has been
- determined by Hesse and Field, who found the typhoid bacilli
to survive as long as four months in sterilized milk. It is,
therefore, readily seen how small particles of infection conveyed
to milk may infect large supplies in the mixing and handling,
and in turn may infect susceptible individuals who drink the
raw milk. Of the infection of milk from human sources there
is now abundant evidence. Rosenau writes that “the more
serious infections in milk come from human origin.” It may
be conveyed directly or indirectly. Typhoid infection may be
conveyed directly to the milk by the person taking care of the
patient, whose other duties, after taking care of the patient
136
and handling soiled bed linen, include the care and handling
of milk. A source determined in recent years to be quite com-
mon is the carrier or person who shows no symptoms of the
disease, but whose excreta contain the infection. These find-
ings have been duplicated so, many times now as to become
commonplace. Twice in this State during the present year has
the same point been completely determined, — in one instance
in a carrier who had the disease five years previous, and in the
other in a carrier who had the disease at least thirty-five years
previous. Lumsden and Woodward cite an‘instance of a woman
milker on a dairy who had typhoid fever eighteen years before:
the outbreak which was attributed to her. Typhoid bacilli
were found in large numbers in her feces. No other source
could be found to account for the infection in the milk.
Still another source of direct infection comes from the con-
valescent whose feces and urine still contain the bacilli, and
who is not sufficiently isolated from the milkers or others han-
dling milk.
Indirectly, typhoid infection may get into the milk through
the medium of sewage-polluted water used for washing the
milk utensils, or by fraudulently adulterating the milk with
specifically polluted water.
Diphtheria infection of milk most usually occurs directly
from persons engaged in milk production or in the handling
of milk while suffermg with a mild or unrecognized form of
the disease; or by persons similarly employed who show no
symptoms of the disease, but who carry the bacteria in the
nose and throat; or by such persons coming in contact with
milkers or others handling milk. Bacteriology now plays an
important réle in the discovery of milk-borne epidemics. Out-
breaks have occurred where persons employed as milkers, upon
bacteriological examinations have shown the presence of viru-
lent diphtheria bacilli in their throats. Klein, through experi-
ments, has tried to show the possibility of bovine diphtheria,
but practically all the present-day authorities hold that there
is no evidence that the diphtheria bacillus is ever of bovine
origin. That teat ulcers may be secondarily infected with diph-
theria bacillus by milkers has been demonstrated. Dean and
Todd in 1902 described a small outbreak in which diphtheria
bacilli were isolated from the teat lesions and from the milk.
137
Through human channels the virus of scarlet fever may be ~
introduced into the milk in similar ways to that of diphtheria.
The usual way is from an unrecognized case coming in contact
directly or indirectly with the milk supply. Harrington records
an extensive outbreak as being caused by a man employed to
taste milk, who used the same spoon in sampling each lot of
milk. The daughter of this man was found to be desquamating,
and he himself showed symptoms of the disease. The possi-
bility of bovine infection with scarlet fever has been studied
by Klein in connection with the Hendon outbreak of 1885, and
while his views were favorable, they have been strongly op-
posed by other observers. Rosenau states that “Cows do not
have typhoid fever, diphtheria or scarlet fever.”
As to the possibility of bovine streptococcus infection being
the cause of septic conditions in the throat of man, Theobald
Smith states, “There is at present no satisfactory evidence that
bovine streptococci associated with mastitis or garget are the
agents of tonsillitis in man.” From the results of certain ex-
' periments conducted by Savage, it is suggested that under
ordinary conditions bovine streptococcus mastitis is not a cause
of human disease. Rosenau says, “It is assumed that the in-
fection usually gets into the milk from human sources, although
it is suspected that streptococci eliminated by diseased udders
may be responsible for some outbreaks.” Milk-borne outbreaks
of septic sore throat in this country, after careful investiga-
tion, have failed to disclose any disease of cows sufficient to
account for the infection.
3. Communicable Diseases of Minor Significance or Relative
Infrequency, in which Milk is concerned as an Agent of
Transmission.
Although there are several other communicable diseases,
which are transmitted through the medium of infected milk,
tuberculosis, diphtheria, scarlet fever, typhoid fever and septic
sore throat cdmprise all the communicable diseases of man, in
whose transmission cow’s milk ever becomes an important fac-
tor, that are of any practical importance in the State of
Massachusetts.
138
4, The Evidence available as to the Relative Importance of
Milk as a Means of Transmission of Communicable Diseases,
as compared with Other Means of Transmission.
Incidental reference has already been made to this part of
the public health problem of milk in considering the individual
diseases, but certain generalizations on this point are needed
to make the exact status of the problem clear.
One point, and only one point, can be considered as settled,
viz., that cow’s milk from either animal (e.g. in tuberculosis)
or human (e.g. in typhoid) sources may, and more or less fre-
quently does, become infected, and thereby under certain con-
ditions subsequently becomes the causative factor in the trans-
mission of such diseases to man. But the all-important ques-
tion in this connection at once arises as to just how great a source
of danger milk is in this respect under our present conditions.
It is not very flattering to the present condition of American
epidemiology to be obliged to report that it is impossible to
give even a roughly approximate estimate upon this extremely
important and practical point.
One point that needs to be firmly kept in mind is that prac-
tically all of our present information, with one or two notable
exceptions, relates to milk as a disease factor wnder epidemic
conditions only. No State in the United States makes a suf-
ficiently careful study of its communicable diseases to give a
reliable basis upon which to form any opinion in regard to the
relative importance of infected milk in the occurrence of the
so-called sporadic or isolated or endemic cases of typhoid, diph-
theria or scarlet fever.
Tuberculosis is a disease that is never epidemic; in all cir-
cumstances it must be regarded as of sporadic or endemic
origin. The reasons why as yet it is impossible to state with
any degree of certainty the possible maximum effect of tubercle
bacilli infected milk upon the prevalence of human tuberculosis
have already been explained. But all of the othgr serious com-
municable diseases of man that, so far as we know, are in part
spread through infected milk occur in both epidemic and en-
demic or sporadic form.
Looking at the problem of the relation of milk to the public
health in its entirety, in order to give it its proper weight and
139
proportion compared. to other health problems, it is highly de-
sirable to know just how great a factor in both the epidemic
and endemic occurrence of typhoid, scarlet fever, diphtheria
and septic sore throat infected milk actually is. Obviously, if
it were possible to prove, or even if it were possible to deduce
strong presumptive evidence to indicate that milk infection is
a 75 per cent. factor in the total incidence of these diseases,
then our obligations to the public health would justify, even
demand, the advocating of prophylactic measures much more
drastic and expensive than would be indicated if, on the con-
trary, infected milk could only be demonstrated to be respon-
sible for 1 or 2 per cent. of the total incidence of these same
diseases.
In the one instance almost any expense and stringency of
sanitary regulations could be justified, for by their vigorous
application there would be every opportunity to rapidly de-
crease the prevalence of these diseases to such an extent as to
render their total suppression a reasonable prospect in the im-
mediate future.
In the other instance there would be no such justification
from a public health standpoint. To make the point clear, let
it be assumed that it had been proved that only 1 per cent.
each of the total number of cases of typhoid, diphtheria and
scarlet fever were due to infected milk; obviously, under such
conditions, the expenditure of enough money and energy to
totally eradicate milk as a source of infection, while a desir-
able object in itself, would have a scarcely appreciable efiect
upon the general typhoid, diphtheria and scarlet fever prob-
lem, and it is highly probable that the same amount of money
and energy directed against other angles of the typhoid, diph-
theria or scarlet fever problem might bring incomparably
greater results in decreasing their prevalence.
Because of the great practical importance of these factors
your Board has endeavored diligently to ascertain what, if any,
reliable data could be obtained upon this point, both within
the Commonwealth and elsewhere. The total information ob-
tained is exceedingly incomplete, but perhaps throws some light
on the problem. |
\
140
(1) EvipENcE as TO THE RELATIVE IMpoRTANCE OF MILK
INFECTION IN THE TRANSMISSION OF CERTAIN COMMUNI-
CABLE DiIsEASES OF MAN BASED ON THEIR OCCURRENCE
IN EPIDEMICS.
It has become quite the fashion of late years among writers
in discussing milk to remark that the importance of milk in
connection with typhoid, scarlet fever, etc., has been until very
recently underestimated. Your Board feels that it is perhaps
not out of place to suggest the possibility that in the past four
or five years at least this tendency has been reversed, and that
to-day there is a strong tendency to overestimate the quanti-
tative, relationship of milk to the prevalence of these epidemic
diseases. }
An interesting example of this probably unconscious tendency
is the following: In 1907 it was reported that out of a total of
18 outbreaks of typhoid fever investigated during the two years
immediately preceding by the Massachusetts State Board of
Health, 14, or 77 per cent., were due to infected milk. In the
years 1910-14 (inclusive) the same Board investigated a total
of 86 outbreaks of typhoid, which were all that came to the
attention of the Board, and presumably represent practically
100 per cent. of all epidemics or outbreaks of any consequence
occurring in the State, but found only 31, or 36.4 per cent., due
to infected milk. Apparently, either the conditions of the milk
supply of the Commonwealth have greatly improved in this
respect, or two years did not cover enough time to give a fair
average, or, aS is more likely, in the earlier series too much
emphasis was placed upon the investigation of outbreaks that
were suspiciously indicative of milk infection from the start.
It is very easy to pile well-proven epidemic on well-proven.
epidemic to demonstrate that milk does transmit epidemic dis-
eases. As far back as 1908 Trask was able to collect 493 epi-.
demics of typhoid, diphtheria and scarlet fever in which the
evidence was conclusive that the cause was infected milk. An
enormous number of similar outbreaks have been reported since,
ample to prove that the danger of milk transmission is serious
and real; but epidemics do not tell the entire story. Although
epidemics furnish the spectacular element: in communicable dis-
141
ease work, their total percentage importance is not to be com-
pared with that of the sporadic cases.
Out of a total of 240 epidemics and outbreaks of typhoid,
scarlet fever, diphtheria and septic sore throat, due to all causes,
investigated by the State Board of Health of Massachusetts
during the years 1910 to 1914, the total number of cases given
by the investigators is 3,198. But in some instances no state-
ment as to the total number can be made, and in many more
instances a number is given with the qualification that the
number is incomplete. Even if we assume that there actually
were aS Many more cases attributable to these outbreaks as
are given, the total number would not greatly exceed 6,000.
But in the same years a total of 85,958 cases of these same
diseases were reported. Since, during these years, practically
every disease outbreak of any material proportions in the Com-
monwealth has been the subject of a special investigation by
the State health authorities, and not over 6,000 cases, at an
outside estimate, can be attributed to these outbreaks, it would
follow that the endemic prevalence of these diseases is in the
aggregate of vastly greater public health significance than the
more spectacular epidemic prevalence, — in this instance at
least fourteen times as great.
The following tabular comparisons based on Massachusetts
investigations are of interest in this connection: —
Summary of Epidemiological Investigations by the State Inspectors of Health
of Massachusetts for the Five-year Period, 1910-14, inclusive, with
Reference to Frequency of Milk Transmission. i
(1) Diphtheria.
, Du
Year. Bumberot | Bent? | to Other | waetaoees
POUL ier) ic iho Mana 4 2 4 =
MOU et ies, cc ha Caen 13 1 12 oil
hy A SA MORI ONE Sf 1269 a 9 1 8 11.0
GR eee ay cee Vk Og wy ener a 9 - 9 -
OC SRAM MERE NSC Me MAINA in 2 26 = 26 -
Totals, . : : a : : 61 2 59 One
142
Summary of Epidemiological Investigations by the State Inspectors of Health
of Massachusetts for the Five-year Period, 1910-14, inclusive, with
Reference to Frequency of Milk Transmission — Concluded.
(2) Septic Sore Throat.
Year. ene | aeue. ane
1STO Ses 6 o 0 5 5 = = = -
LOT eis : : f A 6 : 1 1 = 100
1912, - : é 6 2 = = = =
1913, . c : a : 2 ; 3 2 1 66
1914, . 3 : : B é ; 2 1 1 50
Totals, . ‘ 6 Sites i 6 4 2 66
(8) Scarlet Fever.
LOTS. : 5 C ‘i 5 : il 1 10 9.0
LED Te SNe eae ae Maa 10 1 9 10.0
1912, . : : 2 j a : 8 2 6 25.0
HIG é 5 5 Fi 5 z 23 1 22 4.3
1914, . c ; 3 : i A 35 2 33 6.0
Totalspe eeirehae |! siete wna Seay 7 80 8.0
(4) Typhoid Fever.
1910, . E ‘4 A z 5 “a ali 10 5 66.6
LOD 2 ‘A a 5 0 i 11 2 9 18.2
1912; o 5 2 E 3 6 3 3 50.0
OTS ae f 3 5 ¥ 31 8 23 25.8
1914, . 4 é 2 4 ° ‘ 23 10 13 43.5
Totals, . : 7 4 : 5 86 ae 33 “a 53 38.4
Grand totals, all epidemics, 5 i 240 46 194 19.2
‘In the above tabulation the incidence of more than one case
in different families in the same locality at the same time is
classed as an epidemic or an outbreak, with the natural effect
that, with three or four exceptions, the average number of
cases per epidemic is small. There have been many small out-
breaks where no suspicion has been raised relative to the milk
supply that have been handled wholly by local authorities, and
143
concerning which no epidemiological information is recorded in
the State Department of Health. This fact does not invali-
date the significance of this table, because for several years
past it has been the fixed policy of the Department (Board)
to investigate every case of contagious disease reported from
a milk-producing farm, as well as every outbreak whether in
a large or small community where milk was at all under sus-
picion. Therefore a fuller table would only tend to lessen the
percentage of milk-borne epidemics.
In the same connection it is interesting to note that in the
five years 55 other investigations were made by the State
Health Inspectors in instances when a single case of contagious
disease was reported from a milk-producing farm, and precau-
tions ordered and observed, with no secondary cases of any
nature subsequently occurring.
In 1910 sworn testimony was given by Prof. C. E. A. Wins-
low before the milk investigating committee of the Legislature
(and we have found no contradictory testimony on this point)
that in less than four years five epidemics due to milk had
resulted in 70 cases of diphtheria, 700 cases of scarlet fever,
and 557 cases of typhoid fever in Boston and its immediate
vicinity.
From a combined source of data (consisting of (a) replies to
a questionnaire sent to the local boards of health and (b) an
analysis of the investigations of outbreaks of infectious diseases
made by the State Inspectors of Health) in Greater Boston,
there can reasonably be attributed to infected milk during the
six-year period, 1909-14 (inclusive), 6 cases of diphtheria, 845
cases of scarlet fever, 1,000-+ cases of septic sore throat and
365 cases of typhoid. Thus, in five epidemics occurring between
January, 1907, and July, 1910, 1,397 cases of milk-borne infec-
tious diseases occurred in Greater Boston, while in the same
locality in the six-year period, 1909-14 (inclusive), from all
available sources, 2,210-+ cases of typhoid, scarlet fever and
septic sore throat have been traced to milk.
When it is recalled that by far the greater portion of Greater
Boston’s milk supply is from pasteurized sources, and that all
these cases proved to have been due to comparatively small
raw milk supplies, the seriousness of the milk problem, as it
144
pertains to the occurrence of the diseases in question, cannot be
denied or ignored.
At one time we contemplated making a similar analysis for
the same period of the milk-borne epidemics in comparison with
the total number of epidemics of these same diseases reported
by those States having the most complete communicable dis-
ease reporting systems. Correspondence with the epidemiolo-
gists of various States indicated that such data were not in
readily available form in any of them, and distance and lack
of time have prevented us going any further into this most
interesting and suggestive line of investigation.
A‘ careful, although by no means exhaustive, search of English
references throws no light upon the subject, although we rather
suspect that such data may be available. We have made no
examinations in reference to this point into Scandinavian con-
tributions to the milk question, and consider that any search
into the data available from other European countries, aside
from Great Britain and Scandinavia, would be time wasted
because of (a) the widespread use of goat’s milk in many parts
of the continent milked in containers furnished by the con-
sumers at the consumer’s door, and (6) an almost universal
European practice of boiling the milk as a sanitary precaution.
(2) EvipENcCE as To THE ToTaL RELATIVE IMPORTANCE OF
Mik INFECTION IN THE TRANSMISSION OF CERTAIN CoM-
MUNICABLE DiIsEASES OF MAN BASED ON THEIR OccUR-
RENCE IN ENDEMIC OR SPORADIC FORM AS WELL AS IN
EPIDEMICS.
Although diligently sought, practically no authoritative data,
in our opinion, can be obtained at present upon this important
point. Moreover, such statements, generalizations, inferences
and hypotheses as are found in milk literature bearing on this
subject are not only resting on far from conclusive epidemio-
logical foundations, but are in many instances rather contrary
to such fragmentary epidemiological evidence as we have been
able to uncover.
It is easy to see that the temptation to make out the case
against milk as strong and startling as possible, buttressed by
145
the spectacular corroborative evidence of the milk-borne epi-
demic, has had a tendency to produce these sweeping state-
ments and charges in regard to milk infection. __
It is an interesting reflection upon the inadequate develop-
ment of practical disease-preventive measures in this country
to note that the routine machinery of no State and of but few
city health departments is at the present time developed to
such a comparatively modest degree of efficiency as will enable
them to make routine investigations into the reported cases of
these diseases, known to be at times milk borne, sufficient to
bring out whether or not milk should be considered as a certain
or probable sourcé of infection in any given case or group of
cases.
In the course of its investigations this Board has made a
careful and, we believe, a fairly representative study of the
best available modern milk literature, with special reference to
its bearing upon infectious diseases, infant mortality and the
gastroenteritides of children.
We have been forcibly struck with the casual, elusive and
vague character of statements which continually recur relative
to the proportional significance of infected milk to these dis-
ease conditions.
The literature of milk, when it comes down to this concrete
problem, either ‘admits the total inadequacy of present data
on the relative significance of milk infection in disease trans-
mission, or is discreetly silent, or more often takes refuge in
indefinite and elusive generalizations.
In attempting to arrive at some conclusions in this matter
the following sources of evidence have been carefully con-
sidered: —
(a) Replies to a questionnaire sent to Massachusetts cities
and towns. :
(b) Written and verbal statements of the epidemiological
authorities of various States.
(c) The reports of the special typhoid board of the United
States Public Health and Marine Hospital service in the Dis-
trict of Columbia (1906-10).
.(d) The evidence of the records of the Boston City Health
146
Department supplemented by the evidence of the records of
certain other Massachusetts cities.
(e) Epidemiological résumés of the New York City Health
Department, with special reference to milk, including the resid-
ual typhoid theory, by Dr. M. L. Ogan of the New York City
Health Department. |
(7) “Milk and its Relation to the Public Health” (United
States Public Health and Marine Hospital Service, Hygienic
Laboratory Bulletins Nos. 41 and 56).
(g) Miscellaneous works on milk, or incidental references to
milk in connection with communicable disease by American and
foreign authorities other than above (practically all English).
(a) Reples to a Questionnaire sent to Massachusetts Cities and
Towns.
Owing to the fact that Massachusetts local boards of health
are required by law to report to the State health authorities
only the names, addresses, diagnoses and dates upon which
cases of infectious diseases are reported to them, and that the
routine notifications to the State Health Department are limited
strictly to this information, the records of the Massachusetts
State Health Department throw no light whatever upon the
question under discussion. Thinking that a statement cover-
ing the entire State, based on the records of the local boards
of health, would throw some light on the problem, your Board
prepared and sent out in July of this year a circular question-
naire to all of the local boards of health in the Commonwealth.
Owing to very incomplete replies a second letter, explaining a
little more in detail the purposes of the inquiry, was sent to
those cities and towns that had failed to reply in July. (See
Appendix B.)
The form ,of the questionnaire was extremely simple. A
statement was requested of the total number of cases of typhoid
fever, diphtheria, scarlet fever and septic sore throat reported
to the local board during the five-year period, 1909-13; of the
number recorded as due to milk infection following investiga-
tion by the local board; the number suspected of being milk
borne without conclusive evidence being obtained; the total
number of deaths from the same diseases in the correspond-
147
ing period, and the number of such deaths attributed to milk
infection.
When we consider the widespread interest relative to the
connection between the milk supply and the public health that
has prevailed in this Commonwealth for some years past, and
the amount of public agitation that has arisen in relation
thereto, it must be confessed that the total returns from this
questionnaire were somewhat disappointing. It was sent out
merely as a means of obtaining the facts relative to milk and
communicable disease prevalence, and of supplying information
that the State health authorities had no other means of pro-
curing, and we had. mistakenly anticipated a very complete
response. However, whether from procrastination, thoughtless-
ness or a deliberate intent not to co-operate in this matter, one
city and 156 towns, representing in all a population of 556,554,
or about 16 per cent. of the total population (Census 1910),
failed to make any reply or acknowledge receipt of the two
requests up to date.
Of the entire group of cities and towns replying, 34 cities
and 162 towns, respectively, representing a population of
2,809,862 (Census 1910), or 84 per cent. of the State, the
greater majority replied in full, A number of the smaller
towns, however, simply replied “no records.” We have been
somewhat in doubt whether to interpret this reply as meaning
that these boards of health actually kept no records of com-
municable diseases, or whether it meant that in the period
covered no cases of the diseases concerning which information
was sought had been reported.
Forty towns, having an aggregate population of 50,134, state
that no cases of these diseases due to any causes have been
reported in this period to their local boards of health. Inas-
much as the “no record”’ towns and “no cases” towns are all
‘comparatively small, it may be reasonably inferred that at
least no outbreak of these diseases could have occurred in any
of them during the period under inquiry, for such an occur-
rence would have been practically certain to have become a
matter of record in the local board of health office. It is also
true that in .practically all of these towns the machinery of
milk production and distribution is extremely simple.
148
The remaining 102 towns and the 34 cities — answering the
questionnaire represent a total population of 2,703,759. They
report as follows: —
Total Num-
Cases due Cases Milk
DISEASES. be oer 2 to Milk. suspected. !
Typhoid fever, : i i : A ‘ 11,282 553 135
Diphtheria, . 5 2 s s ‘ : 31,866 11 49
Scarlet fever, . : i : : : : 31,012 495 57
Septic sore throat, . ; - : : : 2,436 1,914 -
Totals, i 3 : : : f ; 76,596 2,973 241
SS TE
Total Num- :
Deaths due Deaths Milk
DISELEIDS: cde Ae veut suspected. }
Typhoid fever, . ; : F : ‘ 1,425 37 8
Diphtheria, : ¢ i ‘ é 6 2 2,580 1 1
Scarlet fever, . : 4 ‘ : i 991 8 -
Septic sore throat, . : : : : 4 49 | 48 -
Mo tals Wap ec Me ree Ea Ok eee 5,045 | 94 9
Analysis of these totals demonstrates that in only 0.03 per
cent. of cases has the transmission of diphtheria been definitely
assigned to infected milk, and in only .19 per cent. was milk
either proven or suspected; 1.6 per cent. of the reported cases
of scarlet fever have been definitely attributed to milk infec-
tion, and 1.8 per cent. proven or suspected; in 79 per cent. of
the cases of septic sore throat (not reportable until 1914) milk
was assigned as the cause; in 5 per cent. of the cases of
typhoid milk was definitely assigned as the cause, and in 6
per cent. milk was either proven or suspected to be the agent
of infection in this disease. Taking all of these diseases in
a group, 3.9 per cent. were definitely attributed to milk, and
in 4 per cent. of all the cases milk was proven or suspected.
Considering mortality, 3 per cent. of typhoid deaths are possibly
attributable to milk, 0.08 per cent. of diphtheria deaths, 0.8 per
cent. scarlet fever deaths, 98 per cent. septic sore throat deaths;
an average for the whole group of 2 per cent. of, the deaths
may be attributed to infected milk.
1 “Suspected’’ here means that milk was considered to be the probable source of infection,
but was not conclusively proven.
149
(b) Written and Verbal Statements of the Epidemiological Author-
ities of Various States.
Specific information upon the point under discussion, 7.e., the
endemic prevalence of milk infections, was sought from the
epidemiological authorities of the States of New York, New
Jersey, Pennsylvania, Maryland, Minnesota and Kansas. (See
Appendix D.) These States were selected because they, and,
as far as we are aware, they only among the several States,
have communicable disease reporting systems analogous to the
Massachusetts system. In fact, the morbidity reporting sys-
tems of these States, which place im the hands of the State
health authorities the individual case reports of communicable
diseases; are supposed to furnish more direct epidemiological
data than does the Massachusetts system. But, as was the
experience in relation to the epidemic prevalence of milk-borne
infections, none of these States was in a position to furnish
even roughly approximate quantitative returns. A résumé of
the replies follows: —
Kansas (correspondence only). — Reported only two epidemics trace-
able to milk on record, but stated that others have occurred. Could fur-
nish nothing as to endemic frequency of milk infection.
New Jersey (correspondence only). — Furnished nothing on endemic
frequency of milk infection. Referred to several interesting milk-borne
epidemics.
Pennsylvania. — No reply.
Maryland (correspondence and verbal) (See Appendix). — Furnished
no data relative to the endemic factor of milk in their diseases. Stated
that they have had eight outbreaks of typhoid, aggregating 390 cases,
which were milk borne, from 1884 to date, and one of septic sore throat
in 1912, involving somewhere between 1,000 and 3,000 cases.
- New York (correspondence and verbal). — Gave some interesting
epidemics, some of considerable extent, of all the diseases under con-
sideration. Stated that as yet no analysis of endemic prevalence had been
made by examining either the records of local boards of health, or by
analysis of the original reports received from physicians on file in the
Communicable Disease Division of the State Health Department, but
expressed an opinion that such a study might be profitably made.
Minnesota (correspondence and. verbal) (See Appendix). — The exact
language used in replying to our letter of inquiry by the director of the
Division of Preventable Diseases of the Minnesota Board of Health is
as follows: —
o 450
In endeavoring to comply with your request regarding instances in which milk
has been implicated in the transmission of scarlet fever, diphtheria and typhoid
fever I am somewhat disappointed. Dr. Greene was kind enough to go through
the records of the division very carefully from Aug. 1, 1909, to date. He made a
card index of reports where it seemed that milk might have been a factor in the
spread of infection. I have personally gone through all these reports. While many
of them indicate that milk was a factor to some extent in the spread of disease, only
in a few was milk the chief route of infection, or definitely proven to be even an
active factor. I may say that in several epidemics which I personally investigated
there was strong circumstantial evidence indicating that milk was the main route
of infection. However, careful investigation proved that appearances were de-
ceiving, for it was readily shown that the milk could not have been infected, and
the cases suspected to be milk infections were traced to direct contact with known
cases at a time which would fully account for the infection.
In addition, reference was made to a considerable number of
true milk-borne epidemics, including one of typhoid which was
due to butter, another, also typhoid, due to both milk and
cheese, and five other milk-borne typhoid outbreaks, two diph-
theria outbreaks, one each from milk and butter, and one definite
and three doubtful milk outbreaks of scarlet fever. In personal
interviews the director of the Minnesota Division of Preventable
Diseases expressed a strong skepticism as to the comparative
frequency of milk infection in both sporadic and epidemic cases
of these diseases. wa
(c) The Reports of the Special Typhoid Board of the United
States Public Health and Marine Hospital Service on. the
Origin and Prevalence of Typhoid Fever wn the Dustroct of
Columbia (1906-09).
Although these reports deal exclusively with typhoid, yet
they have a very great significance because of the exceptional
thoroughness with which the epidemiological studies were made,
their continuance through a series of years (four), sufficient to
offset to some degree the exceptional factors of any single year,
and the fact that the results of this study have in a general
way passed current for several years among American sani-
tarlans as an approximately correct index to the relative im-
portance of milk infection to the spread of typhoid. In trying
to arrive at a fair and just appreciation of the significance of
their results, three facts need to be borne in mind.
1. That the total number of milk-borne cases of typhoid re-
ported upon in this series are explicitly stated to be all cases
occurring under epidemic conditions; in fact, to have been due
151
to six well-defined epidemics. It is striking that such a small
number of localized milk-borne typhoid outbreaks should have
produced so high a percentage of the local typhoid.
2. That while the percentage of cases, attributed to milk
transmission, for the first three years are all approximately 10
per cent., the fourth year the percentage drops abruptly to 2.2
per cent. \
3. That the great proportion of cases unaccounted for may
or may not have contained a considerable number of cases in
which the infection was milk borne. If so, and af the milk epi-
demics occurring in the three earlier years represent a jaw average
of the relative frequency with which milk-borne infections occur,
the relative importance of milk-borne infection in typhoid is
high. Jf the contrary be true, its relative significance com-
pared to contact, or water, is perhaps quite small.
Although these studies relate to District of Columbia con-
ditions exclusively, the conclusion is unescapable, although they
nowhere definitely express such an opinion, that these investi-
gators are strong adherents of the view that milk is a very
great factor, relatively speaking, in the transmission of Ameri-
can urban typhoid. We particularly value their evidence be-
cause it rests on a basis of careful epidemiological work, and
is, together with Ogan’s New York City work, the only evi-
dence we have found that is at all reliable pointing towards a
substantiation of the relatively high milk factor that has been
so commonly, not to say recklessly, assumed by so many
authorities.
The unqualified fashion in which these investigators commit
themselves to this “high milk-borne percentage” theory of
typhoid transmission can be clearly seen by the following
statements: —
Since so many cases occurred in the course of definite and readily
recognizable milk outbreaks, it is almost certain that a number of scattering
cases, probably aggregating more than the number definitely attributable to
milk-borne infection, resulted from milk-borne infection.
: And again: =
In each of the four years the cases attributed to milk-borne infection
' comprised only the cases which occurred in the course of pronounced
-
152
outbreaks among the customers of certain dairymen. In view of the
way in which the bulk of the milk consumed in Washington is handled,
it may be logically surmised that the proportions of cases caused by milk-
borne infection were considerably larger than the figures in the summary
indicate.
Whether the Washington experience can be assumed as fairly
typical for American cities is another question. It is interest-
ing to note that although these investigators, reporting on a
population of approximately one-third of a million, found six
distinct milk-borne outbreaks in a space of four consecutive.
years, the Maryland State Board of Health, reporting for a
population approximately a million greater, only recorded a
total of eight milk-borne typhoid outbreaks in thirty-one years.
Since Maryland all but surrounds the city of Washington, cli-
matic, social and racial factors are fairly comparable, and even
though it be conceded that a great many outbreaks have been
overlooked by the Maryland authorities, as is undoubtedly the
case, yet it at once raises the question as to whether the three
years 1906, 1907, 1908 may not have represented unusually
high years for milk-borne typhoid outbreaks in Washington.
The investigators apparently unhesitatingly assume that the
low percentage of infection definitely attributable to milk dur-
ing 1909 (2.2 per cent. in contrast to the average of 10 per
cent. so accounted for during the three years previous) can be
explained entirely by improvement in the milk supply, or, to
quote their own words: “The number of cases definitely at-
tributable to milk-borne infection was considerably smaller in
1909 than in any of the three previous years, and it appears
quite probable that the decrease in the typhoid rate in Wash-
ington since 1906 has been due in part o che improvement in
the city’s milk supply from year to year.”
No data are given to indicate upon what ground the gene
ment relative to the improvement in the city’s milk supply is
based, but inasmuch as the percentages of the milk-borne cases
for 1906, 1907, 1908 are remarkably even, and the 1908 per-
centage exceeds, although only by a fraction, that of 1907, it
is a little difficult to deduce from this just where the improve-
ment “from year to year” was manifesting itself in such a
fashion as to explain the 75 per cent. “frequency drop” of
153
1909, and we respectfully suggest that these consecutive “high
percentages”’ years may have been of themselves an anomaly.
Every analysis of the six outbreaks listed by these in-
vestigators discloses several interesting facts. In +1908 one
distinct outbreak is recorded involving 52 cases. This out-
break was followed up, the carrier detected, typhoid bacilli iso-
lated from her feces, sale of milk from her premises stopped,
and the outbreak abruptly terminated. This outbreak cer-
tainly fulfilled the most exacting epidemiological requirements
of proof.
In 1909 the single outbreak attributed to milk failed of con-
firmation by application of laboratory methods for detection
of carriers to all who had to do with the milk, although the
circumstantial epidemiological evidence was very strong.
In the other four epidemics, so far as the evidence appears,
the only basis for classifying these groups of typhoid fever as
distinct milk outbreaks was the suspicious frequency of the
occurrence of typhoid cases upon the routes of certain dealers.
We admit that this reasoning is plausible, but in the absence
of any statement as to past epidemiological history of milk
producers on the farms and the dairy employees distributing
these milks, and in the absence of any laboratory confirmative
work, we consider that the conclusions do not rest upon suf-
ficiently sound epidemiological proofs to consider them as fairly
attributable.
Therefore, in all, we find but one of these six outbreaks com-_
pletely proved (the carrier case in 1908). The other five out-
breaks, which the authors consider as positive outbreaks, all
present gaps in evidence of more or less serious nature.
Another extremely interesting observation by the authors is
the following: In the last year reported they state that 4
dairymen, all doing a relatively large business, were that year
pasteurizing their milk, and they make the observation that
1 of them had practiced pasteurization for the whole period
(four years); 2 only began in the middle of 1908; and 1, July
1, 1909. They present a table showing that the number of
eases on these three dealers’ routes per 100,000 gallons of milk
distributed had shown a sharp decline since inaugurating pas-
teurization. This argument is rather weak, in our opinion, for
154
the periods both before and after pasteurization are too short
to justify any deductions as to the cause and effect connection
between pasteurization and typhoid incidence, although in the
case of the dealer who pasteurized throughout, and consistently
had low incidence per 100,000 gallons, the argument may be
given some weight.
The rates of typhoid incidence per 100,000 gallons of milk
distributed, given year by year for the three dealers, are as
follows (the heavy-faced figures indicate time when pasteuriza-
tion began): —
| No. 3 | No. 4 | No. 8
1906, 3 “ 4 5 § 2 ; . 16.6 52.5 35.6
1907, 5 i 6 pi . ‘ : 7.1 21.6 iWfaat
1908, 3 5 3 4 : a 3 : 5.8 10.1 18.8
1909, - P i , i 5 : 1.4 7.0 6.9
It is possible to pick three other dealers, also selling large
amounts, who never pasteurized, and show the same sisi
tabular drops; for example: —
| No. 2 | No. 5 | No. 7
1906, i Ps 5 5 : ‘ PAUL BBS 35.0
1907, ‘ 3 i 5 j 2 23.4 15.6 13.6
1908, ‘ 2 } : 5 3 : ; 10.2 13.3 9.1
1909, : ; : i 5 i 5 : 4.2 8.0 7.8
.
The investigators seem to believe that their pasteurization ~
showing is strong corroborative proof of milk infection being
- a very important factor in the transmission of typhoid. If all
four of the dealers who pasteurized their product in 1909 are con-
sidered in a group, their total output is 799,000 gallons of pas-
teurized milk. They also had a total of 39 cases of typhoid
_on their routes. Presumably the majority of these, at least,
would be considered as due to other causes than milk by the
investigators. But if the 16 other dealers, whose total gallon.
outputs are similarly given, are considered as one group, an
159
interesting comparison ensues. In this group there is a total
output of 1,514,000 gallons of ‘unpasteurized wilk, and there
occurred 98 cases of typhoid on their routes. However, among
them is the one very small dealer (putting out only 7,000 gal-
lons in the period) on whose route occurred the outbreak of 13
cases, which have been considered by the investigators as un-
questionably milk borne. Deducting these, it leaves a total
of 85 cases to 1,507,000 gallons of milk distributed. But the
ratios .of 39 to 799,000 and 85 to 1,507,000 are substantially the
same. ;
We would not have our exceptions to their pasteurization
argument interpreted as meaning that we are skeptical as to
the value of efficient pasteurization as an agency in controlling
disease transmission through milk. We merely wish to point
out that, so far as the Washington typhoid series are concerned,
pasteurization was not applied long enough or generally enough
to fairly attribute typhoid reduction to its influence. This
mathematical comparison leaves the arguments of the inves-
tigators, in which they give the impression that milk infection
is a major although undeterminable factor in the spread of
the Washington typhoid of unattributed causation, rather up
in the air. For it is quite evident that they are citing the
progressive decline in the number of cases per 100,000 gallons
of milk distributed on, the routes of the dairymen practicing
pasteurization, after the institution of the practice, as inferen-
tial evidence that milk infection played a large part in the
transmission of typhoid on their routes before they began pas-
teurization. | :
(d) The Evidence of the Records of the Boston City Health De-
partment supplemented by the Evidence of the Records of
Certain Other Massachusetts Cities.
It is a source of regret to your Board that we did not earlier
realize the great possibilities of a more extensive quantitative
analysis of the records of communicable diseases of the large
cities of the country having well-equipped health departments,
in reference to the question of the frequency of milk transmis-
sion of disease. To make this study of most value, the precise
methods followed as to epidemiological and laboratory proce-
156
dure by each city would need to be clearly known, the relative
efficiency of reporting by physicians, the proportion of certified
and. pasteurized milk used and periods when introduced, and
above all, the basis upon which each department made its
routine classification as the channels of transmission. Studies
among cities of under 100,000 would not be of the same rela-
tive weight, because the total series could not be sufficiently
large to safely draw true relative deductions.
But we believe that carefully analyzed returns from city
health departments of such standards as those of Boston, Provi- .
dence, Baltimore, New York, Chicago, Seattle, and many others
where careful epidemiological and laboratory work is carried
out on every communicable disease case as a routine, would
throw a great deal of light upon this very dark subject.
Because of the fact that the records of the Boston City
Health Department have been immediately accessible to your
Board, we have had opportunity to appraise carefully the
methods of procedure upon which these classifications rest, and
the more we have gone into this subject, through conference
with the authorities of the Boston Health Department, the
more we have been impressed with the thoroughness and relia-
bility of their routine investigations of communicable diseases
as regards the demonstrable or probable sources of infection.
On these grounds, on account of the large aggregate number of
cases and the very evident high degree of co-operation on the
part of the practicing physicians of the city in reporting and
suggesting epidemiological clues to the health officials, we place
a very high degree of confidence in their returns.
According to the data furnished us by the Division of Com-
municable Diseases of the Boston City Health Department, out
of a grand total of 23,336 cases of typhoid, diphtheria, scarlet
fever and septic sore throat, recorded by the Department in
the five-year period, 1909-13, inclusive, only 1,132 cases have
been attributed to milk-borne infection, following careful epo-
demiological. investigations of each individual case. In Boston the
physicians practically never report a case of streptococcic throat
infection as “septic sore throat,’ except in the presence of a
milk-borne epidemic. Therefore the percentage of septic sore
throat among the milk-borne diseases is practically 100 per
cent. When this disease is excluded the relative proportions
157
are: total diphtheria, scarlet fever and typhoid cases, 22,536;
total cases of same diseases attributed to milk, 332. This gives
milk a total percentage importance among the total channels
of infection for these diseases for the city of Boston, for five
years, of approximately 1.5 per cent. If septic sore throat is
- included, the total percentage of cases due to infected milk for
the entire group of the four diseases rises to approximately
5 per cent.
- The most interesting point of all in connection with the
Boston experience is that all of these cases occurred in non-
pasteurized milk supplies. However, the number of dealers in-
volved in these non-pasteurized supplies are about 250, or 83
per cent. of the total number of dealers.
The percentage of pasteurized supply to the total supply
has considerably increased during the five years. The B°ston
Health Department estimates the percentage of pasteurized
milk (including cream) in these years to be as follows: — *
eS
| Por Cont. | Caylonszold
TOOT Rey VM PAT Se ENG) MR 30.68 22,297,722
SSL VP NGAP RC A HEHE OPM MR) a 49.90 23,150,125
Loe Rehr ct his’ <. oheememne 73.62 24,170,026
Td aera lel Dil eles et aa ASR aR Hi 70.59 24,745,423
FA ac ia ie aE oy te RS i a to eg Tle 80.63 27,635,785
Average, . : 4 i : , 6 i E : 62.63 24,499,785
The Boston authorities feel, and with good epidemiological
basis, that the extension of pasteurization has been a most
efficacious safeguard against the possible more extensive trans-
mission of outbreaks of the diseases under consideration through
milk.
But apparently, just as in the case of the Washington, D. C.,
typhoid series, it is scarcely justifiable to conclude that there
would of necessity have been a much greater occurrence of milk-
borne diseases in the city if the milk had not been so generally
‘pasteurized than actually was the case.
Seven other of the larger cities of Massachusetts — Fall
River, Pittsfield, Brockton, Lowell, New Bedford, Springfield
and Worcester—had in 1910 an aggregate population of
158
646,152. This population is fairly comparable to the popula-
tion of Boston in 1910, — 670,586. But only two of these —
Springfield and Worcester —have at present a considerable
percentage of milk pasteurized. Springfield has 38 per cent.
pasteurized; Worcester, 30 per cent.; Fall River, 14 per cent.;
Brockton, 8 per cent.; Lowell, 7 per cent.; Pittsfield, 0 per
cent. New Bedford states that practically none of the milk
supply of that city is pasteurized. This gives an average pas-
teurization of 19.5 per cent. for this group.
The total number of diphtheria cases returned during the .
same five-year period as definitely or possibly due to milk in-
fection for this group of cities is 0; of septic sore throat, 0; of
scarlet fever, 0; and of typhoid, 280. The total number of
cases of diphtheria, scarlet fever, septic sore throat and typhoid
returned by this group for the same period is 16,948. This
gives a percentage of milk-borne cases of these diseases (in this
sefies, all typhoid), for the five-year period for these cities, of
1.5 per cent., the same as the Boston percentage for five years
(omitting the septic sore throat cases) of 1.5 per cent. |
Such results as these were not in the least anticipated when
we began this quantitative study. We confess to surprise, even
astonishment at reaching quantitative results so far apart from
those generally current as to the relative frequency of milk
infection. What can such results mean? Do they mean that
milk outbreaks have been overlooked right and left by these
city departments? Very possible, but not probable. All of
these departments are considered efficient. If pasteurization
is as important as we have always been led to believe in stop-
ping the incidence of milk-borne infection, and if milk-borne
infections are anywhere nearly as frequent an occurrence in
non-supervised milk supplies as has been practically universally
assumed for years, then the relative percentage of milk-borne
infections in these cities from unmistakable outbreaks ought to
be materially higher than the percentage of Boston’s milk-borne
outbreaks, due in every instance to that city’s relatively small
raw milk supply. |
These points are suggestive: — |
First. — It is rather surprising to find that these 7 cities,
whose aggregate population is only slightly less than that of
Boston, report only about three-fourths as many cases of the
159
‘diseases under consideration from all causes. Whether this
means less efficient reporting by the physicians of these cities,
or an actual lower frequency of occurrence of these diseases
than in Boston, we are unable to determine accurately, but
we believe the latter rather than the former factor is princi-
pally concerned. |
Second. — If milk were in reality a considerable factor in
the causation of sporadic cases of these diseases there should
be a reflection of this effect in an increase of the general fre-
quency rate of these diseases, — the exact antithesis of what
. 1s found. |
Third. — Another possible explanation of this discrepancy in
the comparative frequency of incidence of diphtheria, scarlet
fever and typhoid in this group of cities, when contrasted with
Boston, may be their smaller concentration of mass of popu-
lation, with its concomitant lessened opportunities for contact
infection. :
Fourth. — For the most part the milk supply of these cities
is subject to the “short haul.” Just what relation this may
possibly have in reference to the transmission of communicable
diseases it is difficult to state, especially as all the dairies im-
plicated in the Boston series are also “short haul’’ dairies.
Fijth. — Nearly two-thirds of all the cases returned as due
to milk infection in this group are attributable to one carefully
demonstrated typhoid milk infection from a urinary carrier.
This again rather suggests that milk-borne typhoid, scarlet
fever and diphtheria are possibly essentially epidemic rather
than sporadic in nature; that possibly they occur only when
‘a certain complete chain of circumstances in reference to the
carrier or infected person and milk exists, permitting a rather
massive infection of the milk; and that these circumstances
do not occur nearly as often, in the aggregate, as we have
been led to believe from the spectacular and striking character
of the results when such infections do take place.
(e) The Residual Typhoid Theory of Ogan.
Probably no other city in the country makes as careful a
study of its communicable diseases from the standpoint of epi-
_ demiology as New York. Dr. M. L. Ogan, chief of the Division
of Epidemiology of that Department, has made some interest-
160
ing and suggestive studies as to the possible milk factor in the
transmission of typhoid in that city.
His results are particularly interesting, as he comes to the
conclusion that probably 30 per cent. of the endemic typhoid
in 1912—the last year before pasteurization became practi-
cally universal in New York —was due to infection through
milk. To abstract his own words, this conclusion was arrived
at by noting that one large company supplying 325,000 people,
or 12 per cent. of the population of Manhattan borough, had
among its patrons, using its milk exclusively, 111 cases of -
typhoid in 1912. At this ratio the whole population, had it
used this milk exclusively, should have had only 839 cases,
assuming that pasteurized milk could not transmit typhoid;
but from the whole population 1,184 cases were reported for
the year, hence there is left a residue of 345 cases, or 30 per
cent. of the whole, which according to this method of reasoning
(italics ours) are due to milk. The author then adds another
9 per cent. which was attributed —on good epidemiological
grounds, we assume, although the method or basis of classifi-
cation is not given —to milk-borne: epidemics, and concludes
that it is not unreasonable to attribute a total of 39 per cent.
of the borough’s typhoid of that year to milk (30 per cent.
endemic plus 9 per cent. epidemic). He then admits that other
factors might have had an effect in the reduction of typhoid
between 1911 and 1914 which is in all 53 per cent., mentioning
better oyster supply, better water supply, more stringent food
handling sanitary regulations, and advance in sanitary intelli-
gence on the part of the general public. He also states that
this method of computing the residual milk factor in typhoid
is open to some criticism, and in this last we are forced to
agree with him. ©
In brief, while we cannot but admire the ingenuity of his
reasoning, and have the deepest respect for the painstaking
epidemiological and laboratory work that lies back of it, we
cannot see that his conclusions are justifiable; too many other
possible factors still remain unexcluded.
161
(/) “Milk and us Relationship to the Public Health” (Bulletins
No. 41 and 56 of the Hygienic Laboratory, United States
Public Health and Marine Hospital Service, 1908).
This: report has a rather unique claim to authority among
the contributions to the literature of milk. It represents the
final joint conclusions of the medical and agricultural experts
of the Federal government upon this subject, based on pains-
taking studies and researches of their own, as well as careful
and exhaustive reviews of the results of other workers through-
out the world. It may be safely rated as one of the most, if
not the most, painstaking investigations into the subject ever
known. It fills a bulky volume of over 800 pages.
Nevertheless, in searching carefully through it for information
as to the quantitative relation between infected milk and the
transmission of infectious diseases, the nearest to a definite
statement that we can find is the following rather cryptic sen-
tence by Eager. He says: “The effect of milk epidemics on
morbidity and mortality returns may be surmised by the fre-
quency with which such epidemics occur.”
Such statements as these are simply concealing our ignorance
of this subject, our utter lack of reliable knowledge, by impres-
_ sive sounding phrases that get us nowhere. Moreover, if Mas-
sachusetts’ experience is in the slightest degree reliable, the
prevalence of these diseases in epidemics due to all causes
bears but a minor percentage rélation to their total occur-
rence, and, among epidemics, only a minor percentage can be
justly attributed to milk.
(g) General Interature of Milk ciiniewictn and Foreign).
We have studied carefully, though by no means exhaustively,
American and English authorities for definite statements based
on sound epidemiological studies relative to the comparative
importance of milk transmission in the spread of those com-
municable diseases of man which are transmitted at times
through the medium of infected milk. The general consensus
of expert opinion relative to tuberculosis and milk has already
been covered.
_ In studying the general literature of milk and the literature
162
of epidemiology in respect to its incidental discussions of milk
transmission of diseases, especially in reference to the great
trio of epidemic diseases that are universally conceded to be
at times milk borne, —7.e., diphtheria, scarlet fever and ty-
phoid, — statements continually recur of which the best that
can be -said is that they shade from the frankly negative, or
the evidently purposely vague, to the entirely hypothetical in
reference to this important problem.
As we have repeatedly pointed out, the striking spectacular
evidence is always that of the milk-borne, or alleged milk-
borne, epidemic, and this type has been given the entire atten-
tion of the authorities that we have consulted, with one notable
and authoritative exception, — Chapin. When some incidental
reference is made to the problem of the relative significance of
milk infection, about the only surmises hazarded are in refer-
ence to typhoid. Three in particular have struck our attention
forcibly from the widespread manner in which they are quoted
as a basis for judgment. One is the now classical report by |
Harrington, in reference to 14 out of a total of 18 typhoid out-
breaks in Massachusetts being due to milk. Another is the
assumed 10 per cent. factor of milk infection im typhoid trans-
mission of the Typhoid Board of the United States Public
Health and Marine Hospital Service for the District of Colum-
bia. We have already discussed the fairness of these two con-
clusions in-detail. A third reference is worthy of special notice,
as it has been quoted quite as widely as the other two, and be-
cause it may be fairly cited as a typical example of the sweep-
ing generalizations as to the dangers of milk that can be found
in many quarters. We refer to Whipple’s well-known work on
“Typhoid Fever.’’ Another reason why we feel it is particu-
larly worthy of citation is because the eminent author frankly
admits that the assertion rests on no solid epidemiological basis,
and because in justice to him it should be noted that in an-
other chapter of the same work, devoted exclusively to the
effect of milk supplies upon typhoid rates of cities, he par-
ticularly gives this wise caution in reference to the matter:
“ .. the data for a fair discussion of this subject have not
yet been collected.” We have never found this statement
quoted.
163
But very casually on another page in the chapter devoted to
the distribution of typhoid he makes this incautious statement
which we have found quoted, apparently with approbation, in
numerous places: “In a general sort of way it may be said
that in the cities of the United States at the present time
about 40 per cent. of the typhoid fever is due to water, 25 per
cent. to milk, 30 per cent. to ordinary contagion (including fly
transmission), and about 5 per cent. to all other causes.”
The one good authority who challenges the fairness and ac-
curacy of these assertions as to the high percentage importance
of milk infection in the transmission of diphtheria, scarlet fever
and typhoid is Chapin of Providence. In his work on “The
Sources and Modes of Infection”’ he says: —
It will be noted that though scores of outbreaks of typhoid fever may
occur each year, they do not include more than a small fraction of the
total typhoid fever. It may be claimed that only a small proportion of the
milk-borne outbreaks are recognized as such, but I cannot think that
this is so in the English cities and the better class of American cities. .
We can hardly believe that milk outbreaks could have, except rarely,
escaped detection in the English cities, or in such cities as Boston, Worces-
ter, Springfield, Rochester, Baltimore, Philadelphia and New York.
The importance and value of the reports on typhoid fever in Washing-
ton have, as it appears, given a rather exaggerated importance to the
danger from milk. That there was a certain amount of typhoid fever
in Washington, due to milk, during the three years in question, is no
reason for assuming a similar percentage of milk-borne typhoid fever for
the other cities of the country. Trask was able to find during the years
1903-07 about 1,900 cases in the United States traced to milk. During
this period there were in the registration area 57,023 deaths, and the
total number in the whole country must have been at least double, or
114,000.' The fatality is probably not over 10 per cent., so that there
must have been at least 1,000,000 cases. Nineteen hundred is 0.19 per
cent., which is very different from the 10 per cent. now commonly assumed.
as due to milk. I do not of course believe that all the milk outbreaks
were reported, but the number would have to be increased .fiftyfold to
equal 10 per cent., and it can scarcely be believed that 98 per cent. of all
milk outbreaks fail of recognition.
In reference to diphtheria and scarlet fever transmission by
milk, he further states: — -
Scarlet fever and diphtheria are certainly much more rarely trans-
mitted by means of milk than is typhoid fever. Although the percentage
162
of epidemiology in respect to its incidental discussions of milk
transmission of diseases, especially in reference to the great
trio of epidemic diseases that are universally conceded to be
at times milk borne, —7.e., diphtheria, scarlet fever and ty-
phoid, — statements continually recur of which the best that
can be -said is that they shade from the frankly negative, or
the evidently purposely vague, to the entirely hypothetical in
reference to this important problem.
As we have repeatedly pointed out, the striking spectacular
evidence is always that of the milk-borne, or alleged milk-
borne, epidemic, and this type has been given the entire atten-
tion of the authorities that we have consulted, with one notable
and authoritative exception, — Chapin. When some incidental
reference is made to the problem of the relative significance of
milk infection, about the only surmises hazarded are in refer-
ence to typhoid. Three in particular have struck our attention
forcibly from the widespread manner in which they are quoted
as a basis for judgment. One is the now classical report by ©
Harrington, in reference to 14 out of a total of 18 typhoid out-
breaks in Massachusetts being due to milk. Another is the
assumed 10 per cent. factor of milk infection in typhoid trans-
mission of the Typhoid Board of the United States Public
Health and Marine Hospital Service for the District of Colum-
bia. We have already discussed the fairness of these two con-
clusions in detail. A third reference is worthy of special notice,
as it has been quoted quite as widely as the other two, and be-
cause it may be fairly cited as a typical example of the sweep-
ing generalizations as to the dangers of milk that can be found
in many quarters. We refer to Whipple’s well-known work on
“Typhoid Fever.”? Another reason why we feel it is particu-
larly worthy of citation is because the eminent author frankly
admits that the assertion rests on no solid epidemiological basis,
and because in justice to him it should be noted that in an-
other chapter of the same work, devoted exclusively to the
effect of milk supplies upon typhoid rates of cities, he par-
ticularly gives this wise caution in reference to the matter:
“|. . the data for a fair discussion of this subject have not
yet been collected.” We have never found this statement
quoted.
163
But very casually on another page in the chapter devoted to
the distribution of typhoid he makes this incautious statement
which we have found quoted, apparently with approbation, in
numerous places: “In a general sort of way it may be said
that in the cities of the United States at the present time
about 40 per cent. of the typhoid fever is due to water, 25 per
cent. to milk, 30 per cent. to ordinary contagion (including fly
transmission), and about 5 per cent. to all other causes.”’
The one good authority who challenges the fairness and ac-
curacy of these assertions as to the high percentage importance
of milk infection in the transmission of diphtheria, scarlet fever
and typhoid is Chapin of Providence. In his work on “The
Sources and Modes of Infection”? he says: —
Tt will be noted that though scores of outbreaks of typhoid fever may
occur each year, they do not include more than a small fraction of the
total typhoid fever. It may be claimed that only a small proportion of the
milk-borne outbreaks are recognized as such, but I cannot think that
this is so in the English cities and the better class of American cities. . . .
We can hardly believe that milk outbreaks could have, except rarely,
escaped detection in the English cities, or in such cities as Boston, Worces-
ter, Springfield, Rochester, Baltimore, Philadelphia and New York.
The importance and value of the reports on typhoid fever in Washing-
ton have, as it appears, given a rather exaggerated importance to the
danger from milk. That there was a certain amount of typhoid fever
in Washington, due to milk, during the three years in question, 1s no
reason for assuming a similar percentage of milk-borne typhoid fever for
the other cities of the country. Trask was able to find during the years
1903-07 about 1,900'cases in the United States traced to milk. During
this period there were in the registration area 57,023 deaths, and the
total number in the whole country must have been at least double, or
114,000.' The fatality is probably not over 10 per cent., so that there
must have been at least 1,000,000 cases. Nineteen hundred is 0.19 per
cent., which is very different from the 10 per cent. now commonly assumed
as due to milk. I do not of course believe that all the milk outbreaks
were reported, but the number would have to be increased -fiftyfold to
equal 10 per cent., and 1t can scarcely be believed that 98 per cent. of all
milk outbreaks fail of recognition.
In reference to diphtheria and scarlet fever transmission by
milk, he further states: — ~
Scarlet fever and diphtheria are certainly much more rarely trans-
mitted by means of milk than is typhoid fever. Although the percentage
164
of typhoid fever, scarlet fever and diphtheria due to milk is small, the
danger is a real one and the aggregate of cases not inconsiderable and
their occurrence should, if possible, be guarded against.
In all this epidemiological quagmire it is refreshing to be
able to quote at least one authoritative, incisive, sane voice
emphatically demanding that in making our final judgments
in this matter we take our stand upon the definitely proven
facts, and do not pass judgment in advance relative to the —
great mass of cases of infectious diseases whose etiology we
must as yet, in all fairness, class as unproven.
SUMMARY OF EVIDENCE AVAILABLE AS TO THE RELATIVE Iuv-
PORTANCE OF MILK IN THE TRANSMISSION OF INFECTIOUS
DISEASES.
To sum up, the best available information as to the propor-
tionate part played by milk supplies in general in the trans-
mission of the great trio of milk-borne epidemic diseases — —
diphtheria, scarlet fever and typhoid — amounts in substance
to about as follows: —
1. That there have been Heneneue the civilized world up
to the present time a large number of well-authenticated epi-
demics of all of these diseases, definitely due to milk infection.
No one can state at present just how many such epidemics
there are on record, but they are ample in number to prove
the danger of disease transmission through raw milk. From
the accumulated evidence it is possible to state quite defi-
nitely that there is a vast discrepancy as to the relative
frequency of milk infection in these diseases, diphtheria being
clearly the least often so transmitted, scarlet fever relatively
more often, and typhoid unquestionably more frequently than
‘both the other two combined. The fourth, as yet little under-
stood disease, that is known to be transmitted by milk — septic
sore throat — is, in the best understanding of the term now-
adays, considered to be practically always a milk infection.
2. That analysis of both the epidemic and endemic records
of these diseases in the State of Massachusetts for several years
past. would tend to indicate that the total relative importance
of infected milk in the transmission of these diseases is not
nearly as great as has been commonly assumed.
165
3. From a study of all the available literature on the sub-
ject it would appear that three sources have been largely re-
sponsible for the widespread impression among American sani-
tarians that milk infection has been definitely proven to be a
high factor in the transmission of these diseases. They curi-
ously all relate to typhoid alone. They are: (a) Harrington’s
report of 14 out of 18 typhoid epidemics being found due to
milk; (6) the reports of the special typhoid board on the origin
and prevalence of typhoid in the District of Columbia; and
(c) the milk percentage statement by Whipple in his work on
typhoid fever. We are unable to substantiate the conclusions
of any of these reports for reasons detailed above.
4. Replies to inquiries among prominent American epidemi-
ologists are unanimous in testifying that the evidence as to
just what part milk plays in the transmission of these diseases
is not by any means conclusive. Almost without exception
they admit that the tendency of their own experiences is to
explain more and more cases of these diseases on other grounds
than milk.
5. We can find nothing authoritative in any other general
public health or medical literature that throws any conclusive
light on this point.
6. The high residual milk-borne typhoid argument of Ogan
of the New York City Health Department is a very suggestive
theory, but in our opinion not in any sense conclusive.
7. Our own results do not in any sense prove conclusively that
milk is not as important a factor as has been assumed. They.
simply go a long way towards demonstrating that the reasons
hitherto given for the assumption that milk is a large factor
in the transmission of infectious diseases are in many respects
inadequate and unsatisfactory.
In brief, it is our belief that all statements, conclusions and
broad general impressions as to the relative dangers of milk
found in the literature rest on a most shaky and unsubstantial
basis.
We believe that this tendency is wrong. The accumulated
evidence of scores upon scores of definitely demonStrated milk-
borne epidemics is enough to show that raw market milk is
always a risky food. Why not let it go at that? Why lend
color to the charge that practical milk producers so often have
166
flung in our faces during the progress of this investigation, viz.,
that the tendency of sanitarians to-day is to create the im-
pression that milk is inherently little if any short of a poison.
This impression has been undoubtedly created in many people’s
minds by sweeping, startling, unqualified accusations against
cow’s milk that may or may not be justified, and concerning
which we have at present no sound basis whatever in the shape
of good epidemiological proof. ;
5. The Possible Means of preventing Communicable Disease
Transmission through Milk, and their Relative Practi-
cability.
Enough has been shown to demonstrate that, while milk is
probably not as great a factor in communicable disease trans-
mission as has often been asserted, it is none the less a very
real and serious element in the problem of communicable dis-
ease prevention. The next logical step is to eradicate or mini-
mize this danger. One effective way is that of Japan and cer-
tain other Oriental races, — not to use the milk of the cow for
human food., The great benefits that we derive from the use
of cow’s milk are so evident that such a procedure is unthink-
able for an American community. |
There remains the problem of how cow’s milk may be made
safe as far as communicable diseases are concerned. All the
numerous expedients and measures advocated or adopted
throughout the civilized world with this end in view can be
reduced to two general classifications.
1. Efforts to produce a milk that from the cow to the ulti-
mate consumer presents no opportunity for infection.
2. Efforts at disinfection of the milk in some manner by
which the opportunities for subsequent infection would be re-
. duced to a minimum.
In the pursuit of these ends, as in many other aspects of the
milk problem, there has been such a strong bias or prejudice on
the part of many advocates of these two opposing views that
it has rather tended to obscure the fact that there might be
a very distinct, practical and sane middle course-available be-
tween the two extremes.
The advocates of the cause of raw milk have blindly shut
their eyes to certain ugly facts relative to milk and disease
167
transmission, and have enormously extended the prejudice pre-
viously existing against pasteurized milk by such sensational
catchwords and slogans as “Pasteurized milk is only another
name for rotten milk.’ The advocates of sterilized milk in
their zeal have oftentimes seemed to overlook the fundamental
importance, on other grounds than those of communicable disease
transmission, of having milk produced and handled throughout,
in all the processes from cow to consumer, in the cleanest man-
ner possible.
The ideal of the raw milk advocate is in a phrase: Milk
from absolutely healthy cows, milked and handled exclusively
in all its processes of collecting, marketing and distributing by
individuals known to be in perfect health and incapable of
transmitting disease, who at the same time observe the most
rigid precautions as to personal cleanliness and cleanliness of
utensils, who keep the milk throughout these steps at a very
_ low temperature, and who deliver it in the shortest possible
time to the consumer. ‘This ideal finds its nearest approach
to realization in the well-known “certified milks.”
But every year of accumulated experience has demonstrated
certain obstacles to the fulfillment of this program. The chief
ones are these: —
1. That only a very small percentage of milk is so produced,
because such milk is an unusually expensive milk to put on
the market, and thus becomes impracticable for the average
consumer.
2. That even these precautions do not guarantee the con-
sumer against possible infection through milk. For example,
the numerous instances in which a certified herd has most un-
expectedly been found to have become extensively infected with
tuberculosis, or such an occurrence as the great septic sore
throat epidemic of Boston and vicinity in 1911, coming, al-
though not from a certified supply, from a milk supply which
was guarded by most elaborate precautions to insure a high
degree of cleanliness and freedom from infection.
As Rosenau pithily expresses it, “One of the features of
special interest concerning this outbreak was that this milk
has always been a particularly clean, fresh and satisfactory
supply. It is obtained from tuberculin-tested cows, under con-
stant veterinary inspection, and the milk itself is subjected to
168
daily chemical and bacteriological tests. The milk is bottled
at the dairy, the bottles sterilized, and all reasonable and many
eatra precautions are taken to insure its cleanliness and purity.
It emphasizes the lesson that raw milk is apt to be a dangerous
milk.”
In fact, a careful and impartial study of the entire question
will force any one to the practical conclusion that efficient dis-
infection is our only certain safeguard against infectious dis-
ease transmission through milk.
Efficient disinfection can be conceivably brought about by -
either heat or chemical action. There is no chemical process
that we can discover that will efficiently disinfect milk without
at the same time either producing chemical changes that render
the milk entirely unfit for food, or else will introduce substances .
into the milk, as formaldehyde, that are in themselves dele-
terious.
Disinfection by heat may be either by actual boiling or by
pasteurization. Disinfection by boiling produces certain chem-
ical changes in the composition of milk, due largely to the
coagulating of the milk albumen, which materially affects the
flavor. Nevertheless, it is the procedure of choice in many
European countries.
Since it has now been firmly established that pasteurization
properly carried out is an absolute protection against patho-
genic micro-organisms that may have accidentally infected milk,
and, since this process, carried out at proper temperatures and
with proper subsequent handling of the milk, produces no
change in the flavor or appearance, and no chemical changes
of any practical consequence, pasteurization has become firmly
established in America‘as the disinfection process of choice.
6. Pasteurization as a Means of Infectious Disease Prevention.
Pasteurization is considered in another section from various
angles. Here our only interest in the process is the question
of its efficacy as a means of preventing the transmission of
communicable diseases through milk.
In the past many arguments have been raised against pas-
teurization. Unfortunately, in its beginning as a commercial .
practice in the milk industry of this country, pasteurization
169
received a bad name which the easily demonstrable benefits of
the process have never been able to live down.
Pasteurization, as first resorted to in America, was in spirit,
if not in law, a plain, palpable fraud. The process was origi-
‘nally utilized by dealers to keep dirty milk in a marketable con-
dition longer than could otherwise be done. ‘This naturally
had the effect of aligning health authorities against the process.
It was many years before sanitarians generally came to appre-
ciate that this abuse of pasteurization was not any real argu-
ment against the benefits of pasteurization.
Then several authorities brought forward the argument that
‘the process of heating milk produced certain chemical changes
that rendered the milk less suitable for infants’ diet, and that
long-continued use of pasteurized milk tended to produce the
disease known as infantile scurvy. Several years of heated dis-
cussions on this point succeeded in effectually settling this ob-
jection by proving (1) that the disease, infantile scurvy, was
comparatively rare; (2) that it was at least doubtful whether
pasteurization of the milk was the cause; and (3) that it could
be both prevented and cured by the addition of fruit juices,
or animal or vegetable albumin, in simple and easily digestible
form, to the child’s diet.
With this objection disposed of the opponents of pasteuriza-
tion took refuge in the claim that heating milk killed the “life”
of the milk. No one has ever been able to demonstrate just
what the “life” of milk is in the sense in which the objection
was originally used. New milk has a certain inhibitive power
over bacterial growth, but this is lost after eighteen hours, or,
in other words, some time before the ordinary market milk of
our larger cities can possibly reach the market. Milk is “dead”’
and begins to decompose from the moment it is drawn from
the udders, — sometimes before milking.
There are several so-called enzymes, or ferments, in milk the
exact nature of which is still in controversy, but none of these
are in the least affected by the temperature to which milk is
heated in the process of pasteurization except two that, so far
as any one can determine, have no effect upon health.
Another objection that has more weight, and that has often
been raised against pasteurization, is that the process, by de-
170
stroying the lactic acid bacteria which normally bring about
the souring of milk, destroys “Nature’s danger signals.”’ This
argument would be much more effective if it were not for the
fact that pasteurization at the temperature recommended, while
it kills all disease germs, does not destroy all the souring bac-
teria. These will again multiply, and hence souring is only
delayed, not prevented, by efficient pasteurization at approved
temperatures. Nature has no danger signal in milk. Sour milk
is not harmful. Infected milk looks and tastes well.
The great and original objection to pasteurization — 1.e., that.
it promotes dirty, careless methods of milk production, and
leads milk handlers to believe that it is immaterial how much
cow dung or other filth gets into the milk —is still the one
chiefly used by the opponents of pasteurization.
This entire objection falls to the ground if once the sanitary
prerequisite is firmly established that milk must be reasonably
clean to be eligible to pasteurization.
When the positive benefits of pasteurization are considered,
the evidence is so overwhelming as to admit of no answer.
Proper pasteurization kills all the germs of the communicable
diseases of man that can possibly be transmitted through milk.
Pasteurized milk is the only safe milk.
Pasteurized milk in this sense means milk heated to not less
_ than 140 degrees, nor more than 150 degrees F. (preferably
145 degrees), for not less than twenty minutes (preferably one-
half hour), then cooled quickly and kept cool and free from
contamination until delivery to the ultimate consumer.
Milk so treated is just as digestible, just as nutritious and
just as palatable as the raw milk, and this is the simplest,
cheapest and best method of making milk safe from the danger
of transmitting communicable diseases. The certain protection
that pasteurization gives against infection with bovine tubercle
bacilli in itself far outweighs all the economic, esthetic or sani-
tary objections that can be brought against the process. Fur-
thermore, the process is, as Rosenau says, too important a
health matter for its methods of carrying out to be left under
the care of any other agency than that of the health authorities.
No one denies that, except when pasteurization is carried out
in the final container, there is always a more or less remote
possibility of the milk being reinfected, before it reaches the
ligase
ultimate consumer, from direct contact by a convalescent or a
chronic disease carrier. With this limitation clearly understood,
the efficiency of pasteurization as a disease-preventive process
becomes the more remarkable when we reflect upon the as-
tounding fact that, in spite of the hundreds of well-authenti-
cated outbreaks of infectious diseases definitely proven to have
been due to infected milk, and in spite of the ever-increasing
percentage of pasteurized milk placed on the markets of the
large cities of this country in the past twenty years, there has
never yet been an important outbreak of a communicable disease
that could be attributed to a pasteurized milk supply. For this
statement we have no less an authority than Assistant Surgeon
General Trask of the United States Public Health Service,
‘under whose direct personal supervision the prevalence of com-
municable diseases, not only in this country but throughout
the world, has been carefully studied for many years. Writing
under a very recent date, Nov. 24, 1915, in response to an
inquiry on this point, he states: “I have no record of any
epidemic or outbreak of any size that was milk-borne on a
pasteurized milk supply.”
' There have been a few instances in which an outbreak of
communicable diseases has occurred on a milk supply which
was alleged to have been pasteurized, or on the route of a
dealer who handled both pasteurized and unpasteurized milk,
from which the impression at first was that the milk came
from the pasteurized ‘source. In every instance on record in
which such an occurrence has been investigated it has been
found that no real, pasteurization of the milk supply had been
carried out. Either pasteurization was claimed when it had
never been in effect, or else the machinery for carrying out
the pasteurization was at the time of the outbreak out of com-
mission either by accident or neglect. In certain of these in-
stances, when the pasteurizing machinery got out of order,
there was at least a strong suspicion that the pasteurizer may
have acquired only a sufficient amount of heat to act as a
bacterial incubator rather than as a bacterial sterilizer. The
ever-present possibility of such accidents occurring in pasteuri-
zation, even although experience has proved them to be ex-
tremely infrequent, makes the need for efficient governmental
“supervision of pasteurization doubly essential.
172
C. MILK AND INFANT MORTALITY.
By the “infant mortality rate’? we mean the number of
infants under one year old who die as compared to the number
born during that year. To know this we must know how many
are born and how many die. The registration of both births
and deaths is so incomplete in the United States that these
figures are not obtainable for our country as a whole.
The Massachusetts figures, which are fairly accurate, are
steadily improving.
Rate per
Year. 1,000 born.
ICT eT Sues io Mote MORRO SN eR CT: 3 AA ACg RRO HD bale ae Sr VN MR 156.7
FICHE SA SY pa EBBO NNR) MINIS) Va Bt tet ge ROM Chg TS ON eae tT Lu 139.0
PLOW O ML Rack TA Hea Seat MeL AALS A a a. ar 135.6
191s : Z : ; : : : ; \ : ae f ‘ 104.53 .
In Boston the figures were, in 1910, 126 per 1,000 born; in
1914, 102.23; from 1909 through 1913 the average annual rate
was 120 per 1,000 born. .
In foreign countries the data obtainable are not quite so
_ recent. ;
CountTRY. ; Years. area
1
Scotland, . B 3 i 4 : s : 7 3 . | 1893-1902, é 127
INGE AYE Whloctaciis bokth SO) caveat ape eT a (ED Ea RU ia aN ROR TGQD! Lie 94
Sweden, ; A 3 fe Banden i 3 3 3 . | 1898-1902, 4 99
France, : : ‘ ; ‘ 2 d ; : , . | 1893-1902, i 158
Austria, i 5 : 3 E ‘ 5 2 . | 1895-1900, 5 227
Russia, . : F $ B H M 3 AMT 3 . | 1890-99, . i: 272
Hngland, . Blithe : : 4 2 : 3 5
Wales 1901-05, . : 138
1910, 68
New Zealand, . 4 i ; 5 h i : 3 F | LOT tis 3 56
1912, . ; 51
Our Massachusetts rate is not by any means the highest in
the world, but it cannot be considered in the same class with’
173
that of New Zealand, the lowest. We pride ourselves on our
knowledge of science and scientific methods, yet in the matter
of the reduction of infant mortality we are not even in the
advance guard of the nations.
The causes of infant mortality are many and complicated.
The following table shows the relative importance of the prin-
cipal causes as stated by Dr. Emmett Holt of New York, an
eminent authority, by the Maryland State Board of Health,
and by Drs. Koehler and Drake of Chicago.
a
Maryland
| Hot, | State Board | Drake.
Percentages due to: — :
Diarrhceal diseases, i : - 5 : 28.0 38.5 39.8
Congenital defects and childbirth, 5 f 31.3 17.1 24.0
Pneumonia, bronchitis, influenza, . i i 18.5 . 14.7 20.6
Acute contagia, ‘ : ¢ 3 3 5.4 5.0 Bee)
Tuberculosis, . : 6 : 3 4 : 2.0 2.5 1.6
Venereal diseases, . 2 d < 4 1.2 = 1.3
All other causes, .- : 5 ‘ “ 13.6 22.2 4.8
SS
Cow’s milk as an infant food might enter prominently into
the following of these causes: Diarrhceal diseases, acute con-
tagia and tuberculosis.
Its significance in the acute contagia and in tuberculosis are
considered in another portion of this report.
According to the majority of authorities, failure on the part
of mothers to provide breast milk for their children appears to
be-on the increase throughout the civilized world.
Spargo says: —
The modern, mother is growing more and more unable to nurse her child
at her breast. For some subtle reason this function of maternity is being
atrophied in civilized women; and the higher their civilization the less
!
able are they to suckle their children. With the vast majority of women
who find themselves unable to discharge this important maternal duty
the trouble is not social or economic but physiological.
Dr. Holt tells us that among the well-to-do and cultured
mothers not more than 25 per cent. of those who have earnestly
and intelligently attempted to nurse have succeeded in doing
so for as long as three months. Among the poorer classes in
174
our cities there is also a marked decline in nursing ability, al-
though not yet to the same degree as among those higher in
the social scale.
On the other hand, according to Dr. Herman Schwartz of
New York, based on observation of 1,500 babies, 96 per cent.
of the mothers were able to nurse their babies for one month
or less. He says: “This proves very conclusively that if care
is taken from the very start most women can do something
toward nursing their children.”
With every failure in the ability of a mother to nurse her
child comes the demand for a substitute food for the infant.
No ideal substitute has been found. Many milks have been
used which approximate more or less closely to human milk
in composition. Because of the quantity needed, because of
the establishment of the dairy industry in this country and
its consequent availability, because it can be modified com-
_ paratively readily to a close approximation to human milk,
cow’s milk has been and will be our main standby. It then
follows that if we are to provide cow’s milk as a substitute
food for our infants we must see to it that this substitute
saves as many infants’ lives as possible and kills as few as
possible.
The composition of human milk differs from cow’s milk, as
follows: —
| Protein. | Fat. | Milk Sugar. | Spineral
Humanmilk, . Fi : 3 3 1.6 3.4 6.1 6.20
Cow’s milk, 3.2 oe, 4.9 0.75
The greatest difference is in the protein content. Protein is
the muscle-building element. In cow’s milk it is present in
a greater quantity in proportion to the other elements than
the human body requires. To get a sufficient amount of milk
sugar from unmodified cow’s milk a large excess of protein and
a lesser excess of fats would be taken. On the other hand, to
secure proper amounts of protein would be to take an insuf-
ficient supply of fats and a still less sufficient supply of milk
sugar. Again, the protein in cow’s milk is of a different chem-
175
ical composition from that in human milk; it forms a tougher
curd and is more resistant to digestion. The fat in cow’s milk
is in larger globules and has a higher melting point than the
fat in human milk. Raw, unmodified cow’s milk is an unnat-
ural and badly balanced food for infants. By proper modifi-
cation the proportion of the different elements can be brought»
to correspond to the proportions in human milk, but the chem-
ical variations in the proteins and the fats cannot be brought
to correspond.
Human milk as administered by breast feeding requires no
intermediary handling or storage, and is taken into the child’s
stomach with a minimum of contamination and of bacterial
content. Cow’s milk must be handled by milkers, transporta-
tion agents, dealers and mothers or attendants with ever-
present opportunities for contamination by dirt and disease
germs.’ It must be stored in containers, and is more or less
often transferred from one container to another with the at-
tendant dangers from dirty vessels or diseased handlers. The
necessary time elapsing between milking and feeding gives great
opportunity for increase in the bacterial content. All these
factors occurring at all stages of the route of the milk from
the cow’s udder to the baby’s stomach — on the-farm, on the
road, in the distributor’s hands and in the home — furnish
opportunities to render a clean milk dirty, a pure milk infected.
Milk, whether from the cow or the woman, is produced at
body temperature. Both, as secreted, are naturally sterile.
Both may be infected in the process of milking. Bacteria mul-
tiply but little at a low temperature, but milk, at summer tem-
perature, becomes an excellent culture medium for many vari-
eties. The question whether the germs of communicable diseases
of man may multiply in milk to any great extent is still dis-
puted. However, it is not disputed that disease germs live for
varying but considerable periods of time in milk, when once
introduced, and are transmitted by it to their natural environ-
ment, the human body, and there multiply and produce their
specific disease.
Cow’s milk, unless properly cooled and kept cool during the
time elapsing between production and consumption, becomes
loaded with bacteria and their products. Reasonable protec-
176
tion, therefore, demands this prompt cooling and continuous
holding at the safe temperature.
Dirt, with its accompanying dangerous chemical and _ bac-
terial elements, may be introduced into the milk at any or all
stages of its journey, — from dirty udders, teats and flanks of
the cow; dirty hands of the milker; dirty methods of milking;
dirty stables and pails; dirty washing water; dirty milk ma-
chinery; dirty distributors, wagons and bottles; dirty utensils
in the home; dirty attendants; dirty mouths in the babies,
etc.
Cow’s milk for infants is a primarily ill-suited food that is
in constant and continuous danger of becoming a positively
toxic food at every stage of its existence as milk. If, however,
the natural supply of infant food fails, something must be pro-
vided in order to prevent starvation and death, and it is our
office to see to it that the substitute is as little toxic as possible.
The Place of Cow’s Milk as a Cause of Infantile Diarrhea.
In wholly breast-fed babies it can have no effect; in partly or
wholly bottle-fed babies it is of primary importance.
The proportion of breast-fed to bottle-fed babies in our in-
fant population is an unknown quantity.
It is stated that in Norway and Sweden nearly all infants
are breast fed; in Scotland 80 to 85 per cent. are breast fed;
in France there is little breast feeding; in Russia little breast
feeding; in Austria breast feeding is predominant in the upper
classes, artificial in the lower; no definite statements regarding
England and Wales could be found, but all comment indicated
a large percentage of bottle feeding; in this country the general
impression is that breast feeding is steadily declining.
In Chicago, during July, August and September, 1911, ac-
cording to reports from visiting nurses, there were, among the
infants visited by them, 15,861 breast-fed infants and 5,477
bottle-fed infants. Dr. W. H. Davis states that in Boston, in
1911, out of every 100 babies 68 were breast fed and 32 were
bottle fed, and that of the 621 deaths of infants from diarrhcea
and enteritis in Boston during the same period 87 were breast
fed and 534 were bottle fed. In other words, 6 bottle-fed in-
fants died of intestinal trouble to 1 breast fed, and there were
LZ
not half as many bottle-fed babies in the city as there were
breast fed.
Authorities the world over agree almost without exception
that the mortality of bottle-fed infants is frightfully in excess
of the mortality of breast-fed infants, and that this excess of
mortality is in great measure due to intestinal disturbances or
communicable diseases caused by contaminated or infected
milk.
The health of the cow is the first factor in pure milk pro-
duction. No one would expect to get a milk absolutely free
from dangerous possibilities from a sick cow. Of about the
same importance is the health of the person taking care of the
cow. Our records of communicable diseases, showing how in
many instances a case of disease at the dairy is spread along
the milk route in epidemic form, prove the actuality of this
danger.
Cow dung in the milk is at least undesirable from the stand-
point of the average consumer. Many of our best pediatricians
believe that it is a positive danger. An uncleaned cow or an
uncleaned milker, an uncleaned stable or a stable cleaned ‘at
the time of milking, uncleanly methods of milking, straming,
cooling or storing milk, — all give frequent opportunities for
this contamination.
The use of simple and easily learned, clean seeehie ds protect
milk from dirt to an astonishing degree; clean cows, clean
stables, clean, milkers and the small-top pail work wonders.
The dirt that does the most harm in milk is bacterial. Milk
at a temperature approaching body heat is a very perfect cul-
ture ground for many bacteria. Counts of bacteria content
show a steady and extraordinary rapid increase in the number
of bacteria in milk that is held warm, and this increase is
measured largely by the length of time it is so held. On the
other hand, milk at 50° F. or lower is not a good culture
medium, and milk that is cooled immediately after milking to
that temperature and held at that temperature can be stored
for a comparatively long time without showing Breat increase
in its bacterial content.
In the milk business proper cooling of the milk and holding
it cold is not a complicated process, but like many other simple
178
processes it is difficult of execution because it has to be per-
fectly carried out to insure safety. Failure to cool immediately
and to hold cold constantly and continuously spells bacterial
growth. To be safe it must be held cold through the whole
journey from the cow to the baby, in the dairy, during collec-
tion and transportation, at the dealer’s, during distribution and
at the home before use. It is a long chain, and, like all chains,
if a weak link develops it will break there and be worse than
useless.
Of late years there has been much legislative discussion aimed
at the control of the production of milk. Cattle and dairies
are more or less thoroughly inspected, and milk dealers adver-
tise and show to the public as well as to the inspectors the
‘cleanliness and safety of their methods of handling milk. By
constant watchfulness a certain measure of protection is being
secured up to the point of delivery of the milk at the home.
After that point is reached the elements of human ignorance,
poverty and carelessness come into the question where they
are beyond the control of legal remedial measures. That a
very large proportion of the contamination of milk at the
present date occurs in the home seems to be the common con-
clusion of investigators.
Mr. W. E. Kreusi, of the Milk and Baby Hygiene Associa-
tion of Boston, testified in 1910 as follows: —
The committee regards the milk situation very much better with
respect to conditions at the producer’s end, and very much better as to
conditions in the contractors’ and peddlers’ hands, than in the hands of
the ordinary consumer.
The effort to save babies’ lives through baby feeding and
milk stations has gained enormous headway, and has produced
. very definite and highly satisfactory results. As these organi-
zations were originally instituted their object was to furnish a
pure, clean milk as a food for infants. A notable example of
this was the establishment of milk depots in New York through ~
the philanthropy of Mr. Nathan Strauss. It soon became evi-
dent that this did not solve the problem. As one of Dr. Price’s
nurses in Detroit put it, “To successfully combine milk with
a baby you must take care of the baby as well as the milk.”
179
The home conditions, the care of the milk at home, and the
general hygiene of the baby were evidently as important or
even more important than the exceptional original purity of
the milk. The follow-up nurse was introduced, who went to
the home, advised sanitary improvements and taught the igno-
rant mother the simplest principles of the hygienic care of the
baby as well as of the milk. Dr. Price of Detroit reversed his
infant mortality rates — made them lower in the hot months
than they had been in the cold — by the use of nurses alone,
not nurses combined with milk stations.
In the past the cause of summer diarrhceas in infants has
been almost. always charged up to bad milk. It was admitted
that other factors entered in, but it was believed that they
did so to so small an extent as to be comparatively negligible.
Prompted by the results obtained by the work of the visiting
nurse, studies are being made that are showing the unexpect-
edly large measure of importance of factors other than sanitary
milk.
Dr. Arthur Newsholme, an eminent English sanitarian, in a
study of 1,259 infants during an epidemic of infantile diarrhea,
found that artificial feeding was the habit, either wholly or in
part, with the large majority of cases of the disease, showing
the value of breast feeding; but also he found that babies fed
on condensed milk were twice as susceptible to the disease as
were those fed on fresh cow’s milk, showing that it was rather
the artificiality of the feeding than the cow’s milk as a food
that was responsible. Also from this series it might well be
-argued that cow’s milk was the best substitute food if a sub-
stitute must be used.
Prof. C. E. A. Winslow of New York finds that, in the case
of infants, bad ventilation and indoor heat are almost. as im-
portant causative factors in diarrhoeal as they are in respiratory
diseases; that heat alone has a marked effect on the baby. -
In a series of infants who were either breast fed or fed from
bottles under the best conditions he found that while 80 per
cent. of them did well during the winter, only 60 per cent. did
well during the hot months, showing the important definite
effect of heat alone.
Holt and Park say: —
180
The depressing effects of great atmospheric heat, 7.e., a temperature
in the neighborhood of 90° F. or over, were very marked in all infants
no matter what their food. Those that were ill were almost invariably
made worse, and many who were previously well became ill.
Dr. J..W. Shereschewsky of the United States Public Health
Service, in discussing the effects of heat on infant mortality,
concludes that the action of heat as a direct cause has been
greatly underestimated; that it is the indoor heat common in
poor housing conditions that is responsible; that the respon-
sibility of dirty and stale milk has been overestimated, although
breast feeding must still be regarded as a most, if not the most,
important preventive of the summer deaths of infants; that —
future activities for the prevention of infant mortality must
concentrate themselves to a greater extent on the improvement
of housing conditions, and on education regarding the proper
care of babies in the summer.
Infants are delicate machines. It is not necessary that they
should be bottle fed to endow them with a high death rate.
Incomplete development, inherited constitutional weaknesses or
disease, excessive heat, high humidity, poor ventilation, im-
proper clothes, accidents and the various communicable dis-
eases are all factors in it.
The experience of this State seems to be that the causes of
infant mortality cannot be charged in the majority of cases to
the condition of the milk supply as delivered at the door. Un-
questionably this is the cause in many cases of death, but not
in a preponderance of them.
Dr. Gerstenberger of Cleveland, after stating that 300,000
under one year of age die yearly in the United States, says he
wishes to call your attention emphatically to the fact that at
least 50 per cent. of these are dying without any real cause,
- sumply from ignorance of the parents, their advisors, — they
are the physicians and nurses, — and from ignorance of the
public at large. Most parents, especially the more poorly situ-
ated, have but the slightest conception of the proper hygiene —
of the child and its surroundings. The big bulk of advisors of
the parents — the physicians and nurses — are too ignorant to
train and advise parents “because not especially trained for
this.” The public does not appreciate how many lives are
181
lost, and does not know that the power to remedy the condi-
tions at fault lies in its hands, and its hands alone.
Dr. Newsholme states that while infections resulting in in-
fantile diarrhoea are possibly introduced on the farm, in his
opinion the majority are of human origin, and closes his sum-
mary with the following: —
In balancing up the above facts and considerations I have no hesitation
in adhering to the opinion stated in many of my past annual reports, —
that diarrhoea is mainly due to domestic infection.
!
On ahe othe hand, many believe with Dr. ee L. Coit
of Newark, N. J., that our reliance should be placed on the
production of a safe, raw, “certified” milk, controlling it by
flawless inspection from the cow to the consumer; that if we
provide an absolutely safe milk to begin with we minimize the
dangers in the use of cow’s milk as an infant food.
What are the remedies?
1. We must insure a clean, safe milk.
2. We must educate mothers.
1. Insurtne a CLEAN, Sars MILK.
Efforts to secure such a milk supply have occupied the Legis-
lature a goodly amount of time in the past. It is obvious that
hygienic conditions in the dairy, in transportation and in the
sale and delivery of milk can be secured only by constant
supervision. Where a reasonably safe line between expense
and results can be drawn can only be determined by experi-
ence. It' will be best to err on the side of safety. Since the
health of the milk handlers is a matter of importance in the
transmission of communicable diseases, and since many of these
diseases are transmissible before identifiable symptoms appear >
in the patient, it follows that the most carefully inspected,
“certified” milk may become infected in spite of the most
faithful and detailed inspection. As long as human beings are
fallible, so long will contaminating accidents be possible at any
point between the cow and the final consumer.
Heating milk to the boiling point, sterilizing it, frees it from
_ live bacteria. In Amsterdam, Holland, the entire supply of
182
the city is boiled to protect against epidemics. In Europe, in
general, milk is cooked. Advocates of this system extol the
absolute freedom from bacteria and the consequent safety of
the milk. Opponents argue that there is a chemical change
resulting from the heat that changes the digestibility of the
milk and causes digestive disturbances in the consumer, and,
in particular, results in infantile scurvy. Many experiments
by European and American investigators seem to show that
this ‘viewpoint is not supported by fact to a demonstrable
degree. This process does change the taste of the milk, pleas-
antly to some and unpleasantly to others.
Heating milk to between 140° and 167° F., and holding it at
that temperature for twenty minutes, kills the germs of all
the communicable diseases so far as we know them. This
process is known as “pasteurization.” The efficacy of pas-
teurization in the control of milk-borne epidemics has been
frequently proved in the State. It certainly does kill the dis-
ease-producing bacteria, if properly performed. Advocates of
pasteurization base their arguments on the results obtained in
the reduction of infant mortality following the institution of
the process. Opponents state that the rendering milk safe by
this process puts old, stale, decayed milk on an even footing,
from the standpoint of salability, with clean, fresh milk, and
there is no escaping the conclusion that, in part at least, they
are justified. They also argue that, just as in “cooked” milk,
there is the possibility of resultant scurvy in the consumer.
In this particular their arguments appear to be unsubstantiated. —
In the Transactions of the Second International Congress on
the Milk Industry, held in Paris in 1905, Dr. H. de Rothschild,
speaking of infantile scurvy, refers to objections raised to pas-
teurization on the ground that it causes this disease. He says
-that a careful study miade by him for ten years showed only
23 cases in the whole of France; and that he is forced to con-
clude that if such a process is effective in the reduction of
gastroenteritis, tuberculosis and typhoid fever, to base an ob-
jection to its use on the ground that it may cause a disease
that has occurred but 23 times in ten years is not valid.
One or more of these three methods of securing a clean, pure
milk are used in communities the world over with success that
is more or less perfect. The majority of observers seem to favor
183
a combination of thorough inspection followed by pasteuriza-
tion, — not overlooking or belittling the immense advantage
of clean production and distribution, but augmenting that by
the additional safeguard of pasteurization.
Dr. Henry Helmholtz of Chicago says on this subject: —
There are those who would prevent all infant mortality if they could
only feed all children of the tenements a pure, clean, raw milk. There
are those who would accomplish the same end by feeding them, one and
all, pasteurized milk. In each case they do not realize that infant mortal-
ity is a very complex problem, and that either one of these things is only
a small factor, and that when it comes to the feeding end of the problem
perhaps the most important thing is not so much what is fed as the way
in which it is fed.
2. Epucatinc MortTuHErs.
As pointed out earlier, the contamination of the milk after
delivery at the home is perhaps our most common present
source of danger. No matter how pure and clean the supply,
dirt added there renders the article just as deleterious as dirt
added at any point previously, allowing only for the length
of time between pollution and use and its proportionate bac-
terial growth. The mother who lets milk stand in a dirty
pitcher in the sun for an hour or two, then pours it into a
stale pan and puts it, uncovered, into a half-cooled refrigerator
full of stale articles of food, and who goes through the long
list of dirty methods of getting it into a baby’s uncleaned
mouth, is just as crassly ignorant or as criminally careless as
the unhealthy producer who milks unhealthy and uncleaned
cows in a dirty stable into dirty utensils, and the results to
the infant are just as fatal.
We have laws and regulations which, according to our ex-
perience, are controlling the producer and the dealer to some
degree, — many believe to a large degree, — but we have no
way of reaching by legal means the consciously, or uncon-
sciously, dirty woman in her home. The dirtiness is both
visible and invisible, whether added by the producer or the
housekeeper. There is no excuse for visible dirt in either case;
it can be explained in only one way. Bacteriological dirt is
not visible, and its presence may be due either to ignorance,
to carelessness or to a wilful disregard of teaching. Women
do not want their babies to die. When they are told where
184
the danger lies, and really believe that it does lie there,
there is not much wilful disregard left. If the teacher can
‘check up how well her instructions are being carried out there
is not much room for carelessness. Most women with a young
baby have not much time to go to school, nor can they leave
their babies unattended while they do; therefore the school
must be made to come to them. |
So far we have evolved just one agency that answers these
requirements, — the visiting nurse. ‘The mother believes that
the nurse knows what she is talking about; that she is not
visiting her to make capital out of her, but to protect her
baby; that she is a woman and cannot help loving babies; in
short, she gives her her complete confidence. The nurse’s visits
are frequent, and the mother does not have much time to get
rankly careless between them. At each visit the nurse brings
the school to the home in lessons graded. and fitted to the per-
sonal intellectual capacity of the woman.
Combine this system of education with a pure milk supply
and we have the framework of our present-day methods in the
attempt to reduce our infant mortality rate.
Associations and institutions all over the civilized world are
using this method with a success so universal and so generally
appreciated that no statistics are offered.
Summary.
The infant mortality rate is still higher than it should be, —
higher than the investigators feel is inevitable. A still unde-
termined part of this excess is due to the quality of infant’s
food and the method of its administration. Breast milk is the
natural food for the infant. When this maternal function fails
a substitute food is required. Modified cow’s milk is the com-
mon substitute, although it has inherent qualities that make
it an imperfect food for infants. The supply for our cities
must be brought from a distance. It may become polluted at
any time between its secretion in the cow’s udder and its diges-
tion in the stomach of the infant. To make it reasonably safe
it should be controlled by inspection and pasteurization up to
the point of delivery at the home, and controlled after delivery
by the education of the mother in hygienic methods.
185
D. THE NUTRITIONAL VALUE OF MILK.
After trying to digest the mass of conflicting evidence in the
various aspects of the danger to the public health from milk,
—a subject that from the nature of the evidence obtainable
must be insusceptible of definite proof, — it is a pleasure to
approach a subject in which some definite facts can be stated.
Further, it appears to us that, especially in popular discussions
of the milk question, the emphasis has been generally laid on
these dangers, passing over the enormous value of milk to the
human race with a very light touch; therefore it is doubly a
satisfaction to register our appreciation of the unique place
held by this sterling and indispensable food.
The universal use of milk as an ingredient of a large pro-
portion of the products of the kitchen has perhaps made us
lose sight of its prime individual value as a complete food in
itself, and of the fact that it is the only single article of our
foodstuffs which is so constituted, and is in itself so balanced
and complete a ration, that human life can be sustained on
it alone for a long period. For infants human milk is the per-
fect food. As referred to elsewhere in this report, a substitute
food is frequently called for because of the failure of the mater-
nal supply. As also stated, for economic reasons and because
of custom, cow’s milk is the usual substitute in this country.
Cow’s milk and human milk are near enough alike in the pro-
portion of their constituents so that by simple means — so
simple that a person of average mentality can understand and
carry them out — cow’s milk can be made sufficiently digestible
food for the average infant. This is particularly true in cases
where the mother has been able to nurse her child long enough
to get him well started in life. With many infants, however,
the chemical differences between the milk of the cow and of
the woman render cow’s milk, however modified, an unsuitable
food for them.
As compared with the corresponding constituents in human
milk, the proteins in cow’s milk are more abundant and form
a tougher, less flocculent cord, which is less easily penetrated
and dissolves more slowly in the digestive fluids. The propor-
tion of casein in the proteins is larger, and of lactalbumin,
186
smaller. The fats in cow’s milk occur in larger globules and
have a higher melting point. The sugar in cow’s milk is less
in amount, but identical in composition. The salts in cow’s
milk are more plentiful, and are those of lime and magnesium
instead of those of potassium and sodium. Further, while both
are alkaline when drawn, the cow’s milk soon becomes acid
and is usually so when used in the home. These chemical dif-
ferences are inherent and unavoidable. As milk ages, further
changes take place as the result of bacterial action, which are
‘more or less deleterious to the infant. The conditions under
which milk is transported and stored, and the: time elapsing
between milking and consuming, are directly concerned in these
changes. |
Faulty methods of production, distribution and receiving and
caring for the milk at the home give opportunities for pollution
of and consequent changes in the food value of milk. But in
spite of these drawbacks modified cow’s milk is the almost uni-
versal substitute infant food in this country, and is a generally
adequate and satisfactory substitute. Its value to us as a food
for infants cannot be overestimated. It is indispensable. As
a possible negative proof of the value of cow’s milk as infant’s
food the following is of interest: In a New England city of
120,000 inhabitants the total daily consumption is 27,000 quarts
of raw milk, or .22 quart per capita, and 5,000 cans of con-
densed milk. The infant mortality rate is 171 per 1,000. In
investigating the subject the local board of health states that
raw milk is used for infants in very much smaller amounts than
it should be, condensed milk, beer and coffee being used in-
stead. Dr. Howarth of Derby, Eng., is quoted by Newman
as follows: “Children fed on condensed milk show a very
high mortality, viz., 255 deaths per 1,000 of children so fed.”
Physicians would not ordinarily advise the use of beer and
coffee as a substitute for mother’s milk. It is conceivable that
the freer use of raw milk as a food for infants would result in
a lowering of the infant mortality rate in this particular city.
The value of milk as a food for adults is, as a rule, rather
under than over estimated. The digestive apparatus of the
adult can disregard the chemical unsuitabilities with far more
impunity than can the infants’. The worst feature of milk as ~
a sole food for healthy adults is that it is too wholly digestible;
187
it does not contain in itself enough waste matter. The intes-
tines of an adult have been accustomed to a good percentage
of bulky, inert matter to serve as a vehicle for body wastes in
their discharge. Milk itself does not provide this bulky waste,
and for this reason may well be characterized, as has been done
by Rosenau, as “too perfect food for the adult.” Although
perhaps “too perfect”’ for the healthy adult, this stricture can-
not hold in the case of the sick adult. Here its easy digesti-
bility and perfect balance as a food make it about as indispen-
sable as it is in the case of the motherless infant. Dr. George
W. Gay, in his testimony before the milk committee of the
Massachusetts Legislature in 1910, emphasized very strongly
the value of milk to the sick adult. He said, “Milk is the
chief food of sick folks. We could not take care of sick folks
if we did not have milk. The importance of milk as a food
for sick people — adult sick people — cannot be overstated or
overestimated.”
Here, again, the pollution or contamination of the milk before
it is swallowed may reduce its suitability as a food to the point
of rendering it absolutely dangerous even to healthy adults;
far more to sick ones. (
And, again, the statements as to its food value hold good.
Its place as a food for adults, particularly sick adults, cannot
be overestimated; it is indispensable.
As compared with other foodstuffs its value is very high, so
high that at present prices it is one of our cheapest of foods.
As a readily understood comparison take the following: An
adult man would need from 4 to 5 quarts of milk daily to
supply his food requirements. The food value of 4 quarts of
milk, if expressed in common foods, would provide the follow-
ing amount as a daily supply: —
4 eggs.
# pound lean beef.
2 pounds potatoes.
1 pound cabbage.
4 pound bread.
3, pound butter.
A quarts of milk, .
This is not offered as a balanced ration, but as a showing of
the actual food value of milk. In view of this great economic
value of milk as a food the waste that takes place in certain
188
phases of the milk business is much to be regretted. The de-
mand of the public for cream, as such, leaves a large amount
of skimmed milk that has an uncertain market. Skimming
milk removes about two-thirds of the fats, and hardly touches
the proteins and carbohydrates, and the proteins are the
muscle-building part of the milk. On the farm this skimmed
milk is used in the family, fed to swine, calves or chickens, or
thrown away. When used for feeding, of course this valuable
food is not wasted in its entirety, but even then it is using
food of a very high nutritive value where a less valuable one
might possibly be substituted, provided a suitable use could
be found for the skimmed milk. Where it can be obtained in
large quantities, large enough to warrant the investment, it is
manufactured into casein, when the milk sugar is entirely lost.
In the aggregate large quantities of skimmed milk are wasted
through the lack of intelligent demand for a valuable article.
Determined by the chemical analysis, with the retail price of
whole milk at 9 cents per quart, the actual value of skimmed
milk is 4.6 cents per quart, and its retail market price at date
is about 2 cents per quart. When people realize that for 2
cents they can get an article whose actual value is 4.6 cents,
it would seem that the demand for it must increase, that the
price will rise and the waste be checked.
SUMMARY OF PART V.
A number of the human communicable diseases are trans-
mitted through milk. Those of the most importance in Massa-
chusetts are tuberculosis, diphtheria, scarlet fever, septic sore
throat and typhoid fever.
In tuberculosis the milk may be infected by the cow produc-
ing it, or by the human beings who handle it.
-In the other four diseases mentioned, except possibly in the
case of scarlet fever, the infection does not originate in the
cow; the source is in the human handlers.
The amount of communicable disease transmission through
cow’s milk has been overestimated, but such transmission does
occur in a degree of frequency which demands public protection,
The infection of milk with human disease germs may occur
at any time between its secretion in the cow and its consump-
tion.
189
In addition to infection with human disease germs milk may
be otherwise polluted, or may decay to a degree that renders
it an unsafe food for human beings.
To insure its safety as a human food two celeste of con-
trol are necessary. "
First. — By inspection of cattle, methods of production and
transportation, secure a supply that is pure, clean and fresh.
Second. — By the application of heat, destroy all disease
germs that may be in it, whether they come from animal or
human sources.
There are two methods of disinfection by heat in common
(a) complete sterilization by boiling, and (6) partial ster-
ilization, “ pasteurization,’ by heating the milk to between 140°
and 150° F. for from twenty to thirty minutes.
Both of these methods are effective. The partial steriliza-
tion, “pasteurization,” seems to have fewer objectionable fea-
tures, and is already established in this country as an accepted,
successful process.
To obtam the most perfect Baers market milk, intended for
human consumption as milk, should be pasteurized under the
control of central authority and in the final container.
190
PART VI. THE GRADING OF MILK.
A. GENERAL DISCUSSION.
It is the prevailing opinion of those who have made a study
of the subject that milk should be graded, although it is evi-
dent that the ideal system has not yet been devised. The
system should aim, first, to aid in the production and distribu-
tion of milk which is safe from a health point of view, and
which is of varied chemical composition.
The present Massachusetts statute contemplates to a slight
extent the latter consideration by establishing a minimum stand-
ard of 12.15 per cent. for solids and 3.35 per cent. for fat, and
the constitutionality of this type of statute has been repeatedly
upheld by the Supreme Courts of this and other States on the
ground that it is a health law. The courts recognized the fact
that the milk of many cows did not come up to the standard,
but were of the opinion that the people should be protected from
an impoverished food. As a rule, where a minimum standard
is established the quality of the milk adapts itself to the standard.
Massachusetts, however, is an exception to this rule. The fig-
ures obtained from the samples collected by the inspectors of
the Massachusetts State Board of Health show that the average
milk sold in this State is 4.5 per cent. above the standard for
solids and 14.6 per cent. above the standard for fat. The dis-
crepancy is due to the fact that only a sample of skimmed
milk can literally comply with the standard.
The following table shows the average composition of milk
not declared adulterated, which has been collected and exam-
ined by the Massachusetts State Department of Health.
Number P
YAR. of Solids. Fat eos
Samples.
1909 4,242 12.78 4.10 8.68
1910 5,032 12.85 4.02 8.83
1911 4,341 12.83 4.00 8.83
1912 4,516 12.66 3.89 8.77
1913 6,154 12.69 3.84 8.85
1914 5}502 12.70 3.82 8.88
1915 6,765 12.68 3.82 8.86
191
‘Commercial grading of milk is to some extent practiced thus:
Many dealers sell milk of different fat content, charging dif-
ferent prices, and others sell one grade of milk, charging a
higher price than the usual commercial price by reason of its
high fat content. No attempt, however, seems to have been
made at official supervision of the sale of milk upon its chem-
ical composition other than the necessary establishment of mini-
mum standards. |
Attempts have been made by different cities and towns to
control the sanitary condition of milk by fixing by regulation
a maximum bacteria content above which the milk cannot be
sold. This is true of many cities and towns in Massachusetts,
but beyond a few warning letters and some newspaper pub-
licity but little attempt seems to have been made to ae
enforce these regulations.!
Standards of this sort are not to be construed as Le
because they are applied to the milk intended for use by the
ultimate consumer, and the retail or wholesale dealer can easily
devise means of controlling the final product by proper selec-
tion of milk in the one instance and by pasteurization in the
other. The contractor will buy high-grade and low-grade milk
at the same price, and by mixing these various grades of milk
the fat and solid content of the mixture will more or less con-
form to the standard. The producer under these circumstances
is paid by the quart, irrespective of the fat content of the milk,
or, if any change in price is made, it is liable to be a reduction
in the case of the low-grade milk. The contractor will also
buy indiscriminately clean and dirty milk, and will mix, clarify
and pasteurize it, thus giving no incentive to the farmer to
produce clean milk.
There seems to have been no attempt made on the part of
any State to establish and control the grading of milk, but the
cities in New York State, under the provisions of the sanitary
code of the New York State Department of Health, are_at-
tempting to do so. New York City, however, under the author-
ity of the City Health Department, is maintaining. successfully
a grading system, based upon the bacterial content, whereby
both the producer and the consumer are adequately compen-
sated and protected. This system, which can be easily con-
1 Brockton is a notable exception to this statement.
192
trolled when dealing with a congested population, prohibits the
sale of raw milk unless of a quality resembling certified milk.
This milk must be below a maximum bacterial content, must
be obtained from tuberculin-tested cattle which are housed in
stables of a minimum score on the special score card designed
by the Department. All other milk must be pasteurized in
apparatus approved by the Health Department, and in making
the pasteurization regulations the commission has devised the
scheme which makes the system a success, — by appealing to
the commercial instinct of the dealers. If the bacterial content
of the raw milk is above a certain fixed maximum this milk
cannot be pasteurized and sold unless labeled “Grade C, for
Cooking Purposes Only.’ In order to avoid the degrading of
his product the contractor must select his dairies carefully, must
pick out dairymen who furnish clean milk of a low bacterial
content, and, in order to obtain sufficient milk to satisfy the
demands of the retail trade, must pay more money to the
dairymen furnishing such milk. Another important feature of
this system is the regulation regarding two grades of pasteur-
ized milk. The Grade A pasteurized milk is obtained from
better stables and has a lower bacterial content before pasteur-
izing than the Grade B milk, and the public is willing to pay
a higher price for the Grade A pasteurized milk. The sales
of this grade are said to be increasing, and in order to comply
with the demand the dealers made it a financial object for
dairymen to produce milk of the Grade A quality of pasteuri-
zation.
The commercial pasteurization of milk should be inspected
and carefully controlled by the health departments. Notwith-
standing the fact that modern methods of pasteurization render
milk safe, yet it is a fact that pasteurized milk is very easily
contaminated, and after such contamination the growth of the
bacteria is more rapid than in the case of raw milk less than
twenty-four hours old. The reinfection of pasteurized milk can
take place by means of a dirty cooling apparatus, dirty air in
the cooling and bottling rooms, dirty bottles and dirty help.
A man sick with typhoid fever working in a milk-bottling room
can cause as much if not more damage than. if he were on a
farm engaged in milking cows. An occasional visit on the part
193
of the health authorities, with a thorough bacteriological exam-
ination of the milk in all stages of the process, will tend towards
a safer milk supply than uncontrolled commercial pasteuriza-
tion.
The pasteurization of milk should be permitted but once, in
order to render the process entirely a health measure instead
of being largely a commercial measure. This will insure the
sale of milk of near-by production and milk not too old for
consumption. The application of pasteurization was primarily
designed in the case of milk for commercial purposes in order
to enable dealers to market milk which, owing to age, could
not otherwise be done. It should now be regarded as a neces-
sary health measure, and its application be carefully studied
from this standpoint rather than from a standpoint of pure
commercialism.
Wherever milk is bought upon a fair equitable price based
upon the fat content the producers invariably breed cattle
giving milk with a high fat content, probably due to the fact
that they recerve more money per cow than if the milk is
bought upon a flat rate per pound or per quart. It seems fea-
sible that this system should be extended to selling at retail,
and it would result in the paying of a higher price on the part
of the consumer for high-grade milk, and, on the other hand, |
would encourage the sale of milk of a low fat content to those
who could not afford to pay the higher price of milk high in
fat. Under these conditions there would be a greater consump-
tion and less waste than at present of that valuable food, —
skimmed milk. Grading of this sort could be carried out only
after repealing the skimmed milk law and permitting the sale
of mixtures of skimmed milk and cream in all proportions, pro-
vided that the customer is aware of the fact and the per cent.
of fat is stated upon each container. This is to some extent
illegally practiced by many dealers who mix skimmed milk
with high-grade whole milk for the purpose of producing a
product but slightly above the standard, which form of adul-
teration if skillfully done may escape detection upon chemical
analysis. This process, while reprehensible when applied to
milk bought and sold by volume, is unobjectionable if the
purchase and sale were based entirely upon the fat content.
194
If a grading system of this sort were instituted, the present
standards of solids and fat should not apply to milk if the
containers were labeled with the fat content, if (1) the milk
were free from added water, and (2) if it complied with a mini-
mum solids not fat standard based on a sliding scale of 8.7 per
cent. in skimmed milk or milk with 0 per cent. fat, and of 0.0
per cent. in a hypothetical milk with 100 per cent. fat.
195
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Tape II]. — Comparison of Prices and Values of Milk, Skimmed Milk
and Cream by Various Methods of Computation.
Skimmed Milk.
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3 a 20] So a0] So foyer So 2,04 S°0 se 8A, =e)
ie (o) 4 So 4 S _ S a“ S ie S
0 158 1.0 1.7 1.01 2.0 2.02 2.8 2.0 4.6 PR) 5.9
1 203 1.6 2.2 ere 2.5 2.9 3.6 3.8 5.9 4.1 7.6
2 229 2.2 2.5 Zao 2.9 3.8 4.1 5.6 6.7 gt 8.6
3 262 2.9 2.8 3.2 3.3 4.7 4.6 7.4 7.6 7.3 9.8
Whole Milk.
4 316 OL 08) Varo 4.0 4.0 5.6 5.6 9.24 9.2 8.9 11.8
5 369 4.1 4.1 4.7 4.7 6.5 6.5 11.0 10.7 10.5 Bs 7
6 421: 4.7 4.7 5.4 5.3 7.4 feo 12.8 12.3 12.1 15.7
7 470 5.3 52 6.2 6.0 8.3 8.3 14°6 13.7 13)57/ 17.5
Cream.
8 488 6.0 5.4 6.9 6.2 9.2 8.7 16.4 14.2 15.3 18.5
9 526 6.6 5.8 Weds 6.8 10.1 9.3 18.2 18) 16.9 19.6
10 567 UP 6.3 8.4 2) 11.0 10.0 20.0 16.5 18.5 21.1
15 769 10.3 8.5 12.0 9.7 15.5 13.4 29.0 22.4 26.5 28.7
20 972 13.4 10.8 15.8 1253) 20.0 17.2 38.0 28.2 34.5 36.2
25 | 1,176 16.5} 13.0 19.5 14.8 24.5 20.8 47.0 33.2 42.5 44.0
30 | 1,378 (19.6) 15.2] 23.2 17.5 29.0 24.4 56.0 40.0 50.5 51.6
35} 1,579 | 22.7 | 17.4] 26.9 19.9 33.5 28.0 65.0 45.8 58.5 59.1
40 | 1,788 | 25.8] 19.7] 30.5 22.5 38.0 31.5 74.0 51.7 66.55) 66.5
45 | 1,985 | 28.9] 21.9] 34.3] 25.0] 42.5] 35.0| 83.0] 57.7| 74.5| 74.0
50 | 2,188 | 32.0] 24.3] 38.0 27.6 47.0 38.7 92.0 63.7 82.5 81.0
55 |] 2,390 | 35.1] 26.5] 41.7 30.3. 51.5 42.4] 101.0 69.6 90.5 89.2
60 | 2,593 $8.2 | 28.7] 45.4 32.8 56.0 45.9} 110.0 75.4 98.5 96.6
1 Purchasing prices of Turner Centre Dairying Association.
2 Selling prices of Turner Centre Dairying Association.
3 Boston contractors pay from 3 to 3.5 cents per quart for milk,
4 Retail price of milk, 9 cents per quart at 3.7 per cent. fat.
5 Retail price of cream, 60 cents per quart, at 30 to 40 per cent. fat.
198
Under such a grading system the price could be established
in a manner similar to that now employed by the Turner
Centre Dairying Association, — by paying a flat price per quart
plus the value of the butter fat at an established price per
pound.! The tables on pages 195 and 197 show the composition
-of skimmed milk, milk and cream, its food values in calories
per pound, its cost and selling price calculated as described
above, and its monetary value at a definite price per calorie.
The data from which the composition of the milk has been
computed can be found in the reports of the analyst of the
Massachusetts State Board of Health, 1907-14. Judging from
these computations and the data obtained from milk producers,
the Boston milk contractors are buying butter fat from the
farmer at about 31 cents per pound, and selling it at about
85 cents per pound to their retail trade.
A study of Table II. will show that the prices paid for
cream are much higher than the increased food value should
warrant, and that the skimmed milk is far more valuable than
its market price. At the present price of skimmed milk (2
cents per quart) cream containing 40, per cent. fat is worth
22.6 cents per quart, and at the present price of cream (60
cents per quart) skimmed milk is worth 5.9 cents per quart.
It is indeed unfortunate in these days of high food prices that
such a quantity of valuable and highly digestible protein and
carbohydrate food is wasted, owing to the excessive demand
on the part of the public for cream.
The grading of milk by the New York City Health Depart-
ment has been successfully carried out by limiting the number
of bacteria before and after pasteurization, and the dealers now
comply with the regulations without any serious objections;
but on the contrary, no attempt has been made to establish
by law or regulation the sale of milk upon its merits according
to its chemical composition or food value. Any attempt to
establish the latter form of grading would be in the nature of an
experiment, but would in all probability be easier of operation
and control than the bacteriological grading system, because
1 The Turner Centre Dairying Association in October, 1916, was buying milk or cream at 50
cents per 100 pounds plus 37 cents per pound of butter fat, and was selling milk or cream at $1
per 100 pounds plus 45 cents per pound of butter fat. The sale of this milk or cream is almost
entirely wholesale by this company. —
199
the wholesale business in milk is now carried on in many places
by payment upon the fat basis. The public could estimate to
some extent the difference between different grades by the
cream line, and furthermore, the fat content. is more easily
and accurately determined than the bacteria content, and is
not so liable to fluctuation.
A requirement that all milk should be pasteurized could be
easily carried on without hardship in but few cities and towns
in Massachusetts, notably Boston, Cambridge, Somerville,
Everett, Chelsea; Revere and Winthrop. Outside of these
localities, with but few exceptions, the bulk of the milk sold
is raw milk, and is sold by small dealers, many of whom own
their own cows and market their own and their neighbors’
milk. Many contractors in smaller cities do not resort to pas-
teurization, since their milk comes from near-by cities and
towns, and pasteurization is therefore not a commercial neces-
sity, and for them it would in many instances be an expendi-
ture unwarranted from a commercial standpoint by the size of
their business, although public health might warrant its appli-
cation. The most efficient pasteurization from the commercial
standpoint is the continuous process in which, by the holding
system, it is necessary to have sufficient milk to take at least
thirty minutes in flowing past a given point in the apparatus.
The flash process can be operated with a smaller quantity of
milk, as it requires but fifteen to forty-five seconds for the
milk to pass from the mixing tank through the heater, over
the cooler to the bottles. This process, while more expensive
to operate because of the higher temperature to be attained,
however, is open to the objections that the tubercle bacillus
may not be killed in the short time it is exposed to the heat.
It is, however, very efficient in reducing the number of bac-
teria, and causes no coagulation of the milk albumin.
The prohibition of the sale of raw milk from other than
tuberculin-tested cattle could not be put into immediate opera-
tion in Massachusetts without causing a milk famine for a
time at least, as undoubtedly 90 per cent. of the Massachu-
setts dairies supply milk from cows not so tested. The dairy
scores of the Massachusetts State Department of Health ob- .
tained during 1913, 1914 and 1915 substantiate this statement
200
as do the data furnished by the State Department of Animal
Industry; in fact, the figures furnished for 1915 indicate a
much smaller percentage of tuberculin-tested cattle in Massa-
chusetts than during 1914.
A requirement that all raw milk sold in Massachusetts should
come from dairies with a relatively high score on the United
States score card would put 50 to 60 per cent. of the milk pro-
ducers out of business, and would cause a milk famine in all
places other than large cities and towns where the sale of pas-
teurized milk is the rule, and would play directly into the hands
of the large dealers. It is possible, however, to devise a modi-
fied score card where great stress is laid upon methods and less
upon equipment than in the present score card.
If grading were entirely a matter of local option its adoption :
and operation would probably be carried on as extensively in
the future as at present, since each city and town can now
adopt such a system under chapter 744 of the Acts of 1914,
and none have seen fit to do so. The local adoption of such
a system in Massachusetts would lead to serious disturbances
among dealers who sell the same product in several towns, and
it would result in selling elsewhere the milk too poor to conform
to the requirements of certain localities. The cost of operating
the system would be so high that many cities and towns would
be unable to enjoy its benefits. Such a system should be en-
acted by statute, and should be enforced by a central authority,
— the. State Health Department, — since the system has as
its prime motive the health of the people. \
B. RELATION BETWEEN SOLIDS AND FATS IN MILK.
The chemical analyses of milk made by the analysts of the
Massachusetts State Department of Health have shown that
a fairly definite relation exists between the percentage of solids
and of fat. If in the average sample the per cent. of fat is
much higher than the normal fat corresponding to the solids the
sample is probably watered, and if much lower, the sample is
probably skimmed. The greater the difference between the
normal fat and the fat determined upon analysis the greater
the probability of adulteration. The State Department of
201
Health has collected and examined during the past nine years
1,000 samples of milk of known purity from individual cows;
that is, these cows were milked in the presence of an analyst
or inspector of the State Department of Health, the milk of
each cow was thoroughly mixed, and a sample was taken and
examined in the laboratory. ‘These analyses were made for
the purpose of ascertaining the minimum percentage of ingre-
dients below which milk could be declared adulterated; there-
fore the majority of the samples were taken from cows giving
a heavy flow of milk and from those breeds known to give
relatively poor milk. The relation between the solid and the
fat content of the samples has been determined for each 0.1
variation of solids between 10 and 16 per cent., and for each
~ 0.1 variation of the fat between 2.4 and 6.4 per cent., from
which relation the average solids and fat for each 0.1 variation
of either ingredient has been calculated. This table is too
bulky for insertion, and a summary has been made and is
presented herewith.
During the year 1913 the Department collected and exam-
ined 6,044 samples of commercial milk which could not be
declared adulterated by the methods of analysis employed. The
relation between the solids and fat content of these samples
was determined in a similar manner to that employed with
the known purity samples. The summary of this table is
presented herewith.
202
%6$
18°& = £0°9 oh G 68°F LVY 80°7 848 Lvs 82 Ee -| 60°¢ £8°S a a ; . : “qB} od UIOAY
19° GI. 4¥0'9 Or 66 18 68 6LP 190'T 198'T 99ST 19g SOT 6¢ v : : * ‘sejdures yo requin Ny
Ze St L & v = 3 = = = = = 5 =. = : : 5 2 : * *6°9-9°9
G¢ ST 9 I ¢ = 5 = = = = = = = ise f : 3 : : * *¥°9-0°9
18°F ig P 8 & Or = = = S = S 7 S : ‘ : : = * *6°G-G°¢
&& 1 ST 6 It GE 6€ ¥G i = = eee a he = = : 2 : Soe Served ORG
GL TOP - 5 I &% ZO 941 8 6 I em is = = : : Soe : SCE rata
OL &t OIF T = = =. IG 696 999 LV, 8g = T es = : : ; : : a State Oay,
6) GT 8SL'S = es = I LT (ats Ile I 116 66r 9T I = : : : : : fet onGoed eG
90°6t LLVT = 3 = 3 = ¢ 0et 0&$ 666 TOT II I ; : : ; : eae aONe
86 TT 60T = = s = = = = 9 && 97 &% I : 3 : : : * *6°3-9°
19° OL L = = - a = = = z = I ves G : : : 3 ‘ " “F'°S-0°S
“YU [owiawmwumoy fo sajdwungy fo saquin z
S0°7 = 60°9 19'S 96° €8°7 89° P 98°F 66° 99°€ 66° 1G & 88° 196 |” : : : ‘7B eoBIOAY
SLOT 000'T 1G 16 187 LL 06 OFT Tr 4|, 191 OTT 98 87 oT : ; * ‘seydurus jo sequinyy
99ST 1G v1 L = ze E = ze = = = = = ; = : : é e202 020
GOST 8 1 It L id I = = = = = = = : : 2 f = se Ong e deg
66 PL 19 = 8 1G 66 Z g = = = = = ES i : z 5 * * “p'g-0'9
GL ET GET = I rae LE lV 96 L = = = Ee = : 3 ; = * 6-or
20° €1 £06 = > = 6 I 68 99 9T (4 = = = : : : : : * “F407
08 Cr G96 = = = z Fe 61 v6 86 68 ST = = : : 3 = < ie Oncedas
19° TT 96T = = iz = a 3 v Li 04 Lg 9T G : E z : 2 2 PBN) 18
T8OF 19 3 = = 3 iS = = = ¢ v1 Té ia ; : : : : “6589'S
0€° OL v \ = Z es S = = 5 s + = Li & : 3 : : SAPO
*(-qu09 6ST PST 6° FI ina! 6° &T ¥ &1 6° GI pCrL | 6 IT PIL 6° 0T ¥ OF
1d) ‘sopdureg}) —9° CT =) SEAL -0°F1 —o eT -0'&1 “FOL -0 GI =e! -0'11 -2° 01 -0° 01
d jo ‘CINGD udg) IVT
PHOS |raqum
ODBIOA YT ee
‘CINED Utg) SGITIOG IviLoy,
“yp W Apung unouy fo eae {0 Laquin vy
‘YLT U2 DY puw» spyog 170, waamjoq WorDpE¢
203
After the averages had been computed it was found that the
known. purity samples up to 14.7 per cent. solids were rela-
tively higher in fat than the commercial samples, but above
this percentage of solids were relatively lower. The detection
FAT — PER CENT
LS LFO9
BS OOO, U/
AELB SOUOS (EAL, C22kfEg LOME/BY
Y>fPYSSOLOOT APOLLO GYESII/ILSSEY
N}
S
SN
ge
98
NIN
NN
NN
XS
NS
Xo
S
PUPAL
of skimming is difficult when the fat content is between 3 and
5 per cent., and the differentiation between milk and cream
is difficult when the fat content is between 5 and 7 per cent.
These two conditions probably account to some extent for the
difference between the two sets of averages. The curve of the
average solids and fat is shown in the above chart.
204
At the request of Prof. George C. Whipple these analyses
were plotted upon the arithmetic probability scale of Hazen
and Whipple. The percentages are so arranged upon this scale
PERCENT OF INGREDIENTS
Hi noe
MU) THIEFIWMAD 1087 ae
ONY
8 TTT ee
[Ul COO annEB sat amesesazentatae
= SeEeereerstrieter==er =e
PEROT OAOONI jill 8
Hi TH HE tite IS
sree Hit PEEPEEEEEEEHH ew |e
Boe daagessee2 nese ssceeSneeesesec =
| te ttt y
EEE Hh BORG a
Ul PETS og
‘ He Se
: ESS
H . |S
aa)
S
CEG
7
Lito WA
JO NOILIGODGMOD NI NOILY1E7A
HO SNFILIA oy
a
g
,
Gy
SH
sto NECENCEEEEEE
> Hh rain ENTE Hoon ae ai
:- ane Me NTT oo LEN Tea NTT
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:
5
Ag
that if the data are obtained in sufficient quantity, and the
variable follows the law of probability, the resulting curve will
be a straight line. While the lines obtained in these instances
are not straight, they are so nearly straight that we are jus-
205
tified in assuming that sufficient samples have been examined
from which definite conclusions can be drawn.
In the probability chart presented herewith the abscisse
(horizontal dimensions) represent the per cent. of samples, and
the ordinates (vertical dimensions) represent the maximum per-
centage of ingredients. For example, 20 per cent. of the known
purity samples contained less than 11.6 per cent. solids, 3.3
per cent. fat and 8.2 per cent. solids not fat. Twenty per cent.
of the commercial samples contained less than 11.9 per cent.
solids, 3.1 per cent. fat and 8.29 per cent. solids not fat. Not-
withstanding the fact that the solids were higher by 0.3 in the
commercial samples, the fat was lower by 0.2, a difference of
about 7 per cent. in the total fat content. Forty per cent. of
the samples in each instance contained less than 12.35 per cent.
solids, the known purity samples containing less than 3.7 per
cent. fat, and the commercial samples containing less than 3.3
per cent. fat, a difference of 0.4, or about 11 per cent., of the
total fat content.
Under the assumption that the average commercial samples
should contain the same average fat as the known purity
samples of the same total solids content, the per cent. of fat
corresponding to the per cent. of solids has been calculated and
inserted in the chart as a dot and dash line, and the space be-
tween the calculated and found fat percentages has been cross-
hatched in order to emphasize the deficiency in fat of the com-
mercial samples. When the fat exceeds 5.2 per cent., however,
the commercial samples have a higher fat content than those
of known purity, probably because samples of low-grade cream,
claimed by the dealer to be milk when the inspector took the
samples, are included in this portion of the chart. These sam-
ples, however, are less than 1 per cent. of the total number.
Ninety-nine per cent. of the average samples had less fat than
would be expected if they are judged by the average quality
of the 1,000 samples of known purity.
206
PART VII. EXPERIENCES OF OTHER LOCALITIES.
A. REPORT ON AN INVESTIGATION OF THE NEW YORK
CITY MILK GRADING SYSTEM IN THE CITY OF NEW
YORK.
On October 4 representatives of the State Department of
Health visited the Department of Health of the city of New
York, and saw Mr. Lucius P. Brown, chief of the Division of
Foods, and Mr. Russel Sturgis, director of the Milk Inspection
Department.
The present system of milk grading in New: York City has
been in operation for nearly three years, and is meeting with great
success and producing good results. ‘There are four grades: —
Grade A,
one
Grade B, pasteurized.
Grade C, pasteurized.
- All these grades must be properly labeled, and Grade C must
be labeled “For Cooking Purposes Only.” Milk can be pas-
teurized only once. The Grade A raw milk is substantially
the same as certified milk. The Grade A pasteurized milk is
of the same quality as Grade A raw milk, except the cows need
not be tuberculin tested. ‘The Grade B raw has been discon-
tinued. The following table shows the grading system apse
in New York City: —
Grade A.
1. Raw.
Dairies: —
Equipment, . wh TA SRN Tey Mik = ii ys ss AIS ea
Methods, A MEARNS uh a hike SPENDS RIAINL Tah oy eRe ae SL)
Bacteria: —
60,000 per cubic centimeter.
2. Pasteurized.
Dairies: — }
TOL IMO GE e2) o.e oR ie 2 ie eR a
Methods, elle og ac Re Rete a ae 7 Ra Re
Bacteria: —
200,000 per cubic centimeter before pasteurizing.
30,000 per cubic centimeter after pasteurizing.
207
Se a ' Grade B.
Pasteurized.
Dairies: 1 —
TRL TUNT OLA CSTE FRNA ea Sorin icity noe Ms Pea i ke Suber bain’ 8)
IVE TOS ERS) RECN Se ACM MEME UA MANAG, ORR LAYER ROSE Re eg ig
Bacteria: —
1,500,000 per cubic centimeter before pasteurizing in city.
300,000 per cubic centimeter before pasteurizing in country.
100,000 per cubic centimeter after pasteurizing.
Grade C.
Pasteurized.
Dairies: —
CIRC se AGL WAG chad oe Beat} (1 AS AS ROR oe ca 0)
Bacteria: — :
300,000 per cubic centimeter.
If milk does not comply with the requirements of the rules
and regulations it may be degraded. One of the principal fea-
tures of this system is the requirement that milk containing
more than a maximum of bacteria shall not be pasteurized.
This makes it incumbent upon the milk dealer to see that the
farmer is careful in milking, and that he cools the milk and
delivers it as soon after milking as possible. A vast majority
of the Grade B sold in New York City reaches the consumer
not more than thirty-six hours old.
For the control of pasteurizing plants 18 country inspectors
are employed and three city inspectors. These numbers vary
from time to time. Each pasteurizing plant is supposed to be
covered once per month, the inspector taking from 16 to 30
samples in each plant. He carries a special ice box in which are
placed 1-ounce vials with a screw-capped metal cover, and carries
a bundle of sterilized aluminum pipettes about 2 feet long.
In the ordinary inspection ot a pasteurizing plant the in-
spector takes 4 samples from the mixing vat, 4 from the out-
let of the holding tank, 4 from the outlet of the cooler, 4 from
the bottles ready for shipment. The time the samples are
taken is noted upon the sheet, and also the temperature of
the milk and the bottle number. Under extraordinary con-
ditions samples are also taken from the outlet of the clarifier,
from the outlet of the heater, and, if more than one holding
1 At present not enforced.
208
tank is employed, from each of the several tanks. The in-
spector, furthermore, makes a record upon a separate sheet of
the name of the pasteurizing plant, the character of the pas-
teurizing apparatus, the temperature to which the milk was
heated, the length of time it was held, the temperature of hold-
ing, the temperature at which it was received, and the tem-
perature to which it was cooled. The bottles and cards con-
taining the original data of collection are ‘then transported
either in person by the city inspectors, or by express by the
country inspectors, to the bacteriological laboratory. From the
samples taken from the mixing vat two dilutions are made —
1-100 and 1-10,000— and a composite sample is taken for the
isolation of the colon bacillus. The samples of heated milk
are plated from dilutions of from 1-100, and the colon bacillus
is isolated from the sample from the holder. In addition to
this a sample of the water is sometimes taken, and a sample
of can rinsings and bottle rinsings. For this latter purpose
the inspector carries a bottle containing 50 cubic centimeters of
sterile water. The contents of these bottles are poured into a
bottle or can which is thoroughly shaken and the liquid returned
to the original bottle. These samples are plated straight and
1-100 dilution. The results of the 4 samples are averaged, and
the average figure taken upon which to base the opinion of
the conditions at the plant. ;
The Department permitted access to the records, and the
results of 50 inspections were copied, omitting, however, the
name of the dealer. The following are characteristic results
from pasteurizing plants operated under good conditions and
under poor conditions: —
Plant operated under Good Conditions.
Bacteria
CHARACTER OF MILK. per Cubic’ Centi-
meter.
Raw, . A 4 : 2 i z f : i , 5 & % H 124,5001
At various stages of pasteurization: —
From outlet of holding tank, f 5 é i z 5 P 3 2,7002
From outlet of cooler, . 4 H 2 a f 5 g . : : 275
From cans, . : “ : _ i a A 4 : 5 , ‘ 1,975
1 Colon bacillus present in dilution of 1-100.
2 Colon bacillus not present in 4 cubic centimeters.
209
Plant operated under Poor Conditions.
Bacteria
CHARACTER oF MILK. per Cubic Centi-
meter.
Raw, . 5 : 2 “ 3 - : : 5 - a : 3 : 18,850,0001
’ At various stages of pasteurization: —
From outlet of pasteurizer, . y 3 4 : ; g i , 15,000,000
From outlet of holding tank, 5 : 3 : Sve 4 6 ‘ 100
From outlet of cooler, . Fa NBER ayia 2 3 i ; A ‘ 15,000
From cans, . ay . x 4 i : is : y e ‘ 60,0001
1 Colon bacillus present in dilution of 1-10,000.
The dealer was notified to label this product Grade C.
The bacteriological laboratory makes 300 bacteria counts per
day. The work is done by 8 women who are paid about $40
per month each. ‘They work under the direction of a woman
who is a competent bacteriologist and doctor of medicine. She.
has nothing whatever to do with the reporting of the results to the
milk dealers, and gives out no information regarding the work.
The women who do the actual work are divided into two
groups. They plate samples upon one day and count upon
the next day, and the work is so arranged that if one of them
is sick another can take her place. A large clerical force is
used to compile the results. Dealers are not prosecuted, and
in general a threat to degrade the milk is sufficient to induce
the dealer to locate the trouble and make the necessary cor-
rections. R
On October 5 a commercial laboratory in New York City
was visited, and the secretary and the director were interviewed.
Inquiries were made regarding the practical application of the
New York grading system. Both men were of the opinion that
the system is all right, provided the regulations are reasonable.
They criticized the recent regulations requiring milk dealers to
sell milk containing not less than 8.5 per cent. solids not fat.
They stated that grading had come to stay, but the ideal sys-
tem had not yet been devised. The present conditions are
infinitely better than former conditions, and no person would
care to go back to the old system. This laboratory does a
large amount of work for commercial milk dealers, and its
210
opinions would naturally be somewhat antagonistic to the
Department of Health of New York City. x
_A milk contracting company was visited, and the chief veter-
inarian and a member of the sales department were interviewed.
The veterinarian stated that the company maintained 11 veter-
inary inspectors and a local inspector at each country pasteur-
izing plant. The veterinarians make systematic visits to the
dairies, each dairy being visited on an average of every six to
eleven months. The local inspectors situated at the pasteuriz-
ing plants are expected to visit each dairy at least every month.
These visits are made for the purpose of seeing that the cattle
are healthy, as tuberculin testing is required for the sale of
Grade A raw milk, but on the average more for the purpose
of seeing that the dairies are kept in such condition that the
raw milk will fall below the maximum bacteria requirement,
above which it cannot be pasteurized without being degraded.
The company purchase milk upon the fat basis, but they
sell their milk by the quart. On inquiring the reason for this
difference the representative of the company stated it was nec-
essary to do so in order to obtain milk of sufficiently high fat
content so that it could be sold in New York without violating
the requirements of the Department of Health. It also en-
couraged the production of high-grade milk and discouraged
the production of butter on the farm. Shortly after they began
to pay for milk upon the percentage of butter fat it contained,
one farmer stated that he purchased butter for the first time
in eleven years. The result of this method of buying has in-
creased the quality of milk which the company have obtained
from the farmers, because they are getting all the cream given
by the cows. The milk is sold by the quart, the prices vary-
ing according to the bacteriological grades of the New York
_ City Department of Health.
When asked whether or not the people of the city of New
York appreciated the grading system, it was stated that the
increase in the sale of Grade A pasteurized milk had been so ’
rapid that they could not obtain caps for the bottles fast
enough from the manufacturers:
In answer to an inquiry as to whether or not they had any
trouble with the city Department of Health regarding the oper-
211
ation of the rules and regulations, it was stated that the com-
pany had no trouble with the Department of Health in any of
their country pasteurizing plants.
The company stated that they began inspection work before
the New York City Department of Health started the grading
system. They are of the opinion that the dealer should be
regarded as a factor in milk production, and be given proper
recognition; and the larger the dealer the better for both the
producer and the consumer. There is considerable competition
between dealers in the producing territory, and this statement
was confirmed by others. If the dairymen are all producing
milk of good quality they will sell at the best prices. Naturally,
the largest dealers will get the best retail trade, have less bad
bills, and can therefore afford to give the most money for the
raw milk and pick out the best dairies. The chief veterinarian
of the company was of the opinion that the farmers under the
best circumstances could not go into the retail milk business
and make a profit. The sales manager stated that he was of
the opinion that Massachusetts milk contractors did not in-
spect their dairies, and he knew that one Massachusetts com-
pany made no dairy inspection in the buying districts where
they came in competition with the New York company. ‘This
was confirmed by a statement made by one of the New York
City inspectors, that the dairies which were rejected by the
New York company were accepted by the Massachusetts com-
pany. Both representatives of the New York company were of
the opinion that grading has come to stay and will be extended.
They were asked regarding the grading of milk in cities in
New York State other than the city of New York, and stated
that the grading law, with a very few exceptions, would not
be enforced by small local boards of health. These local boards
of health made regulations which were not reasonable, by reason
of the fact that they knew nothing about the business, and
most boards would not enforce a grading law by reason of the
fact that they had no money to do so, or did not care to insti-
tute any complaints against their neighbors. When asked what
was the smallest possible quantity of milk which could be pas-
teurized without pecuniary loss neither man cared to give an
opinion.
212
Another company was next visited, and the manager -was
interviewed. He stated that in his opinion the grading system
was all right, but the regulations should not be changed quite
so frequently. New regulations caused considerable trouble to
the dealer, who would naturally purchase a large stock of caps
for the milk bottles, and under changing regulations many of
these caps became obsolete, and therefore had to be destroyed.
He believed the grading system is a good thing, and should be
encouraged, but other communities should follow the New. York
City system as closely as possible, in order to obtain uniformity in
methods of production and distribution. He was of the opinion
that the public did not appreciate the grading system as it
should, and bought milk upon the recommendation of other
people, or of their family physicians, and in general bought the
grade most suited to their means. .
An assistant manager of this company stated that when the
grading system was first established it was regarded by the
dealers as an imposition. At present he has no objection to
the system as a whole, but does object to the changes in the
regulations, specifically the recent regulation requiring a mini-
mum solids not fat of 8.5 per cent. He stated that some local
regulations, specifically those of Buffalo, were more rigid than
the New York City regulations, but in general, outside of the
city of New York, little attempt was made to grade milk in
New York State.
This company employ 11 inspectors, 3 of which are veteri-
narians. ‘They spend their entire time in inspecting dairies, and
each man inspects about 300 per month. The cost to the com-
pany is about $25,000 per annum, of which $15,000 is for
salaries. ‘The reason for the low expense account is due to the
fact that the men live in their inspecting territory, and travel
around by- means of automobiles, which they own, the main-
tenance of which is paid by the company. ‘The assistant man-
ager thinks this is better than the other systems of inspection,
where local inspectors are’ employed in the forenoon as can
receivers and in the afternoon as inspectors. He believes that
acting in the former capacity is beneath the dignity of an in-
spector, and the dairymen look upon it in this way; but when
a man is inspecting all the time he commands the respect of
the farmers. They buy milk upon the bacterial content and
213
upon the fat per cent. He thinks that the board of health
should score the milk, and not the dairy.
This company also purchase small-top milk pails by carload
lots, and sell them to their dairymen at cost price, which
amounts to about 75 cents per pail. The inspectors, however,
find that the farmers are often very lax in the use of such pails.
A copy of a chart was furnished showing the bacterial content
of the raw milk received in their New York pasteurizing plants
each month during the past three years. This work was done
by a commercial laboratory, about 10,000 samples being exam-
ined each year. The figures for 1914 are considerably below
those obtained in 1913, and the figures for 1915 are, in all
cases, below the requirements of the New York City Depart-
ment of Health for Grade B pasteurized milk. This bringing
down of the bacteria count was entirely the result of the in-
spections made and the advice given to the dairymen by the
company. ‘The assistant manager would not state definitely
how small a quantity of milk could be pasteurized at a profit.
He was of the opinion, however, that a dealer could operate
a single tank set, in which the milk was heated, held and
cooled, without removal from the tank.
On October 6 Dr. Hermann Biggs, Commissioner of Health
for the State of New York, was interviewed. In response to
inquiries relative to the operation of the grading system in
New York State, Dr. Biggs stated that the system is working
as well as could be expected, and a number of cities and towns
which never had done any milk work were now beginning to
do some work. The grades are the same as those adopted by
New York City, but each city or town in the State has the
right to make rules and regulations which may be more, but
- must not be less, rigid than those of the New York State De-
partment of Health. Some cities, notably the city of Buffalo,
have made regulations more rigid than the regulations of the
State. Dr. Biggs was asked if there were any cities in New York
State with conditions analogous to those of Boston; where one
city is making the dairy inspections, and making some attempt to
control the pasteurizing of milk delivered in eight or ten cities,
which do practically nothing in the way of milk inspection.
Dr. Biggs stated there were no such conditions in New York
State.
214
B. REPORT ON A SPECIAL INVESTIGATION OF THE EFFI-
CIENCY OF THE NEW YORK Clee TS SYSTEM IN THE
PRODUCING AREA.
Acting on information from the Connecticut Dairy and Food
Commissioner, that he had heard a rumor that certain milk
dealers in Connecticut were shipping milk to New York in vio-
lation of the New York City requirements, one of the analysts
of the Food and Drug Division, in company with a Connecti-
cut dairy inspector, investigated a plant shipping milk from
Connecticut to New York City. The New York City: system
allows pasteurization plants to be licensed and ship milk to
New York. Some are Grade A plants, which can pasteurize
and bottle milk which comes up to the New York requirements
for Grade A only. A Grade A plant cannot botile milk falling
below those requirements, and if for any reason any dairy ship-
ping to such a plant falls to Grade B, the plant is not allowed
to handle this milk with Grade A, but must ship it in cans as
“C” milk to New York. In New York such milk can be pas-
teurized and bottled as Grade B.
In a similar manner a Grade B plant cannot bottle milk
under the Grade A cap. Any milk coming to such a plant to
be pasteurized must come up to the New York requirements
for Grade B milk. Milk from Grade A dairies, if shipped to
a Grade B plant, must be put out from such a plant as Grade
B. The rumor relative to violations of the New York City
milk rules was that some plants were handling both “A” and
“B” grades, and it was suspected that some Grade B milk was
being sent to New York with Grade A caps.
As far as the Connecticut dairy authorities knew, the only
plant shipping bottled milk to New York with Grade A caps
was Borden’s Grade A pasteurization plant at Washington,
Conn. The original plan of inspection was to visit this plant
and also some of the dairies supplying it, but owing to a heavy
snow fall a few days before, most of the roads were impassable
and train service uncertain, so the Washington plant was the —
only place visited. ipl
This plant receives milk from dairies scoring high enough to
furnish Grade A under the New York requirements. These
“
215
dairies are scored twice a year by agents of the New York City
Board of Health and by Borden’s inspectors about once a
month. Sediment tests are taken frequently at the plant so
that the farmer can see how his milk compares with that of
his neighbors. ‘The investigators saw about 20 sediments from
these tests, and all were unusually clean, some showing no sedi-
ment whatever. Samples are taken for butter-fat tests every
day, as the farmer’s pay depends on the grade of milk plus
the amount of butter fat, Grade A milk with 3.80 per cent.
fat being worth 4 cents per quart. If milk shipped to a Grade
A plant falls to Grade B requirements, the shipper must either
accept a Grade C price, which is 10 cents per can less than
Grade A, or else ship to a plant handling Grade B milk.
At Washington bottles bearing Grade A caps, and others
with Grade B caps, were seen which might lead one to believe
‘that this plant was violating the regulations by handling milk
from Grade B dairies. This, however, was not the case, as all
the milk came from dairies up to the Grade A requirements,
and could be bottled as Grade A if there were sufficient de-
mand for this grade, which costs the consumer 1 cent per
quart more than does Grade B. As there is no regulation for-
bidding the selling of a high-grade milk in place of a lower one,
this plant was merely selling its surplus Grade A milk as Grade
B, for which there was plenty of demand.
At the plat a record is kept of all milk received, source of
supply, and amount of bottled milk sent. away each day, as
well as a record of the temperature and time of pasteurization.
These records are inspected from time to time by the New
York Board of Health. If these inspections show that milk
has been received from Grade B dairies, the plamt’s license may
be taken away and the milk of mixed grades may be destroyed.
The manager of the Washington plant thought that the New
York City system of grading milk was the best one yet devised,
and that other States and cities would adopt a similar one.
With proper inspection of the dairies and the records ot the
plants, there seems to be no reason why a State or city could
not be reasonably sure of its milk supply. If a contractor
tried to evade the law and sell low-grade milk for a higher
one, he would surely be caught in less than a month, and lose
216
more than he could possibly gain. The whole system depends
on proper and frequent inspection by competent men. The
only possible disadvantage to such a system is that it prac-
tically forces dairymen to sell at wholesale rates unless they
can make certified milk.
C. REPORT ON A SPECIAL INVESTIGATION OF THE NEW
- YORK GRADING SYSTEM IN THE PRODUCING AREA.
On Jan. 14 and 15, 1916, a representative of the Massachu-
setts State Department of Health visited a number of tarmers
in the vicinity of Utica, N. Y., to get their opinions of the
present grading system of the New York City Board of Health
for the milk supply of that city. These farmers deliver milk
to three different stations, namely, the Muller Company of
Marcy, N. Y., the Harlem Products Company of Clinton, N. Y.,
and the R. F. Stevens Company of Clinton, N. Y. Two
of the farmers are grange masters, and most of them grange
members. They are nearly all making Grade B, but a few
were making Grade C, milk. None of them were producing
Grade A milk.
The prices paid for milk were from $1.70 to $1.80 per 100
pounds for Grade B milk, and 10 cents per 100 pounds less
for Grade C. In case of the Stevens station a fat percentage
of 3.8 was also required for Grade B, as well as ghe other New
York City grading system requirements; and 10 cents per 100
pounds was offered for every .1 per cent. fat over 3.8 per cent.
The farmers were asked particularly what objections, if any,
they had to the system; also what they received for their milk,
and if prices were satisfactory, and if not, what they considered
fair prices; whether the inspection requirements were consistent
with the prices allowed; whether the inspection was fair or too
rigid for the grade supplied; what grade of milk they supplied
and what determined the grading; if the inducement to supply
a higher grade was worth the extra effort; whether the in-
spectors themselves were competent; and finally, whether the
system was in any way satisfactory to them. Taken individ-
ually, their statements were as follows: —
1. Mr. A, Marcy, N. Y. — Mr. A is furnishing Grade C milk. He re-
ceives $1.70 per 100 pounds of milk. He said he, on the whole, was well
217
/
satisfied; that the treatment of the farmer depended largely on the con-
tractors; that his station did not pay as well as some others; he did not
care to retail milk, as customers were uncertain and the station took all
his product. When asked why he did not get into a higher grade, he said
the scoring requirements would not put him there, and for the little extra
he received (10 cents per 100 pounds) it was not worth while.
2. Mr. B, Marcy, N. Y.— Mr. B is furnishing Grade B milk. He said
at once that he was very much dissatisfied; that in his opinion the require-
ments should be for one grade, with all the farmers in that grade. He said
most decidedly that the price received was not by any means sufficient.
He receives at present $1.80 per 100 pounds of milk. Prices varied accord-
ing to season from $1.05 to $1.85 per 100 pounds. When asked what he
considered a fair price, he said $2 per 100 pounds for the winter months
and $1.50 for the summer monthswould be satisfactory. He said the slight
increase in price for milk of higher grade is not enough to make it worth
while producing it. Some contractors give more than others; the farmer
is at the mercy of the contractor. The inspectors are not practical men
and do not understand their work thoroughly. He did not know of a
good point about the system, and would prefer to retail milk, but had no
near-by market.
3. Mr. C, Marcy, N. Y.— Mr. Cis furnishing Grade C milk. He
receives now $1.70 per 100 pounds. When asked why he was in this
grade he replied that his barn was old and his score did not place him
higher. He was asked about bacterial count placing him in grade, and
he said he heard very little of this, and has only received reports of bac-
terial count twice; but the scoring of his barn was what placed him in
Grade C, although his milk is clean. He considered that the bacterial
count is extremely variable and uncertain, and often ran high for some
unaccountable reason; also thought that scoring and bacterial count were
not consistent. He said also that he knew that Grade B and Grade C
_ milk were iixed at the station; whether it all went out as Grade B he
was not certain, but it was likely that it did. He considered the inspectors
not well informed or practical. Slightly rusty utensils were often com-
plained of, yet rusty and dirty cans often came to him from the station.
When asked in regard to prices he said emphatically that he did not re-
ceive enough money; that the price of help is double what it was ten
years ago, and the price of milk has gone up but 25 per cent.; $2 for six
winter months and $1.50 for six summer months would be bar prices in
his opinion.
4. Mr. D, Marcy, N. Y.— Mr. D is furnishing Grade C milk, and re-
ceives at present $1.70 per 100 pounds of milk. In his opinion his milk is
as clean as he can produce it, yet his score holds him in Grade C. He has
heard but twice reports on bacterial count. The sediment test is taken
once a week, and he considers this a good requirement. He said, more-
over, that clean milk could be produced under almost any surrounding
conditions if cows, utensils and the farmer himself were clean. When
asked in regard to price he replied that it is not by any means enough;
218
the price of raw material, fodder, etc., should be taken into account when
regulating price allowed for milk. Three and one-half to 4 cents per
quart is the present cost of producing milk. He considered that the farmers
are at the mercy of inspectors who do not know their business. He said
that the farmers are fools to let this system continue, and not make some
effort in their own united interests. He also knew that Grade B and Grade
C milk were mixed at the station, and were probably sold as Grade B in
New York City.
5. Mrs. E, Marcy, N. Y.— Mrs. E is producing Grade B milk, and
gets $1.80 now per 100 pounds of milk. She said at once that prices were
not sufficient, and that the difference in price for a grade higher milk is
not enough to make it worth the extra effort to produce it. The grading
in her opinion is done entirely by score card; yet she received a report of
bacteria count once when it ran high, which would perhaps indicate that
this also has some influence on the grading. She considered the whole
system in an unsatisfactory condition. A price of $2 per 100 pounds for
winter months and $1.50 for summer months would be fair. She, more-
over, intends to make cream from all of her milk and sell this rather than
sell milk to the station under present conditions.
6. Mr. F, Clinton, N. Y.— Mr. F sells his milk as Grade B, and all
milk sold to this station is of that grade. He is graded, a’ far as he knows,
according to result of score card rather than bacterial count. He gets at
present $1.70 per 100 pounds, and has received as low as $1.10 per 100
pounds. He said that he was not satisfied, and considers that $2 per 100
pounds for December and January, and $1.80 to $1.90 per 100 pounds the
rest of the year, would be a satisfactory price. He also said that he had
heard that farmers in some sections were considering putting up their own
station owing to low prices received. Mr. F also objected to the return-
ing of dirty cans from New York City to be washed at the station, rather
than washing them in New York City. He said they were returned in an
unusually filthy condition, and had heard also that often garbage, and in
one instance a dead cat, had been found in one of the empty cans. The
writer saw no evidence of this, however. Mr. F also sells some of his milk
at retail in Clinton, N. Y., and finds this method yields him proper returns.
7. Mrs. G, Clinton, N. Y. — Speaking for her husband she said he de-
livers to station, selling on butter-fat basis as well as on grading. She has
heard him say he is very much dissatisfied with prices and intends selling
his cows.
8. H. Farm, Clinton, N. Y.— This farm is producing Grade B milk,
which is also sold on the butter-fat basis, 3.8 per cent. required and 10
cents per 100 pounds allowed for every .1 per cent. over this. This farm
gets now $1.85 per 100 pounds, and is not satisfied with prices, as no profit
can be made with present cost of labor and feed. Two dollars for six
months and $1.50 for six months per 100 pounds would be a fair price.
This farm makes special effort to have a clean stable, yet cannot get into
Grade A because of rigid requirements.
1 Investigations made elsewhere show this statement to be absolutely without foundation.’
219
9. Mr. I, Clinton, N. Y.— Mr. I had gone out of business because
prices were not sufficient to warrant his selling milk. He said he had fig-
ured carefully and found that milk could not be produced on a paying basis
unless $2.25 was received during winter months and $1.75 for the other
six months per 100 pounds. To quote Mr. I: ‘When you feel you are
losing on every quart produced you lack interest and feel antagonized,
especially when inspectors are visiting. If inspection is rigid, and it is
right that it should be, the farmer should get a price which is satisfactory.
The New York Board of Health should regulate price paid to the farmer
as well as grade the milk, and hold him to the requirements of his grade.”
10. Mr. J, Clinton, N. Y.— Mr. J sells to Stevens station, giving price
on butter fat as well as on grade. He sells Grade B milk at $1.85 per 100
pounds (now). He finds it hard, and said others also do, to produce milk
above 3.8 per cent. fat and get a good quantity of milk. The variance in
price is not satisfactory, and the price at any time is not sufficient. Two
dollars in winter and $1.75 per 100 pounds in summer would be fair. Help
is scarce and labor ig high because hands will not work as many hours as
formerly. Mr. J also stated that Grades B and C are mixed at the station;
whether it is all sold as Grade B is not proved. He considered that the
system is not well supervised at the station. It is his opinion that the -
grading results more from the scoring than on the bacteria count.
11. Mr. K, Clinton, N. Y.— Mr. K objected to the same price being
given to farmers whose buildings were in bad condition as to one whose
buildings are well kept. He sells Grade B milk. At present prices he
cannot afford to hire help and buy feed; he therefore does all the work
himself. The cost of feed has made a large advance in the last ten years.
- Mr. K also does not consider it fair to reduce the price in March or April,
which is done, when it costs exactly as much to feed the cows, and the flow
of milk is no greater at this season. As an example of the actual profit he
gets he said it costs him $50 a month to feed 9 cows, and his receipts for
the sale of milk were $110, not counting the cost of hay which he raised
himself. If he hired help he would have little profit left from his milk
business. Mr. K also considered that the requirement for cooling morn- ,
ing milk to 60° F. was a hardship for the farmer, as his facilities were not
as good for cooling as those at the station, especially when the morning
milk could be taken immediately to the station without cooling. Regard-
ing the inspectors themselves, he said they are often not practical men.
He told of one inspector who visited a farm where the cows were in a
basement not easily found. The farmer found him in the hayloft looking
for the cows. Naturally, all respect for the inspector was lost at once.
12. Mr. L, Clinton, N. Y.— Mr. L said at once and emphatically that
the price received was not sufficient, and that he intended to go out of
business. He sells Grade B milk. He said there was not enough induce-
ment to produce better milk.
13. Mr. N, Clinton, N. Y.— Mr. N is not selling to a station, as he
found it more profitable to make butter. When asked why some of the
farmers did not produce Grade A milk he said that the requirements were
220 ©
too rigid; even when the stable is clean and produces a very satisfactory
product, still more is required, and the farmers will not meet the demands.
He said the butter-fat premiums are not regular and are lowered without
reason, perhaps due to a large quantity of milk on hand. Tests for butter
fat made at the station do not always agree with those made by State
inspectors.
It appears from the reports obtained from these farmers that
the main objection regarding the New York City system is one
of price. They do not get enough money to make the business
pay. With one exception, the farmers were very much dis-
satisfied with the system. This man had been in this country
but a comparatively short time, and was doubtless more easily
contented, especially with prices, than an American farmer who
would be in a position for better judgment. They state that
the requirements, especially for Grade A, are so rigid as com-
pared with the price offered for the extra effort that they do
not consider it worth while getting into a higher grade. They
claim that the inspectors themselves are often not competent,
or if competent are not practical in their recommendations.
It further appears from this investigation that there is a dif-
ference in the price paid for milk of different grades. ‘There is
no possibility of a producer making a low grade of milk and
selling it for a higher grade.
D. COPY OF AN ARTICLE BY LUCIUS P. BROWN OF THE
NEW YORK CITY HEALTH DEPARTMENT.
Conclusion and Summary. ‘
1. In a city of large size it is impossible.to so safeguard a
milk supply confined to raw milk only, at any reasonable cost,
as to insure its absolute safety.
2. The present system of milk control in New York City
has justified itself by the absence of any considerable milk-
borne epidemic of typhoid or other disease within the past two
years, and by the ease with which any epidemic appearing can
be now traced and controlled.
3. The New York system of milk control is necessarily 1a
growth of many years, and is a development proceeding pari
passu with the growth of knowledge in preventive medicine,
221
and particularly in knowledge of the principles of pasteuriza-
tion.
4. The essential features of the New York City milk control
system are —
(a) Pasteurization of all milk except that intended for special
uses. ;
(6) In connection therewith bacteriologic standards properly
administered.
(c) The labeling of all packages intended to go to the con-
sumer.
(d) Constant inspection and supervision of the pasteurizing
plants, which is an inspection that it is physically and econom-
ically possible to make efficient, in direct contrast with the
attempt to handle an enormously large number of dairies and
their employees, — a thing which can be done efficiently only
at prohibitive cost. :
To thoroughly understand the situation in New York City
a short statement of the problem is desirable.
This problem is as follows: The control, both chemical and
sanitary, of a milk supply for a city of about 5,000,000 people,
with the aim not only of avoiding raising the cost of the milk, but,
*if possible, of actually extending its use as a cheap and easily
digested food. Analysis of the milk supply shows that about
2,750,000 quarts of milk (including ice cream and condensed
milk) are consumed daily in the city, furnished by 7 States and
by 2 provinces in the Dominion of Canada.
It is estimated that about 50,000 dairies, about 440,000 cows
and about 300,000 people are employed. This milk supply is
handled in 60 city and 436 country pasteurizing plants, and
there are 700 shipping stations for milk shipped raw to the
city pasteurizing plants. The longest haul upon milk coming
to New York is about 460 miles, and 80 per cent. of it over 200
miles. :
The machinery at hand for controlling the milk supply is, of
course, that under the control of the city Board of Health.
Under the Constitution of New York State, and charter of
New York City, the ordinances of this Board have the effect
of laws; its powers are absolute and very broad, being limited
only by the disposition of the city’s financial boards to appro-
299
priate the funds necessary for the enforcement of the laws made
by the Board of Health.
Following is a statement of the chief successive steps taken
for the control of New York City’s milk supply, which have
led up to the system now in effect. The first step taken was
in 1873, when “swill’” milk was forbidden. In 1876 a code
section was passed by the Board of Health forbidding watered
milk. In this control, however, only the well-known lactometer
of the New York City Board of Health was used. The pro-
ducers finally learned how to beat this lactometer, and in 1895
chemical standards were set.
In 1897 a permit system was inaugurated for wagons and
milk stores. In 1900 the cooling of milk in transit was begun,
and there has been progressive improvement in this particular
feature since that time. In 1902 one milk inspector was sent
to the country to examine the sources of supply. In 1904 the
milk inspection work, which was formerly done by the separate
boroughs, was centralized in the hands of the city Board of
Health, and a regulation was made that all milk must be kept,
while in process of shipment or sale, at a temperature not greater
than 50° F. In 1905 a systematic inspection of creameries was
begun, and certain deficient ones were forced out of business.
In 1906 the two inspectors then at work began the inspections
of the dairy farms proper, and 16 new inspectors were added.
Rules and regulations for the guidance of dairymen were made;
and these appear to have been very well received by the dairy-
man, because of the help it gave him in regulating his own
business. In 1907 a beginning of the exclusion system was
made, the requirements being that weekly reports be made by
creamery men and dairymen of contagious diseases occurring
in their establishments, and they were required to cease han-
dling their milk on occurrence of any such diseases. Failure
to’ comply with this regulation meant the exclusion of their
milk from the city. This principle was afterwards applied to
other conditions. Milk stores were likewise regulated as to
sanitary condition, and the score card system was adopted.
A notable occurrence during this year was the appointment
of the McClellan Commission of Physicians, in the report of
which it was recommended that 100 country and 40 city in-
6
223
spectors be appointed. It will be noted that up to this time
all the regulations were designed towards the securing of a sat-
isfactory raw milk supply. In 1908 the first notice in the way
of an official pasteurization was made. ‘This regulated pas-
teurization, which had to be conducted under permit. During
the same year the exclusion system was extended to unsani-
tary conditions at the creameries and dairies, and the wagon
permits were made conditional on satisfactory report of con-
ditions of production and distribution. Likewise in this year
the classification of milk appears to have been first made. It
was graded into selected, inspected, guaranteed and certified,
all conditioned on inspection by medical societies and in ac-
cord with regulations of the Board of Health, taking cogni-
zance of conditions of the cows, bacterial count, time of deliv-
ery, etc. Pasteurized milk was allowed to be sold under permit,
and there were supplementary regulations on pasteurization
passed.
The most notable occurrence of this year was the require-
ment that there should be attached to the container which
reached the consumer, or from which the consumer, in the
case of loose milk, was served, a tag indicating the location of
the dairy or creamery and the date of shipment. In 1909 pas-
teurized milk was defined, and it was provided that the tags
above mentioned must be kept for two months.
It will be noted that still up to this time little notice had
been taken of :pasteurization, but in 1910 a Board resolution
(not having the direct effect of law) was passed, advising the
public that all milk for drinking should be either boiled or
pasteurized, and a tentative plan for grading was made based
on the broad division of —
(a) Milk for infants to drink.
(6) Milk for adults to drink.
(c) Milk for cooking only.
These still form the broad, general basis for grading.
In 1911 announcement was made that after Jan. 1, 1912, all
milk except special high-grade milk was to be pasteurized. The
warning of this contemplated action was given so far ahead
because of the necessity of making changes in the plants of
milk dealers.
224
At the end of 1911 there was a conference participated in by
dealers, the New York Milk Committee, the officials of the
Department and certain physicians, which assumed that in
addition to pasteurized milk two grades of raw milk, one for
children and one for adults, could be sold, based on prescribed
tests for tuberculosis in cows. ‘These rules went into effect in
1912, and are indicated in table on page 228. This step was
enabled by the advance of knowledge as to pasteurization, and,
as will be seen, by recognition of the impossibility of properly
inspecting a raw milk supply of this size. It was in no sense a
backward step. In the year 1913, from the outbreak of a very
bad milk-borne typhoid epidemic (1,100 cases in all), there
resulted the abolition of Grade B raw milk, the pasteurization
of all milk of this grade, and the establishment of bacteriologic
standards throughout. There resulted likewise the simplifying
of Grade A and the inclusion of cream in the pasteurization
requirements. ~
This summary gives some indication of the weary road trav-
ersed by those men to whom is due the credit for the present
excellent supply of milk for New York City. It will be noted
that the essential features are pasteurization almost exclusively,
and bacteriologic control of the raw and pasteurized milk, ex-
cept in Grade A, It will be noted from table on page 229 that
dairy scores are still used to assist in controlling the farms.
This in no sense allows of the pasteurization of dirty milk. As
a matter of fact, as is well known to those having to do with
milk control, dirty dairies with their concomitant of careless
and dirty methods almost invariably produce dirty work, while
on the other hand the clean dairy produces clean milk. Be-
cause of this human factor a fair control of the condition of
Grade B dairies may be effected through the bacteriologic ex-
amination of the milk. Grade A, which is naturally that milk
requiring more supervision, is, of course, designed for the use
of children, and must be, therefore, absolutely above suspicion.
By requiring that no milk of a lower grade than “A”’ be han-
dled in a Grade A plant, the necessary distinction as to that
grade is readily secured. Mr. Russel Sturgis, chief of the
Milk Division, of the Bureau of Food and Drugs of the Health
Department of New York City, in an excellent paper published
225 —
in 1915, on “The Réle of Dairy Inspection in Safeguarding a
City’s Milk Supply,” and to which I am indebted for a very
large part of what I have been saying, suggests that possibly
at some future time, when the private inspection systems of
the milk companies have been more completely developed, it
will be found that the score card standard, at present neglected,
will be appreciated as a measure of value. As a matter of
actual fact, all companies handling milk desire of course to
furnish Grade A milk, selling for the highest price. They there-
- fore pay the farmer a premium for clean dairies and clean milk,
and this operates as an incentive to the producer to improve
his conditions.
It has often been objected to pasteurization, in the language
of certain gentlemen of florid imagination, that the sale of pas-
teurized milk containing dead organisms —a sort of bacteria
soup — is strictly parallel to the sale of a milk soup made from
oysters of an uncertain vintage. I think experience hardly sus-
tains this violent assumption. Whether it be true or not, how-
ever, the impossibility of handling a very large milk supply,
such as that for the city of New York, without prohibitive cost
for inspection, as well as without raising the cost of raw milk to
the consumer to a prohibitive figure, can be readily appreciated.
Moreover, a raw milk supply of this size which is absolutely
safe is a matter of practical impossibility under present con-
ditions; if for no other reason, because of the absolute impos-
sibility of keeping out, in the enormous number of people
through whose hands the milk supply goes before reaching the
consumer, carrier cases of typhoid, diphtheria and the like.
In addition to the occasional farm inspection by the Depart-
ment, farm inspection is promoted on the part of the companies
by the necessary connection of conditions indicated by our in-
spections and counts, by the efforts of small companies trying
to remedy faults, and by dairymen who are trying for the pre-
miums for high dairy scores given by the companies. It may
be further added that prior to 1912, and the inception of this
system of milk control, one or more typhoid outbreaks every .
year in New York City which could be directly fastened on
the milk supply were the rule, and usually these were of very
considerable size.
226
In 1914 and 1915 there has up to date been only one small
milk-borne epidemic of typhoid, promptly stopped by shutting
off the milk supply, and only 90 direct cases in all. This oc-
curred in a pasteurized supply, and appears to have been due
either to a carrier case handling the milk after pasteurization,
or, much more probably, to the water supply of the creamery
becoming suddenly polluted.
A short description of the methods used by the Department
may be of interest. It is required that the pasteurization be
conducted between 142° F. and 145° F. for not less than thirty
minutes; and, of course, cooling after pasteurization must be
very prompt. In making his inspection the operator, of course,
carefully examines all pipes and connections from pumps and
other apparatus, taking everything apart if necessary to assure
himself of cleanliness. He watches the sterilizing of the pipes
and vats before use. In the actual handling of the milk he
notes its condition as to dirt upon receipt, and watches to see
that it is not exposed to dust. If the automatic temperature
recorder is used its accuracy is tested at each inspection. These
recording devices indicate the holding period very well except
in case of continuous retarders, and in this type of apparatus
the holding period is best ascertained by watching the speed
at which the milk is dumped through. It is cooled, preferably
to 45° or lower, and then the milk is immediately bottled or
canned for shipment. By taking the temperature of cooling at
frequent intervals the inspector is able to advise whether the
hot milk is fed to the cooler too fast to obtain good results.
Special stress is laid on the cleanliness of bottles and cans used
for holding pasteurized milk. For this a sterile water control
is used in the bacteriologic examination, and inspectors are
kept closely informed of all results, their personal effort being
of great value in this connection. Water samples for this pur-
pose are transmitted to the laboratory for a count in the same
way as the milk samples, 50 cubic centimeters of sterile water
being used for washing each can or bottle. The accepted stand- —
ard is 1,000 total bacteria in each 50 cubic centimeters so
treated for bottles and 10,000 for cans.
Schedules for inspection are so arranged that samples of milk
are taken during inspection of pasteurizing plants at certain
227
intervals. I quote from Sturgis’s paper previously mentioned,
as follows: —
Four samples are taken at each of the various steps, and from those
four individual samples an average is obtained which fairly reflects the
quantity of the milk and also serves as a check upon the thoroughness of
pasteurization. Usually these samples are taken from (a) the raw milk;
(0) at the outlet of the holder, or after the milk has been heated and held;
(c) from the outlet of the cooler; (d) from bottles or cans that have been
filled for shipment. These samples are thoroughly chilled, packed in ice,
and shipped in the milk car to the city terminal,-where they are collected
upon arrival and taken to the laboratory.
Our present inspection force consists of 20 country inspectors
and 12 city inspectors. The country inspector’s duty consists
in the inspection of plants as just mentioned, and of dairies.
Grade A dairies are inspected three times a year, and as much
oftener as possible. Other dairies are inspected when the occa-
sion allows. All inspections of dairies and creameries are re-
corded on score cards of the New York City form, the dairy
cards being made in duplicate and a copy left at the farm.
The pasteurizing plants are not scored, but are recorded on a
special card where only changes from the last inspection are
noted. This is also in duplicate, but the copy is sent to the
office, and from there sent to the company responsible instead
of being left direct with the company. On occasion the epi-
demiology of suspected milk-borne diseases is investigated by
these country inspectors.
The city inspectors watch the supply to the point of delivery,
that is to say, either to the retail-store or to the customer.
The stores themselves are inspected by inspectors of the Food
Division of the Bureau of Food and Drugs, avoiding in this
way duplication of work. Of the 12 city milk inspectors at-
tached to the Division of Milk Inspection 3 are on bacteria sam-
ples, 5 on samples for chemical analysis, 2 on pasteurizing plants
alone, and 2 on the large city dairies and on the pasteurizing plants
in outlying portions. It is interesting to note here that within
the city of New York itself there are over 100 dairies, with
about 5,000 cows. Each of the bacteria squad takes 68 samples
daily of raw milk going to pasteurizing plants, or of the pas-
teurized milk as offered for sale, making, all told (including 40
228
samples each for the two men on the pasteurizing plants), 284
samples of milk taken in the city for bacterial examination
daily. A list of the various supplies is furnished to each man,
and it is estimated that he will cover his field in three to four
weeks. The chemical squad takes samples from wagons, about
65 a week in all. It will thus be noted that from 1,600 to
1,800 samples for bacteriologic and chemical analysis are taken
per week for milk inspection purposes.
It is proper to state that for a considerable portion of the
information given in this paper I am indebted to a monograph
bearing the name of Lederle & Raynor, published by the De-
partment of Health, and to the paper by Russel Sturgis, chief
of the Division of Milk Inspection, heretofore alluded to.
It is perhaps unnecessary for me to state that my recent
connection with the New York City Health Department has
made it impossible for me to prepare this paper without much
help from others.
1912.
Grade A.
1. Certified or guaranteed.
2. Inspected raw.
Dairies: —
Fiquaiigemaerntey ye oc GE a REA ec 2 ea
Methods, BPA Pies jae kanya Ly Mat)/ ay Re Re peed a an
Bacteria: —
60,000 per cubic centimeter.
3. Selected pasteurized.
Dairies: —
GUT POI eis Nog Re Se RA eae ke
Methods, SM RP ROR ANRnT en neni NE Rc Be ak")
Bacteria: —
200,000 per cubic centimeter before pasteurizing.
50,000 per cubic centimeter after pasteurizing.
Grade B.
1. Selected raw.
Dairies: —
A DYcpany of co S10 re 4 ps Oe. CL OAMMna aS NA TCR mt
Methods, Bee oii Bo got Ng rt a
Bacteria shall not be excessive.
2. Pasteurized.
No dairy standard.
No bacteria standard.
229
Grade C.
For cooking (at first allowed raw).
Later required heated or pasteurized (no standards).
1914.
Grade A.
1. Raw.
Dairies: —
Equipment,
Methods,
Bacteria: —
60,000 per cubic centimeter.
2. Pasteurized.
Dairies: —
Equipment,
Methods,
Bacteria: —
200,000 per cubic centimeter before pasteurizing.
30,000 per cubic centimeter after pasteurizing.
Grade B.
Pasteurized.
Dairies: 1 —
Equipment, .
Methods,
Bacteria: —
1,500,000 per cubic centimeter before pasteurizing in city.
300,000 per cubic centimeter before pasteurizing in country.
100,000 per cubic centimeter after pasteurizing.
Grade C.
Pasteurized.
Dairies: ——.
_ Total,
f, Bacteria: —
300,000 per cubic centimeter.
1 At present not enforced,
25
00
25
43
20
30
40
230 .
E. REPORT ON INFORMATION GATHERED AT THE CON-
VENTION OF THE INTERNATIONAL MILK INSPECTORS
ASSOCIATION.
The following information was obtained from the lectures and
from talking with various local inspectors: —
Cumberland, Md. — All the milk comes from near home, within 30 miles.
About one-half the supply is pasteurized and is not from tuberculin-tested
cows. The standard is 12.50 per cent. solids, 3.50 per cent. fat. The price
is 9 cents retail and about 4 cents wholesale.
Detroit, Mich. — Supply comes from within 100 miles, and all has to
be pasteurized, but does not come from tuberculin-tested cows. The
standard is 12.50 per cent. solids, 3 per cent. fat.
Seattle, Wash. — The supply comes from within 90 miles, and has to be
either pasteurized or from tuberculin-tested cows. The standard is 3.25
per cent. fat and not over 200,000 bacteria. The wholesale price is 16
cents per gallon, and the retail price is 9 cents per quart. The United
States score card is used and is relied upon absolutely. All employees in
pasteurization plants have to be examined to see that they are not disease
carriers.
Manchester, N. H. — Nearly all the milk comes from near home, though
a little comes 200 miles. Some is pasteurized. It is not from tuberculin-
tested cows. Retail price is 8 cents per quart, while the farmer received
3 to 5 cents per quart.
Washington, D. C.— In 1872 the Washington Board of Health re-
quired a permit for milk to come to the District from the surrounding
country, but in 1884 this was stopped. In 1892 the Sanitary League was
formed, and obtained a law compelling inspection before granting permits.
This law was passed in 1895. This was the first system of licensing and
controlling the milk supply, and is the one still used in Washington. Con-
gress passes the milk law for the District of Columbia. The standard is
12.50 per cent. solids and 3.50 per cent. fat. All cattle have to be tuber-
culin tested.
Norjolk, Va. — Supply all raised within 7 miles, and about 40 per cent.
is pasteurized and has to be from tuberculin-tested cows. Retail price is
10 cents. There is not much wholesale milk, but the price is about 20
to 23 cents per gallon. The fat standard is 3 per cent., and the inspector
would prosecute below this figure. Certified milk must not contain over
10,000 bacteria. The inspector likes the United States score card. He
does not believe in milking machines, as they spoil the cow.
New York. — The State standard and methods are used by all local ,
inspectors except in cases where the cities or towns make regulations more
drastic than that of the State. All milk has to be from tuberculin-tested
cows or be pasteurized. Standard is 11.25 per cent. solids and 3 per cent.
231
fat. Milk is graded A, B and C raw and A, B and C pasteurized. For A
raw milk the farmer must score at least 75, and the milk contain not over
30,000 bacteria. Herd must be examined each year. The score must*be
at least 25 for equipment and 43 for methods.
Grade B: Bacteria not over 200,000. Score must be 23 for equipment
and 37 for methods, and herd must be examined each year.
Grade B, pasteurized: Score must be 20 for equipment and 35 for:
- methods, paceat not over 1,000,000, and the herd must be tested each
year.
Grade C is anything from dairies scoring 40 points, but local authorities
may make special regulations.
Grade A pasteurized must not contain over 200,000 bacteria before
pasteurization.
The farmer receives 33 to 4 cents for A pasteurized grade, but for B
grade is paid on a fat basis, which is lower. Retail price of A pasteurized
and raw is the same, but most people prefer raw milk. About one-third
of the milk is pasteurized by heating to 145° and holding thirty minutes.
Heating too high breaks the cream line and spoils the looks of the milk.
Most of this information was obtained from the Auburn, N. Y.,
inspector.
In case of an epidemic the health officer notifies the State Health De-
partment by telephone or telegraph. The State Department notifies the
local authorities to\shut off the supply, and it is done at once. The score
card used in New York is a State one, but is a good deal like the United
States card.
Mr. Purrington of New Hampshire says in New Hampshire
the milk business is a side issue, and the farmer generally
peddles his milk himself instead of selling to large dealers. He
usually has a poor equipment and cannot afford to pasteurize.
Mr. Purririgton does not believe the State has any right to give
definite orders, provided the milk is low in bacteria. The score
should not be relied upon as much as bacterial count. Twenty
per cent. of the cattle in New Hampshire have tuberculosis,
and the tuberculin test is not general. The State is encourag-
ing “inspected milk.” This is milk inspected and licensed by
the State, and the license can be revoked. Dealers producing
“inspected milk” are allowed a special cap with the State Seal
upon it, and receive 1 cent per quart above the regular price.
About 20 producers raise “inspected milk.” Prices of milk are
7, 8 and 9 cents.
Tests are now being made to determine the cost of producing
“inspected milk.”
232
Dr. Wiley says that where dairy interests control, the stand-
ard is low. Illinois has a low fat standard, — 3 per cent. He
claims that New York and Ohio have much tuberculosis, as
farmers are in control of Legislature and do not have proper
inspection. Virginia has an inspection law, but not enough
money to pay for condemned cows. He believes the United
States should help States who try to stamp out tuberculosis.
He believes milk should be graded, and the higher grade should
receive the best price. .
Dr. States of Detroit believes that all milk and its products
should be pasteurized. He claims that heating to 160° for
thirty minutes will kill the germs.
Professor Stocking of Cornell says that only a small propor-
tion of milk drinkers get diseases from milk, but believes all
this is preventable.
Mr. T. of Washington, D. C., a milk dealer who lost his license,
does not believe pasteurization kills germs of tuberculosis.
The general opinion of those with whom the representative
talked and the speakers was that all milk should be pasteurized,
though some believed that m#k from tuberculin-tested cows
was safe if consumed raw. Dairy inspection and the use of the
United States score card were recommended, although the score
card should not be used as a standard for judging the milk, the |
bacterial count being more important. Mississippi and Wash-
ington do not allow disease carriers or those recently having
disease to handle milk, and Seattle requires Widal tests from
all employees in dairies. Montclair requires a health certificate
every three months for employees in plants where milk is not
pasteurized. —
Mr. Stephenson of Washington, D. C., believes in milking
machines where labor is scarce, but thinks it takes experienced
men to use them. They do not pay for less than 20 cows. No
special mention was made regarding different kinds of machines.
One or two men believed in the use of clarifiers, though the use
of them usually increased the number of bacteria.
No one knew of any portable forms of pasteurizers or cheap
forms for small dealers. Co-operative or city plants were sug-
gested, or the use of a wash boiler, as a cheap form of pas-
teurizer, in the home in case of epidemics.
233
The need of pasteurization or tuberculin-tested cattle and
the medical inspection of employees in dairy plants were gen-
erally agreed upon, though the additional cost of the milk and
the driving of small dealers from business were reasons ad-
vanced against these ideas. The United States score card
seems to be considered the best standard there is for dairy
inspection, and no changes were suggested.
If DIGEST OF RECENT AMERICAN MILK LEGISLATION BY
_VARIOUS CITIES AND STATES.
The following milk. laws and regulations were taken from
the bulletins of the United States Public Health Service. They
tend to show the attitude of health authorities toward (1)
securing milk from cattle free from tuberculosis, (2) protection
of milk against contamination from human sources, and (3)
rendering uncertified milk safe for human consumption. The
essentials of the various State laws applying to the protection
of milk against contamination from human sources are as
follows: —
California. — Requires by law that whenever a case of communicable
disease occurs in the house of a milkman, milk distributor or dealer
no milk is to be sold or distributed by him until the health authority
designates a person to conduct the business and to see that no com-
munication is maintained with the infected house except under official
supervision.
New Jersey. — State Board of Health or its officers required to prohibit
transportation of milk believed to have been contaminated from infected
persons.
Colorado, Connecticut, Illinois, Maine, Maryland, Massachusetts, Mich-
igan, Nebraska, New Jersey, New York, North Dakota. — Prohibit sale of
impure milk or milk products produced under unsanitary conditions.
Idaho, Utah and Wyoming. — Forbid by regulation the sale of milk
from quarantined premises.
Pennsylvania. — State Board of Health requires local health official to
notify county medical inspector when milk is marketed from premises in
which communicable disease prevails.
Colorado, Connecticut, Illinois, Maine, Massachusetts, Michigan, Ne-
braska, New Jersey, New York, North Dakota. — Persons in charge of dairy
farms or dairies are required to report communicable diseases on their
farms to health authorities.
Ohio. — Requires milk from infected places to be stopped.
234
California. — Requires pasteurization by law (act of May 4, 1915).
No person, firm or corporation shall sell, exchange or offer or expose or
have in its possession for sale or exchange any milk, cream, skim milk,
ice cream, butter, buttermilk, cheese or other milk product as the case
may be nor use the word pasteurize or any of its derivatives in connection
with the sale, etc., unless the same and all products of milk have been
treated by the process of pasteurization.
Durham County, N. C., has a regulation with special refer-
ence to communicable diseases in persons engaged in the pro-
duction or handling of milk, which reads as follows: — —
No person having tuberculosis, any venereal disease, or any other com-
municable disease shall work in any milk depot, dairy, or in any other
place where milk or its products are handled. When typhoid fever, scarlet
fever, diphtheria, small pox, measles, or chicken pox occur in a house or
family of any one engaged in the handling of milk it shall be the duty of
the owner or manager to notify the superintendent of health at once of
this fact. Examination is required when communicable diseases are sus-
pected. Any dairyman or milk dealer authorized under this ordinance
or any employee engaged in any way in producing and handling milk or
any member of their families, or any persons, residing in the house or on
the premises occupied by such person, if suspected of having any com-
municable disease, may be required to submit to an examination at the
hands of the superintendent of health. . . . Failure to co-operate with
the superintendent in carrying out the provisions of this section shall be
punished by the revocation of the permit held by such person, firm, or
corporation.
For the securing of milk from cattle free from tuberculosis
Richmond, Va., and Durham County, N. C., have the follow-
ing regulations: —
Richmond, Va. — Beginning on and after September 1, 1915, no person,
firm or corporation shall sell or offer for sale or otherwise dispose of within
the city of Richmond or shall transport or carry for the purpose of sale in
said city, or shall have in his or their possession with intent to sell or offer
for sale or otherwise dispose of in said city, any milk or cream produced
in whole or in part from cows which have not been demonstrated by the
tuberculin test to be free from tuberculosis, said test to have been made
within one year. Penalty for violation, . . . said milk or cream shall be
condemned and destroyed by the food inspector or one of his assistants.
Durham County, N. C.— It shall be unlawful for any person, firm or
corporation authorized under the provisions of this ordinance to operate
or maintain a dairy for the production of milk, cream, or buttermilk for
235
sale or other distribution in the city of Durham or sanitary districts of
east or west Durham, to use the milk of or from any cow that has not been
tuberculin tested by the meat and milk inspector or other officers assigned
to make such tests.
Spokane, Wash., has a regulation with regard to pasteuriza-
tion which makes it unlawful for any person to deliver, sell or
have or offer for sale or delivery in the city of Spokane, any
pasteurized milk unless the same shall have plainly marked on
each bottle a label bearing the inscription “Pasteurized Milk,”
and unless ‘the same shall have been pasteurized within twenty-
four hours prior to delivery to the consumer, etc.
The following are sections taken from the 1915 ordinance of
Seattle, Wash. ‘They are models that might well be followed
by other communities.
Srction 16. Provides that the Commissioner of Health shall have the
right and is hereby empowered to condemn, render unsalable and return
to possessor at his expense, milk to which any foreign substance has been
added, ete.
Section 19. Provides that the Commissioner of Health shall have
power to revoke all permits to receive milk within the city of Seattle from
dairies, etc., outside of the city . . . whenever he shall deem such action
necessary.
Section 31. Provides that it shall be the duty of the Commissioner
of Health as often as he shall deem necessary to inspect all dairies. . .
located outside the limits of the city of Seattle, from which milk is shipped
or brought into the city of Seattle.
Section 34. Provides that the Commissioner of Health shall have the
right and is hereby empowered to, and it is hereby made his duty to ad-
minister to all cows within the city of Seattle, an accepted test for the
detection of tuberculosis, as often as he shall deem necessary. . . . All
animals reacting to the tuberculin test shall be marked in a manner satis-
factory to the Commissioner of Health for purpose of identification. . . .
He is empowered to revoke permit issued to any person to sell milk within
the limits of the city when any cow reacts to accepted test . . . and is
not immediately disposed of satisfactory to the Commissioner of Health.
_Aforesaid test not required . . . when all the milk produced . . . is pas-
teurized . . . as defined in another section.
Srction 37. Provides that it shall be the duty of all persons having
charge or control of all dairies, etc., . . . to notify the Commissioner of
Health of any suspected or positive case of typhoid fever, small pox, diph-
theria, scarlet fever, tuberculosis, septic sore throat or any other com-
municable disease in any person upon such premises and no person suf-
236
fering from, or those coming in contact with such persons, etc., shall work
in or about the premises where milk is produced, handled or offered for
sale, for consumption. :
Section 38. Provides that all persons handling milk to be sold in the’
city of Seattle, shall be subject to medical examination by the Commis-
sioner of Health, free of charge. . . . In case of refusal to permit said
examination . . . permits to sell milk in the city of Seattle shall be per-
manently revoked.
Section 44. Provides a penalty not exceeding one hundred (100) dol-
lars, or imprisonment in the city jail not exceeding thirty (80) days, or
both for violation of any of the provisions of the ordinance.
APPENDICES.
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LppuNnpix B.
FORMS OF QUESTIONNAIRE AND LETTERS SENT TO LOCAL
BOARDS OF HEALTH, AND A LIST OF CITIES AND
TOWNS FAILING TO REPLY TO QUESTIONNAIRE.
MassacuusetTts State DEPARTMENT OF HEALTH,
Boston, July 21, 1915.
To the Local Board of Health.
CuntLemEn: — The State Department of Health is making a study
of the relation of milk to the transmission of disease.
We are desirous of getting as complete a record as possible of all cases
of typhoid fever, diphtheria, scarlet fever and septic sore throat, where
milk has been proven to be or has been suspected of being the means of
transmission. w
We will appreciate it, therefore, if you will fill out the enclosed blank
and forward it to us at your earliest convenience, together with any
other facts which you feel may have a bearing on this important matter.
By direction of the Commissioner of Health,
Sincerely yours,
EuGcene R. KELLEY,
Director of Division of ‘Communicable Diseases.
1915.
Dr. Auuan J. McLauesiin, Commissioner of Health, State Department
of Health, State House, Boston, Mass.
Dear Sir: — Below you will find a list of the cases of the following
Giccanes OCCURTIME MG) leu vac ialae cael a crciceslasgis 7 ck anna san during the
years 1909-18, classified by this Department with reference to milk
supply.
Diseases. Total Number.ot Casgp neta Cast Te
Typhoid fever,
Diphtheria, ;
Searlet fever,
Septic sore throat, ,
Total Number of Deaths due to Deaths, Milk
DISEASES. Deaths, 1909-13. Milk. suspected.
°
Typhoid fever,
Diphtheria,
Scarlet fever,
Septic sore throat,
Yours very truly,
Agent or Secretary of Board of Health.
250
Massacuusnetts Statr DEPARTMENT OF HEALTH,
Boston, Sept. 22, 1915.
To the Local Board of Health.
GrnTLEMEN: — Some time ago this Department sent to all local boards
of health in the Commonwealth a questionnaire on the relation of milk
to certain diseases. In looking over our returns we do not find your
reply among them. This is probably an oversight.
We need this information to complete our report on the milk question
for the next General Court. The value of these replies will be directly
proportional to number of towns reporting. The subject of milk in its
relation to disease is so important to every city and town that it ought
to amply repay any local board of health for their trouble in looking
up their records on the subject. |
As you know, the reports of infectious diseases, as they are forwarded
to this office, do not indicate the known or suspected source of the in-
fection. Consequently, this Department can only gather such informa-
tion as is asked for in this questionnaire through the co-operation of the
local boards of health. We would, therefore, very greatly appreciate
an early return of the enclosed questionnaire, even if your records do
not show any cases or deaths due to diseases transmitted by milk.
By direction of the Commissioner of Health,
Sincerely yours,
EucEene R. KELey,
Director of Division of Communicable Diseases.
Cities and Towns that have not replied to Milk Questionnaire.
Abington. Bridgewater. Falmouth.
Acton. Brimfield. — Florida.
Adams. Buckland. Foxborough.
Agawam. Burlington. Gardner.
Amherst. Charlemont. Gay Head.
Arlington. Chelmsford. Georgetown.
Ashfield. Chilmark. Gill.
Barre. Clarksburg. Goshen.
Bedford. Concord. Grafton.
Belchertown. Conway. Granby.
Bellingham. Dalton. Granville.
Berkley. Dana. Groveland.
Berlin. Dedham. Hadley.
Bernardston. Dighton. Halifax.
Billerica. Dudley. Hamilton.
Blandford. East Bridgewater. Hancock.
Bolton. East Longmeadow. Hardwick.
Boxborough. Egremont. Harvard.
Boylston. Enfield. Harwich.
Brewster. Essex.
Hawley.
251
Cities and Towns that have not replied to Milk Questionnaire — Concluded.
Heath.
Hingham.
Holbrook.
Holliston.
Hopkinton.
Hudson.
Hull.
Huntington.
Tpswich.
Kingston.
Lakeville.
Lee.
Leicester.
Lenox.
Leverett.
Leyden.
Lincoln.
Littleton.
Longmeadow.
Ludlow.
Lynnfield.
Manchester.
Mansfield.
Marblehead.
Mari BOROUGH.
Marshfield.
' . Mattapoisett.
Maynard.
Medfield.
Medway.
Middleborough.
Middlefield.
Middleton.
Milford.
Milton.
Monson.
Monterey.
Nahant.
Nantucket. |
Natick.
Norfolk.
North Attleborough,
Norton.
Norwood.
Oak Bluffs.
Orange.
Otis.
Pembroke.
Peru.
Plymouth.
Plympton.
Randolph.
Rehoboth.
Richmond.
Rockland.
Rowley.
Royalston.
Rutland.
Salisbury.
Savoy.
Seekonk.
Sheffield.
Shelburne.
Shrewsbury.
Southampton.
Southwick. »
Spencer.
Sterling.
Stoneham.
Stoughton.
Sturbridge.
Sudbury.
Sutton.
Templeton.
Tewksbury.
Tisbury.
Uxbridge.
Wales.
Wareham.
Warren.
Washington.
Wayland.
Wellfleet.
Wendell.
West Bridgewater.
West Brookfield.
West Springfield.
West Stockbridge.
Westborough.
Westford.
- Weston.
Weymouth.
Whately.
Whitman.
Wilbraham.
Williamsburg.
Wrentham.
252
APPENDIX’ *-C:
ABSTRACT OF MILK-BORNE EPIDEMICS IN MASSACHU-
SETTS FROM 1906-15.
The following is an abstract of epidemics investigated by the.
State Board and Department of Health of Massachusetts from
1907 to 1915, in which milk was either definitely proven to have
been a means of transmission of the infection, or in which the
epidemiological evidence of milk as the cause was considered
strong enough to classify the outbreak as among the milk-borne
outbreaks.
253
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Recapitulation.
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Cases. Epidemics.
Diphtheria, i : : 3 é P "i : i , 131 5
Scarlet fever, . 5 é : a 4 £ “ 4 2,747 10
Septic sore throat, . 4 ‘ i : ; i a 2 2,512 7
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7,605-+- 72
262
APPENDIX
COPY OF LETTER SENT TO, AND REPLIES FROM, EPIDEMI-
OLOGICAL AUTHORITIES OF OTHER STATES RELATIVE
TO MILK AND DISEASE.
The following is a copy of the letter sent to, and replies re-
ceived from, the epidemiological authorities of New York, New
Jersey, Pennsylvania, Maryland, Minnesota and Kansas: —
Boston, Mass., July 30, 1915.
Dear Doctor: — This Department is making a study of the relation
of milk to communicable diseases. —
We are especially anxious to get all the data possible on cases of ty-
phoid fever, diphtheria, scarlet fever and septic sore throat where milk .
has been implicated in the transmission of the infection. Are your routine
epidemiological reports such that we might get from them an idea of the
relative frequency of milk as a means of transmission of these diseases in
your State? Would it be asking too much to let us have any reports, analy-
ses or studies along this line that have been made by your department?
While we appreciate the extent of this request, we are impelled to
make it only by our willingness to co-operate with you in a like manner
at any time. |
By direction of the Commissioner of Health,
Sincerely yours,
Kucene R. KEewiey,
Director of Division of Communicable Diseases.
Boarp or HEALTH OF THE STATE OF NEW JERSEY, TRENTON, Aug. 2, 1915.
Evucens R. Keuuny, M.D., Director of Division of Communicable
Diseases, State Department of’ Health, Boston, Mass.
Dear Doctor: —I am in receipt of your communication of July 30 in
which you ask for information in regard to cases of typhoid fever, diph-
theria, scarlet fever and septic sore throat traceable to milk infection.
We have no special articles on this subject, but I believe there is on
file in your office a complete set of the annual reports of th2 State Board
of Health, and in the reports of the last five or six years you will find
reports of interesting epidemics of this nature which have occurred in
the State of New Jersey.
With kindest regards, I am
Very truly yours,
A. Cuark Hunt, M.D.,
Chief.
263
DEPARTMENT OF HEALTH, City or New York,
BuREAU OF PREVENTABLE DISEASES,
139 CentRE Street, NEw York, Dec. 31, 1915.
Dr. Everne R. Keuury, Director, Division of Communicable Diseases,
Massachusetts State Department of Health, Boston, Mass.
Dear Doctor: — You, of course, understand the impossibility of
judging the number of deaths in endemic typhoid due to milk, for the
reason that no one can designate the cases as they appear. All that
we-can do in this respect is to weigh one set of milk conditions against
another and ascribe the difference to one of them. This is what we have
done in comparing the number of cases prior to pasteurization of milk
with the number after the pasteurization of milk. As the fall was an
abrupt one we felt that we were right in our conception as to the relative
responsibility of raw milk for the endemic disease, especially as the figures
corresponded so closely with those forecast after considering the ex-
perience among the patrons of a milk company selling from one to two
hundred thousand quarts a day of pasteurized milk as compared with
all of the other milk, most of which was unpasteurized. I must admit
I have nothing more than just this, and at the same time I can account
for the change in no other way.
While we cannot give you the actual number of cases and deaths in
the so-called residual milk-borne typhoid, we have them for outbreaks
and submit the following: —
TOM Ms , : f .. 184 cases, ‘ : F d . 22 deaths.
1913, . : s : . 561 cases, ! : ! : . 61 deaths.
1914, . i i j . No outbreaks.
1915, . : ‘ i: . 119 cases, 4 f ‘ : . 15 deaths.
This brings to your attention an outbreak in 1915, after pasteuriza-
tion was generally established. This was a very interesting occurrence.
On July 19, 1915, 3 cases of typhoid fever were reported from one com-
paratively small company, one doing a business of about 10,000 quarts
in a limited area, supplying about one-tenth of the population therein.
The company had several creameries, but all 3 cases were supplied by
one creamery. On the succeeding day 3 other cases were reported. Tele-
phone inquiry developed the fact that various creameries had contributed
to their supply, but this particular creamery had participated in each
instance. The milk was thereupon excluded from the city.
A careful survey of the conditions at the creamery town showed
several cases of typhoid fever in the community, and an examination of
the well water used in washing the bottles and machinery showed a
high degree of contamination. For the bottles only hot water or steam
was used, but on the machinery, especially on the bottler itself, cold
water had been used followed by hot steam for sterilization. Under
the conditions, the steam penetrated to most parts of the machine, but
did not get access to the drop or funnel arrangement by which the milk
was directly conveyed to the bottles. As a certain amount of milky
264
water remained in this situation over night it was surmised that typhoid
bacilli may have been present and developed through culture over night,
resulting in a high degree of contamination of the freshly pasteurized
milk. The well was, of course, at once sealed up before the milk was
allowed to re-enter, and there has been no further trouble. No typhoid
bacilli, however, were found in the water, though colon bacilli were present
in 1400 cubic centimeter, as obtained directly at the well. This goes
to show the danger subsequent to pasteurization under the present
methods.
Of course, pasteurization in bottles would obviate all of this, but the
expen of the glassware and the manipulation would be enormous.
Very truly yours,
M. L. Ocean,
Chief, Division of Epidemiology.
New Yor«k State DEPARTMENT OF HEALTH, ALBANY, Dec. 9, 1915.
Dr. Evcene R. Keruey, Director, Division of Communicable Diseases,
State Department of Health, Boston, Mass.
Dear Dr. Kenizy:— Your letter of November 27, relative to the
number of cases of communicable disease that were transmitted by
infected milk in this State, is received. I have delayed replying because
I hoped to be able to tabulate the reports of the sanitary supervisors
on this subject, but I find that many of them reported the outbreaks
with a question mark as to whether or not milk was a means of trans-
mitting the disease. I have, therefore, addressed a special memorandum
+o them asking them to review their work during the past year, and give
me a statement of the number of outbreaks which they have had due
to infected milk, stating the number of cases and deaths connected with
each outbreak. I think that this report will be much more accurate
than one which I could tabulate from the records.
As soon as this report is received I shall be glad to forward a copy to
you.
Very truly yours,
F. M. Meaper,
Director, Division of Communicable Diseases.
Srarr or MaryLAnp, DEPARTMENT OF HEALTH,
16 West Saratoca STREET, BALTIMORE, Sept. 30, 1915.
Dr. Eugene R. Keuury, Director, Division of Communicable Diseases,
State Department of Health, Boston, Mass.
DeEAR Doctor: — Several weeks ago you requested data on milk-
borne outbreaks of typhoid fever, diphtheria, scarlet fever and septic
sore throat in Maryland. A prolonged absence from the city, combined
with an unusual press of official work, prevented my sending you this
information at an earlier time. If you already have read your paper
(265
on the subject, I trust this material may still be of service to you in your
printed article.
We have had no epidemic of diphtheria or of scarlet fever in which
the milk supply was implicated, but we have had 7 outbreaks of typhoid
fever and 1 of septic sore throat attributed to milk. I shall next give
a summary of the typhoid outbreaks, arranged in chronological order.
Milk Outbreaks, Typhoid Fever, in Maryland.
1. The first recorded milk epidemic of typhoid fever in Maryland
occurred in Elkton, Cecil County, in July, August and September, 1884.
There were 20 cases, but no death. All of the cases but one were supplied
with milk from a certain dairy where there was an undoubted case of
typhoid fever. The outbreak ended when the use of this dairyman’s
milk was discontinued.
2. Late in the summer and early in the autumn of 1900 another milk
epidemic of typhoid fever occurred in Elkton, Cecil County. This out-
break,! traceable to a single dairy, comprised 64 cases, two of which —a
white woman aged fifty-six, and a young colored woman — proved
fatal. The outbreak began on October 11 and subsided after October 29.
Within the first eighteen days, during which time the dairyman’s business
continued, 39 cases of typhoid fever occurred. He ceased selling milk
on October 28. Within three weeks following that date 20 additional
cases occurred. Altogether there were 39 infected houses. The dairy-
man claimed to be regularly supplying 80 houses. On this basis the
house incidence was 48.75 per cent. In the 39 infected houses there
were 180 people, an attack rate of 33 per cent. The case rate was 1.54
per house. The light fatality, 3.3 per cent., suggests a contagium of
slight virulence. The incubation period was variable, ranging from nine
to eighteen days. The first 21 cases seemed to indicate periods of in-
cubation averaging under rather than over fourteen days. Three of the
patients had suffered previous attacks, one in 1884, one in 1893 and
one in 1898.
3 In 1903 an outbreak consisting of 26 cases of typhoid fever, 4 of
which terminated fatally, developed among the employees of a shirt
factory located in Baltimore City. The firm operating the factory served
dairy lunch, the milk of which came from a farm where the water supply
was polluted. The epidemic ceased when the milk supply was changed.
4. In May, 1904, there was a milk outbreak of typhoid fever, con-
sisting of 17 cases with 1 death, at Port Deposit, Cecil County. The
incubation period, as is usual in milk-borne typhoid fever, was short,
all of the cases having been taken ill within a period of ten days. They
had a common milk supply, and were users of raw milk. Previous to
the outbreak there had been a case of illness on the dairy, farm which
was diagnosed “‘grippe.”’
1 See an interesting and comprehensive report of this outbreak by Dr. Fulton, in the Journal
of{Hygiene, London, Vol. I., 1901, pp. 422-429. :
266
5. In October, 1905, there was another milk outbreak of typhoid
fever in Port Deposit. This outbreak, explosive in character and limited
to the users of one milk supply, comprised 19 cases, 1 of which proved
fatal. A case of typhoid was found on the farm supplying the milk.
The outbreak ceased when the sale of this milk was stopped.
6. In April, May and June, 1906, there was a remarkable rise in the
number of cases of typhoid fever. in the Woodberry-Hampden district
of Baltimore City. This outbreak, which occurred on one milk route,
led to the discovery that one of the farms supplying this milk had cases
of the disease among the employees, one of them being a milker. Stopping
the sale of this milk put an end to the epidemic, which totaled 157 cases.
7. In May and June of the present year (1915) there was an outbreak
of typhoid fever at the Maryland Tuberculosis Sanatorium, which at-
tacked the several groups of patients and employees using milk from
‘one of the 7 dairymen supplying the institution. Upon investigation
it was found that an unrecognized case of typhoid fever had occurred
in April, in the wife of the dairyman furnishing the infected milk. The
outbreak subsided when the sale of milk from this dairy was stopped.
The outbreak consisted of 27 cases, 19 of them tuberculous patients
and 8 healthy persons. ‘Three deaths occurred in the former group,
and none in the latter.
Septic Sore Throat.
So far we have had but one explosive outbreak of septic sore throat
in Maryland, spread through the agency of milk. This occurred in
Baltimore City and its immediate vicinity, in February and March,
1912. The extent of this epidemic, apparently a streptococcus infection,
can only be surmised. It may be estimated that certainly not less than
1,000 and perhaps as many as 3,000 cases occurred, causing 30 or more
deaths. Over 85 per cent. of the cases were in families obtaining their
milk supply wholly or in part from a single dairy. -
Very truly yours,
C. W. G. Rourer,
Acting Chief, Bureau of Communicable Diseases.
P.S.— Under another cover I am sending you three reprints on the
septic sore throat epidemic, described in the paragraph immediately
preceding. Two are by Dr. Hamburger and the third by Dr. Frost.
I presume you already possess a copy of Hygienic Laboratory Bulletin
No. 41, entitled “Milk and its Relation to the Public Health,” published
in 1908. It is replete with information bearing upon the relation of
milk to the spread of communicable diseases, ete. — C. W. G. R.
,
267
[EXTRACT.]
Nov. 27, 1915.
Dr. C. Hampson Jones, Chief of Bureau of Communicable Diseases, De-
partment of Health, Baltimore, Md.
Dear Dr. Jones: —
We were much interested in receiving a communication from Dr.
Rohrer, giving the frequency of milk-borne epidemics of typhoid fever,
scarlet fever and diphtheria according to his records. The question has
come up as to whether or not these figures include Baltimore. Will you
kindly let me know?
Sincerely yours,
Kucene R. KELLEY,
Director of Division of Communicable Diseases.
State oF MaryLanpD, DEPARTMENT OF HEALTH,
15 Wzst Saratoca SrREET, BALTIMORE, Nov. 29, 1915.
Dr. Eugene R. Keuey, Director, Division of Communicable Diseases,
State Department of Health, Boston, Mass.
Dear Doctor: — In looking over Dr. -Rohrer’s letter to you I find
that his report includes those outbreaks of disease that occurred not
only in the State, but in Baltimore’ City.
I found, however, that one similar outbreak in Baltimore City has
been omitted which occurred while I was there, and a report of it was
made at the time of its occurrence, but I regret to say that I cannot now
give a reference to the same nor the exact date of outbreak. It is my
impression that it was somewhere between 1908 and 1910, and that it
occurred in summer time, and the cases were detected by the system
we had in the Health Department of daily scanning the report cards of
the health wardens by an officer of the Food and Dairy Division, the
health warden’s cards showing what milk was consumed by the family
of the sick one. .
A dairy located in the tenth ward suddenly looming up with a number
of cases caused a review to be made of the producing dairies which were
sending milk to it, which in this case fortunately happened to be but
few, — not more than four, — so we quickly examined the condition of
the farms of each producing dairy and found a typhoid fever case in a
Harford County dairy that was sending the milk to the distributing
dairy in Baltimore City. The closing of the producing dairy until all
danger had passed effectually and quickly stopped the distribution of
the disease. My recollection is that there developed between 55 and
60 cases of typhoid fever on this man’s milk route.
Yours respectfully,
C. Hampson JONES,
Chief, Bureau of Communicable Diseases.
268
Minnesota STATE BoarD oF HEALTH,
DIvIsIOoN OF PREVENTABLE DISEASES,
University Campus, Minneapouis, Mrinn., Aug. 3, 1915.
Dr. Evcene R. Kewiny, Director, Division of Communicable Diseases,
Massachusetts State Board of Health, Boston, Mass.
Dear Dr. KettEy:— We will be glad to co-operate with you in
every possible way in your study of the relation of milk to typhoid,
diphtheria, scarlet fever and septic sore throat.
We have had no outbreak of septic sore throat reported in Minnesota.
We have a considerable number of records showing the influence of milk -
in the spread of other diseases. I will collect this information for you
as soon as time permits and forward it. |
- With kindest regards, I am,
Respectfully,
A. J. CHESLEY,
Director.
Minnesota Srate Boarp or HEALTH,
DIVISION OF PREVENTABLE DISEASES,
Minneapouis, Minn., Aug. 23, 1915.
Dr. EucenE R. Keuey, Director, Division of Communicable Diseases,
State Board of Health, State House, Boston, Mass.
Dear Dr. Ketitey:— In endeavoring to comply with your request,
regarding instances in which milk has been implicated in the transmission
of scarlet fever, diphtheria and typhoid fever, I am somewhat disap-
pointed.
Dr. Greene was kind enough to go through the records of the Division
very carefully from Aug. 1, 1909, to date. He made a card index of
reports where it seemed that milk might have been a factor in the spread
of infection.
I have gone through all these reports. While many of them indicate
that milk was a factor to some extent in the spread of disease, only in a
few was milk the chief route of infection or definitely proven to be an
active factor. As you know, many times we have been called only when
the epidemic was at its height, sometimes even on the wane, and the
data which are collected under such conditions are not conclusive, al-
though they are very suggestive.
Certain of the instances are given in the enclosed summaries. Others
are to be found in the published reports.
To begin with, I may mention one due to butter, not milk. The sum-
maries for this will be found under the heading, Anoka Typhoid, May
29 to 30 and June 5 to 6, 1912, page 240, Report of the Division of Epi-
demiology, August, 1910, to August, 1912.
Some explanation is necessary in addition to the information given
in the Summaries. Dr. Hill made a very careful epidemiological study,
269
but was obliged to leave Anoka before he had finished, and sent me to
finish the work. He left his epidemiological notes (mostly illegible),
and told me how he had sized up the situation. Acting upon his theory
of causation, I used such data as I could unravel from his notes, then
attempted to solve the problem upon a certain hypothesis. I never did
such a thing before, and have never attempted it since. Of course the
hypothetical solution was to be checked up by actual investigation.
Assuming that butter was responsible for the spread of typhoid in-
fection, Dr. Hill had record of the number of persons in each family who
used the suspected butter. A grocer simply acted as a distributor to
regular customers. The packages were never opened between the dairy
and the customer. There was record of every package delivered. Dr.
Hill had noted whether the families had butter left from previous de-
liveries or not.
I weighed a piece of butter about the size of a chunk ordinarily con-
sumed by one individual at a meal, and figured how many pieces of this
size there would be in each jar delivered. On figuring out the time the
butter would last, it appeared that it had all been consumed four days
before Dr. Hill was notified that the epidemic was in progress, and there-
fore all the precautions taken were of no avail. It appeared that other
cases would come down, up to a certain time.
For instance, in packing the butter into the jars, the upper part of
the first crock would be contiguous to the bottom of the second jar; and
if we assume that infection from the fingers occurred at this time, then
the family using butter from the first jar should fall ill earlier than the
family using butter from the second jar, because they would not get
any infected material until the bottom of the jar was reached. In other
families who had some butter from previous deliveries on hand, the
infection would not be incurred at the time it would in the first family —
mentioned.
The only persons who had typhoid who were not in the families of
regular customers for this butter attended a church social where a woman
who supplied butter had the jar from the dairy delivered at the time it
was assumed the batch had been infected. It was one of those socials
where certain items are supplied by certain women, and this lady supplied
the infected butter, it seems.
I went directly to the farm and found, upon questioning the people,
that a girl visiting in the family had packed the particular batch of
butter under suspicion. The farmer’s wife made the butter, as usual,
but on the morning it should have been delivered she was sick and asked
the girl to pack the butter into the jars. This girl had been feeling unwell
for. some time, and had consulted a woman physician, who afterwards
admitted that the girl undoubtedly had walking typhoid, although she
did not report the case to the local health officer or send blood for Widal
test. The symptoms the girl gave were suspicious.
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280
It will be seen from a perusal of these tables that heating has
but little effect upon the percentage of the milk constituents
estimated other than that caused by a slight concentration. In
the case of the serum, however, there was a diminution of the
refractive index due to more or less coagulation of the albumin.
The maximum and average differences between the milk con-
stituents are shown in the following table.
TaBLE IIT. — Difference between Raw and Pasteurized Samples.
Milk.
Maximum DIFFERENCE.
Average
Pasteurized Pasteurized pasteurized.
above — below —
|
Solids, . 3 2 ; i 4 § é 0.48 0.06 0.17 higher
Fat, . . : 6 3 s % , Fs 0.20 0.10 0.04 higher
Proteins, . 3 : : 3 ‘ : f 0.05 0.15 0.01 lower
Ash, 3 g On ee 4 4 ; & 0.08 0.09 0.003 lower
Lactose, . : ‘ ‘ 3 3 : 0.70 0.10 0.005 higher
Skimmed Milk.
Solids, . F 3 i : a i ; 0.40 0.27 0.095 higher
Bat, . : Ahi AN ; j B 3 3 - - -
Proteins, . . a : 6 A ; 0.17 0.09 0.008 higher
Ash, : 4 : ; , 0.04 0.12 0.008 lower
Lactose, . z 3 4 5 2 y 0.15 0.06 0.036 higher
Cream.
Baten ee 5 5 : 4 ‘ HB i 0.70 0.70 0.045 lower
Proteins, . 2 é s ‘ E ; 0.38 0.14 0.022 higher
Ash, 4 5 a 4 : F é : 0.06 0.04 0.022 higher
Lactose, . 5 3 5 s y é 0.30 0.28 0.018 higher
CoMPARISON OF SERUM OF MILK, SKIMMED MILK AND CREAM.
The serum of skimmed milk and of cream is the same as that
of the whole milk from which it was obtained, although our
figures in a few instances do not seem to bear out this statement.
The variations in the refractive index of the sour serum are due,
no doubt, to changes in the character and the duration of the
281
fermentation. If the same sample of milk is divided into several
portions and fermented with different ferments, the refractive
indices of the serums will be different. The variation in the
refractive indices of the copper serums made from milk, skimmed
milk and cream from the same source can be explained,. as
follows: It is a well-known fact that if a sample of milk is’
allowed to set, the bacterial content of the cream is greater than
that of the skimmed milk. These samples in which the serum
refraction of the cream was greater than that of the milk were
obtained under such circumstances that they could not be cooled
at the time of milking, and were not transferred to the laboratory
ice chest for some hours. The following morning it was noticed
that the cream was slightly sour, although the balance of the
milk was normal. The samples undoubtedly were not poured
over sufficiently to make the serum uniform throughout the
entire mass, although the fat was evenly distributed. As the
refractive index of the copper serum of milk is higher if the
serum is prepared after the sample is sour, the apparent dis-
crepancy is thus accounted for.
INFLUENCE OF PASTEURIZATION ON MILK SERUM.
The heating of milk has a tendency to produce a diminution
of the refractive index of those milk serums which contain the
coagulable albumin. The. higher the temperature the greater
will be the influence until complete coagulation takes place at
about 85° C. or 185° F. The coagulation begins at 64° C. or
147° F., below which apparently it cannot take place in sufficient
quantity to affect the serum. The refractive index of the copper
and sour serums, the ash of sour serums and the temperature of
pasteurization of the samples are given in Table IV.
282
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286
The diminution of the refractive index of the serum by
pasteurization is influenced by the per cent. of fat in the sample
as well as by the temperature to which it has been heated.
Milk with a high fat content has a high protein content, and milk
with a low fat content has a low protein content. A sample of
milk containing 5 per cent. fat would contain about 0.7 per cent.
coagulable albumin. A sample with 4 per cent. fat would con-
tain about 0.6 per cent. albumin and one with 8 per cent. fat,
about 0.5 per cent. albumin. The complete coagulation of the
albumin in a sample of milk from a herd of Jersey cows would
have more influence in lowering the refractive index of the serum
than if the sample was obtained from a herd of Holstein cows.
As the milk with a high fat content gives a more concentrated
serum than the milk with a low fat content, the influence of
heating is less marked in the latter case; in fact, the copper
serum and sour serum prepared from boiled milk is more uniform
than that prepared from raw milk. The refractive index of the
average milk would be reduced to an extent of 1.8 scale divisions _
by boiling; therefore with a sample of milk containing 5 per cent.
fat we should expect a reduction of about 2.1 scale divisions, and
with a sample containing 3 per cent. fat, a reduction of 1.3 scale
divisions. The influence of both heat and fat content upon the
diminution of the refractive index of the copper serum is shown
in Table V., the figures being obtained from Table IV.
TABLE V.
Average Difference
TEMPERATURE. hetwconipes
NUMBER OF ANALYSES. Average fat. | fraction of Copper
Serum before
Degrees C. Degrees F'. and after Heating.
3; : 3 0 b 80 176 4.05 1.70
ire , ; ‘ i 80 176 3.82 1.40
Gos 3 i 5 : 80 176 3.60 1.20
Shc : : t 5 75 167 4.70 1.11
14,7. 3 : : : 75 167 » 3.94 ileal
Ld tie : i 3 4 75 167 3.50 1.10
9, J 4 4 ; 74 165 3.95 0.90
12, . 6 4 é 2 74 165 3.74 0.85
3, . fs . : : 74 165 3.20 0.80
i 6 > . 2 : 70 158 4.05 0.73
20, . : s F 5 70 158 3.95 0.63 —
9, . . 5 0 - 70 158 3.48 0.54
287
From the figures in Table IV. the relation between the temper-
ature to which milk is heated and the percentage coagulation of
the albumin has been computed, and is shown in Table VI. It
should be understood that these figures are somewhat. influenced
by the duration of time the milk has been kept at the tempera-
ture specified.
TaBLe VI.
TEMPERATURE. Pon Gent of TEMPERATURE. Per Cent. of
Aum Gi Ge mapa Albumin
Degrees C. Degrees F. PERE Degrees C. Degrees F. Cone
60 140 - 75 167 60
65 149 10 77 171 70
GY 153 20 78 172 80
69 156 30 79 174 90
71 160 40 80 176 100
73 163 50
288
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289
The figures obtained from those samples which were removed
during the heating and holding process in order to obtain the
-relative rate of reduction of the refractive index of the serum
are given in tabular form in Table VII.
Judging from the results obtained from known purity milk
heated slowly in bulk in the laboratory, we have arrived at the
conclusion that practically no chemical effect takes place in milk
upon heating until the temperature of 64° C. or 147° F. has been
attained. As the temperature increases above this point the
albumin gradually becomes insoluble, and the refractive index of
the serum decreases until the temperature reaches 85° C. or
185° F., above which (up to the boiling point) no further in-
fluence is apparent. The influence of holding is not so marked
as that of heating, and the reduction of the refractive index of
the serum is less a factor of the length of time than of the
temperature, for if the latter is below 64° C. or 147° F. the time
of holding is without influence upon the coagulability of the
albumin.
Pasteurization is without influence upon the sour serum ash,
notwithstanding the fact that the heating of milk above 72° C.
or 161° F. causes the precipitation of some of the calcium salts,
_the exact nature of which is at present a matter of controversy,
but which is coincident with the destruction of the peroxidases.
The formation of lactic acid during the souring of the milk
causes a complete solution of any precipitated mineral matter,
and consequently the sour serum ash of pasteurized milk is the
same as that obtained from the raw milk.
The term pasteurization as used herein has been somewhat of
a misnomer as it has been applied where the terms cooked,
boiled or scalded should have been used. Commercial pasteuriza-
tion is carried out at a temperature of 62.8° C. or 145° F., the
milk going to holding chambers where it is kept for from thirty
minutes to one hour. Under these circumstances there is prac-
tically no coagulation of the albumin, and therefore there is no
‘liability of commercial milk giving a serum of lower concentra-
tion than would be obtained from the same milk before heating.
If, however, milk has been heated sufficiently to cause any
marked diminution of the albumin, it may be detected by per-
forming the peroxidase reaction which will be negative, in which
instance a lower figure may be selected for the minimum re-
fractive index.
After the above experiments had been performed and the
results compiled, it was decided to investigate the influence of
290
commercial pasteurization upon milk. Three pasteurization
plants near Boston were visited, and samples were taken before
and after pasteurization. One plant used the flash system, heat-
ing momentarily to 74.4° C. or 16.6° F., and cooling immediately,
the entire process from the mixing tank to the bottles taking
about one-half minute. In this plant two samples were taken
before and two after pasteurization at such an interval of time
that the pasteurized samples represented substantially the same
milk as the corresponding raw samples. The other plants from
which samples were taken used the holding system, the milk
being instantaneously heated to 146-147° F. (63.3°-63.9° C.),
. transferred. to holding chambers with a loss of 3 to 4° F., held
for a period of thirty minutes with a loss of 1 to 2° F., cooled
and bottled. Two samples were taken, one each from the mixing
tank, from the outlet of the cooler and the outlet of the holder
at such intervals that the raw, heated and held samples were
from substantially the same milk. In one instance samples were
also taken from the tank where the pasteurized milk was mixed
before bottling, and one sample was also taken from the bottling
machine. The results of the analyses are shown in Table VIII.
291
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292
From these figures it can be a irmed that commercial pasteur-
ization is without substantial influence upon the chemical com-
position of milk as determined by the methods described in this
investigation. * As commercial pasteurized milk is not the ex-
clusive product of a two or three cow dairy, but represents the
mixed milk of at least 20 dairies of 15 cows each, there is no
necessity, for the purpose of measuring the purity of this milk,
of applying figures obtained from the milk of a few abnormal
cows which were or may have been afflicted with diseased
udders. Samples of this variety may possibly be obtained from
cows which are under forced rations, for the purpose of obtaining
a heavy flow of milk for advanced registry. It is a notable fact
that cows that have undergone such treatment have more or less
udder troubles, and may not subsequently give normal milk.
Commercial pasteurized milk should be compared with the milk
from herds of 15 or more cows, and if the analytical constants
and ratios are outside of what under these circumstances would
be expected, the sample is adulterated, even if it conforms to
analyses of many samples of abnormal milk from individual cows.
CONCLUSIONS.
The serum of milk, skimmed milk and cream from the same
source is identical. Commercial pasteurization is without
influence upon the components of milk as determined by the
methods employed in this investigation. Heating milk to a
temperature of 150° F. or 65° C. and above for a period of three
minutes or more will cause a coagulation of the albumin, and
consequently a diminution in the concentration of the serum.
Commercial pasteurization being always applied to large volumes
of milk representing the mixed milk of many herds, it is not
essential to use, in judging the quality of such milk, the data
obtained from individual cows, but rather from herds. Heating
is without influence upon the ash of the serum of sour milk, or
of the acetic acid serum of milk.
The thanks of the authors are extended to Miss Katherine E.
Rooney, assistant analyst of the State Department of Health,
for analytical work in connection with the investigation of the
commercial pasteurizing process, and particularly for making the
bacteria counts.
293
/
APPENDIX F.
STATUS OF LOCAL MILK INSPECTION.
The data presented in the following pages were obtained, first,
from the questionnaire submitted to local boards of health in the
spring of 1915; second, from the information gathered by the
Food and Drug Division in personal visits to local milk in-
spectors and agents of local boards of health in the summer of
1915; and third, from repeated correspondence with local boards
of health, in which fewer and simpler questions were asked than
in the questionnaire, in the early autumn of 1915. The State
Department of Health owes its sincere thanks to those employees
of local boards of health who have so kindly and accurately
answered the questions submitted to them, and also to those
who so willingly permitted access to their official records. It is
believed that the compilation is as complete as it is possible to
obtain, and your Board has on file all the data which it has
been able to collect in this State relative to local milk inspection,
from which data this compilation has been made.
~The varied character of the work done by different local
boards of health has rendered it advisable to not only present
the compilation alphabetically by ~-cities and towns, but also to
divide the cities and towns into sections according to the
character of the work done. ‘The first attempt resulted in 25
sections, but after several efforts it was found to be possible to
present the data in 16 sections. These sections are arranged in
the order of the importance of the work done, and are as fol-
lows: —
Section 1.— Cities and towns granting licenses and permits, inspecting
dairies and making chemical and bacteriological examinations of milk.
Section 2. — Cities and towns granting licenses and permits, inspecting
dairies and making chemical examinations.
Section 3. — Cities and towns having milk inspectors who grant licenses,
inspect dairies and make chemical and bacteriological examinations.
Section 4. — Cities and towns granting licenses or permits, inspecting
dairies and making chemical and bacteriological examinations.
Section 5.— Cities and towns granting licenses and making chemical
and bacteriological examinations.
294
Section 6.— Cities and towns making chemical and bacteriological
examinations only.
Section 7. — Cities and towns granting licenses and permits, inspecting
dairies and making bacteriological examinations. \
Section 8. — Cities and towns granting licenses, inspecting dairies and
making chemical examinations.
Section 9. — Cities and towns granting licenses and aes chemical
examinations.
Section 10. — Cities nad towns granting licenses or permits and in-
specting dairies.
Section 11. — Cities and towns having a milk inspector and granting
licenses only.
Section 12. — Cities and towns in which the rapettor was recently
appointed. No work done other than the granting of a few licenses or
permits.
Section. 13. — Miscellaneous.
Section 14.— Cities and towns having an inspector from whom no
reply could be obtained.
Section 15. — Cities and towns doing no milk work under une milk in-
spection laws.
Section 16. — Cities and towns from which no information could be
obtained.
Section 1 comprises 17 cities and towns which carry out the
law as the statutes contemplate. From the data given it may
be easily ascertained how extensively this work is performed. A
bacteriologist can easily make from 50 to 100 bacteria counts per
day, and a competent chemist can easily make from 30 to 50
chemical examinations of milk per day. A dairy inspector
cannot, as a rule, make more than 15 dairy inspections per day
if carefully carried out. In order to effectively supervise the
milk supply of a locality, at least one chemical examination and
one bacteriological examination should be made each month of
the milk of each dealer. Several samples should be taken at
each inspection. This work requires the services of trained men,
and many localities cannot afford the necessary expense.
The cities and towns listed under section 2 carry out the
statutory provisions relative to milk inspection, but make no
bacteriological examinations as do those localities of section 1,
under their statutory powers to make and enforce bacteriological
rules and regulations.
The 22 localities in section 3 effectively protect their communi-
ties by the quality of the work performed, but do not grant
permits as required by the statutes.
295
The 5 towns listed in section 4 perform work almost essential
in character to those in section 1, but both licenses and permits
are not issued.
The 3 towns listed in section 5 do not enforce dairy inspection
and permit laws, but if the work done is performed frequently
and properly it affords good protection to the inhabitants.
Section 6, with the exception of licensing the dealers, is doing
work equivalent to those localities recorded under section 3.
Section 7 consists of 3 towns which are carrying out all the
statutory requirements except the making of chemical examina-
tions for the detection of adulterations.
Section 8, comprising 5 localities, makes no bacteriological
examinations and issues no permits. The dairy inspections, as a
rule, are confined to local dairies.
Section 9 comprises 3 localities, 2 of them being large cities
which license the milk dealers and make chemical examina-
tions.
Section 10 comprises 79 cities and towns, and is the largest
section except that doing no milk work. It is substantially
carrying out the provisions of chapter 744 of the Acts of 1914
relative to dairy inspection. Most of these localities raise their
own milk supply, and as the dairies inspected were but few, the
records of inspection were not investigated excepting those
instances where a large number of dairies were reported to have
been inspected. In some instances, however, the dairy inspection
was confined to local dairies when the locality imported milk.
The dairy inspections were made, in many instances, by the
inspector of animals which, while not strictly conforming to the
requirements of the statutes, were no doubt done as well as if a
special inspector had been appointed for the purpose. In other
instances the members of the board of selectmen or the board of
health performed the inspection work.
Section 11 consists of 13 localities which have milk inspectors
and grant licenses.
Section 12 comprises 8 towns which have recently appointed
an inspector of milk. No work has been done other than the
granting of a few licenses or permits.
Section 13 comprises 7 localities which are classed as miscel-
laneous. These localities grant a few permits and one license.
Section 14 comprises 4 towns having a milk inspector from
whom no replies could be received from a letter asking for
information regarding the character of work done.
296
Section 15 is the largest section and comprises 159 localities
doing no work under the milk inspection laws.
Section 16 comprises 10 towns from which no information |
could be received in response to numerous inquiries. No doubt
these 10 towns belong in group 15, which would raise the
number of towns doing no work to 172.
The figures obtained from these cities and towns were col-
lected between May and November during the year 1915. Most
localities doing work were eager to allow access to their records,.
and were therefore investigated early in the year. The figures
for dairy inspection obtained from these cities and towns are,
therefore, much lower than they’ would have been had they been
collected in October, because the prevalence of the hoof and
mouth disease during the winter of 1914-15 had the effect of
curtailing the inspection of dairies. This was not resumed until
late in the spring of 1915. In fact, many localities did not
begin operations under the dairy inspection law of 1914 until
the summer of 1915.
In the preparation of this portion of the report for the printer,
it was decided to submit to each city and town a statement of
what the Department proposed to print. Therefore a letter was
sent stating this fact, enclosing a form upon which was stated
the name of the State or town, the number of licenses, permits
and dairies inspected in 1914 and 1915, the character of the
dairy inspection, a statement of the records of dairy inspection,
the number of chemical examinations, and the number of bac-
teriological examinations. ‘The city or town to which this letter
was sent was requested to return the statement saying that it
was correct, or to return it stating that it was in error, with a
statement of how the corrected report should read. After these
replies had been received it was ascertained that in a few in-
stances there was a discrepancy between the reports of records
of dairy inspection as brought back by our own investigators
and as claimed by the local men. In these instances the local
men were unable at the time of visits to show any records of
their dairy inspections to the Department’s employees. A few
of the local men have claimed that this was in error, and that
they have records on file in the office. Many of the local men,
however, admit the correctness of our statements that they had
no records of dairy inspection. A large number of cities and
towns have made no reply to this last letter submitted.
297
(A) Summary oF Locat. MILK INSPECTION, CLASSIFIED BY
CITIES AND TOWNS.
Section 1. Curries aNnD TOWNS GRANTING LICENSES AND PERMITS, IN-
SPECTING DAIRIES AND MAKING Cummical AND BACTERIOLOGICAL
EXAMINATIONS.
Amherst.
16 licenses granted.
16 permits granted.
10 dairies inspected.
120 chemical examinations made.
120 bacteriological examinations made.
‘ Boston.
5,381 licenses granted.
_ Permits at present being granted.
7,323 dairies inspected.
15,150 chemical examinations made.
6,834 bacteriological examinations made. Records not investigated by
reason of the difficulty of the task.
Braintree.
31 licenses granted.
21 permits granted.
31 dairies inspected. The dairies are located in Braintree, Randolph
and Weymouth. Dairies of the Barden Cream Company not
investigated. Dairy inspection made for general cleanliness and
recorded as fair, passed, good, etc.
36 chemical examinations made.
12 bacteriological examinations made.
: Brockton.
462 licenses granted.
192 permits granted.
242, dairies inspected, located in Avon, Brockton, Stoughton; Bridge-
water, Abington, East Bridgewater and Randolph. Some of
these dairies scored exceptionally low, the average of all the
dairies being slightly below 50. The bacterial analyses show
the milk sold to be of good quality.
1,524 chemical examinations made.
2,080 bacteriological examinations made.
298
Brookline.
140 licenses granted.
339 permits granted.
354 dairies inspected. Dairy inspection made on special score card.
Brookline has inspected the dairies of the large contractors lo-
cated in New Hampshire, Vermont, Maine and western Massa-
chusetts, and has inspected nearly all the dairies of the smaller
dealers. The contractors are obliged to furnish milk from special
dairies approved by the agent of the board of health. In doing
this work the territory covered by Boston and Newton has been
duplicated. Some of the inspections have been made in col-
laboration with the Newton Board of Health.
470 chemical examinations made.
534 bacteriological examinations made.
Fall River.
741 licenses granted.
407 permits granted.
412 dairies inspected. The dairies are located in Berkley, Dighton,
Fall River, Dartmouth, Somerset, Swansea, Rehoboth, Tiverton,
R. I., Portsmouth, R. I., Little Compton, R. I., and Warren,
R. I. There does not seem to be any duplication of the work by
other cities or towns in making these inspections.
214 chemical examinations made.
2,286 bacteriological examinations made.
Haverhill.
42 licenses granted.
110 permits granted.
26 dairies inspected, located in Haverhill and Bradford. No attempt
made to inspect dairies outside of the city except one dairy in
Salem, N. H. Considerable cream sold by Turner Centre Dairy-
ing Association. Dairies not inspected.
314 chemical examinations made.
2,103 bacteriological examinations made.
Lancaster.
9 licenses granted.
40 permits granted.
48 dairies in Lancaster inspected. United States score cards used.
19 chemical examinations made.
32 bacteriological examinations made.
299
Lawrence.
82 licenses granted.
42 permits granted.
175 dairies inspected, located in Methuen, Andover, North Andover
and Dracut. Inspection made for general cleanliness.
217 chemical examinations made.
125 bacteriological examinations made.
Milton.
36 licenses phanted: A few permits granted.
25 dairies inspected. Score card used in inspecting dairies located in
Milton. Dairies of the H. P. Hood Company, the Elm Farm
Company and Barden Cream Company not known or inspected.
297 chemical examinations made.
103 bacteriological examinations made.
Natick.
57 licenses granted.
65 permits granted.
76 dairies inspected, located in Sherborn, Framingham, Ashland, Hol-
liston, Wayland, Dover, Sudbury and Natick.
30 chemical examinations made.
4 bacteriological examinations made.
Newton.
178 licenses granted.
435 permits granted.
666 dairies inspected. Dairies located around Newton, and contractors’
dairies in New Hampshire, Vermont and western Massachusetts.
Inspections made by United States score cards and records kept.
Work of the Boston Board of Health and Brookline Board of
Health has been duplicated by Newton. Some of the inspections,
however, have been made in collaboration with the Brookline
Board of Health.
821 chemical examinations made.
198 bacteriological examinations made.
Somerville.
610 licenses granted.
336 permits granted.
354 dairies inspected. Dairies of large contractors not inspected. Some
of the out-of-State dairies of the smaller contractors inspected,
going over the territory covered by Newton, Brookline and
300
Boston. Inspection scores of the State accepted, and also in-
spections of Boston, Waltham and Arlington when available.
The inspector relies more upon microscopical examination and
bacteria count of milk than upon dairy inspection.
3,008 chemical examinations made.
1,143 bacteriological examinations made.
Springfield.
732 licenses granted.
78 permits granted. Permits have been issued by regulations of the
city Board of Health before the passage of the 1914 law. New
permits issued during 1914.
997 dairies inspected. Dairies were inspected by the score card method,
the Department covering practically all the dairies supplying
milk to the city. Dairies are located in Agawam, Amherst,
Becket, Deerfield, Enfield, Granby, Greenfield, Greenwich, Had-
ley, Hampden, Hardwick, Huntington, Longmeadow, Ludlow,
Middlefield, Monson, Montgomery, Palmer, Prescott, Savoy,
Southwick, Warren, Washington, Westfield, West Springfield,
Whately, Wilbraham and in Ellington, Hazardville, Somers and
Suffield, Conn. Springfield reports that the milk from many of
these dairies, which was refused admission to Springfield, is be-
ing sold in surrounding towns. No other cities or towns have
inspected these dairies to the knowledge of the Springfield Board
/ of Health. The territory, however, where the dairies are located
has been covered by inspectors of other cities or towns.
2,697 chemical examinations made.
1,120 bacteriological examinations made.
Westfield.
17 licenses granted.
57 permits granted.
110 dairies inspected.
204 chemical examinations made.
23 bacteriological examinations made.
Winchendon.
34 licenses granted.
28 permits granted. y
207 dairies inspected. Dairies inetd in Winchendon. Inspections
made by means of United States score card.
297 chemical examinations made consisting of fat and sediment tests.
35 bacteriological examinations made.
301
Winchester.
49 licenses granted.
38 permits granted.
92 dairies inspected. Inspection made by United States score card
method of dairies located in Woburn, Stoneham, Winchester,
Short Falls, N. H., Wilton, N. H., and Milford, N. H. The
extra-State dairies supply milk to Hood and Whiting.
165 chemical examinations made.
165 bacteriological examinations made.
Section 2. Cririrs AND TOWNS GRANTING LICENSES AND PERMITS, .
INSPECTING DAIRIES AND MAKING CHEMICAL HXAMINATIONS.
Amesbury.
63 licenses granted.
42 permits granted.
92 dairies inspected. Dairy inspection consists of examination for
general cleanliness.
29 chemical examinations made. Chemical examination for fat only.
Arlington.
82 licenses granted.
12 permits granted.
90 dairies inspected.
200 chemical examinations made.
Athol.
20 licenses granted.
20 permits granted.
30 dairies inspected. Dairies inspected for general cleanliness. Rec-
ords show dairies to be good or poor.
24 chemical examinations for fat.
Barnstable.
167 licenses granted. :
126 permits granted.
169 dairies inspected.
80 chemical examinations consisting of fat and enceiiic gravity. Ex-
aminations made for general cleanliness. Rules and regulations
of the board of health require all dealers to obtain licenses and
pay for the same.
a
302
Chicopee.
112 licenses granted.
62 permits granted.
62 dairies inspected. Special card used for inspection on general clean-
liness.
285 chemical examinations consisting of fat determination.
Greenfield.
20 licenses granted.
20 permits granted.
35 dairies inspected. Dairies inspected twice a year for general clean-
liness. Score card occasionally used.
90 chemical examinations made. Chemical examinations consist of
specific gravity and fat.
Hingham.
10 licenses granted.
20 permits granted.
20 dairies inspected. Dairy inspection of general cleanliness confined
to dairies in town.
1 chemical examination made.
Hull.
30 licenses granted.
4 permits granted.
4 dairies inspected. Dairy inspection made for general cleanliness.
, Inspector does not know from how many dairies the town obtains
its milk. Dairies of the Deerfoot Farm and Whiting have not
been inspected.
70 chemical, examinations made. Chemical examinations consist of
fat determination.
Montague.
26 licenses granted.
26 permits granted.
4 dairies inspected.
5 or 6 chemical examinations made.
North Adams.
89 licenses granted.
75 permits granted.
182 dairies inspected. United States score card used in inspecting
dairies. Dairies are scored in the spring and fall. Nearly all the
dairies have been inspected.
340 chemical examinations for fat.
303
Provincetown.
30 licenses granted.
39 permits granted.
21 dairies inspected, located in Provincetown and Truro. General
inspection made and also United States score card used. In-
spection made by the State at the request of the Provincetown
Board of Health.
14 chemical examinations made.
Wakefield.
22 licenses granted.
22 permits granted.
, 12 dairies inspected. Dairies located in Exeter and Epping, N. H.,
North Reading, Lynnfield, Wakefield and Melrose.
100 chemical examinations made.
Ware.
55 licenses granted.
64 permits granted.
142 dairies inspected. Dairies inspected every three months but not
scored.
488 chemical examinations for fat.
Woburn.
107 licenses granted.
105 permits granted to those taking out licenses.
111 dairies inspected. Dairies of D. Whiting & Co. not inspected.
111 chemical examinations made consisting of fat and specific gravity.
Section 3. Critmes anD Towns HAvING Minx INSPECTORS WHO GRANT
LICENSES, INSPECT DAIRIES AND MAKE CHEMICAL AND BACTERIO-
LOGICAL HXAMINATIONS.
Belmont.
41 licenses granted.
61 dairies inspected, located in 10 different cities and towns in the
State.
230 chemical examinations made.
230 bacteriological examinations made.
Records not investigated.
Cambridge.
700 licenses granted
23 dairies (local) inspected.
2,300 chemical examinations made.
842bacteriological examinations made.
’
304
Canton.
25 licenses granted.
Permits granted on strength of previous year’s examination.
29 dairies inspected, located in Canton and Stoughton.
209 chemical examinations made.
228 bacteriological examinations made.
Chelsea.
261 licenses granted. _
18 dairies inspected. Inspection limited to local dairies. The bulk of
the milk sold in Chelsea comes from the large contractors.
226 chemical examinations made.
61 bacteriological examinations made.
Cohasset.
12 licenses granted.
6 dairies inspected, located in Cohasset and Scituate.
10 chemical examinations made.
29 bacteriological examinations made.
Concord.
15 licenses granted.
15 dairies inspected, located in Concord and Littleton.
5 chemical examinations made.
1 bacteriological examination made. ©
Dedham.
24 licenses granted.
51 dairies inspected, located in Dedham, Wesrieask Norwood, Dover
and Needham.
226 chemical examinations made.
51 bacteriological examinations made.
Fitchburg.
110 licenses granted.
114 dairies inspected.
377 chemical examinations made.
76 bacteriological examinations made.
Framingham.
29 licenses granted.
87 dairies inspected, located in Framingham, Holliston, Ashland, Sud-
bury and Wayland.
150 chemical examinations made.
232 bacteriological examinations made.
3005 -
Gardner.
' 48 licenses granted.
120 dairies inspected, located in Gardner, Winchendon, Ashburnham,
Westminster, Hubbardston, Templeton, Phillipston, East Jaf-
frey, N. H., and Hast Rindge, N. H.
379 chemical examinations made.
A8 bacteriological examinations made.
Holyoke.
454 licenses granted. 20 permits refused.
265 dairies inspected; located in Holyoke, Amherst, Sunderland, West:
field, Southampton, Hadley, Granby, Belchertown, South Deer-
field, Whately and Hatfield. These inspections, however, were
made by the State Department of Health at the request of the
Holyoke Board of Health. Local board now making all dairy
inspections.
2,543 chemical examinations made.
40 bacteriological examinations made.
Lynn.
587 licenses granted.
1,034 dairies inspected, located in cities and towns surrounding Lynn,
dairies in Maine including Auburn and Lewiston, also dairies in
the neighborhood of Portsmouth, N. H. General inspection of
dairies show the dairy to be good, fair and poor.
2,024 chemical examinations made.
320 bacteriological examinations made.
Malden.
261 licenses granted.
190 dairies inspected; 75 per cent. of the milk comes from out of the
State, and the dairies have not been inspected by the city of
Malden.
563 chemical examinations made.
103 bacteriological examinations made.
Medford.
183 licenses granted.
15 dairies inspected.
237 chemical examinations made.
3 bacteriological examinations made.
306
Melrose.
71 licenses granted.
45 dairies inspected, located in Melrose, Saugus, Wakefield, Reading
and Wilmington. The large contractors furnish about one-
quarter of the milk supply, and these dairies have not been in-
spected.
285 chemical examinations made.
356 bacteriological examinations made.
New Bedford.
452 licenses granted.
181 dairies inspected. The inspection limited to local dairies except in
rare cases. Score card used, records as shown refer to Sense as
good, fair, etc.
24 chemical examinations made.
698 bacteriological examinations made.
Quincy.
193 licenses granted.
68 dairies inspected located in Quincy. Dairies of the large contractors
not inspected; recorded aS good, fair, poor, very poor, etc. Some
marked “very poor” are apparently selling milk.
8 chemical examinations made.
8 bacteriological examinations made.
Revere.
18 licenses granted.
8 local dairies inspected for general sanitary conditions. Dairies of
large contractors who furnish most of the milk not Hasyn
124 chemical examinations made.
62 bacteriological examinations made.
Salem.
239 licenses granted.
80 dairies inspected. United States score card used in inspecting
dairies.
874 chemical examinations made.
874 bacteriological examinations made.
Taunton.
84 licenses granted.
195 dairies inspected, located in Taunton, Dighton, Berkley, Raynham,
Norton and Rehoboth; recorded as good, fair, etc.
100 chemical examinations for fat.
75 bacteriological examinations made.
307
Waltham.
152 licenses granted.
180 dairies inspected, located in Waltham, Lexington, Lincoln, Bed-
ford, Wilmington, Weston, Wayland, Sudbury, Stow, Box-
; borough, Harvard, Littleton, Acton and Groton.
1,400. chemical examinations made.
427 bacteriological examinations made.
Worcester.
193 licenses granted.
900 dairies inspected. United States score card used.
1,653 chemical examinations made.
281 bacteriological examinations made.
Sanction 4. Crrres AND TowNs GRANTING LicENSES OR PERMITS, IN-
SPECTING DAIRIES AND MAKING CHEMICAL AND BACTERIOLOGICAL
EXAMINATIONS.
Clinton.
53 licenses granted.
66 dairies inspected. United States score card used. Good records.
50 chemical examinations made.
133 bacteriological examinations made.
Watertown.
72 licenses granted.
27 dairies inspected.
339 chemical examinations made.
113 bacteriological examinations made.
Wellesley.
34 licenses granted.
43 dairies inspected.
87 chemical examinations made.
153 bacteriological examinations made.
Westborough.
55 permits granted. .
55 dairies inspected. Inspector is a veterinarian.
90 chemical examinations made. Chemical examinations limited to
fat, specific gravity and sediment test.
25 bacteriological examinations made.
308
Weston.
. 18 licenses granted.
24 dairies inspected.
43 chemical examinations made.
125 bacteriological examinations made.
Section 5. Crrtres AND TOWNS GRANTING LICENSES AND MAKING CHEM-
ICAL AND BACTERIOLOGICAL EXAMINATIONS.
Needham.
11 licenses granted.
48 chemical examinations made.
87 bacteriological examinations made.
Swampscott.
4A licenses issued..
58 chemical examinations made.
24 bacteriological examinations made:
; Winthrop.
51 licenses granted.
130 chemical and bacteriological examinations made.
Section 6. Curries AND TOWNS MAKING CHEMICAL AND BACTERIOLOGICAL
EXXAMINATIONS ONLY.
Walpole.
35 chemical examinations made.
35 bacteriological examinations made.
Section 7. Crrres AND TowNs GRANTING LicENSES AND PERMITS, IN-
SPECTING DAIRIES AND MAKING BACTERIOLOGICAL HXAMINATIONS.
Scituate.
16 licenses granted.
22 permits granted.
7 dairies inspected, location in Scituate. General inspection made.
Records show dairies to be very good or good.
7 bacteriological examinations made.
Stoneham.
50 licenses granted.
52 permits granted.
18 dairies inspected. Dairies of large contractors not inspected.
100 bacteriological examinations made.
309
Whitman.
17 licenses granted.
27 permits granted.
32 dairies inspected. Dairy inspection made for general cleanliness.
Records show dairies to be good, poor or fair.
38 bacteriological examinations made.
Suction 8. Crimes AND TOWNS GRANTING LICENSES, INSPECTING DaAIRIES
AND MAKING CHEMICAL EXAMINATIONS.
Adams.
26 licenses granted.
45 dairies inspected. Dairy inspection for general cleanliness.
150 chemical examinations for fat.
Attleboro.
32 licenses granted.
65 dairies inspected. Dairy inspection carried on by United States
score card. Records shown to investigator. Laboratory appa-
ratus consisting of babcock machine, balance platinum dishes.
33 chemical examinations made.
Beverly.
164 licenses granted.
34 dairies inspected. Unable to state from how many different dairies
the city obtains its milk.
64 chemical examinations made.
Lexington.
44 licenses granted.
20 dairies inspected.
100 chemical examinations made.
Pittsfield.
68 licenses granted.
AQ dairies inspected. Dairy inspection consists of inspection for gen-
eral cleanliness. Recorded as fair, bad and good. Dairy inspec-
tion confined to Pittsfield.
300 chemical examinations for fat.
310
Section 9. Curries AND TOWNS GRANTING LICENSES AND MAKING CHEM-
ICAL EXAMINATIONS.
Everett.
335 licenses granted.
700 chemical examinations made.
Lowell.
600 licenses granted.
2,226 chemical examinations made.
Plainville.
9 licenses granted.
48 chemical examinations for fat.
Section 10. Crrims AND TOWNS GRANTING LICENSES OR PERMITS AND
INSPECTING DAIRIES. -
Acton.
16 licenses granted.
16 permits granted.
16 dairies inspected.
Acushnet.
A licenses granted.
14 permits granted.
14 dairies inspected.
Inspector appointed May 10, 1914.
ms Ashby.
3 permits granted.
3 dairies inspected. '
Ashland.
17 permits granted.
14 dairies inspected, located in Ashland and Hopkinton.
- Avon.
21 permits granted.
24 dairies inspected.
Barre.
32 permits granted.
32 dairies inspected.
Belchertown.
3 permits granted. sae
3 dairies inspected. Records not investigated.
dll
Bellingham.
2 permits granted.
5 dairies inspected. Records not investigated.
Boxford.
13 permits granted.
13 dairies inspected. Records not investigated.
Bridgewater.
21 licenses granted.
4 permits granted.
8 dairies inspected, located in Bridgewater. Most of the dairies in-
spected reported as clean, fairly clean, etc.
Buckland.
7 permits granted.
7 dairies inspected. Records not investigated.
Charlemont.
5 permits granted.
5 dairies inspected.
: Chilmark.
20 permits granted.
20 dairies inspected. General inspection passable or not passable.
Conway.
1 license granted.
1 permit granted. ;
1 dairy inspected.
Dalton.
3 licenses granted.
10 permits granted.
12 dairies inspected. United States score cards used.
Dana.
7 permits granted.
7 dairies inspected. General inspection.
Danvers.
51 licenses granted.
58 permits granted.
60 dairies inspected.
Dover.
10 permits granted.
10 dairies inspected. Inspection made for general cleanliness.
312
Duxbury.
94 permits granted.
94 dairies inspected. Dairies inspected by United States score card
and records kept. Nearly all the dealers have permits. —
East Longmeadow.
3 licenses granted.
14 dairies inspected.
Eastham.
38 permits granted.
38 dairies inspected.
Easthampton.
17 licenses granted.
7 dairies inspected.
Edgartown.
26 permits granted.
26 dairies inspected. Inspection made in collaboration with Dairy
Bureau.
Foxborough.
29 permits granted.
25 dairies inspected. Records not investigated.
Gloucester.
123 licenses granted.
44 permits granted. ;
112 dairies inspected, located in Gloucester, Rockport, Essex, Ipswich
and Manchester.
Gosnold.
4 permits granted.
A dairies inspected. ;
Great Barrington.
18 licenses granted.
24 dairies inspected.
Inspection made by means of score card.
Groton.
77 permits granted.
77 dairies inspected.
Halifax.
11 licenses granted.
4 permits granted.
11 dairies inspected.
Hamilton.
11 dairies inspected.
313
Hanson.
.10 permits granted.
10 dairies inspected.
Holland.
2 or 3 licenses granted.
2 or 3 dairies inspected.
Hopkinton.
54 permits granted.
44 dairies inspected.
: Hudson.
14 licenses granted.
14 dairies inspected.
Ipswich.
29 licenses granted.
46 dairies inspected. Inspection for general cleanliness.
Lee.
Number of permits issued not recorded.
175 dairies inspected. Inspection made for general cleanliness.
; Lenox.
11 licenses granted.
24 dairies inspected. The dairies are scored for general cleanliness.
The inspector is also a policeman.
Ludlow.
30 licenses granted.
60 permits granted.
60 dairies inspected. Town obtains milk from 8 different towns, but
all of these dairies have been inspected by the Springfield Board
of Health.
Marblehead.
79 licenses granted.
27 local dairies inspected. Dairies visited two or three times a year.
Score card used in making inspections. Only local dairies in-
spected.
Marion.
10 permits granted.
5 dairies inspected.
Marlborough.
73 licenses granted.
10 dairies inspected.
The city obtains its milk from 55 different dairies, and also obtains
milk from the Deerfoot Farm.
314
M aynard.
11 licenses granted.
25 dairies inspected. Recommendations “made to dairymen at “he
time of visit.
Medway.
34 permits granted.
34 dairies inspected. Records not investigated.
Middleborough.
85 licenses and permits granted.
88 dairies inspected.
Millis.
3 permits granted.
3 dairies inspected. Records not investigated.
Monson.
10 licenses granted.
3 dairies inspected.
Nantucket.
37 licenses granted. :
37 permits granted.
26 dairies inspected, located in Nantucket.
North Attleborough.
50 licenses granted.
12 permits granted.
58 dairies inspected.
North Brookfield.
7 licenses granted.
16 permits granted.
20 dairies inspected.
North Reading.
33 permits granted.
29 dairies inspected.
Northampton.
55 licenses granted.
114 permits granted.
125 dairies inspected, located in Northampton and surrounding towns.
Inspections made by United States score. cards and complete
records available.
Norton.
130 permits granted.
130 dairies inspected.
B15)
Norwell.
65 permits granted.
65 dairies inspected. Score cards used.
Norwood.
4 licenses granted.
43 permits granted.
43 dairies inspected, located in Norwood. Inspection made by United
States score cards and records available.
Orange.
36 permits granted.
_ 36 dairies inspected. General inspection for cleanliness. Recorded as
passed or not passed.
Orleans.
50 permits granted.
50 dairies inspected. Records not investigated.
Palmer.
70 licenses granted.
70 permits granted.
135 dairies inspected, located in Palmer, Belchertown, Monson and
Ware. General inspection made and dairies recorded as fair,
good or bad.
Peabody.
98 licenses granted.
19 permits granted.
100 dairies inspected. No data kept of inspection; figures given to the
investigator entirely from memory. Dairies inspected are lo-
cated in Peabody.
Petersham.
8 permits granted.
24 dairies inspected. United States score cards used. Records of
scores on file.
Plymouth.
51 licenses granted.
60 dairies inspected.
Rowley.
41 permits granted.
41 dairies inspected.
Salisbury.
~ 26 licenses granted.
18 dairies inspected.
316
Sandwich.
10 permits granted.
20 dairies inspected. Inspection for general cleanliness made.
Saugus.
59 licenses granted.
59 permits granted.
43 local dairies inspected. Inspections made for general cleanliness.
Sherborn.
94 licenses granted. \
94 dairies inspected. Records not investigated.
Shirley.
11 permits granted.
11 dairies inspected.
Somerset.
1 license granted.
All dairies inspected.
Southbridge.
29 licenses granted.
37 permits granted.
30 dairies inspected. Dairy inspections made by United States score
cards. Dairies located in Sturbridge, Charlton, Southbridge.
Records on file.
Spencer.
16 licenses granted.
27 permits granted.
27 dairies inspected, located in Spencer and Leicester. Records of
inspection not investigated.
Stockbridge.
19 licenses granted.
19 permits granted.
19 dairies inspected.
Stoughton. '
2 licenses granted.
31 permits granted.
33 dairies inspected. One dairy located in Sharon, the balance in
Stoughton. Four dairies reported in bad condition. Records
not shown to investigator.
317
Sturbridge.
20 permits granted.
Records not investigated.
Sunderland.
2 permits granted.
2 dairies inspected.
Uxbridge.
5 permits granted.
5 dairies inspected. Records not investigated.
Wareham.
26 licenses granted.
81 permits granted.
80 dairies inspected by inspector of animals. >
West Boylston.
4 permits granted.
7 dairies inspected. Records not investigated.
Westport.
15 permits granted.
15 dairies inspected.
Williamstown.
8 licenses granted.
24 permits granted.
24 dairies inspected.
Wilmington.
24 permits granted.
19 dairies inspected.
SEecTIoN 11. Crrimms anD Towns HAVING A MiuK INSPECTOR AND GRANT-
ING LICENSES ONLY.
Andover. Rockland.
Ashburnham. Topsfield.
Ayer. Warren. »
Fairhaven. West Springfield.
Falmouth. Westwood.
Leominster. Weymouth.
Methuen.
318
Smcrion 12. Crrres anD TOWNS IN WHICH THE INSPECTOR WAS RECENTLY
APPOINTED. No WORK DONE OTHER THAN THE GRANTING OF A FEW
LICENSES OR PERMITS.
Billerica.
Inspector recently appointed. Records not investigated.
Franklin.
Milk inspector reports that no work has been done. Inspector
appointed during the summer of 1915.
Grafton.
Inspector appointed during the summer of 1915.
8 dairies inspected. }
Lunenburg.
No licenses or permits granted. No dairies inspected. Inspector
stated that no appropriation was made to carry out the work.
Marshfield.
Inspector appointed in the spring of 1915 and has done no work.
Northborough.
Inspector recently appointed. No work done.
Pepperell.
12 licenses granted.
12 permits granted. Records not investigated.
Randolph.
Inspector recently appointed.
Section 13. MuiIscELLANEOUS.
Becket.
No inspector.
1 license granted. Records not investigated. -
Milford.
Some dairies inspected.
Newburyport.
44 licenses granted.
400 bacteriological examinations made.
319.
Plympton.
18 permits granted.
Rowe.
10 dairies inspected.
Southampton. h
No inspector.
4 permits granted.
Upton.
7 permits. No dairies inspected.
Suction 14. Crrres AND TowNSs HAVING AN INSPECTOR FROM WHOM NO
REPLY COULD BE OBTAINED.
Carlisle. South Hadley.
Rutland. Sutton. —
Section 15. Crrmes AND Towns poring No Mink WorK UNDER THE
Minx Inspection Laws.
Abington. Colrain. Hancock.
Agawam. Cummington. Hanover.
Alford. Dartmouth. Hardwick.
Ashfield. Deerfield. Harvard.
Auburn. Dennis. Harwich.
Bedford. Dighton. Hatfield.
Berkley. Douglas. Hawley.
Berlin. Dracut. Heath.
Bernardston. Dudley. Hinsdale.
Blackstone. Dunstable. Holbrook.
Blandford. East Bridgewater. Holden.
Bourne. Egremont. Holliston.
Boxborough. Enfield. Hopedale.
Boylston. Erving. Hubbardston.
Brewster. Essex. Huntington.
- Brimfield. Florida. Kingston.
Brookfield. Freetown. Lakeville.
Burlington. Georgetown. Lanesborough.
Carver. Gill. Leicester.
Charlton. Goshen. Leverett.
Chatham. Granby. Leyden.
Chelmsford. Granville. Lincoln.
Cheshire. Greenwich. Longmeadow.
Chester. Groveland. Lynnfield.
Chesterfield. Hadley. Manchester.
Clarksburg. Hampden. Mansfield.
Mashpee.
Mattapoisett.
Medfield.
Mendon.
Merrimac.
Middlefield.
Middleton.
Monroe.
Monterey.
Montgomery.
Nahant.
New Ashford.
New Braintree.
New Marlborough.
New Salem. .
Newbury.
Norfolk.
North Andover.
Northbridge.
Northfield.
Oak Bluffs.
Oakham.
Otis.
Oxford.
Pelham.
Pembroke.
Mount Washington.
320
Peru.
Phillipston.
Plainfield.
Prescott.
Raynham.
Reading.
Rehoboth.
Richmond.
Rochester.
Rockport.
Royalston.
‘Russell.
Sandisfield.
Savoy.
Seekonk.
Sharon.
Sheffield.
Shelburne.
Shrewsbury.
Shutesbury.
Southborough.
Southwick.
Sterling.
Stow.
Swansea.
Templeton.
Tewksbury.
Tisbury.
Tolland. °
Townsend.
Truro.
Tyngsborough.
Tyringham.
Wales.
_ Warwick.
Washington.
Wayland.
Webster. ©
Wellfleet.
Wendell.
West Bridgewater.
West Brookfield.
West Newbury.
West Stockbridge.
West Tisbury.
Westford.
Westhampton.
Westminster.
Whately.
Wilbraham.
Windsor.
Worthington.
Wrentham.
Yarmouth.
SecTIon 16. Cities anD TOWNS FROM WHICH NO INFORMATION COULD
BE OBTAINED.
Bolton. Paxton.
Easton. Princeton.
Gay Head. Sudbury.
Littleton. Wenham.
Millbury. Williamsburg.
o21
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ACP Pain Ds Pox | G
STATISTICS OF MILK TRANSPORTATION INTO BOSTON.
Amount of Milk transported into Boston during 1906 (Quarts).
New Yor
oiton | Boston & | New Haven &
EN IG IR CA Tie rey dink 1,332,604 6,147,201 1,857,863
February, z a 4 4 Be ieeas : 1,205,300 5,320,639 1,699,607
March, . 2 : dj ‘ s ¥ 1,536,120 6,134,064 1,837,624
April, : A Fi . ‘ ; ‘ F 1,587,060 6,051,116 1,902,188
May, : i s ‘ : j ; 1,769,768 6,596,392 1,876,023
June, : : , 5 , , 5 1,759,177 6,964,326 1,913,221
July, 5 F é 3 : u i Ba 1,695,886 6,640,927 1,724,948
August, . : ‘ ‘ 4 f . L 1,630,869 6,372,150 1,610,180
September, e a s 5 : ‘ 1,541,245 6,369,436 1,623,933
October, . ‘i 2 é i 5 : 5 1,524,968 6,266,048 1,686,887
November, 5 g i 5 < 3 , 1,383,409 5,812,806 1,598,172
December, 3 4 3 : : é % 1,382,567 6,054,571 1,638,630
18,348,973 74,729,671 20,969,276
Amount of Milk transported into Boston during 1907 (Quarts).
Tertaey ey a Meanie Gu niaie OM) 1,386,749 6,211,815 1,586,577
Heb reye wr eas i ah ce ae Mian 1,239,827 5,523,853 1,516,558
iN acl a AL A Ps WI A Ma 1,445,484 6,248,497 1,705,893
April, 1,472,430 6,185,519 1,828,261
aN er Me onan sat ba eer oeM nie 1,638,766 6,425,503 2,008,164
Tromed SUA I eS Ps ae NR Ra 1,691,241 6,487,446 2,080,381
Helen ee cries mera nse eB ws 1,648,596 6,669,955 1,933,398
Lone he Oe an Naa nN 1,452,650 5,970,386 1,807,663
Sreyotesrani ta Oe RCN MURR ie 1,170,560 5,574,826 1,708,373
DOC RTM Sen Ti ON uur rite 1,333,905 5,037,707 “1,821,845
RERSMBEE NE A i, ire isylew wie abon pinkie 1,117,282 » 5,087,587 1,788,725
FEreEA BOR eva MUN Hae Veaty pete ls 1,174,929 5,171,399 1,817,197
16,772,419 70,594,493 21,603,035
340
Amount of Milk transported into Boston during 1908 (Quarts).
January, .
February,
March,
April,
May,
June,
July,
August,
September,
October, .
November,
December,
Boston &
Albany.
1,241,221
1,178,499
1,147,551
1,328,558
1,524,713
1,541,900
1,349,026
1,299,259
1,317,270
1,318,707
1,169,345
1,246,882
15,662,931
Boston &
Maine.
5,293,584
4,925,676
5,695,014
5,254,103
5,536,851
5,857,026
5,964,741
5,785,903
5,493,163
5,347,172
5,017,521
5,316,584
65,487,338
New York,
New Haven &
Hartford.
1,934,791
1,822,678
2,013,002
1,987,127
2,029,476
1,985,393
1,858,796
1,817,954
1,806,924
1,984,437
"1,840,372
1,927,122
23,008,072
Amount of Milk transported into Boston during 1909 (Quarts).
January, .
February,
March,
April,
May,
June,
July,
August,
September,
October, .
November,
December,
1,270,903
1,154,657
1,328,015
1,394,808
1,457,053
1,436,432
1,367,055
1,229,491
1,090,133
1,295,629
1,184,849
1,239,835
15,448,860
5,033,372
4,666,690
5,161,949
5,520,840
6,273,596
6,230,925
5,925,875
6,408,328
5,202,991
5,677,456
5,496,995
5,448,159
67,047,176
1,985,717
1,985,717
2,146,038
2,130,839
2,227,183
2,308,070
2,259,036
2,166,728
2,070,207
2,322,280
2,221,723
2,376,820
26,161,126
341
e
Amount of Milk transported into Boston during 1910 (Quarts).
Ne ork,
Hatem & | Boston | Now Haven &
January, . 1,261,493 5,271,660 2,511,295
February, 1,129,956 4,839,106 2,238,771
March, 1,308,125 5,475,06414 | 2,528,599
April, 1,319,982 6,343,029 2,410,224
May, 278,791 5,218,864 2,388,932
June, 965,608 5,638,992 2,266,220
July, 1,165,639 5,599,752 2,411,087
August, 891,673 4,679,669 2,037,164
September, 904,062 4,444,055 1,881,451
October, . 943,466 4,482,585 2,004,881
November, 799,828 3,938,947 1,962,578
December, - 887,902 3,893,803 1,891,326
11,806,525 59,825,52614 | 26,532,528
Amount of Milk transperted into Boston during 1911 (Quarts).
January, .
February,
March,
April,
May,
June,
July,
August,
September,
October, .
November,
December,
954,991
778,233
947,997
970,421
1,000,904
1,059,773
814,939
807,635
794,337
904,345
1,042,719
957,011
11,033,305
3,920,531
3,810,408
3,874,625
4,162,647
4,581,592
4,742,762
6,206,046
5,138,598
5,285,888
5,492,557
5,675,805
5,684,134
58,575,598
1,943,600
1,798,264
2,005,974
1,819,823
2,007,567
2,023,276
1,702,749
1,918,993
1,910,729
1,795,274
1,578,739
1,681,167
22,186,155
342
Amount of Milk transported into Boston during 1912 (Quarts).
(
N
Ragton & | Basten & | ow Haven
TAM Uaryenesly als) UMMM A aR atl 699,099 5,640,607 1,746,433
February, f ; 5 3 i 663,677 5,463,501 1,660,086
March viet. MaMa TE TG, Sy DGt a 778,999 5,059,732 1,798,682
PAS REA Oana COUR ee aS aan 784,973 5,887,748 1,669,220
Suess pies Yh Saag mM ee ARIS 999,002 5,026,088 1,630,478
SRE ee Goll gt Lee aan a OV 852,050 | ° 6,448,720 1,718,713
STUY RY Cena a Weaning) 4s. hp soacgoR 6,389,101 1,468,410
Press Ly Me a1 ae Ss MR ee ee a 4) 6,367,389 1,478,834
Rentembemel 7a MAM betes Sh Oh now noe 6,622,503 | . 1,446,076
(ceobecwyh Me MEMGuR eT, deed 907,501 6,801,240 1,472,292
IGyeMIber NIE Me Oh: bi wgmelbe Ae ilal oy Syltaes 6,534,098 1,354,856
December, { 4 F : ‘ 3 651,882 6,916,685 1,422,419
10,885,289 74,957,502 18,866,499
Amount of Milk transported into Boston during 1913 (Quarts).
January, . 3 : : ci : 429,311 7,179,151 1,446,881
Bemtarys ly se ee Aha Cees f 380,481 | 6,693,732 1,439,468
Tab age 46 Rolie aR am Re 444,513 7,377,392 1,546,405
Bese ii hse i: AVON) oa Ral MIM NM ae 449,251 7,438,618 1,475,735
Mate Natty so BO ana 500,943 7,732,448 1,748,368
Ee tiie ui aa ee gt APP mea elit 465,740 7,520,704 1,662,461
STIS TAs au Ae) Reta eL RE, RAM eR aa 451,915 7,430,444 1,725,201
ICCC CRE Ue Mem IN hah ne 436,862 6,820,345 1,612,586
September! yn ce see di ai uen eet Cuei 490,677 6,151,288 1,550,894
Cra ee ARE eo ction og eR CATE 550,381 5,913,873 1,594,625
NEES IO ele cM DITA © 586,978 5,578,002 1,505,290
TISCETAG BES ik Aen tWalh er knee 564,660 6,290,180 1,501,612
| | "5,744,712 | 82,127,077 | 18,809,526
SS RRR
. 348
Amount of Milk transported into Boston during 1914 (Quarts).
Se
s
January, .
February,
March,
April,
May,
J une,
July,
August,
September,
October, .
November,
December,
.
ew York,
Titan! | TAREE | New haven’
296,935 6,604,900 1,502,442
" 288,116 6,043,261 1,475,780
372,194 6,629,606 1,640,016
393,512 6,373,612 1,829,712
395,019 7,091,511 1,896,857
445,39734 7,471,728 1,906,124
395,25714 7,109,790 1,716,631
506,954 6,717,219 1,498,746
652,448 6,279,826 1,450,443
306,271 6,349,448 1,539,926
293,700 6,182,944 1,625,447
584,22314 6,427,270 1,743,196
4,930,02734 | 79,281,115 19,825,320
Ee
a
844
APPENDIX H.
REPLIES TO QUESTIONNAIRE RELATIVE TO LOCAL MILK
INSPECTION.
In April, 1915, a list of 18 questions was sent to local boards
of health. These questions are as follows: —
. What is the amount of your appropriation for milk inspection?
. Have you a milk inspector?
. If so, how many milk licenses has he issued during the past year?
. What laboratory facilities have you for examining milk?
How many chemical examinations of milk were made?
. How many bacteriological examinations of milk were made?
. How many permits were granted under chapter 744, Acts of 1914?
. How many permits were refused under chapter 744, Acts of 1914?
. How many licenses or permits were granted to owners of dairies of
five cows or less?
. What is the total number of dairies in your town?
. What is the total number of dairy cows in your town?
. From how many different dairies does your town obtain its milk?
. How many dairies were inspected under chapter 744, Acts of 1914?
. In what cities or towns were these dairies located?
. Were any of these dairies inspected by the boards of health of any
city or town other than your town?
. If so, how many?
. Were there any epidemics attributed to milk during the past year?
. Describe the nature of any such epidemic, the number of cases, and
state whether or not it was investigated by a State Inspector of
Health.
OMONMAMPRWHH
ee
- ©
oo
oP WwW bd
eRe et
CeO N &
Of the 353 cities and towns 72 made no reply up to September
1. The replies from the balance have been carefully compiled,
with the results stated below.
Question 1.— What is the amount of your appropriation for milk
inspection?
IN GSAS WET) 0107/0210 Gk DOIN i a alot okie te Ra
No appropriation, . ; : ae Ns ute OBER eal
Appropriation not nected. PND Re MCAT ott a
Specie: appropriation), ) 5 (7AM sition acer wk kane eae vie cca eal oat
345
The specific appropriations are distributed as follows: —
Less than $100,.. 16
Between $100 and $500, Sr cS Ra eS MMe e GRR estat AN Una bad eR AM
Between $500 and $1,000, CE 19 2 NE oI Cin ATC Ce Nt aL) 9
Between $1,000 and $2,000, 6
Between $2,000 and $2,500, 5
Between $3,000 and $4,600, 4
The cities and towns stating that the appropriation was not
specified are as follows: Amherst, Attleboro, Belmont, Boston,
Chicopee, Dalton, East Bridgewater, Framingham, Gloucester,
Great Barrington, Greenfield, Lancaster, Ludlow, Lynn, Marble-
head, Medway, New Bedford, Orange, Palmer, Petersham,
Wellesley and Weston. Ree
Most of these localities spent but little money upon milk in-
spection, but the following cities maintain good laboratories for
several employees, and spend a large amount of money per
annum for this proposition: Boston, Lynn and New Bedford.
The following cities and towns have specific appropriations;
those in italics spend more than $1,000 per annum: Adams,
Andover, Arlington, Barnstable, Beverly, Blackstone, Braintree,
Brockton, Brookline, Cambridge, Canton, Chelsea, Clinton, Co-
hasset, Concord, Danvers, Dedham, East Longmeadow, Everett,
Fall River, Fitchburg, Gardner, Gosnold, Haverhill, Holyoke,
Hudson, Hull, Ipswich, Lawrence, Lowell, Marlborough, Melrose,
Middleborough, Milton, Montague,, Natick, Needham, Newton,
North Adams, North Attleborough, North Brookfield, North-
ampton, Rowe, Salem, Saugus, Scituate, Somerville, Springfield,
Taunton, Walpole, Waltham, Ware, Wareham, Warren, Water-
town, West Brookfield, Westborough, Winchendon, Winchester,
Winthrop, Woburn and Worcester.
Question 2.— Have you a milk inspector?
IVE Rena al ISD ON A a ca cI) 2th OU ea tae aR PRAGA RE 7/52
EE AR) mihi Sita Md Wes Aer SCs es ORRIN a gee 905
No, a dee Has BUR. 9 8.5 NR RE TAC ate ane eae tenner tn (3
353
The following cities and towns from which no reply was
received are known to have milk inspectors: Lexington, Malden,
Medford, N ewburyport, Pittsfield, Quincy, Revere, Westfield.
346
Question 3. — If so, how many milk licenses has he issued during the
past year?
INoireply en ii Fo yh eas oo" NUS Nc Ps cc
INOMEH i ey Cpa ak UOC EN eam ee ane WL ee a a
iy lbaee si nasl eluate) a: WAT Ne ae ea i
Total eases “ema ee Te a 16,521
The total licenses issued throughout the State are, of course,
much greater than this, as each town and city having a milk
inspector failing to reply to this questionnaire issued more or
less licenses. The total number of licenses is probably 1,200 to
1,500 more.
The number of licenses per town are distributed as follows: —
Bet wee%n ulivenacltyy Bis «1 Oe RUS Aer ie en 2s
Between 25am’ G05). Ht eee ahaa Ae ieee a
Between HOsamads (1O0,.) ho), \fiiihest dees hoki ile tot) eae ie a ee
Between TOO me ws ZOO siti hii nig bik Oe Saat solide as hin ae aa 9
Between. 200 amd, 400) cy wie oR hr ig is ao Ute seam +
Between AQ0tandis 2800 in io vey teai tip Wain ween li aie 9
Between 800 and 1,600, 1
5,381, 1
103
Of these 103 cities and towns 79, or 76.7 per cent., issued less
than 100 licenses, total number of licenses being 2,603; 24, or
23.3 per cent. of these cities and towns issued more than 100
licenses per town, the total number of licenses being 13,918.
The average number of licenses was 158. In those issuing less
than 100 licenses the average number was 33; in those issuing
more than 100 licenses, the average number issued was 681.
Question 4. — What laboratory facilities have you for examining milk?
INGE Diya aa ms a ee ey eS Sen
NOHO R et tet aleism e nes ioe SAS et el Ea
Balance: |