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THE MODERN MILK PROBLEM

THE MACMILLAN COMPANY

NEW YORK -: BOSTON - CHICAGO - DALLAS
ATLANTA +» SAN FRANCISCO

MACMILLAN & CO., LruitEep

LONDON - BOMBAY - CALCUTTA
MELBOURNE

THE MACMILLAN CO. OF CANADA, Lrtp.
TORONTO

ail
cans 0071111 with

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Mink in Poxitics—Tue Acute STaGE OF THE PROBLEM, as the car-
toonist sees it. Under these circumstances the legislator is likely to
suspend his dilemma by doing nothing at all.

Boston Herald, May 17, 1912.

THe
MODERN MILK PROBLEM

IN SANITATION, ECONOMICS, AND
AGRICULTURE

BY
J..SCOTT MacNUTT

LECTURER ON PUBLIC HEALTH SERVICE IN THE
MASSACHUSETTS INSTITUTE OF TECHNOLOGY;
AUTHOR OF «A MANUAL FOR HEALTH
OFFICERS ”’

New York
THE MACMILLAN COMPANY

ONT

CopyrricutT, 1917
By THE MACMILLAN COMPANY
Set up and electrotyped. Published June, 1917.

JUN 22 1917

PREFACE

Notwithstanding the fact that the milk problem is
constantly growing more acute in many parts of the
United States, no book has thus far appeared treating,
in a brief space, its main aspects and stressing the
practical and economic as well as the sanitary factors
involved. The present volume is designed to fill this
obvious need by providing a convenient survey of a
perplexing subject,—not merely for health officials and
milk inspectors, but also for dairymen and city milk
- dealers, agricultural authorities, legislators charged with
the framing of milk laws, inquiring consumers and.
members of organizations engaged in efforts to secure
better milk supplies, physicians, and all others who are
interested in the understanding and solution of the milk
problem.

ACKNOWLEDGMENT

The author desires to thank collectively the many
correspondents who have assisted him in the collec-
tion of material, and particularly Mr. Franz Schneider,
Jr., Sanitarian in the Department of Surveys and
Exhibits of the Russell Sage Foundation, for his valu-
able criticism of the manuscript.

Vii

CHAPTER
I.

Ill.

CONTENTS

Wii Loprm IS oe IViILK PROBLEM... 225200. 025.

Nature and Importance of the Problem. Milk: A Cheap
and Universal Food. Milk: A Sanitary Danger. The “In-
visible Cloak” of Contamination: Dirt; Bacteria. Bad Milk
and Infant Mortality. Milk as a Vehicle of Disease. Sum-
mary. A Practical Definition of ‘Pure Milk.”

Pe CASH ONO=DAIe ioc sore ute aia ie ead ates.

The Cry for ‘Pure Milk”: Can Pure Milk be Got? The
Modern Milk Problem: The Old-style Milkman—An Anach-
ronism To-day; The Modern Milk Mechanism. The Parties
in the Case: The Demands of the Health Official; The Pres-
sure on the Farmer; The Farmers’ Need of Organization;
Agricultural Aid; The Position of the Dealer; Railroads—The
Transportation Problem; The Attitude of the Consumer; The
Physician; Unofficial Organizations; The Legislator—Milk as
a Political Issue. Relative Importance of Milk Control.
Conclusion: The State of the Case.

(LEV OANTITARY HA CTORS oy ck Sore Gore Cot in Saag

Early Developments. The Beginnings of the Clean Milk
Movement: Certified Milk. The General Clean Milk Move-
ment: The Score-card Method of Inspection; Rational
Methods in Clean Milk Production—The North System;
Amendment of the Dairy Score Card. Infant Welfare Sta-
tions. Laboratory Tests and Standards: Chemical; Bac-
teriological; Contamination Tests. The Tuberculin Test.
Pasteurization: Methods; General Pasteurization the In-
surance against a General Danger. Clarification and Other
Processes. Publicity of Ratings. Contests, Conferences,
Exhibitions. The Grading of Milk: Grading Systems.

PAGE

Bs CONTENTS

CHAPTER PAGE
Ve am HconoMic PACTORS2. . 320. foo eee 24)!

Economic Value of Milk Production. Decline of Dairying
in Certain Regions. The Crux of the Economic Question.
The Plight of the Farmer: Is the Farmer Getting a Fair
Price?; Another Aspect. Factors in the Final Cost of Milk.
The Milk Dealer: Dealer and Farmer. Anomalies of Milk
as a Commodity. Economic Effects of Sanitary Regulation.

The Great Need—Manifestation of Values: Principles of
Grading; The Public Value of Milk. Costs and Prices. The
Role of the Laboratory. The Réle of Inspection: Dairy Dem-
onstration. Organization and Administration: State and
Local Legislation. Local Differences. Centralization, Co-
operative Plans, Municipalization. The Gist of the Matter.
Who Is to Solve the Problem?

REFERENCES.) 0). 8 hee Sek eek cae ae eetean MAE 177
APPENDICES
Al Some Malik statistics os ee 185
eh GTOGINGSUSTEMUS. ee A Sin kee ee 189
C2 ie North SUstene ie a, eae eae ee 203
DS Costs Gnd. Prices Res kOe ae ene eee 214
E. Local Experiences and Investigations.......... 225
Be Mille Products oe a ee en a ee 253

| Es] 0 Db, aang eee SRM SOU RENMEI he ce Pk a al St 255

ILLUSTRATIONS

FIGURE PAGE
JA ETT o WEE 0) I CGS Sak Ne CaS ot on RR nia a os Aa Se es BAe Frontispiece
1. Composition of Cow’s Milk, Showing Variations............ 6
2. Commercial Appeal on Economic Grounds.................. 8
Seine bones Me SHOrG baud sus Se oles aid oe ea ee 17
POV SuCmISTOl Vine NSU ees. 6 abd © Aleks bs tes aceite ayers 37
5-10. Typical ‘“ Milksheds” of Large Cities:
EyMPNI NE WA NA@T Katies craic ts ae, custaual nig) ahi moma an Sig ee ee eyed 39
Gominlaclelp liars cites. oe we eA eer On oe 4}
Cpt LEXO ISL T 3 be ei We Marte a Nee, ieee Maan onan haan ema nese eae 43
See OicArowey = Geena ue Lei onal aptamer Rel Me PG rate sate 44
OMAVVashineGOMe le. scala crl ecrahan Sponta cies eng ee ON 45
NOSe Mil wawkeere ey ete ser ete eer s ae SU ebereee tee Sela 47
heenne smallmouth vialkime Pails 46400. See sere es ee ee 79
12. Time and Temperature for Milk Pasteurization............. 104
13. Commercial Appeal on Sanitary Grounds.................. 106
14. Commercial Appeal on Sanitary Grounds.................. 107
15-20. Relative Retail Prices, 1890-1915:
fe Mualkeands Hreshy Wags ke ok cscs ce ane cathe 128
1G Wilke and “PoOtatoesan Ge. a0.ce Oo aul aati eo ee ee 129
I7eMiilkandeivouric Sea kes ee sek ee. S kueo ye aes ues esi 130
1S. Milk and Bacon: Ge eWeek oureil os OME ala) 131
Qo eMinlkeanel Wiheatwllountaret aver u sic \ sig aetie ecto: 132
200 Muilkcand Kive: staple HoodSii. 8 se) ace es ul se ee 133
21. Retail Price of Milk Compared with Costs of Production..... 134
22 wero trom Ditrerent« COWS 22% «Saale es ties yee eee yee ees 135
PLATE

1. Interior of a High-class (Certified) Dairy Stable. .opposite page 68
2. Ordinary Dairy Stables in Which Clean Milk Is

IPTOGUGEG 2h tie ced ace Se ee Oe ee cate if “80

3. Ordinary Dairies and Extraordinary Dairymen.. . of oS.

4. (a) Bacteria Plates, (6) Dirt Tests.............. is “ 93

5. (a) Home Pasteurizer, (b) Results of Clarification + 109

6-7. Primitive Conditions in the Milk Industry... .. ss “110

8-14. Advanced Conditions in the Milk Industry... oe TINO

15. Laboratory of a Large Modern Milk Plant....... ie “145
16. A Small Municipal Milk Laboratory............ oe “* 166

THE MODERN MILK PROBLEM

CEAP TEE I
WHY THERE JS A MILK PROBLEM

That there exists to-day a large and, in many
instances, acute milk problem is being increasingly rec-
ognized. Most persons, however, appreciate the nature
of the matter no further than that it involves a ‘‘cam-
paign for pure milk” which appears to them similar to
the movements for other municipal improvements.
Even to the well-informed citizen the factors and persons
involved—the dairy farmer, the middleman dealer, the
municipal official—appear in no distinct perspective; he
is only vaguely aware of the contentions of these differ-
ent parties, except as newspaper publicity may occasion-
ally bring one or another of them to the fore; his interest
usually goes no further than a jealous watchfulness of
the price of the daily family supply; he entertains, there-
fore, no particular ideas as to improvements and read-
justments and the ways of bringing them about. And
this is no wonder when the officials and legislators to
whom the public looks for remedies are themselves fre-
quently puzzled for an answer to this much-debated
question.

At the outset, therefore, the prime underlying con-
siderations must be well borne in mind.

Among all food products milk gives rise to a peculiar
1

2 THE MODERN MILK PROBLEM

question. One hears nothing, in any general and con-
tinuous sense, of a beef or a bread problem. Why, then,
a milk problem?

That such exists is briefly explained by the conjunc-
tion of two conditions:

Milk is one of the most valuable and most largely used
of all foods. ¢

It ts the food which is most apt, by far, to be dangerous
to health. |

This second condition depends very largely upon the
fact that, in this country at least, milk has customarily
been consumed raw, without the cooking, or half-
cooking, which has always protected civilized man
against infection in animal food.

“Milk,” wrote Professor William T. Sedgwick, years
before the problem reached its present acute form, “‘has
always been one of the most trusted of human foods.
Clothed in a veil of white; associated with the innocence
of infancy; of high repute for easy digestibility; believed
to represent in perfection a natural dietary, popular and
cheap,—milk has always deservedly held a high place
in public esteem. Of late years, however, while main-
taining its reputation in respect to cheapness, food
value, blandness and digestibility, it has, in the eyes of
physicians and sanitarians at least, come to be regarded,
while in the uncooked condition, with general sus-
picion.”’ 1 * ,

This well-founded suspicion has developed with the
rise of three branches of sanitary science: bacteriology,
which has demonstrated the readiness with which milk
may be contaminated and act as a medium for the

* Note numbers refer to list of references at end of Chapter V. |

WHY THERE JS A MILK PROBLEM: 3

growth of germ life; epidemiology, which has searched
out countless instances in which it was the vehicle of
disease; and vital statistics, which, in conjunction with
clinical observation, has indicated the part played by
bad milk in the preventable disease and mortality of
infancy. The subject of safe, wholesome milk is there-
fore directly related to the two principal fields of mod-
ern public hygiene,—prevention of communicable dis-
ease and conservation of child life.

The milk problem, as we shall find in the course of
these pages, is characterized by complication and con-
fusion. Its complications are due partly to the pe-
culiar sanitary and economic conditions of the milk
industry, and partly to the difficulties of harmonizing
the several human interests involved. Milk is pro-
duced in quantities enormous in the aggregate, comes
from animals liable to disease, and is handled by per-
sons liable to diseases transferable by milk. It is, for
the most part, under the care (or lack of it) of men
whose education and experience know not the delicate
science of bacteriology. It reaches the city consumer
by a journey which is interrupted at frequent intervals
for transference or handling, and at each stage there are
chances of contamination and improper treatment.
Finally, the consumer has no direct knowledge of its
source, its history, and its sanitary quality when it
~ reaches him. Even in the home, its final destination,
it may, and frequently does, suffer impairment. Sani-
tary measures must be carefully devised and correlated,
and even with an adequate force of officials—frequently
not available—regulations are not easy to enforce.
When strictly enforced they may arouse the antagonism

4 THE MODERN MILK PROBLEM

of farmers and dealers who assert that they are entitled
to additional recompense for the sanitary precautions
they are obliged to take. The price of milk, which
then comes into question, is notoriously a subject of
jealousy on the part of all concerned. Those who deal
with the question find, therefore, that they face not
only a sanitary problem, but also an economic problem
complicated by various human factors.

While the necessity of a safe, wholesome milk supply
is the same for all communities, the difficulties of ob-
taining it are immensely increased in the case of the
cities. The larger the community becomes, the farther
it gets from the individual farmer and the nearer to
the domination of the wholesale dealer and the com-
plications incident to supplies drawn from many and
distant sources. The milk problem is thus characteris-
tically urban, but may exist in the smaller communities
in greater or less degree. }

Some of the reasons for the title of this volume have
now been suggested. Under the conditions of modern,
urbanized life a complicated milk problem has arisen,
involving such questions as:

What is ‘pure milk’’?

Is pure milk—or clean milk—or safe milk—or whole-
some milk—practically possible?—and how can it-be
got?

Will the public pay for it?

The importance of the practical question is shown
by the fact that it has invaded politics and has figured
in a number of States and cities as a political issue.

WHY THERE JS A MILK PROBLEM 5

This development brings out the fact that the several
interests concerned are often in conflict with regulation
or with each other. The appearance of milk in the
political forum is perhaps a sign hopeful! rather than
otherwise, as indicating that this greatest of food
problems has become the subject of a public discussion
which may lead to justice to all concerned.

MILK: A CHEAP AND UNIVERSAL FOOD

Whole milk contains all the elements of nutriment
and combines them in readily digestible form in the
proportions of a balanced ration. Hence its use as a
substitute for mother’s milk for infants, as an important
component in the diet of children, as a special diet for
invalids, and as a considerable portion, directly or
indirectly, of the diet of all adults. Its value in these
respects is such that it must be considered a necessity
of civilization, being in this sense a universal food.

We need not here go into the details of the chemistry
and dietetics of milk. Cow’s milk varies in composition,
but on the average good, unadulterated milk contains
about 87 per cent water and 13 per cent solids. About
one-fourth of these solids consists of protein compounds,
1. e., tissue-forming and waste-repairing substances.
Fats, in the form of butter fats, form one-third of the
total solids. Butter fat occurs in globules throughout
the milk, and it is upon the size and number of them
that the creaminess of the milk consists. Carbohy-
drates, which, like the fats, are energy-producing or
fuel elements, make up somewhat more than another
third of the solids, the most important of them being

lactose, or milk sugar.
The remaining 5 per
cent of the solids con-
sists of mineral mat-
ter. Upon assumed
allowable minima of
these various compo-
nents official require-
ments for ‘‘fats” and
“total... solids” —Yare
based.

The greatest varia-
tions are observed in
the case of the fat
content, which is most
commonly taken as an

6 THE MODERN MILK PROBLEM
index of the food value
of any given milk.

ii Consideration of the

Fic. 1. Composition OF gor ree s Mix, uses of milk leads to

SORES SELON the broad conclusion

Ca a oe EO tht os

staple, the lessened

use of which, either through popular fear of its pos-

sible dangers or through a much increased cost of pro-
duction, would be a grave disadvantage.

——

<j
==

——

——_.
=
===>

Fat

aS
— a
= —_
SS
4
SSS
=~
==
=.

TOTAL
SOLIDS
Sovip
NOT
FAT

SSS] =

WATER
&3%—-90%

WATER

Pecuniary Economy of Milk as Compared with other
Foods

More important than purely abstract laboratory
figures of food values is the question as to how milk
compares with other foods in relative economy. Facts

WHY THERE JS A MILK PROBLEM fi

in this connection have been worked out and the fol-
lowing conclusions drawn from them by the United
States Department of Agriculture:—

Bearing these things in mind, we see that milk at all but
the highest prices assumed is a cheaper source of protein
than any of the animal foods except cheese, very cheap meat,
and salt fish. At usual prices skim milk furnishes protein
more cheaply than any common animal food except salt fish.
The protein of vegetable foods is less expensive, but, on the
other hand, as prepared for the table is less thoroughly di-
gested. Moreover, it is accompanied by such large amounts
of carbohydrates that to secure much vegetable protein in
the diet usually means an excess of the carbohydrates.
Under ordinary market conditions milk, and even skim milk,
is a cheaper source of body fuel than any of the usual animal
foods except cheese and salt pork, but is a dearer one than
the usual vegetable foods. Here again, however, the milk
furnishes the ingredients in a form more readily and thor-
oughly digested than the vegetable foods as ordinarily served.
Milk, then, is fully as economical a source of nutrients as
most animal foods, but is dearer than most vegetable foods.
It has the decided advantage of having no waste, requiring
no time for preparation, and being more digestible than the
vegetable foods. ... Both whole and skim milk at mod-
erate prices are therefore to be ranked among the most —
economical of foods not only when taken as beverages, but
also when used in preparing other foods.’ 3

Attention must be drawn, however, to the fact that
with each cent’s increase in price milk may lose, or
seem to lose, its pecuniary advantage over some other
article or articles (unless they also have risen), which
then tend so far as possible to take its place. Some-
times the rival is a milk product, such as skim milk

8 THE MODERN MILK PROBLEM

Cost of Living

In the past year 5 leading food products have
risen in cost at an average of

64%

Potatoes advanced. .;...114% ?
Beans advanced......... 87% MILK

Codfish advanced....... 50% has_ only

Eggs advanced......... 58% advanced

Butter advanced........ 30% 1 1%

The answer is use more

——’s Milk

A Complete Food.

Clean — Pure — Safe

Reduce the Cost of Living

equals in food

value either =

A Safe Food

9 e :
Bs 6 Milk! Pure Food
A Cheap Food

Drink it Youself—Feed it to the Children

Fig. 2. ComMerctaL APPEAL ON Eco-
NOMIC GROUNDS

This, if accurate, is a legitimate and
useful kind of advertising based on the
importance of milk as a food.

or evaporated milk.
Substances of less
dietetic value are
likely to be substi-
tuted in cookery, and
its use as a table ar-
ticle may be stinted.
At the same time a
‘certain increase in
price may be inevita-
ble, especially when
prices are going up
all around, as they
are at present writ-
ing. This question
will be further con-
sidered in later chap-
ters.

Science and Ex-
perience

The scientific de-
ductions from the fig-
ures for food values
and prices are con-
firmed in the ordi-
nary widespread use
of milk. About one-
sixth of the total food

of the average American family is furnished by milk
and its products.* The average per capita use of milk
(as such) in the United States is estimated by the De-

WHY THERE JS A MILK PROBLEM 9

partment of Agriculture at six-tenths of a pint daily,
or a quart and one-half for each family of five. (See
statistics, Appendix A.) This means that an enormous
capital and an extensively ramifying system of equip-
ment and operation are necessary to furnish the total
supply. Besides the above amount of milk consumed
as such (either drunk or used in cookery) must also be
considered that large amount (about three times as
much) which is made into butter, cheese, condensed
milk, etc. Many of the considerations applying to
milk as such apply also to these derived products.

The following reasons for the use of milk, adapted
from a leaflet issued by the Massachusetts Dairy
Bureau, summarize the matter in a general way :—

It is cheap.

It is nutritious.

It is easily digestible.

It is the best food for babies (mother’s milk excepted).

It should enter liberaily into the diet of children.

Many adults would be benefited by the use of more milk
and less meat.

More milk used in cooking would add the cheapest nutri-
tion of its kind.

Proper nutrition conduces to efficiency and long life,—in
other words, to good health.

MILK: A SANITARY DANGER

The widespread use of milk has, however, another
and an unfavorable aspect. While this universal food
affords vast benefit, it is also, to a certain degree, the
agent of disease. Of all foods it has in this respect the
greatest potentiality.

10 THE MODERN MILK PROBLEM .

THE “INVISIBLE CLOAK” OF
CONTAMINATION

Dirt and Milk

Though it 1s not fanciful to speak of milk as a symbol
of beneficence, it must not be forgotten that its veil
of innocence may hide possible dangers. Most white
things readily show soiling; milk, as someone has re-
marked, stands almost alone in absorbing without ob-
vious sign all but the grossest contamination. The
amount of dirt—to use the mildest term—which can
be added to a bottle of milk without visibly affecting
its virgin whiteness is almost unbelievable. Of each
dose of such contamination some is dissolved, some half-
floats in suspension among multitudinous obscuring
fat-globules, and some settles to the bottom, where least
likely to be observed: only a fraction remains on the
top or otherwise visible. The ordinary milk bottle
tells no tales.

That the opportunities for such contamination under
present-day conditions in the dairy industry are many
is well recognized by all who are familiar with milk
sanitation. In Fig. 3 is shown the long and broken
route which may be required for country milk to reach
the city consumer. At each stage of the journey is the
possibility of contamination or deterioration of the
product. Dirt and manure particles from the flanks
and udder of the cow, hair and dandruff from her hide,
the manurial dust of the stable, the questionable hands
of the milker, the unclean milk pail contaminated with
the decomposed dregs of the previous milking, or rinsed

WHY THERE JS A MILK PROBLEM 11

with polluted water, the unsavory straining cloth, im-
perfectly cleansed pans, further handling in process of
bottling, bottles and other utensils of doubtful cleanli-
ness,—these, together with lack of proper cooling and
frequently many hours of transportation, are some of
the details which demand the attention of the milk
sanitarian. If, as Sedgwick suggests, drinking water
were derived in the same manner and passed through
the same processes as milk—drawn from the body of
an animal standing in a stable, by the hands of work-
men of questionable cleanness, and subsequently
handled as milk frequently is—few would care to drink
it. ‘‘It is clear,” he adds, ‘‘that milk requires and
deserves even more careful treatment than water, for
it is more valuable, more trusted and more readily
falsified or decomposed,” and also, as we shall note
presently—the most important consideration of all—
it is a readier agent of infection.

The dairy cow herself [as Dr. Charles E. North says] con-
tributes a peculiar form of contamination. The udder is
constructed like a sponge. There is a constant shedding of
waste tissue from the lining of the udder. This udder waste
often includes the products of udder inflammation. Such
inflammations are so common they are present in some form
in practically every dairy herd. Even when there is no ex-
ternal evidence there is often internal inflammation dis-
charging its products with the milk.*

Now what is the sanitary significance of all this?

In the first place, no one wishes to eat or drink dirt,
even that of the proverbial “‘peck of dirt.””. The various
kinds of ordinary dirt may or may not be directly in-
jurious to health. At the present time the tendency

12 THE MODERN MILK PROBLEM

in sanitary science is to distinguish between the vari-
eties that are, or may be, accompanied by infection,
and those that ordinarily are not. Nevertheless dirt
of any kind is in itself undesirable.

The instinct of decency is not without meaning. It
is a protective instinct, and it is supported by the
general fact that dirt is suspicious. There are places
where dirt is naturally to be found, but when it is
‘‘matter out of place” it is a sign that something is
wrong. We are not surprised to see muck in the
gutter; we do not shudder at manure in a manure bin;
but when we perceive foreign matter in a milk bottle
we are rightly disquieted. The soiled hands of the day-
laborer are the result of honest toil; the unwashed but
milk-wet hands of the dairy worker excite revulsion.

This instinct has applications which are without
sanitary significance. But in the matter of food it is
truly protective. We have spoken above of ‘‘dirt”’ in
a general sense. But ordinary dirt shades into filth,
such as the manure of the cow stable: from contamina-
tion it is but a step to pollution, and pollution may mean
infection.

It is possible to make theoretical distinctions be-
tween various forms of contamination, and it is possible
to devise practical measures which lay stress upon the
more dangerous. But both decency and experience
aver that we should avoid all forms of contamination.
Decency is, in short, a rough (though, as we shall see
later, an incomplete) insurance of safety. But even
though we are able to secure complete safety by other
means, we should still desire the greatest degree of
decency that we can obtain. Decency, as North points

WHY THERE JS A MILK PROBLEM 13

out, “‘distinguishes humans from animals. Decency
adds pleasure and appetite to food. Cleanliness con-
tributes most to decency. Milk may be safe because
it is boiled but may be indecent because it is filthy.” *

Bacteria and Milk

Dirt (using the word to include all forms of con-
taminating matter) in considerable quantities may be,
in itself, more or less deleterious to health. But it is
the associated bacteria which constitute the real ob-
jection or danger. Various forms of contamination are
accompanied by various forms of bacteria, which may
be more or less deleterious or dangerous. In the case
of milk, they exert their effect upon the consumer either
through their action upon the milk or through their
infectious character.

1. Fermentation, Decomposition—Many of these or-
ganisms thrive in milk, and in so doing alter its
composition and excrete their waste products. The
ordinary souring of milk is the usual form of fermenta-
tion. It may be argued that such a fermentation as
this is not necessarily harmful, soured and fermented
products being used as foods or even as remedies. The
answer to this is that if such products are desired they
should be obtained by known and controlled processes.
The fermentation or decomposition of milk by miscel-
laneous, uncontrolled organisms is objectionable, and
when the milk is to be used as food for infants and
delicate persons it is dangerous. In every such process
are produced greater or less amounts of substances

* Dr. North rates milks according to safety, decency, and price.
(See p. 155.)

14 THE MODERN MILK PROBLEM

which tend to make the milk an unfit or deleterious
food.

The extent of such bacterial changes in milk from the
time that it is drawn from the cow to the time it reaches
the consumer depends upon three things: (1) the
kinds and amounts of contamination, (2) the tempera-
ture of the milk, and (3) the time in transit. The con-
tamination can be reduced to a minimum, the tempera-
ture can be kept low, and, if these two conditions are
right, a reasonable time in transit can be allowed.
Under practical circumstances some latitude must be
permitted in the endeavor to approach the ideal,—
namely, that milk should be clean, fresh, and cold.

2. Infection A different case is that of infection.
The germs of various diseases may gain access to milk,
in which they live and frequently multiply. This is
not merely a matter of contamination but of the trans-
ference of the secretions of already infected animals or
persons. Relatively small contamination may in this
case result in virulent and far-spreading specific infec-
tion. The unwashed hands of milker or milk-handler
in an unrecognized stage of disease, infected manure
from tuberculous cows, utensils which have been in-
fected by washing in polluted water or in some other
way: such are typical modes of infection. Polluted
milk may at any time prove to be infected milk; it is,
so to speak, a lottery of infection. Infection is pos-
sible even with a high degree of visible cleanliness, for
infected individuals may be unrecognized and the trans-
ference of infectious matter undetected. Milk-borne
disease, like other infection, ‘‘walketh in darkness.”

Special reference must be made to carriers of com-

WHY THERE JS A MILK PROBLEM 15

municable disease. Bacteriology has demonstrated the
existence of many persons who harbor and emit germs
of disease without themselves showing any symptoms.
Such carriers have been demonstrated with respect to
typhoid fever, diphtheria, septic sore throat, and a
number of other diseases. While the percentage of
carriers in the population is small, the evidence is that
there are, in the aggregate, many such persons and
many others who manifest only atypical, unrecognized
symptoms of the disease of which they bear the infec-
tion. Such facts must greatly increase the sense of inse-
curity with respect to the sources of disease. It scarcely
need besaid that a proportionate number of carriers exists
in the host of persons engaged in the handling of milk.*

There are two possible measures against infection in
milk, to keep it out, or to destroy it if there. The dif-
ficulty or impossibility of keeping it out has just been
indicated. There is immense importance, then, in
being able to destroy it without material alteration of
the milk. This, fortunately, can be accomplished by
a form of insurance which will be discussed in another
chapter—namely, pasteurization.

BAD MILK AND INFANT MORTALITY

Approximately one-fifth of the deaths occurring in
the Registration Area of the United States are of in-

* It was estimated, for example, by Health Commissioner Lederle of
New York City, in 1912, that about 127,000 persons were engaged in
handling the milk supply of that city, and that there might be perhaps
a hundred typhoid bacillus carriers alone in this army of persons.
Rochester, N. Y., in order to guard against infection, by typhoid car-
riers, of milk to be sold raw, has adopted the requirement of a blood
test for dairymen and their workers.

16 THE MODERN MILK PROBLEM

fants under two years of age. The largest single cause
of mortality among these infants is diarrhea and en-
teritis, to which one-quarter of the deaths is due. The
latest available Census figures (1914) ascribe to this
title in the Registration Area 43,532 deaths (under
2 years), which argues a total in the whole United
States of some 65,000. It is in this figure that we
must look for the effects of bad milk so far as they are
reflected in mortality. Unfortunately it is impossible
to determine just what proportion of these deaths
may be put down to bad milk as compared with such
factors aS improper methods of feeding and improper
hygiene in other respects. We may, however, turn to
some intensive evidence.

Effects of | Feeding Different Milks

The normal and the best food, by far, for the baby is
mother’s milk. Such are the difficulties of artificial
feeding under ordinary conditions that it is estimated
that bottle-fed babies have only one-tenth the chance
to live that breast-fed babies have.? *

There are, however, cases in which artificial feeding
is deemed necessary; besides which, cow’s milk must
always play a major part in the weaning of infants and
the feeding of young children. Milk for infants should,
if possible, be of the highest original sanitary quality.
If the raw product is of a lower quality, it should be
pasteurized. The evidence is that it should be pas-
teurized no matter what its quality.

* From a careful analysis of a three months’ study, the New York
City Health Department determined that almost two and a half (2.4)
times as many infants were attacked by diarrhea among artificially
fed as among breast-fed infants. (Weekly Bulletin, June 19, 1915.)

WHY THERE /S A MILK PROBLEM 17

The Short Haul

70 percent of city babies get their }
§ food through a tube 60 miles long.

It takes about 36 hours—often
| 42 hours—for the milk to run from

the cow end of the tube to the
baby end of the tube.

This tube is open in many places
and baby’s food is frequently pol-
luted. It is often wrongly kept in

| overheated places.

Then there may be a diseased
cow at the country end of the tube.

+ And Yet Some People Wonder Why
So Many Babies Die!

On the other hand the mother-
fed baby gets its milk fresh, pure
and healthful—no germs can get
into it.

To Lessen Baby Deaths Let Us Have
More Mother-Fed Babies. ;

You can’t improve on God's plan.

For Your Baby’s Sake—Nurse It!

ae 3. THE Tone vs. THe SHorT HavL

This cartoon, from the Chicago Health Department, brings out
the contrast between natural and artificial milk supply, and
suggests some of the difficulties inherent in the latter.

18 THE MODERN MILK PROBLEM

An important series of observations was made some
years ago by Park and Holt,® illustrating the effects of
feeding infants with several different grades of milk.
The deleterious results of bad milk during the summer
months are shown by the following table, summarizing
the observations on six groups of babies. (The per-
centages have been computed by the present writer
from the original table.) *

No. of Did Did Did
infants well fairly badly Died

Store mine Ss Ie aM 79 27% 29% 2aT 19%
Condensed milk............. 70 31 29 20 20
Good bottled milk 230 Se eo: 98 38 23 30 9
Milk from Central Distributing

SEAMONS. Vauel eum egaiya 145 58 23 16 3
Bestibottied milke {7.2 4k es. 12 75 25 — —
Breast feeding <7 2... Oe 31 55 22.5 22.5 —

All cases excluding duplications 421 44%, 25% 21% 10%

In the winter observations no appreciable difference
among the different modes of feeding was noted; what
might be considered good results were shown in 93 per
cent of the cases as contrasted with the 69 per cent
indicated by the above table.

* This study is open to criticism in certain respects. The small
number of cases in the fifth group cannot be taken as a sufficient basis
for rating best bottled milk above breast feeding. The number in the
breast-fed group is also rather small for the calculation of significant
percentages. Nor is distinction between raw and heated milk made
in this table. The element of care of the infant (as well as other factors)
in the different groups is discussed by the authors as a separate, im-
portant consideration taken into account in their conclusions, certain
of which are quoted below. There is no doubt but that, were all other
things equal, breast feeding would show decidedly the highest rating.
The Park and Holt study, while not entirely satisfactory, is here quoted
on account of its general illustrative character.

WHY THERE IS A MILK PROBLEM 19

Special observations were made on the effect of pas-
teurized as opposed to raw milk, as summarized in the
following table:—

4 = 1 oO es wet
RES So3 555 32 83
Syd nee Sere Seale Tete a
: ; Oe reo 2 nm
Kind of milk aig (es) ging es OUCH aes eB o >
2 ag fet aay aa ao wd
de EL ese eae ves |) eughis
ZSmGSHagsda3 <8 <a88 0A
Pasteurized milk, 1000 to 50,000
lnaeteria penic.e% 0.) Be 8s. 41 31 10 3 4A oz 3.9 1
Raw milk, 1,200,000 to 20,000,000
baeteblayper'G.@.20 0 ee SISTA ool ogo) ono O“e Alle hae

The results set forth in the first of the above tables
cannot, indeed, be taken as indicating exactly the
effects of the different kinds of milk, for the elements of
care of the infant in the different groups was also of
influence. The following extracts from the conclusions
of the authors, who endeavored to sum up all factors,
must, however, be taken as indicative:—

During hot weather when the resistance of the children
was lowered, the kind of milk taken influenced both the
amount of illness and the mortality; those who took con-
densed milk and cheap store milk did the worst, and those who
received breast milk, pure bottled milk, and modified milk ©
did the best. The effect of bacterial contamination was very
marked when the milk was taken without previous heating;
but, unless the contamination was very excessive, only slight
when heating was employed shortly before feeding.

* Thirteen of the 51 infants on raw milk were transferred before the
end of the trial to pasteurized milk because of serious illness. If these
infants had been left on raw milk, it is believed by the writers that the
comparative results would have been even more unfavorable to raw
milk.

20 THE MODERN MILK PROBLEM

When milk of average quality was fed sterilized * and raw,
those infants who received milk previously heated did, on
the average, much better in warm weather than those who
received it raw. The difference was so quickly manifest and
so marked that there could be no mistaking the meaning of
the results. The bacterial content of the milk used in the
test was somewhat less than in the average milk of the city.

The study just quoted, while not conclusive in all
details, may be taken as roughly indicative of the effects
of good and of bad milk, of raw and of pasteurized
market milk, on infants. We need not go into the
complex question of the mechanism of the effects of
bad milk on the delicate infant organism. Specific
zverms may cause gastro-intestinal disorders and mal-
nutrition in infants, and excessive numbers of germs of
any kind are dangerous. The reason for the greater
prevalence of such maladies and of the greater infant
mortality during the summer months is: (1) That dur-
ing that season milk is much more likely to be fer-
mented, and (2) that warm weather lowers the vital
resistance of the infant organism so as to induce gastro-
intestinal disturbances. While the latter of these
factors may indeed be the more important, attention
must be paid to both.

Such considerations as we have now viewed are sub-
stantiated in the experience of physicians and are re-
flected, though to an indeterminate extent, in the statis-
tics of infant mortality already cited.

It would be desirable to know the exact weight of
milk supply in infant hygiene,—a weight which un-
doubtedly has been exaggerated in some quarters.

* Heated to 165° F. for 30 minutes.

WHY THERE JS A MILK PROBLEM 21

Large groups of deaths are caused by congenital dis-
eases and diseases of early infancy, which are respon-
sible for 35 per cent of the deaths under one year of
age, and by respiratory diseases such as acute bron-
chitis, pneumonia, and broncho-pneumonia (15 per
cent), as compared with diarrhea and enteritis (26 per
cent), the group affected directly by milk supply. And
in respect to all these groups the care given the infant
in regard to methods of feeding, clothing, ventilation,
avoidance of infection, etc., as well as the prenatal care
of the mother and the quality of medical and midwife
attention, are the preponderant factors. In the most
general terms, the fundamental causes of infant mor-
tality are recognized to be ignorance and poverty. In
the infant welfare movement the general lines of attack
are, therefore: first and chiefly, education of the mother,
and, secondly, elimination of evils associated with
poverty. Those who advocate milk control under the
impression that it is the chief means of attacking infant
mortality would do well to correct their judgment by
considering also the other factors involved.’ Improve-
ment of milk supplies does, however, take its place as
an essential part of the general program, with the ob-
ject of ensuring safe, wholesome milk for infant-feeding
at a price within reach of the poor.

MILK AS A VEHICLE OF DISEASE

The readiness with which milk may become infected
and transmit disease has already been mentioned. The
following section, therefore, will be devoted to the
briefest possible summary of the charges which epi-
demiology makes against raw milk.

22 THE MODERN MILK PROBLEM

Diseases Transmissible by Milk
The following are the principal diseases transmis-
sible by milk :—
From human sources: typhoid fever, diphtheria,
scarlet fever, septic sore throat (epidemic tonsillitis),

‘ tuberculosis.

From the cow: tuberculosis, septic sore throat, and
other diseases of bovine origin.

(Milk-caused gastro-intestinal disease of infants was
discussed in the last section.)

‘Milk as a cause of epidemics of typhoid fever,
scarlet fever, and diphtheria”’ is the title of a study
made by Dr. John W. Trask of the United States Pub-
lic Health Service, in which he collected and tabulated
the summaries of 317 milk-borne epidemics of typhoid
fever, 125 of scarlet fever, and 51 of diphtheria.2 This
is the most extensive tabulation which has yet been
made, but in addition to the instances recorded it is
certain that many epidemics have gone unrecorded,
while countless scattered cases of milk-borne infection
must have escaped notice. Rosenau ? mentions how a
single city, Boston, suffered from milk-borne epidemics
in the space of four years, giving the following figures
(greater Boston) :—

1907) Diphtheria: os. . 3). AAR eee 72 cases
TSO TM Scanlepmever. 5.00. See See ann a Tpke
19GS vlad Meverct.- G00) lee ie 400
Tot! !Seanlertevers. )\.) Miser sets Coe oe 842
PO oS? A oases US I ty 2,064

WHY THERE JS A MILK PROBLEM 23

)

The epidemic of ‘‘tonsillitis,’’ or septic sore throat,
put down in this table was notable not only on account
of its extent but also because it was spread by raw milk
derived from a supply subject to expert sanitary super-
vision. The disease has been brought into prominence
through a number of epidemics in recent years. In
some instances the infection has been ascribed to
human sources, e. g., carriers of streptococci; in others
it has been ascribed to udder inflammation in dairy
COWS.

The transmission of bovine tuberculosis to man
through the medium of milk is now well recognized.
The question of the amount of human tuberculosis of
bovine origin has been the subject of much research,
conspicuously by British and German commissions and
the Research Laboratory of New York City. We can
treat the subject but summarily here. Dr. William H.
Park has summed up the evidence and concludes that,
in New York City (italics inserted) :—

About 7 per cent of the infants and young children under
5 years of age dying from tuberculosis do so because of in-
fection derived from infected milk or milk products. Fatal
tuberculosis due to bovine bacilli is rare in those over 5 years
of age, but, on the other hand, infection of the lymph nodes
is frequent; 30 per cent or more of tubercular lymph nodes
occurring in children between 5 and 16 are contracted
through bovine bacilli.“

Applying Dr. Park’s figure to the percentage of
deaths from tuberculosis under five years of age in the
Registration Area (approximately 7 per cent of the
total tuberculosis) would indicate (omitting the rare

24 THE MODERN MILK PROBLEM

deaths above five years of age) that about one-half of
1 per cent of all tuberculosis deaths are definitely due
to the bovine type. Another authority, Ravenel, holds
that there is a possibility of the bovine bacillus chang-
ing its type after becoming rooted in the human sub-
ject, which, if true, would mean that there is more
tuberculosis of bovine origin than we can now
prove.

While the above estimated mortality is not very
great (amounting to about 500 deaths per year in the
Registration Area) as compared with the mortalities
from a number of other preventable diseases, it must
be remembered that there is a much larger number of
serious non-fatal cases and also that the amount of
tuberculosis from this source may be greater than is
now supposed.

In a summary of the researches, Rosenau ! states
that ‘“‘about one-quarter to one-half of all cases of
tuberculosis in children under five years of age is as-
sociated with the bovine type,” probably derived in
all cases from cow’s milk. The great bulk of the human
tuberculosis bacteriologically identified as bovine is in
the form of generalized, abdominal, and glandular
tuberculosis of children. The percentages of mor-
tality given by Rosenau for the age-groups ‘‘under 5,”
‘5 to 14,” and ‘‘15 and over,” when applied to the cor-
responding numbers of total tuberculosis deaths in the .
U. 8. Registration area for 1913 in those age-groups,
result in a total of 1925 deaths, or 2.1 per cent of all
tuberculosis deaths, as due to the bovine type. This
is considerably higher than the above estimate based |
on Park’s figure. Rosenau ™ himself says, ‘‘It is now

WHY THERE JS A MILK PROBLEM 25

estimated that perhaps seven per cent of the tubercu-
losis in man is of bovine origin.”’ The basis of this
estimate does not appear; in view of the others it looks
very liberal.

Altogether, while it seems to be impossible to state
at present the exact amount of human tuberculosis of
bovine origin, it is to be concluded that tuberculous
milk, though not the overwhelming menace it is some-
times thought to be, is a distinct factor in the milk
problem.

Tubercle bacilli may be detected in market milk.
‘Evidence from four typical American cities (Chicago,
New York, Washington, Rochester, N. Y.), summed
up by Rosenau,'* shows that out of a total of 551
samples examined the bacilli were found in 46, or 8.3
per cent. This figure is doubtless an underestimate,
for the laboratory methods may fail to detect the bacilli
when present only in small numbers. At Roches-
ter, N. Y., 12.65 per cent of milk samples taken from
185 retailers reacted to animal tests for tuberculosis.'®
Unfortunately such tests give no indication of the
numbers of tubercle bacilli in the samples.

Tuberculous cows infect the milk through tubercu-
lous udders, but more largely through the manure, in
which the bacilli are excreted in great numbers and
which gains access to the milk at milking time. The
infection is derived not only from obviously tuber-
culous cows but also from many which show no phys-
ical signs of the disease and whose condition can be
determined only by the tuberculin test, to which fur-
ther reference will be made in a later chapter.

26 THE MODERN MILK PROBLEM
SUMMARY

We have seen that there are two general dangers to
health in public milk supplies: (1) general bacterial
contamination and (2) specific infection. Both of
these are aggravated by modern conditions of city
milk supply and even of the supplies of comparatively
small towns, which may be derived and handled in a
similar manner. Collection of milk from many separate
farms, more handlings than ever before, and longer
journeys favor greater bacterial contamination and
alteration. The mixing of many milks to make up
the larger supplies favors the spread of infection to
hundreds of unsuspecting consumers.

Milk-borne disease is indicted by Dr. Charles E.
North as follows, under the title, ‘‘Why milk should
be pasteurized ’”’ :—1

A. Raw Milk Causes Infant Deaths.

Twenty-five per cent of all deaths are of children under
five years of age.

More children die from intestinal disease than from other
causes. Children’s food is chiefly milk.

Dirt bacteria, harmless to adults, irritate and inflame the
intestines of children.

B. Raw Milk Causes Septic Sore Throat.

Septic sore throat is a violent form of tonsillitis.

It is often followed by acute articular rheumatism, erysipe-
las, peritonitis, endocarditis and other serious inflammations. ~

Boston, Mass. 1,043 cases from one raw milk supply
Boston, Mass. 997 « « Gl & ‘
Chicago, IIl. TO, OOO Ces) Mer mes « ‘c
Baltimore, Md. 602 “ « Gon NG ‘c ‘

Cortlind-Homer, NOY: G69 05)" sc ‘c

WHY THERE JS A MILK PROBLEM 27

The disease attacks adults chiefly. There are often deaths.
Bacteria in sore udders of cows closely resemble bacteria
found in these sore throats.

C. Raw Milk Causes Typhoid Fever.
Trask has collected records of 317 outbreaks of typhoid
traced to raw milk. Here are a few:—

Glasgow, Scotland 500 cases from one raw milk supply
Cologne, Germany PM ie ee ‘< 6c
Port Jervis, NEY: Om, <! ‘c Asian Ws ‘cc Ts
Springfield, Mass. 182 “ « Cee a ‘6 «ec
Oakland, Cal. Ia 3S 6c Go er eG 6c 66
Montclair, N. J. NOT ey he ee ce eee
Stamford, Conn. ST. lak eels, yet eine ‘< ‘ec

D. Raw Milk Causes Tuberculosis. :

One hundred and ninety-one tuberculous cows were taken
out of the most celebrated certified dairy herd of 632 animals
in November, 1914. In December, 72 tuberculous cows
were found in a herd of 86 in a model dairy where every ex-
pense and precaution had been taken.

Tuberculosis is very common and the majority of dairy
herds contain tuberculous cows.

Authorities estimate that 75 to 90 per cent of human
beings have tuberculosis at some time during their lives.
Most of this is human, but some of it is bovine.

Tabulation by Park and Krumwiede of 1038 cases of
tuberculosis showed the following :—

Cases Bovine Percent

Acultstover 1G years: {6.00.02 .4. 686 9 ies
Childrem:5'to 16 years. 6... 00 1324) 38 25
Children under 5 years........... 220 59 27

Peel ees ere EP ie od Nae 1,038 101 10

28 THE MODERN MILK PROBLEM
E. Raw Milk Causes Scarlet Fever and Diphtheria.

One hundred and twenty-five epidemics of scarlet fever
due to milk have been collected by Trask. A few examples

are as follows:—

Searlet Fever

w milk su
4 66

Buffalo, N. Y. 57 cases from one ra

Washington, D. C. Bo )) 6 aah: elie |
London, England DOA the ake Ket acon aie
Beverly, Mass. Gas cc |) Neca Rec talent
Liverpool, England Qu ne iM ee ee he ie
Mt. Vernon, N. Y. Ein ete i) Dike, sce eh ipeerniae
Boston, Mass. 195 “ ery Lice Wee waleaee

Diphtheria
Fifty-one ep:demics collected by Trask.

trate :—

Brookline, Mass.

Los Angeles, Cal. 30
Wellsville, N. Y. 84
Clifton, Ohio 36
Hyde Park, Mass. 69
Warwick, R. I. 64

(<9

pply

A few to illus-

12 cases from one raw milk supply

It would be interesting to know exactly what relative
part is played by milk in the transmission of com-
municable diseases. Exaggerated statements are made
by well-meaning but uninformed persons, and the im-
pression is sometimes given that milk is little if at all
short of a poison. This is deplorable, for the truth is
that milk is, on the whole, an exceedingly valuable food
even though, under wrong conditions, a source of :

danger.

Exactly how great this danger is, as com-

WHY THERE /S A MILK PROBLEM 29

pared with that from other possible sources of disease,
is a question which the data of sanitary science are
not as yet sufficient to answer. For present practical
purposes we may say, in the words of an investigator
who has made a noteworthy examination of the evi-
dence on the question,” that ‘‘ 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.”’

A Practical Definition of ‘‘ Pure Milk”

To sum up the whole matter, we wish milk which is:

1. Free from infection of human or animal source.

2. Free from dirt, filth, and other foreign matter.

3. Free from deleterious bacterial contamination or
development.

4. Free from adulteration and of known food value.

Such milk may, in a practical sense, be termed
“pure.”

These requirements may further be summed up in
the three words: safety, decency, nutrition.

Taking safety and decency as the objects of sanita-
tion per se, we shall find that if we secure milk which
meets the requirement of decency, or cleanliness, in
the highest degree, we have gone a long way toward
obtaining also safety. But experience shows that the
two conditions are by no means synonymous and that
if safety is to be entirely ensured the product must be
subjected to a precautionary process—such as pasteur-
ization—before using. Neither a clean milk which is
still somewhat unsafe nor a safe (pasteurized) milk
which is unclean meets the requirements.

30 THE MODERN MILK PROBLEM

So much for the general sanitary desiderata. In
succeeding chapters will be considered the means of
attaining them and the practical difficulties and
personal factors which frequently complicate their
attainment.

CHAPTER II
THE CASE TO-DAY

THE CRY FOR “PURE MILK”

Publicity on such facts as have been outlined in the
last chapter has resulted in a general demand for ‘‘ pure
milk,’”’—a demand associated in the public mind with
the general movement for ‘‘pure food.” A language
of milk ‘‘horrifics”’ has been developed, based at one
end on more or less exaggerated fact and on the other
on the fear emotion of the public. Sanitary reformers,
enterprising health officials, lecturers, and writers
have vied with each other in vivid picturing of the
menaces of impure milk. Bacteria in milk have been
branded as the ‘‘invisible murderers”’ that produce the
‘‘slaughter of the innocents.’”’ Newspapers eager for
popular sensation have been quick to see the publicity
value of all this and have given it columns of space.
Some have even conducted inspection campaigns of
their own, professing their inability completely to
tell the ‘‘unbelievable truth of the unsanitary condi-
tions which have been existing.” As the result of their
efforts they have announced the ‘‘cleaning of the
Augean stables in a day,’ and have then turned the
matter over to be dealt with by the ‘‘angered au-
thorities.”’

The following utterances quoted in a recent news-

paper account of a milk inspectors’ meeting, headed
31

32 THE MODERN MILK PROBLEM

‘“Mr. Milk Supply is worse than Mr. Barleycorn,” are
fair examples of the harrowing type:—*

Fifty per cent of the milk that goes to the creamery for
pasteurization is filthy, utterly unfit for food.

The farmer is hopeless—dirty, mostly ignorant, careless.
Because he can’t get enough for his milk he won’t give good
milk. ‘

We have found to our dismay that dealers on whom we
have been depending have been permitting large numbers
of diseased cattle in their herds.

We can’t get the right kind of legislation.

The politicians are playing a political game with the
farmers. We’ve got to depend on our own efforts.

There are only two grades of milk—good milk and bad
milk. The rest are simply grades of dirt.

Such utterances have awakened public attention,
but they have had at the same time an undesirable
effect on the minds of some persons. Just as publicity
regarding tuberculosis has had as a by-product an
undue dread of consumptives, so has the ‘‘pure milk”’
campaign made some people fearful of milk as such.
This has been perhaps an unavoidable incident of
forceful publicity, but it is an unfortunate one now
calling for correction.

* The language and literature of exposure are not a new development.
A notable example dates back to Smollett’s description, in the novel
“Humphrey Clinker,’ of the milk supply of eighteenth-century Lon-
don:—"‘I need not dwell on the pallid contaminated mush which they
call strawberries, soiled and tossed by greasy paws through twenty
baskets crusted with dirt, and then presented with the worst milk,
thickened with the worst flour, into a bad likeness of cream; but the
milk itself should not pass unanalyzed, the produce of faded cabbage

leaves and sour draff, lowered with hot water, frothed with bruised
snails, carried through the streets in open pails, exposed to foul rinsings

THE CASE TO-DAY 33

Dairies, recognizing the state of the public mind,
have taken to advertising, with the catch-phrase ‘‘pure
milk.’’ Letters are written in the newspapers demand-
ing it. Legislators introduce ‘‘pure milk bills” designed
to conciliate the consumer without arousing the farmer.
Civic organizations make it a major issue, the subject
of campaigns. Investigations are constantly under
way and ‘‘solutions of the problem”’ are galore. Polit-
ical platforms contain ‘‘pure milk”’ planks so guardedly
worded as to conciliate all parties concerned. Health
authorities long ago promised that ‘‘the consumer
should be educated to the value of clean milk.’”’ And
now agricultural authorities, awaking to their responsi-
bilities, announce that ‘‘dairymen must be educated to
the value of clean milk.’’ And farmers hold indigna-
tion meetings to protest that they never intended to
produce anything but pure milk and that they have a
natural right to be let alone by theorists. Everybody
is trying to educate somebody else. ‘‘Pure Milk” isa
phrase to conjure with.

Can Pure Milk be Got ?

Much of this agitation is unaccompanied by clear
understanding of the facts. A recent public health

discharged from doors and windows, spittle, snot, and tobacco quids
from foot-passengers, overflowings from mud-carts, spatterings from
coach-wheels, dirt and trash chucked into it by roguish boys for the
joke’s sake, the spewings of infants, who have slabbered in the tin
measure, which is thrown back in that condition among the milk, for
the benefit of the next customer; and, finally, the vermin that drops
from the rags of the nasty drab that vends this precious mixture, under
the respectable denomination of milkmaid.” Fortunately it takes much
less than such a description to shock the more sensitive, better-informed
modern milk-consumer!

34 THE MODERN MILK PROBLEM

bulletin concludes a discussion of milk supply with
the words, ‘‘The choice is easy. Insist upon clean,
pure milk.” Everyone familiar with the subject has
heard or read that sentiment hundreds of times. The
phrase ‘‘pure milk” suggests its opposite, ‘‘impure
milk,” and it is a common popular idea derived from
these terms that there are two clearly distinct kinds
of milk, good milk and bad milk. Many people doubt-
less believe that an inspector can thrust a tester into a
ean of milk and decide instantly in which category it
belongs. The usual demand for ‘‘pure milk” is a de-
mand for the best milk, and the notion is that one such
best can be both defined and universally obtained.
‘The chief good to be accomplished at the outset,”
writes a newspaper in comment upon a milk campaign,
‘‘will be the arousing of public sentiment against any-
thing but the purest milk.”

The trouble with this is that it requires an absolute
ideal incompatible with practical conditions. Bac-
teria in milk are impurities, but it should be recognized
that a certain bacterial content must practically be
permitted according to the purpose for which the
product is to be used. Again, there are varying nat-
ural degrees of nutritional value, and science has not
determined exactly what is the most nutritive milk.

The air would be cleared if we spoke of milks, thus
emphasizing their differing characters. The scientific
object is to gauge the qualities of milk of different
characters and reduce them to categories. When this
is done it is seen that instead of speaking of one ab-
solute kind of pure milk, it is logical to define what
shall be considered a ‘‘pure milk” for infants, or for

THE CASE TO-DAY 30

adults, or for cooking and manufacturing purposes,
and then to endeavor to get the best possible milk for
each purpose.

To give an answer to the question, ‘‘Can pure milk
be got?” it may be said that to raise all milk to the
highest quality is impracticable, but to obtain a safe,
suitable milk for each purpose is entirely possible.
And this should be the immediate object of practical
milk sanitation.

THE MODERN MILK PROBLEM

The present-day problem of milk supplies is rooted
in an obvious condition of modern urban civilization—
the wide separation of the producer and the consumer.
It is also true, no doubt, that the conditions of urban
life have made city babies and children, and city
dwellers in general, more susceptible to the effects of
bad or infected milk. But it is the long haul and the
broken journey that are chiefly responsible for typically
modern conditions. To illustrate roughly why the
milk question has come to the fore in recent years with
such insistence, we need only point to two contrasted
pictures—the old-time milk supply and that of the
present day in our cities.

The Old-Style Milkman: An Anachronism To-day

The old-time milkman kept his cows just as he
would keep any other live stock. He went about his
milking in the rough, untutored manner that he would
go about any other farm work, without stopping to
wash the dirt of honest toil from his hands, or to clean
the caked manure from the udders of his cows. The

36 THE MODERN MILK PROBLEM

family kitchen was the milk-house where cans were
washed. He drove into the nearby town and with a
dipper ladled out his product into whatever pans or
pitchers were presented to receive it. There were sani-
tary objections to these methods, but few or no sani-
tarians to point them out.

The consumer found no serious fault with any milk-
man but the one who eked out his supply by means
of the pump.

Even to-day. the old-style milkman survives, and
many small towns and some large ones receive their
supplies in some such manner as the above. In fact,
he has by no means disappeared, but has simply be-
come absorbed in the modern milk mechanism.

The Modern Milk Mechanism

With the growth of towns and the reaching-out into
the country for milk supplies from comparatively dis-
tant and unknown sources, the old evils were exag-
gerated and new ones added. Whatever check existed
in the knowledge of the consumer of his source of supply
disappeared. The element of time, with the danger
of stale or decomposed milk, became important. The
product passed through the hands of a new class of
men, the dealers or middlemen, who perhaps scarcely
ever see a dairy farm. The railroad was called into
requisition, introducing a new difficulty. Quantities
of milk were mixed for shipment by wholesalers, thus
making possible the infection of large supplies by a
few quarts. The city milk plant, with its frequent
lack of sanitation, came into existence. And now, at
the present time, the old-fashioned methods of milk

THE CASE TO-DAY

FARMS

FARMS
a
a G
COUNTRY MILK PLANT
1] -JOR COLLECTING POINT
B ia

ic CITY MILK PLANT OR DEPOT
i] a
a a UI a

Fia. 4. Systems or MILK SupPiy

Upper figure: simple or undeveloped state, small communities. Each
dairyman retails his own supply, sometimes drawing from his neigh-

bors. Lower figure: developed state, under city conditions.

Milk

depots for centralizing such operations as collection, pasteurizing,
bottling, and transferring milk by wholesale are in this case an
economic necessity. In many communities a mixture of the two

systems exists.

38 THE MODERN MILK PROBLEM

production prevail to a large extent, with the modern
disadvantages and dangers added to them.

In this final form of milk supply the producer may have
no idea whatever of the final destination of his milk; and
the consumer, as a rule, neither knows nor cares where the
milk which he buys comes from. The personal relation
between consumer and producer is totally lost, and the
middleman comes to hold the position of principal impor-
tance, as the only person in touch with all. These circum-
stances, and the very size of the system, tend to make it
largely mechanical, and all connected with it merely sub-
ordinate parts in a great machine which, for good or ill,
must work on incessantly. . . . Under this system the milk
is often two days old .. . before it is actually consumed.
It also necessarily passes through many hands en route, and
is therefore accessible to manipulation, adulteration and
contamination.!

The following picture, given by Rosenau, sketches
verbally the situation shown graphically in Fig. 3:

Milk when it reaches the consumer in the city is often very
different when compared to the same milk used on the farm.
The farmer cannot understand why it is that the milk agrees
with his baby, but makes the city baby sick. He forgets
that the milk he sends to-the city is often placed in dirty
cans, perhaps rinsed with infected water or mopped “ clean”’
with soiled cloths. The cans are often. placed on the farm
wagon and carted several miles to the nearest railroad sta-.
tion, where they stand some time in the sun and occasionally
are exposed to dust, flies, and prying fingers of irresponsible
persons. After this they are loaded on the milk ear, which is
perhaps warm. Arriving in the city, the cans again stand
around the milk platform waiting for the city wagon, when

Pee ONG IN Soe Ni tho V

SCRLE: MILES
§10 20 30 4° §6
os.

Fig. 5. Typicau ‘‘MinKsHeps” or LARGE CITIES

(a) New York (1905). (This and the next four maps are derived from
Bulletins 81 and 1388 of the Bureau of Animal Industry, U.S. Dept. of
Agriculture. Since the investigations were made the milk octopus has
in each case reached out still farther.)

40 THE MODERN MILK PROBLEM.

they are carted to the city dairy. Here they are opened,
the milk is tasted and smelled, and poured into a large vat,
where the contents of the can is mixed with the milk from
numerous other cans. From this vat the milk is pumped to
a clarifier, where much of the dirt and slime is removed.
From there it may pass through other processes before it is
cooled and bottled. The bottle may not have been properly
cleansed and sterilized. This bottle is placed upon a wagon
and carried to the householder, who thus receives milk that
is several days old, has been frequently handled, has come in
contact with a number of different containers and machines,
and has had a good chance to deteriorate as well as to collect
various kinds of dirt, with the possibility of picking up
infection. City milk, stale, dirty, and bacteria-laden, is
therefore a very different article from the fresh country
brand.”

Fortunately the worst of these features do not always
prevail. There are special milks, such as certified milk,
which are produced and handled with a high degree
of precaution. There are dealers who take every care
asked of them, and there are milk concerns which
have their own inspection and testing systems and
operate plants which are sanitary in every particular.
But we are here discussing the general situation, and
the former picture must be taken as typical of a great
deal of city milk.

This problem of urban milk supplies is not new, but
it is constantly growing. It has been growing in years”
past and will continue to grow with the increasing ur-
banization of our population.* It is, primarily, a mat-

* As an extreme example of the condition toward which urbanization
tends, one may take New York City, which receives very little milk

THE CASE TO-DAY

SCHHSYTI IWOIdAT, *9 ‘DIT

“(GO6T) veydjapopryg (q)

EE es ee
ov og ot OL ¢$

SATiWISaTWIOS

GEN EN ee WW

42 THE MODERN MILK PROBLEM |

ter of the larger centers of population, yet so far is the
urban social structure characteristic even of the smaller
centers that they may have a similar problem. It not
infrequently happens, for example, that a suburb or a
town situated near a large city has milk supplies which
come from that center and are originally drawn from
some distant region; or such supplies may be dropped
off from a main artery of railroad traffic. It is not,
therefore, entirely a question of the size of the com-
munity, but of local conditions. Even towns where
the supply is derived from near by have their difficul-
ties in obtaining satisfactory milk supplies.

THE PARTIES IN THE CASE

The human factor looms large in the milk question.
Aside from the sanitary and economic factors involved,
efforts at a just and harmonious solution have to con-
tend with the different, and too often conflicting, in-
terests of several distinct classes of men. Controversy
has been aggravated and prolonged by ignorance of
underlying facts, by distrust among the parties in the
case, and by natural refusal to concede points not
clearly proved. We shall sketch here the general
grounds of these different standpoints.

from within fifty miles of the city, its daily supply of 2,500,000 quarts
being derived from 44,000 farms located in six different States (1912).
Boston gets most of its supply from outside of a fifty-mile radius, -
drawing from six States and Canada. Chicago presents a somewhat
different picture, most of its supply coming from comparatively near by,
but in this case there are many separate sources of supply and com-
plexity of milk routes. Such conditions, though cited from the largest
cities, are illustrative of general tendencies under urban and even under
suburban conditions.

THE CASE TO-DAY 43

SCALE: MILES
io 20 30

Fic. 7. TypicaL MILKSHEDS
(c) Boston (1905).

44 THE MODERN MILK PROBLEM

THE DEMANDS OF THE HEALTH OFFICIAL

The sanitarian and the health officer have naturally
taken the leading part in the milk debate. On the
whole they have had a fair hearing and there has been
an inclination to heed their counsel when this was strong

F
9
; %

ImcHEnry| LAKE

OONE +

of}
ar.)
a!
eae. ¢
x
wy,
a
&

Ss
VG

Fia. 8. TypicaL MILKSHEDS
(d) Chicago (1911).
and definite. They have, however, labored under the
disadvantage of having to deal with a matter involving ~
difficulties if not complications and one apt to be over-
shadowed by other public health problems. They have
sometimes framed verbose or impossible regulations. -
They have often failed to impress the dairyman by
meeting his practical objections. As one writer says:—

THE CASE TO-DAY 45

The position of the boards of health has been difficult, for
they have been charged by the farmers with ignorance of
farm conditions, by the railroads with imposing impossible

Part benosit

gqure/

e
a
’
/
a
AA
?

Fig. 9. Typican MILKSHEDS
(e) Washington (1911). Heavy dots show points from which milk
cars start, largest shipping points enclosed by circles.
orders as regards icing and other matters, and by contractors
with the promulgation of regulations that were unnecessary,
arduous and expensive.®

The active health officer or milk inspector must ex-
pect more or less objection and misconception from

46 THE MODERN MILK PROBLEM

those whom his activities affect. He must, therefore,
be prepared to deal with difficulties and justify his
course.

THE PRESSURE ON THE FARMER

- It is from the producer, the dairy farmer, whether he
retails his product himself or sells to a middleman, that
the loudest opposition to higher sanitary requirements
has come. His most frequent protestation relates to
the price that he recetves,—namely, that he cannot
make sanitary improvements which necessitate greater
expense and care without some increase in that price.
He argues that his labor is becoming harder, his ex-
penses heavier, and his margin of profit (if, indeed, it
exists) smaller, while time-honored ways are being
replaced by ‘‘new-fangled notions”? which bring him
no benefit. ‘‘The complaint is,’ as an agricultural
journal remarked not long ago, ‘‘that everything used
in the production of milk has increased in cost during
recent years, while the price of milk has remained prac-
tically the same or [is] in some cases even less.”’

In corroboration of this protest of the farmer a milk
specialist of the United States Department of Agricul-
ture writes :—

If the dairy farmers of this country were asked this ques-
tion, ‘““‘What can be done to encourage the production of -
clean milk?” I am sure that nearly all would answer, ‘“‘Se-
cure better prices and markets for our product.’’ There-
fore, the conditions as they exist to-day are these: many
dairymen do not receive enough for their product to warrant
any extensive changes or outlay, and many dairymen who

THE CASE TO-DAY 47

VA
Fond dulac

MAP SHOWING
AVERAGE DAILY SHIPMENT
OF MILK BY RAIL
INTO MILWAUKEE
DURING NORMAL SEASON

Represents Unit of one
® LErght-gallon Can of Milx

Milwaukee

Heavy line about

Milwaunee encloses
region shipping mls
info Mi/wauKee

by wagon

SCALE: MILES
lo 20

Fig. 10. TypicaL MILKSHEDS
(f) Milwaukee (1911). This chart represents only milk shipped by
rail; about as much again is brought in by wagon. (Bulletin 13,
Milwaukee Bureau of Efficiency and Economy, 1912.)

48 THE MODERN MILK PROBLEM

are paying no particular attention to better milk are receiv-
ing the same price for their milk as those who. are trying to
market a clean, safe product. This state of affairs, one can
readily see, does not encourage clean milk production; how-
ever, we must work with the facts as they are. If we expect
the farmers to produce better milk, we must assist them to
receive a reasonable profit for their labor.

In some sections of the country, dairymen state that the
price received for milk is not sufficient to warrant their
staying in the business. If it were not for the value the cows
are to the farm, more dairymen would stop milking them,
and take up some other line of agriculture. The question
of prices and profit is a problem which we must meet. . . .*

Undoubtedly the economic pressure upon the dairy
farmer is heavy, but the question how far his com-
plaint on this score is justified and what the remedy is
must be left for consideration in a later chapter.

A contributing cause to the farmer’s disquietude is
his frequent ignorance and distrust of bacteriology
and sanitary science. The ultraconservative farmer
is apt to consider measures of milk sanitation as mere
theory, as hobbies of the doctor or fads of the health
officer. We cannot, of course, expect farmers to be
versed in sanitary bacteriology, but we can expect
them to so appreciate its aims as to act intelligently
for the attainment of these.

The farmer often bespeaks consideration of the
hardships that beset his mode of life, with the plea
that no further demands should be made upon him
without corresponding additional compensation. Here
is a typical example, taken from the letter of a dairy-
man to a Massachusetts newspaper :—

THE CASE TO-DAY 49

Look at his [the milkman’s] duties. Up in the morning
around two o’clock three hundred and sixty-five days in the
year; hustling to get the milk to his customers. He finally
arrives home at eleven o’clock. Then comes the washing
and sterilizing of bottles, cans, and utensils used. Then a
late dinner, the teams to care for, the surrounding country
gone over to collect the milk for next day. By the time it is
all in, bottled, and iced for next morning’s trade, it is perhaps
nine o’clock. Hurry to bed, for two o’clock soon arrives,
rain or shine. It has to go; no holidays or Sundays here.
Where is the new cow coming from to take the place of the
old one when she is gone? The blacksmith had a much
larger bill the past six months; the milkmen are robbing the
good people of by asking them six cents a quart for
milk when they should get ten cents, its value.

Why are so many dairy farmers going out of business,
five in our neighborhood in the past two years? A sixth
one goes next month, myself. At a cent a quart increase in
wholesale price over four years ago I cannot make both ends
meet in the milk business at the present cost of production.
You people who think you are being imposed on better go
dairy farming a while.

The kind of complaint of which this is representa-
tive, whether coming from the farmer-retailer or the
farmer who sells to a middleman dealer, cannot be dis-
missed without consideration. Its economic basis will
be examined in a later chapter. That it denotes the
attitude of many farmers, an attitude which must be
taken into account in any practical examination of
the milk question, is the point for present marking.
Altogether, the disadvantages of the farmer are many,
and his pleas demand the attention of reasonable men.
‘The dairyman,” as one of them puts it, ‘‘is trying to

50 THE MODERN MILK PROBLEM

make a decent living in a legitimate way, is not trying

to poison anybody, and does not like to be forced out

of business nor to sell out to a trust. He does not want

to raise the price of milk, and will only do so when

forced to.’ If he is averse to altering his methods,

tradition and lack of information are largely to blame.
The case is well put by Rosenau:—

The attitude of the farmer is often unfortunate, but he
cannot be blamed for getting out of patience with the sub-
ject. Heis made the butt of the cartoonists and is hammered
at from all sides. He is inspected and reinspected, preached
to, lectured at, scolded, and the object of legal action. He
is pestered with the enthusiast, the reformer, the sanitarian,
the lawyer, the baby’s mother, and the baby’s doctor. He
is showered with advice, some of it contradictory. In this
predicament he does not know which way to turn. If the
attitude of the farmer is often unfortunate, the attitude
towards the farmer is frequently equally unfortunate. Too
often he is regarded as a back number, unprogressive, in-
competent, and even dishonest. As a class no finer stock
is to be found in the world than the sons of the soil. The city
replenishes its worn-out and effete inhabitants with the
brawn, brain, and character of the country boy and girl.
The harsh, arbitrary methods sometimes directed against
the farmer are not only unjustified, but delay and complicate
the solution of the milk question. Much quicker progress
will be made through mutual respect, a helpful attitude, and
a certain amount of patience necessary for all large sanitary
reforms.°

The dairy farmer is pressed by the health authorities
for better quality of milk and by the dealer for mini-
mum prices. He is not a recalcitrant; he is as glad to

THE CASE TO-DAY 51

help ‘‘save the babies” as anyone else, but he must
live. In many districts dairy farmers are in fact
going out of business. Yet the milk supply must not
only be kept up but be increased. The well-being of
the farmer is necessary to that of society, and the
maladjustment of the conditions under which he
operates must be corrected.

The Farmers’ Need of Organization

The one conspicuous feature in the situation of the
farmer is his lack of organization. In his relations
with dealers and railroads he is at a great disadvantage
in his inability to bargain collectively. It is no wonder
that he is at the mercy of shrewd price-setting milk-
buyers. If he carries on his business as an individual
he is unable either to recognize the true nature of the
conditions which he shares with other dairymen or to
act effectively to secure his due. Organization among
farmers would alter the whole situation. Such or-
ganization would first of all protect and advance the
farmers’ collective interests, and might then perhaps
proceed to such constructive work as the establish-
ment of co-operative creameries and, in co-operation
with agricultural authorities, the improvement of
dairying methods and of agriculture in general.

Farmers’ organizations now exist, to be sure, but
these have not, in general, been sufficiently close-knit
and active to produce much impression on the situa-
tion. Collective action has been spasmodic, short-
sighted, unsystematic, accompanied by no continuous
grip on affairs. Too many farmers have ‘‘stayed out.”
The farmer is by nature a conservative and an in-

52 THE MODERN MILK PROBLEM —

dividualist, too ready to tolerate disadvantages. But
if he is to hold his own under modern competitive
conditions, he must, as a class, learn the lesson of or-
ganization and collective action. Signs of a changing
attitude are to be seen, as, for example, in the present
efforts of organized producers in New England and the
New York district to secure better milk prices (see
Appendix E), but there is much to do in this direction
if the individual farmer is not to continue to be forced
out of business as a milk producer under present-day
pressing conditions.

The sympathies of a disinterested observes would
likely be with the consumer, who is in darkness, and
with the farmer, who suffers most under economic
pressure. But the difference is that the consumer must
look to the authorities for his protection, while the
farmer can, if he will, better his own conditions.

Agricultural Aid

The chief external reliance of the farmer for the
improvement of his status must be the agricultural
authorities who are studying his problems on scientific
principles. State and Federal departments of agricul-
ture with their experiment stations, not to mention
various agricultural colleges, are constantly carrying on
investigations and publishing data and advice of ad-
vantage to the farmer. A great deal of this work is
specialized on the dairy industry. The following para-
sraph by Mr. H. N. Parker sketches the part played
by such authorities:— —

The agricultural experiment _stations naturally see the
farmer’s position and, perhaps, only less clearly, the con-

THE CASE TO-DAY 53

tractor’s. For years station men have been collecting data
on dairying. They know, as no one else does, that the
modern dairy farmer has large sums of money invested in
his business and that he must be a highly trained man in
order to succeed. They appreciate fully that the profits in
dairying are not easy and that only careful management can
reap them. Consequently, the stations have labored zeal-
ously to get dairymen to adopt economical rations, to weed
out non-productive or robber cows, to pay attention to
breeding, and to be biologically clean, so that the products
may be wholesome and of good flavor. ... They know
that dairying must pay a reasonable profit to be sound,
hence the stations have tried to make the dairymen efficient
and have protested when regulations have been proposed
that sounded good and entailed expense, but yielded no
adequate benefit. The work of the stations will grow in
importance, for at present it is the hope of improving farm
conditions that holds out the brightest prospect for a solution
of the milk question.®

One cannot expect that farmers will become agricul-
tural experts overnight. Nevertheless, efficient farm
management has a prime part to play in solving the
milk problem, and there is substantial truth in the fore-
going estimate of the role of agricultural authorities.
Farming is not yet, for the many, a technological
calling, but it is a trade demanding knowledge of
scientific and business principles. It may be that
agriculture will of economic necessity follow the mod-
ern trend and become as specialized as manufac-
turing. But that is, for the present, a development
which interests only the comparatively few of special
training and enterprise. Meanwhile the ordinary
farmer must make the progress that is within his

54 THE MODERN MILK PROBLEM |

power, in which endeavor his chief advisers must be
the agricultural authorities and many of his best text-
books will be their bulletins. It rests with himself as
to whether he will take advantage of his opportunities.

THE POSITION OF THE DEALER

The modern development of the milk business has
brought into existence a highly important factor—
the person or concern known variously as the middle-
man, distributer, retailer, contractor, or dealer. He is
the successor of the farmer-retailer who enlarges his
business by collecting and selling milk from his neigh-
bors, but is a different type in that he is distinctly a
business man. He occupies to-day, in the larger cities,
the central position in the milk situation. Reaching
far out into the country districts by means of the rail-
roads, collecting and distributing on a large scale, he
connects, at the same time that he separates, producer
and consumer. This middleman business involves
large investments of capital and is one of the “big
businesses”’ of to-day.

In milk controversies in the large cities it is the mid-
dleman who seems to hold the key to the situation.
Under ordinary conditions he virtually sets both the
price paid to the producer and the price to be charged
the customer, and he will not readily make concessions
at either end. Being a better business man than the
farmer, it is natural to infer that he reaps the lion’s
share of the profits.

In certain respects, this concentration of the milk
business is, as Rosenau points out, an advantage. It
makes for economic efficiency and at the same time

THE CASE TO-DAY 59

tends to simplify sanitary supervision. Certain large
dealers, recognizing the necessity of sanitation, have
co-operated in the efforts of the health authorities and
have established laboratories and inspection systems
of their own. Such measures are not philanthropic,
but have been undertaken as. good business manage-
ment and in the desire to maintain a good standing.
In the same way some have established bonuses for
milk produced under superior sanitary conditions.
Milk-borne disease is a bugbear of the large dealer
and, to avoid it, he has been willing to go to consider-
able trouble and expense and to adopt pasteurization
and other precautions. The reputable dealer wel-
comes better conditions in the milk industry, but he
is not to be expected to go to extra expense that will
place him at a disadvantage with his competitor. In
fact the progressive, fair-minded dealer will co-operate
in sanitary improvements, but naturally only so far as
they are required by authority, or at least where they
do not conflict with his interest as a business man.

In relation to the farmer, the point of vantage of the
middleman lends itself to price-squeezing in the pro-
ducing districts. Of the two means of profit, the dealer
finds it easier to keep down the price paid to the farmer
than to raise the price received from the consumer.
The producers in a given district may complain, but,
unless they are organized, they must either take the
price offered by the dealer who collects in that district,
or none.

It is no doubt to the advantage of the middleman
to discourage agitation regarding conditions in which
he holds the balance of power. Nevertheless, the

56 THE MODERN MILK PROBLEM ~

situation in some quarters has reached such a pass that.
the abolition of the middleman through the establish-
ment of farmers’ co-operative selling or through other
co-operative or municipalization plans is being seriously
discussed. But this leads us to considerations which
must be postponed to later chapters.

RAILROADS: THE TRANSPORTATION |
PROBLEM

A special matter which calls for attention in con-
nection with the milk supplies of large cities is railroad
transportation. Wherever milk is brought by rail from
long distances special sanitary precautions are neces-
sary, principally with regard to refrigeration, while
the railroads find it necessary to institute divisions of
milk transportation with provisions for special cars,
fast milk trains, depots, etc. The Pennsylvania Rail-
road, for example, a few months ago purchased at a
reported expense of $300,000 thirty-six refrigerator
cars to carry milk from northwestern New York and
Pennsylvania into the cities of Philadelphia, Brooklyn,
Baltimore, and Jersey City, the amount carried at
that time being 265,000 quarts per day. These cars
have a capacity of 12,000 quarts each, and brine and
cold air facilities for holding the temperature down
to 40° F.

The transportation problem has appeared in acute
form in certain regions. The question of rates has
been taken up by the Interstate Commerce Commis-
sion, which has held hearings, e. g. (in 1916) in Boston
and Philadelphia. The complex situation in New
England has also been made the subject of investiga-

THE CASE TO-DAY 57

tion by the Boston Chamber of Commerce (see Ap-
pendix E). Such investigations run into complications
as to systems and rates which it is impossible to discuss
here.

It is, of course, difficult to say to just what extent
the transportation question enters into the general
milk problem, but it evidently constitutes one phase,—
a phase, moreover, which is used as a background for
exhibiting miscellaneous difficulties and grievances.

It is worth noting, in passing, that, while suspicion
has fallen upon ‘‘railroad milk,” still, with the growth
of cities, the milk supply must be drawn from greater
and greater distances. Fortunately it is possible so
to compensate for distance by means of proper precau-
tions that a sanitary milk from two hundred miles
away may be better and safer than one produced
near by but subject to unfavorable conditions. The
final quality of the product is the criterion.

THE ATTITUDE OF THE CONSUMER

The attitude of the consumer is, on the whole, nega-
tive. As one health official puts it, ‘‘ Milk is milk to
the average consumer. A white fluid in a bottle, with
a cream line, is about all he seems to be interested in.”’
The agitation on the milk question is not carried on
by the many but by the very few who have interested
themselves and formed ‘consumers’ associations”’
and the like. The great majority demand only a suf-
ficient appearance of cream and the absence of ob-
viously visible dirt, and are aroused only by an in-
creased price.

This attitude is unfortunate when there comes ques-

58 THE MODERN MILK PROBLEM

tion of sanitary measures for which public support is
required. One authority goes so far as to say :—

Probably the chief obstacle . . . lies at the consumer’s
end of the problem. .. . It is still unusual to find even
educated people willing to pay a cent a quart more for good
milk when they find they can get an ordinary kind cheap.
If the public can only be brought to appreciate the fact
that it is cheaper to pay a little extra for a good quality than
to pay less for a poorer grade of milk, a great reform can be
rapidly brought about. The question whether the milk
supply can be generally improved depends thus upon the
consumer. . . . This reform will come just as soon as the
public is ready for it, and that will be just as soon as the
consumer is ready to pay for quality.’

In a city which was attempting to enforce a tuber-
culin-test ordinance, users of milk informed the health
authorities :—

They could see no difference between the milk from a
tuberculin-tested herd and the milk from an untested herd.
They have explained that the cream line was no lower, that
the milk tasted no differently, and that they could see no
excuse for paying a higher price for such milk. This attitude,
more or less exaggerated, was apparent and general and of
course makes for the defeat of a provision like that requiring
the test. The dealer can quite safely oppose any require-
ment until the public demands it.

There is this, however, to be said for the consumer:
that his inability to judge or control conditions nat-
urally makes him passive. His unwillingness to pay
more for milk is not unjustifiable if he has no way of
knowing that the quality is actually better. Far from
expecting the consumer to take a direct hand in the

THE CASE TO-DAY 59

matter, one should look to health authorities and
legislatures to perform their duty in ensuring that
his welfare is protected. On this score he often has
good ground for complaint in that even the most in-
telligent inquiring citizens often find great difficulty
in making out what the local milk situation is or which
supplies are most worthy of patronage.

A great deal has been said about educating the pub-
lic to demand better milk at a just price, and the
stimulation of such a demand is, to be sure, a good
thing. But the best intentions of the consumer are
ineffectual unless the public health authorities so deal
with the situation as to make discrimination by the
citizen simple and direct. As to the means of doing
this, more will be said later.

THE PHYSICIAN

The medical profession has played a large part in the
promotion of the sanitary milk movement,—most def-
initely through the development of certified milk. It is
the medical observer to whom we turn for knowledge of
the relation of milk to the individual. In the case of
the infant, the invalid, the convalescent, the doctor’s
choice of milk is important, and regulation of milks
must therefore harmonize with medical requirements.

UNOFFICIAL ORGANIZATIONS °

An important part has been played by unofficial
organizations of public-spirited citizens and even by
individuals. Civic bodies, such as women’s clubs, have
done much in stimulating the public sentiment which

60 THE MODERN MILK PROBLEM

is a necessary preliminary to and power behind effective
legislation. Milk distribution from infants’ milk
depots has been a useful constructive activity.* In
many ways such bodies have encouraged and supported
health authorities, and they will continue to do so.

THE LEGISLATOR: MILK AS A POLITICAL
_ISSUE

Milk figures not infrequently as a political issue.
A chapter might be written on milk in politics; it
would, however, be more confusing than illuminating.
An already contradictory subject is further compli-
cated by the partisans of special interests. Legislators
are too apt to aim at something less than a general
solution of the problem. Some seek to gain favor with
the city voter by ‘‘pure milk bills,’’ while others score
with the farmers by their opposition to such bills. All
this is unfortunate in its confusing and obstructional
effect, but it has, at the same time, brought out the
importance of the whole question with its several sides.
It has shown the necessity of, first, unbiased legislation
and, secondly, non-partisan administration of milk
laws.

Clarification of the whole matter will, it scarcely
need be said, tend to remove it from political entangle-
ment. Further, as regards the interpretation of milk
laws by the courts, the adjustment of values is neces-
sary as the basis of right decisions.

*It is to be noted, however, that the distribution of milk is now
considered by no means the most important part of milk station or
infant welfare work. (See pp. 20-21, 87-88.)

THE CASE TO-DAY 61

RELATI VE IMPORTANCE OF MILK CONTROL

The question may well be raised as to the exact im-
portance of milk control in the general sanitary field.
Until recently no idea at all definite was to be had of
this, but a tentative scale of relative values in public
health work has been published by Dr. Charles V.
Chapin,’ Superintendent of Health of Providence, R. I.,
in which, on a scale of 100, a value of 8 was assigned to
milk supervision. Dr. Chapin, in a revision of the scale,
has since, however, reduced his estimation of the milk
figure to 2 per cent (sanitation, 1.7; adulteration, 0.3).
A similar scale has been worked out by Franz Schneider,
Jr.,!! of the Department of Surveys and Exhibits of
the Russell Sage Foundation, assigning to milk control
the value of 2.7 per cent. These figures, though tenta-
tive, tend to indicate that the relative sanitary im-
portance of milk control is not so great as has perhaps
been generally supposed. It must be considered, how-
ever, that the economic difficulties and demoralization
of the vast dairy industry contribute greatly to the
present importance of the milk problem as a whole.

CONCLUSION: THE STATE OF THE CASE

The present status of the milk question as outlined
in the foregoing pages may be briefly characterized as
follows :—

1. The problem is both sanitary and economic. It
involves the all-important question of health versus
dollars—Will the consumer pay for sanitary milk?—
and the correlative one: How, otherwise, is the dairy-

62 THE MODERN MILK PROBLEM

man to make a living by producing it? Also the further
one: How can sanitary milk be produced and distributed
most economically?

2. It arises from the separation of producer and con-
sumer and from the complexities necessited by urban
development. It is characteristic of centers of popula-
tion and tends to become more acute the larger these
centers and the greater and more distant the territory
from which the milk supply is drawn. At the same
time all milk supplies, under whatever conditions and
in all communities, are subject to the same funda-
mental sanitary considerations; hence even compara-
tively small communities may have more or less of a
milk problem.

3. A practical difficulty in its solution is that several
distinct and important parties are concerned in the case:
not only must the sanitarian, the health official, and
the consumer be heard, but also the producer and the
distributer. Hence there is always debate, often con-
troversy, and sometimes a ‘‘milk muddle.” The task
is to get the facts free from the coloring of special in-
terests and prejudices and do justice to all parties.

At a recent Federal hearing in New England the
following statement, summarizing the acute phase of
the matter, was made by a representative of large
milk interests :—

An important point which Mr. made, under cross-
examination by Attorney-General , was that the great
milk problem, both in regard to cleanliness and price, is
pressing for a solution; and whether it is solved now or
later, the agitation by the public will continue until the
solution is reached and the matter is settled once for all on a

THE CASE TO-DAY 63

basis fair alike to producer, shipper, and consumer. Milk,
the witness said, is so vital to a large part of any metro-
politan community that in some degree it may not be too
much to say that life depends upon it—and a matter so
close to the life of the community enforces constant at-
tention.”

In the following chapters the aim will be to outline
the measures of sanitary control, to show wherein
previous and present regulation is inadequate, to set
forth the general economic considerations, and to de-
duce the main principles of equitable adjustment.

CHAPTER III
THE SANITARY FACTORS

With a view to indicating the present status of the
sanitary control of milk supplies, we may now con-
sider briefly each of the means of control. These are
directed toward attainment of the general ideal set
down at the close of Chapter I.

The subjects will be treated in the following pages
in the order, roughly, of chronological development.
There will be seen a gradual evolution in regard to
the point of attack. The earliest regulation was di-
rected at preventing adulteration; in the next stage the
conditions under which it was produced and handled
received most attention; recent developments have cen-
tered about the sanitary quality of the product as de-
termined by laboratory methods and about the specific
treatment known as pasteurization. The development
has not been, however, clearly defined, and the regula-
tions of the present day are a mixture of the ideas of all
the stages. The present-day task of sanitation is to
assign to each of these ideas its proper weight.

Early Developments

We shall not here go into the history of milk regula-
tion except as it has a direct bearing upon still surviving
traditions. This, however, is by no means a negligible

consideration, for in control of milk supplies, as in
m 7

THE SANITARY FACTORS 65

other branches of sanitary endeavor, the inertia of tra-
ditional ideas and routine has been great. To-day there
may be seen the most advanced and promising ideas in
operation side by side with the archaic—the latter still
largely prevailing.

To find the beginnings of milk supply control in
the United States in anything resembling the modern
sense, we must go back some twenty-five or thirty
years. The following passage from a paper by Mr.
H. W. Parker epitomizes those beginnings :—

Most people think that the milk question is new in America,
that it appeared not over twenty years ago, but really it
began to make itself felt in the big cities at an earlier period.
Thus, in 1859 the office of milk inspector was established in
Boston; in 1870 the Board of Health of Providence investi-
gated the milk supply of that city; and in 1871 the board
of health of Washington looked into that of the Federal city.
But in a sense the public is right, for the regular collection
and analysis of milk samples did not become common in
. American cities until the period from 1885 to 1890.* It
seems probable that about this time the family cow disap-
peared and dairymen found it necessary to locate so far
from their trade that they found it difficult to deliver milk
in good condition and had lost personal contact with their
customers.

The efforts at this time were very largely directed
against watering, skimming, and other forms of adul-
teration or sophistication, which were very common at
the time. This work was certainly necessary, and still

* Sedgwick and Batchelder’s work, mentioned below, indicates, how-

ever, that the beginnings of bacteriological control were somewhat
later. —J. S. M.

66 THE MODERN MILK PROBLEM

has a justified place in the supervision of milk supplies.
But, owing to the work of the past, heavy penalties,
and the ease with which adulteration and the use of
preservatives can be detected, the period of extensive
adulteration is over, and the matter is now one of little
significance. It has always been, too, a question of
fraud rather than of health.*

The logical development of these early efforts at
milk control was the adoption of chemical standards,
which will be considered later.

THE BEGINNINGS OF THE CLEAN MILK
MOVEMENT

For many years milk supply reform was summed up
in the movement for ‘‘clean milk,” which may be de-
fined as milk from healthy cows, handled throughout
under sanitary conditions to be obtained by means of
inspection. Bacteriological examination became its
indispensable gauge, and later there was added to the
ideal the tuberculin test for dairy cows. Under the
influence of the movement the dairy score card for in-
spection developed. This was an ideal of fresh raw
milk; hence many of its adherents, until recently at
least, have minimized or opposed pasteurization, thus
giving rise to a controversy, now largely adjusted to
which we shall again allude under the latter head.

Attention was drawn to milk as a vehicle of infec-
tion, through a study, laid before the International
Medical Congress of 1881 by Mr. Ernest Hart, sum-

* Dr. Charles V. Chapin, in a recently devised scale of sanitary values
totalling 100, assigns to milk adulteration a value of but 0.3. (See
p. 61.) |

THE SANITARY FACTORS 67

marizing sixty-nine epidemics which had already been
charged to milk.2 The sanitary importance of con-
tamination in general was later brought out strikingly
by Sedgwick and Batchelder,* who in 1892 published
the results of a bacteriological examination of the
Boston milk supply. This seems to have been the
earliest. recording of the bacterial content of the milk
of an American city. The large numbers reported
amazed sanitarians and public. The modern move-
ment for sanitary milk on a bacteriological basis ap-
pears to have dated from this time.

Certified Milk *

But even before this, important action was under
way in New Jersey, where the State Medical Society,
with the object of improving milk production, began,
in 1889, an investigation of milk supplies, the result of
which was an appeal to the State for strict supervision
of all the dairies within its limits. This appeal failing,
resort was had to an original expedient, that of medical
certification of milk, and in 1893 the production of the
first ‘certified milk,’’ under the supervision of a med-
ical milk commission organized in Essex County, in
that State, took place.

Certified milk may be briefly defined as milk pro-
duced under the strictest sanitary conditions by a pro-
ducer who has entered into an agreement with a med-
ical milk commission by which he stipulates compliance
with the commission’s requirements, while the com-
mission authorizes the use of its certification.* In

*The term ‘certified milk” has sometimes been abused by un-
scrupulous dairymen, but has been legally protected in a number of

68 THE MODERN MILK PROBLEM

effect, certified milk is the highest quality of raw milk,
from tuberculin-tested cows, the bacteria count being
limited to 10,000 per cubic centimeter. The total
production of certified milk is estimated at 25,000
gallons daily; this, however, is but a drop in the bucket,
for even in the large cities where certified milk is es-
tablished it constitutes less than one per cent of the
total milk supply.

The certified milk idea was, until recent years, un-
disputedly predominant in the clean milk movement
and so has served its purpose. In the solution of the
general milk problem, however, certified milk plays
little part. Its market will continue to be restricted
and its quantity small because of the high price at
which it must be sold, and wice versa. This price aver-
ages 14 cents as against an average for ordinary market
milk of about 8 cents. While some of the excess may
be due to lack of business methods among producers,
it is chiefly necessitated by the expense of special equip-
ment and methods and by the small scale of production.
It is, of course, true that if certified milk were more
widely used, some elements in its cost—such as super-
vision and distribution—would be cheapened, but the
price must evidently always be decidedly higher than
that of a widely used market milk.

States. On the part of the medical milk commissions the object is
simply to insure, through special encouragement, a clinically satis-
factory class of milk. Over sixty commissions have been established,
though nearly one-third of the number have become inactive. A
general organization exists in the American Association of Medical
Milk Commissions, which has formulated methods and standards for
the production and distribution of certified milk. The producers have
also organized themselves in an Association.

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THE SANITARY FACTORS 69

The general practical weakness of certified milk is
that it demands multifarious precautions to obtain a
result which, as we shall show later, appears to be
obtainable by much simpler and less expensive means.

It must also be remarked that medical milk com-
missions have undertaken, through practical exigency,
a function of supervision which properly pertains to
the public health authorities. While they have served,
and continue to serve, a useful purpose, it is a fact that,
as official control becomes better and better developed,
the value of such unofficial or quasi-official bodies
diminishes toward the vanishing point. It is simply
an evidence of deficient development in public health
protection that in many communities certified milk
is the only milk distinguished as a standardized class
from the bulk of the market product, and that in many
more others there is no milk at all of such definite char-
acterization.

While the highest ideal of clean milk has been at-
tained in certified milk, which is therefore of a high
degree of safety, it must be remembered that absolute
freedom from possibility of infection is not guaranteed
by this ideal. This, as we shall see later, is the general
weakness of the clean milk ideal; no milk, even the
most ‘‘clean,’’ can be called perfectly safe that has not
been pasteurized.

THE GENERAL CLEAN MILK MOVEMENT

Certified milk established a standard which has
been the ideal of the whole clean milk movement.
This movement, originated thus by unofficial endeavor
and taken up by health authorities, sought to attain

70 THE MODERN MILK PROBLEM

its aim primarily by means of inspection, the results
being checked up by bacteriological examinations of
the product. A later development was the tuberculin
test, which will be discussed further on in this chapter.
Many of those who held the clean milk ideal opposed
pasteurization as an undesirable palliative and relied
on the above means for keeping infection out of milk
so that the protective process of pasteurization would —
not be necessary.

In practice this ideal has been well developed by
Richmond, Va., Seattle, Wash., Portand, Ore., and
Montclair, N. J., in which last community vigilant
supervision of the milk supply was begun with a re-
organization of the health department which took
place shortly after the establishment, in the same
State, of the first certified milk supply. That this
reorganization came about as the reaction to a severe
epidemic of typhoid fever is an indication of the kind
of stimulus sometimes necessary to arouse a com-
munity to sanitary reform.

THE SCORE-CARD METHOD OF INSPECTION

The development of dairy inspection and the ten-
dency to standardize its methods led to the devising of
the dairy score card, which deals with itemized condi-
tions each of which is given a mathematical rating, the
total number of points for a perfect dairy being 100.*

* What appears to have been the earliest dairy score card was intro-
duced and used by Dr. Wm. C. Woodward, Health Officer of the Dis-
trict of Columbia, in 1904. Since that time a number of different cards
have been devised and put in use, and the idea has been extended to
the rating of milk plants and stores handling milk and to other purposes.

THE SANITARY FACTORS 71

The most representative of the various cards which
have been devised is that adopted by the United States
Department of Agriculture in concurrence with the
National Association of Dairy Instructors and Investi-
gators. The most important feature of this card is its
separation and weighting of equipment and methods:
to the former a total of 40 points is allotted; to the
latter, 60.

The score-card method has been commonly ac-
cepted as the standard basis of inspection and record-
ing, both for dairies and for milk plants. Dairy scores
have come to be widely taken as indicating, at least
approximately, the quality of milk produced under
the given conditions and are frequently published as
ratings of milk supplies. Score requirements have
been generally incorporated in grading systems and,
in one case at least (New York State), have been au-
thorized as a sole basis of grading. The exact value of
the score card demands, therefore, most careful con-
sideration.

The Dairy Score Card Under Criticism

It is a curious fact that the score card has been so
unconsciously accepted as a sanitary index that little
attention has generally been paid to the question of
the exact relation between dairy scores and bacteria
counts.* Such study as has been devoted to the matter,

* Throughout the following discussion it is assumed that the ordinary
bacteria count, properly performed according to standard methods, is
a fairly accurate criterion of biological cleanliness. Discussion of the
exact merits and present status of the count is beyond our present
scope. See, however, paragraph c, p. 74, and notes on pp. 92, 94.

72 THE MODERN MILK PROBLEM.

however, has shown results highly destructive of pre-
conception. An investigation of the bacterial count
of the milk from 34 commercial dairies and their scores
as determined by three representative cards—namely,
the Cornell card, the United States (‘‘Official’’) card
referred to above, and the New York City card—has
recently been published by the New York State Agri-
cultural Experiment Station, the investigator being
James D. Brew.’ The purpose of this study was to
determine how nearly different cards agreed when the
same conditions were scored simultaneously by the
same person and what relation existed between score
and bacteria count as an index of sanitary quality.
As might be expected, there was found some variation
in the relative positions of the various dairies when
scored simultaneously with all the cards. But the
striking conclusion derived was this:—

The results of the investigation show no correlation whatever
between the quality of the milk so far as it could be determined
by laboratory methods and the score as expressed by any one of
these three cards.

This is so arresting a result that we must quote fur-
ther from the conclusions of the investigator :—

Milk of all grades ranging from the finest quality to the
poorest, is produced in barns which would be excluded on
account of low scores. Ali grades of milk are likewise pro-
duced in the high-scoring barns.

The real explanation for this lack of relationship between
the scores and the bacteria counts cannot be given.as yet
with absolute certainty. The most apparent reason, as
shown by investigations made at this Station, is that a

THE SANITARY FACTORS 73

large number of the items included on the score card have
little or no effect upon the number of bacteria present in the
milk. In other words, too great emphasis is placed upon
unessential factors in all of the score cards studied, with a
consequent lessened emphasis upon the factors which ac-
tually do affect the milk. |

Some may contend that these findings encourage the pro-
duction of milk under filthy conditions. This contention
will be raised only by those who hold the idea that low-
scoring dairies are necessarily unsanitary and filthy. Such
conditions have, however, not been found to hold true in the
region studied because Jow-scoring dairies were found which
vied in cleanliness with the most ideal of the high-scoring
dairies. On the contrary, however, these facts give decided
encouragement to the intelligent dairyman who finds that
he can produce high-grade milk by the simple observation
of the few essential factors of cleanliness and care. This
places him in a position to secure a greater profit from his
business while at the same time he has the moral satisfaction
of knowing that he is selling a high-grade article. Where
the present score cards are used, all dairies, in order to get
credit for Grade A milk,* are forced to an additional expense
and consequently to an increased cost of production. At
the same time a compliance with the score-card requirements
carries with it no guarantee that the quality of milk will be
improved or rendered more safe from the standpoint of
public health.

The fact that high-grade milk can be produced with simple
equipment, likewise gives encouragement to the consumer
who is as much interested in keeping down the cost of pro-
ducing high-grade milk as is the producer.

The above study deals with correlation in a general
and unmathematical sense. A closer criticism of the
* New York State.

74 THE MODERN MILK PROBLEM.

results would require their expression in exact statis-
tical correlation figures. Such have been worked out
from the original data and presented with inferences,
which corroborate and supplement the original ones,
by Dr. J. Arthur Harris.6 Dr. Harris’s analysis, by
means of the statistical figure known as the ‘‘correla-
tion coefficient,’’ leads to the following conclusions :—

a. The correlation between the total scores assigned the
same barns by the same inspector using the three most im-
portant cards is only about three-quarters of its theoretical
maximum value. The correlation between the scores for
methods only is less than half its theoretical value.

b. There is practically no correlation at all between the
scores assigned the barns by dairy inspectors and the bac- |
terial content of the milk which they place upon the market.

c. When correlations as low as those deduced from the
present figures are found between the bacterial counts of
morning and evening samples of milk from the same barns,
it is clear that much remains to be done in the perfection
of the technique of sampling and bacteriological analyses
of milk.

These data show how flimsy is the basis for the common
belief that there is a relation between the score of a dairy and
the quality of the milk produced by it, and how premature
the official sanction for the grading of milk by means of dairy
scores.

The practical significance of such findings and earlier
ones of others,’ taken in connection with the considera-
tions which we shall next review, is that the present
score cards are extremely inefficient instruments of
sanitation. While Mr. Brew does not construe his
results to disprove the value of the score card idea, he

THE SANITARY FACTORS 75

is constrained to say that ‘‘present score cards cannot
be satisfactorily used as means of grading milk accord-
ing to quality.”

Going back for a moment to the origin of the present
score cards, we find that, in the words of other investiga-
tors along a related line (H. A. Harding ”* and others,
also of the New York State Agricultural Experiment
Station) :—

When health officials, failing to find other means of char-
acterizing sanitary milk, undertook to specify the conditions
under which it should be produced they were confronted
by an almost total lack of detailed information upon this
subject. This lack arose from the fact that the available
studies upon milk sanitation were in the nature of general
surveys of the situation. While these general surveys were
a necessary preliminary, they gave little information as to
either the absolute or the relative importance of any given
dairy operation. .

Later these official dairy regulations took the form of score
cards. These cards not only selected certain operations as
important but assigned to each of them a definite numerical
value.

This arbitrary selection of values in the absence of definite
information upon the subject has frequently done injustice
to the dairy business and can be justified only upon the
ground of the urgent need of official action. The importance
of the interests involved demands that the needed informa-
tion shall be furnished as promptly as possible.®

Mr. Brew, also, says that ‘‘there is little hope of de-
signing a score card which will accomplish this purpose
[of grading milk according to quality] until all of the

* Now of the University of Illinois.

76 THE MODERN MILK PROBLEM

factors which are thought to affect the quality of milk
in any way have been carefully studied and the in-
fluence of each determined and accurately measured.
In this way the really important factors can be singled
out and given the proper value on the score card.”

What these important factors are will be considered
in the following section, after which the question of the
feasibility of amending the score card will be taken up
again.

RATIONAL METHODS IN CLEAN MILK
PRODUCTION

The impression which has long been growing upon
acute observers, that the production of clean milk is
not the complicated matter that it has been supposed
to be, is now scientifically confirmed. For a number
of years some highly significant experiments have been
carried on by Harding and others ° * at the New York
State Agricultural Experiment Station on the proposi-
tion that “‘there is great opportunity for economy in
sanitary milk production through the saving of useless
labor.’’? These experiments, conducted with reference
to single dairy conditions and operations, show that
certain of these, commonly thought influential, really
exert little or no influence on the germ content of the
milk. Following are some remarks from this study
(italics inserted) :—

*In actuality these experiments were-antedated by those of Dr.
North which resulted in his system described below (cf. Appendix C),
but it seems logical to introduce them at this point on account of the
general nature of the ideas brought out by them.

THE SANITARY FACTORS 77

In public discussions of clean milk, the certified milk
standard of 10,000 germs per c.c. is ordinarily taken as in-
suring a milk which is above suspicion of uncleanliness. In
obtaining milk which shall be safely below this 10,000 limit,
it is the custom to expend much labor in washing the cows
and in keeping the interior of the barn scrupulously clean. . .
_ Those who have followed recent discussions of germ con-
tent of city milk and particularly those who are familiar
with the extreme precautions which are taken by many of
the producers of certified milk will be struck by the small
germ content which has characterized the milk obtained [by
simple scientific methods] during these experiments . . . the
large number of counts which are under 1,000 germs per
COs sa

This milk was produced under general conditions which ap-
pear to be no better than those surrounding a considerable num-
ber of the ordinary city dairies, conditions which probably |
would not be acceptable to any certified milk commission... .

The important fact which is being .gradually recognized
through these and similar observations is that the production
of a reasonably clean and low-germ-content milk will be a far
simpler and less expensive undertaking when the factors which
really govern tts production are actually understood.

Some of the separate factors are dealt with in the
conclusions as follows :—

The cleanliness of the interior of the stable, within a fairly
wide range, had no measurable effect upon the milk.*

The protection of milk pails from accidental contamination
after they had been thoroughly steamed had a measurable
effect in reducing the germ content of the milk.

* A recent number of the Journal of the American Medical Association
(Sept. 2, 1916, p. 746) has an editorial entitled ‘The relation of stable

air to sanitary milk,” asserting that aérial contamination in milking
is negligible.

78 THE MODERN MILK PROBLEM

When all of the utensils had been carefully steamed, cool-
ing and straining the milk resulted in only a small increase
in germ content even when this was done under what would
ordinarily be considered as rather unfavorable conditions.

By removing some of the misconception which has
grown up as a result of the misplaced emphasis, by both
certified milk rules and score cards, on dozens of minor
details, such findings as those quoted in the foregoing
pages clear the way for the acceptance of simplified
methods of sanitary milk production.

The North System

The idea of rational simplification has taken con-
crete form in the system of sanitary milk production
devised by Dr. Charles E. North, a consulting sani-
tarian of New York City. This system carries to a
logical conclusion the emphasis upon methods as opposed
to equipment; it centers around a few simple requirements
which may be asked of any farmer, and, on the commercial
side, compensates the farmer through a rational scale of
payments. The application of the ideas exemplified by
Dr. North’s practice should, on present showing, revolu-
tionize the practical production of clean milk by mak-
ing it possible for such milk to be profitably produced
by ordinary farmers on ordinary farms without ex-
pensive equipment and at a reasonable cost.

The fundamental factors upon which this system is
based have been simply stated by Dr. North. Eliminat-
ing all non-essentials or matters of secondary impor-
tance and including those only of primary importance
and ‘‘which even alone are sufficient to produce under
the conditions found in ordinary dairies a milk so clean

THE SANITARY FACTORS 79

that it will have with great regularity a bacterial count
of less than 10,000 bacteria per
e.c.,”’ the list is as follows:—

1. Milking with clean, dry
hands, into covered (i. e., small-
mouth) pails from udders free
from loose dirt; *

2. Sterilization of pails, cans,
strainers, etc., with boiling water;

3. Cooling milk by submerging
cans in tanks of spring water or 5,, 4) Tan cae
ice water. MOUTH Minxkine Path

To which are added as measures An important utensil in
of control:— clean milk production.

: By its use the amount
(a) The taking of samples at BS NANA cald

shipping stations for frequent and dirt falling into the

bacterial tests (at least three times _milk at time of milking
i may be redueed by as
Be week) ; much as 90 per cent.

(ibe spayinent, to the pre- tisre are a numberof
ducers, of premiums (10c. or 20c. types of such pails.
per 40-quart can for milk testing Ths one, used by
nel ene shaetoial staaduna farmers working under

elow the bacterial standards es- p, North’s system, is
tablished, 25,000 to 10,000 per provided with a cover
Cey)..° to protect it after

The complete bacterial trans. “*™ization-
formation, in five different localities under Dr. North’s
supervision, of large volumes of milk produced by many

(OCC CTE)

ANU

* It might perhaps be thought that the use of the milking machines
which have been introduced in-some localities would assist in obtaining
a low-germ-content milk. Experience, however, has shown that the
milking machine is apt not to be thoroughly cleaned and sterilized and
may therefore add large numbers of bacteria to the milk. (Ruediger,
Gustav F., Jour. Inf. Dis., vol. XIX, Oct., 1916.)

80 THE MODERN MILK PROBLEM

dairy farms justifies the conclusion that the measures
employed must be fundamental. A strong point of the
system is that the farmer is asked to do only those few
things which it is essential that he do, while other func-
tions are centralized in a well-equipped country milk
plant, which acts as a combined dairy house for all the
farms.* ; }

Where such a plant is established the requirements for
the farmer may be reduced to Nos. 1 and 3, steriliza-

* The division of requirements as to equipment between farmer and
station is shown by Dr. North as follows:—

““Farm
“1, Cows, healthy. 5. Cow feed, no strong flavor.
2. Cows, tuberculin-tested. 6. Cow feed, none unwholesome.
3. Cows, sound udders. 7. Milkers, no contagious dis-
4, Cows, not in calving period. ease.
“Station
“1. Water supply, pure. 9. Dairy-house, apparatus,
2. Dairy-house, superintendent. _ steam.
3. Dairy-house, employees. 10. Dairy-house, apparatus,
4. Dairy-house, white uniforms. power.
5. Dairy-house, room for wash- 11. Dairy-house, apparatus,
ing. washing, sterilizing.
6. Dairy-house, room for steril- 12. Dairy-house, apparatus,
izing. cooling, bottling.
7. Dairy-house, room for cool- 13. Dairy-house, apparatus,
ing, bottling. pails, cans, bottles.
8. Dairy-house, laboratory. 14. Dairy-house, ice, supply

abundant.

“Those requirements relating to the general health of the cow must
always be insisted upon, with the exception of tuberculin-testing.
Clean milk can be produced from any kind of cows whether tuberculin-
tested or not. I believe that tuberculin-testing is necessary only where
milk is to be sold in a raw state.’”’ (‘‘The Market Value of Cleanliness
in Milk Production,’ address delivered at 36th Annual Convention,
N. Y. State Dairymen’s Association, 1912.)

(b)
Pirate 2. Orpinary Datry STABLES IN Wauicw CiLEan MILK
Is PRoDUCED

(a) This is a dairy of fifty cows which consistently produces milk under
10,000 bacteria per cubic centimeter and the milk from which received
the first prize at the New York State Fair in 1915 with a higher score than
ever given to any milk in that exhibition, including even certified milk.
ey of Dr. C. E. North, North Public Health Bureau, New York

GW is

(6) A cow stable in Maryland in which milk is regularly produced with less
than 10,000 bacteria per c.c. This barn is one in which horses are also
stabled, and in which the light is very deficient and the floors of wood.

(Courtesy of Dr. North.)

THE SANITARY FACTORS 81

tion of all utensils being performed at the plant. The
contrast between the simplicity of this plan and the
many requirements for certified milk, or even for good
market milk under the score-card system, is striking.

Clean milk, requiring more pains and being worth
more than dirty milk, deserves a certain premium. The
extra cost under the North system is roughly indicated
by the following figures, from the plant which was es-
tablished at Homer, New York, by the New York
Dairy Demonstrating Company."

Premiums paid to farmers:
For tuberculin-tested cows................ lée. per quart
For “sanitation’’ (milking into covered pails

washed and sterilized at the receiving sta-

tion, and cooling withice).............. VAG, ea
For keeping bacteria count under 10,000

/O) SIRS mar Dt) An 8 ig a LAO ae

IUCN G2 [Weta een SO). Aens ola OC a i an ane le.

(The payment plan also includes premiums for butter fat.)

A typical monthly bill made out to one of the dairy-
men supplying this station is as follows:—

New York Dairy Demonstration Co., Homer, N. Y., to
Mr. Blank, Dr.

1912

Dec. 1 To 4,500 qts. of milk at 444ec............ $191.25
To premium butter fat 3.9% at 2c........ 9.00
To tuberculin test at 3-8c............... 16.87
To bacteria at Yer eae eo 1125

82 THE MODERN MILK PROBLEM

In this bill it is seen that if this dairyman had sold his milk
to a shipping station buying regular market milk for New
York, he would have received $191.25; but this bill shows
that certain premiums are received by the dairyman of
Homer, because he carries his milk to the Homer station.
The fact that his cows were tuberculin-tested increased his
check $16.87; the fact that his milk contained a bacteria
count averaging less than 10,000 for the month brought him
in $11.25. He also received a premium for richness, because
his butter fat was above 3.7 per cent, which is the standard
set by this station.!”

The additional cost of running the station, over and
above that of an ordinary bottling station, was M%c., —
so that the additional cost of supplying a tuberculin-
tested milk with a bacteria count under 30,000 at time
of delivery was one and one-half cents a quart,—an
amount which certainly cannot be considered excessive.*

Certified milk, owing to its requirements, which
are out of reach of the rank and file of farmers, and its
small volume of production, costs on the average 6
cents more than ordinary market milk. But here is
milk of the highest grade, at a moderate cost, requiring
for its production only an ordinary stable and equipment,
healthy cows properly cared for (tuberculin-tested if the
milk is to be sold raw), healthy milkers, and the exercise
of exceedingly simple sanitary precautions.

(For further details the reader is referred to the
fuller account of the North system in Appendix C,
where a list of Dr. North’s publications is also given.)

* If a non-tuberculin-tested but pasteurized clean milk be desired,
the extra cost would be, on this basis, not over one cent. Milk can be
commercially pasteurized for le. or less per quart (see Appendix D).

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THE SANITARY FACTORS 83

Finally, the newer ideas on sanitary milk produc-
tion—the insistence on effective method as opposed to
observance of arbitrary, unessential requirements,—
are steadily making their way into practice. Speaking
of the fact that the conditions which are ordinarily ob-
served by the dairy inspector bear no definite relation
to the sanitary character of the milk itself, Dr. North
says —

The production of ‘‘Grade A Milk” for the New York
City market in several thousand barns of the ordinary type
by the rank and file of dairy farmers, such milk in most cases
conforming with standards for bacteria of 25,000, and even
10,000, is a demonstration of this fact on a gigantic scale.'®

AMENDMENT OF THE DAIRY SCORE. CARD

We may now return to the question whether, in
view of the knowledge now at hand of the really essen-
tial factors in clean milk production, the dairy score
card can be satisfactorily amended.

Efforts have from time to time been made to correct
the inadequacy of score cards by assigning more weight
to methods than to equipment and by assigning a
greater value than previously to certain of the methods.
Kven so, Harris has shown from the study of Brew
which has already been cited that the two cards which
gave 60 per cent to methods differed distinctly more
in estimation of methods than in that of equipment,
and that even when the score for methods alone was
considered there was no distinct correlation with the
bacterial counts. This leads Dr. Harris to remark
that ‘“‘the lower correlation of the values assigned for
methods as compared with those for equipment is

84 THE MODERN MILK PROBLEM

perhaps the most serious criticism to be made of the
score cards.”

The advocates of the score card believe that it can
be adjusted so that it may still be useful as a means
of dairy instruction, of guidance to the inspector or
demonstrator, of education of the dairy farmer, and
even of rating. An invaluable paper dealing with this
question has recently been published by Dr. North."
After discussing the compositions of well-known score
cards, Dr. North takes up the relations of different
items or factors to the actual character of milk as
shown by bacteria counts, concluding with a suggested
new type of card, in which 90 per cent of the score
relates to the three great considerations: milking,
cooling, and sterilizing. A division of items is also made
between primary and secondary equipment and pri-
mary and secondary methods. This suggested card is,
therefore, not merely a revision of present cards, but
represents a radical change in arrangement and em-
phasis. |

Dr. North’s card, while not put forth as insusceptible
of possible modification, undoubtedly approximates in
its arithmetical degrees of emphasis the knowledge ex-
isting to-day on the relative weights of the various
sanitary items. It therefore affords a hopeful affirma-
tive answer to the question as to whether the score
card can be satisfactorily amended. Although con-
taining a large number of items relating to secondary
or non-essential matters, thus negativing the idea of
an exhaustive yet simple card, it will give both inspec-
tor and dairyman a very fair indication of the im-
portance to be attached to the various points in milk

THE SANITARY FACTORS 85

production. The idea of scoring has become so well.
established and its effectiveness as a means of prac-
tical procedure so well proven that the move to put
it on a thoroughly accurate basis is well worth while.
Some such schedule is evidently desirable to prevent
inspection or dairy demonstration from becoming a
matter of the inspector’s personal opinion and to
answer the farmer’s question as to how he can best
attain the demanded result of low bacteria counts.
Even where sufficient bacteriological testing is not
available, such a card will furnish a valuable guide to
dairy inspection and operation, although the accurate
grading of milks requires such testing. A practical
application of a card of this new type in connection
with bacteria counts would readily determine its ap-
plicability and its degree of correlation with the bac-
terial results.

It must be borne in mind that the score card, useful
as it may be, can give only approximate or probable
indications. The ultimate criterion is the laboratory
test. How, for example, shall we infer that a dairy-
man actually does always use the sterilized small-
mouth pail or that he milks and cools properly, except
by results as shown by regularly favorable tests? His
statement may or may not be dependable, but the test
is a telltale.* The logical mode of control is the valua-

* It is not here meant that the bacteriological laboratory can indicate
the exact history of a milk or absolutely certify that the dairy methods
are correct. Bacteria counts are subject to variations that are impossible
to interpret without a knowledge of circumstances, and can only be
taken as general summings-up. For this reason inspection can never

be dispensed with, but must be considered as complementary to the
laboratory.

86 THE MODERN MILK PROBLEM

tion of milks according to laboratory tests, comple-
mented by instruction of the dairyman in the simple
methods by which he can keep his count down. The
use of a rational score card would make such instruction
definite and accurate, but his attention should be di-
rected through the rating according to his equipment
and stated methods to the desired final bacterial result.

While the part that has been played by the dairy
score card in the past in stimulating milk supervision
is not to be underrated, it must be said that the forms
of the card accepted hitherto represent a phase of
development in which practical exigency required ac-
tion on assumptions now seen to be faulty. Now that
such assumptions may be corrected a reasonably ac-
curate score card may be formulated which will be of
decided service. With the use of such a card there are
probably few farmers who would fail to practice the
indicated methods if the sale of their milk depended
upon results.*

INFANT WELFARE STATIONS

Contemporaneous with the clean milk movement was
the development of infants’ milk depots, or milk sta-
tions, whose initial object was the dispensing, free or
at cost, of a high-grade milk for infant feeding. The
idea was the result of the conviction that the market
milk of large cities was unfit for infant feeding, yet
that the poor must have good milk at a low cost.

* No discussion can be entered into here regarding score cards for
milk plants. Similar considerations, however, apply to such plants
in that they should be judged, not merely by equipment and visible
operation, but chiefly by their bacterial efficiency.

THE SANITARY FACTORS __ 87

The first institution of this kind in the United States
was established at the Eastern Dispensary in New
York, by Dr. Henry Koplik, in 1889. The establish-
ment of the important Straus milk depots was begun,
in New York, in 1893, and have since had a great in-
fluence in this field of endeavor. The Straus depots
dispense milk of the highest grade, modified and pas-
teurized at the depot. Similar work is also carried on
by the New York Milk Committee, the Health De-
partment, and other organizations in New York City.
The first municipal milk station was established in
Rochester, N. Y., in 1897. Infants’ milk depots have
been established, under either unofficial or municipal
control, in all the larger cities of the United States and
in many of the smaller ones.

Curiously enough, what was originally incidental to
the infants’ milk depot has become the chief function
of the fully developed infant welfare station,—con- -
sultation and advice in the general hygiene of the in-
fant. When the milk was modified it was found neces-
sary to bring the baby to the depot for examination
and prescription of the formula; hence the consulta-
tion class. The distribution of milk has now become
subordinate to the encouragement of maternal feeding
and of the general hygiene of the child; and even when
artificial feeding is necessary, instruction in the methods
of feeding and, in many cases, of home modification of
milk is as essential as the milk itself. Dr. S. Josephine
Baker of the New York City Department of Health
has given the opinion that ‘‘the solution of the problem
of infant mortality is 20 per cent pure milk and 80 per
cent training of the. mothers.’’ Prenatal instruction,

88 THE MODERN MILK PROBLEM

consultation, and the encouragement of breast-feeding
are now the chief lines of the best milk-station work.
In short, the doctor and the nurse, rather than milk
supply (important as this is), are the chief force of the
infant welfare station.

Milk stations have served, and do serve, an impor-
tant purpose in providing at cost or less a special grade
of milk for infant feeding. Countless babies have
thriven through the efforts of these agencies when safe
market milk could not be obtained except at a pro-
hibitive cost, and when a poor grade of ‘‘loose”’ or
store milk swarming with bacteria would often have
been used. Such distribution of milk is not, however,
a cure-all. Even in the districts where milk stations
exist, many of the families most in need of good milk
will rely on the ordinary market supplies. There are,
moreover, the families of the middle classes, which
may not get much better milk than the tenements, and
which cannot afford certified milk, but which would
not readily be drawn to milk stations even were they
generally available.

One of the chief objects of adequate milk control is to
bring into the general market, at a moderate price, a
recognized grade of milk suitable for infant feeding. Such
milk could be sold both from wagons and from strictly
supervised stores,—in the latter case, perhaps, at a
lower price. The accomplishment of this will be the
complete attainment of a general object which is now
attained only partly—though in regard to the most
pressing need—through milk stations. The latter, on
the other hand, will be freer to exercise the larger, more
important educational function of the modern infant

THE SANITARY FACTORS 89

welfare station. With reliable infants’ milk well recog-
nized in the market, station distribution and home
pasteurization would be largely unnecessary; the en-
ergies of the station nurses would then be concen-
trated, so far as milk is concerned, on teaching the home
care and preparation of milk, while station prepara-
tion would still be possible if and where deemed neces-
sary. It must be said, however, that at the present
time milk stations are often the only thing that
stands between the baby and the dangers of ordinary
milk.

LABORATORY TESTS AND STANDARDS
I. CHEMICAL

The earliest milk standards adopted were chemical.
Such standards relate to the general composition of
milk, and inasmuch as this in nature varies very con-
siderably, there has been no exact agreement in the
standards set by various authorities. The United
States official standard may be taken as representative:
this requires 12 per cent total solids, 8.5 per cent solids
not fat, and 3.25 per cent fat. A standard of 9.25 per
cent total solids is prescribed for skimmed milk. Stand-
ards set by the various States and cities * vary some-
what from the above and may even establish separate
figures for winter and for summer. It must not be
thought that milk which is barely ‘‘standard”’ accord-
ing to these figures is the ideal; they merely represent

*The U.S. Department of Agriculture has recently issued a sum-
mary of these.

90 THE MODERN MILK PROBLEM

the minimum that the law allows.* Of the special
figures, that for fat is subject to greater variation; the
other solids are more constant. The fat percentage may
be readily determined by the simple Babcock method.

It is important to note that chemical composition. ts
not a matter of sanitary quality but of nutriment. Nor
is it the only factor in nutrition, for the character of
the milk as to digestibility and minute composition,
also enters into the question. Thus milk from Holstein
cows, though thinner in fat than that from Jerseys and
Guernseys, is believed to be more digestible because
the fat globules are smaller; hence it may actually yield
readier nutriment, and physicians often give it the
preference for infant feeding.

That the proportion of fats and other components
is not a sanitary but rather an economic question, does
not, however, justify neglecting the consideration of
chemical composition in attempting to solve the milk
problem as a whole. It is certainly important to the
consumer’s pocketbook if not to his health that he get
his money’s worth in nutriment—that he pay accord-
ing to the foodstuffs he is actually getting. Manufac-
turers of butter, cheese, and other milk products cus-
tomarily recognize this principle when they buy milk
and cream on a butter-fat basis. With market milk,
as with many other food products, it is simply a ques-
tion of right labelling, to which we shall revert in a
later chapter.

Objection has been raised against legal standards

* Distinction must be made between naturally substandard milk and
milk adulterated by watering or skimming. Much heavier penalties
are usually, and justly, prescribed for adulteration.

THE SANITARY FACTORS 91

for composition, largely on account of the natural
variations in milk from individual cows. (See Fig. 1,
Chapter I.) Such cows not infrequently give milk
which fails to comply with official minima. Small
herds may sometimes give such milk. The objection
has been strengthened by the failure of authorities
to agree on any precise standard. Sometimes the
standards have been altered in an attempt at adjust-
ment. In New York State, for example, the dairy
farmers came to produce so largely with cows bred for
quantity but not for richness that the Legislature
lowered the total solids requirement from 12 to 11.5
per cent. Dealers may have to mix milks and creams
so as to meet a standard to which all the milk bought
by them does not attain. The tendency, especially in
the case of the large supplies, is to bring all milks down
to a level just above the legal minimum. Where the
producer has a rich milk there is temptation to skim, or
even to water when the authorities are not vigilant.
It is obvious that such a levelling-down of milks is an
artificially induced condition which operates to drive
the richer milks from the retail market. This makes it
more difficult for the consumer who desires the richer
kinds to obtain them.

In view of such considerations it has been proposed
to abolish the legal standard and permit milks to be
sold on their merits. This was suggested as long ago
as 1907, by Mr. P. M. Harwood, Chief of the Massa-
chusetts Dairy Bureau, in a paper entitled ‘‘Has the
milk standard outlived its usefulness?” 1* The com-
mission on Milk Standards of the New York Milk
Committee has now suggested the regulation of market

92 THE MODERN MILK PROBLEM

milk on the basis of guaranteed percentage composition,
as follows:— |

1. Sellers of milk should be permitted choice of one of
two systems in handling market milk. Milk can be sold,
first, under the regular standard, or, second, under a guaran-
teed statement of composition.

2. Any normal milk may be sold if its per cent of fat is
stated. In case the per cent of fat is not stated, the sale will
be regarded as a violation unless the milk contains at least
3.25 per cent of milk fat.

3. As a further protection to consumers, it is desirable
that when the guaranty system is used there be also a mini-
mum guaranty of milk solids not fat of not less than 8.5
per cent.

4. Dealers electing to sell milk under the guaranty system
should be required to state conspicuously the guaranty on
all containers in which such milk is handled by the dealer
or delivered to the consumer.

5. The sale of milk on a guaranty system should be by
special permission obtained from some proper local au-
thority.“

The application of this idea of fat markings will be
reverted to in Chapter V.

IT. BACTERIOLOGICAL

The total count of bacteria per cubic centimeter * has
commonly been accepted as the most satisfactory single
index of the sanitary quality of milk. This figure
represents in sum the bacterial content resulting from

* Attention has recently been called by Robert S. Breed (Science,
Nov. 24, 1916) to the fact that the customary form of expression—

number of ‘‘bacteria per cubic centimeter’’—is incorrect inasmuch as
“these counts are probably counts of groups of bacteria rather than of

Puate 4. (a) BactTerta PLATES
Hizh- and low-bacteria milks. The spots are bacterial colonies each of which
has developed, in the jelly-like medium, from a bacterium or group of
bacteria in a minute amount of the milk. Bacteria ‘“‘counts’’ indicate the
numbers of colonies developing from precisely measured quantities of
milk, reduced to a basis of ‘‘ bacteria per cubic centimeter.’’ (Courtesy of
the New York Milk Committee and Dr. Chas. E. North.)

COOD FAIR EDIVIT BAD

(6) Dirt Tusts

Dirt strained out of four kinds of milk by use of small cotton disks. The
dirt is mostly manure and contains great numbers of bacteria. Such
manure may contain the germs of bovine tuberculosis. This is a ready
practical method of demonstrating the results of dirty or careless milking,
though it cannot take the place of the far more searching tests of bac-
teriology. (Bull. 361, U. S. Dept. of Agriculture.) é

THE SANITARY FACTORS 93

contamination and from later development of the con-
taminating bacteria. The total count does not, how-
ever, give any information as to the kind of bacteria
present. Pathogenic organisms are not detected. Nor
_is it possible, by this test alone, to determine how far
the count is due to contamination and how far to mul-
tiplication of the bacteria through insufficient refrigera-
tion. The count depends, as a rule, far more on such
multiplication than on the initial contamination. Pas-
teurization, moreover, destroys the value of the total
count as an indicator of the previous state of the milk.
The question may be asked, what means we have of
determining the presence of contaminating matter or
of disease germs in milk. The routine detection of
specific disease germs in milk is impracticable because
of difficulties of bacteriological technique, and their
presence, even if detected, would not be known until
after the milk had been distributed and consumed.
The estimation of dirt or filth contamination is, how-
ever, feasible. The tests for this purpose will be dis-
cussed in the following section.

Notwithstanding what has just been said, the total
count, taken as a general index of contamination plus

individual bacteria and ... are probably always lower than they
should be because of the fact that not all bacteria will grow on nutrient
agar at the incubation temperature used.’”’ While this qualification is
well recognized by bacteriologists, there is danger of its being neglected
even by them. Microscopical studies are cited by Mr. Breed to indicate
that the actual numbers of (living?) bacteria in market milk are from
one and a half to twenty-five or more times the number of colonies
developing, depending on the kinds present. Until, however, some
other form of statement is adopted, the number of ‘“‘bacteria per ¢.c.,”
i. e., of plate colonies, remains the practical basis of comparison of the
general bacterial character of different samples of milk.

94 THE MODERN MILK PROBLEM

bacterial fermentation or decomposition, has an ac-
cepted value together with the merit of simplicity in
routine milk examination.*

Standards + for total count of bacterra have been
adopted by many municipalities; in fact such a stand-
ard—or rather, maximum for market milk—has been
considered the necessary basis for administrative use
of the counts. The first bacteriological standard in
the United States was adopted by the New York City
Board of Health, which in 1900 set a limit of 1,000,000
bacteria per cubic centimeter, which, however, it was
found at that time impossible to enforce. Boston
adopted in 1905 a legal limit of 500,000, the figure
which is still its standard for all market milk. The
United States Public Health Service has ascertained
the limits which have been established by some 150
cities of 10,000 population or over. These range from

* An important study of the technique of the bacteriological deter-
mination of the total count, based on a co-operative test by four of the
large laboratories in New York City, has recently been published.
(Conn, H. W., ‘‘Standards for determining the purity of milk: the limit
of error in bacteriological milk analyses,’’ Reprint 295 from Public
Health Reports, Aug. 13, 1915.)

This paper finds defects in technique under present standard methods
but concludes that these methods are sufficiently accurate to warrant
the grades recommended by the Commission on Milk Standards (Ap-
pendix B). In routine bacteriological milk analyses the Standard
Methods of the American Public Health Association, as amended from
time to time should be exactly followed. A new report by the Com-
mittee on these methods was presented at the 1916 meeting of the
Association and a revised edition of the Methods has been published.

} This use of the term “‘standard”’ is unfortunate in that it implies
an average acceptable quality if not something better. Exactly stand-
ard milk would, of course, be barely within the limit of the law and
hence of the poorest salable quality. ‘Legal limit” is a better
term.

THE SANITARY FACTORS 95 —

100,000 to 500,000 for market milk in general, but a
number have different requirements for raw and for
pasteurized milk and, where grading has been adopted,
for more than single grades of these. Some cities have
established separate standards for summer and winter,
on the principle that lower counts can be obtained in
the colder months.

Marked improvements have been brought about
through bacterial standards even where rigid enforce-
ment has not been obtained. In the large cities the
number of bacteria in many supplies in the summer
months has been so great that their reduction to below
the standard was not to be accomplished at a stroke.
In the smaller places the low germ-content has been
more attainable. The town of Montclair, N. J., for
instance, which has for years followed the clean milk
ideal, has succeeded by vigorous measures in obtaining
milk supplies of which 85 per cent of the samples run
below 100,000 bacteria per cubic centimeter.

For example of bacterial limits for different grades
of milk, see the classification of milk, Appendix B.

It is worthy of note that the Commission on Milk
Standards appointed by the New York Milk Committee
gave special consideration to bacterial standards and,
with regard to its recommendations, reported :—

The Commission believes that the adoption and enforce-
ment of these bacterial standards will be more effective than
any other one thing in improving the sanitary character of
public milk supplies. The enforcement of these standards
can be carried out only by the regular and frequent labora-
tory examinations of milks for the numbers of bacteria they
may contain.’

96 THE MODERN MILK PROBLEM.

Microscopic Examination

Microscopic examination of milk for the determina-
tion of pus and bacteria has been coming in recent years
somewhat rapidly into use, but is not fully established
as a standard method of estimating numbers of bac-
teria. It is now under consideration by a special sub-
committee of the National Commission on Milk Stand-
ards and will be reported upon later.* The following
comment, from the paper by Dr. Conn already re-
ferred to, is meanwhile of interest :—

The direct microscopical examination of milk smears by
the Breed method will classify raw milk into grades A, B,
and C with about the same accuracy and much more quickly
than the plate method of bacteriological analysis will do.
It is of no use in the study of pasteurized milk, however,
since it discloses dead as well as living bacteria, no method of
distinguishing between them having yet been perfected.
It might be of value in telling whether such milk had be-
come old before it was pasteurized, since such would show
large numbers of dead bacteria by the microscopic method,
though it might show small numbers by the plate method.

The direct microscopical method of bacteriological analy-
sis... may be of great aid to the large dealer to enable
him to determine promptly whether he is purchasing milk
of A, B, or C grade. The possibility of quick results and

* It is, however, discussed in a recent provisional report of the Com-
mittee on Standard Methods of Bacteriological Analysis of Milk, of
the Laboratory Section of the American Public Health Association
(Am. Jour. Public Health, Dec., 1916).. While the method is not as
yet recommended by the Committee as a standard method of estimat-
ing numbers of bacteria, its value in rapidly dividing raw milk into
grades and in detecting large numbers of streptococci is recognized.

THE SANITARY FACTORS 97

ease of making the smears at the dairy or shipping station,
subsequently sending them to the laboratory for microscopic
examination, renders the method especially applicable at the
dairy end of the line.”

III. CONTAMINATION TESTS

We have already referred to the value of being able
to determine the presence of dirt and filth, particularly
manural pollution, in milk. Concerning the present
status of tests for such contamination we cannot do
better than to quote at some length from a paper of
Dr. John Weinzirl:—

This problem [of eliminating dirt from milk] resolves
itself into two distinct phases: first, the problem of finding
the most suitable method of detecting dirt in milk; secondly,
bringing the evidence home to the dairyman and making him
respond to the new demands. Let us first consider the
methods of detecting filth in milk.

Three methods are in use more or less commonly, viz.:
(1) Determining the total number of bacteria present in
the milk, assuming this to be an index of its cleanliness, and
fixing a line beyond which the count may not go, otherwise
sale is forbidden. (2) Determining the number of B. coli
present and setting a similar standard. (3) Determining
visible dirt, and again making a standard for purity. To
these the writer now desires to add another, (4) Determining
B. sporogenes and creating a standard of purity.

It is well known that the total count depends upon other
factors as well as upon dirt, for time and temperature may
cause a high count in an otherwise clean milk; doubtless
such milk should be barred from sale, but it does not reach
the real question, which is, the amount of dirt present in it.
Again, if the milk is pasteurized, the total count fails utterly .

98 THE MODERN MILK PROBLEM

to indicate dirt.* Since the use of pasteurized milk is rapidly
increasing, the ultimate failure of the total count is obvious.
As to determining the number of B. coli and using the data
to indicate manure, this method will fail for the same reasons
that the total count must fail. In addition, the determina-
tion of B. coli requires rather too elaborate a technique to
make it generally available. Up to the present time the
method appears to have gained little favor. When the test
is made sufficiently early and before the milk is pasteurized
it has been shown f that the method is an excellent one for
the purpose. The dairy in which the method was applied
received its supply from a comparatively limited area and
from only twenty dairymen. Special endeavors were made
to produce only superior milk.

At present the determination of visible dirt appears to be
in greatest favor and has proven itself a valuable asset to the
sanitarian in checking up supplies. The ease with which
the determination is made and the tell-tale nature of the
evidence presented speak highly in its favor. The Wizard
Sediment Tester [ has proved very satisfactory in our hands.
Indeed the method leaves little to be desired so long as the
producer does not become wise and adopt clarification
methods such as heavier strainers or centrifugation. Ob-
viously the method will fail as soon as better clarification
methods are adopted. Such clarification cannot lessen the
number of manurial bacteria in milk or the soluble portion
of the manure, but rather aids in their better distribution.
From these considerations it is quite clear that we have no
method for determining manurial pollution which does not
fail at some critical point. The total count and B. coli deter-
minations fail in milk that has been held for some time or has

* Except in that samples taken before pasteurization indicate general
sanitary quality.—J.S. M.

+ Weinzirl, John, and Felder, H. A., unpublished data.
t The Creamery Package Mfg. Co., Chicago, II.

THE SANITARY FACTORS 99

been pasteurized, and the sediment test fails af er clarifica-
tion. :

To overcome these difficulties is the purpose of the B.
sporogenes determination as an indicator of manurial pollu-
tion as proposed by Weinzirl and Veldee.* B. sporogenes
is an intestinal organism, and hence indicates manure when
found in milk; it does not multiply at ordinary temperature
at which milk is held, and so it truly indicates the pollution
even of milks kept for varying periods of time and at varying
temperatures; it produces spores but these are not killed
by pasteurization; and, finally, the organism can be easily
and quickly determined.”

Thus far most of the work of health authorities on
the dirt question has been concerned with visible dirt
as disclosed by the sediment tester.t (See Plate 4.)
The method is simple and is effective for demonstra-
tional purposes. Its weakness, on the other hand, has
been pointed out above. The B. sporogenes test is
already known in water bacteriology, and its develop-
ment in relation to milk is to be viewed with interest.

Dirt, or Sediment, Tests and Bacteria Counts——To
avoid possible confusion it is well to note that, as im-
plied by Weinzirl and shown by recent experiments,” t
the quantity of sediment or visible dirt caught on the
disk by the straining tests is no criterion of the bacteria
count of the milk. High-bacteria milks may by these

* Am. Jour. Public Health, 1915, Vol. V, p. 862.

} There are several varieties of these. The New York City Health
Department requires the test to be applied in all creameries shipping
milk to the city, and has established a standard for use in determining
whether milk contains excessive dirt. (Regulations, March 30, 1915.)

t In these experiments (in the U.S. Department of Agriculture) the
Lorenz apparatus was found the most convenient and practical.

100 THE MODERN MILK PROBLEM

tests be shown ‘‘good,” and low-bacteria milks ‘‘bad.”’
This may readily be understood, for the bacterial flora
depends not merely upon the amount of dirt con-
tamination but also—and much more largely—upon
the kind of contamination, the age of the milk, and the
temperature at which it has been kept. Hence the
dirt tests can throw light on but one item in milk
sanitation—viz., the amount of sediment in unstrained
milk (previous straining or clarification practically
destroying the value of the tests)—and are far from
being a general criterion of the conditions of production
and handling.

THE TUBERCULIN TEST

One of the noteworthy discoveries of modern sani-
tary science is that bovine tuberculosis may be trans-
mitted to human beings through the medium of cow’s
milk.* At the same time a test—namely, the tuber-
culin test j—has been perfected by which tuberculosis
can be determined in that important class of cows which
are infected yet show no physical symptoms. This
adds to veterinary examination an exceedingly valu-
able diagnostic agent.

The tuberculin test appears to have been first re-
quired, in addition to physical examination, by the

* This matter, with some reference to the amount of human tuber-
culosis of bovine origin, was touched upon in Chapter I.

{ The test consists essentially in the hypodermic injection of an
emulsion of killed bovine tubercle bacilli (tuberculin). Animals in-
fected with tuberculosis react by a marked rise in temperature. This
reaction has been accepted in the courts, as well as in veterinary medi-
cine, as a thoroughly ‘reliable test of a very high eco of accuracy
when competently applied.

THE SANITARY FACTORS 101

Board of Health of Montclair, N. J., in 1907, which
specified that the milk from reacting cows should be
excluded from the local milk supply. The test was
opposed by a large dairy company and the case was
contested through the courts until a complete victory
was won by the Board of Health. The’ decision has
been supported in other cases, so that the legal status
of the test is now secure.

The amount of tuberculosis among cattle varies. Some
idea of the relative numbers of reactors which may be
found by the tuberculin test may be had from the ex-
perience of Montclair when its ordinance went into
effect in 1907 :—

Of the New Jersey cows that had not been previously
tested, 25 per cent reacted. Many of the figures that are
available on the subject . . . relate to suspected or picked
herds, whereas the percentage of reactions above mentioned
represents conditions of herds taken practically at random
over a considerable area, with the exceptions that they had
more than the average veterinary inspection, and that they
had been stabled under good conditions.”?

In individual herds as many as a half or even three-
quarters of the animals may react. The suppression
of bovine tuberculosis by scientific methods is, apart
from milk sanitation, an important object of animal
husbandry.

In the elimination of tuberculosis from dairy herds
a serious economic question arises. Drastic measures
will result in a great diminution in the herds, a large
financial loss to the dairymen, and a corresponding
lessening in the milk supply with a resultant increase

102 THE MODERN MILK PROBLEM

in the cost of the product. Elimination has, on the
other hand, been encouraged in some States by legal
reimbursement of the owner for a large part of the loss
due to the slaughter of tuberculous cattle. However
the loss may be met, it is a real one and means, directly
or indirectly, a higher cost of the milk. It is natural to
expect that this increase in cost will be reflected in the
retail price, perhaps to the extent of a half-cent a quart,
though it may be partly met through payments out of
public funds to the dairyman in consideration of his
loss through slaughtered cattle.

State regulation for the official testing and certifica-
tion or condemnation of cattle obtains in certain States.
It does not, however, even where adequate, advantage
neighboring States, but tends to make them, unless
their own or Federal regulation intervene, a dumping
ground for condemned animals. Fraud, too, is possible
in that a positive tuberculin reaction can be prevented
by covertly injecting the animals with tuberculin shortly
before test and thus passing off such ‘“‘plugged”’ cattle
as sound.

If milk is to be consumed raw, it can be adequately
protected from bovine tuberculosis only by requiring
the tuberculin test as well as the physical examination
of cows. But fortunately, as will be shown directly,
there is a practical alternative in the process of pas-
teurization, which, moreover, saves the economic value
of the cattle.

PASTEURIZATION

Thus far we have considered measures developed
under the clean milk ideal; we now take up a remedy

THE SANITARY FACTORS 103

which, without dispensing from other precautions,
cancels dangers which, practically, cannot be other-
wise dealt with.

In a general way the dangers of raw milk have long
been recognized. The European domestic custom for
centuries has been to heat milk before use,—the result of
the experience that uncooked milk, like uncooked meat,
was dangerous. ‘This is still to a great extent the cus-
tom, although since the time of Pasteur his method of
heating milk only to a temperature sufficient to destroy
the great majority of the germs present has been looked
upon with increasing favor, principally because in this
way the ‘‘cooked”’ flavor of boiled milk may be avoided.
But in the United States that tradition did not hold,
and the consumption of raw milk has been the rule:
it has required scientific propaganda and official ac-
tion to bring pasteurization up to its present level of
favor.

The term ‘‘pasteurization” has been used in a
variety of meanings more or less approaching the
original method of Pasteur. Through inaccuracy the
process has not infrequently been misrepresented. It
is essential that an exact scientific definition be recog-
nized. Such a definition, applied to milk, has been
framed by the Commission on Milk Standards *:—

That pasteurization of milk should be between the limits
of 140° F. and 155° F. At 140° F. the minimum exposure
should be 20 minutes. For every degree above 140° F. the

* The Commission on Milk Standards of the New York Milk Com-
mittee is, in its personnel and scope, virtually a national commission,
and is often so called. It will be referred to in these pages by its short
title.

104 THE MODERN MILK PROBLEM >

FAHRENHEIT

49 | v) Mins

TEMPERATURE

Fic. 12. TimE AND TEMPERATURE FOR
MILK PASTEURIZATION

It is to be noted that the pathogenic bac-
teria are killed at temperatures and
times below those at which the physical
and chemical constituents of the milk
are affected. The neutral zone between
these two sets of phenomena permits
considerable latitude in the choice of the
pasteurization conditions. (Report of
Commission on Milk Standards, N. Y.
Milk Committee, 1913.)

time may be reduced
by 1 minute. In no

| case should the ex-
| posure be for less than

5 minutes.

In order to allow a
margin of safety under
commercial conditions
the commission rec-
ommends that the
minimum temperature
during the period of
holding should be
made 145° F. and the
holding time 30 min-
utes. Pasteurizing in
bulk when. properly
carried out has proven
satisfactory, but pas-
teurization in the final
container is preferable.

It is the sense of the
commission that pas-
teurization in the final
container should be
encouraged.”

The effect of prop-
er pasteurization, as
above defined, is to
kill the vast majority

of the bacteria in milk without actually sterilizing it.
Among the organisms destroyed are those of typhoid
fever, diphtheria, scarlet fever, tuberculosis, septic sore

THE SANITARY FACTORS 105

throat—in fact, of all the common milk-borne diseases.
Moreover, through the destruction of miscellaneous bac-
teria and their toxins the milk is rendered a safer—often
far safer—food for infants, young children, and invalids,
with the result of a corresponding reduction in gastro-
intestinal disorders and an increase in vital resistance
to other diseases. A number of authorities might be
cited on this point. Dr. W. H. Park concluded from
researches which have been quoted in Chapter I that
“mother’s milk is the best milk for a baby and pas-
teurized milk is the next best.”

Proper pasteurization does not affect the flavor, odor,
appearance, or cream line of milk, materially alter its
chemical components, nor diminish its digestibility or
nutritiousness.

At the same time, the process is not a cure-all for milk
evils and, as Rosenau remarks, should never be used as a
redemption process for bad milk. Its proper use is, in
the phrase of 8. H. Ayers, not to try to make a dirty
milk a clean milk, but to make a clean milk a safe milk.

From the facts cited the following conclusions are
to be drawn :—

Proper pasteurization of milk supplies under official
supervision (with safeguard of the pasteurized product)
vs the only absolute insurance against milk-borne infection.

Through the general bacterial reduction effected it renders
the milk a safer—often a far safer—food for infant feeding.

While rt should not be taken to dispense from necessary
supervision of supplies both before and after the process,
ut affords an insurance unattainable by inspection, medi-
cal and veterinary examinations, and laboratory analysis
alone, however searching these may be.

106 THE MODERN MILK PROBLEM

RAW OR PASTEURIZED MILK
WHICH IS THE SAFER?

You insure your life against the time when accident
or sickness may occur.

You buy safe milk against the time when other milk
may spread disease.

Because you have been fortunate in keeping well
does not mean that you do not need safe milk
right now.

One man delivered milk for 30 years and his customers
were safe until an epidemic of typhoid fever was.
traced to his supply and 295 of his customers
were made sick and 10 died. He delivered raw
milk.

An epidemic of disease has never been traced to
Perfectly Pasteurized Milk.

’s Milk is Perfectly Pasteurized and is
Pure-—Clean—Safe.

The cheapest form of life insurance for yourself and
family ————’s Milk.

’s method of Perfect Pasteurization does not
change the taste of milk, nor alter its digesti-
bility. It makes the milk Safe.

Safeguard the health of your family by using

———’S PERFECTLY PASTEURIZED MILK

“Tt costs you no more than unsafe milk”

A postal will bring one of our representatives to
explain our methods and show you our plant in
pictures.

—

Visit Our Milk Depots
Order of our drivers, write or telephone

Fic. 13. CoMMERCIAL APPEAL ON SANITARY GROUNDS

This newspaper advertisement emphasizing the value of pas-
teurization has a publicity power not attained by many
health bulletins.

In 1907, Health Commissioner Lederle of New York
City took the position that practically universal pas-
teurization must be insisted upon. In spite of con-
servatism and prejudice, expert sentiment has steadily
grown to favor this view. The consensus of the best

THE SANITARY FACTORS 107

opinion is reflected by the Commission on Milk Stand-
ards, which has made the following unanimous recom-
mendation :—

Pasteurization is necessary for all milk at all times, ex-
cepting Grade A, raw milk. The majority of the commis-
sioners voted in favor of the pasteurization of all milk, in-
cluding Grade A, raw milk.” *

In view of the present status of the matter, it is
scarcely necessary here to go into the details of the
ease for pasteurization, which have been abundantly
set down elsewhere,”* nor to dwell on objections which
have been disproved.

ALL ‘““————_””? MILK
is raised within 40 miles of the city, and does not
leave our own care from the farm to your door.

It is fresh, normal milk, not ‘‘ pasteurized ” scalded,
or heated in any way.

Cattle, barns, food and water constantly inspected
by our own veterinary, and milk daily examined and
tested by Professor of —————.

It is a daily milk—Inspected, Bottled, Shipped,
Delivered arid Guaranteed daily.

Fic. 14. CommerctiaL APPEAL ON SANITARY GROUNDS

This firm, a rival of the foregoing, argues on a decidedly
different basis. This milk might be guaranteed clean and
fresh, but not necessarily free from infection, as was shown
by an extensive epidemic of septic sore throat traced to
the supply. The firm afterwards adopted pasteurization.

The matter of pasteurization is now one, not of theoretical
debate, but of practical application.
Objections on dietetic grounds have been based upon

* The Commission’s recommendations as to grades (see Appendix B)
make pasteurization of Grade A milk optional.

108 THE MODERN MILK PROBLEM

unproved assumptions and unsatisfactory evidence.
The recent reported increase of cases of mild scurvy
or similar nutritional disease among infants in New
York City as a result of the greater use of pasteurized
milk cannot, even if fully substantiated, justly be used
as an argument against the process, the remedy being
merely a little orange juice, or other antiscorbutic, in the
diet of the infant. To give over a great means of safety
on account of a minor disadvantage would be absurd.
Special medical requirements may, if necessary, be met
by permitting the sale of the highest grade of raw
milk, as is recommended by the Commission on Milk
Standards.

The pendulum of medical opinion appears now to be
swinging in the direction of favoring even boiled milk.
The scalding of milk as a domestic precaution previous
to infant feeding and other uses has long been a com-
mon practice in certain European countries, and the
American prejudice against the practice seems now to
be dying out in the absence of dependable evidence
regarding scurvy and rickets supposedly caused by
heated milk.”

Other objections deal, not with the scientific process,
but with possible abuses in its application; such objec-
tions should properly be taken merely as cautions.
Thus, it is true that pasteurization and repasteuriza-
tion may be used by unscrupulous dealers as a cloak
for bad milk, that milk may be sold for pasteurized
which has not been adequately treated, that the adop-
tion of pasteurization ordinances does not necessarily
mean their proper enforcement. But these are all
simply questions of supervision. It is, of course, neces-

Puate 5. (a) Homer PASTEURIZER

When reliable pasteurized milk cannot be obtained, milk may be pasteurized
in the home, for infant-feeding, by means of this apparatus, or even with
ordinary kitchen utensils (see p. 109). A still readier means of safety is
simply to heat the milk to boiling. Effective home heating ensures that
no infection enter the household by medium of milk, and illustrates private
prophylaxis as opposed to public prevention. The latter, however, affords
general protection, while the private process, even when adopted, may be
inefficiently performed. (Courtesy of the New York Milk Committee and
Dr. Chas. E. North.)

(b) RESULTS OF CLARIFICATION
The two bottles on the left show sediment and slime removed frem milk of
cows with normal udders, by the clarifier. The two bottles on the right
show sediment and slime removed by the clarifier from the milk of two
cows with sore udders, which caused a septic sore throat outbreak of
669 cases, with 14 deaths. (Courtesy of the New York Milk Committee
and Dr. Chas. E. North.)

THE SANITARY FACTORS 109

sary not only to establish the proper definition of pas-
teurization but also to exercise adequate control of the
commercial process * and supervision of the product
both before and after, and this will require more ex-
tensive work than in the case of raw milk supplies.
Such is the sum and substance of the opposition, once
loud, now dying away, from uncompromising raw-milk
advocates.

Methods of Pasteurization

Milk may be pasteurized in the home { or commer-
cially. The latter way, under adequate supervision,
is the more effective and economical. Various types of
machinery for commercial pasteurization have been
devised, of varying degrees of efficiency.”2 What is
called the ‘‘flash”’ method, by which the milk is kept
heated for perhaps two minutes and then rapidly
cooled, was formerly most in vogue, but has been super-
seded to a large extent by the ‘‘holding” method,
which is much more reliable. (Plates 8, 10.) In this

* For specifications as to inspections, temperature records, and bac-
teriological tests, see 3d Report of the Commission on Milk Standards.

+ The following practical method of home pasteurization of a one-
quart bottle of milk is given in the Health News of the New York State
Department of Health for September, 1916. It is stated that this
process ensures thorough pasteurization without undesirable changes.
(It is well, when possible, to check such methods by use of a ther-
mometer. )

“1. Boiling 24% quarts of water in a large agate sauce-pan, or better

“2 Boiling 2 quarts of water in a 10-pound tin lard pail, placing
the slightly warmed bottle from ice chest in it, covering with a cloth
and setting in a warm place. At the end of one hour the bottle of milk
should be removed and chilled promptly. The water must be boiled in
the container in which the pasteurization is to be done.”

For a method of home pasteurization in infant’s feeding bottles see
Plate 5.

110 THE MODERN MILK PROBLEM

process the milk is held at pasteurizing temperature
for a longer time though at a lesser heat. Of the two
methods only the latter complies with the definition
which has been quoted. Even with this process there
is a possibility that the milk may be contaminated
through being run into unsterile containers, a danger
which may be obviated by running the hot milk im-
mediately into well-sterilized bottles or by pasteuriz-
ing in the final container.” (Plate 14.) This last
method, which is considered ideal, is now being tried
under commercial conditions.

The proper care of pasteurized milk does not differ
materially from that of raw milk, although there are
biological reasons for taking somewhat greater care with
the former. It has been shown, however, that properly
pasteurized milk normally sours like raw milk; hence
the supposed objection that pasteurization induces
putrefaction does not hold. As Rosenau says, ‘‘the
bugaboo that nature’s danger signal is destroyed in
pasteurized milk vanishes before the facts.”

General Pasteurization the Insurance against a General
Danger

The necessity for universal, or nearly universal, pas-
teurization which is now being urged more and more
emphatically by the highest authorities arises from the
fact that even with the greatest practicable precautions
unpasteurized public milk supplies cannot, in the light of
experience, be considered free from a greater or less ele-
ment of danger.

Pasteurization is most obviously needed in the larger |

PLaTE 6. (a) PRIMITIVE CONDITIONS IN THE MILK INDUSTRY

While it is the dairyman, not the dairy, which counts, the man who conducts
his business under these conditions is not likely to pay much attention to
essential sanitary methods in milking and handling milk. (Bull. 56,
U.S. Hygienic Laboratory.)

(b) INSANITATION PLUS WASTE ON THE FARM

Besides being contrary to decency and sanitation, this not uncommon condi-
tion means the waste of much liquid manure, one of the most valuable
assets of the farm. (26th Annual Report, Bureau of Animal Industry,
U.S. Dept. of Agriculture.)

PuatTe 7. PRIMITIVE CONDITIONS IN THE MILK INDUSTRY
Children entrusted with the important work of washing milk bottles, in a
shed which is a mere apology for a dairy house. (Bull. 56, U. S. Hygienic
Laboratory.)

A milk house inviting dirt and rubbish and used as a repository for miscel-
laneous objects. (Bull. 56, U.S. Hygienic Laboratory.)

PuaTE 8. ADVANCED CONDITIONS IN THE MILK INDUSTRY

Complete Modern Milk Plant, showing: (a) Milk Clarifier, (b) Heating and
Holding Tanks, (c) Milk Cooler (covered type), (d) Storage Tank for
Cold Milk, (e) Bottle-filling and Capping Machine. This picture assem-
bles units such as are shown on a larger scale in Plates 9-11. (Courtesy
of Dr. Chas. E. North and the New York Milk Committee.)

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PuatTEe 11. ADVANCED CONDITIONS IN THE MILK INDUSTRY (continued)

Cooling and Bottling. After pasteurization the milk is run over the Cooler,
F, which reduces it within 10 seconds to a temperature of 38° F. A dust-
less atmosphere is essential to the protection of milk which is run over
open coolers. It is also necessary that all apparatus and piping with which
milk comes in contact be capable of being thoroughly cleansed and ster-
ilized. After cooling, the milk passes to-.a vat, G, provided with me-
chanical agitation, and thence to the rotary fillers H H, by which the
bottles, previously sterilized, are mechanically filled and capped. This

type of filler permits ready inspection of bottles. Employees medically
examined weekly. (Courtesy of H. P. Hood and Sons, Boston.)

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THE SANITARY FACTORS 111

cities, where, fortunately, facilities in the shape of
modern commercial milk plants are often found. In
such centers it is rapidly gaining ground, and the bulk
of the milk supply in certain cities is now pasteurized.
Many large milk concerns have taken up the process
as a means of self-protection against the possible con-
sequences of unpasteurized milk.

In smaller cities and towns, on the other hand, the
need of pasteurization has been largely unrecognized
and has not made the progress that conditions demand.
It should be noted that the principles of grading rec-
ommended by the National Commission on Milk
Standards (Appendix B)—which allow for only one
kind of unpasteurized milk, in the highest grade—are
intended to apply to small as well as to large cities and
towns.* Communities which do not choose or manage
to adopt this standard suffer under greater or less dis-
advantage or danger. Some of the smaller communi-
ties have, indeed, adopted the clean raw milk ideal.
Montclair, N. J., and Palo Alto, Cal.,—to name two
widely separated towns—have under expert adminis-
tration, carried that ideal to a high point. They have
considered it their chief object to secure clean raw milk
and to minimize its possible dangers.t But in both
these cases it is to be observed that all market milk

* The latest report of the National Commission on Milk Standards
states that ‘‘for the use of small dealers in cities and small producers for
towns and villages, efficient pasteurizers costing less than $200 are
available. The Commission, therefore, thinks that milk ordinances for
towns and villages, as well as for large cities, and also state milk laws,
should provide compulsory pasteurization, except for Grade A raw
milk.”

{ Pasteurized milk is, however, provided for under the regulations
of these towns.

112 THE MODERN MILK PROBLEM

sold raw must meet the requirements which the Com-
mission classification prescribes for the highest grade.
The centralization of pasteurization, bottling, and dis-
tribution at a few plants or a single plant in the smaller
cities and towns would promote economy and simplify
sanitary supervision. (See pages 171 and 250.)

The value of pasteurization in making possible the
use of milk from cows which would otherwise be ex-
cluded by the tuberculin test is not sufficiently recog-
nized. In the East pasteurization has gained a foot-
hold which seems likely to be permanent. In other
parts of the country, especially in the South and in
the far West, agitation for the tuberculin-testing of
dairy cows and opposition to the pasteurization of
milk appear to be in full sway, and the conditions seem
to be very similar to conditions in the East five and
ten years ago. It is certain that in due time the South
and West will come to realize the importance of pas-
teurization and will give it the same prominence which
it has already gained in the East.

In brief, pasteurization is the most powerful single
instrument that milk sanitation possesses to-day. Com-
bined with adequate bacteriological control, it meets
conditions which cannot be met by unsupplemented
clean milk methods. Theorists may say that it should
be unnecessary, but inexorable conditions leave no
choice.

In summing up the matter of pasteurization we can-
not do better than quote the remarks of Professor
William T. Sedgwick, in his presidential address before
the American Public Health Association, on American
achievements and failures in public health work :—

THE SANITARY FACTORS 113

We have as yet, and in spite of ample knowledge, failed
to make our American milk supplies what they should be.
This is partly because we have been too timid to insist that
good milk not only costs more to make but is worth more and
must therefore be paid for, and partly because we have not
yet taught the public as we should that the only safe milk
is cooked milk, and for infants, milk that is pasteurized—
preferably in the final container. I have myself lived through
the last year of the period—now happily remote—when no
milk was pasteurized by anybody; through the next in which
only pioneers like Nathan Straus preached or practiced pas-
teurization, while many, if not most, physicians deprecated
the practice; through the one following, in which the scales
began to turn in favor of pasteurization; and into the present
when almost no one fully informed on the subject actively
opposes pasteurization. And yet, even to-day, some phy-
sicians are shortsighted enough to tolerate if not to recom-
mend the general use of raw milk, which still constitutes
the great bulk of the milk used by infants and adults all
over the land. Such use of raw milk we must count as long
as it lasts one of our worst public health failures.

CLARIFICATION AND OTHER PROCESSES

Ordinary farm milk contains more or less dirt, as well
as natural waste from the udder of the cow, and often
pus and bacteria from udder inflammations unnoticed
or unnoticeable. By passing the milk through a centrif-
ugal machine, or ‘‘clarifier,”’ these matters are largely
thrown out in a residuum which consists partly of sub-
stances normally present in milk and partly of those
which are adventitious or abnormal.*! (Plate 5.) The
quantity of this is stated by North to be ordinarily
about one pound to every six thousand quarts. The
process has come into wide use in milk plants as a trade

114 THE MODERN MILK PROBLEM

measure, to remove the visible dirt which would inter-
fere with the sale of bottled milk. It has thus been
used to a greater or less extent to take out dirt that
should have been kept out. At the same time the
process has safety and decency values and is worthy of
favor when used in connection with proper supervision
of supplies and methods. Its exact status, however,
has not yet been settled, and present evidence does
not warrant the requirement of general clarification,
as has been proposed in some quarters. (For a summary
of advantages and disadvantages see 3d Report of the
National Commission on Milk Standards.)

The scope of this volume does not permit mention
of the various processes of milk adjustment and manipu-
lation which are practiced in the industry or discus-
sion of how far these may be legitimate or the reverse.
A mechanical process which has come into some promi-
nence in recent years is that of homogenization of milk
or cream.*? In this process the fat globules are forcibly
broken up so as to be in more intimate mixture with
the liquid. The process makes possible also the ad-
mixture of inferior fats. It is chiefly used in ice cream
manufacture, but has other uses, among them being the
production of an apparently greater richness in cream.
There is no objection to homogenization in itself, but
fraudulent practice is, of course, possible. The product
should be fully labelled. :

PUBLICITY OF RATINGS

The desire to more than maintain merely a minimum
standard has led in many instances to the publication
of the ratings of milk supplies. (The town of Mont-

THE SANITARY FACTORS 115

clair, N. J., was perhaps the earliest to adopt this
method in order to secure the co-operation of its citizens
in favoring the best milks.) Such ratings have been
given out in reports, bulletins, and newspapers, in
answer to inquiries, or posted publicly. Besides general
observations, publication has been made, by name, of
dairy scores, laboratory analyses, and verbal descrip-
tions of the sources of supplies.

Such publication is advantageous with the more
inquiring citizens, but such value is largely limited to
small communities where that class is numerous. Even
the intelligent reader, moreover, may find it difficult to
interpret columns of figures for different kinds of data,
while the characterization of milks as ‘‘excellent,”’
“good,” ‘‘poor,” ete., is but a makeshift for accurately
defined grades. Where, however, official grades have
been established, supplies may, if desired, be further
rated according to bacteria test, etc., within the grades.

The greatest effect of such publication is, after all,
on the dealer. Even if only a few consumers read the
list, the dealer is disturbed to find himself rated low and
is stimulated to make some effort. to improve his stand-
ing. But this effect is obtained in much more efficient
degree under the grading system, to which we shall
give next consideration.

CONTESTS, CONFERENCES, EXHIBITIONS

Contests in which dairymen compete for prizes for
the best milk have been held by Federal and various
State authorities, usually in connection with confer-
ences, exhibitions, and fairs. Such contests and the
lectures and demonstrations which accompany them

116 THE MODERN MILK PROBLEM

have been an important educational force with dairy-
men and to a lesser degree with the public. It must be
admitted, however, that they do not (nor are they
intended) to go far toward the solution of the general
milk problem; rather are they a useful auxiliary. Fair
competition is to be encouraged, but can have full play
only when degrees of merit are generally recognized in
the market.

THE GRADING OF MILKS

We now come to the most recent and the logical de-
velopment in the administrative control of milk sup-
plies.

There was a time when just two general kinds of
milk were recognized—good, or salable, and bad, or
unsalable. As the situation grew more complex, and
bacteriological analysis came into use, it was seen
that the matter was not so simple. It then appeared
to those who made a special study of milk supplies,
that, while the supplies in large cities might be made
to comply with certain minimum legal requirements,
few—perhaps none with certainty—could be relied
upon as fit for the use of infants and invalids. It was
recognized as impossible to bring the general supply
up to this desired standard. Hence the introduction
of the milk depot for supplying special milk to the
babies of the poor and the devising of a special grade
of milk—namely, certified milk— medically supervised, :
for the babies of the well-to-do. Then, gradually, it
came to be seen that these two special kinds—the one
being on a philanthropic basis and the other costing a
luxury price, could not solve the whole problem. Mean-

THE SANITARY FACTORS 117

while the situation had intensified; milk-borne disease
became more and more insistent; a new factor had
arisen in the shape of commercial pasteurization; the
necessity of public control became more pressing.
To-day the problem is how to exert such control in
a way which is scientific, just to all parties concerned,
equal to sanitary needs, yet economically practicable.

Progressive sanitary authorities have recognized the
fallacy of attempting to make all market milks conform
to the same standard by lumping ogether raw and pas-
teurized milks, milks for infant feeding and milks for
ordinary household use. Distinctions must be made.
The result has been the establishment of grades of milk
publicly distinguished by means of simple labelling.

Such classification must logically be based on the
uses to which milk is put and the corresponding sanitary
criteria. The simplest division of uses is: (1) milk for
infants, (2) milk for adults, (3) milk for cooking and
manufacturing only. This requires three corresponding
grades. The conspicuous criteria are bacteriological
character and the application or non-application of
pasteurization. It is essential that the grades be few,
clearly defined, and readily understood.

The idea of milk classification is not new. A rudi-
ment of it exists in the setting-aside of the special grade
of certified milk, which, however, has never played a
quantitively important part in general milk supplies.
Dr. Ernest Lederle, then Health Commissioner of New
York City, advocated as long ago as 1907 the grading
of milks in some such manner as has since been effected
in that city. Dr. A. D. Melvin, Chief of the Bureau
of Animal Industry, United States Department of

118 THE MODERN MILK PROBLEM

Agriculture, proposed at about the same time a classi-
fication (see below) which has done much to further
the grading idea. Since then other systems have been
devised. The principle is so rapidly gaining acceptance
that the diversity of the different systems may become
a problem in itself. As close conformity as possible to
one generally accepted plan—e. g., that of the Com-
mission on Milk Standards, cited below, would be de-
sirable.

Grading Systems

The following, in outline, are some representative
plans of classification. (For a fuller description of
grading systems, see Appendix B.)

1. United States Department of Agriculture.
Class A. Certified milk or its equivalent.
B. Inspected milk (raw, tuberculin-tested).
C. Pasteurized milk.

(This classification is interesting as being, apparently,
the first attempt to devise sanitary grades. It was pro-
posed by Dr. A. D. Melvin, in 1908. It does not, how-
ever, express the ideas of to-day as do the following.)

2. National Commission on Milk Standards (of the
New York Milk Committee) .*
Grade A. Raw.
Pasteurized.
B. Pasteurized.
C. Pasteurized (for cooking or manufac-
turing purposes only).

* This classification applies also to cream.

THE SANITARY FACTORS 119

a. New Vork Citys
Grade A. Raw.
Pasteurized.
B. Pasteurized.
C. Pasteurized (for cooking or manufac-
turing purposes only).

4. New York State Sanitary Code.t}
Grade A. Raw.
Pasteurized.
B. Raw.
Pasteurized.
C. Raw.
Pasteurized.

Some municipalities have partly recognized the
grading idea through establishing standards for such
milks as ‘‘Inspected”’ ft or ‘‘Pasteurized,’”’ and the
principle is being increasingly adopted in milk legisla-
tion. There is nothing that would so quickly bring
about the desired approximation to uniformity in
methods of milk regulation as this principle. The
grading idea has long been recognized in Continental

* This classification applies also to cream. It is closely similar
to the preceding, there being some difference in the exact require-
ments.

+ This classification applies also to cream if labelled or otherwise
designated for purposes of sale. Certified milk is specifically authorized
as an extra class and the term protected. It will be observed that this
is a much less strict classification than the others, on account of its
admitting raw milk to all three grades. It is, however, noteworthy as
being the first state system of grading.

t The term “‘inspected milk”’ has been used in various significations
and is unsatisfactory.

120 THE MODERN MILK PROBLEM |

countries, though developed from a chemical rather
than from a bacteriological point of view.*

With the grading system the education of the dairy-
man and of the consumer about which so much is said
would come automatically. The one would learn ex-
actly what is required of him; the other, exactly what
he is getting.

An important concomitant of the system is the
tonic effect on administration. Health authorities
would find themselves freed of ineffective routine and
would at the same time have to make their methods of
administration so thorough as to bring out the full
effect of the plan. It scarcely need be said that grading
required but not fully enforced would be a conspicuous
failure and only discredit an excellent principle.

* In Germany such classifications as: (1) Market milk, (2) Skim milk,
(3) Infants’ milk, are common. (Sommerfeld, ‘‘Handbuch der Milch-
kunde.” Cf. Rolet, ‘“‘Lait Hygiénique.’”’) We have already referred
to the Continental practice of domestic heating of milk, which partly
takes the place of official safeguards, though pasteurization is now ex-
tensively practiced in Continental countries. In England, apparently,
the grading idea has received little attention, and pasteurization of
market milk has not made great headway.

CHAPTER IV
THE ECONOMIC FACTORS
Economic Value of Milk Production

The economic value of milk as a food has already
been made clear in preceding pages, and a glance at
statistics presented elsewhere (Appendix A) will indi-
cate the importance of milk production and distribu-
tion as an industry of the very first magnitude.

Quite aside from dairy specialization, milk produc-
tion may be called an essential function of the ordinary
farm. Dairying is an integral part of general farming.
The dairy cow makes economical use of roughage and
pasturage, and returns to the farmer milk for his own
use as well as for sale. Furthermore the wastes of the
cow stable have a large value as fertilizer. Dairying is
often said to be the “‘backbone”’ of agriculture.

Again, the relative economy in milk production is
much greater than in beef production. Good dairy
cows produce human food in the form of milk far more
economically than food products can be obtained in
the form of beef, pork, or mutton. This is a fortunate
fact for densely populated regions where intensive use
must be made of agricultural resources.

Decline of Dairying in Certain Regions

But, in spite of this relative economy in milk produc-

tion, there are regions where dairy farming is in turn
121

122 THE MODERN MILK PROBLEM |

found comparatively unprofitable. A table given in
Appendix A shows a striking decline in numbers of
milch cows in certain States the while populations are
steadily on the increase. These States are those of
New England and the Middle Atlantic seaboard where
cities large and small abound. While, through better
breeding, there may be some increase in the produc-
tivity of the milk stock, there is no doubt that the de-
cline in milk production in these regions is very marked.
The lower cost of milk production in more distant
regions, makes it more economical for milk contractors
to buy milk and pay the railroad charges from two or
three hundred miles away, and many of the nearer
farmers cannot meet the competition. This condition
is hard on the latter and also adds greatly to the diffi-
culties of milk sanitation, but it is a natural economic
result of the growth of urban areas, their effect on the
value of neighboring agricultural land, and_ their
reaching-out, octopus-like, for ever-increasing milk
supplies.

THE CRUX OF THE ECONOMIC QUESTION

While sanitarians and health officials have been
agitating for the sanitary improvement of milk supplies,
an insistent complaint has gone up on the part of the
producer to this effect: that everything used in the pro-
duction of milk has increased in cost during recent years,
while the price of milk has farled to rise proportionately.
Sometimes the assertion is even stronger, viz., that
the price obtained by the farmer has remained sta-
tionary or has even decreased. It is from the dairy
farmer that this complaint comes with ever-increasing |

THE ECONOMIC FACTORS 123

force; to him the additional trouble and expense of
complying with sanitary regulations are the latest ag-
eravating factor in the situation.

Since the above statement seems to sum up the com-
plaint of the producer, it must be examined in some
detail, especially as it runs counter to the impression
of many householders that the price of milk to the
consumer has risen at a rapid rate and is partly respon-
sible for the increased cost of living.

THE PLIGHT OF THE FARMER

In many regions the cry goes up from the dairy
farmer that he is being ‘‘forced out of business.” It
is asserted that many farmers to-day are producing
milk at a loss and that many more are going through
the processes of dairy farming with little or no return
for their investment and labor. ‘‘It is claimed,” says
an official of the United States Department of Agricul-
ture, ‘that only about one-third of the dairy cows in
New York State are kept at a profit. If this is true of
New York, it is probably true of many other States.”’ 4
Testifying at a Federal hearing on milk rates, at Boston
in 1916, Professor Frederick Rasmussen of the New
Hampshire State College of Agriculture, is reported as
asserting from computations that the ‘‘average milk”’
in that State was produced at a slight loss.? (This
statement, though indefinite as reported, may ap-
parently be taken to mean that more farmers produc-
ing milk in New Hampshire do so at a loss than at a
profit.) Several years ago a farmer, ‘‘reported to be
the most successful in New England, in a public address
stated that the price received by him for milk during the

124 THE MODERN MILK PROBLEM >

past year gave him no profit whatever on his product,
but brought him out just even. If this is true of the
most successful farmer in New England, what is to be
said of the great majority of the men engaged in milk
production?’’? Magazine articles have appeared under
the titles, “‘The marketing of milk—how farmers are
driven out of business and the cost of living is forced
up” and ‘“‘How New England dairy farmers are driven
out of business.” * While such statements are usually
couched in general terms, they are, coming from many
quarters, significant.

We have already, indeed, in Chapter II, referred to
the plaint of the farmer, but it is so outstanding a
feature of the milk situation to-day that a few further
words here, before proceeding to its economic basis,
will not be out of place. Some of the more specific
complaints of the farmer are expressed in the following
passage from the editorial column of a Southern news-

paper :—

The dairyman is a manufacturer of milk. His cows are
his machines—and very delicate ones. They are liable to
disease and death. At the best they will not produce milk
the year around, probably only two-thirds or three-quarters
of it. He must have enough of them to allow some of them
to occasionally “loaf on their job.”’ If he has much of a
herd he must keep a registered bull costing in the thousands,
often. . . . [A high-bred cow] will cost as much as $300 in
her heiferhood, in many cases. .. .

These machines and their product alike require great care
and attention to prevent them from becoming diseased
themselves or being the means of diseasing the dairyman’s

* Current Opinion, November and December, 1915.

THE ECONOMIC FACTORS 125

customers. They must be tested for tuberculosis, and, if
they develop it, he must kill them or have them killed. The
milkman’s stables have been proved, in some cases of careless
dairymen, to be foci of disease, especially typhoid and con-
sumption. Therefore, he must submit to sanitary regulation
and examinations that the public may be assured of pure
milk, for disease germs increase rapidly in milk. Where
the product is not pure it is one of the most dangerous of
foods, as pure milk is one of the best possible.

Not only must his milk vessels be scrupulously clean, but
there is considerable labor and expense involved in making
absolutely clean the bottles in which he delivers the milk.
He must be watchful . . . that his help may not be possible
“typhoid carriers,” or otherwise liable to pass disease germs
into the milk from their hands . . . ; his cows must also
be clean before they are milked. All this that his customers
may have pure, clean, wholesome milk.

All of this means a greater expense than was ever dreamed
of by the milkman of old, who drove up to your door and
ladled out a pint or a quart of milk from a big can into the
can or kettle you presented to him for your daily serving.
Yet we have given here only an incomplete skeleton of the
modern dairyman’s extraordinary expenses.

His ordinary expenses are greater, because the cost of feed
is so much higher than it was a score, or even a decade, of
years ago. Nor will the health authorities allow him to keep
his herd in such a cheap barn as that in which the 10-cents-a-
quart * milkman often kept his cows--dark, ill-ventilated,
perhaps rarely cleaned.

He is not only entitled to some return on the capital in-
vested in his milk-producing machines and his tools, but also
to day wages as a workman. No matter how much help he
may have, he must, if he would have his business thrive,

* Milk is more expensive in the South than elsewhere.—J. S. M.

126 THE MODERN MILK PROBLEM

begin his day’s work at 2 o’clock in the morning or some
other such heart-rending hour, to gather his product and
start it off to his customers—for there is no middleman in
the dairy business. Rising in the small hours of the morn-
ing to begin work by lamplight, he sometimes knows no rest
until some hours after darkness has come again.

Yet his profits on the nutritious article of food he sells
bear no comparison with those of the grocer, butcher or
baker.

To demand food that is entirely free from suspicion of
carrying disease to ourselves and our children, and then to
quarrel because we must pay more for it is utterly childish.*

The foregoing was prefaced with the statement that
‘“pure milk, clean milk, cannot be sold at the price of
dirty milk,” and was entitled ‘‘We must pay the cost.”

It is certainly worth examining how far the extra
costs that are putting the farmer out of business are
unavoidable and how far, therefore, ‘‘we,’’ the con-
sumers, must pay them.

Is the Farmer Getting a Fair Price?

This burning question, which lies at the very root of
the economic problem, has been well discussed in a
paper by Mr. Ernest Kelly of the Dairy Division,
United States Department of Agriculture, who writes
as follows (italics inserted) :—

Within the last few years there has been much dissatis-
faction among both milk producers and consumers. The
dairy farmers claim that they are not receiving enough for
their milk, while consumers complain that they are forced to
pay exorbitant prices for the same article. It is apparent .

THE ECONOMIC FACTORS 127

to anyone who has looked below the surface of this question,
that many dairy farmers to-day are not receiving a price for
their milk which will yield a fair profit. . . . In view of the
increased cost of producing and handling male and consider-
ing its high food value, consumers in many cities are paying
a price which is much too low to allow a reasonable profit to
the producer. The dairyman receives at his shipping station
from about 2 cents to 5 cents per quart for his milk, depend-
ing upon the time of year and upon the city in which his
product is marketed. Probably the bulk of market milk in
this country is sold by the farmers at about 314 cents per
quart, whereas the price to the consumer in the various cities
ranges from about 6 cents to 10 cents per quart, depending
upon the locality and upon whether the milk is sold “loose”
or bottled.

It is extremely doubtful if the dairyman in many cases re-
ceived enough for his milk to pay for the bare cost of production
at these prices. Bulletin 73, issued by the experiment station
at Storrs, Conn., gives the cost of producing milk on the
experimental farm for a period of five years. When the milk
produced by the herd was figured as worth 4 cents a quart at
the farm, the business was conducted at a loss every year out
of the five. Where the milk was figured at 5 cents a quart at
the farm, the books showed a net profit four years out of the
five. Besilt: similar to these have been obtained at several
other stations.®

Mr. Kelly presents in his paper some exceedingly in-
teresting figures which the present writer has elaborated
and brought up to date and plotted in Figs. 15-20. A
glance at these charts will show that the rise in the retail
price of milk as compared with some other staple food
products has been relatively slow. The figures upon
which these curves are based were compiled by the

128 THE MODERN. MILK PROBLEM

Government from the most important industrial cities
throughout the United States. The level of 100 shown
in each chart is the base of the relative prices,—that
is, the price indices relate to a value of 100 repre-
senting the average price for each food during the
period 1890-99, so that they give percentage variations
and may be ae compared. In the last of the series

PEE OTC EVAR EAE RPER EOE EEL
ea
| |cccmasteses || ||| La TLL LT
eLLEELLLEEL CerT T e
[ al
i l

cal
120 LUE Ea ae
7) ECHLETTECCRPRECT TE —
0 Walaa ae

ime. 15. RevativE Retait Prices, 1890-1915-
Milk and Fresh Eggs

a combined curve is given for the five staple foods as
compared with milk. It will be seen that, with the
exception of wheat flour, these have increased in price
more rapidly than milk, and, taken all together,
markedly.

The economy of milk as a food has already been re-
ferred to in Chapter I, but may here be re-emphasized.
It was there pointed out that milk is ordinarily one

THE ECONOMIC FACTORS 129

of the cheapest of foods,—a fact reinforced by the con-
siderations that it is free from waste material, is easily
digested, is indispensable for infants and children, and
may be used either without preparation or in ready
combination with other food materials.

170

Eta
Ae
| fee Moroes [|| TT ETT TFET
so00ec POTATOES
| F

HUET
HELTER

are LTE EPEAT
0 f

Fig. 16. Re_ative Reta Prices, 1890-1915
Milk and Potatoes

We may now examine the complaint of the farmer
that the cost of producing milk has increased greatly
in recent years without a commensurate increase in the
price of the product. Data on this point are set forth
in Fig. 21. This shows the relative increases in the two
great items of cost of farm labor and of cattle feeds,—
items which constitute 80 to 85 per cent of the total
farm cost of milk production. Labor for the dairy

130 THE MODERN MILK PROBLEM

farm is hard to secure at any price, for many farm hands
object to milking and will not hire out where they have
to do this kind of work. In the chart the value 100, as

5 aie eee ae
200 ;

te
EE
LEE
ELL
HL
Aly
ih
‘LA
al

ee
: Eh HEEL
90 Tet li

NMenZ®R DAS ~NCMEH OROHO~ NMYE

Fra. 17. RELATIVE nee PRICES, pene
Milk and Round Steak

before, represents the ten-year average of prices from
1890 to 1899, inclusive. This chart is taken from a
paper by Mr. Kelly on factors-influencing the cost of
milk to the consumer.’ Mr. Kelly describes the manner
of constructing the dotted curve and draws conclusion
from it as follows (italics inserted) :— )

THE ECONOMIC FACTORS 131

From the source already noted,* figures were compiled
showing the increased cost of all the various staple grains
which are used for cattle feeding, and also the increased
cost of hay. These two sets of figures were combined, giving

220

UT Tet Wal
IML A aT
PAT - a TT
AEE EPC

= yt eee yee y eta i. Sk
2

Fig. 18. RELATIVE nee Prices, 1890-1915
Milk and Bacon

the two varieties of feeding stuffs (grain and hay), the im-
portance which they would play in the feeding of an average
dairy cow. From this combination of figures was plotted a
curve called the “‘feed curve.’”’ A separate curve was plotted

* Bulls. 94, 99, U. S. Dept. of Commerce and Labor.

132 THE MODERN MILK PROBLEM

for the increased cost of farm labor. Finally, these two
curves, viz.: the feed curve and the labor curve, were com-
bined into one, giving each of the two items the weight which
would be attached to it in the maintenance of the average
cow. The combination of the feed curve and the labor curve
is represented by the dotted line. While this curve does not
represent the total cost of milk production, it does represent
about 83% of the total cost, and the other factors which go

—— LK
seeeeee WHEAT FLOUR

bead
Ht ie intl
a AL tit
aT tte

160

Fra. 19. RELATIVE ane PRICES, 1390-1915
Milk and Wheat Flour

to make up the other 17% have probably increased in at
least as rapid a ratio.

After studying this curve there can be no doubt that the aver-
age milk consumer 1s paying much less for milk than is war-
ranted by the increased cost ef production, to say nothing of the
increased cost due to the more elaborate system. of distribution
now wn force.

Finally, Mr. Kelly draws the following general
conclusion :—

THE ECONOMIC FACTORS 133

The consumer is already buying his milk at a low price as
compared with many other foods, and if he wishes a clean milk
he must expect to pay more in the future than he does at present,

A Rac. ci aa SDS lS DIOS Sie ny VS)
sea)
~

Fic. 20. Revative Rerait Prices, 1890-1915
Milk and Five Staple Foods

unless a more economical method of production and distribution
can be installed.

Another Aspect

Such considerations strongly support the case of the
farmer. Still, they require some qualification. The
matter has another side which we have not yet con-
sidered. Itis well put by Mr. Kelly (italics inserted) :—

The dairy farmer himself is not blameless. Sometimes his
business is carried on in a wasteful, extravagant manner.
Unprofitable cows are kept, and uneconomical methods of

134 THE MODERN MILK PROBLEM

feeding are followed. It is unfair to ask the milk-consuming
public to pay him a profit on such a slipshod system, and
yet that is what is often expected.®

This widespread condition of agricultural and busi-
ness inefficiency is fostered by the fact that a great

1890=94 1895-99 1900-04 1905-09 1910e14

Fig. 21. Retart Prick or M1tK CoMPARED WITH COSTS OF
PRODUCTION

Five-year periods, 1890-1911.

deal—perhaps the bulk—of market milk comes from
small farms where it is regarded simply as a by-product.
The farmer keeps a few cows for his personal use and
sells the excess product. He gives the subject of milk -
production just as little attention as he can. The state
of affairs is described in further detail by another Gov-
ernment agricultural expert :— |

THE ECONOMIC FACTORS 135

$90.69 ;
$68.55
$5072
$29.72
$24.82
HALL: $3. ‘a
Total valos of produc Scare less eres crete haan? ais

Fic. 22. PRorir FROM DIFFERENT Cows

Average annual value of product from two cows for three years.
Observe the scant net profit on Cow No. 2, compared with No. 1, as
shown by the two bars at the right. The values of his cows as pro-
ducers are of the utmost importance to the dairy farmer, yet few
farmers have any exact knowledge as to which cows in the herd are
bringing in a profit in relation to the cost of their keep and which
ones are kept at a loss as “boarders” or “rabbits.” Yet such
knowledge can be gained simply by keeping records for individual
cows and, when possible, making butter-fat tests. Such differences
as the above are very common in dairy herds, and greater ones are
often met with,—facts which must be considered in connection with
the complaint from the farmer that ‘there is no money in the milk
business.” (Circulars 67, 122, Ohio Agricultural Experiment Station.)

As I visit the dairymen of this country, I am impressed
with the statements that they make in regard to the amount
of milk received per cow. Some dairymen say their cows are

136 THE MODERN MILK PROBLEM

averaging about one gallon each, while others say theirs
give three. Why this difference? There are several things
that might assist in this condition of affairs, yet I believe it
is principally accounted for by the difference in cows. A
profitable cow costs little more to keep than an unprofitable
one; yet farmer after farmer is keeping these scrub cows. It
is also a question of the dairyman not really knowing which
are his profitable cows and which the “boarders.” ‘Too
many think they have no time for the Babcock test and the
scales. If dairymen are to produce milk on an economical
basis, they must start with better cows. Then they must
properly care for and feed these cows if best results are to
be obtained. Successful dairymen are using silos, growing
alfalfa, etc.; therefore other farmers should study these
matters.

Again, as one travels over this country, he cannot help
being impressed with the many kinds of waste that are con-
tinually occurring on our farms. The farm machinery that
should last a number of years is allowed to deteriorate rapidly
because it is not properly housed and cared for. One of the
most valuable assets to the farm, namely, the liquid manure,
is allowed to waste by soaking into the ground near the barn.
Even the solid manure is thrown under the eaves, and the
soluble elements, which are the best form of plant food, are
allowed to be lost. So we might mention loss after loss that
is continually occurring on our farms, mainly because of poor
management. I can hardly see how the dairyman can ex-
pect the consumer to pay for such losses; yet that is really
what he wants when he allows these conditions to exist, and
cries for better prices.

From this it is clear that, while justice must be done
to the farmer in a fair price for his product, he must,
if he is to stay in business, use business methods. Not
that he can be expected to become an agricultural or

THE ECONOMIC FACTORS 137

business expert, but he should certainly take advantage
of the expert information and advice now available to
him. One great drawback is most farmers’ apparent
inability to make use of printed matter. Federal,
state, and college authorities are continually publishing
literature that should be in the hands of milk producers,
yet it is surprising how few avail themselves of this
free information as well as that contained in dairy
periodicals. There are indeed hopeful signs in the
increasing attention being paid to high-grade stock, to
cow-testing for the purpose of weeding out animals
which are kept at a loss, and to other points of man-
agement. But it is evident that a great deal of agricul-
tural extension work—to take knowledge personally to
the farmer—will be needed to bring about the requisite
improvement in dairy husbandry. —

There has naturally come about considerable spe-
clalization of dairy farms. The larger these are and the
more closely organized and managed, the greater will
be the profit. This development has suggested that
the small dairy farmer may eventually be crowded out
of business. How far this may come to pass is hard to
tell, but the economic function of the dairy cow on the
ordinary farm indicates that we must still continue to
depend upon the ordinary farmer for a large share of
the milk supply. So far as sanitation goes, by the
simple methods outlined in Chapter III sanitary milk
can be produced, at a moderate cost, on almost any
kind of farm by ordinary dairymen.

A certain number of all businesses fail, and one can-
not hope that every last dairyman can be made suc-
cessful. But standards can certainly be raised. And

138 THE MODERN MILK PROBLEM

it is to be hoped that not only will justice be done
to the farmer, but also that he will make use of
the means of his own advancement, thereby bene-
fiting simultaneously the consuming public and him-
self.

FACTORS IN THE FINAL COST OF MILK

The various factors which make up the total cost of a
unit of milk may logically be considered under the
following heads: (1) Production, (2) Transportation,
(3) Handling in country or city milk plant, and (4) De-
livery to the consumer. A detailed consideration of
these would split them up into a number of items to
be figured separately. Thus, for production, which
includes all that is chargeable to the farmer, the sub-
heads would be: interest on investment; insurance,
taxes, etc.; cost of feed; labor cost; miscellaneous
charges; and hauling to the station or milk plant when
the farmer does not retail his own product.*

A number of special studies dealing with the costs of
the various processes and stages have been made, some
of the findings of which are gathered together in Ap-
pendix D. In considering cost figures it must be re-
membered that very few dairy farmers keep even
approximately accurate records, so that at the present
time it is impossible to get data of this kind except
by means of special investigation; and also that, on
account of trade reticence, it is difficult to obtain in-

* Further details on figuring milk costs are given in the paper by
Kelly already referred to and in the various special studies cited in
Appendix D.

THE ECONOMIC FACTORS 139

dicative figures from dealers, although the large com-
panies of course figure carefully their own particular
items. Data on production costs have been gathered
by various experiment stations, and show considerable
differences according to locality.

Systems and rates of transportation as complica-
ting factors have elsewhere been referred to (Chap-
ter II).

The cost of distribution has come in for special at-
tention. A large proportion of the total cost of milk
is chargeable to this item. The Boston Chamber of
Commerce investigation showed that ‘‘the greatest
single item of cost is delivery to the family trade,
equaling the total cost of collection in the country, the
operation of country plant, railroad transportation,
and city plant expenses.’’ In some cases it approaches
the price paid to the producer. A notable study of the
distribution situation in one city, Rochester, N. Y.,
has been made by Dr. John R. Williams,’ who esti-
mated the difference in cost between an assumed model
system of distribution and the system actually exist-
ing among the distributers.* This difference was sur-
prisingly large, the extra cost due to the duplication of
routes and dispersion of customers under trade condi-
tions figuring to some $500,000 yearly for that city.
Bottle losses were also a very considerable item, esti-
mated at about $10,000 a year. Such charges are, of
course, paid by the consumer in the retail price. Dr.
Williams presents statistical details from investigation

* The U.S. Department of Agriculture has collected figures showing
large variation in the economy of distribution as practiced by different
dealers. (Milk Plant Letter 15.)

140 THE MODERN MILK PROBLEM

and experiment, and concludes with a plea for cen-
tral delivery under municipal management of milk
supplies.

Various practical objections have been brought
against the idea of a central delivery, either privately
or municipally managed. A number of such objections
were collected by the Boston Chamber of Commerce
committee.!! The idea has apparently not been tried
in practice. As a trade measure such centralization
would necessitate the actual formation of companies
large enough to undertake all the operations connected
with large volumes of milk, for delivery is so vital and
competitive a part of local milk trade that it is difficult.
to see how mere co-operation could be made to harmo-
nize with individual interests. Otherwise the indi-
vidual dealer would be left so limited scope for initiative
and activity in competition that general discontent
would be inevitable, and either complete amalgamation
or the restoration of previous conditions would be a
forced conclusion. Co-operative plans and municipaliz-
ation will be further discussed in Chapter V. A general
criticism of such proposals is that they minimize or
omit practical difficulties and dangers in organization
and operation.

The tendency of the trade in the cities to become
concentrated in the hands of comparatively few dealers
or companies is a hopeful factor in the delivery situa-
tion. It is clear that such concentration favors greater
efficiency and economy in handling in all respects. It
may be added that the sale of milk from properly
supervised stores is another means of lowering the cost
of distribution. | :

THE ECONOMIC FACTORS 141

THE MILK DEALER.

In what may be called the semi-developed state of
milk industry the farmer produces and distributes his
own product, perhaps deriving a greater or less part
of his supply from his neighbors. In the developed
state the milk dealer is differentiated as a distinct in-
dividual. The dealer collects the milk brought in by
producers, either at a country bottling plant or, more
frequently, at a city plant to which the separate sup-
plies have been brought, usually by railroad. The
dealer thus specialized is not only able to carry on
milk processes on a large scale, but also can dispose of
surplus milk through the channels of the manufacture -
of butter, cheese, etc. (Establishments for these last
uses are called ‘‘creameries,”’ a term sometimes loosely
applied to milk depots or milk plants proper.) Urban
conditions not only make it difficult or impossible for
the farmer to distribute his product himself, but further
tend to force the small dealer either to go out of business
or to amalgamate with others in the formation of
businesses of economic size,—hence the large dealer
of to-day.

The dealer thus occupies a central point from which
he can see, and to a certain degree control, all the
ramifications of the industry. But, while he possesses
an advantage in being more of a business man than
is the farmer, and may use this advantage unscru-
pulously, his position is not always an easy one. Often,
as Dr. Charles E. North wrote several years ago, ‘“‘he
finds himself opposed on the one hand to the public
health authorities in the city where he markets his

142 THE MODERN MILK PROBLEM

product and, on the other hand, he is opposed by the
milk producers from whom he secures his raw material.
In some districts these antagonisms have become so
acute that the large dealer has a tendency to believe
he must look upon the dairy farmers who produce milk
and the health authorities who supervise the industry
as permanent enemies of the milk business.’’ Obviously,
the remedy for this is mutual understanding, fair
dealing, and the adjustment of aggravating conditions.

Dealer and Farmer

The general situation between dealer and farmer has
already been considered in Chapter II and need not be
further discussed here. Projects to eliminate the mid-
dleman, wholly or partly, as a supposed special ob-
stacle to the solution of the milk problem, have been
offered, the merits of which will be discussed in Chap-
ter V. We may consider for the present the concrete,
practical plan of farmers’ co-operative milk depots in
country districts. One of the principal recommenda-
tions of the Boston Chamber of Commerce committee
of investigation into conditions in New England *
dealt with this idea as follows:—

A plant, [reported the committee] well built and equipped
would cost from $2,000 to $20,000, according to its capacity
and the number of operations carried on. The plant could
be owned by the farmers and business men of the locality.
Money could be raised by the issuing of non-voting preferred
shares to the business men and investors locally, and voting
common share to the farmers.

*See Appendix E.

THE ECONOMIC FACTORS ten ee

The producers would then have facilities for the disposal
of their product in the manufacturing of butter or cheese,
if they are unable to secure satisfactory prices from the
dealers.

Producers may look forward to receiving more from their
product when they cease to allow others to furnish them
their cans, to collect (taking all grades, little or much), to
dictate price and to process, grade and market their milk and
cream.

Co-operative creameries have failed in the past largely
because of inefficient management (a poor bookkeeping sys-
tem, no allowance for depreciation, no allowance for surplus,
no safeguard preventing one or two persons from gaining
control of the company, and the lack of knowledge of new
methods of testing, manufacturing and marketing).

A milk plant is important to the prosperity of the com-
munity. A certain small plant, not well equipped or man-
aged, in one of our New England localities, paid the farmers
last year nearly $100,000, which brought as much money
into the community as many manufacturing establishments
employing one hundred and fifty to two hundred men each.

If, as this committee reported, “at present the
general farmer has very little voice in determining the
price to be paid for his milk and cream,” and “‘takes
what the dealer offers, which is generally the price for
no special grade of product and is influenced largely by
the yearly surplus,’ and is otherwise at a disadvan-
tage——then this proposal of co-operative plants is one
seriously to be considered. (For further details see the
report of the committee.'”)

144 THE MODERN MILK PROBLEM

The care of surplus milk in the country was con-
sidered by the committee just quoted to be a very
important matter :—

In addition to producing good, clean milk and cream and
grading it, the producers, to assure themselves of greater
returns for their product, would do well to process it and to
make arrangements to care for the surplus. Too much em-
phasis cannot be laid upon the taking care, in the country,
of the surplus; manufacturing it into butter, skim milk or
cheese. As pointed out previously, this surplus item is one
of the most serious causes for the present chaotic condition in
the industry.

The above plan, it will be seen, proposes for the coun-
try a concentration at the farmer’s end and for his ad-
vantage similar to that which now exists at the dealer’s
end in cities. |

Many large dealers buy milk on a sliding scale which
varies the price both according to month and according
to percentage of butter fat. For years past farmers
have been breeding cattle for quantity, not quality.
The result has been a great increase in numbers of
cows, such as Holsteins, which yield milk in large quan-
tity but with a low butter-fat test. In: the case of New
York State the Legislature was induced to take account
of this situation and lowered the legal minimum of
total solids. In order to secure a sufficient percentage
of cream the sliding scale of prices according to fat
was adopted by dealers. This is obviously a fair way
of buying milk, for it makes the distinction between,
say, Jersey and Holstein cows and between high-test
and low-test Holsteins.

Certain large dealers have also saablisned premiums

: (‘uojsog ‘suog pues poor ‘d ‘H
jo AsoJIn0D) ‘“sul[es pue Surknq oie Aoyy 7eYy YIU Jo SorneNnb oy} utezI1e08se 04 JopiO UT
SOI10} B10 B] [BOISO[OLIO}OVG PUB [BoIUIOYY UTVJULBUL OJ SNOESeJUGAPR 4 PUY Slo[vap dAISSa1SOIg

INVId WII] NYAGOJY ADUV]T V AO AYOLVHORVT “CL ALVIdG

THE ECONOMIC FACTORS 145

for milk of better sanitary quality. A noteworthy ex-
ample of this idea is the payment for low bacteria counts
which is made under the North plan of milk produc-
tion (page 78).

Such differential payments for milk are all in the
right direction as recognizing the commercial value of
quality and should be complemented by differential
prices for the retail product.

For the purpose of avoiding uncertainty dealers enter
very generally into contract relations with dairy farmers
according to which certain quantities of milk are de-
livered at schedule prices over greater or less periods
of time. These contracts usually fix the monthly prices
for six months at a time. One of the large New York
companies has recently adopted experimentally the
new departure of monthly bidding.

The cry of ‘‘monopoly”’ is not infrequently raised by
the farmer, and it is true that as an individual he often
has no choice to whom and at what price he is to sell his
milk. The farmer’s remedy, as we have pointed out in a
previous chapter, is organization to protect and ad-
vance his interests. Certainly, as an individualist he
is at a vast disadvantage. There are some signs that
the farmers are beginning to recognize this fact. Col-
lective action, though spasmodic, has been effected in
some instances, and the farmers’ ‘‘milk strike” has
recently come into existence in earnest.

ANOMALIES OF MILK AS A COMMODITY

Milk as a commodity is characterized by two peculiar
facts which are to be considered in connection with
the solution of the milk problem :—

146 THE MODERN MILK PROBLEM

1. Stability of Retail Price—While the cost of pro-
duction of milk and the available supply vary from
month to month, the price to the consumer remains
constant through long periods. The explanation of
this seems to lie in the regularity of consumption, which
enables the dealer to depend on an average price to
cover fluctuations in cost, and in the avoiding of dif-
ficulties which would arise from variations in the price
of a commodity delivered on standing order. At the
same time custom has brought about what one dealer
has called ‘‘the tyranny of the conventional price,”
and any increase in the established price is sure to call
forth a storm of public protest. Considerable increases
in the prices of meats and other foods are accepted
quite readily, for these prices are subject to constant
fluctuation, but an increase in the price of milk is re-
garded as an encroachment. Proposed raising of that
price often results in starting a ‘‘scare”’ with calls for.
prosecutor’s investigation,—an interesting example of
the power of convention. This is a condition naturally
deprecated by the distributer of milk, through whom it
reacts on the farmer.

Attention may here be called to the ticket system of
payments as a means of adjustment. Under this sys-
tem the dealer sells the customer for cash a strip or
book of tickets each of which is good for a quart or a
pint of milk. Because of the saving to the dealer in
collections and the ease with which the amount charged
for tickets can be adjusted so as to take account of
fractions of a cent in the quart price, customers who
use tickets can obtain milk at a lower rate than those
who pay on credit in round cents. With or without.

THE ECONOMIC FACTORS 147

this system, the adjustment of retail prices in fractions
of a cent for regular customers seems worthy of more
attention than it has received thus far. One of the
large companies of New York has recently been con-
sidering the plan of a weekly retail price which will
allow for fluctuations in cost.

2. Non-recognition of Quality Differences—To the
public “milk is milk,” and naturally, for the consumer
ordinarily has no knowledge of its source or actual
sanitary quality. Its whiteness and cream line are
all that are visible to the housewife. Hence, while
eggs, for example, are sold under four or five different
grades, there is, so far as official designation gOes,
(certified milk aside), generally only one kind of milk
on the market. Vital distinctions are thus ignored
which it should be the object of regulation to make
clear.

ECONOMIC EFFECTS OF SANITARY
REGULATION *

Those who view the milk problem from the sanitary
side are so apt to slight the economic bearings of sani-
tary regulation that some consideration of them here
will not be out of place.

In the absence of any effective regulation market
milk is bought and sold irrespective of sanitary quality.
In this case ‘“‘milk is milk” and there is one retail price
for all except in so far as certain milkmen may have
built up a public reputation of their own.

Where certain minimum sanitary regulations are put
into effect, the situation, assuming that the cost of

* Cf. figures on cost of sanitary items, Appendix D.

148 THE MODERN MILK PROBLEM

this minimum sanitation is no considerable item, will
be much the same. Any tendency to increased price
will be modified by the fact that cleanliness, refrigera-
tion, and pasteurization do not operate entirely to
raise costs, for they have an economic value of their
own in preserving milk and making it more salable and
would be practiced to some degree even if not required
by public authority. Under this condition of enforced
minimum standards some of the producers and dis-
tributers would doubtless naturally practice sanitation
above the requirements, but those dealers who rise
above the average in this respect would derive no extra
recompense.

If, now, the sanitary requirements be made de-
cidedly strict, a certain number of dealers will find
themselves unable to meet them, and will go out of
business. If the cost of production for the others is
materially increased, there will then normally be a
corresponding increase in price, and an increase will be
further favored if the elimination of the other dealers °
has reduced the total supply. The increase in price
may, on the other hand, reduce the demand, people
preferring to use less milk and dealers handling no
more milk than they can profitably sell at the increased
cost of production. Under these conditions the milk
industry tends to become concentrated in the hands of a
comparatively few men who can give it the demanded
special attention. This is what has happened, for
example, in a town which is notable for its strict regula-
tion, viz., Montclair, N. J., where the number of dealers
has been much reduced and milk is sold at a higher
price than in neighboring communities. |

THE ECONOMIC FACTORS 149

Under the system of regulation by minimum, which
has thus far been considered, it is clear that the price
of milk normally takes a single level which corresponds,
roughly, to the average cost of production. The poorest
qualities of milk cannot be sold; on the other hand,
qualities better than the average (with the exception
of certified milk, where sold) bring no added price and
there is no economic incentive to produce them.”

In a recent discussion of the milk situation in Ver-
mont the Commissioner of Agriculture of that State,
Hon. E. 8. Brigham,!* mentioned three ways in which
the situation might be improved :—

1. The limitation of the requirements of health boards to
those things which are necessary to safeguard the public
health.

2. The payment for milk on a basis which will make a
distinction in price between good milk and poor milk.

3. The securing for the producer of a price which will en-
able him to make a reasonable profit in his business.

Continuing his discussion of the economic question,
the Commissioner made the plain statement, based on
some analysis of figures, ‘‘I have yet to be shown where
the shipping of milk, under present conditions, is of
any value to our Vermont dairyman.”’ Referring to the
fact that the milk contractor will pay no more than
he has to, the speaker advocated concerted action by
the farmers in order to command higher prices. In
regard to the second of the propositions quoted, the
Commissioner asserted that, in accordance with the

* This condition may, of course, be modified by official publicity

regarding qualities of milks. Such publicity is not, however, very
effective except under special conditions. Cf. p. 115.

150 THE MODERN MILK PROBLEM

economic principle stated in Gresham’s law of cur-
rency, “if poor milk as a commodity of commerce
commands the same price as good milk and is cheaper
to produce, we may expect the milk supply to tend to
approximate the poore t quality which health officials
will allow to be sold.’’ Affirming that such premiums
for quality as have been established by some contrac-
tors are ‘‘entirely inadequate,” he continued :—

Now the question is this, Can milk which is dirty and
loaded with bacteria be cleaned by running through a clari-
fier, have its bacteria killed by pasteurization, and still be a
good, clean, wholesome product, fit for human consump-
tion? If so, there is very little need to encourage cleanliness
in production, because when the producer of clean milk sees
his product emptied into the same vat with the product of
the filthy producer, as is now the case, and he receives no
reward for his pains taken, he soon grows tired of attempting
to produce a clean product, and the quality of the milk supply
sinks to a low level. I have been repeatedly asked by . . .
contractors to devise some way to encourage the produc-
tion of clean milk. I have always inquired if clean milk was
worth any more than dirty milk so that they would care to
make an adequate distinction in price, but I have not yet
had a satisfactory answer.

The remedy of this situation is obviously not the
throwing of discredit upon clarification and pasteuriza-
tion—processes good in themselves—but the estab-
lishment and enforcement by health authorities of
standards which will act back to the original product
and necessitate a monetary distinction between good
milk and better milk and rule out the worse. For if
certain official grades of milk are established (as was ~

THE ECONOMIC FACTORS 151

described in the last chapter), there is brought about a
market condition in accordance with facts, each grade
_ publicly recognized commanding a price corresponding
to its quality and cost of production. This condition
supersedes—or should supersede—any unofficial or
ill-defined characterizations, such as are sometimes
given to milk by dealers. Most important of all, from
the economic standpoint, superior grades of milk are
then no longer lumped with the inferior, but bring the
higher price to which they are entitled. Only thus can
justice be done to both producer and consumer.

CHAPTER V
HOW SOLVE THE PROBLEM?

It now remains only to sum up the indications of
the preceding chapters, together with some considera-
tions of a more sweeping character.

THE GREAT NEED: MANIFESTATION OF VALUES

The great difficulty in the milk situation to-day is
that values, both sanitary and economic, are not
clearly recognized. Milk is the one staple food which
varies in sanitary value, in food value, and in cost of
production without these variations being generally
recognized in retail price. This is the ‘‘milk is milk”
difficulty.

Eggs are sold according to freshness, butter accord-
ing to flavor, flour according to its bread-making quali-
ties, meat according to the cut; but milk is sold, by an
outgrown custom, as plain milk—a white fluid in a
can or a bottle. If it can be sold as such, the dealer is
satisfied; if he obtains cream for his coffee and an
opalescent liquid for his children, the customer is con-
tent. The dairyman of slovenly methods may compete
with the cleanly, careful dairyman so long as he man-
ages to meet the minimum requirements of the law.
He may get the same price, and his methods play the
predominant part in fixing the market price of the

product known without discrimination as ‘‘milk.”’
152

HOW SOLVE THE PROBLEM? 153

For such reasons authorities are agreed that milk
should be graded according to definite standards and
should be labelled and sold on that basis. It only re-
mains to put the principle into operation.

Principles of Grading *

The following considerations should govern grading:

1. It should take account of sanitary quality, i. e.,
of safety and decency.

2. It should take account of composition, i. e., roughly
speaking, of nutritional quality.

3. It should be simple and practicable. The grades
should be few and the requirements as simple as pos-
sible.

4. It should take account of uses, with special refer-
ence to infant feeding.t

5. It should be evident to the consumer, which
means clear and simple labelling.

The requirement of safety will make pasteurization
essential for all grades except, possibly, raw milk of
the highest class. The impossibility of immediately
securing general pasteurization in many communities,
especially small ones, may, however, necessitate con-
cessions. This is the case with the classification pre-
scribed by the Sanitary Code of New York State (Ap-
pendix B).

In addition to the criterion of pasteurization, the
most feasible basis of classification as to sanitary quality

* For grading systems see Appendix B.

7 A rational classification is: (1) For infants and children (Grade A,
raw and pasteurized); (2) For adults (Grade B, pasteurized); (3) For
cooking and manufacturing purposes only (Grade C, pasteurized or
boiled—to be authorized only where necessary).

154 THE MODERN MILK PROBLEM

appears to be the total count of bacteria. Other labora-
tory tests may also be found to be applicable, with
special reference to dirt determination. Objections
to dairy score requirements for the different grades
have been discussed in Chapter III. The logical way
to rate milk is by the quality of the product itself, not by
the equipment of the dairy or the methods which the
dairyman is believed to use. In short, the proof of the
milk is the testing.

The most practical criterion of composition is the
butter-fat percentage, which varies more than the
solids not fat, is easy of determination, and is a point
of particular importance in artificial infant feeding.

A natural application of the above considerations
would be to grade milk according to sanitary quality
as “‘Grade A,” ‘‘Grade B,” ete., with the use of the
word “raw’’ or “ pasteurized’; then to add a figure
indicating for each supply the butter-fat percentage.
This latter might be stated by limits of variation, e. g.,
3.5 to 4.0% fat,” or by a single figure, as ‘‘ 3.5% fat,”
with a legal limit as to the permissible variation of the
actual content from such figure. Butter-fat labelling
has not yet, so far as the writer knows, been attempted,
but has been proposed * and, if proved to be prac-
ticable, would be the logical way of selling milk aeccord-
ing to richness. It would ensure the purchaser the
desired amount of cream and, if sufficiently accurate,
would be a guide for removing cream from milk in pre-
paring it for infant feeding. At the same time, the
health authorities would have to perform sufficient

*See recommendation by the Commission on Milk Standards,
p. 92, which further advises a guaranty of milk solids not fat.

HOW SOLVE THE PROBLEM? 155

testing and dealers would have to exercise care in mix-
ing milks so that the fat percentages would correspond
with the markings; otherwise these would only be mis-
leading.

Under the grading system the producer is paid for
the kind of milk that he produces, the dealer is paid
for the kind or kinds that he sells, and the consumer
pays for what he chooses to buy; and this result comes
about largely automatically. Natural differences will
be evident instead of being confused. The great mass
of consumers will doubtless continue to buy the cheap-
est milk that they can, but an increasing public recog-
nition of the better grades should develop when these
are clearly labelled and their use advocated by health
authorities. The system is therefore not merely puni-
tive as regards bad milk but is a means of developing
the production of good milks.

The Public Value of Milks

It is obvious that the availability of a given milk to
the consumer depends not only upon its sanitary and
food quality but also upon the price which he has to
pay. Dr. Charles E. North has sought to combine
the various items involved, by means of an ingenious
method of rating the public value of different milks.
Dr. North states that ‘‘the public value of milk, as-
suming that the average chemical composition of the
different grades and classes on the market is about the
same, depends chiefly on three fundamental charac-
teristics. These are safety, cleanliness, and price.”
His method of rating, on a scale of 100, is set forth in
the following table:—

156 THE MODERN MILK PROBLEM

POINTS POINTS POINTS

FOR SAFETY FOR DECENCY |/FOR PRICE*

IGRI yh ouei Wehner aeeh as aes 50||PERFECT....... 25||/PERFECT ...25
BACTERIA
IN RAW PRODUCT

Pasteurized in bottles......... 50 10,000. .25}| 9c or less. .25
Pasteurized in bulk, and bottled 45 100,000. .20)|10c........ 20
Medical} 200,000. .19||l1e........ 15
Veterinary ' Inspection penta ik 30 500,000.10) 1265. 10
Sanitary | 1,000;000.. 5)/15e........ ‘5
Scorimestarms)0.240.. 6 yeas 25
No Inspection....... Reese ia 0}/Over 1,000,000. . O)|20c........ 0

(Clarification would add 5 points to decency of all milk and in the
case of raw milk would also add 5 points to safety.)

This scale, applied, for example, to the milks sold
in New York City, gives values ranging from 89 down
to 70 for the three market grades A, B, and C. Certi-
fied milk is valued at 60, being rated down on safety
and price, while ordinary raw milk, excluded from sale
by the above grading, is given no credit except for
price, having the low value of 25. Dr. North states
that “the milk of the future will be reasonably clean
and scientifically pasteurized, and will be sold at a
moderate price. Such milk as Grade A pasteurized at
9 or 10 cents per quart is the milk toward which the
industry and the majority of sanitary authorities are
now working.’ This method of rating and its implica-
tions are discussed by Dr. North in publications on the
subject.t. It is obviously not to be taken too literally,
but simply as making general comparisons between

* Price scale adjusted to prevailing market prices for bottled milks,
minimum here being taken as 9 cents. ;

HOW SOLVE THE PROBLEM? 157

established grades of milk more definite than would
otherwise be possible.

COSTS AND PRICES *

Here may be summed up the main considerations
relating to costs and prices. These may be conven-
iently shown as follows:—

FACTORS
TENDING TO RAISE COSTS TENDING TO LOWER COSTS

Increasing farm costs of feeds,
labor, and other necessaries

methods

Greater efficiency of milk plant
machinery and methods and
of distribution (all favored by

Peto of dairying

Agricultural inefficiency

Increasing distances and rates of
transportation

concentration)

Increasing city expenses of dealer

Sanitation Simplification of sanitary require-
ments .

TENDING TO ADJUSTMENT OF COSTS AND PRICES
Recognition of grades
Organization of farmers

The above is simply a view of salient features with
the omission of considerations as to supply and de-
mand, adjustment of railroad rates, and other compli-
cating factors.

Regarding the general level of milk prices, the im-
pression got from considerations set forth in the last
chapter is that, at time of present writing, costs are

* Cf. Appendix D, Costs and Prices.

158 THE MODERN MILK PROBLEM

increasing distinctly more rapidly than the price to the
consumer. Hence, while better methods in milk sanita-
tion will tend to keep down costs, the consumer must
expect, so long as these are actually increasing, to pay
for the increase. If, as appears, a great deal of milk
is now produced at little or no profit or even at a loss,
and this is becoming increasingly recognized, then
rising prices must naturally be looked for. Again,
wherever materially stricter sanitary requirements
are made, it is to be expected that a corresponding
compensation in increased price will be demanded.

It is unreasonable to expect that, when the costs of
staples and labor are rising, the price of milk should
remain stationary, for the farmer and dealer are sub-
ject to the same economic conditions as the popula-
tion in general. Regarding any increase in the retail
price, it is fair to suppose that it should be shared by
farmer and dealer. Up to the present the farmer appears
to have had the small end of the division of profits. At
the same time a legitimate increase in price paid to the
producer should not serve as an excuse to dealers acting
in concert or combination to raise unduly the price to
the consumer. Unfortunately the present system re-
quires retail prices to be stepped up or down by whole
cents, while the dealer can adjust his price to the pro-
ducer in small fractions.

As to the cost of sanitation considered separately,
sanitary milk need not cost much more than unsani-
tary milk. Some idea of the items in this regard is
given by the North system (page 78) and by some of
the figures in Appendix D.

The advantages of the ticket system and of the ad-

HOW SOLVE THE PROBLEM? 159

justment of retail prices by fractions of a cent have
already been discussed in Chapter IV (pages 146-47).

Whatever price readjustments take place with the
adoption of the grading system will normally be the
just results of recognition of quality. In New York
City Grade A milk sells at one cent a quart more than
Grade B, while Grade C (an unbottled milk for cooking
or manufacturing purposes) is two cents below B. It
is clear that since proper grading in the average com-
munity, would raise standards, corresponding in-
creases in prices might be expected, but these would
fall chiefly or wholly on the better grades, and should
be by no means excessive.

Finally, the system of grades, by clearing up con-
fusion, permits freer play to the economic force of com-
petition and to the economic law of supply and de-
mand. There has been much talk about securing the
codperation of the dairyman and persuading him to go
to trouble and expense for improvements which are
not recognized in an increased price for his product
over that of other diarymen less amenable to persua-
sion. Codperation is an excellent thing, and it is well
to encourage individual effort. But competition is,
after all, the dominant force. It is not necessarily true
that, as has been asserted, ‘‘commercial competition
hurts the quantity and the quality of the milk supply.”
Quality is impaired only when sanitary regulation is
so inadequate as to permit it to be. Establish and
enforce definite milk standards for different grades,
and competition should operate to produce each grade
most efficiently and cheaply, while economic law should
ensure that the supply of each approximate the de-

160 THE MODERN MILK PROBLEM

mand,—although, to be sure, these effects are subject
to modification by conditions of present-day milk in-
dustry which we have considered elsewhere.

THE ROLE OF THE LABORATORY

In gauging the quality of milk the scientific method
is to rely upon the indication of the laboratory as op-
posed to the less accurate indications of inspection.
Reasons for this have already been set forth in Chapter
III, in the discussion of the score-card method of
dairy inspection. By means of inspection such matters
as health of cows and methods of operating milk plants
may be looked after, but, as regards operations in the
dairy, it is seldom possible to observe them. Inspec-
tion is therefore chiefly a means of giving advice or
instruction to the dairyman. But, by means of the
laboratory, samples of a milk may be taken at any
stage of its history and subjected to specific tests.
These tests can disclose not only its general bacteri-
ological and chemical character but also, perhaps, the
quantity of dirt which has contaminated it, and can
even detect abnormal udder conditions in the milch
cow when physical examination of the animal would
not do so.

Laboratory methods are steadily being developed in
scope and exactitude. They must rightly be regarded
not as a mere adjunct of inspection but as a first means
of indicating where Speco mas rather instruc-
tion—is needed.

A recent paper by Dr. Charles E. North, arguing
cogently for proper correlation of laboratory and in-
spection work, and putting the laboratory test before

HOW SOLVE THE PROBLEM? 161

the inspection, along the line from city to country,
concludes as follows (italics inserted) :—

In forming plans for the expenditure of the annual ap-
propriation for milk control the milk dealer as well as the
health officer should bear in mind that one laboratory worker
can test the milk of fifty dairy farms for bacteria while one
dairy inspector is inspecting five dairy farms, and that there-
fore one dollar spent in laboratory testing covers as much
territory as ten dollars spent in dairy inspection. The labora-
tory test should come first and make the diagnosis; the dairy
inspector should come second and apply the remedy. ‘These
principles result in the greatest economy and efficiency,
whether control is being exercised by the milk dealer or by
the health officer.”

THE ROLE OF INSPECTION

Inspection seems to have been originally regarded
as a species of policing, often with the elements of de-
tective work. The object was to ‘‘catch” the bad
milkman. This idea has now been largely superseded
by that of advice, of ‘“‘education of the dairyman.”

Dairy Demonstration

The conclusion toward which modern milk control
is tending is this: if the product, the milk itself, is to
be judged, rather than the dairy, and the dairyman
understands that its resultant bacterial character is
the all-important thing, then he will welcome advice
which will help him to produce better milk. If he be
held responsible and be paid for good results, he will
practice the methods for getting them.* And if those

* Under the North system (p. 78) it was stipulated that the dairyman

162 THE MODERN MILK PROBLEM

methods be simplified to the greatest possible degree,
so that he is not confused and discouraged by minutie,
then his codperation will be completely secured.

All of this has been shown to be perfectly possible
by North’s methods (described in Chapter III, where
also the use of a new type of score card was discussed).
Mere inspection as a mode of regulation has certain
serious inherent difficulties. The usual impossibility
of being present at milking time and other times when
operations connected with milk are going on has made
inspection often a mere survey of premises and equip-
ment. Questioning and injunctions do not ensure that
the dairyman use specified utensils and methods. A
small-topped milking pail on the wall may mean
nothing. But if the dairyman is directly responsible
for the bacterial content of his milk, he will not wisely
shirk methods as he is tempted to do when the emphasis
is placed on inspection.

Under these circumstances inspection, far from
being the bane of the farmer, would be indispensable
to him. Its frequency would be governed by the re-
sults of laboratory tests. It would be largely instruc-
tional; the inspector would be an adviser or demon-
strator of methods. The idea of inspection proper
would of course apply to such special examinations as
may be required, taking of samples, surveillance of milk
plants and of the sale of milk, and similar functions.
And when methods are to be criticised, advice or warn-
ing on the basis of unfavorable bacteriological. tests
will carry far more weight than any made “‘in the air.”

should share his sanitary premium with his milkers, thus carrying the
principle of payment for results to its logical extent in this direction.

HOW SOLVE THE PROBLEM? 163

A sane milk supply [says a recent writer] must be cheap
enough to be within reach of the common people; for this
purpose certified milk is a failure; on the contrary, if dairy
demonstration supersedes dairy inspection, and laboratory
tests the score card in grading milk, when care is made su-
perior to equipment . . . then a clean milk may be had at
a reasonable price as well.®

ORGANIZATION AND ADMINISTRATION *

The ideal plan for the administration of milk laws
would combine local and state supervision. Sanitary
authority being primarily local in nature, local munici-
palities should have ample power to control their milk
supplies; but there are certain things outside of their
territorial limits that can be done more efficiently by
the state. Local control has developed in advance of
_ that of the state, but the tendency is now toward giv-
ing greater powers of supervision (not abridging, but
supplementing, those of local municipalities) to state
authorities. Local authorities could, under proper
organization, enforce their ordinances through the
cooperation of the latter, who would thus exercise
supervision but not actual control. Modern laboratory
methods fortunately enable each municipality (pro-
vided laboratory facilities are adequate) accurately to
gauge the quality of milk as it is received within its
limits. ‘‘Country work” by state authorities is an
advantage for the reasons that they may economically
district their territory, that reduplications and long
trips by local officials may be avoided, that supplies
rejected by one municipality may be prevented from

* Cf. following section, on Legislation.

164. THE MODERN MILK PROBLEM

going to another without detection, and that uniformity
of methods may be secured and friction eliminated.
Supplies originating in one State and sent to neighbor-
ing States for sale may be supervised by officials of the
latter on condition of not being allowed entry to the
State without approval of their quality and treatment
and access of such officials to the sources and the line
of transportation. Theoretically, the state might best
perform all the necessary supervision outside of the
limits of each municipality.* But many municipalities
do all or a great deal of such work, for state control is
undeveloped and immediate expediency has dictated
such activity.

The state authorities referred to are those dealing
with health and with agriculture and animal industry.

One problem [says Dean Russell of the Wisconsin College
of Agriculture] which so far has not received the attention
which it should is the correlation of the work which should
be performed by the state. At present three generally unre-
lated state organizations may be concerned with the milk
problem:

(1) State boards of health, which are directly interested
in public health problems.

(2) State live-stock sanitary boards, or live-stock commis-
sions, which are concerned with the control of animal dis-
eases.

(3) State dairy and food commissions, which control the
purity and wholesomeness of food supplies.

Too frequently there is no correlation in the work of these
respective bodies. The milk problem touches all three of

* This principle was endorsed by the New York Milk Committee

in 1913, in a plan advocating uniform state legislation fixing milk
standards.

HOW SOLVE THE PROBLEM? 165

them, with none of them is it a dominant phase of their
activity. The consequence is that the problem in its en-
tirety does not receive the adequate attention of any of them.
In this respect improved conditions would undoubtedly
obtain, if a more thorough correlation of these various or-
ganizations could be brought about.

The milk problem, as such, is properly a hygienic matter.
Under these conditions, there is no question but that the
public health organization is in a better position to exercise
more effective control than either of the other two.*

The work of Federal authorities in this field is chiefly
advisory, consisting in investigation, advice to States
and communities, and publication of information of
more or less general application.

The situation as to state control is commented upon
by Dr. Charles V. Chapin, in a recent survey of the
work of state health departments, as follows:—

The subject of milk control is one of the most complicated
and difficult in the whole field of public health. There are
some who feel that it is a local problem and should be left
to the municipalities to work out for themselves. The ma-
jority believe theoretically in uniform state laws and state
control, but these are difficult of attainment. In agricul-
tural states, with small cities, the difficulties are not so great,
and they are most acute in the northeastern states, where
there are many large cities and less good agricultural land.
Theoretically, the State Board of Health should be entrusted
with the enforcement of milk laws, as well as consulted in
their framing. Actually, state legislatures have not given
the State Board of Health much authority, owing to fear
on the part of the farmers. In some states it is claimed that
authority over milk has been given to the department of
agriculture, to keep it away from the health department, or

166 THE MODERN MILK PROBLEM

a special dairy department has been created for a similar
purpose.°

The development of extension work by state agricul-
tural authorities is of the greatest importance. It is not
sufficient to publish scientific bulletins; the most ef-
fective service requires that agricultural experts—ad-
visers or demonstrators—go regularly to the farmer and
assist him with his problems. In preceding paragraphs
we have seen how important is this practical advice as
distinguished from mere inspection and how it is a nec-
essary complement of milk regulation

LOCAL SUPERVISION

Granted that efficient public health service and a
system of grading have been established, the most im-
portant single means of local supervision is the labora-
tory. The apparatus for performing even as many as
100 to 200 bacteria tests daily can be installed at a
small expenditure ($200 to $500). .(The apparatus for
ordinary chemical tests is also inexpensive.) Under ex-
pert supervision, tests may be made by a careful worker
(young man or woman) at a very moderate salary.

The effort should be made to examine each supply
for total count at least once a week, especially during
the warmer months, and to make any special examina-
tions that may be necessary.* Chemical tests may
be made less frequently, unless milks are labelled for
fat content. Other laboratory tests, e. g., for dirt, may
also be practiced.

The amount of attention devoted to milk ahaa by

* Cf. resolution of Commission on Milk Standards relative to tests
for grading, Appendix B

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HOW SOLVE THE PROBLEM? 167

local health authorities varies greatly. Information
collected by the Department of Agriculture in 1912-13
from 162 cities of the United States showed that the
amount of money spent for dairy inspection ranged all
the way from nothing to 19 cents per capita per annum,
with an average of 3.6 cents. But, beyond the mere
fact that the amounts were spent, we know nothing as
to the methods, efficiency, or results accomplished.

Cooperative Local Supervision—tIn connection with
local work mention must be made of the fact that com-
munities which are too small to be able to afford ade-
quate milk control, and especially the laboratory at
which it should center, may codperate in maintaining a
common laboratory and joint service. Such codpera-
tion is in effect at Wellesley, Mass., with a number of
neighboring towns, at La Salle, Oglesby, and Peru, IIl.,
where a common Hygienic Institute, or health depart-
ment, has been established; and among the munici-
palities centering about Orange, N. J. In the first two
cases the codperation is for public health service in
general, while in the last case it is simply for super-
vision of milk supplies. It is obvious that such plans
not only simplify and economize the control of over-
lapping milk supplies, but also make it possible for
even the smallest of the towns concerned to obtain
expert service and adequate laboratory facilities at a
moderate cost.

LEGISLATION

What has been said in the preceding section fore-
shadows the remarks appropriate to this head. While
the sanitary function of milk regulation is ‘primarily a

168 THE MODERN MILK PROBLEM

local matter, there is now a tendency to make state
legislation more specific and to give the state board of
health or some other body power to promulgate regula-
tions applying to the state as a whole, excepting, per-
haps, the largest cities. Such legislation and regulations
may ensure uniformity of fundamental requirements,
and are a special manifestation of the general tendency
to establish state sanitary standards. A notable step
in this direction has been taken in New York State,
where a sanitary code prescribed by the Public Health
Council applies throughout the State with the excep-
tion of New York City. (For the system of milk grad-
ing established by this code, see Appendix B.) A
similar power has also been conferred upon the State
Board of Health of New Jersey.

Legislatures may embody more or less specific regula-
tion in statute, leaving subordinate regulations to some
special body, or they may confer large general powers
in the matter to such a body. The normal agency for
the formulation of state regulations primarily affecting
public health is the state board of health, but, on ac-
count of the several interests involved, there has been
some controversy as to what body should be empowered
to prescribe milk regulations. Composite boards or
commissions have, therefore, been proposed in which
health and agricultural authorities should play the
chief part, along with representatives of local boards
of health, farmers’ and dealers’ organizations, etc.
It seems clear, however, that the sanitary authorities
should alone be vested with power to establish regula-
tions primarily affecting health. A mixed board, es-
pecially if at all large, is likely to be a disharmonious

HOW SOLVE THE PROBLEM? 169

and therefore a weak board. The practical effect of
such a board is likely to be to obstruct if not to nullify
the efforts of the health authorities. Compromises
are the result of undue jealousy on the part of agricul-
tural and milk industry interests, which cannot in
justice oppose legitimate sanitary control under proper
legislation. :

LOCAL DIFFERENCES

Local or regional differences in the intensity of the
milk problem are determined by the following general
factors :-—

1. Degree of urbanization and of development of
milk traffic.

2. Value of agricultural lands.

3. Development of efficiency of the dairying in-
dustry.

4. Costs of feeds and other farm material, of farm
labor, transportation, handling, and distribution.

5. Sufficiency or insufficiency of local milk supply.

6. Sanitary control or its absence.

7. Adjustment or maladjustment of milk prices.

These factors naturally vary greatly according to
place, and certain of them fluctuate from month to
month. A complete survey of the milk situation of a
region or city is a matter of much complexity. Men-
tion of some such surveys is made in Appendix E.

To establish sanitary control in any given town or
city, extensive preliminary investigation is usually
unnecessary. Chief attention is to be paid to the ques-
tion of how much laboratory and inspection work is
necessary for the given number of supplies, dairy farms,

170 THE MODERN MILK PROBLEM

milk plants, etc., and its cost. Facts well recognized
regarding the milk problem in general should be as-
sumed. It is well to bear in mind that some local data
have primarily an administrative value, while others
are assembled chiefly in order to convince governing
and appropriating bodies of the necessity of control.
In proposing regulation the recommendations of the
National Commission on Milk Standards should be
consulted. In establishing the grading system it is of
course necessary to specify a thorough working mech-
anism as a prerequisite to the proper enforcement of
the system.

CENTRALIZATION, COOPERATIVE PLANS,
MUNICIPALIZATION

The difficulties, sanitary and economic, of the milk
problem under present trade conditions are such that
various plans for centralization and codperation have
been proposed. These may be classified as fol-
lows :—

1. Farmers’ codperative milk depots in country dis-
tricts.—Such a plan has been described by the Boston
Chamber of Commerce committee as quoted on pages
142-44 of the present volume. Under this head may
also be included plans for the organization of such
depots under the auspices of city organizations, as in
the case of the Homer plan (Appendix C).

2. Farmers’ codperative city marketing, involving sale
of milk by bidding or auction to city dealers, with the
object of breaking up price-dictation by middlemen.
This has recently been proposed by New Hngtand
producers shipping milk to Boston.

HOW SOLVE THE PROBLEM? 171

3. Codperative pasteurization plants, under private
or public control.

4. Central city delivery, under private or public
control (see pp. 139-40).

5. Complete municipalization,—i. e., handling under
the control of the municipality from the farm to the
consumer. This plan has recently been proposed for
all municipalities in the State of Rhode Island by a
legislative commission of inquiry (Appendix E).

Concentration is clearly a great factor in efficiency,
as is shown by the large milk companies of the cities.
Individual retailers, as well as the farmers, have been
slow to see the great advantage of concentration; hence
they labor under difficulties. Farmers’ codperative
milk depots in country districts have been advocated
as practical (see pp. 142-44). Codperative pasteuriza-
_ tion and central distribution to obviate the wasteful
overlapping of delivery routes have been tried in
one instance known to the writer, with apparent
success (see p. 250). Certain practical difficulties are to
be met in connection with these last ideas,—difficul-
ties which could be obviated only by amalgamation
or assumption of the interests of the dealers involved
(see p. 140). The association of individual dealers to
form businesses of efficient size would eliminate the
disadvantages and wastes existing when bottling,
pasteurization and distribution are so dispersed that
overlapping of function and high operating expenses
are inevitable. ‘There is more hope in the general
recognition of this economic fact by dealers and in
their voluntary or economically forced amalgamation
of interests than in cooperative plans which have to

172 THE MODERN MILK PROBLEM

contend with the individualistic attitude of retailers
in competition.

Those who advocate the extreme of municipaliza-
tion—for instance, Nathan Straus ’—draw a parallel
between water supplies and milk supplies, and argue
that, as municipalities have had to own the former, so
they will have to come to owning the latter. The basis
of the parallel is that milk, like water, is distributed
in larger quantities and bears an important relation
to public health, and that milk supply cannot be satis-
factorily controlled by public authority acting in a
simply supervisory capacity. The mere condemnation
of the idea as ‘“‘socialistic” is, of course, superficial;
it should be examined on its actual desirability.

The proposition comes into relation with the general
idea of municipal management of public utilities. It
may be taken as a principle of political economy that
such management, in general, should not be under-
taken unless public regulation has proved to be a failure.
Such failure is most likely to occur in connection with
monopolies, and the argument is strongest in the case
of natural monopolies, such as water supply. But
in the case of milk supplies, monopoly is seldom ad-
vanced as a reason, the proposal of municipalization
being based upon desired expediency of regulation or
efficiency of operation.

As a general principle, ‘‘reasonably successful regula-
tion,” writes the economist Taussig,® ‘‘is more easy
to attain than reasonably successful public manage-
ment,’’ and under conditions in the United States there
has been a marked and justifiable tendency to rely
upon private enterprise for the performance of even

HOW SOLVE THE PROBLEM? 173

distinctly public services of an industrial character.
The supplying of water to town and city dwellers has
been (as another economic authority ° says) ‘‘the only
important exception ... and this has been under-
taken by municipal governments less because of any
distrust of private enterprise in this field than because
good water has been demanded by public opinion even
before the business of supplying it gave promise of
proving financially successful.” The writer just quoted
also cautions us that, in general, ‘‘the objections to
such policy [municipal ownership or management] for
the cities of the United States are very strong.”’

In point of actual operation the public assumption
of the milk trade, especially by large cities, would
obviously involve serious difficulties not found in the
simple taking-over of a water system. In view of the
fact that there are as yet (so far as the writer knows)
no data of the actual operation of any such plan, cau-
tion is certainly justified. The immediate embarrass-
ment arising from disturbance of the milk trade must
be considered, as well as the possible evils of political
control. The debate between those who believe that
the difficulties of the milk problem can thus be swept
away at a stroke and those who hold that satisfactory
public supervision is not only possible but safer and
more favorable to efficiency than public management
would be, is not unlikely to issue into some trial of the
idea.* Auspicious conditions for this might possibly

*The author has not been able to obtain any information as to
whether the idea of municipalization has been put into practice any-
where in the United States. At Jamestown, N. Y., however, a plan
has been under consideration (Western Medical News, June, 1915).
Municipal milk plants, mainly for pasteurization, have been proposed

174 THE MODERN MILK PROBLEM

be found in a well-governed municipality, of the smaller
size, where the town functions of individual farmer-
retailers could readily be assumed by the municipality
without serious disturbance. In instances where the
question of the tuberculin test is being agitated, farmers
might prefer to sell to a coéperative or municipal pas-
teurizing and distributing plant rather than under-_
take the test. Such a plant might possibly be financed
and managed by an association of citizens with the
object of securing better milk and eliminating: in-
efficiency in distribution, as an alternative to munic-
ipal management. In short, as with some other pro-
posals of coéperation or municipalization, exceptional
local conditions might perhaps render such a project
feasible. But the sweeping claims attached to the
general idea must certainly be viewed as extravagant.

THE GIST OF THE MATTER

To sum up the salient factors in the solution of the
problem :-—

Milk must be both safe and decent.—It should also
be of known food value.

To secure Decency: Supplies should be controlled by
laboratory tests supplemented by inspection in which
instruction in simple, rational methods of clean milk
production should play the chief part.
in several instances. The Health Officer of Brookline, Mass., makes
such a proposal in a recent report. The most conspicuous plan of munic-
ipal management is that recently proposed by a legislative commission
in Rhode Island (see Appendix E). It is interesting to note that even
a socialist, John Spargo, while accepting the theory of socialization of

milk supplies, has not favored attempting to apply it under American
conditions (‘‘The Common Sense of the Milk Question,” 1908).

HOW SOLVE THE PROBLEM? 175

To secure Safety: All milk, excepting possibly a class
of the highest grade, phone be pasteurized under ade-
quate official supervision.*

To secure Justice: Milk should be graded and labelled
on the basis of laboratory tests and pasteurization.

Grading and the laboratory are the most important
single means of sanitary control.

Grading is the most important single factor in eco-
nomic adjustment.

Quality should be recognized through fair milk prices
to both farmer and dealer. |

The advantages of centralizing at a few plants the
operations of handling, pasteurization, bottling, and
distribution should be recognized.

WHO IS TO SOLVE THE PROBLEM?

While the various factors in the milk problem some-
times appear to have reached a pass which may be
described as a puzzle, a deadlock, or a ‘‘muddle,”’ its
solution should not be so difficult as it often seems,
provided only that facts be recognized and right prin-
ciples adopted. It will not, however, be lastingly
solved by any one group of persons without regard to
the others concerned.

Health authorities must adopt improved methods
of sanitation and, with legislative sanction and sup-
port, establish rational regulation based upon the
grading principle.

* It may here be again noted that, although the recommendations
of the National Commission on Milk Standards leave the pasteuriza-
tion of “Grade A” milk optional, the majority of the commissioners
voted in favor of the pasteurization of all milk.

176 THE MODERN MILK PROBLEM

Legislators must recognize the necessity of legisla-
tion authorizing such regulation, as opposed to the
dangers of inaction or partisan interest.

Agricultural authorities must advise the farmer in
the methods of producing sanitary milk efficiently.

The dairy farmer must welcome this assistance and
make use of all possible means of improving his methods
and management, and he must organize.

The dealer must respect the interests of the farmer,
work for the solution of their common problems, and
pay a fair price for milk according to quality.

The consumer, finally, must recognize quality in
milk; he must be willing to pay a fair price for good
milk and a reasonably higher price for better milk.

REFERENCES

(References are given for the more important matters cited in
the text, but no attempt has been made to make the list exhaustive.)

CuapTer I. Wuy THERE Is A MILK PROBLEM

1. Sedgwick, Wm. T., ‘‘Principles of Sanitary Science and the
Public Health,’ New York: The Macmillan Co., 1905, p. 263.

. Farmers’ Bulletin 363, 1910 (reprint, 1915), pp. 33-35.

3. Liid., p: 7.

4. North, C. E., “Safeguarding Nature’s Most Valuable Food,
Milk,”’ pamphlet prepared for the New York Milk Com-
mittee, 1915. Cf. note, ‘The bacteriology of milk from
normal udders,”’ Jour. Am. Med. Assn., 1916, vol. LXVI,
p. 1930.

5. U.S. Children’s Bureau, “‘ Baby-saving Campaigns,’ 1913, p. 45.

6. Park, Wm. H., and Holt, L. R., “Report upon the results with
different kinds of pure and impure milk in infant feeding in
tenement houses and institutions of New York City: A
clinical and bacteriological study,” Archives of Pediatrics,
Dec., 1903.

7. Meigs, Grace. (Children’s Bureau, U. 8. Dept. of Labor),
‘“‘Other factors in infant mortality than the milk supply, and
their control,” Am. Jour. Public Health, 1916, vol. VI, p. 847.

8. “Milk and Its Relation to the Public Health,” Bull. 56, Hyg.
Lab., U. 8. Public Health Service, 1909, p. 25.

9. Rosenau, M. J., “The Milk Question,” Boston: Houghton
Mifflin Co., 1912, p. 90.

10. Biggs, H. M., ‘“Milk-borne septic sore throat—a new public
health problem,” Medical Record, Dec. 4, 1915.

Davis, D. J., “Milk epidemics of septic sore throat in the
United States and their relation to streptococci,” Science,
Nov. 13, 1914, p. 1037.

MacNutt, J. S., “A Manual for Health Officers,” New York:
John Wiley and Sons, Inc., 1915, p. 288.

177

178

12.

13.
14.
113).

16.
Nf,

—

REFERENCES

Park, Wm. H., “The réle of bovine tuberculosis in the produc-
tion of human tuberculosis,” Trans. XV Internat. Congress
on Hyg. and Demography, 1912, vol. IV, pp. 267-72.

Rosenau, M. J., ‘Preventive Medicine and Hygiene,’ New
York: D. Appleton and Co., 1913, pp. 124-25.

Ibid., p. 124.

Rosenau, M. J., ‘The Milk Question,” p. 97.

Goler, G. W., 2d Ann. Trans. Am. Assn. for Study and Prev.
of Infant Mortahty, 1911.

North, pamphlet cited.

Kelley, Eugene R.: ‘‘The evidence available as to the relative
importance of milk as a means of transmission of communi-
cable diseases, compared with other means of transmission,”
Rpt. of Special Milk Board of Mass. State Dept. of Health, °
1916; “The quantitative relationship of milk-borne infection
in the transmission of human communicable diseases,” Jour.
Am. Med. Assn., 1916, vol. LX VII, p. 1997.

Cuapter II. Tue Case To-pay

. Sedgwick, op. cit., pp. 271-72.

2. Rosenau, “The Milk Question,” pp. 19-20.

. Parker, H. N., “The city milk trade,” Nat. Mun. Review, Oct.,

O13) nT:

. Cook, L. B., ‘‘The encouragement of clean milk production,”

Circ. 38 (from 62d Ann. Rept.), Mass. State Bd. of Agricul-
ture, 1915. |

. Rosenau, “The Milk Question,” pp. 243-44.
. Parker, loc. cit.
. Conn, H. W., “Will any milk do?’’, Harper’s Weekly, Feb. 8,

1913.

. Luening, F. W., Deputy Health Commissioner, Milwaukee:

personal communication.

. Chapin, C. V., ‘Effective lines of health work,” Providence

Medical Jour., Jan., 1916.

. Chapin, personal communication, Sept. 29, 1916:
. Schneider, Franz, Jr., ‘‘ Relative values in public health work,”

Am. Jour. Public Health, Sept., 1916.

. Boston Transcript, March 3, 1916.

OO bh =

REFERENCES 179

CuaprTer III. Tue Sanirary Factors

. Parker, loc. cit.
. Sedgwick, op. cit., p. 265.
. Boston Med. and Surg. Jour., vol. 126, 1892, p. 25. (Quoted in

Bull. 56, Hyg. Lab., U. S. Public Health Service, p. 450.)

. Kelley, Ernest, ‘Medical milk commissions and _ certified

milk,” Bull. 1, U. 8. Dept. of Agriculture, 1913.

Coit, Henry L., “The work of medical milk commissions . . . F
Trans. XV Internat. Congress on Hyg. and Demography,
1912, vol. IV, p. 611.

“Methods and standards for the production and distribution
of ‘certified milk,’” adopted by the Am. Assn. of Med.
Milk Commissions, 1912: Reprint 85 from Public Health
Reports.

- Brew, James D., “ Milk quality as determined by present dairy

score cards,” Bull. 398, N. Y. Agric. Experiment Station,
Geneva, N. Y., 1915.

. Harris, J. A., Science, Oct. 8, 1915) p.503.
. Brainerd and Mallory, ‘A study of the bacterial count and

dairy score card in city milk inspection,” Bull., Virginia
Polytechnic Institute, Sept., 1911.

. Harding, Ruehle, Wilson, and Smith, “The effect of certain

dairy operations upon the germ content of milk,” Bull. 365,
N. Y. Agric. Experiment Station, Geneva, N. Y., 1913.

Sw hogih
- North, “A Survey of dairy score cards,’ Am. Jour. Public

Health, 1917, vol. VII, p. 25.

. North, “Sterilizing stations in dairy districts,” Jour. Am. Public

Health Assn., 1911, vol. I (0. s. VID), p. 654.

. North, ‘The market value of cleanliness in milk production,”

address delivered at 36th Ann. Convention, N. Y. State
Dairymen’s Assn., 1912.

. North, “Bacterial testing versus dairy inspection, Am. Jour.

Public Health, 1916, vol. VI, p. 572.

. See 10.
. “Infant mortality and milk stations,” special report of Com-

mittee on Reduction of Infant Mortality, of the N. Y. Milk

180

22.

23.

24.

20.
26.

27.

28.

29.

30.

REFERENCES

Committee, 1912; Kerr, J. W., ‘Data regarding operations
of infants’ milk depots in the United States in 1910,” Re-
print 64 from Public Health Rpts.; and many other sources.

. Am. Food Jour., Aug., 1907, p. 33. (Quoted in Bull. 56, Hyg.

Lab., U.S. Public: Health Service, 1909, p. 380.)

. Reprint 141 from Public Health Rpts., 1918.

. Reprint 192 from Public Health Rpts., 1914.

. See 17.

. Reprint 295 from Public Health Rpts., 1915.

. Weinzirl, John, ‘‘A safe and sane milk supply,” read in

Jan., 1916, before Subsection D-IV, Sec. VIII, Pan-American
Scientific Congress; to be printed by the Congress.

Campbell, H. C., “Comparison of the bacterial count of milk
with the sediment or dirt test,’’ Bull. 361, U. S. Dee of
Agriculture, June 29, 1916.

Wells, C. H., “The saecesstul efforts of a small city to secure a
milk serail from tuberculin-tested cows,” Am. Jour. —
Health, 1912, vol. II, p. 703.

Reprint 141 from Public Health Rpts., 1913. Cf. bulletins
relating to pasteurization published by U. 8. Dept. of Agri-
culture.

Reprint 141 from Public Health Rpts., 1913.

Jordan, E. O., “The case for pasteurization,” Trans. XV In-
ternat. Congress on Hyg. and Demography, vol. IV, p. 627;
Ayers, S. H., “The present status of the pasteurization of
milk,” Bull. 342, U. 8. Dept. of Agriculture.

Kilbourne, Chas. H., “The Pasteurization of Milk from the
Mechanical Viewpoint,” New York: John Wiley and Sons,
Inc., 1916. (The dealer contemplating pasteurization or
improvement of methods will find this book of advantage in
comparing different types of commercial pasteurizing ma-~
chinery.)

“The value of boiled milk,” editorial, i our. Am. Med. Assn.,
1916, vol. LX VII, p. 1674.

Ayers, 8. H., and Johnson, W. T., Jr., “Pasteurization in bottles
and the process of bottling fot Saat aed milk,” Jour. In-
fectious Diseases, 1914, vol. XIV, p. 217.

Sedgwick, Wm. T., ‘‘American achievements and American

dl.

32.

(opr) oe & be

oo won

REFERENCES 181

failures in public health work,” Am. Jour. see Health, 1915,
vol. V, p. 1105.

‘Bahlman, Clarence, “‘ Milk clarifiers,” Am. Jour. Public Health,

1916, vol. VI, p. 854.
Baldwin, H. B., ““Some observations on homogenized milk and
cream,” Am. Jour. Public Health, 1916, vol. VI, p. 862.

CuHapteR IV. THE Economic Factors

. Cook, L. B., loc. cit. under Ch. II.

. Boston Transcript, March 8, 1916.

. Clean Milk Bulletin (Charles E. North), Dec., 1911.

. Editorial, Jacksonville, Fla., Times-Union, March 6, 1913.

. Kelly, Ernest, ‘Factors influencing the cost of milk to the

consumer,’ Hoard’s Dairyman, April 24, 1914.

. Bull. 156, U. S. Bureau of Labor Statistics, March, 1915;

Monthly Review, same Bureau, vol. II, no. 6, June, 1916.

. Kelly, loc. cat.
. Kelly, loc. cit.
. Cook, loc. cit.
. Williams, John R., “The economic problems of milk distribu-

tion in their relation to the public health,” Trans. XV In-
ternat. Congress on Hyg. and Demography, 1912, vol. V,
p. 128.

. Report on Milk Investigation, Boston Chamber of Commerce,

1915, po: 32: cl p. 68.

. Ibid., pp. 49 ff.
. Bull. Vt. State Bd. of Health, Dec. 1, 1916.

Cuaptrer V. How SoLvE THE PROBLEM?

. North, C. E., “The public value of different milks,” Med.

Record, Nov. 22, 1913; ‘‘Safeguarding Nature’s Most Valu-
able Food—Milk,’’ booklet issued by N. Y. Milk Committee,
1915.

. North, “Bacterial testing versus dairy inspection,” Am. Jour.

Public Health, 1916, vol. VI, p. 578.

. Weinzirl, op. cit. under Ch. III.
. Russell, H. L., “The function of the state in milk-control

182 REFERENCES

work,” Trans. XV Internat. Congress on Hyg. and Dem-
ography, 1912, vol. IV, p. 600 f.

5. Chapin, C. V., Report on State Public Health Work, based on
a survey of state boards of health, Am. Med. Assn. (n. d.,
1915 or 1916), p. 171.

6. North, loc. cit. (2), p. 578.

7. Straus, Nathan, ‘The relations of the city to the milk supply,”
Am. Jour. Public Health, 1915, vol. V, p. 11.

8. Taussig, F. W., “Principles of Economics,” New York: The
Macmillan Co., 19138, p. 413.

9. Seager, H. R., “Introduction to Economics,’ New York:
Henry Holt and Co., 1906, p. 457.

10. Seager, ‘‘ Economics: Briefer Course,” 1909, p. 368.

GENERAL REFERENCES

Although the literature of milk is very voluminous, there are few
good books on the subject. Most of the vital information is scat-
tered through periodical and bulletin literature such as that to
which the preceding references relate.

The most valuable single item is the reports of the National
Commission on Milk Standards appointed by the New York Milk
Committee (105 East 22d Street, New York City), which contain
important recommendations concerning grading and regulation of
milk and milk products.

A comprehensive work dealing with the various phases of milk
industry and methods of control, by Horatio N. Parker, has re-
cently appeared: “ City Milk Supply ”’ (McGraw-Hill, 1917).

One of the best general works, non-technical, is Rosenau’s “‘The
Milk Question” (Houghton Mifflin, 1912).

“Milk and the Public Health,” by W. G. Savage, an English
authority who quotes freely from American sources (Macmillan,
1912), is an excellent summary of ‘professional milk literature up
to that date. This work deals with the bacteriology and bac-
teriological examination of milk, milk and human disease, and
control of milk supplies. <A still more recent work, also English,
of the same character, is “‘Milk and Its Hygienic Relations,” by
Dr. Janet E. Lane-Claypon (Longmans Green, 1916).

REFERENCES 183

In 1908 the Hygienic Laboratory of the United States Public
Health Service published a large volume entitled “Milk and its
Relation to the Public Health,” embodying monographs on the
various phases by different collaborators. This was revised and
enlarged and republished as Bulletin No. 56 of the Laboratory, 1909.

Bulletins on various subjects relating to milk and to dairy hus-
bandry and industry are constantly being published by the United
States Public Health Service, by the United States Department of
Agriculture, and by state departments of agriculture and experiment
stations. Papers and notes appearing in such journals as aré
mentioned in the foregoing bibliography may also be consulted
for current developments..

APPENDIX A
SOME MILK STATISTICS
GENERAL ESTIMATES FOR THE UNITED STATES *
Total annual production of milk (1915)

11,590,000,000 gallons Tf
(115 per capita)

Value of the same, on the farms............ $2,320,000,000
Milch cows on farms (Jan. 1, 1916)......... 21,988,000
NWoalievomihe same. 0. al obo ee cles $1,185,119,000
pwerace yield per COW W.)..2 62h se a 537 gallons per year
Average per capita use of milk as such.. 0.6 pints per day

* Drawn from Monthly Crop Report, U. S. Dept. of Agriculture,
vol. 2, no. 1, Jan. 31, 1916.

t+ Of this the larger part is used for the manufacture of butter, cheese,
condensed milk, and other milk products. The proportion consumed
as milk is estimated as about one-quarter of the whole.

185

186 APPENDIX A

-PopuLATION AND MiucH Cows IN THE UNITED States. Compiled
and computed from the U. 8. Census and the Yearbook of the U.S.
Department of Agriculture for 1915. (Except as otherwise noted,
figures relate to January 1 of each year.)

Population of Mitch cows| Average
Year continental Milch cows | per 1,000 of | price per
United States population head

LSSOMe Ge * 50,155,783 | * 12,443,120 t 248 $23 .27
SOO er * 62,947,714 | * 16,511,950 t 263 22.14
PIOO Eis eee 75,451,000 16,292,000 216 31.60
NGOOR Re ee Aes, * 75,994,575 | * 17,135,633 E225) eae
OOD Re sca 76,938,000 16,834,000 219 30.00
TOOD see ees 78,556,000 16,697,000 212 29.23
POOR aL ie 8 80,174,000 17,105,000 213 30.21
TGOS oes as 81,792,000 17,420,000 213 29.21
TOWS ee ey. 83,410,000 17,572,000 211 27.44
HOO eee: 85,028,000 19,794,000 233 29.44
TOOTS Beene ae 86,646,000 20,968,000 242 31.00
OOS ee eee 88,264,000 21,194,000 240 30.67
PO OO: ice ee 89,882,000 21,720,000 242 32.36
TOO ele 91,500,000 21,801,000 238 35.29
POLO es eee T 91,972,266 | 7 20,625,482 1224 0 ahaa
1118 Naame ee 93,118,000 20,823,000 224 39.97
RS) 241 3 ae at 94,736,000 20,699,000 219 39.39
MOU eae, 96,354,000 20,497,000 213 45.02
1G ie BA oe 97,972,000 20,737,000 212 53.94
Oa Se ere pines 99,590,000 21,262,000 213 55.33
LTC sae 101,208,000 21,988,000 27) | 63.90

* Census as of June 1.
t Census as of April 15.
t At date of census.

APPENDIX A 187

MitcuH Cows, By States: 1905; 1915, and 1916. Fundamental
figures are taken from Yearbooks of the U.S. Department of Agriculture
for 1904, 1914, and 1915.

(Numbers represent thousands, estimated for January first of each
year.)

| Increase | Decrease*

1905 1915 Sone cand) | per com 1916*
Mme Rn Ae ee 189 157 ie 159
New Hampshire... . 130 95 27 97
Wermiontiid.. yo 2423)- 285 268 6 273
Massachusetts ..... 191 157, 18 155
Rhode Island...... 25 23 8 22
Connecticut....... 131 118 10 119
News Mork i oi). 1,722 | 1,509 12 1,539
New Jersey........ 185 146 20 152
Pennsylvania...... 1,087 943 13 971
Delaware.........: 35 Al a7; 42
Maryland 0's 30) 2. 147 WAT 20 181
Varennes a0: 153 349 | 128 359
West Virginia...... 180 234 30 241
North Carolina .... 193 315 63 321-

South Carolina..... 110 185 68 189

*In considering the exact significance of the movements shown in
this table, the ratio between the estimated number of milch cows and
the estimated population of the state at each date should be taken into
account. Thus relatively to population, several other States—e. g.,
Illinois—would be placed in the group showing decrease as between
1905 and 1915. Figures on actual production of milk in the years
taken are not available, but the question of productivity may be dis-
regarded in considering the general phenomena brought out by the table.

+ This column is added to show the recent trend, as between 1915
and 1916. It will be observed that those States which showed a de-
crease during the preceding decade have now (and perhaps had before
the close of the decade) entered a period of increase, with the exception
of Massachusetts and Rhode Island. In Connecticut, however, this
increase appears to be less than proportionate to the increase in popu-
lation.

188 APPENDIX A

Increase | Decrease

1905 1915 (per cent) | (per cent)
(C(2 (01 0a te RE a eae PAM A 406 47
lontears 206 .fs ee 87 133 53
Ohigee sce welt es 791 895 13
Inara. <s2. a. e 548 646 18
HOS: eee ee 995 | 1,007 1
Macha ana 556 814 46
WHSconsim: 0 Gees. 1,096 | 1,626 48
Mannesota:e 27.27. 2 837 | 1,186 42
MWA TS co HE tte tts 1,336 1.377 a
INGISSOUEIA es eee 570 797 40
North Dakota ..... 194 339 75
South Dakota...... 402 453 13
INebraska 9. aoe 669 625 %
Wansas ois. ee 671 726 8
Kentucky 2 Ys. ./.0 7 287 390 39
Tennessee......... 283 355 25
Alabama. ty 2.5% 230 384 67
Mississippi........ 272 434 60
owistana. Vo... 166 268 61
MORASS cere Gi etnnd ae. 838 | 1,086 30
Oklahoma 2.35: 187 494 164
ATKANSAS. \o\ 27), ok 281 387 38
Montana. be toa) 55 114 107
Wiyomuinge . 3 24s 20 46 | 130
Colorado jae 554. 121 205 70
New Mexico....... 20 68 | 240
JNTVAGIOVE He ee tal dissin ene 19 44 132
ian aS eect 3 92 26
Nevadare ease eee. 17 24 41
Nidan eee un as: 60 120 100
Washington....... 159 253 59
Orecon sha aee ee 139 210 51
California cue. 2) 355 541 5.

All States...) 17,572 | 21,262 | 20.9

1916

414
136
922
672

1,047

847
1,675
1,210
1,391

837

373
485
650
762
406

366
396
447
271
1,119

519
402
129

50
219

76
53
96
25

126
263
216
568

|| 21,988 -

APPENDIX B

GRADING SYSTEMS

COMMISSION ON MILK STANDARDS
of the New York Milk Committee *

Proper milk standards are essential to efficient milk con-
trol by public health authorities. In the first place health
authorities must ascertain that the chemical composition
corresponds with established definitions of milk as food, but
their more important duty is to prevent the transmission of
disease. This means the prevention of the transmission by
milk of infant diarrhea, typhoid fever, tuberculosis, septic
throat infections, scarlet fever, diphtheria, and other infec-
tious diseases. In the interests of milk consumers public
health authorities must take positive action to prevent the
transmission of any of these diseases, in addition to their
duty of preserving the food value of milk.

The milk producer is interested in proper standards for
milk, and should support a movement to secure proper stand-
ards, for the reason that these contribute to the well-being
and dignity of the milk industry itself. Proper standards,
rightly enforced, distinguish between the good-milk producer

* Extracts from 3d Report (Public Health Reports, Feb. 16, 1917).
This commission is national in personnel and scope and is loosely known
as the “ National Commission on Milk Standards.’ The reader is
earnestly referred to the reports of the Commission for fuller informa-
tion on milk control, production, handling, and distribution than can
be given in these limited excerpts. These reports are the most im-
portant item in milk control literature. They may be obtained from
the N. Y. Milk Committee, 105 East 22d St., New York City.

189

190 APPENDIX B

and the bad-milk producer. This inevitably will lead to the
improvement of dairy farming, and eventually to an increase
in the financial prosperity of the milk producer himself
through better prices for better milk. It will enable the pro-
ducer to get properly paid for the quality of milk he produces,
and thus put that industry for the first time upon a depend-
able basis.

The milk dealer finds the classification of milk resulting
from milk standards to his financial advantage for the reason
that it identifies clearly first-class milk and distinguishes it
from second-class milk. Such a distinction gives to the seller
of first-class milk the commercial rewards which such milk
deserves, and the official label creates a market for first-class
milk which the dealer alone is unable to create.

For milk consumers the setting of definite standards ac-
companied by labeling with official control of the labels
makes it possible to know the character of the milk which is
purchased, and to distinguish good milk from bad milk. The
establishment of standards for quality, and of labels on
retail packages indicating the quality, compels the industry
not only to purchase milk on a quality basis, but also to
sell milk on a quality basis. The selling of milk strictly on a
quality basis, which includes not only chemical composition
but sanitary character, makes it possible for consumers by an
inspection of the label intelligently to select milk which in
quality and price is most suitable for their needs.

ADMINISTRATIVE EQUIPMENT

Standards are useless unless properly guarded and enforced.
The chief objection that has been raised to a grading system
for milk is the difficulty of insuring that milk labeled as of a
certain grade is actually of that grade when sold to the con-
sumer. a |

The prime requisite for efficient milk control is that health

APPENDIX B 191

departments shall be adequately equipped with men, money,
and laboratory facilities. The commission is of the opinion
that satisfactory results cannot be expected from laws when
there is not sufficient appropriation, and when there is no
machinery for their enforcement. A survey of the money
appropriated for milk control shows that in the majority of
municipalities this is entirely insufficient for public needs.

The key to the solution of the problem of the proper use
of grade labels is the laboratory. The establishment and
operation of an efficient milk testing laboratory is commonly
supposed to be an item of great expense. This, however,
the commission is convinced, is a mistake, since there are
numerous laboratories scattered all over the land not only
private, but public, which are inexpensive and operated at
low cost. By efficiency methods a large number of tests can
be made at a very low cost. Even small communities can
afford to maintain and operate such laboratories. Where
for any reason it is not possible to do this, it has proven to be
practicable for one community to enter into laboratory
arrangements with another, and even several can combine
in the use of a common laboratory.

GRADING OF MILK

There is no escape from the conclusion that milk on the
market must be graded just as other commodities such as
wheat, grain, beef, etc., are graded. The milk merchant
must judge not only of the food value but also of the sanitary
characteristics of the commodity in which he deals. . . . The
high-grade product, fresh and cold, will cost more to buy
from the producer, and should sell for more to the consumer
than does the low-grade product. The commission’s most
important work has been the attempt to separate milk into
grades and classes. The commission has endeavored to make
its grading system as simple as possible, and at the same time

192 APPENDIX B

to distinguish between milks which are essentially different
in their sanitary and other character. The commission is
convinced that the experience of the last three years has
fully demonstrated the value of the grading system in the
communities in which it has already been applied, both from
a public health and an economic standpoint. The commis-
sion believes that the grading of milk offers a satisfactory
solution for most of the sanitary and economic problems
which have hitherto prevented efficient milk control, and
that it is feasible for small communities as well as large
communities to adopt a grading system and to secure its
benefits. . ..

The Commission believes that all milk should be classified
by dividing it into three grades, which shall be designated
by the letters of the alphabet. It is the sense of the Com-
mission that the essential part is the lettering and that all
other words on the label are explanatory. In addition to the
letters of the alphabet used on caps or labels, the use of other
terms may be permitted so long as such terms are not the
cause of deception. Caps and labels shall state whether
milk is raw or pasteurized. The letter designating the grade
to which the milk belongs shall be conspicuously displayed
on the caps of bottles or the labels of cans.

The requirements for the three grades shall be as follows:

Grade A

Raw Milk.—Milk of this class shall come from cows free
from disease as determined by tuberculin tests and physical
examinations by a qualified veterinarian, and shall be pro-
duced and handled by employees free from disease as deter-
mined by medical inspection of a qualified physician, under
sanitary conditions, such that the bacteria count shall not
exceed 10,000 per cubic centimeter at the time of delivery
to the consumer. It is recommended that dairies from which

APPENDIX B 193

this supply is obtained shall score at least 80 on the United
States Bureau of Animal Industry score card.*

Pasteurized Milk.—Milk of this class shall come from cows
free from disease as determined by physical examinations
by a qualified veterinarian, and shall be produced and han-
dled under sanitary conditions, such that the bacteria count
at no time exceeds 200,000 per cubic centimeter. All milk of
this class shall be pasteurized under official supervision, and
the bacteria count shall not exceed 10,000 per cubic centi-
meter at the time of delivery to the consumer. It is recom-
mended that dairies from which this supply is obtained
should score at least 65 on the United States Bureau of
Animal Industry score card.

Grade B

Milk of this class shall come from cows free from disease
as determined by physical examinations, of which one each
year shall be by a qualified veterinarian, and shall be produced
and handled under sanitary conditions, such that the bac-
teria count at no time exceeds 1,000,000 per cubic centi-
meter. All milk of this class shall be pasteurized under
official supervision, and the bacteria count shall not exceed
50,000 per cubic centimeter when delivered to the consumer.

It is recommended that dairies producing Grade B milk
_ should be scored, and that the health departments or the con-
trolling departments, whatever they may be, strive to
bring these scores up as rapidly as possible.

Grade C

Milk of this class shall come from cows free from disease,
as determined by physical examinations, and shall include
* The fallacy of the present dairy-score requirements for grades has

been discussed in the present volume (pp. 73, 74, 75). It is found in all
the classifications given in this appendix.—J. 8. M.

194 APPENDIX B

all milk that is produced under conditions such that the
bacteria count is in excess of 1,000,000 per cubic cen-
timeter.

All milk of this class shall be pasteurized, or heated to a
higher temperature, and shall contain less than 50,000
bacteria per cubic centimeter when delivered to the con-
sumer.

Whenever any large city or community finds it necessary,
on account of the length of haul or other peculiar conditions,
to allow the sale of Grade C milk, its sale shall be surrounded
by safeguards such as to insure the restriction of its use to
cooking and manufacturing purposes.

[Recommendation relative to bacteriological tests for
grades :—|

That the grade into which a milk falls shall be determined
bacteriologically by at least five consecutive bacteria counts,
taken over a period of not less than one week nor more than
one month, and at least four out of five of these counts (80
per cent) must fall below the limit or standard, set for the
grade for which classification is desired.

[The Commission’s definition of pasteurization has been
quoted on a previous page (p. 103).|

CREAM

Cream should be classified in the same grades as milk in
accordance with the requirements for the grades of milk,
excepting the bacterial standards, which in 18 per cent cream
shall not exceed five times the bacterial standard allowed
in the same grade of milk.

Cream containing other percentages of fat shall be al-
lowed a modification of this required bacterial standard in
proportion to the change in fat.

APPENDIX B 195

Grades for Smail Cities and Towns

This Commission recognizes that, because of climate,
size of the community, nearness to the sources of supply,
ease of transportation, and progress already made in im-
proving the general milk supply and in educating the dairy-
men and the public, different communities are in position
- to secure varying degrees of excellence in their standards for
the grades of milk. This Commission, therefore, urges that
its standards for Grade A, B, and C milk be regarded as
minimum standards, and that any community may adopt
higher requirements for its grades if its conditions make this
feasible and desirable.

As a guide to health officers in the establishment of grades
best adapted to their local communities, the following gen-
eral broad principles are offered :—

(1) A careful preliminary survey of the milk situation
should be made before the requirements of the several grades
are adopted.

(2) No matter how excellent the general milk supply of a
community, it is not all of asingle standard of excellence; hence
there are actually different grades of milkin every community,
and the recognition of such grades is always advantageous. ,

(3) Grades in any community should always be such as
to separate into two, or at most three, classes the milk supply
of that special community. Where little or nothing has been
done towards improving the general milk supply, it may be
desirable to adopt temporary grades (but not below the
minimum requirements suggested by this Commission),
with a time limit as to when more rigid requirements for the
grades will be enforced.

(4) Grades as adopted in any community should be such
as not, under any circumstances, to sanction the sale of milk
below the minimum standards which it is feasible for that
community to require.

196 APPENDIX B

(5) Whatever departures are made by any community
from the exact definition of grades as recommended by this
Commission, several fundamental principles are recognized
by the Commission as of universal application, and from
these there should be no variation. These fundamental
principles are:—

(a) Grade A milk in a general way, is milk which complies
with requirements of such character and degree that, for all
practical purposes, no real advantage would be gained by
further and higher requirements. The standards for this
grade should, therefore, be placed high enough to attain this
end, but not so high as to limit too greatly the supply or,
through unduly raising the price to the consumer, to limit
too greatly the demand.

(b) Grade B milk is all the remaining milk of the com-
munity which is suitable for drinking purposes, after pas-
teurization, but which does not comply with the high re-
quirements for Grade A milk. |

(c) Grade C milk is milk which falls below the minimum
requirements for milk suitable for drinking purposes, even
after pasteurization. Its use must be confined to cooking
and manufacturing purposes. Recognition of this grade of
milk is not recommended by this Commission except in
communities in which such recognition is an economic neces-
sity.

(6) The fundamental objects in grading milk are:—

(a) To aid in making safe for human consumption all
milk which can legally be sold for drinking purposes;

(b) To distinguish between classes of milk which, while
all are safe, are of different degrees of excellence in respect to
cleanliness and care in handling.

Each community should, therefore, endeavor to grade
its milk supply so as best to attain these objects without
departure from the broad general principles above laid down.

APPENDIX B 197

NEW YORK CITY *

The basis of this system is the division of supplies into:
(1) milk for infants, (2) milk for adults, and (3) milk for
cooking and manufacturing purposes only,—requiring three
corresponding grades.

Grade A

Raw Milk.—Cows tuberculin-tested annually and in good
physical condition. Bacterial limit, 60,000 per c.c. Dairies
to score 75 on the Department’s score card.T

Pasteurized Milk.—No tuberculin test required, but cows
must be healthy—annual physical examination. Bacterial
limits: 200,000 before, 30,000 after, pasteurization. Required
dairy score, 68.

Grade B

Pasteurized Milk.—No tuberculin test required, but cows
must be healthy—annual physical examination. Bacterial
limits—before pasteurization: 1,500,000 if pasteurized in
city, 300,000 if pasteurized outside city; after pasteurization,
100,000. Required dairy score, 55.

Grade C

(For cooking and manufacturing purposes only)

Pasteurized Milk.—No tuberculin test required, but cows
must be healthy—annual physical examination. Bacterial

* Abstracted from the Rules and Regulations relating to the Sale
of Milk and Cream of the Department of Health of New York City,
to which the reader is referred for further particulars. (See also: Brown,
Lucius P., ‘‘The experience of New York City in grading market milk,”
American Journal of Public Health, July, 1916, p. 671.) This classi-
fication closely approximates that quoted above.

| There are also score requirements for equipment and methods
separately considered, in addition to the total score required under
each grade. See footnote, p. 193 of the present volume, regarding score
requirements in general.

198 APPENDIX B

limit after pasteurization, 300,000. Required dairy score, 40.
(Grade C milk is milk not conforming to the requirements
of any of the above classes and which has been pasteurized
properly or boiled for at least two minutes.

Pasteurization

Official definition: subjection to a temperature averaging
145° F. for not less than 30 minutes.

CLASSIFICATION OF CREAM

The same classification applies to cream, but the bacterial
limits (after pasteurization, except in the first case) are as
follows: Grade A (raw), 300,000; Grade A (pasteurized),
150,000; Grade B (pasteurized), 500,000; Grade C (pas-
teurized), 1,500,000.

The following commentary from the Secretary of the New
York Milk Committee, Mr. Paul E. Taylor, regarding the
effects of grading in New York City, is of interest (italics
inserted) :—

Notwithstanding the Department’s activities in enforcing the
present standards, the good dealers and the clean producer agree
that the new system of grading milk on its sanitary character for the
first time gwes public recognition to those who produce and handle a
clean article.

That the dealer recognizes the commercial value of Grade “A”
pasteurized milk is shown by the fact that one large company doing
business in several cities, in October, 19/4, was selling an average
daily total of 22,000 quarts of Grade “‘A”’ pasteurized nilk, pro-
duced under conditions in accordance with requirements of the
New York City Board of Health regulations, and the producers of
which received a bonus because of the extra care exercised. Wher-
ever this milk was sold it bore the label ‘“‘Grade A Pasteurized”’ and
brought 1 to 3 cents a quart more than the ordinary bottled milk.
In October, 1915, the average daily sale of this milk by the company
was 300,000 quarts. The managers of the company say this method

APPENDIX B 199

of giving recognition to clean milk is the best thing that ever happened
to the milk industry.

.. . The success of the system depends upon maintaining the
integrity of the label.

About 99 per cent of New York City’s milk supply is pasteurized.*

NEW YORK STATE +
Grade Aft

Raw Milk.—Annual tuberculin test. Bacterial limit:
60,000. Dairies must score 25 per cent for equipment, 50
for methods, on the score card officially prescribed.

Pasteurized Milk.—Annual physical examination of cows.
Bacterial limits: 200,000 before pasteurization; 30,000 after.
Required dairy scores: 25 per cent for equipment, 43 for
methods.

Grade B

Raw Milk.—Annual physical examination of cows. Bac-
terial limit: 200,000. Required dairy scores: 23 per cent for
equipment, 37 for methods.

Pasteurized Miik.—Annual physical examination of cows.
Bacterial limits: 1,500,000 before pasteurization; 100,000
after. Required dairy scores: 20 per cent for equipment,
35 for methods.

* Personal communication, Dec. 6, 1915.

+ Abstracted from the Sanitary Code established by the Public
Health Council of the State of New York, as amended.to and including
Oct. 5, 1915. The above are only the salient requirements; the reader
Gg referred to Ch. III of the Code and its revisions for details. The
classification is prescribed to apply except as otherwise stated, through-
out the State with the exception of New York City. Some account of
its working is given by Linsly R. Williams, Deputy Commissioner of
Health, “The grading of milk in small communities,” Am. Jour. Public
Health, Oct., 1916.

{ Certified milk constitutes a special class.

200 APPENDIX B

Grade C

Raw Miik.— Required dairy score, 40 per cent.
Pasteurized Milk. Same.

CREAM

Cream is classified in the same grades, but the bacterial
limits are higher.

The bacterial count herein required shall be made only at county
or municipal laboratories or such other laboratories as may be ap-
proved by the state commissioner of health.

In those municipalities where a bacterial count of the milk is,
in the opinion of the local health authorities, impracticable, they
may in their discretion grade milk and cream according to the score
of the dairies producing it, as prescribed in this regulation, but no
such milk shall be designated ‘‘certified,” ‘Grade A raw,” or
“Grade A pasteurized.” *

This regulation shall not be construed to rescind or modify any
existing local regulation or ordinance controlling the grading of
milk or cream established prior to the first day of September, 1914.

The health authorities of any municipality may in their
discretion increase the stringency of these regulations or add
to them in any way not inconsistent with the provisions
thereof.

It will be noted that the above classification is more lenient
than those preceding. In view of this fact and the circum-
stance that this is the first state classification, it may be
presumed that these standards may later be raised.

RICHMOND, VA.

Richmond, Va., a city of some 150,000, the health depart-
ment of which has long been active in clean milk work, has

Such authorizing of grades according to dairy scores alone is a very
serious defect of this system. See footnote, p. 193.—J. 8. M.

APPENDIX B 201

recently established a simpler classification than any of the
above, as follows :—

Grade A

Raw Milk.—Cows free from disease and tuberculin-tested.
Employees free from disease. Bacterial limit: 25,000 (No-
vember to March, inclusive); 50,000 (April to October).
Required dairy score (U. S. Official): 80 points, of which
at least 45 for methods.

Pasteurized Milk.—Same, with bacterial limit after pas-
teurization of 5,000.

Grade B

Pasteurized Milk. Cows free from disease—at least one
official physical examination per year. Bacterial limits:
250,000 before pasteurization, 25,000 after. Required dairy
score, 70 (65 permitted, temporarily).

Cream is classified in the same manner, but with higher
bacterial standards.

ORANGE, N. J.

The following plan was adopted in 1915 under the co-
operative organization for milk contro! in Orange, N. J., and
neighboring municipalities (see page 167) :—

Grade A

Raw Milk.—Cows in good physical condition and tuber-
culin-tested. Bacterial limit: 50,000 (November to April,
inclusive); 100,000 (May to October).

Pasteurized Milk.—Cows physically examined. Bacterial
limits: 200,000 before pasteurization and 30,000 after
(summer months); 100,000 before and 10,000 after (winter
months).

202 APPENDIX B.

Grade B

Raw Milk.—Cows in good physical condition and tuber-
culin-tested. Bacterial limit: 100,000 (winter months);
300,000 (summer months). ,

Pasteurized Milk.—Cows physically examined. Bacterial
limits: 750,000 before pasteurization and 75,000 after (sum-
mer months); 500,000 before and 40,000 after (winter
months).

Score requirements (U. 8S. Official card), respectively:
75, 70, 65, 60.

Certified milk is made an extra class.

EXTENSION OF THE GRADING IDEA

Other communities than the foregoing have also adopted
or are considering grading systems. The author has not
sought to make a complete collection of data on the subiect.
The New York Milk Committee has sought to bring the rec-
ommendations of the Commission on Milk Standards be-
fore many communities, and reports that the grading idea
is making encouraging progress as shown in recent milk
regulations.

APPENDIX C

THE NORTH SYSTEM *

Origin and Development.—The plan of milk production
and milk handling outlined below was first proposed by
Dr. Charles E. North in September, 1903. In old barns on
the premises of his certified dairy farm in New Jersey and in
old barns in the immediate neighborhood, he was successful
during the years 1903 and 1904 in producing milk containing
exceedingly small numbers of bacteria by the practice of a
system which he had devised. Jn 1908 Dr. North became a
member of the New York Milk Committee and pointed out
to this organization the advantages of this method of milk
production. This committee raised the capital for the or-
ganization of a small milk company, which had for its object
the carrying out, experimentally, of this milk system on a
large scale. Because of its experimental character the milk
company took the title of The New York Dairy Demonstra-
tion Company.

For two years past [i. e., since 1910] the company has
operated a milk shipping station at Homer, N. Y., and has
produced milk in accordance with the system proposed by
Dr. North and has conducted all its sanitary operations
under his personal supervision.| Beginning with three dairy

* Reprinted, by permission, from a description issued in 1912, by
Dr. Charles E. North, Director, North Public Health Bureau, 30
Church St., New York City, with additional notes from information
personally communicated. This system is referred to at p. 78 of the
present volume.

+ “Since the rather perilous undertaking at Homer,” writes Dr.
North, ‘‘the soundness of the principles developed there has been em-

203

204. ; APPENDIX C

farms and about 600 quarts of milk two years ago, the com-
pany now receives milk from about 70 dairy farms and its
volume of business has grown to more than 10,000 quarts
daily. It has found its largest market in the infant milk
depots operated by the New York Milk Committee and
under the auspices of the New York City Department of
Health. During the summer of the present year there have
been 55 milk depots in Manhattan and Brooklyn, feeding
during the hot months 14,000 babies per day. The company
has supplied all of the milk to these stores and this supply
has been a large factor in the reduction of infant mortality,
which this summer has been the lowest in the history of the
city.

Outline of North’s Milk System

1. Object—The objects of this system are the production
of clean milk at low cost; to secure clean milk from the
present milk producers and under the auspices of present
milk dealers with the least possible disturbance of commer-
cial conditions; to reduce to a minimum the dairy equipment —
and the sanitary measures used on dairy farms, retaining
only those things positively essential for clean milk produc-

phatically demonstrated, not only there, but in numerous other places.”
There are now (1916) established under supervision of Dr. North a
station in Maryland, one in New Jersey, three in Pennsylvania, two
more in New York State, and one in Vermont. There are over one
hundred farms supplying milk to the Homer station at the present
time, and the total number of quarts is over 20,000 quarts daily. The
number of milk depots in Manhattan and Brooklyn is now over sixty,
and the number of babies feeding from these is nearly 25,000 daily.
At Oxford, Pa., the station ships milk produced by 135 dairymen.
“This place,” says Dr. North, “is more remarkable than Homer,
because the majority of the men do not have ice, and the character of
their barns and dairy equipment is very much inferior to that at Homer,
yet, in spite of these drawbacks, the majority of them are producing
milk with a very low bacterial count.”

APPENDIX C 205

tion; the securing of such clean milk as is to be sold in a raw
condition; the cleaning up of all milk which is to be pas-
teurized, in the belief that all milk used for drinking purposes
should be clean in the first instance, whether pasteurized or
not.

2. Centralization—The backbone of the system is the
principle of centralization. While modern business has
brought about great organizations in the selling department
of the milk industry, the producing end of the line has been
left largely to shift for itself. Milk producers are permitted
to produce milk under their own auspices and by such meth-
ods as their ignorance and carelessness may dictate. Many
things done on dairy farms can be done much better in a
central station. Among these are washing and sterilizing
of milk cans and milking pails, bottling of milk and labora-
tory testing of milk. Sixty per cent of the dairy farms have
polluted well water and as large a percentage have inefficient
methods of washing and sterilizing utensils and of cooling
milk.

3. Organization——The advocates of certified milk have
not considered fully business organization. Certified dairies
make no use whatever of the principle of centralization.
Each certified dairy conducts its business in a most extrava-
gant and inefficient manner. Each certified dairy farm is
fully equipped to conduct its business as a separate unit,
regardless of the volume of business.

Instead of each farm being a separate unit with a small
volume of business, North’s Milk System makes them each
a part of a large organization with a large volume of busi-
ness. . . . [See lower diagram of Fig. 4, chapter II, as a
substitute for the diagram which we omit here.] The dairy
farms are each members of a group patronizing the central
sterilizing station. At the central plant milk is received and
shipped. This station, as a matter of fact, is a large dairy
house and performs all of the functions of a dairy house for

206 APPENDIX CG

each of the different farmers. In short, the dairy farmers
take care of their barns and feed and milk their cows, while
the central station takes care of the milk which the farmers
bring to it. From the central station the milk is shipped to
the city in the usual way.

4. Plant and Equipment.—The plant consists of a build-
ing such as is commonly used for creamery purposes or for
a milk shipping station. It must be large enough to accom-
modate the volume of milk which it is expected to collect
from the territory and must be constructed in accordance
with the well-recognized principles of milk sanitation. It
must have water-tight floors, abundant lighting and ventila-
tion, proper drainage and water supply, and must be con-
structed so that it can be easily cleaned. It should include
separate rooms for receiving milk, for washing pails and
cans, for cooling, bottling and pasteurizing milk, for bottle
washing, for power plant, for ice, and accommodations for
employees, office, laboratory and storage. The equipment
should include tanks for receiving milk, cooling, bottling and
pasteurizing equipment, bottle washing machinery, power
plant, refrigerating apparatus, and equipment for washing
milking pails and milk cans, a complete laboratory equip-
ment for examining milk for bacteria and butter fat, and the
proper type of covered milking pails and milk cans, milk
bottles, ete.

So far as the dairy farms are concerned but little addi-
tional expense is necessary. Of the seventy farms at Homer,
N. Y., which have patronized the station of the New York
Dairy Demonstration Company, the only expense generally
undertaken has been for tanks of wood, or of cement, or of
galvanized iron, to hold ice-water in which the 40-quart
cans of night’s milk have been stood for cooling purposes.
Aside from this, more frequent whitewashing of barns and
additional care in cleaning cow stables have been the chief
external evidences of extra sanitary precautions.

APPENDIX C 207

5. Sanitary Measures.—The following is a list of sanitary
measures which are insisted upon:

1. At Dairy Farms: —

(a) All milking must be done in covered milking pails
provided by the central station. These milking pails
must have small mouths with tin covers and must be
kept clean during transportation from the central sta-
tion to the farm.

(b) Milking pails and milk cans must not be washed
or sterilized on the dairy farm.

(d) All milk must be cooled in 40 qt. cans by placing
the cans in ice water, excepting where milk is delivered
to the central station within three hours after milking.

2. At Central Plant:

(a) All farmers’ milking pails are washed, sterilized
and dried.

(b) All milk cans are washed, sterilized and dried.

(d) Bottle washing and sterilizing.

(e) Refrigerating and shipping.

6. Sanitary Control.—It is one thing 10 recommend sani-
tary measures; such recommendations have been made
for years by public and private authorities interested in
milk reform. It is quite another thing to have sanitary
measures adopted and carried out. If there is any virtue in
the milk system herein described, it lies not so much in the
sanitary measures themselves, which are already well known,
but it lies in the means taken for securing their adoption.
These may be summed up under the term of Sanitary Con-
trol, and are as follows:—

(a) Medical inspection of dairy employees by-a resi-
dent physician. The local country doctor finds it con-

208

APPENDIX C

venient in his frequent trips to keep posted as to the
health of the dairy employees and to make regular re-
ports to the central station.

(b) Veterinary inspection of the dairy cattle by the
local resident veterinarian with regular reports of their
physical condition.

(c) Sanitary inspection of dairy farms by a resident
sanitary expert, who is the superintendent of the central
station. This superintendent must have bacteriological
training sufficient to enable him to carry out laboratory
tests for bacteria, or to supervise the same. He must
also supervise all sanitary processes in central plant and
on dairy farms. His influence must be the chief factor
in maintaining sanitary conditions and in interpreting
laboratory results, so that milk producers will have
confidence in the same.

(d) Regular laboratory tests for bacteria of each
farmers’ milk made in the laboratory of the central
station. This laboratory needs only simple and inex-
pensive equipment and the bacterial work consists of
making bacteria counts by the plate method. Samples
are taken of farmer’s milk as this milk is delivered each
day to the station.

(e) Chemical tests for butter fat and total solids when
necessary from samples taken of milk delivered by the
farmers. These tests also to be made in the station
laboratory.

(f) A bulletin board on which are posted the results
of all laboratory tests, so that they may be seen by the
farmers patronizing the station.

(g) Payment to dairy farmers for milk based on its
sanitary character as shown by bacterial tests and on
its richness as shown by chemical analyses. This method
of payment is the secret of the Sanitary Control. By
exercising extreme care and thereby reducing the bac-

APPENDIX C 209

terial count of his milk, the dairy farmer can earn more

money than he does if he is careless and delivers milk
containing large numbers of bacteria. The adjustment
of the price to the bacterial count on the one hand, and
to the percentage of butter fat on the other hand, gives
a strong stimulation to the dairy farmer to produce
milk which is both clean and rich. Only small premiums
are necessary to give great stimulation in these two
respects.

(h) Tuberculin testing of dairy cattle is an entirely
separate problem. It has become recognized that raw
milk to be safe for drinking purposes must be obtained
from cattle which are free from tuberculosis as deter-
mined by the tuberculin test. The securing of such
milk involves principles which are the same as those
above outlined, namely, that the producer must be paid
for the cost. More than half of the milk delivered to
the central station at Homer, is obtained from dairies
having herds which have passed the tuberculin test.
These tests have been made as the direct result of a
special premium paid to the dairy farmers for milk from
tuberculin tested cows. This premium has been paid
in addition to the other premiums mentioned.

Results

The use of this system on a large scale has given all of the
results anticipated from the preliminary experimental work
carried out by Dr. North in old dairy barns in New Jersey.
The daily bacterial tests of milk carried out in the laboratory
of the central station of the New York Dairy Demonstra-
tion Company at Homer, N. Y., are now on file, and show
that, while there have been some irregularities, yet in general
the milk delivered to this station is clean, and has a bacterial
count which is far lower than can be obtained by ordinary

210 APPENDIX C

methods. This has been confirmed by the tests made in
other laboratories in places to which this milk has been
shipped.

As an illustration of the character of the milk delivered to
the station by dairy farmers, one of the daily laboratory
record sheets is given below:

CREAMERIES OF THE
NEW YORK DAIRY DEMONSTRATION CO.

ANALYSIS OF MILK AND CREAM
Date, July 26/12.

TUBERCULIN-TESTED DAIRIES

Bacteria per c.c.

Dairy Name of owner Butter-| Temp) ee
no. fat Night Morning
TGFs ES] Be) pant ied ee ed ee 325) 52 500
PANDY VGRT1 BX) | IR sh niles Maes ey Soe
SiC Cimbennett g4.. . ee 56 500 400
AO OR egIG Sirairraln anaes eaese ole: 3.4 56 2,500 2,000
Be HRM UGLeTy acti cas cae as 32 46 500 1,500
6 SiC SHe Button. se. oi: Be 50 10,000 500
TENG Cre BUN ROLL ele ee eroaaa 3.8 46 4,000 2,000
rest hig ( Cee ag a Naa ine iON 3.4 54 9,000 15,000
O., (HKG. Crofoot | 3355) 52 15,000 1,000
10 |Crofoot & Cummings...
I (id Hester. eee 54 1,500 1,000
2 OXGBTOS)s Neda say aha
LSS AMS Gill kere aeeateea aie at ee 3.5 52 10,000 1,000
14 Velden. blathweaye% ae ee 3.2 50 1,000 1,000
15 |N. D. Hitchcock....... 48 1,000 1,000
Ge elie Fed Re) Ko BAe ae eae 52 1,000 5,000
Lee EEL: ones er) aucune 3.6 50 1,000 5,000
LSU Ma Ones ei nee aes cree 3.8 54 2,000 3,000
LO pL eH ao eke. Mh whines. 50 1,000 2,500
20 |W. H. Miller 0004) 48 1,000 1,500
Zi erty MSsrosee 2 hime. coals 4.4 42 3,000 1,500
22 i Coe Prather. se eee ae 3.6 48 2,000 1,500
2a) NN SEP Pagtas. suc 3.6 48 1,500 2,500
Be PEE BRACE Menai tr) Ah eee 3.5 52 1,000 2,500
25 (|Crofoot & Rogers......
AOC ID) Sellen aes ae ; 54 5,000 1,000
27 NCW Wilkins. (ve) 3.8 | 46 1,500 2°500

APPENDIX C 211

NON-TUBERCULIN-TESTED DAIRIES

Bacteria per c.c.
Dairy Name of owner Butter- | Temp. e

No. fat Night Morning
29, iG. Baldwin's ...05..46) 2). |
30. |D. Bingham: 2.4525 6504

ot, Eh. Carpenters. 2). uu, 52 2,000 1,500
SA WC OOmne fants ets e 52 1,000 1,000
30. DAC ortribegs 24. )s0 ae fee 54 2,000
of. VAC Cranmap tome cic sh .n.c/3 52 2,000
ao (he Crampbolyas sae. so. 50 750 800
aor |CSIDe VOCs...) 6 ci Bes es 56 30,000 6,900
Bf) VAM Wwardsi s/s fis) 5

oo Moubldredees e025 0520

a0 rtiC. Goodale conte.

AQ) Wt HOOKER si. os 54 12,000 4,000
215i) i} OS (Vb eS ena a 56 7,000 1,000
Aen Gs JOMES 4 2 s)he eh 52 12,000 2,000
43, (He Kingsbury .. 5.0: 3... 52 1,000

CVE BE ll Gory] 00129 0) 0) Ret

24s) valll Lidl Urehei it=(0) 0 ener een 44 3,000 3,000
46° Did. MeAuliio: so. 52 6,000 4,500
AL Wie Moxie 42% oie kale. 46 4,000 4,500
AS oo \W ce ViMGe ye os 8s ee) 5 56 15,000 5,000
a0y |e OC Connor 25s 2. 54 2,500 2,000
50 |Mrs. J.O’Connor...... 56 20,000 14,000
ole PO Connon.) hee. 54

oe (P.O) Donnell. os 56 3,000 5,000
bey lege AMINE 3 cPanel satan kets 54 2,000 5,000
Bey sds Qumalan. oes) se foe 58 20,000 15,000
Bore i Quinlan ie ee, 56 10,000 2,000
Over cas Meads a scie WO EN | 52 3,000 10,000
Boy NaS KAMINS ra il a ao

DS) (9. SPENCER. 2 ss. . oe. 54 15,000 7,500
SOP eS tatord te a. eer, 54

60 |Sweeney Bros.......... 56 15,000 2,000
Gl” IC. Sweeney: 25 Sane: 54 3,000 2,500
G2. |M. Sweeney... 2... 22.5. 54 3,000 6,000
Go) (2. J. Sweeney . 2223. 56 6,000 9,000
G4 a Ree Purmer o2 24 siah 54 1,500 4,000
G5e) IW. Twoomey ..253 /524. 60 4,500

66 |J. B. Underwood....... 50 1,000

Guin Jo Weddle. ccna ace: 56 5,000
Gaye Ge Walson 2) pone ae ae 46 | 10,000

The dairy farms on which this milk is produced, while
some of them are of superior character, are in general the

~ 212 APPENDIX C

type of dairy farms seen throughout the great producing
sections of the milk industry.* The majority of the dairy
barns are simple and inexpensive in construction, and have
none of the elaborate and expensive features of the certified
dairies. The cleanliness of the milk produced by these
dairies was well illustrated in the recent milk competition
held at the New York State Fair, at Syracuse, in September,
1912. In this contest two of the Homer farmers obtained
scores for their milk superior to the scores of fifteen certified
dairies entered, and were only beaten by the score of one
certified competitor. Of the thirty-nine entries in the com-
petition, seven were milks from the Homer station, and these
took five places out of the first fourteen entered.

Relation to Milk Industry

There are several branches of the milk industry which
have already shown an interest in the adoption of this system
of milk production and handling. Certain modifications are
necessary to adapt the plan to the peculiar character which
the industry may have in different parts of the country.
Enough work has been done to date, however, to demonstrate
that in this way clean milk can be produced in large quanti-

* “The fact that the shipping stations and dairy farms furnish no
external evidence to the casual inspector of any differences from other
stations and farms shows that external appearances give a very small
clue to the real character of the product. The testing of the product
itself shows immediately to the investigator a most startling difference
between the milk produced at these stations and the milk produced at
ordinary shipping stations. Furthermore, the most vital factor at work
in these dairy districts is invisible, because this factor is summarized
in the word ‘influence.’ The influence of the bacterial test and of the
system of payment on the mind of the producer keeps him keyed up to
a high pitch of watchfulness and care. When the producer sits down
to milk, his mind is preoccupied by two thoughts: one, bacteria; and
the other, dollars. It is this influence which achieves the remarkable
results brought about at these stations.’ (Communication from Dr,
North.)

APPENDIX C 213

ties by our present milk producers at a comparatively low
cost. The principle of centralization of effort through the
establishment of a central station under the supervision of a
resident Sanitary Superintendent, and the payment for milk
based on sanitary quality and chemical quality as deter-
mined by laboratory tests, are principles which can be
adopted in any locality and which will bring sure results. A
large volume of business can be secured by one central sta-
tion receiving milk from a number of dairy farms. This
makes necessary only one power plant, one bottling equip-
ment, one washing and sterilizing equipment, one good ar-
tesian well, and the salaries of one superintendent and one
force of dairy employees to handle the milk from several
scores of farms. The volume is such that the tax for Sanitary
Control and handling on each quart of milk is small. This
form of organization gives efficiency and economy and
means clean milk at low cost.

References

The following is a list to date of papers by Dr. North concerning
the above system, its development and related matters :—

‘““A method of milk production,” New York Medical Record, Feb.
15, 1908.

“Sterilizing stations in dairy districts,” Journal of the American
Public Health Assn., Sept., 1911.

“The production of sanitary milk by our present milk producers,”
59th Annual Report, Mass. State Board of Agriculture, 1912.

“The market value of cleanliness in milk production,” address
delivered at 36th Annual Convention of New York State Dairy-
men’s Association, 1912.

“The dairyman versus the dairy,” American Journal of Public
Health, June, 1915.

“Bacterial testing versus dairy inspection,’ American Journal
of Public Health, June, 1916.

“A survey of dairy score cards,’ American Journal of Public
Health, Jan., 1917.

APPENDIX D

COSTS AND PRICES

Various investigations have been made of economic costs
at different stages of the milk industry from cow to con-
sumer. No attempt will be made here to present any general
abstract of these, much less to discuss all the details. Cost
items, furthermore, vary decidedly at different times and
in different regions. Hence the results quoted below are to
be taken merely as illustrative. The figures of direct sig-
nificance in any locality are those derived from local con-
ditions, e. g., by investigating bodies and agricultural
agencies.

COST OF PRODUCTION

While most of the controversy relative to prices has cen-
tered about the cost of production, this is the hardest of the
various costs to draw from practical conditions. Accurate
bookkeeping by dairy farmers is very rare. Figures presented
by farmers operating under common conditions show dis-
crepancies and variations which must produce a sense of
caution with regard to all such figures. The majority of
dairy farmers, particularly small farmers, do not know the
profit or loss on their business of milk production as a whole,
much less on the outputs of individual cows in their herds.
Many such farmers are producing milk either at a loss or
at little or no profit, are not taking measures to improve
their conditions, and are unable to present convincing figures
when the question of milk prices arises.

The Boston Chamber of Commerce, through its ‘Cone:
214

APPENDIX D 215

on Agriculture, in codperation with various agricultural
agencies, conducted throughout New England, in 1914, a
series of public milk hearings which were attended by about
2,500 farmers.* At these hearings the farmers were interro-
gated on the following points:

What it costs per year to keep a cow.

The average production per cow per year.

Value of the calf.

Value of manure.

Other problems incident to the production of milk.

Their views as to what ought to be done.

The number of producers [reports the committee] who kept a
strictly accurate record of all the [necessary] items was naturally
small. During the last five or ten years, however, more attention
has been given to the question of the cost of keeping a cow, and the
number of producers who have kept accurate records has been
rapidly on the increase. As a matter of fact, it was shown that it
has been only within the last seven to ten years that serious con-
sideration has been given to an analysis of the items of cost in the
keeping of a cow.

More accurate figures were furnished by the producers of Ver-
mont than by the producers of any other part of New England.
It was shown that Vermont was the largest dairy state in New
England and supports 34 cow test associations.

The testimony given by the farmers in the various sections of
New England naturally showed a wide range of opinion as to the
value of calf and manure, and as to the amounts and prices charged
for the individual items. The peculiar conditions in each locality
proved to be a large determining factor.

Taken over New England generally, under varying conditions
and with varying degrees of efficiency (varying ability) and varying
accuracy as to items of cost, the following range of figures represents
fairly the evidence obtained at the hearings. . . .

* This was part of a general investigation of milk and cream condi-
tions in New England. See Appendix E.

216 APPENDIX D

Torau Cost *

Producer Producer Producer
No. 1 No. 2 No. 3
1. Feed,—hay, grain, ensilage, pas-
DURES WOR yn coon ate nae $49.40 $51.54 $68.00
Janis] BH OVO) BMA Ue Ra CR I SLetgh Nk Al ae 17.72 18.15 45.00
3. Overhead charges
a. Interest on money invested

PNCOWais Rei eine amie: 3.00 5.85 10.00
b. Insurance on cow....... 45 Ol 3.00
Gi Waxes On coma ia ce eee Pap il) we
d. Depreciation of cow...... 5.00 9.75 20.00
eu Bariwrenmte | Seen Nata i 2.86 2.00 1.00
POC CMO ae rae onsen en a 2.00 1.00 5.00
zg. Keepror ull neue ee 2.86 3.00 5.00
h. Incidentals,—light, medi-

cine, veterinarian, heat-
ing water in winter, salt,
Cid SoS WINE Ur NLU RE aaa 1.50 .50 5.00

$86.94 $92.91 $162.00

* “The two fundamental figures entering into the cost of a quart of
milk are the net cost of keeping a cow per year and the amount of.
milk the cow produces in a year.’”’ ‘All of the figures can be obtained
by accounting for the total amount of each one of the items for the
entire herd, then dividing by the number of cows, to obtain the in-
dividual cost. The total production of each cow, however, should be kept
separate, as should also her' butter-fat test.’ The manner of figuring cer-
tain cost items is explained in the report as follows:—

1. Feed.—Hay, clover, alfalfa, were figured at the market prices that
could be received for the same in the barn on the farm; grain for what
it costs plus delivery to the farm; pasture according to its value, taken
in comparison with hay and grain; ensilage at its estimated value,
$3 to $4 per ton. .

2. Labor.—Labor was charged at the local market price for just
the time it takes to care for the cows.

3d. Depreciation of Cow.—Depreciation was reckoned in two ways:
(1) depreciation over a period of 3, 5 or 8 years, as to deaths, injuries,

APPENDIX D 217

CREDITS :
No. 1 No. 2 No. 3

Wile Or Cali... 10 See een $1.00 $11.00 $5.00
Waltie vob MAnUre:. = acs 6 lcs ele ee 5.00 10.00 15.00

$6.00 $21.00 $20.00
NET COST TO KEEP A cow... $80.94 $71.91 $142.00

(These figures show that it costs No. 3 almost twice No. 2 to keep

a@ cow.) :
Figures obtained on production varied from 3,500 to 15,000 lbs.

per year.
In the above three instances, the amount of production per cow

was as follows:

No. 1 No. 2 No. 3
5,293 Ibs. 6,590 lbs. 8,000 lbs.
The cost of 100 lbs. of milk to each was, therefore,—
$1.5291 $1.0911 61.775
Cost per quart,— |
$0.0332 $0.0237 $0.0385

It is, however, ‘clear from the inconsistencies in these
figures,” remarks the Committee, ‘“‘that they furnish no real
basis for determining the actual cost of production.”

The several factors entering into the foregoing results were
found to vary widely in the different sections of the pro-
ducing territory according to the grade of stock kept, the
methods of feeding, and the character of the soil. These
factors are discussed in the report.

As to the lack of accurate knowledge of cost of production
among farmers, the Committee has this to say :—

It appeared that the situation was further complicated by

loss of udder quarters; (2) depreciation as to the highest selling value
of the cow as compared to its final value for beef.

3d. Barn Rent.—Barn rent was charged on a basis of what it would
cost to erect a stable to keep the number of cows the producer maintains.

218 APPENDIX D

the fact that producers generally had no accurate knowledge
of a number of important factors affecting the cost of produc-
tion on their farms.

Wide Range in Production.—1. This was particularly true in re-
gard to the number of pounds of milk per cow. While figures ob-
tained by the committee ranged from 3,500 Ibs. to 15,000 lbs. per
year, it was clear that there are many cows in New England pro-
ducing under 3,500 lbs. per year.

It is exceedingly doubtful if most of the cows in New England are
producing much more than 3,500 to 4,000 lbs. per year.

Small Percentage of Pure Breds.—The evidence demonstrated that
while in many towns there are from 5 to 25 producers who have pure
bred bulls and some have pure bred cows, as a matter of fact the
majority do not have either; and outside of the cow test associa-
tions a disappointingly small per cent weigh or measure, although
there has been a great increase in weighing in the last three or four
years.

High Percentage Without Records—Probably 80% of the farmers
have no accurate idea what their cows are producing each year in
pounds of milk, to say nothing of their test in butter-fat.

[The rest refers to inaccurate charging of barn rent and incl-
dentals.]

The lack of any standardized methods of production and
of accurate knowledge of costs is due, says the Committee,
partly to temporary, partly to permanent, causes. The
evidence indicated the following as the principal factors in
producing and continuing this condition:

Commercial Dairying a New Industry—1. The selling of milk and
cream and the commercial creamery and cheese factory are not
old, established industries. Fifty years ago saw the first commercial
cheese factory, and thirty-six years ago the first commercial cream-
ery. General shipping, to any great extent, of milk and cream by
cars began less than forty years ago. Formerly, farmers sold from
their farms, for their cash income, corn, oats, wheat, beef, sheep,
wool, eggs and poultry, home made cheese and butter, wood and
logs.

APPENDIX D 219

2. One great factor in the situation is the varying amount that
the milk check contributes to the total amount of money received
from all products within the year. Producers are of two main
classes.

Milk Production the Main Business.—a. Producers whose milk
and cream check is 90% of their total income.

Mulk Production as a Side Issue-—b. Producers whose milk and
cream check is 10% to 60% of their total income; who are selling
market-garden produce, eggs, poultry, onions, tobacco, apples,
potatoes, pigs, hogs, young stock, cows, wood and logs.

The (a) producer is generally more concerned about his dairy
business than (6) producer, who is making milk a side issue and does
not pay much attention to breeding, feeding, amount of production
as compared with (a) producer, but (6) producers are a big factor
and produce in the aggregate much milk and cream for the market.

Advent of Foreigners.—3. Many foreigners are taking up farms
and producing milk, working the entire family on the farm. Few.
of these figure labor costs, but their milk and cream come into
direct competition with the producer who figures each item.

Causes of dissatisfaction among producers were brought
out as follows:—

Producers’ Solution—Although the cost of production varies
greatly and is not accurately known, producers are practically unani-
mous that they are not receiving enough for their milk. The pro-
ducer’s solution is more money for his milk, ranging from 4 cents to
6 cents a quart at his door.

Test and Price Suspected.—It also developed that the producers
suspected certain dealers of not giving them an honest test for butter-
fat. In some localities it was claimed that dealers paid producers
a higher price for their milk or gave them a bonus for hauling milk,
so as to keep peace in the locality, and prevent producers from
getting together.

Deduction for Sour or Frozen Milk.—The dealers in some instances
charged the producers for shortage, sour milk and frozen cream,
for which the producer claimed he was not to blame, having de-
livered his product to the dealer in good condition and full measure.

220 APPENDIX D

Monopolistic Methods.—It was also brought out that, in certain
instances, dealers entered creamery districts offering the producers
higher prices until such time as the dealer could secure control of
the local creamery, when the prices paid producers would be re-
duced to make up for the higher prices previously paid.

The above has been quoted in order to indicate some of
the considerations involved in detailed investigation of the
economics of milk production. There never was a time when
economic pressure required so much as now that the farmer
consider carefully the actual cost of milk production. For
every dairy farmer there are two problems: to detect, by
means of individual records,* the poorest cows in his herd
and dispose of these; then, by means of accurate farm ac-
counts, to determine the costs after the poorest milkers have
been eliminated. These costs, as we have remarked, vary
so much by time, locality, and individual farm conditions
that general figures are impossible. The important figure
is the local figure, but it is, as yet, rare to find dependable
statements even among those producers who claim to keep
systematic accounts. Hence it is that a number of agricul-
tural experiment stations have undertaken to ascertain
accurately the costs in their respective localities. These
figures are most useful when they not only make possible a
comparison between efficient and inefficient farm manage-
ment but also distinguish between ideal and practical condi-
tions. It must be borne in mind that the average farmer
cannot humanly be expected to take up at once the methods
of the scientific expert of the experiment station.

To quote here the diverse figures obtained in different
‘investigations under various conditions would confuse rather
than illuminate. The reader will be best enlightened by
consulting the most recent results from the experiment sta-
tion in his own State. One of the most thorough experiment

* Cow-test associations assist the individual dairyman in doing this, -
or he may make his own tests.

APPENDIX D 221

station studies comes from New York.* This gives the cost
of producing milk on 174 farms in one county and also
figures taken from bulletins from certain other States in
recent years. The figures are, for cost per quart: New
Hampshire, 4.2 cents; Massachusetts, 5.2; Connecticut, 4.6;
New Jersey, 4.2; Delaware County, New York, 5.1 (1912)
and 4.4 (1913). The writer of this bulletin recommends that
“without doubt the greatest need for this region is more
efficient cows,” but adds that in his opinion “the farmer
does not receive enough for his milk.”

RELATIVE COSTS OF LINKS IN THE MILK CHAIN

Figures indicate that when milk is marketed through a
middleman the farmer receives, roughly, from one-third to
one-half the retail price, the remainder going for transporta-
tion, processes, distribution, overhead, and middleman’s
profit.

Owing to wide variations it is impossible to give adequate
estimates of the general costs of the different operations of
the city milk industry. Some idea of these is given by the
finding in a recent investigation in New England { that
the total cost of collection in the country, operation of coun-
try plant, railroad transportation, and operation of city
plant was a little over or under 3c.; while the cost of distri-
bution to the family trade was 2c. to 5c.; to retail stores, in
cases of bottles, 1c. to 2c.; and to the wholesale trade, 4c. to le.
“The greatest single item of cost is, therefore, delivery to
the family trade, equaling the cost of collection, country

* Thompson, A. L., “Cost of producing milk on 174 farms in Delaware
County, New York,’ Cornell University, Agric. Exper. Sta., N. Y.
State College of Agric., Bull. 364, Oct., 1915. Studies have also been
made in other counties of New York. For further data see bulletins
of the Federal Department of Agriculture and of the various state
departments of agriculture and agricultural experiment stations.

+ Boston Chamber of Commerce, special report, 1915.

222 APPENDIX D

plant, railroad transportation, and city plant expense.” *
We have elsewhere (pp. 139-40) discussed this important
item and its possible reduction.

The cost of the important sanitary item of pasteurization
has been determined for certain city milk plants as (aver-
age) .313c. per gallon of milk (range, .229-.436) and .634c.
per gallon of cream (range, .378-.939)., The “holding”
method, which sanitary efficiency requires, was found to be
more economical in use of heat than the “flash”? method.
In Chicago the cost of pasteurizing milk was found to range
from one-thirtieth of a cent per gallon for large plants to
.85c. per gallon for one small plant.

(Some details and unit costs of milk plant operations are
taken up in the circular letters to city milk dealers pub-
lished by the Dairy Division, Bureau of Animal Industry,
United States Department of Agriculture.)

THE EXTRA COST OF PRODUCING CLEAN MILK

Little attention has, until recently, been paid to the cost
of the sanitary factors in milk production, but, in view of
the past non-recognition of the relative values of these fac-
tors, the deficiency is not serious. Whitaker, of the United
States Department of Agriculture, in 1909 estimated the
additional cost of complying with certain important items
of the Department’s dairy score card, and concluded that
“‘a reasonably clean milk is worth 2 cents more than common
slovenly milk. The former is safer and therefore cheaper at

* The average price received by the dealer for milk delivered to
family trade was 9c. per quart and to retail stores 6c. to 8c.

+ Bowen, John T., “ The cost of pasteurizing milk and cream,” U. S.
Dept. Agric. Bull. 85, 1914. .

t Rpt. of Senate committee of the 46th General Assembly to in-
vestigate the tuberculin test and the pasteurization of milk and its
products (as quoted by E. O. Jordan, Trans. XV Internat. Congress on
Hyg. and Demography, 1912, vol. IV, p. 637).

APPENDIX D 223

the increased price.” * With more efficient methods of pro-
ducing clean milk, based on the present better understanding
of the importance of certain items, the cost of sanitation may
be reduced. Such methods are now, fortunately, illustrated
by the system of Dr. North, who found the additional cost
necessary to supply a tuberculin-tested milk with a bac-
teria count under 30,000 at time of delivery to be one and
one-half cents per quart (see pp. 81-82). The extra cost of a
non-tuberculin-tested but pasteurized clean milk would be,
on this basis, not more than one cent.

PRICES, WHOLESALE AND RETAIL {

Wholesale prices for milk vary greatly according to place,
time of year, and economic conditions. ‘There are a num-
ber of different systems of payment in use—according to
the can (of various content), hundredweight, butter-fat, etc.
General figures compiled by the United States Department
of Agriculture { from milk dealers throughout the country
show that the average price paid to farmers in 1912 was
3.57 cents a quart; in 1913, 3.85; and in 1914, 3.80 (figures
net at farmers’ shipping stations). The average varied in
1914 from a maximum of 4.20 in December to a minimum of
3.26 in June. The highest prices were paid in New England
(average, 4.66) and the lowest in the Mountain States (3.45).
The highest monthly average was in New England in No-
vember (5.05) and the lowest in June in the Middle Atlantic
States (2.84). One dealer in the latter region reported that
he paid only 90 cents a hundredweight for milk in June,

* Whitaker, George M., “The extra cost of producing clean milk,”
Bureau of Animal Industry, U. 8. Dept. of Agric., Cire. 170, 1911 (re-
printed from 26th Ann. Rpt. Bur. An. Ind., 1909).

+ For more recent prices later publications from the sources men-
tioned may be consulted. Those quoted are the most recent obtain-
able at time of writing.

t Weekly News Letter to Crop Correspondents, Jan. 20 and April 28,
1915.

224 APPENDIX D

which would be only a little more than 1.9 cents a quart.
The above figures are quoted to give an idea of the varia-
tions commonly met with.

In publications of the Federal Department of Labor *
may be found the average wholesale prices of milk in the
New York market for a series of years. Taking the average
for 1890-99, 2.55 cents (net price at shipping stations sub-
ject to a freight rate to New York of 26 cents per can of 40
quarts), as the base (=100), the relative price figures are
as follows: 1900-04, 108.8; 1905-09, 124.8; 1910-14, 139.3;
1915, 139.2. The actual average price in 1915 was 3.51
cents per quart at the stations shipping to New York and
3.76 at those shipping to Chicago. |

The average retail price of milk in certain representative
cities of the United States has been as follows: 1890-1900,
6.8 cents per quart; 1901-05, 7.1; 1906-10, 8.1; 1911-15,
8.9; December, 1915, 9.0. The average retail price paid to
producers in the United States, derived from figures of the
Department of Agriculture,t was, for 1915, 7.1 cents per
quart; for 1916 (eleven months), 7.3. Comparisons showing
the smaller increase in the retail price of milk as compared
with certain other important food products have been given
in Chapter IV.

* Bull. 81, Bureau of Labor; Bull. 181, Bureau of Labor Statistics;
Bull. 200, Bureau of Labor Statistics, July, 1916.

t Bull. 197, Bureau of Labor Statistics, June, 1916.

t Information by letter.

APPENDIX E
LOCAL EXPERIENCES AND INVESTIGATIONS

NEW ENGLAND

The milk question in all its bearings has for years been a
subject of difficulty and controversy in New England. This
region, in which large industrial communities have grown
up, drawing their milk supplies from ever widening circles,
shows doubtless the most acute milk situation to be found
anywhere in the United States, and one never so acute as at
the present time.

In Massachusetts the population is increasing at the rate
of twenty per cent per decade, yet the number of milch cows
has fallen off in the past ten years by eighteen per cent.
There has also been a decrease in milch cows in neighboring
States (see Appendix A). Concerning this phenomenon the
Chief of the Massachusetts Dairy Bureau has had the fol-
lowing to say :—

The elimination of unprofitable dairy cows and the dropping out
of unsuccessful dairymen, for whatever cause, as well as the inevit-
able reduction of the milk supply to such a point as will bring the
price of milk to a profitable figures, are but the results of an in-
adequate price for milk.

The decline in the number of cows is greatest in those localities
where milk is shipped by rail to large cities for consumption. It
is, therefore, perfectly natural that nearby localities are first to be
affected. This decline, however, does not stop, but goes on and on
no matter how far the area of milk supply is extended, and the near
future will undoubtedly see further decline, especially in northern
New England and even in Canada until milk producers come to a
realizing sense of the great fundamental fact that milk has been too

225

226 APPENDIX E

long sold below cost price. Milk production will decrease until the
great law of supply and demand does its share of the work in rectify-
ing the situation. The remedy, so far as we are concerned, is the
education of the consumer to the food value of milk as compared
with other animal foods, together with the education of all to the
exact knowledge of the producer’s position. Greater economy in
milk production must be practiced. Better cows, more scientific
feeding and improved business methods are urged of the farmer.
Economy in handling, especially in the method of distribution, is
urged of the distributer, and a sense of justice and willingness to
pay a fair price for milk is urged of the consumer.*

It may be added that there is a feeling among Massa-
chusetts producers that they have been under stricter super-
vision, entailing greater trouble and expense, than those
sending milk from outside of the State, without corre-
spondingly greater compensation; and this feeling has further
complicated the situation.

The New England milk problem, centering about the city
of Boston, has been subjected in past years to a number of
general or limited investigations, by the Federal Dairy Divi-
sion and by other investigators, mainly from the sanitary
side. In 1914 the whole matter was taken up afresh by the
Boston Chamber of Commerce, which, through its Com-
mittee on Agriculture, made a thorough investigation of all
phases with special reference to economic and business con-
ditions. The reasons and scope of this inquiry were as
follows :—

It has been apparent for some time that the production and dis-
tribution of milk in the New England States is not on a sound
economic basis, and that there is something radically wrong with
the way in which this important industry is now being conducted.
It is obvious that the opportunities in the industry are far from
being fully realized.

*62d Ann. Rpt. Sec’y Mass. State Board of Agriculture, for 1914,
p. 424.

APPENDIX E 227

Milk has always been a staple article of consumption with all
classes, and is among the best and cheapest foods on the market.
The large cities of southern New England would naturally look to
the adjoining territory for their supply. This territory (northern
and central New England) is well able to support a flourishing dairy
industry—and dairying should naturally be the largest single
branch of New England agriculture, our greatest single industry.

Generally speaking the per capita consumption of milk in the
United States has been steadily increasing; but in certain districts
of New England the per capita consumption has been decreasing
for the past ten years, and the amount required has been drawn
from a larger and larger territory, and from districts more and more
remote.

In short, despite the increase in our urban population, the output
of the principal agricultural industry in the immediate adjoining
territory has declined. Country districts, which ought to be flour-
ishing, are at a standstill. No one has appeared to understand the
cause of the difficulty, or to have comprehensive ideas for its solu-
tion. |

The Committee on Agriculture of the Boston Chamber of Com-
merce, in view of this situation and at the request of the New Eng-
land Milk Producers Association (an organization of about 2,000
New England farmers), has made this investigation in the hope of
being able to throw a strong light upon the fundamental causes of
the difficulty and of being able to work out suggestions for its solu-
tion. This investigation has been conducted in coéperation with
the agricultural agencies of the various New England States. The
Federal Department of Agriculture also has rendered assistance in
the transportation features.

It appeared necessary, first, to obtain exact facts as to conditions
now existing in New England regarding production, transportation,
inspection, grading and distribution; second, to make a thorough
analysis of this information, studying the methods adopted by rail-
roads and cities elsewhere; third, to make, if possible, reeommenda-
tions helpful in putting the industry on a sound basis.

The report has two divisions. The first outlines the present
conditions in each phase of the industry, undertaking to give the
reader a mental picture of how milk and cream are produced,

228 APPENDIX E

transported, processed, inspected, graded and distributed, and
giving the costs and principal problems connected therewith: the
second contains comments and suggested recommendations.

The resultant report is an exceedingly valuable document
to all concerned in readjustment of the milk industry, being
packed with data which are not only of local application but
are of comparative and suggestive importance for other
regions where similar investigation may be needed. It may
be noted in passing that one of the principal points brought
out was the lack of standardization and grading of milk
which has been the main theme of the present volume. To
attempt to quote or abstract from this report further than
we have done elsewhere would hardly do it justice; the in-
quiring reader is therefore referred to the original publica-
tom:

The subject of railroad rates for milk and systems of
shipping, having reached an acute stage, was taken up by
the United States Interstate Commerce Commission in a
long series of hearings held in Boston in February and
March, 1916.7 f

The chief milk measure before the Massachusetts Legisla-
ture in 1916 was a bill prepared by the State Department of
Health, on the basis of extensive investigation, providing
for the formulation by the Health Commissioner of regula-
tions involving the grading of milk throughout the State
by a plan applying progressively in communities of different
sizes over a period of several years. The agricultural in-
terests, however, preferred no general legislation, and had
their way, the bill finally being defeated.

*“Tnvestigation and analysis of the production, transportation, in-
spection, and distribution of milk and cream in New England,” Boston
Chamber of Commerce, July, 1915. The Chamber has also issued a
pamphlet showing in detail how grading may be carried into effect.

t “The New England milk case,’”’ Supt. of Documents, Washington,
D. C. (5 ets.).

APPENDIX E 229

The question of milk prices in New England reached a
crisis in the fall of 1916, as the result of demands by or-
ganized producers for a higher price from the dealers. As a
result of the controversy, which centered in the Boston
market, where an effort was made to withhold milk, some
price increases were obtained. At the same time the retail
price was raised by Boston dealers to ten cents. More re-
cently (1917) the producers have obtained a further increase
in summer wholesale price, and the retail price of staple
market milk has gone to eleven cents. Costs of feed and farm
labor are reported to have risen greatly in the last year;
hence the farmers’ demand for the higher price. There is
evidence of increasingly effective organization among the
farmers of this region.

Very full data regarding the milk situation in Massachu-
setts, embracing conditions in the milk-producing districts
of New England, with discussions bearing on the general
milk problem, have recently been published by a special
board of the State Department of Health.*

NEW YORK STATE

Reference has been made, elsewhere in this volume, to
the system of sanitary grading prescribed for the towns and
cities of New York State (other than New York City) by
the State Sanitary Code. This, so far as the writer knows,
is the only state system that has thus far been established,
and its working is being watched with interest. The New
York City system has also been referred to. (See Appen-
dix B.)

The aim of a statewide system of grading is to secure a
desirable uniformity of standards and to induce communi-
ties which would otherwise remain apathetic to strengthen

* Report of the Special Milk Board of the Massachusetts State De-
partment of Health, 1916.

230 APPENDIX E

their milk supervision. Confusion and demoralization in
the milk trade through the adoption of differing local stand-
ards are thus avoided. As long, however, as local organiza-
tion and resources, particularly as to laboratory facilities,
remain deficient, effective grading throughout a State can-
not become an accomplished fact. The logical function of
state authorities is to supervise adequately the supply of
each town until it reaches the town confines, but in any case
final tests and the enforcement of grading are matters of
local control.

The economic difficulty has recently become acute in
New York State. The Legislature of 1916 authorized a
special committee to investigate the market conditions of
agricultural products in general, including milk as a subject
of chief importance. Senator Charles O. Wicks, introducing
the resolution, is reported to have spoken as follows:—

“The farmers,” he said, “‘are getting less for their milk than they
were getting two years ago, despite the fact that the price of feed
and the wages of their help have soared in the meantime. The
farmers are compelled to sell their milk for less than three and one-
half cents a quart. I do not know whether it is due to a combine of
the big middlemen or not, but I do know that the dairy farmers
are suffering severely and that many of them are being forced out
of business.

‘A situation might thus readily arise which would be very serious
to the consumers in such large communities as New York City.
Something should be done to remedy the situation.” *

The above-mentioned committee is interested in markets,
prices, and methods of marketing, including economic ques-
tions connected with the milk industry.

The price controversy between producers and dealers in
the New York market came to an acute issue in the fall of
1916. The organized producers withheld large quantities

* New York Times, April 4, 1916.

APPENDIX E 231

of milk, cutting down the city’s supply at one time to little
more than a third of normal, and threatened to attempt to
establish a codperative distribution system through the
medium of the State Commissioner of Foods and Markets.
The boycott resulted in victory for the farmers, the dealers
granting the cent-a-quart increase demanded.

NEW JERSEY

Under a law reorganizing the State Department of Health,
provision has been made for the adoption of a state sanitary
code, which, when drawn, will include milk regulations.
These, at present writing, have not yet been published.

RHODE ISLAND

In 1915 a special commission was authorized by the Legis-
lature to inquire into the agricultural resources of the State.
A large share of the attention of this Commission was de-
voted to the milk and dairy problem. In a recently pub-
lished preliminary report * the Commission says:—

The situation in respect to this industry is serious . . . there is
general dissatisfaction, (1) on the part of the producer because the
dairy business is on the whole unprofitable, and (2) on the part of
the consumer because of the poor quality of milk furnished by the
producer. From the standpoint of health also there is profound
dissatisfaction.

The Commission recommends measures for excluding
tuberculous cattle, for improvement of stock, and for in-
struction of dairymen. Attention is called to the decrease
in milch cows in the State and the tendency to go out of the
State for milk.

* Preliminary Report of the Commission of Inquiry into the Agri-
cultural Resources of the State, Providence, 1916.

232 APPENDIX E

There are many reasons for this decrease in the number of cattle,
but they may all be summed up in the statement that the keeping
of cattle has ceased to be profitable under present conditions. The
demand from the cities for improvement in the quality of milk has
not been met, simply because the average farmer who sells his
milk to a middleman cannot make dairying pay. . . . To-day the
whole subject is misunderstood both by producers and consumers.
Whether rightly or wrongly, consumers believe that milk should
be delivered to them at a price not more than nine or ten cents a
quart. Any attempt to raise that price will only result in a lessened
consumption, an end not to be desired if we consider the food values
of milk and the health of children.

Believing that ‘the trouble arises chiefly from the middle-
man, who purchases at low rates from the producer milk
both good and bad, mixes these, averaging their butter-fat
contents, and then sells a low-grade milk at a large profit,”
the Commission makes the following radical recommenda-
tion :—

In view of these facts your Commission therefore recommends
that cities or urban centers having a population of over 5,000 be
required to establish municipally owned central milk depots, con-
venient to transportation centers, and to allow no milk whatsoever
to be sold within their limits before it has passed through these
depots for standardization and pasteurization, under the supervision
of their Boards of Health, in accordance with rules approved by the
State Board of Health.

This recommendation does not apply to the smaller towns, whose
milk supply is as poor, if not poorer, than the supply in cities. Some
arrangement, however, can easily be made, either to have the milk
of the towns standardized at the nearest city depot or to let certain
towns, in combination or separately, set up depots of their own.

The Commission “believes that no solution of the milk
problem is worth while unless it insists on a thorough stand-
ardization, so that each consumer may know exactly what he
pays for in purchasing milk,”’ and recommends the classifica-

APPENDIX E 233

tion of milk in four market grades, all of which, except the
highest, must be pasteurized at the central milk depot. The
lowest of these grades is ultimately to be dropped. The
question of distribution is discussed and it is proposed that
the privilege of delivery by districts be sold or auctioned in
each municipality.

Whether this plan by which the community supersedes
the individual in the sale of milk will be put into operation
and whether it can be justified as a legitimate exercise of the
police powers of the State remains to be seen. It is perhaps
most interesting as a commentary on conditions which have
been thought to call for so drastic a remedy.*

MILWAUKEE

The following interesting account of recent developments
in the milk situation in Milwaukee has been received from
Mr. F. W. Luening, Deputy Commissioner of Health, under
date of January 28, 1916: —j

Our local problems here have most recently revolved about the
question of the tuberculin test and pasteurization. There are
incidentally, questions concerning the merits of clarification, and
to us the big question of public understanding and codperation.

Milwaukee some years ago enacted an ordinance requiring that
all milk sold in the city come from tuberculin-tested herds. An
injunction was promptly served, prohibiting the city from enforcing
this ordinance. An organization of milk shippers then took the
matter into the courts and delayed enforcement for a number of
years. The case was carried from a first hearing in the presence
of a court commissioner to the supreme court of the United States.
In every instance the city had the better of the argument. When

* Cf. the discussion on municipalization, Chapter V.

+ In the course of his study the author has had correspondence with
a number of officials in different towns and cities. Some of their remarks
by courtesy of the writers, are reproduced here as furnishing useful
first-hand information.

234 APPENDIX E

the final decision was rendered by the supreme court of the United
States, an attempt to enforce the provisions of the ordinance was
made. There was an immediate strike of milk shippers. They
refused to ship milk to Milwaukee, and succeeded in curtailing the
supply appreciably. The larger dairy companies, however, would
readily have won this battle had they actually been concerned in
it. It became evident that they were not directly concerned nor
that they even desired that the ordinance be enforced. While they
managed to procure milk, they took a stand against the Health
Department, and with the shippers, succeeded in at least rendering
negative most of the favorable public opinion, and took the matter
into the Common Council, where a bitter fight was waged on the
floor, which finally was won by the Health Department.

The dealers then protested that it was impossible to continue the
milk business under existing conditions—that is, with the curtailed
supply and the opposition of the shippers.

Ultimately, the department was compelled to procure temporary
shippers without the enforcement of the ordinance.

The fight was then taken to the floor of the state legislature,
which met in the fall, and there a second long battle was waged,
which was again won by the Health Department.

It has not yet been possible to fully enforce the ordinance, how-
ever, despite these victories, perhaps as largely because the milk
dealer does not want a restricted source of supply as because the
shipper does not want to test his cattle. By codperative work,
however, and educational effort, the shipper is gradually coming to
see the merits of the test and is no longer the most active opponent.
The dealer, on the other hand, appears to see a threat to his source
of supply in that the test will restrict the number of shippers and
thus permit a comparatively compact body to dictate prices.

The question of pasteurization was incidentally brought up in
connection with the test when the dealers contended that their
pasteurizers were all-sufficient to take care of any contamination
by tuberculosis that might exist in the milk, and by suggesting
that a pasteurization ordinance be passed. Eighty-five per cent
of Milwaukee’s milk supply already is pasteurized, and, although
such an ordinance is in contemplation, it has not yet been intro-
duced.

APPENDIX E 235

The broader question of public coéperation was also brought
forcibly before us during the recent years and in consequence of the
efforts to enforce the tuberculin-test ordinance. The public is
negative in the matter of milk purchases. Milk is milk to the aver-
age consumer. A white fluid in a bottle with a cream line, is about
all he seems to be interested in. In fact, users of milk here, have
told us that they could see no difference between the milk from a
tuberculin tested herd and the milk from an untested herd. They
have explained that the cream line was no lower, that the milk
tasted no differently and that they could see no excuse for paying a
higher price for such a milk. This attitude, more or less exag-
gerated, was apparent and general, and, of course, makes for the
defeat of a provision like that requiring the test. The dealer can,
quite safely, oppose any requirement until the public demands it.

So that the milk question, like most other public health ques-
tions, is compelling the Health Department to become an educa-
tional institution primarily, and is relegating the police powers to a
secondary place.*

The producer also must be made to follow the public understand-
ing of the milk question. So long as milk is accepted by the public,
either in urban or rural communities, without question concerning
its source, filthy milk will be produced, and the product of the cow
will be contaminated until it is hardly fit for food. So long as the
public is willing to rely upon strainers, clarifiers and other artificial
means of removing ‘dirt, the producer will not concern himself
greatly about keeping dirt out of the milk.

The commercial aspects, of course, play a further part, as is
indicated in the attitude of the dealer toward the tuberculin test.
The milk dealer will always want as wide a market as he can get,
as many shippers as he can get and as many other sources of supply,
including creameries, cheese factories and other concentration
centers. He will always, directly or indirectly, oppose restrictions
by authorities or the public, that will curtail his supply. It is not
to his advantage to deal with a body of shippers who have complied

* This can rightly be taken to mean only that in practice a great
part of the work of effective health departments is educative or suasive
rather than compulsive. Authority still remains, of course, the Gasis
of administration —J.S. M.

236 APPENDIX E

with certain ordinance provisions and therefore are exclusively in a
position to supply a particular milk. This would place these ship-
pers in the position of dictators, whereas, under existing conditions,
the dealer is the dictator. It is not within the plan of the distributer
to permit a concentration of the present scattered sources of supply
that are working without codrdination, largely without codpera-
tion, and almost entirely without organization. Whether, from a
public viewpoint, anything would be gained by placing the power
in the hands of the shipper rather than in the hands of the dis-
tributer, is questionable, of course. That the producer is capable of
assuming an arbitrary and arrogant stand, is evidenced by the milk
strikes conducted by milk shippers on two occasions. While it is
true that these particular strikes could readily have been broken by
the dealers, the public and the authorities working together, it is
questionable whether such strikes might not be used to the decided
disadvantage of the consumer, were the producers well organized.

BROCKTON, MASS.

The city of Brockton has for some years been conspicuous
for success in bringing about sanitary improvement of milk
supplies through regulation based upon bacteriological tests.
The city maintains a general municipal laboratory, the
Director of which, Mr. George E. Bolling, also Inspector of
Milk, several years ago wrote as follows concerning appear-
ance vs. results in dairies :—

Our experience in the supervision of our local milk supply has
shown us that the appearance presented by a dairy or the score it
obtained was not a criterion of the cleanliness of its product, and
that intelligent personal supervision by the owner of the detailed
work in a dairy essential to the production of clean milk went
further toward securing such a product than fancy equipment
turned over to hired help. Our motto became ‘‘The proof of the
pudding is in the eating,’’ and when milk taken from the wagons
of the dealers when ready for final delivery to the consumer showed
a clean product, we did not insist on more or less costly changes
at the dairy that regularly marketed such milk.

APPENDIX E 237

We became convinced, also, that there was an economic side to
the milk question and that it vies with the health aspect in impor-
tance, for, as runs the famous receipt for rabbit pie—‘“‘first catch
your hare”—so someone must first produce the milk, and if it is
not made a profitable undertaking for someone, who will produce
it and then where does the health question enter in?

Our final conclusion was that the proper way to inspect milk was
by the laboratory and if anything went wrong an inspection of the
dairy became necessary, and that to rule indiscriminately that
each dairy must be equipped thusly and score a certain percentage
was unnecessary.”

A recent report of the Brockton Health Department
states :—

As we have reiterated from year to year, and as further demon-
strated by our work in 1914, the high scoring dairy does not neces-
sarily produce the cleanest and safest milk.

Dairymen supplying Brockton have succeeded in produc-
ing unusually low-bacteria-count milk in stables of inex-
pensive construction (see Plate 3, p. 83) and the names of
the most meritorious are published in the annual reports of
the Health Department. The following statement, in answer
to a short list of questions, is furnished by Mr. Bolling:—

1. Sanitary milk inspection for Brockton began in 1906; that
year the local board made rules and regulations to supervise the
production, care, and sale of milk. Among the regulations was one
limiting the number of bacteria in milk intended for sale to 500,000
per c.c. Collection of samples from wagons and stores to deter-
mine their relation to the bacterial standard began immediately
upon adopting the rule in 1906. The first year about 600 samples
were examined by the plate method of counting and in the last ten
years 12,300 have been so examined. Persistent violations of this
rule have been prosecuted, about a dozen altogether in the ten
years. Only such cases have been prosecuted, however, as proved

* “The development of a municipal laboratory,’’ American Journal
of Public Health, June, 1912.

238 APPENDIX E

to be unamenable to advice and instruction how to produce cleaner
milk. Since 1909 the Statute standards of solids and fats have been
enforced, about 1,500 to 2,000 chemical examinations being made
yearly.

2. We have no “milk problem”’ here that I recognize as such.
The one matter in which I would like to see a change is for the
public to be more willing to pay a higher price for the cleaner milk.
This would be automatically brought into effect by sanitary grading.

3. From the standpoint of a health official I would say the most
important single regulation is the one limiting the bacterial content
of milk intended for sale.

4. As regards pasteurization I believe that the New York system
of grading as well as the scheme just proposed by the Massachusetts
State Health Department will both serve admirably to induce quite
general pasteurization. I believe it should be generally required
and that we can hardly err in so doing.

The retail price of milk in Brockton is nine cents, which
implies that sanitary improvements have been brought about
without excessive increment of cost.

For a city with a raw milk supply, Brockton has been
unusually free from traceable outbreaks of milk-borne dis-
ease. In 1915, however, two such occurred, involving
(though promptly checked) some 48 cases; *—merely an-
other demonstration of the fact that city milk supplies,
however clean in the ordinary sense, may carry infection
unless efficiently pasteurized.

PALO ALTO, CAL.

As an illustration of experience in a small community,
Palo Alto, Cal. (population ca. 6,000), may be taken. Mr.
Harold F. Gray, the former Health Officer,t has kindly fur-
nished some particulars. This community relies upon tuber-

* Personal communication, Mr. Bolling.
{| Now Asst. Health Officer, San José, Cal. -

APPENDIX E 239

culin tested clean raw milk for its supply. Concerning the
introduction of the tuberculin test Mr. Gray writes :—

We had practically no real difficulty. The campaign for tuber-
culin-testing, with pasteurization as an alternative, was gradual,
and began shortly after the very severe milk-borne epidemic of
typhoid fever in 1903. At that time the Board of Health employed
a veterinarian to tuberculin-test the various dairy herds. There
was no local authority, however, to compel the elimination of re-
actors, some of the dairymen getting rid of them and some retaining
them. At this time most of the milk sold at from 5c. to 6c. a quart,
retailed.

This test, however, called the attention of the local public to the
situation, and several of our more progressive dairymen began the
annual testing of their cows and advertised the fact, obtaining a
higher price for their milk. As time went on, more of them followed
suit.

The history of the campaign for better milk is summarized
as follows :—

Near the end of 1910 under a new city charter, the Board of Pub-
lic Safety installed a modern health department, directed by a non-
medical but technically trained health officer, who began an ag-
gressive campaign for a better milk supply. The great majority of
dairymen tested their herds, and when the writer took office at the
beginning of 1914, there were only three large and one small dairies
remaining untested, and of these one large dairy had tested, but
had not excluded the reactors.

About the middle of 1914 . . . I obtained from the City Council
an ordinance compelling either tuberculin-testing or pasteurization.
For a while some pasteurized milk was sold in Palo Alto, but event-
ually this was discontinued for the reason that the public preferred
the raw milk.

I am very aware of the great merit of pasteurization as a measure
of safety against milk-borne epidemics in cities where a close super-
vision of the milk supply is not possible. In Palo Alto, however,
we are able to supervise our dairymen so closely that the danger
of milk-borne epidemics is practically negligible. As a further pro-

240 APPENDIX E

tection in the new ordinance which we are now drafting, to make
our local ordinance conform to the new state dairy law which goes
into effect on October 1st, we are providing that all employees
engaged in the production of the higher grades of milk shall have at
least an annual medical examination.

I am sure that at the present time none of our local dairymen
would want to return to the old conditions, even though some of
them bucked against the changes pretty hard. The public has sup-
ported us in our work and, so far as I know, has not objected, ex-
cept in some few rare instances, to the increase of retail prices. At
the present time the better grades of our milk are retailed for 10c.
a quart and few dairies still supply a small amount of milk at 84 c. a
quart. The probability is that after the new law goes into effect
guaranteed milk will sell for about 11lc. or 12c., grade A, 10c., and
grade B, 84c. a quart.

Some effort was made to obtain exact financial data re-
garding the relative cost and profit in producing high-grade
and low-grade milk, but little information was forthcoming
from the dairymen.

Several stated to me, however, [writes Mr. Gray] that their
net profit was considerably larger for the production of good quality
milk as against poor quality. They based this statement on these
factors: *

(1) The better care of the dairy cows meant an increased produc-
tion per cow, the value of which increase was much in excess of any
expense of additional feed.

(2) The greater interest in quality has led to a greater interest in
production per cow (as well as practically compelled it), so that
they have weeded out the “boarders” or unproductive cattle.

(3) A higher grade milk has commanded higher prices, both
wholesale and retail.

It is to be wished that such results were more frequently
the case.

* These evidently refer to general care of cows and food quality of
milk as well as to sanitation —J. S. M.

APPENDIX E 241

MONTCLAIR, N. J.

The town of Montclair, N. J., was the pioneer in the
United States in official work for clean milk, and has, under
a succession of trained health officers, brought its milk stand-
ards to the culmination of obtaining a tuberculin-tested milk
of high sanitary quality. At Montclair the legal question
of the tuberculin test was conspicuously fought out, with
the result that an important victory was won by the Board
of Health and the legal status of the test firmly established.
In previous pages reference has been made to Montclair on
several points. For further information the reader is re-
ferred to the annual reports of the Board.

RICHMOND, VA.

Strict regulation aiming at clean milk has also been prac-
ticed for some years in Richmond, Va., under the direction
of the Health Officer, Dr. E. C. Levy. Nearly half of the
market milk in this city runs under 10,000 bacteria per c.c.,
and 83.3 per cent of it below 50,000. The infantile diarrhea
death rate has declined remarkably, year by year, for the
last four years, though Dr. Levy remarks that he does not
hold ‘‘the primitive view that the milk supply is everything
in this connection or, indeed, that it is, in all probability,
the most important single thing.” The classification of
milk recently adopted by this city, (see Appendix B) shows
the requirement of pasteurization of milk not of the first
grade.

WINNIPEG, CANADA

Dr. A. J. Douglas, Medical Officer of Health, writes as
follows :—

From the experience I have had, my personal view is that pas-
teurization offers the most satisfactory solution of the problem of
how to secure a safe milk. In this city at least I do not see how the

242 APPENDIX E

situation can be adequately dealt with in any other way. This
department has endeavored for the past fifteen years to educate
producers and to point out the advantages, both to producer and
to consumer, of clean and safe milk. . . . At the present time pos-
sibly eighty per cent of our local supply is pasteurized, and we know
that this process is adequately carried out, as we keep an inspector
on the floor of each plant. A few years ago no pasteurized milk
was sold here. At that time a year never went by without one
or more outbreaks of disease, usually typhoid, which could be traced
unequivocally to the milk supply. Since pasteurization has come
extensively into use some four years ago, we have not had a single
outbreak of disease which we could prove was milk-borne.

MILK SUPPLIES OF TEN EASTERN CITIES

Several years ago the Jersey Bulletin* collected some
interesting information and figures regarding the milk sup-
plies of New York, Philadelphia, Boston, Cleveland, Buf-
falo, Providence, Columbus, Toledo, Hartford, and Burling-
ton, Vt., published in an article concluding as follows:—

In summarizing, it will be seen that the average price paid per
quart by the consumer in all the ten cities is about 734 cents. While
specific information regarding the price received by the producer
was not obtained in every instance, it is plain to see that it averages
close to 31% cents a quart, or less than half the retail price. In
other words, the farmer or the dairyman has to keep up his farm,
maintain his cows, feed them, milk them and see more than 50 per
cent of the final receipts go into others’ hands, while his receipts, in
many instances, barely pay the cost of production.

As to the tuberculin test, the average opposition to rules laid down
by health boards in this regard seems to be about 98 per cent;
though of course this does not apply in the case of certified pro-
ducers. The feeling of the farmer producing market milk has al-
ways been antagonistic to strict regulation by city authorities, and
no doubt always will be just so long as he is given no monetary in-
ducement to practice better methods.

The fact remains, however, that the average standard of the milk

* Jersey Bulletin and Dairy World, Indianapolis, Aug. 23, 1911.

APPENDIX E 243

supply of our large cities has greatly improved in the last few years,
and even though the methods used in bringing this about have
been in many places strongly objectionable to the producer, the
results have directly or indirectly been generally successful; and
now that the public has become better educated to the value of
good milk, it remains for the farmer or producer to impress this
fact more strongly than ever by keeping up the quality, to the end
that he may receive for his milk not only what it costs him to pro-
duce it, but a reasonable profit thrown in.

THE DAIRY SITUATION IN FREDERICK AND
BALTIMORE COUNTIES, MARYLAND

All of the general positions taken in this book have been
strikingly confirmed in an intensive survey, made during
the summer of 1915, of the milk situation in Frederick and
Baltimore Counties, Maryland. This survey brought out
exceedingly important points, and, since similar conditions
prevail in many other regions, has more than a local interest.
Hence a summary account of it is here reprinted entire.
The investigation was made by the Women’s Civic League
of Baltimore, in codperation with the dairymen, through an
investigator qualified to deal with agricultural questions.
The findings involve an interesting comparison between
differing conditions in the two counties: at the same time
they may be compared, as a small-scale survey, with the
large-scale survey in New England by the Boston Chamber
of Commerce which has already been referred to. The
analysis of the sanitary and economic questions centering
about the price of milk is the pervading characteristic of the
report, which we quote without further comment: *—

The purposes of these investigations were two: (1) To secure the
point-of-view of the man behind the cow in things as they are in

* Reprinted from The Town, organ of the Women’s Civic League,
Baltimore, Md., June 10, 1916. The report is based, with omission
of some details, on two earlier reports.

244 APPENDIX E

the milk business and to record his suggestions for the improve-
ment of these things; (2) To secure facts and figures relative to the
actual cost of production, selling price and profit or loss among the
dairymen. This information should serve as a basis for intelligent
legislation.

Those farms selling milk direct into Frederick City were be-
lieved to serve best the purposes of the survey, and it was from
these 47 dairymen that the 25 units of the survey were selected.
They presented a problem purely productive in nature and uncom-
plicated by long hauls to distant markets. |

IS DAIRYING YOUR SPECIALTY OR JUST A SIDE-LINE? With all of
the 25 men, except 2, who sold to retail trade, the milk business
was merely a side-line.

Is IT BETTER OR WORSE THAN IT USED TO BE? Only 2 thought it
better, 16 declared it worse, and 7 thought it just about the same.

Do YOU WEIGH THE MILK FROM EACH COW AND TOTAL HER PRO-
DUCTION? Only 1 of the 25 took this business precaution.

Do YOU KEEP FARM BOOKS? Only 2 of the 25 kept farm books.

The next three questions established the fact that the average
dairyman had to get up about four in the morning and that many
milked by lantern light. The average working day was 1434 hours!

THE TUBERCULIN TEST had but 7 converts and many of these
qualified their declaration with, ‘‘but not as it is done down here.”
Eighteen were dead against it. There were no neutrals.

ARE THE PRESENT MILK LAWS FAIR TO THE INTERESTS OF THE
FARMER? Upon this point there was a great unanimity of opinion.
Only 3 men believed that the farmer was getting a square deal,
while 20 were loud in protestation to the contrary. Two were
neutral.

DOES DIRTY MILK CAUSE DISEASE? There were no neutrals on
this point; 15 believed that dirty milk might cause disease or even
death, but 10 denied that such a danger existed.

MILK PRODUCED PER COW PER YEAR, 5,943 pounds. The average
of the State is about 3,500 pounds. This average is very low and
capable of being doubled and then doubled again.

Cost OF PRODUCTION PER QUART OF MILK: The amount of milk
produced and the cost of production: These two factors control
in so far as the producer is concerned, the extent of his profit or loss.

APPENDIX E 245

Yet only one farmer out of 25 was able to approximate the amount
produced, and not one was able to even hazard a guess at his pro-
duction cost. Which represents the main distinction between the
“milk business”’ and simply ‘‘shipping milk.”

To PRODUCE A QUART OF MILK Cost, on the average, 3.5c. (14.0e.
per gallon the year through.)

THE AVERAGE SELLING PRICE PER QUART was 3.8c. (15.2c per
gallon the year through.)

It will be at once observed how small is the margin of profit from
the sale of milk alone. Nevertheless, of all the 25 dairymen, only 5
were actually losing money, and the value of calves and manure
produced redeemed 3 of these to the extent of just about breaking
even.

Although 20 herds were making some money, very few were
making their owners rich or even adequately compensating them
for trials and tribulations undergone. The average dairyman
ended the year about $330 ahead—a little less than a dollar a day
profit from the sale or utilization of both milk and calves. To this
may be added the value of manure produced by each cow during
the year.

AVERAGE PROFIT PER COW PER YEAR: From milk and calves sold
or utilized, this profit was $17.

_ WHAT IS WRONG WITH THE MILK BUSINESS?

THE LAWS were attacked by 12 farmers, mainly on the grounds
that they were written from a citified viewpoint and likewise en-
forced; that they raised expenses without raising prices; and that
they were inefficiently administered.

INADEQUATE PRICES had six adherents. Most of these took the
stand that if the towns want better milk they must pay better
prices. They called attention to the fact that the price of feeds,
fertilizer and labor has almost doubled during the last decade and
that there has been no corresponding increase in the price of dairy
products.

THE MIDDLEMAN was attacked by only two of the 25.

WHAT SUGGESTIONS HAVE YOU TO MAKE THINGS BETTER! An-
swers on this point were vague and varied. Those who held legisla-
tion at fault wanted ‘‘better laws;” those who complained of ‘ poor
prices’’ wanted ‘‘better prices;”’ and the two who were against the

246 APPENDIX: E |

middleman advocated direct selling. All agreed that “ codperation”
was necessary to secure their several ends.

DOES DIRTY MILK CAUSE DISEASE? Undoubtedly it does, and
sometimes death, especially among infants. To the 10 men who
stated their disbelief in any danger from dirty milk, and to any
other who may hold a like opinion, we would say: ‘Ask Your
Doctor.”’

WHAT IS WRONG WITH THE MILK BUSINESS? Certainly not all
the trouble can be traced to Inadequate Prices. The production
end of the milk business is, for the most part, being carried on in
an unbusinesslike manner, and the producer himself thus takes rank
among the factors which prevent his realizing from his herd all that he
is entitled to. We believe that the time will come when every dairy-
man will find it profitable to produce clean milk and when he will be
able to turn to his books to prove the extent and sources of this
profit. The first interest of the State should be the industry which
feeds the State. The main dependence of Maryland agriculture is
the dairy farmer.

We cannot believe that the present milk laws represent the main
difficulty, no matter how imperfectly they may have been drafted
or unsympathetically applied.

Any one dairyman can of himself reform his own business and,
even at current conditions and prices, make it pay. How? Ask the
man who belongs to a Cow Testing Association! Of course, a man
does not have to join a Cow Testing Association; he can weigh
the milk, make the tests and figure the results for himself. But, if
he is to make money out of dairying nowadays, he must do one or
the other.

Baltimore County showed an encouraging degree of enlighten-
ment and fairmindedness in regard to the latter-day features of
the business. Where Frederick County farmers had gone on record
as in favor of only about one-third of these things, Baltimore County
declared for 80 per cent of them.

Frederick County produced its milk more cheaply and made
more money from its herds. Its production cost was only 3.5c. per
quart as compared to an average quart-cost of 4.5c. in Baltimore
County. And to this latter cost may be added 0.5c., the quart-cost
of “milk tickets,’ a thing unknown in the field of the Frederick

APPENDIX E 247

County investigation, where the shippers sold directly into Fred-
erick City. This half-cent transportation charge is not, strictly
speaking, a part of the Production Cost, but it does represent a
substantial part of what might be called the Producer’s Cost, and
so should be counted in. If it be so considered, the Baltimore
countian averaged an expenditure of 5.0c. for every quart of milk
produced. Of course, this does not apply to the few who shipped
to a creamery or supplied a small local trade.

An (f) after a figure means that this figure is greater than the
corresponding result of the Frederick County investigation; a
minus-sign means that it is less.

Is DAIRYING YOUR SPECIALTY OR JUST A SIDE-LINE? Fifteen (-)
thought the business a side-line; ten decided it was a specialty.

How LONG HAVE YOU BEEN IN THE MILK BUSINESS? The average
was 18 years (f).

Is IT BETTER OR WORSE THAN IT USED TO BE? Two thought it
better; 19 (7) worse, and four either had no opinion or thought it
just about the same.

Do YOU WEIGH THE MILK FROM EACH COW AND RECORD HER PRO-
DUCTION? Five (f) of the 25 took this business precaution.

Do YoU KEEP FARM BOOKS? Ten (7) of the 25 kept books.

‘THE WORKING DAY was thirteen and one-half hours, more than
an hour less than that of the Frederick County dairymen, but
quite a day at that.

WoULD YOU RATHER SELL TO A CREAMERY OR DIRECT TO TOWN
AT A BULK PRICE? ‘Twelve (f) preferred the creamery and ten
shipping to town. Three had no preference.

ARE THE PRESENT MILK LAWS FAIR TO THE INTERESTS OF THE
FARMER? Three thought the laws all right; eight, among whom was
a lawyer, declared them unfair, and 14 held no opinion.

NUMBER OF COWS PER HERD: The average was 30 (f).

POUNDS OF MILK PRODUCED PER COW PER YEAR: 5,089 (—). Equiva-
lent to less than two gallons per day for a period of 365 days.

To PRODUCE A QUART OF MILK cost 4.5c. (ft). (18c. per gallon
the year through, to which may be added 2.0c., the gallon-cost of
milk tickets.)

THE AVERAGE SELLING PRICE PER QUART was 4.2c. (fT). (16.8c.
per gallon the year through.)

248 APPENDIX E-

PROFIT OR Loss: With the production price exceeding the selling
price a county-wide loss would seem self-apparent. This loss, how-
ever, is slightly more than redeemed by the value of calves and
manure produced. The farms included in the survey were, in al-
most every individual case and on the average, just about breaking
even.

From the sale and utilization of milk and calves there was an
annual average loss per cow of $6; a loss offset by the manure which
a cow will produce in a year. So it seems that Baltimore County
is just about breaking even from its efforts to supply Baltimore
City with milk.

Aside from the fertility factor—an important but not a very
tangible reward—the only other excuse for being in the milk busi-
ness seems to be the monthly check. This is an undoubted advan-
tage. In the present absence of any logical system of rural credit
many farmers are practically banking with the milk middleman;
pouring in their daily deposits of value and drawing out in cash at
the first of the month.

WHAT IS WRONG WITH THE MILK BUSINESS? This question, put
to 25 Baltimore County dairymen, elicited 23 decided opinions.

One dairyman writes, ‘‘Allow me to predict that, if conditions
are not soon bettered, most of the men now engaged in the milk
business will be forced out of it.”’

Where in Frederick County the disposition was to lay the blame
upon the present laws, Baltimore County was practically unani-
mous in blaming the system of marketing.

Sixteen thought the present prices paid for milk to be insufficient
in view of the constantly growing production cost—a belief some-
what supported by the facts obtained. Six attacked the middle-
men. One man thought the trouble to be in “over-production”
and counselled combination in view of finding ‘‘some method to
take care of the surplus.”

WHAT SUGGESTIONS HAVE YOU TO MAKE THINGS BETTER? The
great majority of answers to this question simply advocated a ‘fair
price.” Some specified this price to be “‘20c. in summer and 25c. in
winter, showing that the farmers have at least an idea of what it is
costing them to produce the milk they are selling for 16.2c.”’

“Milk should be graded as is the case of all other foodstuffs, ”

APPENDIX E 249

writes one large producer and two others say almost exactly the
same thing.

Apropos of the condition and correction for the condition of the
milk business are the remarks of one of the largest milk middlemen
of Baltimore, made recently in the presence of a representative of
the League:

THE MIDDLEMAN’S VIEW-POINT: ‘‘ Farmers often come to me and
say, ‘I’m losing money by selling milk. I’ve got to have a better
price.’

“<How much money are you losing?’ They don’t know. ‘Don’t
you keep books?’ No; they never bother with them. They don’t
weigh their milk and keep account of their individual cows; their
herds are full of star boarders, eating their heads off. Very often
they don’t have silos; they don’t try to raise all of their own feed,
and they don’t feed intelligently. Their product is poor and often
below city standard. No wonder they are losing money!

“Some farmers producing milk testing high in butter-fat, low in
bacteria, and who have their cattle tuberculin tested every 12
months are getting now, an advanced price.”

‘A general rise in the retail price of milk, however, is next to
impossible in the light of present public opinion.

“Tt is true that the margin of profit is small; the only way for the
producer to make money is through more economical methods and
‘better cows.’”’

The wide difference of opinion between the producer and the
seller of milk is at once apparent. They see the thing from entirely
different angles. Broadly speaking, each blames the other. It is
important to note, however, that the middleman quoted was in
complete accord with the several producers who advocated a system
of graded milk—a practical point in favor of the system. .

It seems obvious that the dairy business can easily be system-
atized and improved so that much larger profits will be earned.
Then the dairy farmer can satisfy the demands of the consumer
and can, when the legitimate costs justify it, ask a larger price for
his commodity. The consumer should be willing to pay a fair price
for safe milk, but he should not be asked to pay for a high cost of
production due to inefficient methods.

RussELL R. Lorn.

250 APPENDIX E

Limitation of space forbids further mention of conditions
in individual localities. A great many special investigations
have been made, some by the Federal Department of Agri-
culture, some by state or local authorities or individual in-
vestigators. The preceding condensed statements are in-
tended to be merely illustrative of varying local situations
and individual comment.

COOPERATIVE PASTEURIZATION AT RIVERSIDE, CAL.*

A codperative pasteurizing plant which has many novel features
has been operated for some time in Riverside. While owners of
small dairies under the new law, may have their cows tuberculin-
tested, without resorting to pasteurization, it is possible that owners
of small dairies may desire to codperate in the establishment of a
pasteurizing plant like the Riverside institution.

Seven dairymen organized the company in Riverside, which was
incorporated with $20,000 capital stock, $8,500 of which was paid
in by the organizers. This capital paid-in stock was to draw 7 per
cent interest, payable semiannually. A sufficient amount of money
- was borrowed to buy the property, build the plant and install the
machinery. The plant started operating in March, 1911. No
stock has been sold since that date and none is held by any one
other than a dairyman.

_ Dr. George E. Tucker, city health officer of Riverside, says of
the operation of this plant and of its effect upon conditions in
Riverside:

_ “Before this plan was started, eight dairies were selling milk in
the city, with eight wagons making two deliveries a day, and prac-
tically every block within one mile square was covered by each of
the eight wagons in the early morning and in the evening.

“In July, 1910, milk retailed at eight and one-third cents per
quart. In November, 1910, the price was raised to ten cents per
quart. A series of tests showed the butter-fat content to vary from
3 to 41% per cent, depending to a certain extent upon the convenience
of the water supply.

* Bull. Cal. State Bd. of Health, May, 1916.

APPENDIX E 251

“After formation of the dairy company, the price was immedi-
ately reduced and reductions have continued until at the present
time milk containing 4.2 to 4.5 per cent butter-fat is sold for 15
quarts for $1.00, or at 67/3 cents per quart.

“Since the formation of this company the number of dairies in
the county has doubled.

“All the milk and cream is pasteurized by being subjected to a
temperature of from 147 to 160 degrees for ten to fifteen minutes.
The milk is first aérated and cooled at the dairies, delivered im-
mediately to the central plant, where it is pasteurized, bottled,
reduced to a temperature of between 30 and 40 degrees Fahrenheit
in the precooling plant and delivered to the consumer.

“For the purpose of delivery but three wagons are used for the
retail trade, whereas formerly the same amount of milk from the
same number of dairies would have required fifteen wagons.

“ The total investment in this distributing station at the present
time represents in real estate, buildings, machinery and improve-
ments about $31,000. There is a floating indebtedness of $11,000,
drawing 6 per cent interest, and accumulated assets of $9,500.

“ Three dairyman are employed to manage the business at a suf-
ficient salary to justify them in accepting such employment and
discontinuing active dairy work. Sweet milk and cream are sold
not only in the city of Riverside, but in the adjoining towns.

“There are at the present time ten employees: the three dairy-
men above mentioned, three men for delivery and three men who
operate the plant, and one bookkeeper.

“ The advantage of this method of handling the city milk supply
is apparent. If at any time it is found on inspection that any of the
contributors to this station are producing milk under conditions
which are not satisfactory, a notice to the producer from the plant
is sufficient to prevent the sale of this milk. The fact that our
general milk supply is pasteurized does not in any way deter either
the dairymen or the inspectors from insisting upon the production
of clean milk.

“T believe that the result of the central dairy plant experiment
has fostered and very greatly increased the dairy business; that
the dairymen receive more for their products; that the consumer
receiyes a higher grade of milk at a less cost, and that two-thirds of

252 APPENDIX E =

the vexatious problems in the control of a small community’s milk
supply have been solved by the introduction of this plan.”

HINTS FOR LOCAL MILK COMMITTEES *

1. In undertaking to secure better milk for any community it is
first important to read the reports of the New York Milk Committee
and those of other cities, and it will be found helpful to read the
reports of the Public Health Service on milk. Perhaps the most
valuable document is the Report of the Commission on Milk Stand-
ards appointed by the New York Milk Committee, printed by the
United States Public Health Service in 1912 and again in 19138.
[A third revised report has appeared in 1917.—J. 8. M.]

2. It is also indispensable that by every possible method, com-
mittees dealing with milk should know thoroughly the methods of
production, from cow to consumer, and the difficulties that beset
the dairy farmer and the city dairy companies.

3. But perhaps the most valuable step is that which puts a milk
committee in touch with the local public health authorities. It will
be found in most communities that both city and state health de-
partments are inadequately manned and equipped to deal effectively
with milk problems. Even if this is not true the health department
will undoubtedly welcome any agency helping to bring to the at-
tention of the public the rules and regulations of the department
and suggestions for better health conditions.

4. The next step will commonly be to employ an investigator, who
has had proper scientific training, to work with the health depart-
ment in securing a report on the exact condition of the milk served
to the public. This can then be made the basis of requests from the
appropriating powers for proper men and equipment to take care
of the milk situation where it should be handled—in the health
department.

* From an article entitled “How a civic league secured a clean milk
supply,” by Harlean James (Exec. Sec’y, Women’s Civic League,
Baltimore), The Survey, Jan. 16, 1915.

APPENDIX F

MILK PRODUCTS

The scope of the present volume has forbidden treatment
of the various products derived from milk by modern in-
dustry. For these the same general considerations hold, so
far as may be, as for milk. The pasteurization of the milk
from which these products are made, or of the product itself,
is very desirable and is, in fact, rather general in practice.
The concentration of manufacture in plants of some size is
a factor which makes for the readier control of milk products,
though the sources of the milk entering into these also call
for attention. Through modern economic conditions certain
of these products, such as condensed milk, evaporated milk,
and skim milk, have come into wide use as substitutes for
fresh milk.

The National Commission on Milk Standards (of the New
York Milk Committee) has had under consideration certain
products—such as butter, ice cream, condensed milk, skim
milk, buttermilk, and homogenized milk and cream—and
the reader is referred to the reports of the Commission * for
information on their sanitary aspects. In the control of these
products the principle of correct labelling plays a most im-
portant part.

*See 3d. Rept.

253

INDEX

Administration of milk control,
163

Agricultural authorities,
164-66

52-54,

Bacteria and milk, 13

Bacteriological tests and stand-
ards, 67, 92. See also Labora-
tory.

Baltimore, 243

Boston. See New England.

Brockton, Mass., 83 (pl.), 236

Butter fat, labelling as to, 92,
154-55; payments for, by
- dealers, 144; standards for, see
Chemical tests.

“‘Carriers,”’ disease, 14-15

Central distribution, 1389-40, 250—
52

Centralization, 170

Certified milk, 67

Chemical tests and standards, 89.

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