these gas bubbles in a marked degree. In three instances the cap seemed to be raised by the gas generated. The bubbles permeated the cream layer, and were observed as numerous small depressions and lines in the milk clot. In two instances the milk clot seemed to be made lighter by the gas, and floated.

The souring of milk should not be accompanied by gas formation. If certain aerogenic bacteria thrive in Certified Milk, it is evidence that their growth is not inhibited by the lactic acid bacilli. In fact, the very slow souring of Certified Milk permits aerogenic and peptogenic bacteria to multiply enormously. Certified Milk not kept under conditions of proper refrigeration, may thus become much more dangerous than commercial milk. It may produce dyspeptic symptoms. In fact, it is a frequent clinical observation that some infants digest commercial milk better than Certified Milk.

According to Ford and Pryor, the destruction of all lactic acid micro-organisms by pasteurization is attended by some danger in that other micro-organisms have a free field. The question naturally arises, does a very rigid asepsis in dairying exclude mostly beneficent micro-organisms? Some clinicians of my acquaintance go so far as to add some cultures of lactic acid bacilli to the Certified Milk. They claim that this is safer. The wide use of these cultures for digestive disturbances in the infant is well known.

My own observations limited to the gross changes in the souring of milk tends to confirm the theory, that the removal of all lactic acid bacilli from the milk is a mistake. This is given in no sense to disparage the efforts of dairymen to give us clean milk. But this subject deserves more extended study, and it is for this reason that I present this subject at this time.

To sum up my observations:

Certified Milk requires several days to sour.

The product is far from uniform. The taste and odor of the milk vary.

The milk clot varies in consistency, some produces a hard clot, others, very soft.

The separation of the milk serum may be very perfect, or no separation occurs.

Gas bubbles in large numbers appear in many specimens, which indicates an activity of micro-organisms different from the ordinary lactic acid bacilli.

The digestion of raw Certified Milk offers greater difficulties than one containing more lactic acid bacilli.

The keeping of Certified Milk for 24 hours or more in a warm place, may be attended by danger, in that the harmful bacteria are not inhibited by a large number of acid producing germs.

Great progress is promised in the production of Clinical Milk by a careful qualitative bacteriological study of Certified Milk as it stands in the household receptacle.

President McCleave: Limitations of time make it necessary that we omit any discussion of these papers, however interesting and valuable they may be.

I will now call on Dr. Ferguson to read a paper which came in too late for printing on this program, "The Making of a Milk Commission," by Dr. J. W. Van Derslice, Assistant Professor of Medicine in Rush Medical College, and Secretary Chicago Medical Society Milk Commission.

R. Ralph Ferguson, M. D., Chicago, Illinois: I have here a paper by Dr. Van Derslice which he proposed to come here and read. The reason why Dr. Van Derslice has written this paper and presents it for your consideration and publication, is because the Chicago Medical Society is in receipt of inquiries every week and every month, inquiring as to the best method of organizing a Milk Commission; and inasmuch as it is impossible to reply to all of those inquiries in detail, Dr. Van Derslice has written this for your approval, and in order that it may be sent out to the different County Societies and other places throughout the State, to assist them in forming Milk Commissions.

Dr. Ferguson then read the paper by Dr. Van Derslice, as follows:

The Making of a Milk Commission

J. W. Van Derslice, M. D., Assistant Professor Medicine, Rush Medical College. Secretary Chicago Medical Society Milk Commission

Certified Milk has now reached a point in its development at which it is no longer considered solely as a clinical milk but rather as a commercial commodity which by its utility has gained for it the high plane of regard in which it is now held by the profession and laity.

Certified Milk was first produced under the certification of the Essex County, N. J. Medical Milk Commission, in 1890, Dr. Henry L. Coit, being the originator and indefatigable promoter.

The vision of Dr. Coit and his co-workers in the field of a clean, pure milk was sufficiently broad to embrace the ever widening scope of this work; this is manifest by the comprehensive contract first entered into between the producer and the Commission, this contract with but minor changes is accepted as the working standards of all Medical Milk Commissions.

The propaganda for clean milk which crystallized in the Certified Milk movement was the pioneer of the Infant Welfare organizations and there is a connecting link in most of the Milk Commissions with the Infant Welfare Societies.

The conception of Certified Milk embraces not only the production of a clinical milk but the broader view of encouragement of the production of a better milk supply for the community at large. The educational effect of Certified Milk production is proportionately of far greater value to the community than the supplying of the very limited amount of Certified Milk and this aspect of the work by the Commission should be ever borne in mind. It is a matter of current knowledge that in farming communities where Certified Milk is being produced upon one or more farms there is a tendency to clean up upon many of the adjacent farms and there is the factor of imitation to a greater or lesser degree both as to methods and equipment throughout that vicinity. In the Chicago district where there are upward of a dozen Certified Milk producing plants there is being spread the gospel of pure clean milk in a practical way to practical men.

The education of the medical profession to the value of a clinical milk is of no inconsiderable importance and when one

considers the apathy with which the milk supply for the unfortunate baby deprived of its natural aliment is so frequently considered this demand for education of physicians who prescribe the feeding for these unfortunates is paramount.

Milk is milk and to the housewife the cream line is the gauge by which all qualities are measured. However, the possibility, yes, the practicability of the distribution of a safe clean wholesome milk is gradually sifting into the minds of these housewives, and, today, in many communities there arises a demand for such a milk long before either the profession or commercial enterprise is prepared to supply a milk of Certified grade.

Of no mean importance is the value of the Milk Commission to Public Health work. The stimulation of an active energetic Milk Commission upon the Health Officers of a community is indeed wholesome.

Certified Milk is milk produced under the certification of a regularly appointed Milk Commission of a County Medical Society. This definition for this product has many advantages over a definition which embraces the working methods and standards of the A. A. of M. M. C. These methods and standards are subject to change from time to time as the knowledge of milk hygiene increases. Furthermore, from a protective point of view this definition meets the conditions to the best advantage. In many states Certified Milk has received legal recognition by the enactment of laws by the several legislatures. The charter of the State of Illinois is such that the best legal advice which the Chicago Medical Society Milk Commission could obtain gave as their opinion that any statute that would stand the test of law would be more harmful than beneficial to the cause; as the law governing such products declared that one could not go behind the container; milk must have standards which apply only to the milk as delivered in the bottle or can. This product can only be protected under the laws appertaining to misbranding and the copyright laws.

The originators of Certified Milk contemplating this aspect had the term copyrighted under the ownership of the producer of Certified Milk to the Essex County Commission. By consent such copyright is extended to any regularly constituted Milk Commission. The value of this copyright has never been decided by a higher court but it is of common accord believed to

be entirely valueless; in the face of such conditions the Attorney for the Chicago Medical Society Milk Commission advised that the Commission have an original design drawn and that a copyright of such be taken out and to secure further protection to have said meaningless design registered under the registration and trade-mark acts of Illinois and Wisconsin. Accordingly this was done. All the literature, bottle caps, etc. bear this insignia, so that today, the public is educated to demand a bottle sealed with this label when purchasing Certified Milk.

Under the misbranding laws several courts of record have decided that Certified Milk had by usage become known and accepted as a milk for clinical purposes produced under the direction and supervision of a County Medical Society. The Chicago Medical Society Milk Commission is of the opinion. that this is a better protection than any legal procedure could be, even were it possible to have Certified Milk given a legal status by act of legislature.

Certified Milk is extra-legal. For it to remain in the high regard in which it is now held it must always be in advance of legal ordinance.

There are but three Milk Commissions in Illinois and approximately seventy-five in the U. S. In many communities there is developing a demand for a milk of the grade of Certified. Where there is such a demand it is the duty of the County Medical Society to have such a milk furnished that the many babes who of necessity must be given artificial food may have a clean wholesome milk. In the development of such a demand there is of necessity a slow growth and in many cities and larger towns the production of a Certified Milk for a small growing demand would be at a considerable financial loss. It would appear that this early loss to a very large extent could be obviated by temporarily receiving their supply from a neighboring Commission. There are few places in which it would not be possible to deliver Certified Milk within twenty four hours after milking.

In the establishment of a Milk Commission there should be a canvas made of the various charitable and uplift agencies to work up an atmosphere for such a propaganda. The many Women's Clubs welcome speakers upon this subject: The County Medical Society should establish a Milk Commission as one of its standing committees. The charter of the Chicago