A Plan to Pro care Cows Milk 
Designed for Clinical Purposes. 
BY 
HENRY L. COIT, M. D. 
Paper read before the Practitioners' Club, Newark, New Jersey, 
January, 1893. 
NEWARK, N. J. 
L. J. Hardham, Printer and Binder, 243 & 245 Market Street. 
1893- A Plan to Procure. Cows Milk Designed for 
Clinical Purposes. 
By Henry L. Coit, M. I). 
Paper read before the Practitioners' Club, Newark, 
New Jersey, January, 1893. 
When it is found that the mortality of the race 
is increased by the impoverishment of any article of 
food, this particular item should be singled out, receive 
extraordinary care and be placed under particular sur- 
veillance. 
It is generally conceded by physicians, that cows' 
milk as supplied in large cities, is, as a rule, much below 
the required clinical standards of purity. This article has 
come to be the chief agent by which the children of 
our race are nourished. There is also a causative 
relation between the character of the food provided for 
this class, and the death-rate among them. 
When, therefore, it is considered that at the present 
time, the mortality among infants comprises about thirty 
per cent, of that occurring in all ages, and from all 
causes, we are led to the conclusion that the relation of 
the medical profession to this subject is far more im- 
portant than would appear to a casual observer. 
Aside from the foregoing considerations, the physician 2 
often fails to secure results in his professional work among 
the sick, because of impoverished milk, and it is prob- 
ably no less an essential medical feature of the subject, 
that a large proportion of those under his care must be 
fed on this article alone. 
In seeking a remedy for the difficulties which sur- 
round the milk supply in large cities, we find that it must 
lie within three possible lines of action. 
First: Legislation. It is common to appeal to the 
law-makers in matters of this kind; but we are convinced 
that legal enactments will not afford us the needed relief. 
On our statute books there now appear, all the laws we 
require. These would be sufficient if they were ad- 
ministered, but that they are not effectual is apparent to 
all. It is thirteen years since the first law was passed in 
New Jersey relating to the inspection of milk, and now, 
at the end of this period, we are prepared to affirm that 
little has been accomplished by legislation, except to 
establish commercial standards of purity. 
The following expressions, from men prominently 
connected with the regulation of milk production in this 
state, are significant: Dr. E. M. Hunt, Secretary of the 
State Board of Health, writes: " There is far more 
danger of a weakening of the law than there is prospect 
of its being made more stringent. It would afford us 
pleasure to be of greater service in this direction, but 
we really do not see how we can be at present." 
George W. McGuire, State Dairy Commissioner, 
writes: " Such a radical reform as we desire in the pro- 
duction and handling of milk, may not be accomplished 
in our generation." Words, such as these, would indi- 
cate that our legislative bodies are helpless to give us 
relief, especially, when their dictum runs counter to 
the larger and more powerful commercial interests. 3 
Second: Public opinion. This is always a variable 
quantity, dependent largely upon individual caprice, and 
the influence of vested interests, both of which are 
mirrored in the public press and are known as public 
opinion. Furthermore, the public are proverbially lax 
and indifferent, with reference to matters connected 
with sanitation and hygiene. Destruction of property 
always arouses alarm, but a sacrifice of life, through 
greed or by ignorance, is not sufficient even to awaken 
the slightest concern on the part of the masses. The 
moulding of public opinion for our purposes is therefore 
a useless task. 
Third: Medical supervision. The interest which is 
being awakened in the profession on this subject is 
evident. The recent report made by the writer to the 
Medical Society of New Jersey, called forth editorials in 
four leading journals, two of which were medical publi- 
cations. The physician is the proper custodian of 
matters affecting public health; his knowledge of the 
possible causes of danger best equip him with agents of 
warfare against current evils of this class ; and when he 
is handicapped by the need of reform, or confronted 
with conditions which menace human life, he is not likely 
to make concessions for the sake of expediency. 
The clinical relations of the milk supply appeal with 
special force to the physician. The feeding of the 
young, both in infancy and childhood ; the dietetic man- 
agement of the sick, where the clinician so frequently 
needs to be assured of purity; the many instances where 
the approach of infection calls for unusual judgment 
in the selection and use of this food, all combine to 
impose upon the physician certain important responsi- 
bilities, and to make him the proper supervisor of milk 
production, where it is designed for his purposes. 4 
In order to secure all the qualities which we desire in 
cows' milk, such as uniform nutritive values, reliable 
keeping qualities and freedom from pathogenic bacteria, 
we propose that an organized effort be made, whereby 
the above-mentioned conditions may be acquired under 
our own supervision. 
Our plan includes three general requirements, each of 
which are essential, and, we believe, if put in operation, 
would, taken together, establish a reliable safe-guard. 
First: That physicians give their practical support 
to an effort conducted by a commission selected from 
their own number, who shall endeavor to bring to the 
city a supply of milk, produced under such regulations 
that purity shall be assured. 
Second: That approved and trustworthy dairymen, 
possessing honor, financial ability and dairy facilities, 
shall be induced by reason of promised medical support 
and the increased price of their milk, to conduct their 
dairies, collect and handle the products, in conformity with 
a code of requirements made by the aforesaid medical 
commission, and imposed by them in due legal form. 
The contract shall include the sureties for its fulfill- 
ment; the location and character of the land; the con- 
struction of buildings; the water supply; the surround- 
ings; the health and breed of the dairy stock; the 
housing and care of the cows; the feeding; the col- 
lection and handling of the milk ; its cooling and prepar 
ation for shipment; the bottling and transportation, 
together with the minor details of delivery. 
Third: That the commission shall carry on its 
work without pecuniary compensation. Their duties 
shall be: First, to establish correct clinical standards of 
purity for cows' milk. Second, to be responsible for a 
periodical and personal inspection of the dairy or dairies 5 
under their patronage. Third, to provide for bi-monthly 
expert examinations of the dairy stock by a com- 
petent and approved veterinarian. The milk produced 
shall be subjected to chemical analysis and to bacteria- 
htgical tests, made under the direction of the commission 
at such times as in its judgment is desirable. 
The veterinary surgeon, chemist and bacteriologist 
shall be selected by the commission, and when so re- 
quested, cither periodically or otherwise, they shall 
render their reports in writing. The expense of all ex- 
aminations should be defrayed by the dairyman, since he 
is the only party gaining a pecuniary advantage. These 
expert reports, although designed for certificates, may 
also be used for the information of the medical fraternity, 
in the localities where the milk is sold. 
After receiving these reports, the commission should 
send a certified copy of the same to the owner or agents 
of the dairy or dairies under its supervision. Duplicate 
printed copies, bearing the signatures of the experts, and 
the names of the commission, should be issued by the 
dairymen, at such times as may be agreed upon, and the 
circulation should, for obvious reasons, be limited to 
physicians. 
The milk thus produced should be known as certified 
milk; should be sealed in separate quart containers and 
bear the name of the producer, together with the date of 
milking. The milk being designed especially for clinical 
purposes, should be subject to the following restriction 
in its sale, namely: that when at any time, the demand 
is greater than the supply, and the milk is required by 
a physician, either for infant feeding or the diet of the 
sick, it should be agreed that the phyiscian or his patient, 
shall be a preferrcdjpurchaser, PROPOSED AGREEMENT. 
For the use of Medical Commissions organized to carry forward the 
foregoing plan.* 
The following agreement, made thisday of 
18.., betweenM. D.; 
M. D.;M. D.;M. D.; 
M. D., andM. D., 
parties of the first part, andof 
New Jersey, party of the second part. 
Witnesseth, that the party of the second part doth hereby bind 
himself to a fulfilment of the provisions of this contract, for and in 
consideration of the benefits hereinafter named by the parties of the 
first part. 
Furthermore; the following named persons:of 
(New Jersey ;)of 
.... (New Jersey,) andof 
(New Jersey,) all acquaintances of the party 
of the second part, hereby affix their signatures to this agreement, 
and thereby attest to the honor of the party of the second part, be- 
coming each for himself, and not for the others, surety for the 
execution of this agreement. 
The party of the second part, hereby agrees to conduct such 
parts of his dairy as may be hereinafter named, collect and handle its 
products, in conformity with the following code of requirements, for 
and in consideration of the promised endorsement of the parties of 
the first part, as hereinafter indicated. 
The milk thus produced shall be known as certified milk, shall be 
designed especially for clinical purposes, and, when at any time the 
demand should be greater than the supply, and is required by a 
physician, either for infant feeding, or the diet of the sick, it is hereby 
agreed that such shall be the preferred purchaser. 
The party of the second part further agrees to pay for chemical 
*The writer acknowledges valuable suggestions by Prof. Albert R. Leeds, 
Ph. D., and the members of a medical commission in Essex County, N. J., 
organized to carry the plan into effect. 7 
and bacteriological examinations of the aforesaid certified milk, at 
such times as in the judgment of the parties of the first part is 
desirable. He also agrees to defray the cost of a bi-monthly inspection 
of his dairy stock, or oftener if necessary, by a competent and 
approved Veterinarian, all of which persons, namely: the Chemist, 
the Bacteriologist and the Veterinary Surgeon, shall be chosen by the 
parties of the first part, to whom they shall render their reports in 
writing. 
It is furthermore agreed that the party of the second part, on 
receipt of a certified copy of the reports of the experts, shall mail to 
the persons indicated by the parties of the first part, and not to 
others, a duplicate printed copy of the aforesaid reports, bearing the 
signatures of the experts, and the names of the physicians. The 
same to be issued at such intervals as in the judgment of the parties 
of the first part is desirable ; also, that the necessary expenditures for 
printing and circulation be met in the same way as herein provided 
for the expert examinations. 
LOCATION OF LANDS. 
It is hereby understood and agreed, that the lands used by the 
owners, agents or asignees of the dairy, conducted by the party of 
the second part, and employed for pasturage, or any lands that may 
hereafter be acquired for such purpose, or such lands as may be used 
for the cultivation of hay for fodder, shall be subject to the approval 
of the parties of the first part. 
BUILDINGS. 
It is also understood and agreed that the buildings, such as 
stables, creamery, dairy-house and spring-house, shall be constructed 
after the most approved style of architecture, in so far as construction 
may affect the health of the dairy stock, or the character and con- 
ditions of the milk. That the buildings used for the housing of the 
animals shall be situated on elevated ground and capable of being 
properly drained; said buildings to be sheltered from cold winds, 
lighted and ventilated according to approved hygienic methods. The 
buildings shall be constructed, so as to favor the prompt and easy 
removal of waste products; and the apartments used for the storage 
of either feed or fodder shall be removed from possible contamination 
by stable waste or animal odors. 
All buildings, shall, in addition to healthy location, approved con- 8 
struction and proper ventilation, be kept free from animal or vegetable 
matter in a state or process of decomposition or decay, and always 
free from accumulations of dust and mould. 
THE WATER SUPPLY. 
The dairy shall be supplied with an abundance of pure water, 
and no water from shallow wells or springs, holding surface drainage, 
shall be used for watering stock, cooling milk, or cleaning vessels. 
Nor shall any well or spring be located within three hundred feet 
of the stable. 
SURROUNDINGS. 
It is further understood and agreed, that the immediate surround- 
ings of the buildings shall be kept in a condition of cleanliness, and 
in order. There shall not be allowed to accumulate in the vicinity, 
any loose dirt, rubbish, or decayed vegetable or animal matter, nor 
animal waste. Nor shall there be within three hundred yards of any 
building, any constantly wet or marshy ground, or stagnant pools of 
water. Nor shall there be kept within three hundred yards of any 
building used for dairy purposes, any fowls, hogs, horses, or other 
live stock. 
CONDITIONS OF THE DAIRY STOCK. 
It is hereby understood and agreed, that the following unhealthful 
conditions shall be a sufficient reason to exclude an animal from the 
herd used for any purpose, in the aforesaid dairy: Any animal that is 
judged by a competent observer to suffer from tuberculosis, even 
though the disease be localized in a part distant from the vital organs ; 
any animal with fever; any animal suffering from septic absorption, 
or other disease following, or associated with parturition ; any animal 
suffering either from mammitis, or mammary abscess; any animal 
with persistent diarrhoea, or any other abnormal physical condition, 
which could in any way be detrimental to the character of the milk. 
It is furthermore agreed, that when an animal shall be found by a 
competent observer to be in a state of ill-health, prejudicial either 
to the other animals in the herd, or to human health, the same 
shall be removed immediately ; and if, in the judgment of the parties 
of the first part, it is necessary, shall be killed within twelve hours 
thereafter. 
It is also understood and agreed, that the party of the second 
part, shall exclude from the herd, used for producing certified milk, 
immediately after discovery, any animal subject to th? following con- 9 
ditions: any animal that was bred through close consanguinity; any 
animal that was not, as a heifer, kept sterile during its first twenty- 
seven months ; any phenomenal milker, except that glandular disease, 
or tubercle has first been excluded by a competent observer. 
It is furthermore agreed, that if at any time, it is desired by the 
parties of the first part, that a different breed of milch cows, should 
be substituted for the one in use, in order that the standards of 
quality in the milk may be raised; the party of the second part will 
endeavor to carry the same into effect. 
HOUSING AND CARE. 
It is furthermore agreed, that the dairy stock employed in the 
production of certified milk, shall be properly sheltered from the 
influences of weather and climate, prejudicial to their health; also, 
that the animal shall be kept clean, groomed every day, and treated 
kindly at all times. The waste products of the stable shall be 
removed so frequently and the stable floor so thoroughly cleaned, 
that the same shall be as free as possible from animal odors. 
It is also agreed, that no milch cow shall be used for dairy pur- 
poses while in a state of excitement, either as a result of, or during 
the period of estrux, or which has been made nervous, either by beat- 
ing, whipping, kicking, prodding or running. 
FEEDING. 
It is hereby understood and agreed, that the methods of feeding 
the cows furnishing the certified milk shall be subject to the approval 
of the parties of the first part. 
The feed and fodder shall consist only of nutritious and wholesome 
materials-such as grass, clover and timothy hay, whole grain, or the 
entire result of the grist. No materials shall be employed which are, 
or may become injurious to the health of the animals. There shall not 
be fed at any time or in any quantity, either alone or mixed with other 
feed or fodder, hulls, screenings, wet or dry brewer's grains, oil cake, 
sour ensilage, the refuse from distilleries, glucose or starch factories, 
any waste bi-product in the treatment of grain, low marsh grass, 
or any of the questionable or exhausted feeds or fodders employed either 
to increase the milking capacity of the animal, or that will produce an 
impoverished milk, or that will impart to it unnatural odors or flavors. 
Nor shall the cows be allowed to eat green or worm-eaten fruit, 
poisonous weeds, or to drink poisonous or stagnant water. 10 
COLLECTION AND HANDLING 
It is furthermore understood and agreed, that the cows from 
which is obtained certified milk, shall be milked only in a clean 
building, and not in an illy-ventilated stable containing foul odors 
and bad air. No animal furnishing certified milk shall be milked 
until the udder shall first have been cleaned in a manner approved by 
the parties of the first part. No person shall be allowed to draw the 
milk that has not, within fifteen minutes of the milking, first washed 
his or her hands, using soap and nail brush, and afterward thoroughly 
rinsing the hands in clean water. The person or persons engaged in 
milking shall also be dressed in clean overclothes. No person shall 
be allowed to draw the milk who has been engaged with the care of 
horses, in the same clothing, or without first washing his hands. 
No milk shall be represented as certified milk that is not received 
from the udder into vessels, and from these into cooling cans, both of 
which are perfectly clean and dry, having been scoured and scalded 
at a temperature adequate to effect complete sterilization, since the 
last milking, and have been kept inverted in a clean, dry and odorless 
atmosphere. 
No milk shall be represented as certified milk, that has not been 
passed through a sieve of wire cloth, either while milking, or immedi- 
ately thereafter, having not less than one hundred meshes to the linear 
inch. 
No milk shall be represented as certified milk that does not 
consist of the entire contents of the udder at each milking, including 
the foremilk, middlings and strippings. 
No milk shall be represented as certified milk that has been 
drawn from the animal at abnormal hours, such as midnight or noon ; 
nor from any animal, for a period of nine weeks before calving; or 
that has not been separated for nine days after parturition. 
No milk shall be represented as certified milk which has been 
exposed to the emanation or infection of any fcrm of communicable 
disease, either in the person or persons handling the milk, or by 
accidental contamination in cleaning milk containers, or by the associ- 
ation of any person, engaged in handling the milk, with person or 
persons sick of contagious disease. 
PREPARATION FOR SHIPMENT. 
It is hereby understood and agreed, that all milk represented as 
certified milk shall receive every known detail of care that will pro- 11 
mote its keeping qualities and favor its safe transportation. That 
this milk on being drawn from the cow, shall be treated by ice, or 
clean cold water in motion, and proper aeration, in order, first to 
remove its animal heat, and second to reduce its temperature to a 
point not above fifty degrees nor below forty degrees, Fahrenheit ; 
said temperature to be acquired within forty-five minutes after the 
milking, and maintained within the above limits, while held for ship- 
ment, during its transportation, and until it is delivered to the 
purchaser. That the cooling of the milk shall not be conducted in 
the same building in which it is drawn, nor in an atmosphere tainted 
with animal odors. That all the foregoing provisions, concerning the 
cleansing and condition of vessels, or utensils shall be complied with 
in the said cooling process. 
It is furthermore agreed, that no milk shall be represented as 
certified milk that has been changed or reduced in any way by the 
addition of water, or any solid or liquid substance, in or out of 
solution; or the subtraction or removal in any manner, of any part 
thereof. 
THE BOTTLING. 
It is hereby understood and agreed, that all milk to be repre- 
sented as certified milk shall be packed in flint glass quart jars 
immediately after it is cooled, said jars to be of the most approved 
pattern. It is furthermore agreed, that the bottles or jars, before 
being used, shall be cleaned by hand separately, with the aid of hot 
water, alkaline soaps, rotating brush and steam; and that they 
shall be rinsed in two separate baths of clean hot water, and then 
baked in hot air at a temperature of not less than i8o° Fahrenheit, 
and kept inverted until used, without covers, in a clean dry atmos- 
phere, free from oders. It is agreed, that the jars shall be filled by a 
method approved by the parties of the first part. That they shall be 
sealed, after all air has been excluded, by the most approved device 
for closing them. The bottles after being filled, shall be labeled 
across the cap, bearing the words certified milk, with the names of 
the dairyman and distributing agent, together with the date of 
milking. 
It is furthermore agreed, that no milk shall be sold as certified 
milk that is more than three hours old when bottled, nor more than 
twenty-four hours old when delivered. 12 
TRANSPORTATION AND DELIVERY. 
It is hereby understood and agreed, that the transportation and 
distribution of all milk represented as certified milk, shall be con- 
ducted by the party of the second part, either in person, or by persons 
employed by him. That in transit, the milk shall not be exposed to 
any of the foregoing prohibitory conditions. That it shall not be 
subjected to agitation. That it shall not be exposed to the heat of 
the sun. That the delivery wagons shall be so constructed, that the 
temperature of the milk may be maintained during transit, and that 
before the wagons are filled for shipment, the body, the trays and 
compartments shall be flushed with boiling water. It is furthermore 
agreed, that the distributing agents shall, during the transfer of the 
milk from the dairy to the purchaser, be subject to the following 
restrictions, namely: That they shall use no tobacco; that they shall 
take no intoxicating drinks; that they shall not collect the empty con- 
tainers, nor receive money, or milk checks, from houses in which an 
infectious or contagious disease is known to exist. 
It is also hereby agreed, that the collection of empty bottles, 
from places where infectious or contagious diseases are known to 
exist, shall be made by other persons than those employed to deliver 
the milk. That these collections be made with wagons not employed 
in the distribution of the milk, and that before these empty bottles 
shall be returned to the dairy, they shall be carried to a separate 
building, and first be subjected to the process of cleaning bottles 
indicated in a former clause of this contract. 
It is hereby understood and agreed, that if any further pre- 
cautions, or changes in method, calculated to improve the quality of 
the milk, or guard the same from impurities or dangers, is desired, 
that the party of the second part, will cheerfully be governed by such 
additional rules and regulations as may be laid down by the parties 
of the first part. 
Finally: It is understood and agreed, that nothing in this 
contract shall prevent the abrogation of any of the provisions of the 
same by the parties of the first part, provided that it shall be done 
for the purpose of substituting other provisions designed to promote 
the objects of their organizaion. 
[Other protective clauses may be added, referring to a breach of 
agreement, or that may restrict the sale of the milk to a limited 
territory.] 
In witness whereof, the parties have hereunto set their hands, etc.