Nurture Turned to Poison

NURTURE TURNED TO POISON FREDERICK STENN* Milk is our most cherished food, wholesome, nutritious, sweet, and cool. Its high standards of cleanliness are jealously guarded and rigidly controlled, from the udder of the cow to the lips of the child. Yet, for 150 years, this same milk was as deadly as Socrates' hemlock. The struggle to obtain clean, healthful milk against unyielding prejudice, medical indecision, scientific conflict, commercial indifference, legislative torpor, personal calumny, and if I may say, downright stupidity—this painful struggle crowned with success constitutes a capital event in the history of mankind [I]. It is a story of asking the right questions to get the right answers. The high mortality in infancy caught the attention of Jean Jacques Rousseau in 1761 [2]. This mortality reached the frightful figure of 400 per 1,000 births in New York City in 1880, little better than the figures of death among the ancient Indians of the Pecos Valley. Roussel, the humble child's doctor of late nineteenth-century France, reported 100 percent mortality for the first year in foundling homes. Archaeological, church, cemetery, and hospital records showed one-third of all burials under the age of 5 years. As late as 1915, George Bernard Shaw pointed out that, in England, out of 800,000 births, 100,000 died. Those of us who are over the age of 60 remember that parents considered themselves lucky if their children survived the first year of life. As far back as the finger of history can reach, a sizable part of society expressed as little interest in the welfare of the infant as twentiethcentury culture does in the plight of the aged. Families were large, Address delivered to the Chicago Literary Club, December 4, 1978, and printed here with the permission of the club. The author thanks the following for their help: Professor William Beatty of Northwestern University Medical School; Roger Tachuk and Jean Emery of the Northwestern University Medical Library; Murray Brown, M.D., health commissioner of the City of Chicago; the Archives Division of the Chicago Historical Society; William Siarny, Jr., assistant librarian of the National Dairy Council; Raymond W. Mykleby, executive vice president of the Dairy Research Council, Inc.; and his wife, Harriett .»Address: 1240 West Park Avenue, Highland Park, Illinois 60035.© 1980 by The University of Chicago. 0031-5982/81/2401-02 14$01.00 Perspectives in Biology and Medicine ¦ Autumn 1980 | 69 poverty oppressing, food and shelter in short supply. Criminal disposition of the infant and child was rampant: disposition through exposure, torture, starvation, overlaying, drowning, immolation, abandonment, farming out, and selling into slavery. Leaders were crying out, as Chap ín, the pediatrician, did, that the life of the child is the most valuable asset of the state [3]. But society was not prepared to believe that the child was the most valuable asset of the state—no, not for another 75 years. John Dewey said the same thing in another way: "The indefinite improvement of humanity and the cause of the little child are inseparably bound together." People, including doctors, I regret to say, believed that natural death in infancy was due to early weaning and teething, a concept that was recognized as axiomatic in Hammurabi's time. The accusing finger pointed at infectious diseases, malnutrition, and malformations. But the giant share of infant mortality and morbidity fell to spoiled milk. I do not include here milk sickness of tremetol poisoning due to the poisonous snakeroot that killed Nancy Lincoln nor to selenium poisoning that destroyed cattle in the Dakotas. Spoiled milk in reality served as a household word at all times. The Zulus blamed menstruation as the cause of spoiled milk, and each age and each people gave their own explanation (including thunder) of spoiled milk. But the subject appeared seriously on the stage of history with the growth of cities about 1825. Even earlier Tobias Smollett, in his Expedition ofHumphrey Clinker in 1771, describes the milk "carried through the streets in open pails exposed to foul refuse discharged from doors and windows, spittle, snot, and tobacco quids, from foot passengers, from mud, carts, spatterings from coach wheels, dirt and trash chucked into it by roguish boys...