h whom they come in contact has any kind
of contagious disease, are all obligatory. The feed for the cows and
the purity of the water given them to drink must be inspected and made
to conform to the standard laid down for certified milk. The milk of
sick cows and those having tuberculosis is absolutely condemned. The
composition of certified milk is standardized as follows: the fat
standard shall be 4%, with a permissible range varying from 3.5% to
4.5%. The proteins shall be 3.5%, with a permissible range varying
from 3% to 4%. Certified milk shall not contain more than 10,000
bacteria to the cubic centimeter when it is delivered. This inspection
and standardizing necessarily raises the price of certified milk above
that of milk not so rigidly cared for, and when the additional expense
makes it impossible for the patient to afford certified milk, the only
thing to do is to be sure of the reliability of the dealer from whom
the milk is purchased and the cleanliness of the dairy from which it
is procured. Buttermilk and butter are the milk products which
require some attention as to selection. The former grows sour with age
and the odor of advanced fermentation and decomposition is readily
recognized. Sweet butter, butter without salt, is less apt to be old
when purchased than the salted variety, as the flavor of rancid fat is
unmistakable in butter which has not been especially treated.
~Milk.~--Milk is without a doubt the most valuable food in the invalid
dietary, furnishing not only a highly nutritious beverage, but
likewise acting as a carrier of additional nourishment when such is
necessary. Its form, its lack of definite flavor and odor, all add to
its value as a food in sickness. Milk is one of the few foods which
includes in its composition all of the chemical combinations known as
foodstuffs. The carbohydrates, comprising 4.88% to 5% of the solids in
milk, occur as lactose or milk sugar. This sugar belongs to the
disaccharide group, and is, in the majority of cases, readily digested
by even the most delicate digestive apparatus. This form of sugar
lends itself particularly well as a reinforcing agent, and is
generally used in such cases as typhoid fever, etc. The fat in milk,
comprising 4% of the solids and occurring as butter fat (cream), is
made up chiefly of olein and of palmitin, with smaller amounts of
stearin and from 5% to 6% of its composition in the form of butyric
acid (the fatty acid to which butter
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