gallon, 8 cents a quart in summer, and 9 cents a quart in the winter time. The cream on this milk is not sold but is used after laboratory modification of it.

President McCleave: The next paper is on "The Care of Certified Milk Immediately after Delivery," by Dr. J. P. Sedgwick, Minneapolis, Minn.

The Care of Certified Milk Immediately after Delivery

J. P. Sedgwick, M. D., Minneapolis, Minn.

I have been interested in one part of this subject that I think should be brought out here. I have been attending these meetings six or seven years, and although this matter has been brought up before, it has not been brought up during that period to my knowledge, that is, the connecting link between the consumer, that means the baby, or the one that is to take the milk, and the time when it is delivered by the producer, the time when the Certified Milk is handed over from the wagon.

I began by making some experiments with the temperatures of refrigerators, beginning with our own refrigerator, and I found most of them of the ordinary construction run from 60 to 65 degrees Fahrenheit, in hot weather. Then I branched out to the neighbors' refrigerators, and I found out that they were not any better. Then I went to the refrigerators in the hospitals, and with one exception, I found that they were not any better, that the temperatures in the refrigerators where the milk was supposed to be kept under proper conditions, was usually over 60 degrees, and some times as high as 65 degrees, in the very hottest weather. Now that is not cool enough and does not show proper respect to the milk which has been prepared with care at the Certified Milk Dairy.

I then went to the Minneapolis City Hospital and saw the Superintendent, and we have constructed a proper cooling apparatus for keeping the milk cool, so that the milk bottles are kept in ice water. I had the same apparatus constructed in the University Hospital. It seems to me that the lesson from that is that such coolers should be devised for private use, in private residences. I had a brother who was connected with a large manufacturing concern, and he had constructed for me an apparatus a great deal like a water cooler; in fact, they were building water coolers in that establishment. It was constructed of galvanized iron cylindrical, and it was so arranged that ice and water could be placed in it. We filled the bottom with asbestos and the top with asbestos, very much like the ordinary water cooler, except that it was lower and broader in shape. All that was necessary was to put into that apparatus a rack to hold the milk bottles, and then put ice water with ice between the racks. We found that the temperature of that ice water was,

as you would naturally suppose, just about freezing, and that the milk which was contained in the milk bottles was not 65 or 70 degrees Fah., but just above 32 degrees Fah.

I am sure that the milk which the producers are taking such great care to prepare for us, and which the Milk Commissions are taking such care to certify, is being handled all over the country, that is in most cases, in such a manner as to lessen the benefit that should be got from it, and that these refrigerators which are showing temperatures at 65 degrees or 70 degrees, are not proper places in which to put such milk.

I should like to urge that this be discussed here, and that our body recommend that an effort be made to keep Certified Milk in containers in ice water. (Applause.)

President McCleave: Dr. J. R. Williams, of our Council, found the same thing to be true of the refrigerators in Rochester, that Dr. Sedgwick has found to be the case regarding those in Minneapolis. I have tested some here, and while we never have excessively hot weather here, still the temperatures of these so-called ice boxes are far above the temperature of the milk when it is put into them, and our refrigerators do not anywhere nearly approximate the temperature that they should.

I think a reform of the home ice-box is one of the pressing needs of the day in the care of food stuffs, because the day has come now when our food stuffs are being handled excellently outside of our home and then subjected to mismanagement in the home, as Dr. Sedgwick has said.

The next paper is by Dr. John Zahorsky, of St Louis, Mo., on the subject, "Some Observations on the Fermentation of Certified Milk." I will ask Dr. Zahorsky to read that now.

There are some here who were not present yesterday whom we would like to fill out registration cards, and it is particularly important that you let us know, whether or not you desire to go upon the trip tomorrow morning. Please remember that our party will be met at the ferry entrance by Dr. Fleischner, who has the tickets, and will hand them to all of you. You are all invited to go upon this trip. You will find it a very interesting one. You will please recall the notice that I gave you yesterday that the time as printed upon the program is in error. the Sausalito Ferry at the foot of Market Street, at 8:45, instead of 9:15 A. M. as printed.

Dr. Zahorsky read his paper, as follows:

You take

Some Observations on the Fermentation of Certified Milk By John Zahorsky, M. D., St. Louis, Mo.

It is generally conceded that more or less fermentation of the chyme, or chyle, takes place during the process of digestion, and its character and intensity have a marked influence on the digestive and nutritive function of the infant. Following the teachings of the modern German School of pediatrists, there is a strong tendency to lay the most stress on the functional activity of digestion to keep the fermentative process in check.

Some of us still hold to the theory that there is such a thing as an infectious diarrhea, in which the intestinal wall is infected and thereby diseased. Personally, the theory of chymus infection by a large number of bacteria foreign to the normal bacterial flora still finds favor. That a coagulum of casein may thus carry fermentative and putrefactive germs through the stomach and intestinal juice, may be safely affirmed.

As soon as the milk enters the stomach, conditions for the multiplication of bacteria are very favorable. We cannot depend on the antiseptic power of the gastric juice. The changes that take place in milk kept in a warm place are imitated, though more or less modified by the digestive process, in the alimentary canal. We know that in the ordinary course of souring milk, the lactic acid bacilli soon predominate and destroy other forms of bacteria. These lactic acid germs are harmless, even for the youngest infant, and lactic acid products are innocuous.

Buttermilk is one of the safest foods in fermental diarrhea. The clabbermilk of the farms is a healthful food. That milk, therefore, would seem the safest in which the lactic acid bacilli predominate at once, and thereby prevent other bacteria from proliferating.

We have learned from the experiments of Ford and Pryor that milk pasteurized at a temperature of 65 to 85 degrees is really an unsafe food, since the spores of bacteria, which remain, may be harmful.

My observations were suggested by the complaint of some mothers, that Certified Milk on standing develops a very disagreeable odor. Some of these odors were evidently due to the fact that the cows had eaten some weeds (wild onions). A few,

however, suggested that Certified Milk on standing may not sour promptly, and putrefactive germs predominate. (Bacillus putrificus.)

It seemed worthy of trial, therefore, to test the souring or fermentation of Certified Milk. It might be different from the ordinary commercial milk, since the bacterial content is so low to begin with, and the lactic acid micro-organisms so few that the usual changes, especially in a sealed bottle, may be disturbed. I determined to make some observations on this point, namely, to determine the gross physical changes, which Certified Milk undergoes in a warm room. For after all, when it is delivered to the consumer, 24 hours old, and some of it fed to the infant as long as 36 hours later, and after being kept in an ice-box, the temperature of which is often 50 degrees or more, the milk will undergo some change.

Every day for a fortnight pint bottles of Certified Milk, from three different dairies, were delivered to me. These were placed in a warm room, (temperature, 70 to 85 degrees), and allowed to ferment. No bottle was opened before the third day. Some were not opened for four or five days. The contents were inspected, the character of the curd, the separation of the whey, and the presence of gas bubbles in the milk clot or cream, noted. The odor of the cream and milk tested. Finally, the clabber was tested. Certified Milk, having a bacterial content of 10,000 or less, begins to turn sour on the second or third day. On the fourth day in all cases, the milk clot appears. While this typical appearance was noticed in the majority of bottles, quite a number of variations occurred.

In three bottles the milk clot instead of settling to the bottom of the bottle, floated, and the serum lay below it. This might be attributed to a lessened separation of the cream, but in two instances the impression was produced that the lightened milk clot was due to its being permeated by numerous gas bubbles.

No offensive odor was detected in any of the bottles. Some of the cream on top of the milk had a disagreeable odor of butyric acid. The taste of the coagulated milk was usually agreeable.

There was one phenomenon to which particular attention should be given, and that was the appearance of gas bubbles. Twenty-one bottles were free from gas. Ten bottles showed