[Reports and Appendices] of the Irish Milk Commission, 1911.

  • Great Britain. [Royal] Commission on the Irish Milk Supply.
Date:
1913
Catalogue details

Licence: In copyright

Credit: [Reports and Appendices] of the Irish Milk Commission, 1911. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    1032/1108 (page 150)
    John Robertson.—9th November, 1912. ]50 a sufficient quantity of milk available at all seasons of the year for the mothers having infants desiring to feed them artificially if they have money to buy?—Yes. 32146. And with regard to the quality of the milk, are you satisfied that it is such as is likely to nourish the children properly?—Yes. That is a point in regard to which I think there are some wrong opinions held at the present time, and I should like you to know my view on the matter. 32147. We should be very glad to?—It is this. I admit at once that a certain part of the milk that goes into every town in varying proportion is not as gc-od as one would like it from the point of view of cleanliness, but I feel very strongly that the milk that does couw in is not the great cause of the infant mortality, which is often attributed to it: that is to say, that by establishing, we will say, milk depots, or by various similar methods, I do not think that we should gain a very large amount by the extra cleanliness or the extra disinfection of germs in the milk that would arise from such procedure. Yon know now in American cities what a lot has been done there—all for the good, I admit at once, and a thing one would like to see heri>— in the direction of certified milk: but I do not think that alone is going to lower our infant mortality. In fact, I am quite sure it will not. My reason for that is this. We make very careful inquiries into the causes of the death, and the type of dwelling in which death takes place among infants, and we find that among the poorer half of the population of Birmingham—I am using the word poorer in its ordinarily accepted term— among the poorer half of the population, the whole of the deaths from, we will say, sunniier diarrhcEa take place, and that you have practically no deaths among the other half of the population. That is to say, you have got a town of 8r)0,000. There is one 400,000 with the whole of the deaths taking place among that group, and another 400,000 with a very large nimibor of infants with practically no deaths. 32148. A very limited death-rate?—It is practically a negligible thing. Now, I am certain there is not very much difference, there may be a little, but there is not very much difference in the milk supply of the two classes. That is to say, the better half of the population get ordinary commercial milk, and the poorer class get ordinary commercial work. Some of the better class probably get a better quality of milk I grant you, but that does not account for the difference; the diSerence is in the handling of the milk, and the care and feeding of the child in the dwellinghouse. While I say that I want to guard myself against any suspicion of being thought to be satisfied with the cleanliness of our milk supply as it is at the present time. 32149. The point you make is this : that the immunity from death amongst the better half of your population is not accounted for by the superiority of the food on which the children are nourished?—That is right. 32150. And most of the trouble that arises is con- sequent on careless or negligent habits on the part of mothers and nurses, and those in charge of baby children in the industrial houses?—Within the industrial houses. 32151. That is a clear and definite statement. You have no reason to believe or apprehend that these mothers are from any cause unable to procure milk for their children if they have money to buy?—No: I am quite sure that in Birmingham we have got an ample supply if they have money to buy it. 32152. And you .have not considered the situation so acute that it would be necessary for the public health authority to undertake any scheme for the establishment of milk depots to distribute milk to the industrial popu- lation at a reduced rate and to ensure its purity?—The question has not arisen here, so far as the inability of the poorest classes to obtain something which was a reasonably good article. Of course, we have considered the question of whether the establishment of a milk depot would be advantageous or not. I have had the question under consideration for a great roany years now; in fact, I thinlc I was one of the first in the United Kingdom to look into the question and draw attention to it. But I have never myself advocated a milk depot on the ordinary lines on which they have been advocated in St. Helens, Liverpool, Battersea, Edinburgh, Glasgow, and many other places, because I recognised at once that in all these places only the people who most needed it did not get it. 32153. Lady EvERAnn.—Do you allow your health visitors to order nourishment if necessary?—No, we do not allow the health visitors to give any charity what- ever. What we do is this : they are in contact with all the charities, and if they come upon a family requiring anything they give advice as to how best they can go about getting it, but they do not actually give it. For instance, we have in Birmingham the Charity Organisation Society; we have also got the City Aid Society, both aid societies, which give help in many ways. 32154. I see, yes?—And the health visitors instruct the parents how to approach these societies, or other kindred societies. 32155. The Chairman.—Those are purely philan- thropic organisations, and receive no aid from the rates? —No. 32156. Do you believe that the good properties of milk are impaired by pasteurisation or sterilisation?—To a limited extent they are. 32157. But not to any serious extent?—Not to a serious extent. 32158. And would you think the elimination of danger from bacilli would compensate for whatever injury might be done to the food properties of milk?— Well, I should have to qualify my answer to give it correctly. I think it would be undesirable to feed a child continuously upon something, milk being one of the things, which is continually sterilised. The danger, however, to young children of conveying disease by milk is so great that I think you would undoubtedly be wise to sterilise milk, but allow the child to have other things which were not sterilised, possibly later on. If a child were fed on sterilised food until four or five years old I am quite certain damage would result, but before the child becomes a year old he gets many things that arc not sterilised, and the danger is removed. 32159. Have you ever traced an outbreak of infectious disease to the milk supply?—Oh, yes, many. 32160. And do you consider the powers at present vested in the. Public Health Committee sufficient to deal with those cases?—Yes, in most instances. I have always found them ample. We have had many outbreaks, we will say, of scarlet fever and typhoid due to the milk, and by taking immediate action, and going to the source of the milk, and pointing out exactly what the dangers were, and what would result if they did not take action, we have got the necessary action taken at once. So that I think, as far as prevention of the serious infectious diseases goes, we have got powers that are quite good. 32161. And how far are they eSective in the rural districts from which a large proportion of your milk supply is drawn?—Of course, we only know when some- body in our own town, in our own citjs becomes ill, and there is some evidence that the illness is due to the milk supply; it is only then that we have any power to make any investigation. Stray cases, single cases, do happen, due to the milk supply, where we cannot take any action, because we have not any evidence with respect to that supply, but where a number of cases occur, and where we have got suspicion, we go out to the farm and make inquiries and put the thing right. 32162. Yes, but is not that rather a slow process to arrive at a result that would seem to need urgency. If the medical officer of health of a district in which a farm, say, twenty miles from Birmingham, is located, knows that scarlet fever or diphtheria is present in the family of the owner of the dairy, or any of those engaged in handling the milk, would it not be a more direct and proper method of arresting the supply if he were in a position to communicate with you straight off, and warn you against all probability of danger?— Obviously. It would not always follow, of course, that the milk supply would be stopped. 32163. Not necessarily stopped, but at the same time would it not be a precautionary measure that would be helpful to you in limiting the spread of the outbreak or the development of it?—Very much so, indeed; it would obviously be an advantage to us to know that one or two cases about which we are doubtful just now were traceable to the mill;. 32164. At the present moment, if you get a sporadic case cropping up here and there, and if it does not spread, you may come to the conclusion that that is due to some local cause, but if it becomes generalised in a district from which the milk supply is derived from one farm or one animal, then, of course, your suspicions are at once aroused. What I suggest is in order to lead to a more prompt discovery of danger, and thereby lessen the chance of its infecting the area outside that in which it is generated?—Obviously it would be of great advantage.