MILK PROBLEMS

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the partial maintenance of other activities. Such apractice is obviously far from the university ideal,and to it may be attributed in large part the presentstagnation of the science in which no discovery offirst-rate importance has been made for many years.The hygienic importance of diagnostic bacteriology isbeyond question, and if it was in the proper hands-i.e., those of the medical officers of health-it wouldachieve even more usefulness than it has done already.But to employ those who should be finding and teachingin bacteriology to earn money is as bizarre a proceedingas it would be to charge the professors of Greek andmathematics with the duties of furnishing inscriptionsfor tombstones and checking the calculations ofinsurance companies. What there is most needed atthe present time by all those who are engaged on thetechnological applications of bacteriology is the pro-vision of facilities for teaching and research into howbacteria, irrespective of their human importance, liveand move and have their being. How this would bestbe arranged no doubt varies with local circumstances ;it may be in the department of hygiene or better inthe department of botany. The course and diploma atManchester are a small beginning along the right lines ;we wish Prof. W. W. C. TOPLEY all success with hisenterprise.

MILK PROBLEMS.THE Director of Water Examination may boast of the

apparent ease and regularity with which London’s sevenmillion persons are supplied with water fit to drink.There is no director of milk examination for Londonor elsewhere, and if there were he would hang his head.The annual report of the chief medical officer for theMinistry of Health, whoss remarks on the milk problemare summarised on p. 620, states that a beginninghas been made in setting up new ideals in the milktrade by means of the " grading " Order. It is onlya small beginning. There are now, for instance, onlyenough cows in the country guaranteed free fromtuberculosis by the tuberculin test to supply a popula-tion of 50,000 with a pint of milk each per day.The reports of medical officers of health as they comein show that the introduction of the Order has excitedlittle or no interest in most districts. The NationalMilk Publicity Council has its work before it.The milk problem as it exists to-day, like the slum

problem, is a modern one. Before the days of rail-ways the consumer lived near the producer, the milkwas delivered fresh, the dairy farms were small, thefarmer’s wife superintended the dairy, and his daughterdid the milking. The labour was therefore of a

superior type. With urbanisation and railways thefarms became bigger, larger herds of cows were

kept, milk no longer fresh was delivered in bulk,and the conduct of milking operations was handedover to labourers. For a long time the dairy farmsremained in the towns, the herds were increased insize and housed in buildings not intended for the

purpose, and tended by labour unversed in traditionsof dairy cleanliness. The new conditions make

necessary an even greater regard for cleanliness thanin pre-railway days. The first essential therefore iseducation of the dairy farmer and his staff by meansof agencies such as the Reading Institute-such aninstitute would be welcome in every dairying district- boy clean milk competitions and by the efforts ofcounty agricultural organisers. Sir GEORGE NEWMANremarks that tin consumer can demand clean milk,lhe trade has shown that it can supply it, and eachlocal authority should see that it does. But whatare the facts ? Although there may be sporadicigns of interest, the public as a whole is apathetic.

Only a small section will agitate ; the majority willcontent themselves with neglecting milk as an articleof food unless its quality improves. No doubt if

improvement occurred they would welcome it and

gradually learn to use more milk. Nor have localauthorities taken more interest in the matter. Themilk produced in their areas is consumed elsewhere,they have been content to leave it to the farmer tosatisfy his customers. Some county councils interestthemselves in organising clean milk competitions, andin trying to get the district councils to combine forthe appointment of veterinary inspectors. Most ruralcouncils, however, imitate the Ministry of Agriculturein their tender treatment of agricultural interests.There are encouraging signs that the Ministry is

beginning to see that the interests of the consumerand producer coincide in this matter and that a largerconsumption of milk depends upon the productionof a better article. Some stimulus must be providedto induce the authority supervising dairies and cow-sheds to do its duty. It is open to discussion whetherthis object would better be secured by grants-in-aidor by transference of the responsibility from the

district to the county councils.There are statutes and Orders which would

improve the condition of the milk-supply if theycould be put in force. The Council of theBritish Medical Association recently, however,decided that the time was inopportune to pressupon the Government the operation of the Milkand Dairies Act and the Tuberculosis Order of1914. We do, however, most cordially agree withDr. H. G. DAIN, who spoke strongly on the subject atthe annual meeting in Bradford, that the questionof the sale of milk containing tubercle bacilli mustnot be shelved any longer. The position taken upby Dr. DAIN is substantially as follows : As a profes-sion we are not primarily concerned with the cost,nor are we tied to a particular method, of stoppingthe sale of tubercle-infected milk, although it mightreasonably be made an offence to sell such milkwhen the addition of so harmless an impurity as

water is punishable and when the vendor whosemilk disseminates typhoid soon finds himself introuble with the sanitary authority. We are toldthat tuberculosis in cattle is so prevalent that toeliminate all tuberculous animals would practicallydestroy our herds and do away with our milk-supply.To begin by searching for and destroying tuberculouscattle, compensating their owners for the loss, is noteconomically sound and is to attack the problem fromthe wrong end. The cost of tuberculosis to the com-munity may be illustrated by the case of a boy,cured of tuberculous hip disease, whose treatmentover a period of five years, including a final osteotomyto correct deformity, had cost £500 apart from anymedical or surgical fees. The agriculturist, facedsome years ago with a disease in potatoes whichthreatened the whole industry, soon discoveredimmune varieties of the tuber. In so serious a matteras the stamping out of tuberculosis every effortshould be directed towards breeding cattle less subjectto this disease. Dr. DAIN’s objection to reliance onthe grading of milk for elimination of tubercle isthat the bulk of the poorer working-class populationwould continue to drink the lower grades as beingless costly, and the net result of grading would be toprovide the well-to-do with the opportunity ofescaping calamities which their poorer brethrencould not avoid. Why should it not be made a

punishable offence to offer for sale milk containingtubercle bacilli ? It is to-day, Dr. DAIN has the

courage to insist, a perfectly practical thing to do.