Apart  from  this.it  has  been  demonstrated  that  milk  is  the  most  fre-
quent cause  of  cholera  infantum  and  the  diarrheal  diseases  in  children,
especially  when  such  milk  is  produced  under  unclean  conditions,
which,  together  with  a  high  temperature,  favor  rapid  germ  prolifera-
tion and  tne  production  of  toxins.  Milk  may  also  be  rendered  unfit
for  use  and  cause  sickness  in  children  by  reason  of  improper  food  of
the  animal,  or  while  the  animal  is  being  treated  with  strong  remedial
agents,  which  may  be  excreted  in  the  milk,  and,  finally,  milk  may  be
morbific  as  the  product  of  a  diseased  animal.  I  have  elsewhere  pointed
out  that  inflammatory  conditions  of  the  udder  and  teats,  especiallv  the
conditions  known  as  garget,  are  doubtless  responsible  for  a  large
number  of  cases  of  pseudodiphtheria  and  other  septic  infections.  The
milk  of  animals  sunering  from  acute  specific  enteritis,  puerperal  and


17GU  GOVEByMEST    UOSPITAL   FOB   THE   INSANE.
other  i^eptic  fevers,  foot-and-mouth  disease,  cowpox,  anthrax,  pleuro-
pneumonia, rabies,  and  tetanui^  haa  al^o  been  known  to  produce  sick-
ne88  in  the  consumer.
A  review  of  the  milk  l^islation  shows  that  the  laws  which  have
been  enacted  deal  largely  with  the  prevention  of  milk  sophistication,
and  those  who  are  familuir  with  the  surroundings  of  our  milk  farms
and  the  habits  of  the  average  dairy  employees  need  no  argument  for
the  necessity  of  sanitary  reforms  and  additional  legislation  upon  this
subject.  Smce  it  is  doubtful,  however,  whether  l^islation  in  matters
of  this  kind  is  ever  as  effective  as  public  education,  the  establishment
of  sanitary  dairies  and  creameries  should  be  encouraged.  Such  insti-
tutions, in  addition  to  official  control,  are  subject  to  frequent  unan-
nounced inspections  by  members  of  voluntary  milk  commissions  and
have  doubtless  a  very  useful  future.
