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14
those who were first breast-fed and subsequently hand-fed furnished
a rate of 21.6, and those who were exclusively hand-fed, a rate of 51.7.
As pointed out in my last Report, there are, of course, numerous
circumstances contributing to the deplorable infantile mortality in
cur large cities, but improper feeding and maternal neglect are two
of the most important factors in the problem. As a factor in the
reduction of infantile mortality a pure milk supply (comparatively
free from dirt and preservatives) is perhaps the greatest public
health need of the day.
The arguments in support of the frequent veterinary inspection
of cows, the milk of which is used for human consumption (whether
as milk, cream or butter), is overwhelming. The inspection is more
particularly necessary as a precaution against the spread of Tuberculosis.
Veterinary Authorities are agreed that some 20 per cent.
of milch-cows are tuberculous and that about 1 to 2 per cent. of
these have tuberculous deposits in their udders. It is not surprising,
therefore, that of the dairy samples of milk taken in our large towns
and examined over 10 per cent. of these have been found to contain
the tubercle germ. The present Royal Commission, as the result of
a mass of most painstaking and exact experimentation, unanimously
conclude that the human and bovine diseases are caused by the same
germ, and are therefore intercommunicable; and this is the conclusion
of practically all living experts, Koch and a few followers being
the sole exceptions-
Such an inspection cannot be provided by the Rural and small
Urban Sanitary Authorities, for many reasons, and it certainly would
not be fair to saddle all the expenses involved upon the dairy districts.
Failing these authorities, the duties would devolve upon the County
Councils, and failing them, upon the Local Government Board, or
the Board of Agriculture. Personally, I should favour a system of
a quarterly inspection under the latter Board, and it should
have power to act quite independently of the local sanitary