MILK-INSPECTION AND MILK-STANDARDS. 
BY 
HENRY LEFFMANN, M.D., 
OF PHILADELPHIA J 
MICROSCOPIST AND FOOD-INSPECTOR, PENNSYLVANIA STATE BOARD 
OF AGRICULTURE. 
{Reported from advance sheets of the forthcoming 
annual report of the Board.} 
FROM 
THE MEDICAL NEWS, 
February 2, 1895. [Reprinted from The Medical News, February 2, 1895 ] 
M ILK-INSPECTION AND MILK-STANDARDS.1 
HENRY LEFFMANN, M.D., 
OF PHILADELPHIA J 
MICROSCOPIST AND FOOD-INSPECTOR, PENNSYLVANIA STATE BOARD OF 
AGRICULTURE. 
[Reprinted from advance sheets of the forthcoming annual 
report of the Board.] 
No topic in sanitary science has received greater and 
more careful attention in the past twenty years than the 
analysis of water and milk, and few topics have exhibited 
greater transformations as to the principles on which 
judgments as to sanitary value may be based. The ex- 
tension of bacteriology has enabled us to identify the 
causes of disease and to demonstrate in many cases the 
methods of propagation. 
In water-analysis we can still rely with much confi- 
dence on the merely analytic results, though we recog- 
nize that the figures for chlorin, ammonia, and so on, 
are merely indexes of pollution and not injurious in 
themselves. In milk-analysis, we have first been obliged 
1 At the annual (1894) meeting of the Board one session was 
devoted to the discussion of questions relating to " Milk-Stand- 
ards and Milk-Inspection." These subjects were selected because 
at the preceding session of the Legislature the Senate Committee 
on Agriculture had requested the Secretary of the Board thus to 
introduce the question at one of the meetings of the Board, and 
obtain the opinions, /ro and con, of those interested. 
All parties interested were invited by advertisement and pro- 
grams, and a number of persons known to hold diverse views 
were invited, to be present and explain their positions. 2 
to correct our analytic methods, and, lately, to revise 
materially our views as to the manner in which milk 
affects the public health. 
In the judgment of the results of a water-analysis, 
chemists have never been misled into attaching undue im- 
portance to the proportion of dissolved matters; but in 
judging of the results of milk-analysis this error has long 
been made, and is still being made by sanitary officers. 
Thus, in the early days of the agitation of the question 
of milk-inspection in Pennsylvania, reference was not 
infrequently made to the high rate of infant-mortality, 
and this was ascribed to the reduction of the strength of 
the milk-food by dilution and skimming. 
At the present day we are in possession of a much wider 
and more exact knowledge as to the manner of the 
distribution of disease by milk. We now know that 
serious dangers arise from the contamination of the milk 
by microbes, and that such dangers fall practically into 
two classes. 
The first class is that due to contamination of milk by 
specific micro-organisms from disease, either among the 
milk-yielding animals or among the persons about the 
farm. I do not think that it will be necessary to discuss 
these questions in much detail, for all are pretty familiar 
with the subject. Possibly, some may not fully appre- 
ciate the extent to which specific disease in dairy cows 
exists, and to which it infects human beings; but I 
frankly say that I am a convert to the view that the 
production of cows' milk for human food, under the 
present methods of collection and use, is one of the 
most dangerous of human industries. As an illustration 
of the extent to which tuberculosis may exist in herds, I 
take the following articles from the Medical Record of 
January 6, 1894. 
" Probably few physicians are aware of the enormous 
practical value in the animal industry of tuberculin, 
that is to say, if the position taken by the New York and 3 
other State Boards of Health regarding it is correct. 
A gentleman who has a valuable herd of thoroughbred 
cows writes us that twice within the last six months his 
herd has been examined by competent veterinarians 
and pronounced healthy. A third examination, how- 
ever, with the aid of tuberculin, caused a condemnation 
of over one-half of the herd. He adds : 
" ' The New York State Board of Health is killing by 
the hundreds animals condemned by diagnosis with tuber- 
culin, and the State is paying full value for them. The 
veterinarian says that the autopsy shows the diagnosis 
to be correct in every case.' He says, also, that it is 
impossible for the best veterinarian to discover tubercu- 
losis by physical examination except in extreme cases. 
* My herd is apparently in splendid condition. Breeders 
do not know of its existence in their herds. They let a 
cow remain in the herd until she is unquestionably 
tuberculous, and then remove her, but she has then 
already infected the herd. A temperature of 103° F. 
condemns the cow.' In a herd of Jerseys, at Troy, of 80 
head, he has killed 33, and will kill 20 more of them this 
week. Autopsies are held in the presence of physicians 
and veterinarians. There have been 15,000 tests with 
tuberculin in England. New York evidently believes 
in this kind of diagnosis, and will probably have to pay 
$500,000 to eradicate tuberculosis. The veterinarian 
says the State is full of it, in herds of thoroughbreds 
and common cows. 
" We understand from other sources that the State 
Board of Health fully believes in the certainty of the 
tuberculin diagnosis. Through its means it has been 
discovered that some of the best-bred herds, supplying 
high-priced milk, cream, and butter are infected." 
It is apparent from this article, which is merely one of 
many similar statements, that we have not fully realized 
the relations of milk to the prevalence of the disease 
which is known to be the cause of one-seventh of the 4 
total deaths in civilized countries, and is the unsuspected 
cause of many more. 
It is, however, not only disease in the cow which may 
be conveyed. The conditions of farm-life are such that 
milk often conveys virulent, infectious diseases from the 
dairyman's family to his customers. Here, again, the 
literature is so abundant, and the facts are so generally 
known, that I need not stop to detail them. Those who 
are interested in this phase of the question will find some 
valuable and recent data in the report of the State Board 
of Health of Massachusetts. Several epidemics of 
typhoid fever were traced to milk supplied from a farm 
on which a case of this disease existed. 
We find, however, that even when milk is taken from 
cattle entirely healthy, and on farms in which no specific 
disease exists, it may become a most dangerous article 
of food. This is due to the decompositions which are 
induced in it by bacteria. Milk is a close approach to 
a perfect food. It is not an absolutely perfect food for 
human beings, because it is deficient in iron ; but it serves 
admirably as a medium for the growth of bacteria, many 
species of which produce remarkable changes in the 
casein, by which highly poisonous compounds are set free. 
Now, under the ordinary methods of milking, infection 
with multitudes of the common bacteria of the air, water, 
and even soil is certain to occur. That milk usually con- 
tains these is proved by the deposits obtained in centrifugal 
swimming, which show, under microscopic examination, 
many repulsive materials. When milk as ordinarily 
furnished is kept at summer temperature, the bacteria 
increase with great rapidity, and it is now recognized 
that a proportion of the infant-mortality in the warmer 
season is caused by this condition. In fact, the informa- 
tion at present in our possession shows that, unless col- 
lected under extreme precaution, raw milk, at least cow's 
milk, is not a suitable food for human beings. Hence 
the general practice of sterilization, which has resulted 5 
so favorably in the feeding of infants. Statistics have 
been recently published which show that death from 
tuberculosis occurs in large proportion in infants, the 
action being due to the entrance of the tubercle-bacillus 
into the lacteals, thus preventing the absorption of the 
food and causing death by starvation. 
I have endeavored so far to indicate briefly, but I hope 
distinctly, the idea that sanitary control of milk-supply 
may have little to do with the mere question of the 
chemic composition of milk. It is of very little moment 
to the consumer, except on a question of cost, whether 
milk contains 12, 13, or 14 per cent, of solids. The claim 
that milk watered or skimmed is unwholesome rests on 
no positive information, and within certain limits of vari- 
ation, the regulation of the composition of milk is no 
more a matter of sanitary duty than the regulation of 
the proportion of fat and lean in the meat sold in our 
markets, or the proportion of alcohol and extract in beer 
and ale. Nevertheless, economic considerations will 
doubtless lead to the establishment of some standard for 
milk, and it will be sufficient to fix the minimum, not the 
average. The time is passed when we can claim 9.50 
solids not fat for a standard, and even 9.00 per cent, is 
unjust. In my opinion, there should not be fixed in any 
legal enactment a higher figure than 8.50 per cent, of 
solids not fat, and 3.00 per cent, fat for whole milk. 
Skimmed milk should be permitted to be sold as such, 
and should not be required to contain any fat; that is, 
any one purchasing skimmed milk should assume that 
all the fat may have been removed. I have never been 
able to understand the logical process in the minds of 
those who desired to prohibit the sale of skimmed milk. 
However, when we remember that the same parties who 
last winter were trying to prevent the sale of skimmed 
milk proposed also to prohibit the sale of condensed 
milk containing less than twenty-five per cent, of fat, 
which would exclude all the standard brands in the 6 
market, we can appreciate the impracticable views that 
may be advanced. 
It has been the custom of some persons to designate 
the skimmed milk from centrifugals as " separator slop," 
but I am unable to see that such an article is any more 
of the nature of a refuse than buttermilk, whey, or cheese. 
The standard of the Society of Public Analysts of 
England, an organization which represents, I think, the 
highest judgment and experience on the question, is 8.50 
solids not fat and 3.00 of fat. Concerning this standard, 
Dr. Vieth, a dairy-chemist of large experience, recently 
expressed himself as follows : 
" My object is by no means to raise the cry that the 
standard adopted by the society is too high; on the con- 
trary, I think it is very judiciously fixed, but in uphold- 
ing the standard of purity it should not be forgotten that 
the cows have never been asked for, nor given their as- 
sent to it, and that they will at times produce milk be- 
low standard. A bad season for hay-making is, in my 
experience, almost invariably followed by a particularly 
low depression in the quality of milk, toward the end of 
winter. Should the winter be of unusual severity and 
length, the depression will be still more marked. Long 
spells of cold and wet, as well as of heat and drought, 
during the time when cows are kept on pasture, also un- 
favorably influence the quality, and, I may add, quan- 
tity of milk." 
Much discussion has been given to the effects of 
special forms of food and their relation to the whole- 
someness of milk. Legislation promoted by health- 
boards often involves prohibition of the use of brewers' 
grains or distilling refuse. In regard to these matters I 
desire to transcribe two personal letters received from 
Dr. Vieth, whom I have just quoted : 
" The reason that I have not acknowledged and an- 
swered your favor of August 21st ere this, is, that I de- 
sired to give you as much information as possible on the 7 
subject of the effect of brewers' grains and similar refuse 
on the wholesomeness of milk. 
" I suppose it is about the same in your country as it 
is in ours, viz.: that people are not slow in passing an 
opinion on the matter in question either one way or the 
other; but when one sets to work to follow the matter 
up, one finds these opinions not substantiated by facts. 
I was, when I received your letter, not aware of any 
publication on the matter in question, and have since 
taken much trouble to find one or collect information 
worthy to be transmitted to you. I am sorry to say that 
I have failed in my endeavors almost entirely. Hunting 
through the literature, I have found brewers' grains 
barely mentioned in connection with the question of the 
wholesomeness of milk-and have got the impression 
that no one thinks of expecting any bad effect from the 
use of that food. Here the question turns almost en- 
tirely about the admissibility of distillery-wash as food 
for milk cows. This food has a good many adversaries, 
but, it seems, even more defenders. It is generally ad- 
mitted that, when fed in moderate quantities and in a 
fresh state, and other food given besides, it will do no 
harm. When given in large quantities-say from fifteen 
to twenty gallons per day-it certainly produces a very 
poor milk, which is said to have a bad effect on infants. 
This is most likely true, but I have failed to find it 
proved by experiments or exact observations. The best 
observations on the subject I have come across are made 
by Prof. Konig, and are contained in a paper which has 
been published in Repertorium fur Analytische Chemie, 
1881. They are also based on theoretic speculation, 
and not on actual experiments. Before leaving the 
subject I should like to mention that there is most likely 
a considerable difference between brewers' grains from 
ale and from lager beer breweries. 
" When your card of the 21st ult. arrived I had just 
come into possession of some more evidence with regard 8 
to feeding milch-cows with distillery-wash; that is, the 
refuse from the manufacture of potato-spirit. Professors 
Konig, of Munster, and Maercker, of Halle, are two 
eminent authorities on the subject of cattle-feeding. The 
former is of opinion that there is no objection to giving 
to cows from forty to fifty liters of fresh distillery-wash per 
diem, provided other suitable food is given in addition. 
He would rather not have the distillery-wash used in a 
sour condition, and objects to feeding children with 
milk from cows which have received it. (In the pro- 
hibition of the use of distillery-wash he would see a 
serious injury ; but it should be demanded by law that 
milk thus produced should all be sold in the sterilized 
condition.) All the objections would be overcome by 
the use of distillery-wash in the dried state. 
" Prof. Maercker writes that the supposition that the 
milk from distillery-wash fed cows is injurious to health 
is in no way supported. The distillery-wash is com- 
pletely sterilized in its manufacture, which is not the 
case with any other food. If milk from distillery-wash 
fed cows has caused illness, the fault is that proper care 
had not been taken to keep the cowsheds, and more 
particularly the mangers, clean. Under such condi- 
tions, any food might produce similar ill-effects. 
" Ohlsen and Uffelmann, of Rostock, have made an in- 
vestigation into the matter and published the results in 
the Jahrbuch fur Kinderheilkunde, 34, vol. 1. The re- 
sults are, in short, as follows : 
"The milk from cows fed with distillery-wash is ot 
neutral, sometimes alkaline reaction. Acidity did not 
set in before the lapse of forty-eight hours. Provided 
suitable food be given in addition, the milk does not 
appear unsuitable for feeding infants. There is no proof 
that the milk produces indigestion or rachitis with in- 
fants. Microscopic and bacteriologic examination did 
not prove any difference from other milk. 
"The work of Ohlsen and Uffelmann is the first evi- 9 
dence on the subject, founded on exact observation, 
which has come to my knowledge, and as I thought it 
might be useful to you I wish to draw your attention to 
it without delay." 
It appears, then, that the danger from milk, as far 
as the dairyman is concerned, is the introduction of 
specific germs through diseased cattle ; and it is worthy 
of note that the liability to such disease is as great, if 
not greater, in cattle yielding rich milk than in those 
yielding poor milk. One of the reasons that sanitary 
officers have sometimes given for asking that the legal 
limits of milk shall be fixed above the average is that 
it will tend to "improve the quality of the dairy-cattle " 
supplying the city. Independently of the fact that it is 
no part of the sanitary method to develop superior 
types, it seems that such stimulation will lead to the 
worst conditions. Questions of chemic composition are 
trifling in proportion to the matter of the prevention of 
the spread of specific disease. The Medical News. 
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