DistrictsFor many reasons the popularity and consumption of milk are on the increase, so that the time has come for the medical profession in general and health authorities in particular to take stock of their position in this matter. Milk is the vehicle for carrying many unpalatable things: farm dirt, cow manure, filth from milkers' hands, dirt from vessels, as well as other things not unpalatable but often disastrous to man, such as Brucella abortus, Koch's tubercle bacillus, and the organisms of enteric fever. There is a school of thought which believes that we must all swallow "a peck of dirt before we die." This should be a consolation to the many who are forced to drink milk with admixture of manure in varying strength, and until the far-off day when all milking will be mechanically performed, with conveyance direct from the cow into sealed sterilized bottles, it seems reasonably certain that milk will continue to contain dirt.For
Pathogenic Organisms Derived from the CowPathogenic organisms may gain entrance to milk before and after it leaves the cow. In the first group are those arising from cattle infections, the chief organisms being bovine tubercle bacilli, Brlcella abortus, and streptococci from mastitis. The incidence of bovine tuberculosis in children, as meningitis, cervical adenitis, and lesions of the bones and joints, has been estimated by various workers. Dr. Stanley Griffith (1934) DalrympleChampneys (1934) records that only five cases were reported. In 1932, with increasing diagnosis, this number was fifty-seven. There is little doubt that the true number of infections is considerably in excess of this, possibly even ten times that number (Wilson, 1932). DalrympleChampneys has collected 147 cases, and reports " that 141 of these were consumers of raw milk-that is, milk which had not been boiled or pasteurized "-and he adds: " It is important to note that two of these patients drank Certified milk, three Grade A tuberculin-tested, and four Grade A." He recommends that, failing the provision of abortus-free herds, " all medical officers of schools should insist upon a pasteurized supply of milk."There is a similar uncertainty as to the incidence of streptococcal infections resulting from mastitis, sores on the teats, and other septic infections. Such infections are not notifiable, and they go for the most part unrecorded. In America (Rosenau, 1935)