The Prevention Of Cholera Infantum And Kindred Diseases

TYROTOXICON, CHOLKRA INFANTUM, ETC. Tlic experimenta upon animáis (which are trlren In tlie full paper lo be publishcü in the animal report of the State Board of lleakh) con vinco me tli.-ii the ilevelopment of tyrotoxicon la milk s h frequent cause of cholera iiifuntum and kind red affectlons. When we remember that theae diseases are most prevalent among the poor classes of our large cities whe.ro fresh uillk is almost unknown, we can readily understand their frequency. By such people milk is often not obtained until it has begun to sour, then it is kopt at a high temperature umi often in a most foul atmosphere, and we all know sometbing ot the readiness with which milk takes up bud odors. This milk is theu eaten by the little ones who are weakened by poverty and everythinr that poverty mean?, instifücient food generally, and that of the poorest qiiality, insnfficient clotbing, insullicient and viliated air. With these] f acts before us, it is not surprising that in all our large cides thousands of cliildren die annually trom the slimmer diarrlxeas. Moreover, in our country places, how little attention is given lo the food of children, we all know from actual observation. Cows stand and are niilked in tilthy barns and yards. The udders are generally, so far as my observatlon goes, not washed beforc milking; the vessels for the milk are frequently found not as clean as they should be. Then there are the tbousands of children that must draw their sustenance from bottles, the cleansing of which is iu many families not properly attended to. Crusts of the decomposing milk liiíii around the neck of the bottle, In the tube and nipple, and lead to the rapid decompositiou of the entire contents of the bottle. [ think that one of the most important advantages to be secured to breast-fed children ariMf from the lessened danger of inlection of the milk with aerms which may produce poisonous ptomaines. 1 wi-uld not claim thatdecomposed milk is the solé cause of the suuuue r diarrluuas of children, nor would I claim that tyrotoxicon is the only poieon that may be developed in milk. It is only one of a large class of bodies which are produced by putrefaction, and niauy of tiiese are catliartic in action. RULES FOR THE I'REVENTION OF TYROTOXICON IN MII.K. 1. The cows should be healthy and the milk of any animal which seems ïndisposed should not he mixed with that trom the pcrfectly healthy aiiimxlü. 2 Cows must not be fed Upou swill or the refuse of breweries, or glucose faetones or any other fermonted food. 3. Cows must not be allowed to drink stagnant water; but must have free aecess to pure, fresh water. 4. Cows must not be heated or worried before being milked. 5. The pasture must be free frnrra noxious weeds, and tbe barn and yard must be kept clean. 5. The udders should bc washed, if at all dlrty, before the milking. 7. The milk must beat once thornughly cooled. This is best done by pliuflng tb milk can in a tank of cold spring water or ice-water, the water being of the same depth as the milk in the can. It would be well if the water in the tank could be kept tlowing; indeed, this will be necesi-aiy uulesB ice water is used. The tank should be thoroughly cleaned evory ilay to jirevent bad odors. The eau should remain unoovered during the cooling, and the milk should be gently stirred. The temperature should be reduced to 60 F. witbin an hour. The can shonld remain in the cold water until ready for Uelivery. 8. In suminer, when ready for delivery, the top should be placed on the can and a cloth wet In cold water shotild be spread over the can, or refrigerator enns may be used. At nu season should the milk be f rozen ; but no bu ver should rocrive milk which a temperature hijrher than 65 F. 9. After the milk has been received by the consumer, it should be kept iu a perfectly clean place, free from dust, at a temperature not excecding 00 F. Milk should not be allowed to stand uncovered, eyen fora short time, iu sleeping or living rooms. In many of the better houses in the country and villagcs, and oceasionally in the cities, the drain from the rt-fi igerator load into a cesspool or kitclien drain. This is highly dangerous; tlioro should he no conuection between the refrlgerntor and any receptacle of tiltli. 10. The only vossel. in wliich milk should be kept are tin, or porcclain. After using the vessel, it thould be sciildcd and then, if possible, exposed to the air. PUEVKNTION OF SUMMER I 1 V lil; II 1 s. But in the prevention of the summer diarrhuias, attentiou to the food must not slop with lts introduction into the body. The ferment which produeei tyrotoxicon is widely distributed, and it only awaits conditions suitable for ils development. We do not know exactly wlmt germ it is that produces this poison; but it is cither the butyric ai:id fenueut or some ferment which ís frequently developod alon;; with tlie bacillu butyrivuu, becausu I have found that If some butj'ric acid ferment bc repared uccordiug to the method usually followetl in inakln? butyric neiil, and milk bc tnocculated with this and llowed to staml at tbc tempcriiture of the body lor a few hours or at the ordlnary tumpersture of tlie room for 8överal diiyg, the poison will appear. Moreover, as is well known, the bacillut butyricus grows lH"St in the absence of air, we have alrcady seen that the exclusión of air fnvofs tht' dcvclopment of tyrotoxicon. We are ware ot the fact that the butyric acid férfnent (icqin-tilly d( ep develop In the stomnch. Therefore, 1 think th.it tbe prevention of these disensos neceMitates some atteutlon to digestión. If the food lies in tlie stomao.h or iutestines undigested, putref active changes will occur there. During the hot month, children who are allowed to take food at will often drink large quanlities of milk slinply for the purpoM) of quenching thirst. I feel that this overlonding the stomach with milk, caused by thirst, often ia oL no litilo (letriment. It is liardly neéetMtj ti sjiocify in ngttfi O other ways in which atteution should be given to the digestive organs of children. Those that partake of other foods with their milk should be ullowed onlv the niot wholesome artieles, HMil tUé KjlOllld he tl most pol teel ooudilion. Moreover, the depressing effoctó of extremo heat on the uervous System and its consequent iiyury to digestión should alwaysbe borne in mimi. WIIAT TO 1H WHKN SUMMER IHARRIK1 s OCCUR. The fin thing to do t (o stop the wiiiintration of mük in any form. The terment is present in the alimentary canal and giving the best of mllk would be slmply suppljiug the geroi with material for the production of the poison. This no-milk tre.itinent is not by any a new idea; but the reason of It lias not beeu hilherto understood. Now, that we know wbat that a powerful poison is formad trom the putrefaction of milk, the necessity of its exclusión must become appareut to all. The loods used may conslat of chicken and mutton broths. beef juiee, and rice or burley water. With thls list no difflculty will be experienced in living the child eufflcient nourishment.