Papers Relating to the Foreign Relations of the United States, 1916, Supplement, The World War
File No. 763.72112/2462½
The Ambassador in Germany (Gerard) to the Secretary of State
[Received May 8.]
Sir: I have the honor to transmit herewith, for the Department’s information, a copy of a report dated April 17, 1916, which has been [Page 961] made to me by Dr. A. E. Taylor, one of the camp inspectors officially attached to my staff, regarding the conditions in the milk supply of the German Empire, together with a discussion of the relations in the health and death rate of infants and children.
I have [etc.]
Dr. Alonzo E. Taylor to the American Ambassador in Germany (Gerard)
Report on milk supply in Germany
Sir: I have the honor to transmit herewith a statement of considerations bearing upon the conditions in the milk supply of the German Empire, together with a discussion of the relations in the health and death rate of infants and children.
In time of peace the milk production of the German Empire is very large.[1]1 Not only is there extensive use of milk in the diet of children and of the sick; there is also a large manufacture of cheese, and milk is a common beverage of healthy adults.[2] When, at the beginning of the war, a large number of cattle were slaughtered and the acreage devoted to fodder reduced, the result was an immediate and heavy reduction in the production of milk.[3] This reduction in milk production was further accentuated during the past winter by the fact that the grain and fodder crops of Germany were very light in 1915. Thus, even with the reduced number of cattle, the rations of the milch cattle during the past winter have been reduced to the physiological minimum.[4] The period of lowest milk production is in the months of January to April; when the spring delivery of cows occurs and the new fodder of spring appears, the production of milk rises sharply. The question of the adequacy of the supply of milk for the needs of the German Empire was realized early in the war and regulations were promulgated by the authorities for the purpose of accurate control. The use of milk, apart from that applied to the making of cheese, was grouped under four headings:
- (a)
- Use of milk by the nursing mother and the weaned infant.
- (b)
- The use of milk by children from the second to the twelfth or fourteenth year.
- (c)
- The use of milk by the sick under the care of physicians.
- (d)
- The use of milk as a beverage by healthy adults.
The use of milk as a beverage by healthy adults was regarded, under the conditions at present pertaining in the German Empire, as a luxury; and it was ordered that no milk shou d be dispensed for this purpose until all requirements under the three first-named headings (a, b, c) had been fully supplied. The reduction in the milk supply has naturally been felt most keenly, and indeed almost entirely, in the cities; and in many cities in the Empire there has been during the past winter little or no use of milk as a beverage of healthy adults.
Has the milk production of the German Empire during the past six months been adequate to supply the requirements of the people under the three first-named headings? This may be discussed from the standpoint of the infant, of the child after the period of infancy, and of the sick of all ages.
In order to understand the milk needs of the infant population of Germany it is necessary to recognize the change in the birth rate. Beginning with May 1915, the official figures of the German Empire presented a sharp falling off in the absolute number of births and in the birth rate. This has continued since and has, indeed, in many places become more marked. An analysis of the figures up to the 1st of April of this year, undertaken through the kindness of the chief statistician of the Kaiserl. Gesundheitsamt, Doctor Roescke, suggests that several causes operated to this end. Obviously, the presence of millions of soldiers in the field has led to a marked reduction in the marriage rate and in the birth rate in the families of soldiers at the front. The war has, however, also led to a reduction in the marriage rate of men not at the front; and has, furthermore, led to a reduction in the birth rate in the families of men not [Page 962] at the front. The official figures for Switzerland, Holland, and Denmark indicate also a sharp reduction in the birth rate in those countries, and to a lesser extent this holds even in Sweden and Norway. This reduction in the birth rate [5] has in various portions of the Empire amounted to from one fourth to one-third. During the past winter, therefore, the problem of feeding the infants of Germany has been a lesser task quantitatively than under normal conditions.
The Kaiserl. Gesundheitsamt [6] keeps a special record of the death rate of children under one year. These figures are published up to the 1st of January, and the unpublished figures up to the 1st of April have been kindly placed before me in the Gesundheitsamt. They display, in a most striking manner, a reduction in the death rate, a reduction unparalleled in Germany in time of peace. In fact, viewing the figures as a whole, it is clear that the reduction in the death rate under the first year of life has been so large as to have compensated for half of the reduction in the birth rate during the past year. This extremely favorable and impressive reduction in the death rate of children under one year was achieved through the cooperation of several agencies.[7] It is an axiom with workers in social service that the fewer the children the better the care which they receive; and this undoubtedly has held in Germany, particularly in view of the insistence placed by the press upon the preservation of the future generation. Added to this was the fact that the summer of 1915 presented a subnormal mean of temperature, which, here as everywhere; operates to reduce the so-called intestinal diseases of infants. Lastly, the social service organizations in the cities of Germany have during the past winter reached a point of unequalled thoroughness and excellence. In the city of Berlin alone there are some 6,000 workers actively engaged in social service. Under these circumstances it has been possible to uncover and combat practically all instances of need in the care of infants. There is nowhere to be found any evidence of any reduction in the milk supplied to nursing mothers and infants in Germany during this period of time.[8] The production of so-called certified milk (by which is meant a superfine grade of milk with a known and low content of bacteria and with a known content of fat, protein and sugar, which may be modified according to the prescription of the physician), a type of milk sold at a high price to people of means, has been curtailed. This has, however, resulted in no hardship. Instead of there being any truth in the statement that the infants of Germany are suffering for lack of milk, the very opposite is true; the infants of Germany as a class have presented during the past months a condition of health and a reduction in death rate not present before the war.
There is no evidence in the statistics of the Kaiserl. Gesundheitsamt tending to indicate any increase in the death rate of children from the second year to the age of puberty. These figures are in every way normal [9] when compared with the previous statistics of the German Empire. There has been no unusual prevalence of infectious diseases; there has been no unusual prevalence of alimentary diseases. Geheimrat von Hansemarnn, the director of the department of pathology of the Virchow Krankenhaus, advises me that the records of his department suggest nothing to indicate an increased morbidity in children. The director of the Virchow Krankenhaus also advises me that the experience in their wards, which draw their patients from the poor of Berlin, tend in no way to suggest suffering or sickness due to lack of milk. Professor Langstein, who as director of the Kaiserin Augusta-Victoria-Haus zur Bekämpfung der Säuglingssterblichkeit im Deutschen Reiche, has most unusual opportunities for observation of conditions not only in infants, but also in older children, advises me that he has seen no indications of subnutrition in the children of Berlin as a result of insufficiency of the milk supply; the well children of Berlin receive the normal and usual milk of the child’s diet, and there is no difficulty in securing milk of excellent grade in any needed quantity for sick children.
The director of the Virchow Krankenhaus advises me that there is no difficulty in this large hospital in securing all the milk needed for the use of the sick children or adults. General inquiry in medical circles in Berlin [10] has elicited the same response.
It seems therefore clear that, through scientific management, conservation of the milk supply, even under the present conditions of restriction in production, prevention of waste, and restriction or in some instances abolition of the use of milk as a beverage for adults and in the preparation of food for adults, the [Page 963] German authorities have succeeded in securing sufficient milk to cover the needs of nursing mothers, infants, children up to the age of puberty, and the sick of all ages.[11] It is the belief of the authorities that the lowest point in the production of milk has now been reached, that during the on-coming summer the milk supply will be adequate to permit the return to a daily use of milk as a beverage for adults,[12] and that in the event of a normal crop in the summer of 1916 it is not expected that the production of milk in the winter of 1916–17 (in the event of the continuation of the war) will be as restricted as it has been during the past winter.[13] In addition to this a movement is now under way for the utilization of goat’s milk throughout the country.
Owing to the conditions of the fodder, the milk of cattle in general during the past winter has tended to present a somewhat subnormal content in fat. This, however, while a matter of importance in the nutrition of the population when viewed in relation to the limited fat supply of the German Empire, has not been marked enough to suggest that the milk in question when used for infants, children, and the sick, has failed of its normal function in nutrition because of this reduction in fat. A return to more normal [14] conditions in fodder with the on-coming of summer will tend to restore the normal fat content of the milk, which will have the effect of reducing the scarcity of butter. It is a commonly accepted view in the medical profession, a view now scientifically confirmed by extensive investigations in the metabolism of the growth period of the lower animals, that a certain minimum input of native fat is necessary for the normal growth of the young individual as well as for the maintenance of health. There is no reason to believe that the children of Germany are in this sense suffering from subnutrition of fat.[15] In northern Germany, fat has always been used in the diet to an extent commonly regarded as verging upon excess.[16] In South Germany this has not been the case; and under these circumstances the people of South Germany complain far less of the fat restriction [17] than do the people of North Germany. It is clear that this is a question of habit and not of physiology. Whether the infant and child population of Germany could continue year after year upon the present limited input of fat without physical injury, can not be judged upon the basis of the available experimental data in animals or upon clinical observations. Fat comes of course from many sources, and the fat of milk, though an important source, is by no means the major source; the total reduction in the fat input of the German people at the present time is only for the smaller part to be attributed to reduction in the milk supply. For the present certainly there is no evidence that the children of the German Empire are suffering from nutritional disturbances [18] dependent upon diminution in milk (viewed as a whole or as milk fat) in the diet.
I have [etc.]