Popular Science Monthly/Volume 19/August 1881/The Insufficient Use of Milk
By DYCE DUCKWORTH, M. D., F. R. C. P.
I DESIRE to call attention to the insufficient employment of milk as an ordinary article of diet in this country. It may seem hardly possible to maintain that such a complaint is rightly grounded. All classes of persons are supposed to use milk, to some amount, as a matter of course. And although adults are not supposed to take very much, save what they consume with tea and coffee, yet children are commonly credited with the consumption of a good deal, or, at all events, of a sufficiency, of this commodity.
In this communication I propose to show that this common belief is largely erroneous, and that persons of all classes, and of all ages, in England, consume too little milk. The consequences of this starvation I hold to be serious, and the remedy for it perhaps not far to seek. The subject may be best considered, first, as it affects the communities settled in cities and towns; and, secondly, in relation to the peasantry and country population generally.
Is is not too much to say that a fitting supply of milk is at present too seldom secured even by families who can well afford to pay for it. The full value of milk as an article of diet is not yet sufficiently appreciated by people who ought to be aware of it. Many adults regard it mainly as food for children, and many believe that they can not digest it, and state that it "curdles on the stomach," and makes them "bilious." The ordinary milk-supply to many establishments is just sufficient to allow their tea and coffee to be colored with it. A very inadequate quantity is often given to children, and the quality of it is no better than that yielded by skimmed milk, with, possibly, more or less water added to it. And in such households as I am now referring to, there is often, curiously enough, a stinginess in respect to cream, or what is made to pass for it, which, paltry and niggardly as it is, contrasts ridiculously, and I will say vulgarly, with the more free expenditure not uncommonly assented to on bad sherry and worse claret.
Any one, who knows what is meant by a cup of good tea, knows also that a certain quantity of good cream is an essential ingredient in it. There is, then, an incongruity between the inadequate supply of milk and cream and the free use of wine in such households, and the consequence is a serious nutritional loss to all the members of it.
The question of expense, however, does come to be a consideration in many families who are consistently economical, yet, even here, I maintain that a false economy prevails, if milk be in any degree stinted to their young and growing members.
The poorer classes are greatly starved of milk in the towns. Many among them so seldom get good milk that they acquire gradually a complete distaste for what goes by the name. The same, too, is the case with tea and coffee. The miserable decoctions which, among the poor, pass for these precious beverages, are so far from what they might and should be, that these people are naturally led to the unwholesome substitutions of bad beer and worse gin. A cup of good tea or coffee, with abundant milk in it, is a very unwonted treat and novel experience to the poor. I find much difficulty in enjoining the use of milk among hospital out-patients (and I order nothing so freely), partly, because they are incredulous as to its value; partly, because they can not get enough of it, and when obtained it is so inferior; and also, because they either dislike it, or allege that it disagrees with them. A sickly laborer, for instance, accustomed to sundry pints of beer and "drops" of gin, is aghast at the recommendation to substitute for these a pint or two of milk. Milk is as nauseous for him as his physic, possibly more so.
Now, in the matter of taking milk, there are reasons why this repugnance is felt. We most of us take, and enjoy, that which we have been accustomed to get, and those who have been brought up largely on milk naturally regard it with liking. Thus, the hardy Scotsman or Irishman, who has been well nourished on buttermilk, can well appreciate good milk when it is forthcoming. The southern Englishman is a poor creature in this respect.
Again, milk is a food that should not be taken in copious draughts like beer, or other fluids, which differ from it chemically. If we consider the use of milk in infancy, the physiological ingestion, that is, of it, we find that the sucking babe imbibes little by little the natural food provided for it. Each small mouthful is secured by effort, and slowly presented to the gastric mucous surface for the primal digestive stages. It is thus regularly and gradually reduced to curd, and the stomach is not oppressed with a lump of half-coagulated milk. The same principle should be regarded in the case of the adult. Milk should be slowly taken in mouthfuls, at short intervals, and thus it is rightly dealt with by the gastric juice. If milk be taken after other food, it is almost sure to burden the stomach, and to cause discomfort and prolonged indigestion, and this, for the obvious reason that there is insufficient digestive agency to dispose of it. And, the better the quality of the milk, the more severe the discomfort will be under these conditions,
Milk is insufficiently used in making simple puddings of such farinaceous foods as rice, tapioca, and sago. Distaste for these is engendered very often, I believe, because the milk is stinted in making them, or poor, skimmed milk is used. Abundance of new milk should be employed, and more milk, or cream, should be added when they are taken. In Scottish households this matter is well understood, and a distinct pudding-plate, like a small soup-plate, is used for this course. The dry messes commonly served as milky puddings in England are exactly fitted to create disgust for what should be a most excellent and delicious part of a wholesome dinner for both children and adults.
I am of opinion that much mischief results from the use of condensed milk, called Swiss milk, for children. I think it has a poor nutritive value compared with fresh good milk, and it is simply foolish for people to employ it when they can procure the real article. At sea, or when such milk as can be had is of doubtful quality, there may be just cause for resorting to it, but it is as unwise to employ it when fresh milk is procurable as it is to use extract of beef when freshly made beef-tea can be had. I am aware that some infants will only take condensed milk, and appear to thrive upon it, but I think it is not to be trusted to for the highest nutritional purposes, and it should be discarded as soon as possible. The value of milk for the aged is not appreciated as it should be. If old age is a second childhood, the food for such persons should be that adapted to feeble digestive powers and the edentulous condition.
Many invalids and feeble persons can be induced to take milk with rum in it. This is at times a valuable prescription, but I find that people resort to it without medical advice, and some make it practically a mere excuse for a pernicious form of dram-drinking.
Milk and eggs in the form of custard is of high value. Some invalids, it should be known, can take custard-pudding cold when they can not take it hot, and with salt in it instead of sugar.
To illustrate what should be considered a proper milk-supply for a family and household consisting of ten persons, adults and children, I may state that five quarts per diem is the least quantity that should be consumed for all purposes. Children of any age may very well take a quart a day. If this, or anything approaching this, were the rule, instead of the exception, rickets, in its manifold phases, would be completely banished from this country, and a much higher standard of health and robustness would unquestionably prevail.
I pass, secondly, to consider the present inadequate supply of milk to the peasantry and country people generally. It is not commonly known that the English peasantry get, as a rule, and in many parts of the country, less milk than the population of the towns. The swine are really better off in many instances.
Buttermilk should be used, and proves most wholesome and nutritious. When the gentry in any neighborhood are supplied with milk, little remains for the poorer folks to buy, and much of what they get is either doled out, as a form of charity, from the dairies of the rich, and is already skimmed, or too little for their real wants and requirements remains available for purchase.
The results of this milk-starvation in the country are readily observed; the children suffer much from want of good milk, and, hardly less, many of the adults. Milk and meat are rare commodities among the peasantry who are not so situated as to secure supplies on the estates of their masters. The loss of meat can be far better borne than that of milk. A good supply of vegetables, with cheese and onions, will make up for loss of much animal food, especially if wholesome brown, or whole meal, bread be eaten. The fact that the best bread, as it is termed, is so largely used by the poor, has often been shown to be due to the erroneous belief that the whitest bread is more wholesome and "goes further" than that made from "seconds" flour. A diet of this "best" bread and a scanty allowance of skimmed milk is, in truth, a very poor and ill-nourishing one. The strange fact remains that pampered servants, and the lower orders generally, prefer this poor stuff because it is called the best, while their betters, who eat darker-colored, or whole-meal bread, have no influence whatever in setting them a better example. It must strike all trained observers that there is a great deal of anæmia among the poorer country-folks, even in the healthiest districts, and much of this I believe to be due to errors in diet, and some of it to insufficient use of milk.
It comes to this, therefore—a large increase in our milk-supply is absolutely called for. It seems certain that our farmers can no longer grow cereals so as to make them a source of profit, or to meet the wants of our population. America, Canada, and India can always meet our deficiencies. Our corn-fields are rapidly being laid down in permanent pasture, but the herds of grazing-cattle we were wont to see are gradually dwindling away. Cattle-plague and various murrains explain this lamentable fact. But are these henceforth to prevail to such an extent as to curtail our home-growth of beef and our milk production? I, for one, sincerely trust not, and I hope I am not too sanguine when I express the belief that the time is not far distant when, by a large, a very large, increase in our grazing-stocks, we may at least meet the crying want of a much better milk-supply for the whole country.—The Practitioner.