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TABLE OF CONTENTS.

1. INTRODUCTION

2. MILK AS A CAUSE OF EPIDEMICS OF TYPHOID FEVER, SCARLET FEVER, AND DIPHTHERIA

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11

19

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Outbreak of diphtheria in Dorchester, Milton, and Hyde Park

36

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93, 134

105, 143

113

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3. THE MILK SUPPLY OF CITIES IN RELATION TO THE EPIDEMIOLOGY OF TY

PHOID FEVER.

149

Milk and other dairy products as factors in spread of infection_.
Ways in which the milk may become infected.

151

152

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Measures to prevent the dissemination of the infection of
typhoid fever_____.

158

The prevention of the introduction of infection into milk...
The destruction of infection in milk..

158

159

4. FREQUENCY OF TUBERCLE BACILLI IN THE MARKET MILK OF WASHING

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The number of tubercular cows in the dairies supplying Washing-
ton, D. C-------

173

Results of tuberculin tests elsewhere than in herds supplying
Washington_-_-

174

Characteristics of Rabinowitsch's butter bacillus..

175

Collection of samples and technic_____

177

Use of tuberculin to eliminate infection with other acid-fast or-
ganisms______

179

Table of results of autopsies on guinea pigs.

179

Résumé

191

5. THE RELATION OF GOAT'S MILK TO THE SPREAD OF MALTA FEVER Characteristics of Malta fever____.

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Methods through which the infection is acquired by the goats..

203

Clinical indications of infected animals__

203

Outbreak of Malta fever on the Joshua Nicholson....

204

History of the investigation of the disease at Gibraltar, and pre-
ventive efforts and legislation_.

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7. RELATION OF COW'S MILK TO THE ZOO-PARASITIC DISEASES OF MAN. Remoteness of danger of infection through milk..........

Methods of possible contamination of the milk with preventive

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7. RELATION OF COW'S MILK TO THE ZOO-PARASITIC DISEASES OF MAN-
Continued.

Methods of possible contamination of the milk with preventive
measures-Continued.

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Improper disposal of fecal matter..

Personal habits______

Fecal material from animals.

Infections from dogs and cats.

8. MORBIDITY AND MORTALITY STATISTICS AS INFLUENCED BY MILK.

Quantities of milk consumed__

Milk and disease_--_.

Statistics of infantile mortality.

Diarrheal diseases and milk___

Mothers' milk and lessened infantile mortality_

224

225

225

225

227

229

229

230

232

233

Infantile mortality, a class mortality----

Scientific artificial feeding and the mortality rate..

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Bacteriological investigations of ice cream in the District of
Columbia -

249

The significance of a pure ice cream supply in relation to the
public health____.

263

Definitions and descriptions of ices in trade and other books_
Ice cream standard..........

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The composition and general characteristics of milk..
Changes in the composition of milk..

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By the digestive ferments-the rennin coagulation of milk.
By the action of bacteria and other micro-organisms_

The lactic acid fermentation__.
Abnormal fermentations of milk_

Milk poisons-galactotoxismus.

Legal standards governing the sale of milk_

United States and State standards_.

Milk adulterations.

342

353

353

361

366

370

371

372

373

Skimming, watering, and the addition of foreign substances.
Significance of watering in relation to the public health__.

374

375

Artificial coloring matters and milk preservatives_.

Effect of artificial coloring matters and preservatives on
digestion and health_____

376

378

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Table I, results of the chemical analyses of Washington
milks

397

Table II, milks below standard and those containing dirt____
References to the literature of milk______.

406

409

11. THE NUMBER OF BACTERIA IN MILK AND THE VALUE OF BACTERIAL

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The practical value of bacterial examinations of milk....
Bacterial counts in Washington___.

427

429

Methods

429

Results tabulated.

431

Results of bacterial counts of market milk in Washington in
1906 and 1907_--_

431

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13. THE SIGNIFICANCE OF LEUCOCYTES AND STREPTOCOCCI IN MILK.
14. CONDITIONS AND DISEASES OF THE COW INJURIOUSLY AFFECTING THE
MILK

477

487

Importance of a wholesome milk supply----

489

Milk from unhealthy cows as a factor in the spread of disease_-
Tuberculosis___.

490

490

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14. CONDITIONS AND DISEASES OF THE COW INJURIOUSLY AFFECTING THE

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15. SANITARY INSPECTION AND ITS BEARING ON CLEAN MILK.

509

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17. METHODS AND RESULTS OF THE EXAMINATION OF WATER SUPPLIES OF

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Cities in the United States in which are located infants' milk

depots

583

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