Second Annual Meeting 
 
 OF THE 
 
 (California 
 
 AT THE ^ . 
 
 UNIVERSITY FARM 
 
 DAVIS, CALIFORNIA 
 
 APRIL 18, 1910 
 
SECOND ANNUAL MEETING OF THE CALIFORNIA 
 
 ASSOCIATION OF MEDICAL MILK COMMISSIONS. 
 
 (At the University Farm, Davis, California.) 
 
 (Monday, April 18, 1910.) 
 
 A meeting of the Medical Milk Commissions of California was 
 held at the University Farm, Davis, on April 18, 1910. This 
 meeting was open to the public and was attended by about seventy- 
 five persons, who were interested in the production and sale of certi- 
 fied milk, and who took part in the discussions. The following milk 
 Commissions were represented: 
 
 Alameda County Medical Milk Commission. 
 
 Los Angeles County Medical Milk Commission. 
 
 Santa Barbara County Medical Milk Commission. 
 
 San Francisco County Medical Milk Commission. 
 
 Previous to the regular program an opportunity was given the 
 visitors to go over the University Farm Dairy and Creamery and to 
 view the work which is being done by this important department 
 of the University. 
 
 An exhibition of certified milk was held which was contributed to 
 by the following producers : 
 
 1 Burrough Bros., Walnut Grove Dairy, San Jose, Cal. 
 
 2 The Ideal Farms, San Anselmo, Cal. 
 
 3 The Potter Dairy, .Goleta, Cal. 
 
 4 -E. F. Robbins, Arden Dairy, Pasadena, Cal. 
 
 5 H. R. Timm, Dixon, Cal. 
 
 After lunch at the University Farm Dining Hall, the following 
 program was presented : 
 
 1. Address of Welcome, Mr. Roger Roberts. 
 
 2. History of Certified Milk in California, Dr. Adelaide Brown. 
 
 3. Demonstration of the Tuberculin Test in Cattle and Physical 
 Examination of Infected Cows ? Dr. C. M. Haring and Dr. Walter 
 Bates. 
 
 4. The Milk Production Problem, Prof. Herbert A. Hopper. 
 
 5. Control of Bovine Tuberculosis in Certified Dairies, Prof. 
 A. R. Ward. 
 
 6. Use of the Score Card in Dairy Inspection, Dr. Chester Road- 
 house. 
 
 7. The Pure Milk Problem, Prof. F. D. Hawk. 
 
 8. Results of Some Investigations Concerning Bovine Tuber- 
 culosis, Prof. C. M. Haring. 
 
 9. Demonstration of the Organs of a Reacting Cow Previously 
 Examined Before the Meetm^ yr^Ches^er Roadhouse. 
 
At six o'clock the delegates and visitors assembled for dinner at 
 the University Farm Dining Hall, after which an informal discus- 
 sion was held on various topics of interest to Medical Milk Com- 
 missions. 
 
 It was decided that the Medical Milk Commissions, now certify- 
 ing milk in California, should form an association to be known as 
 the Association of Medical Milk Commissions of California, for the 
 purpose of co-operating with the Public Healtft Association, for 
 holding public meetings of an instructive nature similar to this one 
 and for furthering in every way the production and sale of certified 
 milk. 
 
 No officers were elected. 
 
 It is proposed to hold another public meeting of this Association 
 in September in conjunction with the meeting of the Public Health 
 Association. Respectfully, 
 
 LEWIS SAYRE MACE, M. D., 
 ADELAIDE BROWN, M. D., 
 
 Executive Committee. 
 
MEETING OF THE MEDICAL MILK COMMISSIONS OF 
 
 CALIFORNIA. 
 
 (The University Farm, Davis, California, Monday, April 18,1910.) 
 
 Address of Welcome. 
 By Mr. Roger Roberts 
 
 Dr. Anderson deeply regrets being unable to be present 
 to-day to welcome you in person; so do I. It is now approx- 
 imately four years since the Legislature at Sacramento appro- 
 priated money for the purpose of founding this Farm and 
 School of Agriculture thereon. The administration of the funds 
 was in the hands of the regents of the University of California. The 
 first steps taken in the development of this farm was the erection 
 of buildings for the harboring of live stock. In time we were able 
 to handle milk and milk products in a scientific, modern way. The 
 next thing was the erection of a dormitory for the boys who are 
 interested enough in agriculture to come here to receive what we 
 have to give. Now buildings have been erected and the whole thing 
 has gone forward until you see the plant that we have here to-day. 
 Live-stock buildings and other barns are now needed ; exactly where 
 we have the administration building, grain houses are to be erected. 
 Much good work has been done here. In Dr. Haring we have a man 
 who is capable of the best. Three years ago he commenced opera- 
 tions here under very trying conditions, as there were practically 
 no buildings and no equipment. His building is now up, although 
 not thoroughly equipped, and the next time that you come here we 
 hope you can approach it over a pleasing grade, and I know that 
 you will find all corrals well ordered, operating room fitted with 
 sinks, the carpenter work will be finished and the building in such 
 a way as to meet the highest possible ideals of sanitation. We hope 
 that in the future our work will be such as to meet with your 
 approval. It is a great pleasure for us to have you here to-day and 
 it will gratify us to take you over the grounds and through the 
 buildings for your inspection. 
 
 3 
 
HISTORY OF CERTIFIED MILK IN CALIFORNIA. 
 
 By Dr. Adelaide Brown. 
 
 The first Medical Milk Commission was established by Dr. Henry 
 L. Coit, of Newark, New Jersey, in 1893. The general plan of this 
 Medical Milk Commission has been followed since throughout the 
 United States. The production of the dairy which comes up to the 
 requirements for cleanliness as shown by the bacterial count, fat 
 percentage and general chemical tests, and in dairy technic and the 
 tuberculin test given every six months to the herd is certified ; 
 these being the standards of the Commission for the production of 
 a pure and completely sanitary milk. 
 
 In 1907, as a result of the example of this first Medical Milk Com- 
 mission, twenty-two milk commissioners sent their delegates to 
 Atlantic City, and the American Association of Medical Milk Com- 
 missions was formed. This Association was addressed by the 
 United States Department of Agriculture experts, by specialists in 
 sanitation, etc., and resolved itself into standing committees to dis- 
 cuss the points of variation in the individual commissions and to 
 construct a working standard for the use of all milk commissions. 
 The reports of the work of these committees and the reports of the 
 certified dairies made the program of the second meeting of the 
 American Association of the Medical Milk Commission at Chicago 
 in 1908. At this meeting the milk commission had increased in 
 number from twenty-two to forty-eight, and standard requirements 
 on the fat test and bacteriological test as recommended by the 
 American Public Health Association were adopted. In 1909 the 
 third annual meeting of the American Medical Milk Commissions 
 took place at Atlantic City and reports were sent in from fifty-six 
 commissions, representing twenty-two different States, many States 
 having protected during the year through legislation, the term 
 "certified milk," thus recognizing and endorsing the voluntary work 
 of the milk commissions. The California Legislature passed such 
 an act in January, 1909. 
 
 In California there are at present three milk commissions repre- 
 senting the Alameda County Medical Society, the San Francisco 
 County Medical Society and the Los Angeles County Medical 
 Society; and in the process of the making there is one in Sacramento 
 and one in San Jose. The milk commissions in the bay region of 
 California are certifying to three dairies and San Francisco is to-day 
 consuming 2,000 quarts of certified milk, while probably about 1,500 
 quarts are being used in Oakland, Alameda and Berkeley. Certified 
 milk is also procurable on the trains of the Southern Pacific and has 
 been sent across the continent and across the Pacific numerous 
 times. 
 
 The certified dairies of Mr. Nelson and Mr. Timm entered into 
 the contest in Cincinnati and were high up in the honorable mention 
 class. Though their milk was eight days old when it reached Cin- 
 cinnati, the bacterial count was excellent. One sample contained 
 "only 100 bacteria to the cubic cm. and nine of the twenty-four 
 samples sent contained less than 1,000 bacteria to the cubic cm." 
 (below 10,000 being required). 
 
 4 
 
A most valuable demonstration of the use of certified milk has 
 been made this year in San Francisco when the foundling infants 
 were removed from the Asylum and the "boarding-out" system tried. 
 Under this change alone a death rate of 40% plus was reduced to 
 12% in the first six months, the feeding of the child being left to 
 the judgment of the woman with whom it was boarded. A careful 
 investigation then showed that the children were not gaining as 
 normal children should and in most cases were being fed condensed 
 milk. Certified milk was then secured for these infants, and under 
 the services of a nurse the foster-mothers were taught artificial 
 feeding, with the result within the next six months of a death rate 
 of less than 2%, and an absolute gain in the normal in practically 
 all of the cases. The remarkable effect of clean milk in infant feed- 
 ing can only be appreciated by the physician who is constantly in 
 contact with the problem of artificial feeding. The bottle baby has 
 become with this pure food product a more normal citizen. The 
 work of the Medical Milk Commissions seems to me to express 
 as thoroughly as does the anti-tuberculosis work of the medical 
 profession the new and preventive methods in medical practice. 
 Keeping the child well is far more worth while than caring for its 
 digestive disturbances when poor grades of milk are furnished it. 
 
 THE MILK PRODUCTION PROBLEM. 
 
 By Prof. Herbert A. Hopper. 
 
 Much that will be said in this paper is already well known to those 
 who are following the trend of modern tendencies in the produc- 
 tion and handling of milk for direct consumption. From the finan- 
 cial and especially the public health point of view, it is a national 
 problem and is absorbing the attention of thinking men and women 
 everywhere. While most forms of food have in recent years come 
 more or less completely under the supervision of the pure-food 
 authorities, no one form has given them so much anxiety as has the 
 milk supply. Certainly their efforts in controlling the sanitary 
 features of other food supplies have met with more success than 
 those directed toward the dairy and its product. The reasons for 
 this are not hard to find. The problem is a complex one. Unlike 
 some other forms of production, dairying does not yield readily 
 to centralization. Its separate units are hard to fit into a sys- 
 tematic organization. The local and special demands of each 
 farm makes its successful operation largely a problem by itself, 
 and to this extent so far has prevented any considerable number 
 of farms being operated in accordance with any plan or scheme of 
 centralization. The points of view, training, methods and aims 
 of the operators have lacked so much in uniformity that the 
 quality of the product has been made more difficult to control. 
 Methods of inspection and control as used in other lines have often 
 met with uncertain results when applied to the milk supply. 
 Further, the attitude of producers in general, and the training and 
 personality of the inspector as well are to be considered. At best, 
 it has been a long-range effort, associated with many serious diffi- 
 culties, though much progress, has been made. The subject of 
 milk production is too large to compass in one paper. It is my 
 
desire, therefore, to consider a few of the economic features of the 
 business that tend to encourage or discourage the production of 
 more acceptable grades of milk. 
 
 There are numerous organizations to promote better methods 
 among milk producers. In order that their efforts may be most 
 fruitful, their recommendations must point the way to greater 
 profits for the producer. Nothing educates so effectively as an 
 increase in price. In the butter-producing industry we are now 
 confronted with an aggravating situation as regards appreciation 
 for quality in cream deliveries. The competition has been so 
 strong for cream of any quality that the respect of the producer 
 for proper sanitary provisions has been well nigh destroyed. With 
 the knowledge that poor stuff commands the same price as good 
 material, he has lost interest in maintaining high standards. 
 This emphasizes the necessity for a price recognition in order to 
 attract and hold quality and is applicable to the improvement of 
 the milk supply. Any effort to improve the milk supply which 
 overlooks this fact, starts out at a disadvantage. 
 
 Milk Has Not Sold for Its Full Value. 
 
 In recent years the cost of labor and food supplies has advanced 
 rapidly and most producers with herds of only average economic- 
 ability have been getting the short end of profits from the sale of 
 their product. The advancement of the selling price has not kept 
 pace with the increase in cost, and, consequently, dairymen have 
 often looked upon the agitation for better milk with considerable 
 well-founded suspicion. It is said that since 1894 the cost of labor 
 has increased 100% ; the installation of new appliances and equip- 
 ment for the proper handling of milk, 20%, and feed in general, 
 50%. The cost of sound cattle has advanced 75%. Where a few 
 years ago, bran, a staple dairy concentrate, could be purchased at 
 $14.00 per ton, it now costs about $30.00. With a similar advance- 
 ment in other feeds, as well as in labor, it is conservative to say 
 that these elements in the cost of production have doubled in recent 
 years. 
 
 A further and equally important factor influencing increased 
 cost is the. rapid increase in land values, especially of those lands 
 available for dairying. Naturally, the milk supply must be drawn 
 from territory within a "certain radius of the centers of population. 
 Consequently, the price that is forthcoming will determine the 
 lands that can be used and their location will affect directly and 
 indirectly the quality, as well as the quantity of milk to be pro- 
 duced. With good cows and good business methods, dairying will 
 pay on high-priced lands, if milk is paid for at a price commensurate 
 with other food products. When the consumers refuse to pay a 
 fair price, production is shifted to cheaper and more remote lands 
 where it is harded to supervise and the difficulties of transportation 
 augmented. Many a careful producer has been crowded out 
 through the preference of consumers for a cheap, inferior grade of 
 milk. Cases of this kind are matters of common observation. 
 Until some substantial readjustment of cost takes place, we can 
 expect little more in the way of care on the part of average open- 
 minded dairymen. 
 
It stands to reason that milk produced under proper sanitary 
 conditions cannot be sold for the same price that is demanded by 
 the dealer in unsanitary milk, and no sane consumer, were he to 
 give the matter thought, would begrudge the difference in price. 
 Who is to derive the benefit from these efforts, if not the consumer? 
 Let him bear his share of the burden. 
 
 Producers Should Seek to Reduce the Cost. 
 
 It is not to be supposed that the bulk of dairy farmers are doing 
 all that they can to reduce cost of production, and for this reason 
 the consumer should not be expected to make up for the short- 
 comings of the former. My own study of dairy cows and dairy 
 farm practices has shown that a considerable portion of the cows 
 are not profitable as fed and cared for, and that those in charge of 
 them are often not sufficiently alert to the opportunities for cutting 
 down the cost. There is a wealth of data to establish these facts, 
 but, in spite of them, the indifferent producer is more inclined to 
 look for relief in a larger price than to try to reduce the cost. The 
 establishment of herd improvement associations for the encourage- 
 ment of systematic record keeping and breeding, as well as better 
 dairy ideals and practices, will do much to narrow the gap between 
 cost and selling price. The most careful attention to economy 
 cannot be expected, however, to counterbalance the increased price 
 of raw material. 
 
 Producers Should Be Consulted. 
 
 In most discussions and arguments which have led up to the 
 adoption of new regulations, the farmer has not been consulted 
 and his opinion has not been asked. Rules and regulations have 
 been enacted quite arbitrarily by those who happen to be in 
 authority, without conference or consultation, not only with the 
 producer but with many others whose opinions and judgments 
 would be of value in arriving at a decision which would be just 
 and equitable to all concerned. In some cases, progress has been 
 blocked by trying to force regulations upon an unwilling dairyman. 
 While the enforcement of regulations is necessary, the indifferent 
 ones are more successfully dealt with by encouragement and 
 instruction. The bulk of dairymen are reasonable if approached 
 in the proper way. 
 
 Best and quickest results will follow the taking of the producer 
 into confidential relations. Give him credit for a knowledge of his 
 own requirements and necessities. Assume that he is willing to 
 regard the rights of others and expects to have the same courtesy 
 extended to him. Committees on milk improvement should 
 include leading producers who are in touch with the practical diffi- 
 culties of the business. Their actions will render the actions of 
 the committee more sane and stimulate the confidence of other 
 producers in such measures as are enacted. Give the dairyman a 
 hand in the formulation of regulations and you bind him to their 
 execution without strict inspection. 
 
Producers' Attitude Toward Sound Cows. 
 
 While the atmosphere has cleared considerably regarding the 
 importance of sound cows, there are still some anomalous situa- 
 tions. Opposition to the tuberculin test has been more an eco- 
 nomic objection than a sanitary or public health objection. On 
 the fact of it, the compulsory disposal by slaughter of an afflicted 
 animal without partial reimbursement is resented as contrary to 
 economic necessities. This position has been quite generally 
 assumed by dairymen everywhere. They have failed, however, to 
 see an advantage in the larger economic returns of a sound herd. 
 This is a strong argument for the voluntary weeding out of afflicted 
 animals. It comes with especial force to the dairyman breeder 
 who is looking for two returns from his herd. Everything that will 
 contribute to soundness must be encouraged, but we should not 
 stop at mere freedom from disease. The herd must pay. Certain 
 figures have been exhibited that go to show that the continued 
 testing of a herd for tuberculosis will eventually weed out the 
 most profitable cows. If this is true, it strikes right at the vitals 
 of the business. 
 
 I call to mind two herds. In one, the owner has been working 
 for years to establish large yields by judicious breeding, feeding 
 and care. The present condition of the cows shows that he has 
 been remarkably successful to this end. The great, strong cows, 
 with every evidence of marked capacity for profits, are uniformly 
 admired. He has never made a practice of tuberculin testing, 
 but has exercised his own form ,of control by removing animals at 
 the first indication of physical decline. This herd is one of the 
 most profitable I have ever seen, and outwardly is in the best of 
 physical condition. , 
 
 The other herd has been gathered from the four winds and rep- 
 resents a heterogenous mixture of common stuff without evidence 
 of improvement. Periodic tests are made, and each time a certain 
 percentage must go. If any of the cows happen to have eminated 
 from communities where improved stock has been bred, these are 
 usually the better producers and often, as well, the reacters. It is 
 necessary to be continually buying, and, at the same time, avoid 
 the disease if possible. The returns from the limited product may 
 justify the methods followed, but it is a question how long they 
 will do so. Don't understand me as opposing the test. I state the 
 facts about these two herds as I understand them. The contrast 
 is indeed remarkable. One is economically strong and probably 
 not dangerous to public health ; the other is evidently economically 
 weak, but free from disease. Cannot the two ideas be harmonized 
 to the advantage of the business? 
 
 It seems like a needless calamity that our zeal for sound cows 
 should lead us to act contrary to established economic facts in 
 selecting them. 
 
 Breeding Sound Dairy Cows Will Pay. 
 
 Fortunately, some breeders of dairy stock have seen the trend of 
 conditions and requirements, and have fortified themselves against 
 future demands. The future demand will be and is now for the 
 sound cow and the profitable cow. . These two properties should 
 
 8 
 
reside in the same individual. Profitableness without soundness is 
 dangerous and regrettable, but soundness, without profits is an 
 aching void that cannot long maintain itself. Breeding establish- 
 ments for the rearing of sound profit-producing cows should be 
 operated in connection with certified dairies or independently as 
 feeders for the same. If the demand for this class of milk assumes 
 the proportions that its advocates claim for it, the fine-tooth-comb 
 method of collecting economic outcasts to replenish these dairies 
 will soon exhaust the supply. It should not be necessary for the 
 buyer to feel that he must avoid improved herds. The possibilities 
 of rearing sound stock of good breeding are so inviting that a little 
 encouragement along that line would contribute much toward 
 raising the standard of profits. The breeders of registered stuff 
 are realizing the value that soundness adds to their cattle, but there 
 is also an opportunity for the breeder of grades to meet a real need 
 by producing the kind of cow that will make her owner profits 
 from milk that is above suspicion. Such is the cow we seek, and 
 with her advent in sufficient numbers will come the solution of one 
 of the main difficulties in the milk-production problem. 
 
 Discussion of paper, "The Milk-Production Problem," Prof. Her- 
 bert A. Hopper: 
 
 Mr. F. V. Nelson: I have not much to say with regard to this 
 paper read by Professor Hopper. He referred to the fact of there 
 being some milk producers present, and I think they will agree 
 that no one could have presented the facts of the case better than 
 the professor has done. 
 
 Mr. H. R. Timm, Dixon : I can hardly believe that pure breed 
 cattle are mostly diseased as Professor Hopper intimated, because 
 a great many men raising pure-breed cattle are keeping them 
 weeded out so as not to distribute the disease. I think there are 
 many herds which should be tested and are not. I do not know 
 whether he referred to my herd in making the comparisons. In 
 my herd I am weeding out all those animals that are not profitable, 
 and I will finally have a herd that I think will be an average one; 
 I have mostly Durhams, but am adding Holsteins as fast as I can; 
 I have a few Jerseys that I got in bands that I purchased. As Dr. 
 Adelaide Brown has stated, they do not want rich milk, and when- 
 ever they take a test of my milk or any other milk that is certified 
 and it runs over 5% we generally hear from them, so we have to 
 try to get cows that test from 3.5% to 3.7%, and the Holstein 
 seems to run the nearest to that average. 
 
 Dr. E. C. Fleischner, San Francisco : In regard to the economic 
 question, if the production of the milk is going to prove a loss to 
 the men who endeavor to produce it, we must get the people to 
 pay more for it. We give the milk to the babies and patients 
 because we think that we get better results from its use, and the 
 people who believe as we do are willing to pay for it. It seems 
 discouraging if we must demand this milk from the producer with 
 a loss to him. 
 
 Dr. F. H. McNair, Berkeley : The record of a Jersey herd in 
 New York State two or three years ago might interest you. The 
 owner had had the band in operation for about eight years, num- 
 bering 200 registered Jerseys. While his milk product was paying 
 
well, still he expected to sell the animals and make most of his 
 profits by such sales. Out of five animals sold to New Zealand 
 at $500 each, three were rejected because found by testing to be 
 tuberculous. He immediately went to work, and by the tubercu- 
 lin test began the weeding-out process, thinking that it would pay 
 him to create a herd free from tuberculosis. When I was work- 
 ing on the herd he was losing four or five of his best cows every 
 year with tuberculosis in different forms. It would doubtless have 
 been to his financial interest to have started out with the tuberculin 
 test in making his original purchases. 
 
 Professor Herbert A. Hopper : In answer to the question that 
 Dr. Fleischner raised with reference to the discouraging features, 
 I wish to say that I do not look at it as discouraging. In time the 
 customer will have to come to pay the price that the milk is worth, 
 but just at the present time I hope that the producers will not 
 stand in the way of progress and ask for a higher price. These 
 things always work out right, and we will not have a good milk 
 supply until the people are willing to pay for it. 
 
 THE USE OF THE SCORE CARD IN DAIRY INSPECTION. 
 
 (By Chester Roadhouse, D. V. M.) 
 
 A question which is important to organizations in milk improve- 
 ment work is how can the conditions under which milk is pro- 
 duced be best reported, and which method is the most thorough in 
 reporting these conditions? 
 
 In the general milk improvement work by municipal boards of 
 health which has developed in the large cities throughout the 
 United States, it has been found that by the use of the score card 
 a rating can be given each dairy and that with the score card the 
 inspector can make a more perfect study of conditions at any 
 dairy. Until the appearance of the score card little effort was 
 made to classify the many details which have to do with the 
 purity and wholesomeness of milk. The many items requiring 
 attention are now listed ; and, still better, they are given numerical 
 values in the score card. By the use of the score card a competent 
 inspector is able to designate the character of defects at the dairy, 
 and also he can indicate the seriousness of such defects. The 
 great advantage is that it is educational and that it shows the 
 conditions in terms that the dairyman with little study can under- 
 sand. 
 
 Dr. Woodward, Health Officer of the District of Columbia, was 
 the first to introduce the score-card system of reporting on dairies. 
 A little later, in 1906, Prof. R. A. Pearson of Cornell University 
 introduced a score card for the same purpose. The United States 
 Department of Agriculture then took up the work with the hope of 
 extending the use of the score card and thereby a more thorough 
 inspection. After three years' work, scoring several thousand 
 dairies in all parts of the country, the department adopted a score 
 card, somewhat modified from the ones previously introduced, and 
 which is now in use in over one hundred cities and towns in this 
 country. 
 
 10 
 
The cities that have adopted the score-card system and are 
 regularly following it are reporting dairy conditions constantly 
 improving. Dealers often pay more for milk from high-scoring 
 dairies, which encourages better work on the part of the producer. 
 The good dairymen naturally want a high score, and by studying 
 the points in the score card are able to improve their conditions. 
 
 The history of the production of "certified milk" shows that 
 it was early determined that a close supervision of the dairy was 
 necessary to insure a continued high standard. The herd and farm 
 inspections should cover the state of health of the cow, herd 
 hygiene, the sanitation of the buildings and premises, the care of 
 utensils, the farm and dairy methods and practices and inquiries 
 regarding the health of the dairymen, milkers and their families. 
 The use of the score card is applicable for this purpose, as well as 
 for the average dairy, and realizing this fact the Executive Com- 
 mittee of the American Association of Medical Milk Commissions 
 in 1909 recommended the adoption of an official score card. 
 
 In brief, the following recommendations were made by the 
 Executive Committee : 
 
 First That no producer should be considered for the production 
 of certified milk by the Medical Milk Commission unless his dairy 
 shows a score of 90% or _ more. 
 
 Second A system of scoring should be adopted under which 
 detached statements of conditions obtained at the dairy shall be 
 reported to one Central Committee, for the entire country, which 
 shall reduce these reports to percentage standings. 
 
 Third That the score cards for the dairy be prepared by a 
 person who is acceptable to the local Commission and the dairy- 
 man. 
 
 Fourth That similar reports be made from time to time also 
 by a Federal or State official not interested locally. 
 
 If these recommendations are followed by all Medical Milk Com- 
 missions in the United States it means that all certified dairies will 
 be producing milk under the same standard, which will lead to 
 uniformity in the production of certified milk and a fairness to all 
 dairymen, which is to be desired. So far as I have been able to 
 learn, the official score card has not been prepared for the Ameri- 
 can Association, although the report of the Executive Committee 
 was adopted. 
 
 It might be said that the score card used in the dairies of the 
 East would not be applicable for the dairies in California, where 
 the conditions are so widely different. But this is not necessarily 
 so. If the meaning of the score card is properly interpreted it is 
 possible and practical to adopt a uniform system of scoring for all 
 dairies. 
 
 Personally I have scored 150 dairies which supply milk to San 
 Francisco, using a score card modeled after the one recommended 
 by the United States Department of Agriculture. The average score 
 for these dairies was below 60%. Using the same score card for the 
 two certified dairies supplying milk to San Francisco, I found 
 them at all times to score above 90%. 
 
 11 
 
Sixteen certified dairies supplying various cities in the United 
 States were visited and scored by a representative of the United 
 States Department of Agriculture. They showed a score varying 
 from 79 to 99.5%. 
 
 In all cases the cows were in almost perfect condition. Averag- 
 ing the scores for all conditions, one dairy was found to score 
 below 80%, three over 80% and less than 90; two scored 99 and 
 two 99.5%. The average score for all dairies was 93.4%. Com- 
 paring these conditions with the average of some 2,000 dairies pro- 
 ducing ordinary market milk for city consumption, and which were 
 also scored by the United States Department of Agriculture, we find 
 a striking contrast, the average score for the latter being about 50%. 
 
 In conclusion, I would say as a suggestion that it would seem 
 desirable that all Medical Milk Commissions in this State adopt 
 the use of the official score card recommended by the American 
 Medical Milk Commissions as soon as it is prepared; not for the 
 purpose of reporting all inspections at the dairy, but that it be- 
 used at intervals during the year for the information of the mem- 
 bers of the local Commissions and of other Milk Commissions. 
 
 Discussion of paper, "The Use of the Score Card in Dairy Inspec- 
 tion," by Chester Roadhouse, D. V. M. : 
 
 Mr. F. W. Andraesen (Secretary StaU Dairy Bureau), I would 
 like to state that in April, 1905, the State Dairy Bureau of Cali- 
 fornia adopted a score card, and believe that some official from 
 the Agricultural Department at Washington assisted in preparing 
 it. This card has been in use in this State ever since. At a later 
 date, 1908, an excellent and very complete score card was adopted 
 by the United States Department of Agriculture. The State Dairy 
 Bureau, of this State, did not at that time think it advisable to 
 change the card already in use in this State. First, because the 
 one in use seemed well adapted to the conditions on this Coast, 
 and the Department of Agriculture in their Circular No. 139 say, 
 "In traveling across the country we find the dairy conditions 
 somewhat varied, particularly in respect to climate. For example, 
 in the New England and Central State the temperature frequently 
 drops several degrees below zero during the winter months. This 
 necessitates tight barns and an automatic system of ventilation, 
 together with a reasonable amount of air space, if the animals are 
 to be kept comfortable and healthy. On the other hand, there are 
 sections in the South and on the Pacijic Coast where the stables 
 are simply open sheds, which afford all the protection necessary. 
 Here sunlight, ventilation, and air space are unlimited, ana tnese 
 points hardly need to be included in a score card." Cows in this 
 State are not kept in the barn more 'than two hours at a time, only 
 just long enough to milk and feed them. The State Dairy Bureau 
 has a large territory to cover, and but little money to work with, 
 and therefore cannot go so completely into details as the United 
 States Agricultural Department or some of the large cities in the 
 United States. A dairy inspector employed by a city to inspect 
 the conditions under which the milk supply for that city is pro- 
 duced is expected to visit every dairy supplying milk once a month, 
 and if he has once measured and calculated the cubic feet of air 
 space, the sona.re feet of glass per cow, in every stable in his 
 
 12 
 
district, then that part of the scoring is easy on subsequent visits. 
 But where the State Inspector cannot visit each dairy more than 
 once a year, and some of them only once in two years, the scoring 
 of light and ventilation becomes a great work. Therefore, though 
 some credit is given for good ventilation and light, in the old score 
 card much time is not devoted to measuring actual number of feet 
 of space per cow. The score card is of great advantage to the 
 inspectors in that it assists him in remembering every point of 
 importance which should be inspected and the condition of which 
 should be recorded. It also assists him in calling the dairyman's 
 attention to conditions where he could easily raise his score. As, 
 for instance, if the watering troughs are dirty, or the water that 
 the cows drink is contaminated, he could point out to the dairy- 
 man how he could better these conditions, and thereby raise his 
 score five or six points. These score cards are filed away, and 
 at any time the public can see which dairies are in good condition, 
 and the inspectors can also see it, and make it a point to visit the 
 unsanitary ones as often as possible. 
 
 Chester Roadhouse, D. V. M. : Mr. Andreasen is correct in his 
 statement about the score card in one way, but I wish to say that 
 there is an advantage in using a uniform system of scoring dairies 
 throughout the United States. Mr. Weld, from the Dairy Division 
 of the United States Department of Agriculture, recommended 
 this when he visited this Coast a year ago. The score card rec- 
 ommended by the United States Department of Agriculture can 
 be made applicable for all dairies if it is properly interpreted. To 
 illustrate this point we may refer to the topic "ventilation" on the 
 score card. In the cold sections of the country where dairy cows 
 are kept in stables during the winter months we would require the 
 King system of ventilation for a perfect score, but in California 
 the King system of ventilation would be no more beneficial to the 
 dairy herd than any other system, and consequently we would not 
 require it in California for a perfect score. In California we may 
 give a perfect score on bedding for the cows when no bedding is 
 provided in the cow stable, but where the cows are in the stable 
 only for milking, their bed is usually a green grass plot where they 
 rest and sleep and where the conditions are ideal in keeping the 
 animals clean. If cows are kept in the stable at night and are not 
 bedded, we score off for lack of bedding. Directions for scoring 
 may be printed on the back of the card to aid those who are not 
 familiar with the requirements for the dairy. Following such 
 directions, even the inexperienced individual would be able to score 
 within three to five points of the proper score. 
 
 13 
 
MILK PRODUCERS AND PURE MILK. 
 
 By Professor F. D. Hawk. 
 
 Given Before the First Annual Meeting of the Milk Commission 
 
 of the San Francisco County Medical Society, 
 
 University Farm, Davis, Cal., 
 
 Monday, April 18, 1910. 
 
 The producer of milk is a business man, so, naturally, when he is 
 approached on the subject of pure milk he begins to ask questions 
 that are of vital importance to himself and not those of importance 
 to the consumer from his view point. 
 
 First The questions to be met are, Can I make more money by 
 producing and marketing milk under the rules of certification than 
 I can by going ahead with an ordinary dairy, or will the market for 
 certified milk justify me to make the necessary expenditure to run 
 such a plant? 
 
 Second Will I have co-operation in my venture to raise the 
 standard of milk? In other words, will the people who have certifi- 
 cation in charge, and who have the health of the cities uppermost 
 in their hearts, do as much as is in their power to get me a market 
 for my milk as they do to bind me to my contract to produce this 
 article of pure milk ? 
 
 Third What are the results of the tuberculin test, and how will 
 it affect my business? 
 
 In looking into these questions I find myself puzzled about just 
 what to say, when I stop to consider the conditions that exist in 
 our dairies as a whole. I will admit that there are all too many 
 of our dairymen who are producing milk under the most foul con- 
 ditions that can exist, and the article produced shows the unkempt 
 method in which it was handled in the dairy. 
 
 One need not visit these dairies in order to get a mental picture 
 of yards covered with litter and filth ; of barns cleaned but once a 
 week and cobwebs hanging from every timber, probably never 
 brushed down from one year's end to another; even the cow her- 
 self in a poor condition, carrying tags all over her hind quarters. 
 
 An article for human food produced under such conditions 
 should not be allowed upon the market under any consideration. 
 Such slovenliness cannot be excused or even tolerated on the 
 ground that it is a cheaper way of production. In the first place, 
 it is anything but cheap, even to the producer. Cows kept in 
 shacks filled with manure have great obstacles to overcome such 
 as impure air, uncomfortable quarters and lack of kindness, all of 
 which are necessary to cows before they can do their best. 
 
 Another source of loss comes through the disgusted visitor who 
 tells his friend what he has seen, and in consequence customers 
 become fewer and fewer. 
 
 14 
 
Thanks to our city Boards of Health for inspecting dairies and 
 preventing such people from sending milk to their city market. 
 
 There is another producer of the middle class from whom we 
 seek material for the certified dairy. He is the man who has good 
 buildings, keeps his stables moderately clean, has fairly good cows 
 and handles his milk in the ordinary way. This is the man from 
 whom these vital questions come. He is not in the business for 
 his health. He is the. man that knows dairying is not the easiest 
 business he might follow, but it is the dollars that he is looking 
 forward to, and not the cities' health. 
 
 What does pure milk mean? It means milk that is produced 
 from healthy cows and under such conditions as shall be pre- 
 scribed by the Medical Milk Commission for pure milk. You 
 gentlemen are all familiar with the rules, and can you wonder why 
 there are so few who contract to follow these rules at the price 
 now paid for certified milk? 
 
 Is it more plausible to ask a dairyman to clean up his dairy 
 than it is to ask a consumer to purchase clean milk at a reasonable 
 price that will compensate the producer for his trouble? I think 
 not. 
 
 If certified milk can be put on the market with greater net 
 returns, then a part of our problems are solved. Figures that are 
 reliable on this point will do more than any one thing towards 
 having clean milk, provided it can be shown that it pays more than 
 the dairy that is run under the ordinary methods. If certified 
 milk plants cannot show favorable figures, then we can readily see 
 why we have no more dairies of that class. Here 'in California the 
 retail price is five cents per quart more for pure milk than for ordi- 
 nary milk. This difference of five cents is not enough when we 
 consider the cost of extra equipment, labor, icing and shipping, 
 and the loss of animals discarded as a result of tuberculin testing. 
 
 Will the dairyman have co-operation in his venture to raise the 
 standard of milk? Yes; but how much I cannot say. The Milk 
 Commission will help to clean up his dairy and keep him fairly close 
 to the rules. But what his fellow dairymen will do I rather think 
 will be anything but to co-operate they will give him a hit here 
 and a hit there. This, of course, is not the right spirit, neverthe- 
 less it will be true. Men interested in clean milk will write long 
 articles on the subject, telling how essential it is that we should 
 use the clean article. He will also even tell how to keep the dairy 
 clean. These articles appear mainly in agricultural papers, and 
 therefore one of the main issues is lost, for the subject does not 
 come to the notice of those it is meant to reach the consumer. 
 
 The stimulus for clean milk is the thing that is necessary, but it 
 must get to the vital point the consumer. Here is where co- 
 operation is most needed. Create a demand, and that demand, ii 
 great enough, will be satisfied. 
 
 There is another phase, of the clean-milk proposition, and that 
 is the tuberculin test and its results. We know that it not only 
 takes very valuable animals from the herd, which is a source of 
 great loss to the owner, but it reduces patronage, the amount of 
 which one seldom knows until' he has had the experience. I can 
 
 15. 
 
relate instances where dairymen have quit testing their herds for 
 tuberculosis because they lose so many customers when cows react 
 and are taken from the herd.. This is no more true of the ignorant 
 class of people than it is of those well educated. These s?me cus- 
 tomers immediately began taking milk from dairies where th~ cows 
 are never tested and where the item of cleanliness is of no great 
 importance. The matter of testing the herd might be kept from 
 the general public and no more attention paid to it than other 
 operations of cleaning up, if there was more co-operation among 
 dairymen. But such conditions do not exist, for in every com- 
 munity there are dairymen waiting to get an article in the news- 
 paper to inform patrons of what was found in this or that tested 
 herd. The newspapers, too, grab at such material for the press, 
 never thinking how much better the space might be used in creat- 
 ing a demand for clean, healthful milk. 
 
 The raising of the standard of ordinary milk is solved, to a great 
 extent, by the Medical Milk Commissions, by inspecting dairies 
 and keeping the milk from the market if not produced under fair 
 conditions. .'This, however, will not reach the other side of the 
 pure-milk question. I think there should be figures showing net 
 returns from different classes of dairies so producers can compare 
 net returns and act accordingly. If five cents more per quart is 
 sufficient to pay for the loss of animals and the extra cost of run- 
 ning a pure-milk plant, with a little larger net returns, no doubt 
 more people will go into the business. 
 
 Another point worth while, instead of wasting so much space in 
 the agricultural papers telling consumers how vital to health is the 
 use of pure milk, is to get it on the front pages of the daily news- 
 papers and m magazines. This will help to create a demand that 
 is now lacking, and this lack of demand is manifest in the cry of 
 too high a price for milk. The way these articles should be written 
 I am not prepared to say, but I would suggest that at regular 
 intervals of two or three weeks articles on the value of pure milk 
 should appear prominently in the daily papers and magazines, so 
 that the attention of consumers may be kept on their physical wel- 
 fare. Even after a demand has been created for the pure article, 
 the dairyman will not be able to appreciate the benefits of it, for, 
 under the ordinary run of affairs existing in our cities, the milk 
 dealers form among themselves a kind of corporation and dictate 
 what prices they will pay for the milk. On ordinary milk the San 
 Francisco dealer gets half of the gross returns and more than half 
 of the net returns. Instead of doing so much to encourage dairy- 
 men simply by taking and writing, steps should be taken to regu- 
 late affairs so the dairymen can secure just returns for his whole 
 milk. Under present conditions it would be better for him to sell 
 butter fat to the creameries and use the skim milk as feed for hogs 
 and poultry. 
 
 Since such conditions do exist, what is to be done in regard to 
 the dairyman trying to .produce pure milk? Considering that the 
 price is sufficient to pay them^ we must keep the dealer on satis- 
 factory terms; or if dealing direct with the consumer he must be 
 kept on the purchasing list. To do this I would suggest that the 
 dairy be located where the consumer cannot keep in touch with 
 
 16 
 
the every-day run of affairs and where the local dairymen are not 
 all striving for the same market. This will prevent patrons from 
 being cognizant of all of the details and therefore of the unavoid- 
 able things which are bound to come up now and then, and they 
 will only know that the Medical Milk Commission is keeping 
 supervision over it and considers the milk of the best quality. 
 
 I have spoken of co-operation for the betterment of milk condi- 
 tions, and I want to bring it before you again, for co-operation with 
 education will be one of the greatest elements in settling the prob- 
 lem. Educate the producer to the point where he can see tho 
 advantage of co-operation, then with the aid of the Milk -Com- 
 mission the producer can get returns for his labor. How would 
 I have them co-operate? By joining forces and doing something 
 on the order of the fruit growers; put in a milk station of their 
 own and hire a man to take charge of the milk similar to the middle- 
 man of the present time. The men that go into this can make 
 rules for the producers to follow in marketing. Outsiders could 
 get their milk through the milk producers' station by paying a 
 prescribed rate. 
 
 If some such system was adopted the consumers and producers 
 could be brought in closer contact, and in this way results can be 
 obtained that cannot be brought about in any other way. 
 
 Discussion of paper, "Milk Producers and Pure Milk," Prof. F. 
 D. Hawk: 
 
 Dr. J. L. Milton, Oakland : I think certified milk has come to 
 stay. A few years ago when we first started to have certified 
 milk it was only with great difficulty that we could get our patients 
 to order it ; now our patients suggest it themselves and want to 
 know where they can get it for the baby. At the start we had 
 some difficulty, too, with the certified milk itself; for a while in 
 Oakland the milk was bad, and the people who were impressed 
 with the idea that they must have certified milk were discouraged 
 when the milk was delivered in a dirty manner. Sometimes it con- 1 
 tained flies and bristles, but that has all been rectified now. As 
 an example of the good condition of certified milk that we now 
 get, one doctor in Oakland went away on a vacation of five days 
 and during his absence his milk was delivered regularly, and on 
 his return he found the milk in good condition, and this shows the 
 value of certified milk. People are realizing that certified milk is 
 clean, and sometimes they say there must be some preservative 
 used, as it never gets sour. I think that certified milk has come to 
 stay, and it is really surprising how many people have come to use 
 it; people on small salaries are using it. 
 
 Dr. A. A. Stafford, Alameda : I feel certain that certified milk 
 has come to stay. The question of price is not one that the con- 
 sumer talks very much about ; patients are constantly asking where 
 they can get good milk for the baby. The question of price is 
 seldom kicked about, and there are many people who do not know 
 about certified milk, and I am sure that a little advertising among 
 the people will help create a demand for it. As the professor said 
 in his paper, if a half column was bought in the newspapers, or 
 even a little square, which the producers of certified milk could 
 
 17 
 
use for advertising purposes, it would doubtless increase the de- 
 mand very rapidly a little advertising helps a great deal, especially 
 around the city. 
 
 Mr. H. R. Timm, Dixon : I would like to ask the doctors and 
 members of the Milk Commission whether or not it would be 
 advisable to raise the price of certified milk. The question was 
 raised once before, but some of the dairies thought it would not 
 be the proper thing to do. 
 
 Dr. Adelaide Brown, San Francisco : I think this is an economic 
 question absolutely. If certified milk is a good thing I dislike 
 having anybody deprived of having it on account of the price. 
 Perhaps it is worth the test of raising the price. I think that a 
 perfectly flat declaration of what the cost of production is is what 
 we want to get. At Lake Forest, 111., Mr. Meeker knows what 
 every bit of the work of production costs; he can tell what the 
 milk has cost delivered at the station, knowing the cost at every 
 point in connection with its production. At Lake Forest Station they 
 get 9 l /2 cents, the rest going to distribution, etc., 12 cents per quart 
 being the retail price in 1908. There they have everything figured 
 out absolutely, and I think the only way to decide any such ques- 
 tion is through accurate figuring. I think the producers should 
 get the best return they can for their money. After two years of 
 careful work, for the City of San Francisco by the dairies, if the 
 increase in price is a legitimate one, the Milk Commission would 
 not gainsay that raise. No matter what the people are paying for 
 certified milk, they are not paying as much as they do for Malted 
 Milk, Mellin's Food or Nestle's Food, which are very expensive. 
 Artificial feeding is not cheap, and the use 'of certified milk has won 
 the mothers' support as well as that of the Medical Societies wher- 
 ever it is produced. 
 
 Mr. F. V. Nelson, San Francisco: As regards the change in the 
 price of certified milk, I would suggest that the question be con- 
 sidered very carefully. The demand for milk for infant feeding 
 alone is not sufficient to keep up the certification of a dairy ; in 
 other words, the distributor or producer has to rely on the patron- 
 age of families generally. One principal difficulty, I think, is that 
 in infant feeding the mother as a general thing will want the milk 
 for a few months only, and just as soon as the child is old enough 
 the mothers conclude they have no further use for the certified 
 milk. Hence the demand is a fluctuating one. I think that all 
 producers have to consider a larger demand coming from family 
 trade. Were the price raised the demand would not increase ; more 
 likely it would decline. My recollection is that statistics in the 
 East show that there has been but a very small gain annually in 
 the amount of business done, Chicago and New York showing not 
 over 10% increase in the use of certified milk. The increase is to 
 be reached only by means of education along reasonable lines. 
 
 Mr. E. C. Burroughs, San Jose : I agree with Mr. Nelson that 
 the question of raising the price of certified milk is a serious one. 
 If it were raised 25% it would put it up to a pretty high figure, 
 and I think it is an important question whether or not it would be 
 
 18 
 
advisable to raise it. Two years ago last February the price of 
 certified milk was raised from 12 cents to 15 cents per quart, and I 
 fear another raise would curtail the demand. 
 
 Dr. E. C. Fleischner, San Francisco : Some time ago the Asso- 
 ciated Charities of San Francisco undertook to board out the babies 
 in their care with the result that the mortality was decidedly 
 reduced. Of course these children were fed in all sorts of ways. 
 When one went among these individuals it was one's experience to 
 find the types of food which these babies were being fed were 
 primarily condensed milk, one of the patent foods or ordinary milk 
 in some form or other. Through the efforts of the Association of 
 Collegiate Alumnae certified milk was furnished these children 
 and the mortality was reduced from 12% to 2%. I really feel that 
 it is a sufficiently definite result to call to the attention of everyone 
 here, a sufficient result to make everybody note the results that can 
 be obtained and ought to be obtained with certified milk in this 
 community. This phase of the pure milk problem should surely 
 not be overlooked in discussing the question. 
 
 Dr. H. E. Wright, Sacramento : If certified milk is such a good 
 thing and has come to stay, as we believe it has, why not enact 
 legislation to make all milk producers meet certification? Make 
 the conditions so that only certified milk could be bought, and 
 eventually all producers would have to charge the increased price 
 to cover the cost of certification. If no one were allowed to furnish 
 anything but certified milk it would be a perfectly even case of 
 competition. It seems to me that this is a matter for legislation. 
 The best for all is none to good. Why not pure food for all, in 
 milk as in other foods? 
 
 Professor F. D. Hawk: I believe that certified milk has come to 
 stay, but that the price has not come to stay. In the cities we can 
 find the common milk to-day on the market for about four cents 
 a quart and it is retailed at ten cents, the difference being for the 
 middleman to carry on his operations, while the producer gets four 
 cents. As far as going ahead to get pure milk through legislation, 
 I think we better walk before we try to run. If we can get the 
 producers together to work in unison with the city officials we can 
 regulate some of the other things and get the price for pure milk 
 for the producer. 
 
 19 
 
THE RESULTS OF SOME BOVINE TUBERCULOSIS 
 
 INVESTIGATIONS AT THE UNIVERSITY FARM, 
 
 DAVIS, CALIFORNIA. 
 
 By C. M. Haring, D. V. M. 
 
 Presented at the Second Annual Meeting of the Medical Milk Com- 
 missions of California, April 18, 1910. 
 
 The results of certain investigations concerning bovine tubercu- 
 losis that have been carried on at the University of California Farm 
 for the past three years cover several subjects which it is impossible 
 to embody in a brief heading. They'may be stated as follows : 
 
 (1) A test of von Behring's Bovovaccine. 
 
 (2) Observations on the Spread of Bovine Tuberculosis Undei 
 Outdoor Conditions. 
 
 (3) Retesting Recently Tuberculinized Cattle. 
 
 (4) A Search for Tubercle Bacilli in the Circulating Blood of Re- 
 acting Cattle. 
 
 (5) Result of the Introduction of Cultures of Virulent Tubercle 
 Bacilli into the Circulation. 
 
 A preliminary report of this work has been given in a paper by 
 Haring, Sawyer and Morgan 1 and in a monograph by Sawyer. 2 
 The present paper is intended to embody the results of the investi- 
 gations previous to May 1, 1910. 
 
 A Test of von Behring's Bovovaccine. 
 
 In the spring of 1907 forty-five calves were secured for experi- 
 mental purposes. Twenty-two of these were treated with bovovac- 
 cine after the manner of von Behring and twenty-three were kept 
 as controls. Twenty-seven of the calves came from a dairy of 
 thirty cows which were proven to be non-reacting by two tuber- 
 culin tests. Eighteen came from a dairy of eighty-four cows, six- 
 teen of which reacted to tuberculin. Of the twenty-seven calves 
 from the non-reacting dairy herd thirteen were treated with bovo- 
 vaccine, and of the eighteen from the eighty-four cow dairy, nine 
 were so treated. 
 
 Great care was taken to follow the method and technic prescribed 
 by von Behring. The instrument case recommended by the Mar- 
 burg Institute was secured and the technic of inoculation carefully 
 followed. I will not take the time to describe the procedure in de- 
 tail, as most of you are familiar with this and the requirements of 
 von Berding as to age, environment, and manner of raising the 
 calves. An assistant in the employ of the University was sent to 
 the dairies to superintend the feeding and care of the calves. In 
 Professor von Behring's circular of directions No. 5, as published by 
 
 iHaring, C. M.; Sawyer, W. A., and Morgan, D. N., Bovine Tuberculosis 
 Investigations. Proceedings of the American Veterinary Medical Associa- 
 tion, Chicago, September, 1909, pp. 252-2CO. 
 
 2 Sawyer, W. A., Tubercle Bacilli in the Blood. Archives of Internal 
 Medicine, December, 1909, Vol. iv., pp. 628-638. 
 
 20 
 
Bischoff & Co., it is stated : "As a rule only apparently healthy 
 animals at the age of from two weeks to three months (for the 
 first inoculation) are chosen. In such calves a previous tuberculin 
 test is not necessary, even if the animals were taken from a notori- 
 ously tubercular herd." However, Bischoff & Co. wrote that the 
 tuberculin test should be made, and accordingly it was, except in a 
 few cases which a year afterwards proved to be non-reacting. We 
 found the normal temperatures very variable, as would naturally 
 be expected in such young animals. We believe that the tuberculin 
 testing of calves less than sixteen weeks old is unreliable as an 
 indication of tubercular infection. Nevertheless none of the calves 
 which showed an abnormally high temperature after injection were 
 vaccinated. 
 
 Another requirement imposed by Bischoff & Co. was that the 
 calves be kept from possibility of tubercular infection until four 
 months after the second vaccination. This in a measure was possi- 
 ble with the calves secured from the non-reacting herd, and the 
 danger to the calves in the other herd was obviated as much as 
 possible by weaning them at as early an age as seemed expedient. 
 As soon as possible the calves were all removed to the University 
 Farm, where at that time there were no tubercular cattle. 
 
 In the winter of 1908 the calves were all tested with tuberculin 
 and none reacted. They were then subjected to infection by placing 
 in their pasture five reacting cattle that were apparently in an 
 advanced stage of tuberculosis. They were associated with the 
 calves in a twenty-acre pasture and in a corral. Within six months 
 these five cattle had all died of tuberculosis as proven by autopsy 
 in each case. During the winter of 1909 no tubercular animals were 
 with the young cattle. They were fed under a shed during rainy 
 weather. Other than this they lived out-of-doors. In March, 1909, 
 ten reacting dairy cows were placed in the corral and pasture with 
 the young cattle. The proofs that several of these cows were af- 
 fected with open tuberculosis are given later in this paper. 
 
 In July, 1909, all the young cattle were tested and the reacting 
 ones sent to an abattoir having federal meat inspection. Special 
 arrangements were made with the abattoir company and with the 
 federal veterinary inspectors for their post-mortem examination. 
 The animals were killed after all other killing was over, and a more 
 searching inspection than usual made. 
 
 Since last July two tuberculin tests have been made on the re- 
 maining cattle, and to date (April 30, 1910) twenty-four of the 
 experimental animals have been slaughtered and found tubercular. 
 
 OF THE TWENTY-TWO VACCINATED CATTLE TEN 
 WERE TUBERCULAR; SIX OF THESE CAME ORIG- 
 INALLY FROM THE NON-REACTING DIARY HERD, AND 
 FOUR FROM THE REACTING DAIRY HERD. OF THE 
 TWENTY-THREE NON-VACCINATED CATTLE FOUR- 
 TEEN WERE TUBERCULAR, SEVEN CAME FROM THE 
 REACTING DAIRY HERD AND SEVEN CAME FROM THE 
 NON-REACTING DAIRY HERD. 
 
 21 
 
Table I. 
 
 Showing the age at vaccination and source of each tubercular 
 animal and the extent of its lesions. 
 
 No. of 
 the 
 animal 
 
 Original Source 
 of the 
 Calf. 
 
 Age at 
 1st vac- 
 cination. 
 
 Date of 
 
 Slaugh'r. 
 1909. 
 
 Location of Tubercular 
 Lesions Found on 
 Autopsy. 
 
 II 
 
 From a tubercular herd 
 
 10 wks. 
 
 Aug. 25 
 
 Liver and portal lymph glands 
 
 
 
 
 
 Lungs and mediastinal glands 
 
 12 
 
 Non-tubercular herd 
 
 14 wks. 
 
 Aug. 25 
 
 Right precrural lymph glands 
 
 26 
 
 Tubercular herd 
 
 12 wks. 
 
 Aug. 25 
 
 Mesenteric lymph glands 
 
 29 
 
 Non-tubercular herd 
 
 20 wks. 
 
 Aug. 25 
 
 Mesenteric lymph glands 
 
 
 
 
 1910. 
 
 
 48 
 
 Tubercular herd 
 
 12 wks. 
 
 Jan. 29 
 
 Posterior mediastinal gland 
 
 15 
 
 Tubercular herd 
 
 16 wks. 
 
 Jan. 29 
 
 Lungs and mediastinal glands 
 
 33 
 
 Non-tubercular herd 
 
 6 wks. 
 
 Jan. 29 
 
 Lungs, bronchial and mesen- 
 
 
 
 
 
 teric glands 
 
 32 
 
 Non-tubercular herd 
 
 4 wks. 
 
 Jan. 29 
 
 Posterior mediastinal gland* 
 
 21 
 
 Non-tubercular herd 
 
 16 wks. 
 
 Apr. 25 
 
 Rethopharyngeal lymph gland 
 
 22 
 
 Non-tubercular herd 
 
 5 wks. 
 
 Apr. 25 
 
 Lungs, pharyngeal and medi- 
 
 
 
 
 
 astinal glands 
 
 17 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Lungs, pleura, mediastinal 
 
 
 
 
 
 glands 
 
 23 
 
 Tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Cervical and thoracic lymph 
 
 
 
 
 
 glands 
 
 
 
 
 
 Cervical and mediastinal 
 
 27 
 
 Tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 lymph glands 
 
 
 
 
 
 Hepatic and mesenteric lymph 
 
 
 
 
 
 glands 
 
 36 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Bronchial, mediastinal and 
 
 
 
 
 
 portal glands 
 
 38 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Mediastinal lymph glands ^ 
 
 43 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Lungs, bronchial, and medi- 
 
 
 
 
 
 astinal and portal glands 
 
 44 
 
 Tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Generalized tuberculosis 
 
 5i 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Aug. 25 
 
 Bronchial, mediastinal and 
 
 
 
 
 1910. 
 
 portal glands 
 
 39 
 
 Tubercular herd 
 
 not vac'd 
 
 Jan. 29 
 
 Lungs and bronchial, medias- 
 
 
 
 
 
 tinal and mesenteric glands 
 
 47 
 
 Tubercular herd 
 
 not vac'd 
 
 Jan. 29 
 
 Posterior mediastinal gland 
 
 28 
 
 Tubercular herd 
 
 not vac'd 
 
 Jan. 29 
 
 Mesenteric gland 
 
 40 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Jan. 29 
 
 Bronchial gland 
 
 3i 
 
 Non-tubercular herd 
 
 not vac'd 
 
 Jan. 29 
 
 Bronchial gland 
 
 35* 
 
 Tubercular herd 
 
 not vac'd 
 
 Apr. 18 
 
 Lungs, liver and associated 
 
 
 
 
 
 lymph glands 
 
 *This animal was the one killed as a demonstration at the meeting of the 
 Medical Milk Commissioners of California at the University Farm. 
 
 It has been necessary, for economic reasons, to dispose of some 
 of the fattest non-reacting vaccinated cattle. In these no tubercular 
 lesions were found by the federal inspectors. 
 
 It would seem from these preliminary findings that von Behring's 
 Bovovaccine fails to confer on calves a degree of immunity suffi- 
 cient to absolutely protect them against infection until two and one- 
 half years of age when associated with tubercular cattle on pasture 
 and in corrals. However, this does not contradict evidence that 
 bovovaccinated calves have for a time an increased power of resist- 
 ance to tuberculosis. 
 
 22 
 
Observations on the Spread of Tuberculosis Under Outdoor 
 
 Conditions. 
 
 In at least one respect the problem of dairy sanitation is not as 
 great in California as in many other parts of the United States. The 
 problem of proper ventilation of stables is not a great one. The 
 climatic conditions are such that tight barns are unnecessary. Most 
 dairies do have barns, but the doors and windows are left open the 
 year round. Many have no cow stables. In such cases a shed 
 without side walls is usually available to milk under during rainy 
 weather. In one of the certified dairies, that at El Monte, supplying 
 milk to Pasadena and Los Angeles, the milking barn has no side 
 walls ; the cows are seldom under a roof more than four hours a day, 
 two hours at each milking. Naturally, under such conditions it 
 would be ridiculous to put stress on the King System or other 
 devices for ventilation. In dairy cows kept under these conditions, 
 tuberculosis is common. We believe that it will spread even under 
 strictly outdoor conditions. Even in range cattle the disease seems 
 to be increasing. 3 We have already mentioned the fact that in ex- 
 posing the bovovaccinated calves and the controls to infection the 
 association and resulting infection took place entirely in the out-of- ( 
 doors. The size of the pasture was about twenty acres, the corral* 
 was about one-half an acre in size. In the corral was a watering 
 trough, but the animals also had access to a stream and an irrigating 
 ditch in the pasture. The first five tubercular cattle that were 
 secured for infecting the experimental calves were stock kept under 
 semi-range conditions. In central California are vast swampi 
 called tule lands. Much of the year these furnish excellent green 
 feed for cattle. The five cattle were selected from a band of about 
 150 cattle that had been raised in these tules. 
 
 The probabilities are that they had never been under a roof. In 
 riding through the swamp, six animals were selected, which were 
 emaciated or coughing. On tuberculin test five of these reacted 
 and in May, 1908, they were taken to the University Farm. In six 
 months all had died of advanced tuberculosis, as proven by autopsy 
 in each case. The last of the animals died October 9, 1908, making 
 the time they were confined with the experimental calves less than 
 six months. 
 
 In March, 1909, nine reacting dairy cows were secured. Two of 
 these were in full lactation, but were rapidly dried up. The others 
 were dry. Some of them had been tuberculin tested in February, 
 1909, and some in March, and had been removed from a certified 
 herd because of reactions. Most of them were in poor condition, 
 but under their changed conditions all but one improved in appear- 
 ance. In April one died. The autopsy on this animal was imper-, 
 fectly performed, but the lungs were noted to be calcareous. On 
 June 3, 1909, the nine remaining cows were tested with 3 cc. of 
 University of California tuberculin, and none of them reacted. On 
 
 3 Ward and Haring, Bulletin 199, Agricultural Experiment Station, Berkeley, 
 California, August, 1908. 
 
 23 
 
July 4th they were tested with 4 cc. of Bureau of Animal Industry 
 tuberculin. Four of them showed a rise in temperature, but the 
 curve was not typical of a tuberculin reaction. We have proven 
 that all but one of them were tubercular, in the following manner : 
 
 Seven were autopsied, and in six of these extensive lesions were 
 found in the lungs and associated lympathic glands ; in the other the 
 retropharyngeal glands only were involved. One was proven 
 tubercular by infecting a guinea pig from pus from a tubercular 
 abscess in the prepectoral region. This cow was eventually autopsied 
 after having been inoculated in the carotid artery, as is describee 
 later in this paper. The eighth cow was proven tubercular by in- 
 fecting a guinea pig with her feces. One of the interesting things 
 to be noted is that the tuberculin test failed to give a reaction, 
 although the animals were actively tubercular. We have observed 
 this failure to react in an instance where about twenty reacting 
 dairy cows were removed from a dairy ^ dried up and turned into a 
 mountain pasture. When re-tested several months later most of 
 them failed to react. These observations support us in the stand 
 that in removing cows from dairy herds because they react to the 
 tuberculin, no re-tests should be permitted. We believe the rule 
 should be : Once reacted, always condemned. Outdoor life and 
 freedom from the drain of milking may possibly cure some, cows, 
 but the cases just described show that, although they may improve 
 in condition and cease to react to tuberculin, they may still be dis- 
 seminating virulent bacilli, and that young, susceptible animals 
 quickly contract the disease, even under an environment which acts 
 with benefit on old and chronically tubercular dairy cows. 
 
 Re-testing Recently Tuberculinized Cattle. 
 
 Tests of Vallee's method by re-testing recently tuberculinized cat- 
 tle have been made on thirty-seven reacting cows. By this method it 
 is claimed that animals can be successfully re-tested in forty-eight 
 hours after a previous injection. The procedure is to inject a double 
 or triple dose and take the temperatures every two hours from the 
 second to the eighteenth. The reaction is said to usually occur much 
 sooner than in the original test. The results of our work as given in 
 the following table are based on the injection of 4 cc. of tuberculin at 
 the retest, the temperature being taken every two hours from the 
 second to the eighteenth hour after injection. 
 
 
 
 
 Hour at which the 
 
 Hour at which the 
 
 Number o 
 
 Reinjected 
 
 Number reacted 
 
 temperature rise 
 
 temperature rise 
 
 animals. 
 
 in. 
 
 on retest. 
 
 occurred on the 
 
 occurred on the 
 
 
 
 
 retest. 
 
 initial test. 
 
 3 
 
 48 hours 
 
 I 
 
 9 
 
 13 
 
 14 
 
 58 hours 
 3 days 
 
 7 
 
 i 
 
 10 
 
 ii 
 
 12 
 
 9 
 
 6 
 
 5 days 
 
 i 
 
 i? 
 
 12 
 
 4 
 
 45 days 
 
 4 
 
 14 
 
 12 
 
 4 
 
 2 months 
 
 4 
 
 13 
 
 14 
 
 It is interesting to note in corroboration of Vallee's observations 
 that, in the retests made within five days, the animals reacting to the 
 second injection usually had a rise of temperature sooner than at the 
 first test, but the only conclusion to be drawn from this limited num- 
 
 24 
 
ber of cases is that the retesting of cattle within six weeks is not 
 satisfactory, even when a double dose is used, and the temperature 
 taken every two hours from the time of injection until the eighteenth 
 hour. The cases already reported of the retesting of non-lactating 
 dairy cows, indicates that sometimes tubercular cattle will not react 
 to tuberculin on retest even after a period of three months. 
 
 A Search for Tubercle Bacilli in the Circulating Blood of Reacting 
 
 Cattle. 
 
 Considerable interest has been aroused by recent articles claiming 
 that tuberculosis, in all its forms, is a bacteriemia. Rosenberger 4 - 5 
 claims to have found tubercle bacilli in the circulating blood of 300 
 people, some of which were affected with incipient tuberculosis. 
 Petty and Mendenhall 6 and Forsythe 7 claim to have obtained posi- 
 tive results with Rosenberger's technic. The technic employed by 
 Dr. Rosenberger is to draw 5 cc. of venous blood, mix it with an 
 equal amount of 2% sodium citrate in physiological salt solution, in 
 an ordinary test tube. This blood mixture is placed in a refrigerator 
 for twenty-four hours, by which time a reddish sediment will have 
 formed in the bottom of the tube. A portion of this is smeared on a 
 slide, fixed and stained in the usual way. For decolorizing be used 
 Papenheim's solution (1% rosolic acid in absolute alcohol). 
 
 The important bearing of Rosenberger's claims on the bovine 
 tuberculosis problem is evident. From the standpoint of the meat 
 inspector alone, it is of vital importance, and the necessity of verify- 
 ing or refuting Rosenberger's work in so far as it applies to cattle is 
 great. Schroeder, Cotton, and Mohler 8 ' 9 have already published 
 work done on fifty tubercular cattle. They failed utterly to find 
 tubercle bacilli in the blood of these cattle. Failures to find the 
 bacilli in the circulating blood of tubercular humans have been re- 
 ported by Ravenel 10 and Smith, Burnham 11 and Lyons, and 
 Dailey. 12 Attention has been called by Brem 13 and others to the 
 liability of distilled water to contamination with acid-fast bacilli. 
 
 4 Rosenberger, Randall C. The Presence of Tubercle Bacilli in the Circulating 
 Blood in Tuberculosis. American Journal of Medical Science, vol. 137, No. 2, 
 pp. 267-269. Philadelphia, Feb., 1909. 
 
 fi Rosenberger, Randall C. Presence of the Tubercle Bacillus in the Blood. 
 New York Medical Journal, 1909, Ixxxix, 1250. 
 
 B Petty, O. H., and Mendenhall, A. M. Tubercle Bacilli in the Blood. Journal 
 American Medical Association, 1909, liii, 867. 
 
 7 Forsythe, C. E. P. Occurrence of Tubercle Bacilli in the Blood. British 
 Medical Journal, April 24, 1909. 
 
 8 Schroeder, E. C., and Cotton, W. E. Tests Concerning Tubercle Bacilli in 
 the Circulating Blood. U. S. Department of Agriculture; B. A. I. Bulletin 116. 
 
 9 Schroeder, E. C., and Cotton, W. E. Tests Concerning Tubercle Bacilli in 
 the Circulating Blood. The Archives Int. Med., 1909, iv, 133. 
 
 10 Ravenel, M. P., and Smith, K. W. Detection of Tubercle Bacilli in the 
 Blood. Proc. State Med. Soc. of Wisconsin, abst. in Journal American Medical 
 Association, 1909, liii, 649. 
 
 11 Burnham, M. P. Tuberculosis A. Bacteriemia. Journal American Medical 
 Association, 1909, liii, 731. 
 
 12 Dailey, M. A. The Presence of Tubercle Bacilli in the Blood in Tubercu- 
 losis. Boston Medical and Surgical Journal, 1909, clxi, 318. 
 
 13 Brem, W. V. Investigation of Blood for Tubercle Bacilli; Contamination 
 of Distilled Water with Acid-fast Organisms a Source of Error. Journal Amer- 
 ican Medical Association, 1909, liii, 909. 
 
 25 
 
Since the results of our work are also negative, and the length of 
 this paper limited, I will give merely a summary of the work done. 
 
 In 167 preparations made from the blood of 49 bleedings from 21 
 tuberculous cattle no tubercle bacilli were found in 110.9 hours' 
 search ; 133 of the specimens, made from gravity sediments of blood- 
 citrate mixture, were searched 88.9 hours ; the remaining 34 slides, 
 made from laked and centrifugalized blood, were searched 22 hours. 
 
 In one instance tubercle bacilli were recovered by both methods of 
 examination from blood drawn twenty-five minutes after inoculation 
 of the arterial blood-stream. 
 
 Guinea-pig inoculations with the blood sediments of twenty tuber- 
 culous cattle failed to produce tuberculosis. 
 
 Not less than thirty minutes was devoted to the diligent micro- 
 scopical search of each slide. The findings were negative. In most 
 instances the work was controlled by having two or more individuals 
 examine each slide. Large numbers of acid-fast bacilli were found 
 in one of the specimens prepared by dissolving the blood clot with 
 pepsin. We believe this to be a contamination. Dr. Rosenberger 
 kindly sent us a slide of blood presumably from a case of human 
 tuberculosis. In this we found numerous acid-fast bacilli, indis- 
 tinguishable from tubercle bacilli. He wrote us that we would 
 find the organisms in our preparations if we would only search long 
 enough; so some of our most promising specimens were diligently 
 searched for several hours by three persons accustomed to the use 
 of the microscope, without finding a single organism resembling a 
 tubercle bacillus. Thirty-seven guinea pigs were inoculated with 
 blood sediments. They were autopsied after two months, and failed 
 to show lesions. Control pigs, inoculated with blood sediments to 
 which small quantities of tubercular pus from one of the cows had 
 been added, were tubercular. 
 
 Introduction of Virulent Cultures of Bovine Tubercle Bacilli Into 
 
 the Circulation. 
 
 In order to make a study of the methods of detecting tubercle 
 bacilli in the blood, it was attempted to produce artificially the tuber- 
 culous bacteriemia which we had failed to find. A cow suffering 
 from advanced tuberculosis (No. 7) and a plump three-year-old 
 steer (No. 18) were selected for experiment. The cow had a sub- 
 maxillary abscess from which tuberculous pus and a calcareous 
 gland had been taken. The steer had been twice inoculated when a 
 calf with attenuated cultures of tubercle bacilli. There was no re- 
 action to the tuberculin test. The animals received in their jugular 
 veins quantities proportional to their weights of a suspension of live 
 bovine tubercle bacilli in normal salt solution. No. 7 received 200 cc. 
 and No. 18, 250 cc. The bacilli had been washed, dried, ground dry 
 for ten minutes in a revolving Erlenmeyer flask containing glass 
 balls, and had been rotated for several hours more after the addition 
 of normal salt solution. About 200 mg. of tubercle bacilli were con- 
 tained in 250 cc. Smears of the suspension mixed with blood per- 
 mitted the rough estimate to be made that there were many more 
 free bacilli, and as many clumps, in the suspension injected into No. 
 
 26 
 
18 as there were white corpuscles in the entire circulating blood of 
 the animal. Inasmuch as many corpuscles had been found in almost 
 every field of most of the blood-preparations of this investigation, it 
 was expected that many bacteria would be found in each field of the 
 slides of the steer's blood. No. 18 was bled from the jugular vein, 
 of the side which had not received the inoculation, at intervals of 
 thirty minutes, five hours, eleven hours, twenty-five hours, forty-six 
 hours and ten days from inoculation. The routine miscroscopic 
 blood examination failed to reveal any tubercle bacilli. 
 
 Part of a mixture of the blood sediments of the first five bleedings 
 was inoculated intraperitoneally into a guinea pig, which was 
 allowed to live eleven weeks. Another guinea pig received the sedi- 
 ment of the sixth and last bleeding and was killed at the end of ten 
 weeks. At autopsy both animals appeared to be entirely normal. 
 
 The steer's temperature rose rapidly to 105.5 after inoculation, but 
 fell to normal the next morning. After a few days the temperature 
 began to rise again, and four weeks after inoculation the animal died. 
 Autopsy, performed twenty-four hours after death, showed the lungs 
 to be crowded with miliary tubercles. The spleen contained on the 
 average one miliary tubercle in each square centimeter of its surface. 
 The kidneys contained a few miliary tubercles and the liver none. 
 The mediastinal, inguinal, pelvic, and crural lymph-nodes were en- 
 larged and soft. In the heart were a clot and some red turbid serum. 
 The centrifugalized sediment of this serum showed many coarse 
 bacilli and one group of three tubercle bacilli. 
 
 Cow 7 was bled one hour, five hours, eleven hours, twenty-five 
 hours, forty-six hours and fourteen days after inoculation, and the 
 blood was examined. One short structure resembling a tubercle 
 bacillus was found in a smear from the top layer of the sediment 
 drawn eleven hours after inoculation. This slide had been decol- 
 orized by the rosolic acid solution. All the other slides were unques- 
 tionably negative. 
 
 A guinea pig which received part of a mixture of the sediment 
 from the first five of the six bleedings was killed eleven weeks after 
 inoculation and found to be normal. 
 
 The cow's temperature rose immediately after inoculation to 107.5, 
 and in a few hours fell almost to normal. Then the temperature rose 
 gradually to 107.8 and subsided almost to normal. The curve of this 
 last rise and fall suggested the course of a severe tuberculin reaction. 
 No corresponding rise and fall had occurred in the temperature of 
 steer 18. The cow died nine weeks after inoculation. Autops> 
 showed extensive chronic lesions and no acute miliary tuberculosis. 
 The right submaxillary, bronchial, anterior mediastinal, portal and 
 mesenteric lymph-nodes were found calcified. The left mediastinal 
 and parotid lymph-nodes were caseous. The left submaxillary 
 lymph-nodes had broken down and had formed a large abscess. 
 Both lungs were extensively involved with old lesions, some con- 
 necting with the bronchi. The spleen showed a calcified nodule 2 
 cm. in diameter. The liver and kidneys were normal. 
 
 A third time we introduced tubercle bacilli into the circulation of 
 the cattle and attempted to recover them from their blood. Cow 3 
 of Group A had advanced tuberculosis. Tubercle bacilli had been 
 found in the pus of a large axillary abscess. The animal was put 
 
 27 
 
deeply under the influence of chloral and its right carotid artery was* 
 exposed. Fifteen cc. of suspension of 180 mg. of live bovine tubercle, 
 bacilli, which had been washed, dried and ground in a revolving flask 
 for one hour before the addition of normal salt solution, was intro- 
 duced through a needle into the artery. Blood was withdrawn from 
 the jugular vein of the same side, but from a point distant from the 
 operation wound, twenty-five minutes, one and one-half hours, two 
 days, and six days after the inoculation. The blood drawn twenty- 
 five minutes after the introduction of the organisms showed tubercle 
 bacilli as follows : 
 
 A search of seventy minutes in the specimen from the centrifugal- 
 ized and laked blood showed five clumps, one group of four, one 
 group of two, and one single bacillus. 
 
 A search of fifty-five minutes in the first preparation from the top 
 layer (decolorized by rosolic solution) showed two clumps. 
 
 A search of sixty minutes in the second preparation from the top 
 layer (decolorized by nitric acid) showed one clump. 
 
 Both smears from the bottom of the sediment (one decolorized by 
 rosolic and one by nitric acid) showed no bacilli after sixty-six and 
 seventy-two minutes' search. 
 
 No tubercle bacilli were found in specimens from the bleedings 
 made from one and one-half hours to six days after inoculation. 
 
 Half of a mixture of the sediments drawn twenty-five minutes and 
 an hour and a half after inoculation was inoculated intraperitoneally 
 into a guinea pig. Ten and one-half weeks later the guinea pig was 
 killed. Three tubercles 2 mm. in diameter were found in the spleen. 
 No other lesions were discovered. 
 
 A guinea pig was inoculated intraperitoneally with the combined 
 sediments of the blood specimens drawn two and six days after inoc- 
 ulation. The animal died six weeks after receiving the blood. Autopsy 
 showed the presence of three full-term fetuses, but no lesions of 
 tuberculosis. The results of the guinea-pig inoculation in this case 
 confirmed the miscroscopic findings. The natural conclusion would 
 be that the abundant tubercle bacilli had been rapidly filtered from 
 the blood. 
 
 The temperature of cow 3 dropped for two hours after inoculation 
 and then rose rapidly to 106. The temperature soon fell slightly and 
 then slowly developed a marked daily variation. This animal had 
 been running an irregular elevated temperature before the experi- 
 ment. Death resulted five weeks after inoculation from hemorrhage 
 from a ruptured aneurism at the point of inoculation in the carotid. 
 Autopsy showed many hard tubercles averaging 0.5 cm. in diameter 
 scattered throughout both lungs. One small tubercle was seen in the 
 right kidney and one in the tissues near the aneurism. The medi- 
 astinal lymph-nodes were calcareous and the post-pharyngeal nodes 
 were purulent. Most of the lesions appeared to have been of long 
 duration, and autopsy gave no evidence of acute miliary tuberculosis. 
 
 The experiments just described show that artificially introduced 
 tubercle bacilli are rapidly removed from the circulation of healthy 
 and of tuberculous cattle. That the capillaries of the lungs are more 
 efficient as filters than the capillaries of the peripheral circulation is 
 suggested by the almost complete, if not entire, absence of tubercle 
 
 28 
 
bacilli from blood which had necessarily passed through the pul- 
 monary circulation, and by the presence of bacilli in blood which 
 needed to go only from a peripheral artery to the corresponding 
 peripheral vein. Possibly this quality of the lung capillaries may be 
 one of the causes of the great frequency of pulmonary involvement 
 when tubercle bacilli have entered the body at points distant from 
 the lungs. 
 
 It will be noticed that inoculation produced in a healthy young 
 steer a rapid and fatal miliary tuberculosis, while in Cows 3 and 7 
 not more than an aggravation of the existing extensive chronic 
 tuberculosis was brought about. It would appear that long-standing 
 chronic tuberculosis produced a ,much higher power of resistance 
 against newly introduced infection than did the intravenous injec- 
 tion of attenuated cultures. That cattle affected with chronic tuber- 
 culosis should be somewhat resistant to acute tuberculosis from 
 inoculation would be expected; but the great resistance shown by 
 Nos. 3 and 7 to overpowering introductions of virulent bovine bacilli 
 into the blood stream is interesting and suggestive. 
 
 The work on tubercle bacilli in the blood was done in conjunction 
 with Wilbur A. Sawyer, M. D., physician at the University of Cali- 
 fornia Infirmary, Berkeley. 
 
 Dr. Sawyer and I are indebted to Archibald R. Ward, B. S. A., 
 D. V. M., Assistant Professor of Bacteriology in the University of 
 California ; to Miss Margaret Henderson, B. S., Instructor in Bacteri- 
 ology in the University of California ; to David N. Morgan, B. S., and 
 to Ned D. Baker, B. S., for valuable advice and assistance. 
 
 29 
 
CONCLUSIONS. 
 
 This paper is intended as a preliminary report and as more data is 
 obtained, these conclusions may be modified somewhat. They arc 
 given merely as a summary of results thus far obtained. 
 
 (1) Bovovaccine fails to protect calves until two and one-half 
 years old, under California conditions. Some immunity seems to be 
 produced. 
 
 (2) Tuberculosis will sometimes spread rapidly in cattle under 
 strictly outdoor conditions. 
 
 (3) The retesting of cattle within six weeks, even when Vallee's 
 method is used, is unsatisfactory. Some tubercular cattle will not 
 react to tuberculin on retesting even after three months. 
 
 (4) Numerous microscopic examinations, by Rosenberger's 
 method, of blood sediments from twenty tuberculous cattle, failed to 
 give evidence that tubercle bacilli existed in the circulating blood. 
 
 (5) In one instance tubercle bacilli were recovered from blood 
 drawn twenty-five minutes after inoculation of the arterial blood- 
 stream. 
 
 (6) Guinea- pig inoculations with the blood sediments of twenty 
 tuberculous cattle failed to produce tuberculosis. 
 
 (7) Tubercle bacilli which have been experimentally thrown into 
 the blood-stream are rapidly removed from the circulation. Experi- 
 ment suggests that the capillaries of the lungs are more efficient in 
 arresting bacilli than the peripheral capillaries. 
 
 (8) Judging from two instances only, cattle affected with chronic 
 tuberculosis seem much more resistant to acute tuberculosis from 
 inoculation than one-tubercular cattle. Chronic tuberculosis in 
 cattle appears to produce a partial immunity against fresh inocula- 
 tion with bovine tubercle bacilli. 
 
 University Farm, Davis, California. 
 
 30 
 
REMARKS. 
 
 Dr. Lewis Sayre Mace, San Francisco : I believe the skin tests 
 are largely in disfavor now, on account of their inaccuracy. The 
 reaction may be present in a case of tuberculosis where a very 
 small and absolutely insignificant lesion is present. It has been 
 shown that these reactions depend upon certain conditions which 
 follow no rule. Personally I would not place any dependence 
 upon the Moro or the von Pirquet reaction or the ocular reaction, 
 and I will say that I have seen negative results in early cases in 
 which removed tissue gave a positive result in guinea-pig tests. 
 
 Dr. Stanley P. Black, Pasadena The question of testing of cattle 
 I think is a very important one. I am very glad that it was brought 
 out to-day. For several years we have been retesting cattle with 
 doubtful reactions in Pasadena. While I have not felt quite clear in 
 my conscience in regard to it I have re-admitted two herds of cattle 
 which have stood the second tests. Now I think that was wrong. 
 We must adopt the sign of the Roman Coliseum for the slaughter, 
 "Kill." However, it is not right that the dairymen should lose 
 every penny of the money. Some of them are dishonest enough to 
 sell cows to somebody else, cows that should be slaughtered; this 
 I know has been and is being done all the time. When we have 
 reacting cows in Pasadena we now brand them with a large tbc. 
 on the jaw, so that she cannot be sold to some unsuspecting person 
 as a good cow. This is a great help in recognizing them when they 
 are to be separated from the herd where before the only way we 
 had of finding them was by reading the number of the ear tag, and 
 until we adopted this method of branding we had a hard time in 
 finding the infected cows. The only way of solving this question, 
 of preventing the sale of infected meat, is for the State to pay an 
 indemnity for tubercular cattle. The public ought to pay the bill 
 as it is the only way out of it. 
 
 Previous to the reading of the foregoing papers several tuber- 
 culous cows were examined and the various phases of the tuberculin 
 test exemplified by Dr. C. M. Haring and Dr. Walter Bates. 
 
 A reacting cow was selected and after physical examination iu 
 the amphitheater, removed and slaughtered. 
 
 At the close of the program the tubercular lesions of the animal 
 were demonstrated by Chester Roadhouse, D. V. M., Ex-U. S. 
 Meat Inspector and Veterinarian of the San Francisco County 
 Medical Milk Commission. 
 
 31 
 
REPORT OF THE ALAMEDA COUNTY MEDICAL MILK 
 
 COMMISSION. 
 
 Alameda, Cal., April .16, 1910. 
 President and Members, California Milk Commission, 
 
 Dear Sirs A little over a year ago the Alameda County Medical 
 Society took up the "Certified Milk" work theretofore done by the 
 "Home Club" of Oakland. The Society appointed a milk commis- 
 sion consisting of five (5) members and gave this commission full 
 power to act. 
 
 The Commission chose for its experts Dr. A. R. Ward, State 
 Bacteriologist, and Professor M. E. Jaffa, State Chemist, who 
 ren'der frequent reports on the conditions of the herds and dairies; 
 on the methods of producing and handling the milk and on the 
 quality and purity of the milk itself. 
 
 We now issue certificates to two dairies, "Walnut Grove Dairy," 
 of Santa Clara County, and "Timm's Dairy," of Dixon. 
 
 The expenses of the chemical bacteriological and veterinary in- 
 spections are paid for by the dairymen ; while the running expenses 
 of the Commission are covered by the receipts from the sale of 
 certificates. These certificates are sold for $1.25 per 1,000, or one 
 eighth of a cent a piece. 4 
 
 We find this sufficient to pay all our expenses and to leave us a 
 balance on hand of $193. 
 
 At present these two dairies are delivering daily in Alameda 36 
 quarts, in Berkeley 264 quarts, and in Oakland 830 quarts, a total of 
 1,130 quarts daily. 
 
 We have endeavored to keep our requirements for "Certified 
 Milk" in accord with those of the Milk Commission of the San 
 Francisco Medical Society, so that the requirements of the Com- 
 missions about the Bay of San Francisco would be uniform. 
 
 The milk situation in Alameda County is very good; but great 
 progress can be made by a continuous campaign of education- 
 education of the physician as well as of the consumer. 
 
 We are now issuing educational pamphlets to be distributed by 
 the dairies and by the Women's Clubs of the county. 
 
 The Commission does not recognize "Inspected Milk or Pasteur- 
 ized Milk." It recognizes "Certified Milk" only. 
 
 Yours truly, 
 
 J. K. HAMILTON, 
 Secretary Milk Commission, Alameda County Medical Society. 
 
 Bay Station, Alameda. 
 
 32 
 
Pamphlet 
 Binder 
 
 Gaylord Bros., Inc. 
 
 Makers 
 
 Stockton, Calif. 
 PAT. JAN. 21. 1908 
 
 M1189Q 
 
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