First: Money to finance a county wide inquiry into many phases of the milk question that touch the public welfare from the standpoint of health.

Second: It would require universal interest on the part of the public for whom this would be carried on and the press whose assistance would be required to accomplish it and the cooperation of between thirty and forty official health bodies and agencies beside the thousands of commercial interests involved each of which would have to yield up many facts before a comprehensive knowledge could be gained.

Third: It would require law with which to support and authorize the inquiry through innumerable avenues of approach to the more innumerable facts.

Fourth: It would require several kinds of knowledge, the use of which would be necessary in the interpretation of the facts gained by the inquiry including clinical, chemical, bacteriological, veterinary, prophylactic and commercial as exemplified in the experience and judgment of the physician, the chemist, the bacteriologist, the veterinarian, the sanitarian and the producer of this most important of all food products.

The market or mass milk problem will never be solved except by engaging the time and talents of three general classes of agents.

First: Municipal administrative officers with authority.

Second: Professional sanitarians with special knowledge and laboratory workers properly equipped for research and investigation.

Third: Philanthropy which, if public funds fail, will finance the crusade conducted by the first two classes.

The ramifications of the milk problem are very numerous and a comprehensive investigation of the subject would involve a large number of workers and many thousands of dollars. Your committee herewith submits an outline showing the lines through which such an investigation must be made in order to be complete and useful.

First: To examine all the sources of supply which are found in several states and scattered over a wide territory.

Second: To chart all the avenues of transportation and the methods used by these carriers from the foregoing sources of supply.

Third: To locate and investigate the innumerable centers of milk distribution in the county each of which may be a menace to the safety of this sensitive food product.

Fourth: To validate evidence of falsification where it exists and where claims of purity and safety cannot be maintained.

Fifth: To establish the evidence of disease producing contaminations in market milk which would require the cooperation of the State and Federal authorities.

Sixth: To carry on a county wide inquiry into the biological and chemical conditions and the food values of all milk found in the thousands of milk shops, institutions and homes, which would require a large force of experts and an enormous expenditure of money.

The foregoing outline is submitted in order to show the magnitude of this work and its prohibitive character and at the same time furnish a basis for any attempt to secure information on this large and important question. A County Medical Society can simply offer recommendations. To conduct such an investigation, if it were possible, would be to usurp the function that naturally belongs to the health departments of the State and local governments which could far better be carried on by these bodies which are generally capable and interested and would be efficient if they could command the funds.

Since it is purely a matter for administrative action and since a Medical Society has no legal authority as a compelling agency, your committee would state that its chief function would be, as seen in its previous reports, to keep the Society informed on all important facts connected with the milk problem and lend its best efforts to aid all authorized and organized agencies official or otherwise. We believe a County Medical Society can in this way be of great assistance to the public by its special knowledge and moral support; by encouraging publicity through the press and by other means with the object to educate the public.

President McCleave: Dr. Coit's paper is now open for dis

cussion.

M. B. Marcellus, M. D., Portland, Oregon: I have been intensely interested in both of the two papers that have just been read; in the first one, because of the fact that Dr. Fleischner has discovered that the medical profession as a rule shows a lack of interest not only in Certified Milk but in all milk; in the second paper, because of the fact that I am at the head of the Health Bureau and also a member of the Medical Milk Commission which has just been organized in Portland. Dr. Brown has offered some good-natured criticism of this Commission, and perhaps she is right; but at the same time it is impossible for us to secure the cooperation of the city and county medical societies in this work. Two Certified Dairymen have appeared before the Society endeavoring through their own efforts to get the Society to appoint such a Commission. Five members were appointed but have never met to even organize. That was two years ago. So, in order to allow those men to enter the contest which is being held in this city at the present time, it was necessary that some Commission should be organized that would be recognized by the National Medical Milk Commission. We wrote to the Secretary and he informed us that under the present arrangement they would not accept the certificate of the State Health Officer who was endeavoring to certify to these dairies; so that in conjunction with the Certified dairymen, the chief milk and dairy inspector of the city and myself got together and drafted an ordinance, which is almost indentical with the Cincinnati Ordinance, and asked the Mayor to present it to Council, which was done, with the result that it passed.

As I stated this morning, I succeeded in having the President of the City and County Medical Society and two other doctors who were interested in the milk problem because of the fact that they were both children's specialists and interested in having the ordinance passed, meet and organize a Commission, and the President of the City and County Medical Society, Dr. K. A. J. MacKenzie, who was at one time First Vice-President of the American Medical Association, was elected President. During the following few days the Commission visited both Certified Dairies. I am very glad to say that the three members of the Society are very much interested in the work, and I believe that that Commission is going to work out to very good advantage. I do not feel that the fact that the Health Officer and the Chief Milk and Dairy Inspector are on the Commission will hinder its work. I would like very much to have Dr. Coit tell us

what he thinks will be the outcome of such a Commission. I believe that it will do a great deal of good in bringing about cooperation between the Bureau of Health and the City and County Medical Society.

President McCleave: Is there any further discussion? Have you anything further to add, Dr. Coit?

Henry L. Coit, M. D., Newark, N. J.: I believe not.

President McCleave: That completes the program for this afternoon, and I will just remind you again about the meetings tomorrow.

The Alameda County Commission wishes you to take luncheon with them tomorrow at the Faculty Club, at the University of California. We will meet in one of the University buildings after our automobile ride in the morning. Those who do not go on the automobile ride can reach the University tomorrow afternoon by the Southern Pacific, it being only a short walk from Berkeley Station. If you cannot go on the ride, come to the luncheon. If you cannot come to the luncheon, be sure to come to the Agricultural Building of the University and be present promptly at two o'clock for our afternoon session

tomorrow.

On motion, the Conference now adjourned to 2 P. M., June 18, 1915, to convene in the Agricultural Building of the University of California at that time.

THIRD SESSION

Friday Afternoon, June 18th

The Conference met pursuant to adjournment, the present session being held in the Agricultural Building of the University of California, and called to order at two o'clock, President McCleave in the Chair.

President McCleave: The first paper on the program is No. 15, "What can be added to our Laboratory Methods and Standards to Improve Certified Milk," by J. Traum, D. V. M., University of California, Berkeley, Cal.

Dr. Traum read his paper as follows:

What Can be Added to Our Laboratory Methods and Standards to Improve Certified Milk

J. Traum, D. V. M., University of California

While the production of the cleanest possible milk, of constant nutritive value and free from pathogenic bacteria is the object of Certified Milk Commissions in all communities, the methods of controlling the production of such milk varies somewhat in different localities, and, although my paper treats principally of the problems that confront and have been referred to the laboratory connected with the San Francisco and Alameda County Medical Milk Commissions, I feel that these problems are more or less common to most of us who are interested in Certified Milk production.

Bacterial Content of Certified Milk: As an index to the cleanliness and care observed in producing and handling milk the bacterial content of a representative sample is the most practical and reliable. We have had no difficulty in maintaining the standards set by this Association. Table I contains the results of bacteria counts of Certified Milk sold in the San Francisco Bay region for the year ending April 30, 1915.