Though there can be no doubt as to the virulence of tuberculous milk, it may be remembered with satisfaction that only about two per cent. of tuberculous cows have unmistakably tubercular milk. Even of this tubercular milk, unless it is very rich in bacilli and is ingested in large quantities, the risks are practically small or even absent. Practically the danger from drinking raw milk exists only for persons who use it as their sole or principal food, that is to say, young children and certain invalids. With adults in normal health the danger is greatly minimised, as the healthy digestive tract is relatively insusceptible. Moreover, dairy milk is almost invariably _mixed_ milk; that is to say, if there is a tubercular cow in a herd yielding tubercle bacilli in her milk, the addition of the milk of the rest of the herd so effectually _dilutes_ the whole as to render it almost innocuous.
But if for practical purposes we look upon all milk derived from tubercular udders as highly infective, we may adopt a comparatively simple and efficient remedy. To avoid all danger it is sufficient to bring the milk to a boil for a few minutes before it is consumed; in fact, the temperature of 85° C. (160° F.) prolonged for five minutes kills all bacilli. The common idea that boiled milk is indigestible, and that the boiling causes it to lose much of its nutritive value, is largely groundless.
Milk may become tubercular through the carelessness or dirty habits of the milker. Such a common practice as moistening the hands with saliva previously to milking may, in cases of tubercular milkers, effectually contaminate the milk. Again, it may become polluted by dried tubercular excreta getting into it. Such conveyances must be of rare occurrence, yet their possibility should not be forgotten.
An infant suckled by a tuberculous mother would run similarly serious risks of becoming infected with the disease.
In Liverpool, Dr. E. W. Hope, the Medical Officer of Health, has organised an admirable system of examination by skilled bacteriologists to find to what degree the Liverpool milk supply is contaminated with tubercle. The final result of this pioneer work, which ought really to be undertaken by every great corporation responsible to the citizens for a pure water and pure milk supply, is to the effect that in Liverpool 5.2 per cent. of the samples of milk taken from the city shippons contains tubercle bacilli. As regards the milk sent in from the country, the return is that 13.4 per cent. is contaminated with the bacillus of tubercle.