Fabian Tra 0. 122 


MUNICIPAL MILK 

AND 

PUBLIC HEALTH. 

II\" 

F. LAWSON DODD, 
M.R.C.S., L.R.C.P., D.P.H. Lond. 
Pt Itt tl~ll ,,, t (I H\' 

THE F. BL OCIETY. 

PRICE ONE PENNY. 

LO. 'D .·: 

TH F IIA :\ "O I 1\, TR,\. n, \\'.C. 


Municipal Milk and Public Health. 


THE attention of students of social science, as well as that of public 
health workers generally, is daily being more and more directed to 
the food supply of the people. The great epidemics of the nineteenth 
century resulted in such legislation as the Public Health Acts, 
which aimed at the external control of the environment of the 
population of the urban and rural sanitary authorities. But experience 
shewed that mere external interference was insufficient, and 
hence a movement became general towards investing the ow11ership 
as well as the control of the water supplies of the country in the 
hands of the community. The result shewed that although carelessness 
was not entirely got rid of, yet the condition of the publiclyowned supplies was far safer and better than those left to privatecommercial management. It was proved that in the case of such a 
prime necessity as water-one so liable to pollution-the aim of 
profit-making must be superseded by the consideration of the public 
health, even though this might involve financial loss. No one will 
now deny the beneficial results of this change, and few will be found 
who oppose, in principle, the municipal ownership of water supply. 
This change has consisted in the replacement of an unlimited 
number of privately owned wells, from which bad water was sold at 
a high price, by a popularly owned central supply systematically distributed 
at about cost price to rich and poor alike. This change 
of industrial method, combined with public knowledge, has been the 
main cause of a reduction in the death-rate':' of about 3 per I ,ooo 
per annum in the space of about twenty years. The annual rate of 
mortality from enteric fever-the chief of water-borne diseases-
sank in the same time from ·390 per I ,ooo to ·Ioo. 

With these facts in view, sociologists are beginning to ask themselves 
the question whether there is not the same need for public 
ownership and control of the milk supply. At the present time 
this indispensable commodity is being drawn from a thousand indiscriminate 
sources, whose main characteristic is the general dirtiness 
and stupidity of their methods of production ; and whose distribution 
is through agencies, most of which are marked by their liability 
to contaminate the article they handle. It is no exaggeration to say 
that the great bulk of milk producers, distributors, and retailers 
know nothing of the nature and properties of the material they deal 
in, while such an elementary knowledge is essential for the publicsafety. County councils are doing something to teach dairying, but 
so long as it is as profitable to sell dirty milk as clean, or preservatized 
butter as fresh, these efforts will produce but scanty fruit. 

* See Sixty-Sixth Annual Report, Registrar-General for England and Wales, 1905. 

4 

Public attention has recently been drawn to the existence of 
widespread physical deficiency among the children attending the 
public elementary schools of the country, and although the Inter-
Departmental Committee on Physical Deterioration reported that 
there was no evidence to prove the existence of actual degeneracy,
both that body and the Scotch Commission on Physical Training 
draw attention to the infantile mortality which is now actually higher 
than in the decennium r84I-5o, as well as to the manifest weakness 
and liability to disease of a considerable proportion of the children at 
or below school age. Both agree that for children, at all events for 
young children, the most important factor in development is their food, 
and that, in this particular, everything seems against the children of 
the poor in increasing degree towards the earlier periods of life. 

In times when breast feeding is on the decline*, milk is becoming 
the staple food of an increasing number of the population. Throughout 
the earlier years of life it forms the most important element of 
diet, and hence the absence of milk from the diet of the poor 
involves almost certain underfeeding, or even starvation, for a proportion 
of their children. In order to build up the physique of the 
masses of the people, some method must be devised of procuring for 
them a clean, wholesome, and cheap supply of milk, and the question 
to be answered is: Can complete public control do this, or can it 
be better done in some other way? Let us, however, see what are 
the present methods of production and distribution. 

Present Methods. 

It may be confidently said that nowhere, except on the very 
small number of model farms, is anything like a really scientific 
method of milk-production known. But the most noticeable thing 
is not the absence of science, but of common cleanliness. Indeed, 
many dairy farmers believe that dirt is a good thing, that heated and 
ill-ventilated cowsheds are good for the cows, and that manure gives 
body and flavor to the milk. For instance, Dr. Leslie Mackenzie, 
speaking for Scotland, says : "To watch the milking of cows is to 
watch a process of unscientific inoculation of a pure, or almost pure, 
medium with unknown quantities of unspecified germs. Everywherethroughout the whole process of milking the perishable and highlynutrient liquid receives its repeated sowings of germinal and non-
germinal dirt . . .. and this in good dairies. What must it be 
when the cows are never groomed, and the udders are never washed, 
where the byres are never even approximately cleaned, where ventilators 
are never opened, where the pigs are a few feet away, where 
cobwebs are ancient and heavy, where hands are only by accident 
washed, where heads are only occasionally cleaned, where spittings 
are not infrequent, where the milker may be a chance comer from 
some filthy place, where, in a word, the various dirts of the civilized 
human are at every hand reinforced by the inevitable dirts of the 
domesticated cow."t 

*Infantile Mortality and Infant Milk Depots. G. F. M'Cleary; 1904. Chapter I. 
t " The Hygiene of Milk," Edinburgh MedicalJ oumal ; r8g8. 


5 


In a series of articles, entitled "The Milk Supply of Large 
Towns," the Brz"tzsh MedzcalJournal drew attention, in March, 1903, 
to the defective conditions of milk production which are so prevalent.
The Commissioner, reporting on a farm outside a large town , says : 
" The operation of milking was in full swing, three dirty-looking 
boys being hidden away behind their respective cows.... The 
clothes which the boys wore were equally dirty, and the stalls, which 
they were supposed to have been cleaning out while l was waiting, 
were several inches deep in manure and foul-smelling straw.... 
The hind-quarters of the cows were coated with filth . .. _ I was 
horrified to see the filthy state of the milk as it flowed out of the 
pail. It was discolored with grit, hair, and manure. 'Look at that,' 
I said, pointing to a specially large bit of manure. I regretted my 
zeal, for Tom dipped his whole hand into the pail, and, as he 
brought it out, said, ' Oh that aint nothing ; it's only off the cow.'" 
That this condition is a very prevalent one is shewn by reports of 
medical officers of health from widely separated parts of the country.* 
In Staffordshire, for instance: '' The ventilation of the [cowJ sheds 
was, in most cases, not attended to in the slightest degree. In some 
it was necessary to open the doors for a few minutes before going in 
on account of the oppressive smell and moisture-laden air ; in some 
there was no means of ventilation. . . . In few was there any 
attempt at keeping the floors or walls clean, and, in some cases, 
they were filthy. The hind-quarters of the cows were in a similar 
condition." In a county report, Dr. Reid summarizes the condition 
of Staffordshire dairy farms as follows :-" I may mention generally 
that I very rarely come across a dairy farm which is satisfactory as 
regards the cowsheds ; most are £!1-lzl, over crowded, badly venttlated, 
and badly draz"ned.'' "With a few exceptions," says Dr. Newman, 
" the farms in Leicestershire sending milk to Finsbury appear to be 
neither regulated nor registered.'' Similarly unsatisfactory reports 
come from all over the country. 

From a recent report of the Local Government Board (England)
t it will be seen how little control is exercised over the farms in 
Ireland. The dirty and insanitary condition of many of the Dublin 
cowsheds is specially mentioned, and the general condition of the 
provincial dairy farms seems also very unsatisfactory. 

These are but specimens, and give only a feeble idea of the 
extent and nature of the unwholesomeness of sources of the food of 
the invalid and infant. 

Some Results. 
All observers are agreed that the conditions described above 
form the rule, and that a cleanly managed dairy farm-clean even 
in the everyday meaning of the word-is the exception. There are 
two ways of measuring the results on the health of the community.
First, by means of the recorded epidemics which have been traced to 
milk ; and next, by the Registrar-General's Mortality Returns. 

*Report on the Milk Supply of Finsbury. Dr. Newman ; 1903. 
t Parliamentary Paper (Cd-833). Appendix IV. 



6 

It must.be borne in mind that the study of milk as a vehicle of 
disease is a comparatively recent one, and that it is, in regard to many 
diseases, such as diphtheria, only in its infancy ; thus it will be seen 
that recorded epidemics probably represent only a small part of the 
disease due in reality to milk infection. There is little doubt but 
that large numbers of isolated attacks of illness are due to this cause, 
although no one has a suspicion as to their origin.

In 1900 the Local Government Board for Ireland issued a report 
on the spread of typhoid fever, which alleged that ''there had 
been repeated and detailed observations of the spread of enteric 
through creamery skimmed milk." In Glasgow in r88o there was 
an epidemic of typhoid which caused 508 cases and 69 deaths ; 
altogether no less than 200 of these epidemics were traceable to contaminated 
milk supplies. About 18 epidemics of diphtheria have 
been traced to milk-borne infection, one of the worst was in St. 
John's Wood in 1878 when 262 persons were attacked, and 38 died. 

About 73 epidemics of milk-borne scarlet fever have been traced 
to carelessness or ignorance among milk producers. In most cases 
these were due to infection among the employees which had been 
kept secret, and, in some instances, it is more than probable that the 
cows themselves were the source of the disease. 

There is little doubt but that a proportion of the tuberculous 
disease, which is such a scourge of modern communities, is due 
to the drinking of milk from tuberculous cows, or infected with 
dust containing the bacilli. This is especially the case with regard 
to the young, who not only, as a rule, drink milk more freely, but 
are also more susceptible tha11 are adults. 

One of the most fatal diseases from the child's standpoint is that 
of dzcwrhrea. In 1901, 30,121 deaths':' were recorded as due to this 
cause alone. In London in 1902, 2,504 deaths were due to this 
malady. In Brighton in 1901-2 out of 226 deaths from diarrhcea, 
19 I were directly traceable to the unwholesome milk supply, and 
there is every reason to believe that this proportion holds good for 
the country generally. That this disease is prevalent in hot weather, 
that it occurs most frequently where food is liable to contamination, 
that it is much less common among children who are breast-fed, 
and that its incidence is most heavily felt by those who live exclusively 
on cow's milk-all point to the fact that the milk supply is the 
main cause of this waste of human life. 

Much of the disease just referred to was conveyed by the milk, 
through dirty water either used to dilute the milk, or to clean the 
vessels in which it was conveyed. Some was traceable to dust or 
dirt getting into the supply on its way to the consumer; some again 
to diseased people coming in contact with it. But, in addition, there 
is the question of diseased cows to be considered. If we take the 
proportion of tuberculous cows discovered in Manchester as the 
general average for the whole country, we shall find that about 
ro,8oo out of 2,ooo,ooo milch cows are affected in the udders with 

* Registrar-General's Annual Report. 

7 


this dangerous disease. But experience has shewn that country cows 
are, owing to less stringent inspection, more diseased than those 
kept in towns, and if we add to this the fact that there are several 
other diseases in the cow which, though apparently slighter, can 
yet cause severe illness in the human being, we shall realise that the 
proportion of diseased milk-sources is much higher than this.':' 
Under present conditions it is to the interest of farmers to hide the 
fact of disease among the cows, and hence the financial interest of 
one class is directly opposed to the health interest of another, and in 
this case, at least, the money wins. Any solution of the milk 
problem must aim at harmonizinp; the interest of producer and 
consumer, so that the occurrence of disease in an animal shall not be 
financially disastrous to the one or physically injurious to the other. 

The Use of Preservatives. 

The distance which modern town life has necessarily placed 
between the source of the milk supply and the consumer has not 
only tended to remove control from the producer, but has necessitated 
a growing delay between the milking and the final delivery of the 
milk. With the present dirty methods of production it can easilybe understood that the milk, butter, and cream are peculiarly liable 
to decompose, especially in hot weather. Hence it has become an 
almost umversal custom for dairymen to mix varying quantities of 
chemical preservatives in their milk, cream, and butter, in order that 
they may keep well. With a public unable to detect the taste of 
the added chemicals, with a complete ignorance as to the physiological 
action on the part of the purveyor, and with such excellent 
results for the trade, it can easily be understood why this custom has 
grown so rapidly. A Departmental Committeet in 1901 shewed 
that r8·z per cent. of the milk samples examined for them, 77"9 per 
cent. of the cream samples, and 57' I per cent. of the butter samples,
had been doctored with such substances as boric acid, formalin, 
salicylic acid, or benzoic acid. In butter the common proportion is 
about r lb. of chemicals to roo lbs. of butter ; but the proportion is 
generally left to the " inspiring moment's care." This custom at 
Southampton, if we are to believe the borough analyst, is more ingenious 
with regard to the milk; here r lb. of preservative is added 
to a gallon of water. and I pint of this mixture is added to every 8 
gallons of milk, so that with every tumbler of milk you take 6 grains 
of some sort of chemical. " Both boric acid," he says, " and formalin 
preparation are being increasingly used." 

But Southampton is not alone in this matter. The analyst of the 
Dairy Trade Protection Society asserts that there is an enormous 
amount of preservatives used in the milk trade of London-" far 
more than anyone has any conception of." Most preservatizing goes 
on in summer, and especially on Sundays-a day that is hallowed in 
many ways by the dairy trade. 

*Swithinbank and Newman: Bacteriology of Milk. 
t Departmental Committee on Food Preservatives and Coloring ~fatter: Report. 


8 


The use of these pre en·atiYes is a necessary corollary of the 
dirty methods of production, and, while their action on healthy 
adults is at present unknown, it seems certain that for infants, youngchildren, and invalids, the results are pernicious. The use of 
chemicals, again, while failing to arrest the growth of dangerous 
organisms, will hide the fact that the article is stale, and will thus 
encourage its consumption, even when unfit for food. In the words 
of the report of the Preservatives Committee: " There is further 
objection to the use of preservatives in the milk traffic, that they may 
be relied upon to protect those engaged therein against the immediate 
results of scrupulous cleanliness. Under the influence of the e 
preservatives, milk may be exposed, without injury, to conditions 
which otherwise would render it unsaleable. It may remain sweet 
to taste and smell, and yet have incorporated disease germs of 
various kmds." 

"It has been put before us that it is not po. sible to supply large 
towns, especially London, with new milk without the aid of preservatives, 
but we have abundant evidence to prove that t/iz"s zs 110 more 
tha1l a matter oforgamz ation and system. No doubt the prohibitionof preservatives in milk offered for sale would tend to the disadnntage 
of small retailers, who have no cold storage, but tins zs 1lOt a C0 11szderatio1l 
which should stand in the way of a much needed reform." 

Denmark has prohibited the use of all preservatives, even in the 
butter destined for exportation, and has had to introduce greater 
cleanliness of production to compensate. At one time, France also 
had a prohibition law, but this was relaxed with regard to export at 
the urgent request of the British butter trade. 

Adulteration. 

\Vhile the use of chemical preservatives and coloring matter in 
dairy produce i essentially a form of adulteration, a few persons may 
yet be found to defend the custom ; but these are practices which no 
one will defend, practices which exist to a great extent-even an increasing 
extent-among the sellers of dairy produce. \Ve have just 
seen how the consequences which should normally result from the 
dirty methods of production, and which themselves represent a greatfinancial . aving on the proper cost of production, are hidden by the 
use of chemicals. We have now to consider a less legitimate, 
although equally harmful custom. It may be pleaded that the use 
of preservatives is the result of ignorance, but such an excuse can 
hardly be put forward to defend adulteration. From earliest times 
milk has, by its very nature, lent itself to the dishonesty of the 
dealer. In the old day , chalk and calves' brains were said to han: 
been added to replace quality ; water wa added to increase the bulle 
But the use of the former ingredients have long since been gi,·en up, 
and the main form which adulteration take , are:


The addition of small quantitie of water. 

The addition of separated to "whole " milk. 

The abstraction of cream. 

The addition of diluted condensed milk. 


9 

The business of adulteration is a highly skilled one, and has 
increased in cleverness to meet the demands of a growing number of 
public analysts. Formerly the making of a profit and the keeping 
up of a business connection were the two ends to be kept in view ; 
now detection by experts has to be avoided as well. As a guide to 
analysts the Board of Agriculture has fixed the standard of 3 per 
cent. by weight of butter-fat, below which it is illegal to sell milk as 
"whole." This is to ensure that the customer shall have milk of a 
reasonably good quality, and which has not been grossly tamperedwith. This standard is arrived at by experts in dairy work, and on 
the basis of a very large number of analyses. That the standard is a 
low one is shewn by the chemist to the Aylesbury Dairy Company 
who, after analyzing Ioo,ooo samples, found the average of fat was 4 
per cent. by weight. The amount of fat in good milk generally 
amounts to about 3 · 5 per cent. to 4 per cent. in winter, and often to 
as much as 5 per cent. in summer. The recommendation of the 
Departmental Committee to raise the standard to 3·25 per cent. is 
not, therefore, an extravagant one. The great drawback of indirect 
interference in the matter of an arbitrary standard is shewn by the 
fact that many members of the trade consider it legitimate to make a 
profit out of any fat which happens to exceed the standard amount. 
Hence a custom has grown up called "toning down the milk,'' 
which consists in the addition of skimmed milk to such an extent as 
just to reduce the percentage of fat" to the legal minimum. By the 
addition of separated milk (z".e., milk free from fat) the adulteration 
is rendered less easily detectable as the proportion of" solids not fat" 
is left normal, and only the proportion of fat reduced. In this way 
it is much easier to plead that the milk had only been standing, and 
that the cream had been taken away from the top layers by earlier 
customers. 

In 1902':', II ·6 per cent. of the samples taken in England and 
Wales were reported against, and this was the highest rate recorded 
for ten years. The percentage of adulterations discovered in London 
was I 5"6 per cent. In six metropolitan boroughs the percentage of 
adulteration to samples taken was no less than 20 ; and in the 
Borough of Finsbury the average percentage taken over a period of 
ten years was 25, or a quarter of the whole. It is always possible to 
raise these percentages by the appointment of a fresh and speciallyskilled inspector. For instance, in Islington, of 385 samples taken bythe ordinary inspector, 23 or 6 per cent. were adulterated ; while out 
of 547 taken by a special officer, I I I or 20·3 per cent. were con 
demned. The multiplication of hands through which the milk 
passes greatly adds to the rate of adulteration. The profits of adulteration, 
even when balanced against the fines of the police courts, 
must be very great ; in 1902 the Local Government Board reportedthat, on the return made to them, the people of London were paying 
an annual sum of £3o,ooo for water which had been fraudulentlyadded to their milk. If we take this basis for the United Kingdom, 

*Annual Report Local Government Board, 1902 . 


IO 

the nation is paying about £240,ooo annually to the adulterators for 
the water they add ;':' to this must be added the annual cost of the 
medical officers, sanitary inspectors, police courts, lawyers, etc., etc., 
after deducting the fines and costs recovered. It has been estimated 
that, at the lowest, the people of England and Wales are paying 
about £zs,ooo per annum under these heads also. It would be 
thought that private enterprise had done enough when it had caused 
the great amount of illness which dirty and slip-shod methods can 
account for, without defrauding those who already suffer so much. 

It must not be thought, moreover, that the monetary loss represents 
the total social cost of adulteration. To adults it may do, but 
it is far otherwise with regard to the infant population. For them 
directions are issued by means of which cows' milk is diluted and 
prepared so as to somewhat resemble human milk. These proportions 
are based upon the use of good whole milk, and when the 
dealers have already tampered with the milk, the mother or nurse is 
misled, and the modified milk sinks below the proper standard of 
nourishment. In this way those children who are unfortunate 
enough to be hand-fed may be slowly starved. There is no doubt 
that the high infantile mortality, attributable to dirty milk, is increased 
by the supply of diluted and preservatized milk. 

But it should not be imagined that all the blame rests with the 
producer or middleman ; owing to the present slip-shod methods of 
distribution the employees on the rounds are doing their part in the 
general swindle. They, on their own account, dilute, give short 
measure, and tamper with the milk which, totally unguarded, is 
left in their hands. And in these circumstances the middleman is 
powerless, for if he prosecutes a dishonest employee he only condemns 
his own business, and publishes the condemnation.+ Finally, 
there is no doubt at all as to the existence of a system of blackmail 
among the inspectors themselves. A recent writer+ describes the 
process. "I do not think that anything is to be gained by beatingabout the bush in this matter, and so let me briefly state that the inspector's 
fee is one guinea, as a rule paid in cash, but occasionally in 
kind. Now there are two ways in which this transaction may be 
viewed. You may picture the wicked trader bribing the innocent 
inspector to overlook his crimes, or you may imagine the inspectorthreatening the dairyman with-' Your money or your reputation.' 
It is not very difficult to see on which side the blame lies. It is a 
negative advantage only which the dairyman's money gains for him. 
The inspector does not say, ' Give me my guinea, and I guaranteethat you will not get into trouble,' but 'Refuse me my guinea, and 
I guarantee that you will get into trouble.'" This is another explanation 
why the full burden of adulteration never sees the light of day. 

Social Reaction. 

It is impossible to do more than outline, in the limits of a Fabian 
Tract, the present chaotic and disastrous conditions which private 

*The Problem of the Milk Supply. F. Lawson Dodd. 
t Vide Economic Review, January, 1905. Article on Milk Trade from Within. 

I I 

enterprise in the supply of a commodity which is essentially suitable 
for collective ownership, has brought into existence. The methods 
of distribution are as bad as those of production ; the railway companies 
have no financial or other interest in the delivery of clean 
milk, and therefore very seldom provide proper vans for its conveyance. 
Fish, paint, petroleum, or any other unsuitable goods are 
packed along with the milk. The churns from the farms are allowed 
to stand for hours on platforms of rural stations to be dealt with as 
ordinary goods, or to await the slow milk train. While thus waiting, 
the milk is often exposed to the hot rays of the sun and the dust of 
passing traffic, which both make for increased bacterial contamination. 
It is improperly covered in badly shaped receptacles, which 
are scarcely ever locked, and from which the contents are often 
pilfered or polluted. Neither farmer, middleman, nor railway company 
cares what happens to the delicate foodstuff which they are 
handling, and so long as the farmer gets his price, the company its 
rate, and the middleman his fat profit, considerations of cleanliness 
and public health are little cared about. "If the Almighty had 
intended that there should be no manure in the milk, he would have 
placed the udder at the other end of the cow" represents the rural 
mind. "Doctors' fads " suffices for the rest. Hence, after passing 
on its slow and often interrupted journey, it finally reaches the poorest 
customer who buys it from a small shop where pickles, soap, vinegar,
and paraffin are its close companions, and where, remaining uncovered, 
in a doubtfully clean basin, it forms the last resting place of 
flies, and a receptacle for the dust and dirt of the shop and the street. 
When it reaches the jugs of the poor in pennyworths and ha'porths,
it is often as much as three days old, and is loaded with bacilli, but 
alas! unprotected by the souring which would have occurred had it not 
been for the doses of chemicals which it has received in its strange 
career. Good milk may contain so,ooo to soo,ooo micro-organisms 
to the cubic centimetre: it will now be understood why Dr. Newman 
records the numbers in milk sold in the City of London and Holborn 
as 4,8oo,ooo at a good class shop, and as 3,2oo,cioo in a poor class 
shop in Finsbury. "In 1899, 50 samples of milk were examined in 
St. Pancras: I6 (or ]2 per cent.) were normal healthy milks; and 34 
(or 68 per cent.) were unhealthy milks. Of the latter, I2 samples 
contained pus [matter from abscesses J in smaller or greater amount, 
and 5 (or IO per cent.) contained the tubercule bacilli."'' 

In the face of such facts, which could be multiplied many times 
over, the urgency of the matter of milk supply is beginning to dawn 
on the minds of the people. But something has already been done 
which may be summarized here. 

The Dairies, Cowsheds, and Milkshops Orders, J885-18991 are 
issued now on the authority of the Local Government Board, under 
powers granted under the Contagious Diseases Animals Act, I878. 
These orders throw upon every urban and rural sanitary authoritythe duty of regulating and supervizing the milk trade, and of carrying 

*Report on the Milk Supply of Finsbury. Dr. Newman. 


12 

out certain general regulations prescribed by the orders. They 
further have the power of making and enforcing bye-laws under 
section I 3· A register of all cow keepers and dairymen is to be keptand revised from time to time. Before any fresh dairy or cowshed is 
occupied the authority must be first satisfied as to its sanitary condition 
; and it is made unlawful to occupy any such place if it is likely 
to be injurious to the cattle, or to the milk, or may afford opportunities 
for infection or contamination. 

It is further made illegal for any infected person to take part in 
the supply of milk ; and no dairy may directly communicate with a 
water-closet, or be used as a sleeping apartment, or a piggery; lastly, 
no milk from a cow suffering from certain specified diseases (now 
including tuberculosis) may be sold for human food, or for food of 
animals unless first boiled. 

Under the provisions of the Infectious Diseases Prevention Act, 
I89o ; and for London. under the Public Health (London) Act, 
I89 I, sanitary authorities are given the appearance of powers for 
dealing with milk-borne epidemics. When such an epidemic appears 
the Medical Officer of Health may, after obtaining an order from a 
magistrate of the locality where the dairy is situated, proceed to inspect 
such dairy, and, if accompanied by a veterinary surgeon, the 
cows also. If satisfied that this is the offending dairy, he must 
report to his council, and they may order the dairyman to appear 
before them within 24 hours, and shew cause why an order should 
not be made forbidding him to sell his milk in the district of the 
authority concerned until their order is withdrawn. If the offender 
refuse to obey, then proceedings may be taken in his own district, 
and he may be fined £5 and 40 shillings for each day of default. 

This measure has been found quite worthless in practice, as 
it takes three or four days at least to get in motion, and then further 
delay may be achieved by the dairyman, who would thus get time 
to dispose of a diseased cow. While this delay takes place the 
people are all the time consuming the diseased milk. In fact, 
promptness is the main factor in dealing with milk epidemics, and 
under this Act it is the very thing that is impossible. Then, too, when 
all is done, you have only locked the stable door after the escape of 
the horse, you have not got such control as wzllpreve1lt the occurrence 
of dzsease. 

Prevention of Fraud. 

We have now seen what society has done to protect itself againstthe filthy conditions which are so prevalent in the places where milk 
is produced. The machinery has been at work since 1885, and verylittle has been done at the sources, at least, for the administration of 
the law is in the hands mainly of the very persons whose interest 
lies in its neglect-viz., the farmers. Then, too, the somewhat 
later attempt made to control milk-borne disease is admittedlya failure.':' We will consider lastly the measure against fraud in the 
form of adulteration which has been in operation since I875, and 

*See Dr. Newman's Report on the Milk Supply of Finsbury, 1903. 


which was strengthened in 1899, and under which adulteration 
seems, till quite recently, to have been on the increase. 

The Sale of Food and Drugs Acts, I875-1899 , are aimed at the 
prevention of (a) the mixing of injurious ingredients with any article 
of solid or liquid food or drug, (b) the selling of any such article of 
inferior quality, and (c) the abstraction of anything from such article 
which might injuriously affect its quality. In one class of cases it 
must be proved that the added substance is injurious, and, in the 
other class, it is only necessary to prove that the article is not of the 
nature, substance, or quality demanded. It is under these Acts that 
sanitary inspectors take samples. It will be seen from what has 
already been said of adulteration that it is still profitable, and that 
this law although preventive in its action in some cases, does not seem 
to touch the bulk of the evil. It may be mentioned that inspectors 
may not take samples outside their own areas ; and that the use of 
coloring matter and preservatives does not constitute an offence. 

These attempts to control from the outside by legislative 
methods a trade. so thoroughly disorganized, ignorant, dirtilymanaged, and permeated with dishonesty, have naturally failed to 
produce any real and lasting result, and it is certain that such 
measures, while acting as palliatives, will never prevent the evil or 
wholly remove it. 

The law then is hopelessly inadequate, even if carried out to the 
letter. Under the Dairies' Orders satisfactory regulations have been 
adopted in only a few districts, and in others they are not nearlystringent enough. Those in force in London were drawn up bythe old Metropolitan Board of Works at a time when the relation 
of milk to disease was little understood. '' In the eyes of the law 
milk may contain large quantities of. preservatives, such as boric or 
salicylic acids ; it may shew a deposit of stable manure ; it may be 
colored with annatto or turmeric ; it may contain pus or innumerable 
micro-organisms, either harmless or pathogenic ; it may be coated 
with dust from the street, or contain dead flies in suspension ; it may 
contain saltpetre to hide the flavor of some unsuitable food given to 
the cow ; it may be the product of a cow fed on such fermented food 
as brewer's grains, which renders it unfit for infants' food-it maycontain all these impurities, and yet be legally 'pure milk !'"':' 

Certified Milk. 

The Borough of Sunderland, amongst others, has started a movement 
for the improyement of the milk supply by means of certificates 
granted to those producers who fulfil certain definite conditions. 
These certificates, renewable from year to year, give a guaranteeof quality on behalf of those who fulfil their conditions, and maybe used as an advertisement. The system has not found much 
favor, and the ignorance of the public is at present so greatthat, while caring little for the conditions of milk production, they 
certainly do object to the added cost that is entailed by any extra 
precautions under the present system. 

• " The Problem of the Milk Supply." !90{. 

Municipal Milk Depots. 


It was in France, where an increasing infant mortality accompanying 
a falling birth rate led people seriously to consider the questionof the food of the infant population, that the first Infants' Milk 
Depot was started by Dr. Dufour at Fecamp under private auspices. 
Many local authorities, on both sides of the channel, have now followed 
this example. Liverpool, St. Helen's, Bradford, Battersea, and many 
other places have inaugurated depots in this country. The general 
plan in all these is to provide, at a low price, sterilized humanized 
milk in sealed bottles with sufficient in each for one meal. The 
sterilization kills the germs, and the humanization adapts the milk to 
infants' digestive processes. These bottles of milk are sold at a 
central depot, and, in the case of Liverpool, at about 30 dairies as 
well. In this last named place 3,ooo bottles per day have been sold. 
The cost to the parent for the food of one child is about Is. 6d. to 
1s. 9d. per week, and in Battersea about 400 children are being fed.':' 
By far the best municipal milk supply is that established iri the City 
of Rochester, U.S.A., in I 897, and, as it shews the main lines on 
which all public supplies should be carried on, it will be useful to 
describe its method of working. "A central station at which the 
milk is prepared is organized each [summerJ on a farm outside the 
city, where a trained nurse and assistants have full control of the 
cows, utensils, bottles, etc., and where all of the milk-work is carried 
on in a portable milk laboratory. Everything coming in contact 
with the milk is thoroughly sterilized in steam sterilizers. The milk 
itself is not subjected to any Pasteurizing or sterilizing process. 
Sterilizing and Pasteurizing are only an open invitation to the 
milkman to be careless in the production and handling of milk. 

"At the milk station on the· farm the milk is taken from clean, 
well-fed, tested cattle, into sterile cans which are carried to the farm 
in sterile cheese-cloth bags. Just before milking, the cows' udders 
are washed. A sterilized cheese-cloth fly cloth is placed over the 
cow, the first portion of the milk being rejected. So soon as the 
cans are filled they are immediately covered by a layer of cheesecloth 
held in position by a rubber band. The cans of milk thus 
covered are immediately taken from the barn into the laboratory, 
about 200 yards away, where the milk is properly diluted, sweetened, 
and turned off into sterile nursery bottles of various sizes of the 
Siebert type. The bottles are corked with sterile rubber corks, 
placed in racks, covered with cracked ice, and immediately transferred 
to the city for use. Of the cleanliness of milk prepared 
in this way, forty-three daily samples were found to average not 
more than q,ooo bacteria+ per cubic centimetre, while the city milk 
for the same period approximated 235,000 bacteria per cubic 
centimetre."t 

* Annual Reports on the Health of Battersea. 1903 and 1904. 
t Cp. number found in London milk noted above. 
t" The Influence of Municipal Milk Supply on the Deaths of Young Children." 
Dr. Goler, Health Officer Rochester, N.Y., U.S.A., .Vew York StateJour1lalof Medi


ci·nt , 1903. 


Of most municipal milk depots it must be said that they are 
only attempts to solve a great problem, but, though small, they goin the right direction. Good has been done, but it is little, owing to 
the following reasons :


I. The farms are not under the control of the depots, and hence 
sterilization is necessary, although in itself bad. 
2. The sale of only one kind, viz., modified milk, reduces the 
usefulness, as those who wish to prepare their own infants' food get 
the unwholesome milk of the ordinary dairy. 
3· There is no system of advising each mother, and supervizingthe growth of the child as is the case in Paris. 

4· They do not touch the really important point. which is the 
clean production and general organization of the milk supply of the 
poor. 

5· No help is given to the deserving mother, suckling her own 
child, who therefore needs extra nourishment for herst:lf, and often 
finds it impossible from lack of food to continue in this right course. 

Private Experience. 

Many attempts have been made by private enterprise with varying 
success, and recent revelations in connection with one of the 
best companies in London have shewn that they in no really effi. 
cient manner protect the public from danger.':' In York a pure milk 
supply has been carried out on commercial lines, under a skilled and 
intelligent dairy farmer, and so great has been the demand that 
prices have had to be raised above the ordinary market rate to choke 
off business. In Paris, Dr. H. Rothschild has organized a supply of 
pure sterilized milk which is sold in several depots in the poorer 
districts, the demand is very great, and continually increasingowing to the quality, cleanliness, and price of the milk sold ; but 
although this milk is supplied at a much cheaper rate than at 
other dairies the profit made is considerable, and that the benefit has 
been great is evidenced by the vital statistics of the city. Another instance 
of a useful attempt to solve the problem by private effort is 
that afforded by the Copenhagen Milk Supply Company under the 
able direction of Mr. W. Busck. This company pays a limited dividend 
of 5 per cent., and the managing director expends much time, 
energy, skill, and experience without any remuneration. It has 
not only improved the quality and sources of the milk, but has successfully 
prevented the attempts of other companies to form a corner 
to raise prices. Another valuable work done to supply pure milk to 
the very poor is that of the Hon. Nathan Straus in New York. He 
has succeeded in giving good milk at reduced cost to the poor by 
means of careful organization of supply and distribution.+ It is 
needless to enumerate more cases. Two main facts stand out prominently 
to the student. First, all attempts at improvement on 

*Vide case of Typhoid Fever caused, in the opinion of 'the jury, by the Milk from 
a farm on the books of the Aylesbury Dairy Company. Frost v. Aylesbury Dairy Co. 
Court of Appeal, Feb. 1905. Times Law Reports, p. 300. 

t Infant Mortality and Infants' Milk Depots, p. 68. 

• 



r6 

present line of distribution inevitably keep up and raise the market 
price of milk. The second point is that wherever improvement has 
taken place and the price has been kept down or lowered, the undertaking 
has not only been on a large and carefully organized scale, but 
there has always been an absence of the mere commercial element. 
Dr. Rothschild and Mr. Busck both bear testimony to this. 

The Lines of True Reform. 

Mention has already been made of the municipal milk depotsestablished in many large centres of population. These have commenced 
the work of public supply; and the next move must be to 
enlarge their basis and increase their control over their sources of 
supply. Hence, each town should have a municipal milk depot for 
the sale of milk of all kinds-whole, separated, buttermilk, cream, 
and other dairy produce-connected with a farm under the same 
ownership and control. These depots should be situated in the 
poorer districts, and they should sell the articles at a cost coveringproduction and distribution. To secure freedom from adulteration, 
all the employees should be well paid, and the milk should be distributed 
in sealed cans and bottles to the depots or the consumers. 
At first it might be made compulsory for the customers to fetch 
their own milk, and thus save the cost of delivery, as at Dr. Rothschild's 
depots in Paris. The municipal farm should also supply 
pure milk to all public institutions, whether officially or privately 
managed, such as fever hospitals, asylums, workhouses and schools. 
In connection with the elementary schools it would be advisable to 
follow the suggestion in the Report of the Scottish Physical TrainingCommittee: "It would in many cases be an inestimable advantagecould regular and sufficient meals-such as broth, porridge and milk, 
or bread and milk-be provided at a minimum cost" ':' ; or to obtain 
half a pint of milk for each child at least once a day. Such an arrangement 
would secure a saving on the cost of the milk purchased from 
the contractors, and would prevent such epidemics as have occurred 
even in the largest London hospitals. This is no new idea. The 
Corporation of Nottingham, for instance, supplies its asyl um from 
its own herd of cows, and receives about £2,500 per annum for the 
sale of milk and butter. In 1903-4 the Birmingham Drainage Board 
took £r,894 for the sale of 61,404 gallons of milk produced on their 
sewage farm ; and at Reading the same thing is done. It is imperative 
that all such institutions as have just been mentioned should have 
an unimpeachable milk supply ; and the only way to ensure that is 
by giving them one under the direct control of the local sanitaryauthority. If the physique of the poorer classes is to be built up, it 
is essential that their food should be both good and cheap, and 
this applies especially to the milk supply. The milk produced on the 
municipal farm would be distributed to the local depots, and the 
extra cost of clean and healthy production would be saved from the 
profits of the middlemen and the loss entailed in bad organization. 

* r"ide Report, p. 30. 

17 


These model farms should be run in connection with the technical 
schools, and the science and art of dairy-farming taught under the 
most favorable conditions. It is certain that no mere tariff interference 
can prevent the loss of an industry carried on in a way which 
not only displays technical ignorance, but also want of organization,
combined with practices which are injurious to the public health. 

The establishment of municipal milk depots supplied from municipal 
farms is the first step towards the social organization of 
the dairy industry; and this would inevitably lead towards a complete 
organization of the supply. Well-to-do people would soon 
purchase their milk from stores which they could rely upon, and 
each successive increase in demand would render the whole process 
more economical, and hence a lowering of price possible. The community 
would take over the whole of the supply, and production as 
well as distribution would be completely organized on one system. 
The milkman would be on the same footing as the postman, and his 
rounds would be as regular, although their frequency would be 
greatly reduced, owing to the better keeping quality of milk produced 
under clean conditions, and also to the fact that all milk would 
be bottled at the farms after being cooled, and thus protected from 
the sources of pollution which under present methods are so harmful. 
The number of carts and men and shops would thus be lessened, and 
the saving could be used to improve the article or lower the price. 
The number of hands through which the milk passes would also be 
reduced, and hence the possibility of infection or contamination 
made less. The sources of supply-the cows, farms, farm-hands, etc. 
-would be under control and supervision, and epidemics could be 
entirely avoided. Encouragement would be given for honesty on 
the part of the men in case of infectious disease existing in their 
homes or families ; they would be paid the usual wages even when 
not at work if they gave the needed information, and punished if 
they failed to give it. The presence of disease amongst the animals 
would be known, and precautions would be taken to isolate the cow 
if curable or to destroy it if incurable or dangerously ill. Such a 
decision would be arrived at easily when there was no question of 
bringing serious financial loss to one man in the interests of the 
many; the community would lose the animal, but the community 
would gain the immunity; whereas, under present circumstances, if 
anything at all happens, it means that the gain of the one is made 
the loss of the other. The industry would for the first time be putinto the hands of skilled persons, and controlled in the interest of the 
public health. What has happened to water will take place in 

regard to milk, with the same beneficent results. 

The most important industries should be put under publiccontrol first. It was epidemics and not epigrams that caused the 
municipalization of the main sources of our water supply. If tram-
ways or electricity are mismanag.ed, the public reap incom·enience 
in transit or lighting; but if the supply of milk is mismanaged-ashas been shewn to be the case-the community reaps disease and 
physical degeneracy in its youngest members, as well as death and 


18 


misery resulting from the frequent epidemics amongst the adult 
population. It is only necessary to convince the public that it 
can no longer afford to drink dirty and expensive milk in order 
to support its adherence to a worn-out and obsolete economic 
theory. 

BIBLIOGRAPHY. 

l. PARLIAMENTARY PAPERS. 
Annual Reports Local Go1•ernment Board. Eyre and Spottiswoode ; +S. rrd. For 
adulteration statistics. 
Annual Reports Registrar.General. Eyre and Spottiswoode; 2s. 2d. For infantile 
mortality statistics, etc. 
Report and Appendix of Inter-Departmental Committee on Physical Deterioration, 
1904; IS. 2d. 
Report Departmental Committee on Food Preservatives. 1902 [Cd 833]. EspeciallyAppendix IV. on visits to Ireland and Denmark by Dr. Bulstrode. 
Annual Reports of Boards of Agriculture for England and Ireland. 
Royal Commission on Tuberculosis. Interim Report, 190+. 
Report Medical Officer Local Government Board, 1875, Vol. VI I., p. So. 
Report of Royal Commission on Physical Training, Scotland. 
Report of Departmental Committee on Milk and Cream Regulations, 1901. 

II. BOOKS: TECHNICAL AND GENERAL. 
Bacteriology of Milk, Swithinbank and Newman. Murray, 1903. 
Infantile Mortality and Infants' Milk Depots, G. F. McCleary, M.D. P. S. King and 
Sons, 1905; 6s. 
The Theory and Practice of Infant Feeding, Chapin. Bailliere, Tindall and Cox, 
1902. For "certified milk" and America. 
Pediatrics, ProL Rotch. Lippincott and Co., 1904. 
Manual of Hygiene, Dr. Hamer. Churchill and Co., 1902. For a good account of 
milk epidemics. 
Dairy Chemistry, Droop Richmond. Griffin and o., 1899. 
Problem of the Milk Supply, F. Lawson Dodd. Bailliere, Tindall and Cox, 1904 ; 
IS. 6d. 
Food and Principles of Dietetics, Hutchison. Arnold and Co., 1903. For the food 
value of milk. 
Municipal Sanitation in the United States, Chas. Chapin. Snow and Farnham, 
Providence, U.S.A., 1901. For methods of control in U.S.A. 
Traite de l'Allaitement, Marfan. Steinheil, Paris, 1903. For value of milk in 
infant feeding. 
Bacteria in Milk and it Products. Rebman, Conn., 1903. 
Die Milch, by \'arious writers. C. Boy en, Hamburg, 1903. Contains a 1•ery large 
bibliography. 
Grundriss der Milchkunde und Milchhygiene, ProL Jensen. Stuttgart, 1903. 
Bibliographia Lactaria, Dr. H. de Rothschild. Paris. 
Milk Supply in Copenhagen, McGregor. Scott, Ferguson and Co., Edinburgh,
1890. 
ale of Food and Orugs Acts. Bell and Scrivener, 4th ed., 1903. 


[! [. ARTICLES, SPECIAL REPORTS, ETC. 

Report on Milk Supply of Finsbury, Dr. Newman, 1903. 
The Reform of the Milk Supply, Dr. McCleary. Public Health, April, 1905. 
The Milk Supply of Cities, Prof. Park. Journal of Hygiwe, Vol. I. 
The Milk Supply of Large Towns. British Medical Journal, 1903. 
The Control of the Milk Supply, Dr. Newman. British Medical Journal Office, 


1904; 6d. 
Die Bekampfring der Sanglingssterblichkeit Zeitschrift fur Hygiene, Von Ohlen. 
January 28, 1905. An account of the chief infants' milk depots in Europe and 
America. 
Reports on the Health of Liverpool, Dr. Hope, 1898-1903. 
Reports on the Health of Battersea, Dr. McCleary. 
Report on the Health of St. Pancras, 1899. 
Report on the Health of Brighton, 1902. 
Report on the Health of Manchester, 1902. 
See also other local reports of places where infants' milk depots are 
established :-St. Hden's, Bradford, Dundee, Glasgow, Ashton-under-
Lyne, &c. 
Lecture, Dr. R. Jones. Society of A1·ts Jounzal, ;\larch. 1903. 
The Hygiene of Milk, Mackenzie. E dinburgh MedicalJounzal, 1898. 
Study of Epidemic Diarrhrea, Arthur Newsholme, M.D. Rebman, 1900. 
Milk and Epidemic Diarrhrea, Dr. M. Richards. Joumal of Hygiene, 1903. 
" Pus as a Beverage." British MedicalJounzal, }[arch 12, 1904, p. 6o+. 
lndustrie Laitiere au Danemark, Dr. H. de Rothschild. Paris, 1903. 
Le Lait aCopenhagen, Dr. H. de Rothschild. Paris, 1903. 
L'CEuvre Philanthropique du Lait, Dr. H. de Rothschild. Paris, 1902. 
Sir R. Douglas Powell. Journal Sanitary Institute, August, 190+. 
Milk Supply of Two Hundred Cities and Towns. U.S. Department of Agriculture, 
1903. 
Journal of Royal Statistical Society, r8g2, pp. 265·7· r or average annual consumption 
of milk. 
Report of Minister of Agriculture for Canada, 1902. 
Transactions British Congress on Tuberculosis, 1902, Vol. !., p. 84 
Nineteenth Annual Report of the Bureau of Animal l ndustry, 1902. 
Edinburgh MedicalJournal, 1858, pp. 993-100+. 
Joumal of Hygiene , 1891, 1892, and 1903. 
Report of Medical Officer of Bedfordshire County Council, 1902. 
The Milk Trade from Within, Charles Hassard. Eco1wmic Review, January. 1905. 
Report of Medical Officer of Health of St. Pancras (Dr. Sykes) on Prevention of 
Infantile Mortality, 1904. 


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