upply. This is rendered more probable when it is
remembered that bottle-fed infants suffer a much higher mortality
than breast-fed children, due probably to the fact that the
lengthened period between the time the milk is drawn and consumed
permits of abundant bacterial growth. Much carelessness also
prevails among the poor in cities, relative to the care of utensils
used in feeding children. Nursing bottles often serve to infect the
milk. Where milk is pasteurized, or properly heated, it has been
found that the mortality rate has been greatly reduced, thus
indicating that the condition of the milk was directly responsible
for the death rate. In fact, the mortality from these indefinite
intestinal troubles probably exceeds that from all of the specific
infectious diseases combined. Improved care in handling this
sensitive food supply will do much to better conditions in this
direction.

=Ptomaine poisoning.= Acute poisoning affecting adults as well as
children, not infrequently occurs from the use of foods of various
kinds. Cases of poisoning arising from the use of shell fish, canned
meats, ice cream, cheese, and other dairy products, are from time to
time reported. These troubles are due to the production of toxic
compounds, in the main, probably caused by bacterial decompositions.
Often such troubles may affect a number of persons, as at banquets
and such gatherings, thereby giving the semblance of an epidemic.
While such troubles are doubtless to be ascribed to bacterial
activity, they are not transmissible from person to person.

In the case of troubles arising from ice cream and such confections,
the probable cause is due to the storage of milk or cream under
refrigerator conditions, where germ growth can go on in the product,
and yet the temperature be sufficiently low to prevent the usual
acid fermentations.

CHAPTER V.

FERMENTATIONS OF MILK.

Milk, under normal conditions, is always contaminated with bacteria
coming from the most varied sources. If it is produced under clean
conditions, the number of bacteria will be small, but in any case,
the number of kinds of bacteria that find their way into milk will
be large. Many of them find in milk at ordinary temperatures
suitable conditions for growth; they use a portion of some of the
constituents of the milk as food, producing certain other compounds
that are known as "by-products." These by-products impart to milk a
taste and odor that is not fou