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The milk supply of New York City
9~66
PUBLIC HEALTH.
By means of the Far Eastern Bureau of the Epidemiological Intelligence Service just established at Singapore, wireless information is now being received weekly on the incidence of cholera and plague in Far Eastern ports. The Health Committee authorised endeavours to obtain from the health administrations concerned similar telegraphic information from Mediterranean and Black Sea ports. All this material is worked up into regular epidemiological bulletins, which will eventually be wirelessed to all health administrations. The work of the Commission on Public Health Instruction was approved and the Committee gave instructions to proceed on the same lines, namely to ascertain which of the factors in the teaching of hygiene in different countries may be utilised to the best advantage for promoting human welfare and to analyse the different kinds of instruction in hygiene in relation to general medical education and to the habits of the public. It was decided to continue the work of the Tuberculosis Commission on the incidence of tuberculosis, with the principal object of ascertaining the cause of the general decline in tuberculosis and the reasons for the great differences in tuberculosis mortality and morbidity in different countries. It is hoped that this investigation will throw light on the relative importance of the different causes of tuberculosis. The Cancer Commission of the Health Committee is for the moment confining itself to the investigation of the specific problem of the difference in cancer mortality in various countries. The cancer mortality in certain cases, for example, is twice as great in England as in Italy. The work done so far has established the fact that this difference is real, and not due to external causes such as better diagnosis or more accurate statistics. Future investigations will comprise work in the United States and Switzerland, under the direction of the national health authorities. The Health Committee further decided that two of its principal members should present a preliminary report for the next session in regard to abuses arising from the use of patent medicines. Among other matters considered 1by the Committee, on which Sir George Buchanan is the representative of the British Government, were the standardisation of sera and serological tests, the epidemiology of small pox, sanitary regulations concerning emigration and immigration, and malaria control. It will be gathered therefore that this branch of the League's activities is doing a great deal to promote useful and harmonious co-operation between the nations.
JUNE,
T H E M I L K SUPPLY OF NEW YORK CITY. The improvement of the milk supply is so difficult to accomplish on account of the many interests involved that the experiences of other countries, and especially those of the United States of America, where concerted efforts have proved very successful, are of the greatest value and are worthy of careful consideration. Mr. Wilfred Buckley, who has done so much to focus the attention not only of the general public but also of the farmers on the pressing need for a clean milk supply, has investigated the present position of the milk supply of New York City, and has published under the auspices of the National Clean Milk Society, with which he is so closely associated, the results of his observations. He has always bean a strong protagonist of grading of milk, in fact,in this he has differed in his opinion from most of us; nevertheless, his work in the interests of clean milk has been invaluable. Mr. Buckley points out that the general milk supply of New York is classified into four grades, Grade A raw, Grade A pasteurised, Grade B pasteurised, and Grade C pasteurised (for manufacturing purposes only). Grade A is equal to our Certified milk in being produced from tuberculin tested cows, in being cooled to 50 ° F., and in containing a maximum number of bacteria of 80,000 per c.c. This grade includes Certified Milk as authorised by the State law. Grade A pasteurised is from cows which have been examined by a veterinary surgeon, is cooled to 50° F., and does not contain more than 80,000 bacteria after pasteurisation or 200,000 before pasteurisation. The third Grade, Grade B, is similar to Grade A except that after milking it should be cooled to a temperature not exceeding 60° F., and should not contain 100,000 bacteria after pasteurisation or 1,500,000 before pasteurisation. According to Mr. Buckley, Grade C is in reality a penalty grade, and seldom if ever, is any milk sold under this designation. It is interesting to note that the only raw milk sold is of the quality of Certified Milk, all other milk being required to be pasteurised. Pasteurisatlon in New York City means heating to a temperature of at least 142" F., and holding at such a temperature for 80 minutes or more. Delivery of all milk must be made in sealed bottles. In London, and in some of the provincial towns, particularly Birmingham, the tendency is to have all except Certified or Grade A (Tuberculin Tested) milk pasteurised by the positive holder method as defined by the Milk (Special Designations) Order at 145° F., for 80 minutes. So long as insufficient care is exercised at the cowsheds and so long as
19~.
PUBLIC HEALTH.
regular veterinary inspection of the cows is lacking the natural tendency will be the pasteurisation of the general milk supply, at least in London, and in the larger towns. Mr. Buckley in his pamphlet particularly draws attention to the high quality of the milk supplied in New York by the Clover Farmers Company, consequent on their action in supervising the farmers and in getting them to deliver milk of a high quality, much of which is supplied to the Infant Welfare Centres of that City. The high quality of the milk has been obtained by the payment of a bonus to the farmers according to the bacterial quality of their product. This method has met with some success at Birmingham where, as Dr. Robertson has previously pointed out, a certain distributing company has effected a great improvement in its supplies by offering bonuses in a similar manner to producers. The general adoption of this practice on the part of distributors would go a long way towards improving our general milk supply. The milk question is not a simple one, on the contrary, there are many difficulties to surmount and different methods may succeed under different conditions. One thing of which we are convinced is that whatever method promises to bring about an improvement is worthy of a serious trial. THE
P R O T E C T I O N OF U N D E R G R O U N D WATER.
The ever-increasing demand for water in England and Wales, due not only to the growth and greater urbanization of the population, but also to the larger consumption of water per person, and the demand for higher standards of purity render the present unsatisfactory position with regard to underground water as a danger that must be remedied at the earliest possible moment. To meet this demand requires not only efforts to find fresh sources of supply, but also that existing supplies should be conserved and safeguarded. The report recently issued by the Advisory Committee on Water, of the Ministry of Health, refers to the latter only. Whilst all water authorities are compelled to take such steps as will not deprive any neighbours of their water rights, these neighbours are under no such restriction and can deprive the authority of water by sinking wells, etc., and may carry out works which may ultimately effect the purity of the water. Mines and shafts may be sunk, and thus denude the whole surrounding area of water, and the aggrieved persons have no remedy. So many instances of such effects (vide appendix to
267
report) have come to the notice of the Ministry of Health that they decided to appoint an Advisory Committee, which has resulted in the publication of the Report under review in the hope that water engineers, Medical Officers of Health, and others, will make further suggestions before the Ministry proceed to draft a Bill for submission to Parliament. The Report deals mainly with the protection of good underground water from waste and pollution. The principal interest affected is that of mining. A fair remedy ought to be found, as it is to the advantage of the mining industry to prevent the incursion of underground water. Waste.--Under the common law every landowner has unfettered rights in regard to all water under his land which does not flow in defined channels. He is entitled to abstract an unlimited quantity of such water for his own use or sale to others, and he may allow any water, which he does not require, to run to waste. Instances are quoted such as : An East Kent colliery pumps water from strata below the chalk and discharges it on the surface in large quantities; another colliery Company elsewhere pumps huge quantities of water to waste within a water company's statutory limits; in Flintshire lead-mining operations have tapped the source of St. Winifred's well at Holywell ; disturbances in water-bearing strata through mining operations divert the natural flow of underground water into new channels, and thereby affect the supply of water in wells. PoUution.--Heavy pumping by a colliery company has had the effect of drawing sea-water into the underground supplies of a neighbouring public well, and thus rendering the water unfit for public supply purposes. Waste water discharged on the surface in great quantities has gained access to and contaminated the water in the chalk formation. The remedy suggested is some form of State control, in order to remove or mitigate the harmful result of the present system. Particular reference is made t o (a) The control of the abstraction of underground water. (b) The prevention of waste of underground water. (c) The prevention of contamination of underground water. With certain defined exceptions, it is proposed to make it unlawful for any person to commence to construct any new well, boring, shaft, etc., or extend any existing well, boring, or adit, for the purpose of abstracting underground water unless he has given notice to that effect, and if objection
PUBLIC HEALTH.
By means of the Far Eastern Bureau of the Epidemiological Intelligence Service just established at Singapore, wireless information is now being received weekly on the incidence of cholera and plague in Far Eastern ports. The Health Committee authorised endeavours to obtain from the health administrations concerned similar telegraphic information from Mediterranean and Black Sea ports. All this material is worked up into regular epidemiological bulletins, which will eventually be wirelessed to all health administrations. The work of the Commission on Public Health Instruction was approved and the Committee gave instructions to proceed on the same lines, namely to ascertain which of the factors in the teaching of hygiene in different countries may be utilised to the best advantage for promoting human welfare and to analyse the different kinds of instruction in hygiene in relation to general medical education and to the habits of the public. It was decided to continue the work of the Tuberculosis Commission on the incidence of tuberculosis, with the principal object of ascertaining the cause of the general decline in tuberculosis and the reasons for the great differences in tuberculosis mortality and morbidity in different countries. It is hoped that this investigation will throw light on the relative importance of the different causes of tuberculosis. The Cancer Commission of the Health Committee is for the moment confining itself to the investigation of the specific problem of the difference in cancer mortality in various countries. The cancer mortality in certain cases, for example, is twice as great in England as in Italy. The work done so far has established the fact that this difference is real, and not due to external causes such as better diagnosis or more accurate statistics. Future investigations will comprise work in the United States and Switzerland, under the direction of the national health authorities. The Health Committee further decided that two of its principal members should present a preliminary report for the next session in regard to abuses arising from the use of patent medicines. Among other matters considered 1by the Committee, on which Sir George Buchanan is the representative of the British Government, were the standardisation of sera and serological tests, the epidemiology of small pox, sanitary regulations concerning emigration and immigration, and malaria control. It will be gathered therefore that this branch of the League's activities is doing a great deal to promote useful and harmonious co-operation between the nations.
JUNE,
T H E M I L K SUPPLY OF NEW YORK CITY. The improvement of the milk supply is so difficult to accomplish on account of the many interests involved that the experiences of other countries, and especially those of the United States of America, where concerted efforts have proved very successful, are of the greatest value and are worthy of careful consideration. Mr. Wilfred Buckley, who has done so much to focus the attention not only of the general public but also of the farmers on the pressing need for a clean milk supply, has investigated the present position of the milk supply of New York City, and has published under the auspices of the National Clean Milk Society, with which he is so closely associated, the results of his observations. He has always bean a strong protagonist of grading of milk, in fact,in this he has differed in his opinion from most of us; nevertheless, his work in the interests of clean milk has been invaluable. Mr. Buckley points out that the general milk supply of New York is classified into four grades, Grade A raw, Grade A pasteurised, Grade B pasteurised, and Grade C pasteurised (for manufacturing purposes only). Grade A is equal to our Certified milk in being produced from tuberculin tested cows, in being cooled to 50 ° F., and in containing a maximum number of bacteria of 80,000 per c.c. This grade includes Certified Milk as authorised by the State law. Grade A pasteurised is from cows which have been examined by a veterinary surgeon, is cooled to 50° F., and does not contain more than 80,000 bacteria after pasteurisation or 200,000 before pasteurisation. The third Grade, Grade B, is similar to Grade A except that after milking it should be cooled to a temperature not exceeding 60° F., and should not contain 100,000 bacteria after pasteurisation or 1,500,000 before pasteurisation. According to Mr. Buckley, Grade C is in reality a penalty grade, and seldom if ever, is any milk sold under this designation. It is interesting to note that the only raw milk sold is of the quality of Certified Milk, all other milk being required to be pasteurised. Pasteurisatlon in New York City means heating to a temperature of at least 142" F., and holding at such a temperature for 80 minutes or more. Delivery of all milk must be made in sealed bottles. In London, and in some of the provincial towns, particularly Birmingham, the tendency is to have all except Certified or Grade A (Tuberculin Tested) milk pasteurised by the positive holder method as defined by the Milk (Special Designations) Order at 145° F., for 80 minutes. So long as insufficient care is exercised at the cowsheds and so long as
19~.
PUBLIC HEALTH.
regular veterinary inspection of the cows is lacking the natural tendency will be the pasteurisation of the general milk supply, at least in London, and in the larger towns. Mr. Buckley in his pamphlet particularly draws attention to the high quality of the milk supplied in New York by the Clover Farmers Company, consequent on their action in supervising the farmers and in getting them to deliver milk of a high quality, much of which is supplied to the Infant Welfare Centres of that City. The high quality of the milk has been obtained by the payment of a bonus to the farmers according to the bacterial quality of their product. This method has met with some success at Birmingham where, as Dr. Robertson has previously pointed out, a certain distributing company has effected a great improvement in its supplies by offering bonuses in a similar manner to producers. The general adoption of this practice on the part of distributors would go a long way towards improving our general milk supply. The milk question is not a simple one, on the contrary, there are many difficulties to surmount and different methods may succeed under different conditions. One thing of which we are convinced is that whatever method promises to bring about an improvement is worthy of a serious trial. THE
P R O T E C T I O N OF U N D E R G R O U N D WATER.
The ever-increasing demand for water in England and Wales, due not only to the growth and greater urbanization of the population, but also to the larger consumption of water per person, and the demand for higher standards of purity render the present unsatisfactory position with regard to underground water as a danger that must be remedied at the earliest possible moment. To meet this demand requires not only efforts to find fresh sources of supply, but also that existing supplies should be conserved and safeguarded. The report recently issued by the Advisory Committee on Water, of the Ministry of Health, refers to the latter only. Whilst all water authorities are compelled to take such steps as will not deprive any neighbours of their water rights, these neighbours are under no such restriction and can deprive the authority of water by sinking wells, etc., and may carry out works which may ultimately effect the purity of the water. Mines and shafts may be sunk, and thus denude the whole surrounding area of water, and the aggrieved persons have no remedy. So many instances of such effects (vide appendix to
267
report) have come to the notice of the Ministry of Health that they decided to appoint an Advisory Committee, which has resulted in the publication of the Report under review in the hope that water engineers, Medical Officers of Health, and others, will make further suggestions before the Ministry proceed to draft a Bill for submission to Parliament. The Report deals mainly with the protection of good underground water from waste and pollution. The principal interest affected is that of mining. A fair remedy ought to be found, as it is to the advantage of the mining industry to prevent the incursion of underground water. Waste.--Under the common law every landowner has unfettered rights in regard to all water under his land which does not flow in defined channels. He is entitled to abstract an unlimited quantity of such water for his own use or sale to others, and he may allow any water, which he does not require, to run to waste. Instances are quoted such as : An East Kent colliery pumps water from strata below the chalk and discharges it on the surface in large quantities; another colliery Company elsewhere pumps huge quantities of water to waste within a water company's statutory limits; in Flintshire lead-mining operations have tapped the source of St. Winifred's well at Holywell ; disturbances in water-bearing strata through mining operations divert the natural flow of underground water into new channels, and thereby affect the supply of water in wells. PoUution.--Heavy pumping by a colliery company has had the effect of drawing sea-water into the underground supplies of a neighbouring public well, and thus rendering the water unfit for public supply purposes. Waste water discharged on the surface in great quantities has gained access to and contaminated the water in the chalk formation. The remedy suggested is some form of State control, in order to remove or mitigate the harmful result of the present system. Particular reference is made t o (a) The control of the abstraction of underground water. (b) The prevention of waste of underground water. (c) The prevention of contamination of underground water. With certain defined exceptions, it is proposed to make it unlawful for any person to commence to construct any new well, boring, shaft, etc., or extend any existing well, boring, or adit, for the purpose of abstracting underground water unless he has given notice to that effect, and if objection