THE SUPPLY OF PURE MILK
IT is becoming more and more certain that the character and quality
of the actual things--the natural products--which we use as food and
accept as "diet" are far more important matters in regard to the
preservation of health than had been until recently supposed. There has
been a tendency, resulting from some of the well-ascertained chemical
necessities of the animal body and the equally well-ascertained
chemical composition of different articles of food, to suppose that
all that we have to do in regard to diet is to make sure that our
food supplies us with so much carbon, hydrogen, nitrogen, and oxygen,
with small quantities of phosphates, sulphates, and chlorides of
potassium, sodium, calcium (lime), and iron, in a "digestible" form,
in order to replace those chemical elements as their combinations are
used up and thrown off as waste by our bodies. The general notions
current are little more exact than this. It is recognized, it is true,
that these elements must be combined in certain forms; that it is
necessary to take so much "proteid" (meat, gluten of flour, casein
of cheese and milk, albumen of egg), in which nitrogen is a leading
component, foods which are called flesh-formers; and, further, that it
is necessary to take others which supply carbon and hydrogen but have
no nitrogen, namely, the hydro-carbons--fat, butter, and oil--and
the carbo-hydrates--sugar and starch--foods which serve as mere fuel
or heat-and-force givers. The late proprietor of "Truth," Mr. Henry
Labouchere, once said to me that the doctors ought to provide us with a
sausage containing in their simplest form the necessary proportions of
proteid and of heat-giver (fat and sugar), and that we should abandon
all "sit-down" meals, pulling the necessary sausage out of our pockets
without any fuss or interruption to our occupation, and eating a couple
of inches or so, three or four times a day! Experimental feeding of
animals (in menageries, etc.), and even of men (in prison, on the
march, and on ships), has sometimes taken very nearly as simple a form
as this.
But we now know (and many, indeed, have recognized it for many years)
that the nutrition of the animal body, and especially of man's body, is
not so simple a matter as this method would suppose. It is necessary
not merely to supply the proteids, fats, starches, and sugars, in
correct weight and bulk, but also certain qualities and substances in
food, much more subtle and difficult to estimate precisely, which are
required in order to maintain health. There are elaborate chemical
compounds present in really "fresh" meats and vegetables which seem to
be absolutely necessary in order to keep man (and some of the higher
animals) in health, and not only that, but it is ascertained that
without them he cannot be properly nourished, but dies! These subtle,
highly complex bodies seem to be present in very small quantities in
good fresh food, and yet are absolutely necessary though so minute in
amount. The failure of a diet consisting exclusively of tinned meats
and preserved foods is due as much to this as to the nausea set up by
it--of which I have written on a former occasion ("Science from an
Easy Chair," Second Series, 1913, p. 171, "Food and Cookery").
Let us take an example. A distinguished medical chemist, Mr. Gowland
Hopkins, has recently published an account of some experiments in
which he fed young rats on a purely chemical, or "artificial" diet. He
gave them, in proper proportions, chemically purified casein or curd,
starch, sugar, lard, and salts, mixed into a thin paste with water,
of which they had an abundant separate supply. Young rats fed with
abundant natural foods of mixed substances, such as cheese, bread,
egg, bits of meat and vegetable, and water, grow rapidly; they double
their weight in twenty days. The young rats fed by Mr. Hopkins upon
the artificial pure food--though supplied with it and taking it in
abundance--did not increase in weight, and most of them died before
the twentieth day! The curious and important fact was established (by
careful and repeated experiment) that if a teaspoonful of milk was
added to the artificial food (less than one twenty-fifth of the solid
matter of their daily food) the young rats did as well as on "natural"
food, doubled their weight in twenty days, and grew up to be strong
and healthy rats. It was made clear that something was obtained by the
rats from the small quantity of milk--something necessary for carrying
on their nutrition, something the importance of which was not its
quantity but its peculiar quality, which was absent in the artificial
diet, but present in the mixed diet of varied materials which a young
rat naturally gets. It seems that some highly elaborated proteid is
necessary, if only in minute quantity, to set nutrition going, and that
this is furnished by the teaspoonful of milk. Here, then, we have a
case in which the simple rough conclusions as to all that is necessary
in diet being the proper quantities of flesh-forming and heat-giving
substance, are found to be erroneous.
Take another case--that of the disease known as "scurvy." The word
"scurvy" means "afflicted with scurf, mean and dirty." It was applied
to persons afflicted by this particular disease, and a Latin medical
word, "Scorbutus," was made from it in the Middle Ages, which survives
as "scorbutic" at the present day. Scurvy was formerly very common on
board ship, in beleaguered armies, in prisons, and in other conditions
in which men's food was limited to dried and salted, often badly
preserved, meat and biscuit, or stale bread. Its real causation is
not even now agreed upon: some holding that it was due to actual
poisoning by the badly preserved food, others that it was due to the
absence of certain elements--only to be obtained from fresh meat or
fresh vegetables. Others think that it was caused by a bacterium. The
victim of scurvy becomes much debilitated, the gums become spongy and
ulcerated, and extravasations of blood are found in all parts of the
body, often leading to ulceration. In the old times a whole ship's crew
of the Navy would be attacked by it, and half or more died before a
port could be reached and fresh food obtained. It was found that the
use of fresh vegetables, fresh meat, and the juice of fruits prevented
its outbreak, and cured it when once started. For one hundred and fifty
years it has been held in check by the use of lime-juice as a drink
whenever supplies of fresh vegetables and meat run short. It has now
become so unusual a disease that there has been no proper study of it
in the light of modern knowledge.
It seems to be essentially the same condition of malnutrition as
that which prevailed in cities and large tracts of country in the
Middle Ages and occurs at the present day in Norway, caused by a diet
of badly salted fish and dried meat. This produced ulceration of the
extremities, allowing the leprosy bacillus to make its way through the
broken skin into the tissues, and thus led to the widespread occurrence
of leprosy. Whether bacilli of any kind were concerned in the old
virulent outbreaks of "scurvy" on sailing ships must remain uncertain,
but it is highly probable that they were. In any case, it is certain
that the juice of fresh meat or of fresh vegetables when taken set
going a better condition of nutrition in the body, and so acted as
a preventive and a cure of scurvy. Some writers suppose that it was
the salts, such as citrates and lactates, present in fresh fruits and
vegetables which were effective in staying the disease; but this has
by no means been proved, and is not, at the moment, accepted. It is
probable that here, as in the case of Mr. Hopkins's rats, it was a
quite minute quantity of a readily-destroyed proteid present in fresh
meat and vegetables which was necessary to keep the chemical processes
of nutrition in healthy activity.
This view is supported by the fact that in recent years a disease of
infants similar to scurvy, and called "infantile scurvy," has been
described by Sir Thomas Barlow, and fully recognized. It is a condition
of "malnutrition," and is accompanied by "rickets," and is due in the
first place to failure of the mother's milk, and secondly to the bad
quality of the cows' milk substituted for it. Owing to the danger
of infection by bovine tubercle-bacillus and the great expense of
"certified" milk from specially selected cows (eightpence a quart),
it is customary to boil the milk given to children. There seems to
be no doubt that good milk, freshly boiled, is satisfactory. But the
constant use of sterilized milk and so-called Pasteurized milk, as
well as inferior "watered" and more or less stale milk, is frequently
the cause of infantile scurvy. Something is destroyed in the milk by
prolonged heating which is necessary for its proper action as a food.
The addition to the milk of a small quantity of fresh meat-juice
or beetroot-juice appears to replace this destroyed matter, and to
prevent malnutrition and scurvy. And thus the babies are rescued from
"infantile scurvy." Here, again, it is a question of the presence of a
minimal quantity of an easily destroyed proteid, which is necessary to
start the nutritional process and to keep it going.
A very interesting case of the unsuspected influence of minute
quantities of such a "proteid" body (that is, a body like casein and
albumen, but higher in the complexity of its chemical structure and
nearer to the readily destroyed chemical complexity of living matter
itself) has lately been discovered. In the East, especially amongst
Chinese "coolies" and other people who feed on rice, a very troublesome
disease is known, called "Berri-berri." It is chiefly marked by pains
all over the body, lassitude, and debility, and renders its victims
unfit for labour, and so causes great inconvenience to employers of
"Chinese cheap labour." All sorts of causes have been suggested for
it. But it has now been found that it is due to the feeding of the
coolies with "polished rice." This is an inferior rice, the grains
of which have become (by bad, damp storage) rough and powdery on the
surface. The bad rice grain is purchased by dealers and shaken up and
sifted so as to get rid of this dull surface, and is then known as
"polished rice." The grain has lost its outer coat. It has been found
that domesticated birds (pigeons and fowls) fed on this polished rice
become ill with symptoms like those of "Berri-berri," and even die.
And it has been further discovered that these same birds can be cured
by mixing some of the separated outer coat of sound rice grains with
the "polished rice." The result of this observation on birds has been
applied to human patients suffering from "Berri-berri." It is found
that they are rapidly cured by giving them rice "outsides" to eat, and
that those who are feeding on "polished rice" can be prevented from
acquiring the disease "Berri-berri" by mixing rice "outsides" with the
polished rice. The study of the subject has gone further.
A crystallizable substance allied to proteids has been separated by the
chemist in quite minute quantity (one part by weight in 10,000 parts of
rice) from the outer coat of rice grain, and is called "vitamine." It
is this substance which prevents the "whole" rice grain from causing
"Berri-berri" in men and birds who feed on it, and it has been shown
experimentally that it prevents the development of "Berri-berri" when
taken with "polished rice," and cures it when administered to man or
bird suffering from that disease. This case calls to mind the popular
notion that the indigestion caused by eating a "peeled" raw cucumber
can be prevented by eating some of the dark-green "rind" or outside
of the cucumber. I do not know that anyone has ever shown that this
is a true doctrine, but it serves as an illustration of what has been
demonstrated in the case of rice grains and "Berri-berri." Here, then,
again we have, in the case of rice, a minute quantity of a substance
naturally present in an article of food when taken in its natural
normal condition, which is destroyed and removed by the ignorant
manipulation of man, although necessary and essential if that article
of food is to serve as healthy diet. In this case (as so many others)
it is the attempt of greedy traders to make money by giving to a
worthless spoilt article the appearance of the regular and valuable
article, which has led to disease and disaster. It becomes more and
more obvious that the selection of articles of food and the whole
question of what is a healthy diet, are not such simple things as is
often supposed. Here, as in everything we do, we must either keep to
the long-established habits sanctioned by Nature, or we must have full
and detailed knowledge to guide us in new ways, so that we shall not
recklessly blunder by ignorance into disaster and death. The "feeding"
of man and of his herds requires new and continued investigation. Old
convictions and traditions in these matters must not be lightly thrust
aside by the possessor of that little knowledge which is a dangerous
thing. Meanwhile, for the civilized man the advice of Pasteur's pupil
and successor, the late Professor Duclaux, is noteworthy: "Do not
eat much, but eat many things; there is safety in variety, danger in
uniformity."
When we reflect on the importance of these small quantities of easily
destroyed constituents in natural foods, we begin to appreciate the
difficulty of securing a pure milk-supply which shall be at the same
time a nourishing and a healthy one. The sterilizing of milk by heat
before it is sold as an article of diet seems to be desirable in order
to destroy the bovine tubercle-bacillus which may be there and the
other injurious microbes due to the dirty conditions in which the cow
is kept and the milkers keep themselves. The heating of the milk for
some twenty minutes to a temperature below that of boiling water seems
to be the best plan. For infants, meat-juice or beet-juice may then
be added to the milk when used, and so "infantile scurvy" be avoided.
Consumers (older children and adults) who are taking other foods do not
need this additional precaution. Milk thus "Pasteurized" is the safest
milk.
But there is a very serious precaution to be observed in all cases. In
such Pasteurized milk the lactic organism or ferment usually present
is destroyed. Consequently the milk does not "go sour" by the growth
of the lactic ferment. This is no advantage, but a serious danger. For
the lactic "souring" of milk is not injurious, but, on the contrary, a
safeguard. It actually prevents the growth in the milk of other really
harmful and deadly germs. Thus when the lactic germ is not there,
but killed by heat, these other deadly germs get their chance. A fly
or other dirt-carrier brings to the sterilized milk "putrefactive"
bacteria and such germs (terribly common) as those of "green" or
infantile diarrhœa, not to mention others. If the milk had been
unsterilized and gone sour by the growth of the lactic ferment, these
more dangerous germs could not have flourished in the acid conditions
produced by it. The danger of Pasteurized milk is that if kept more
than a few hours at the ordinary temperature of a dwelling-room, and
not carefully protected, it may be a very ready means of communicating
infantile diarrhœa and other intestinal disease. It would therefore
seem to be desirable to restore to the Pasteurized milk a small
quantity of a pure culture of lactic germs. This could be easily done.
The milk would have had its tubercle-bacilli and others removed by
heat, and then, after cooling, it would receive a very few lactic
germs as a protective in case it should be kept by the consumer long
enough to get infected by the bacteria of intestinal disease. It is
imperative that good, nourishing milk, free from germs of tubercle
and of diarrhœa, shall be accessible to the millions in this country
who cannot afford to pay eightpence a quart for it. It is a difficult
demand to meet. What is said above explains the difficulty, and
suggests an attempt to overcome it.