Alan Czaplicki

Pure Milk Is Better Than Purified Milk

Pasteurization and Milk Purity in Chicago, 19081916

This article explains how pasteurizationwith few outspoken political supporters during this periodfirst became a primary milk purification strategy in Chicago and why eight years passed between pasteurizations initial introduction into law and the citys adoption of full mandatory pasteurization. It expands the current focus on the political agreement to pasteurize to include the organizational processes involved in incorporating pasteurization into both policy and practice. It shows that the decision to pasteurize did not occur at a clearly defined point but instead evolved over time as a consequence of the interplay of political interest groups, state-municipal legal relations, and the merging of different organizational practices. Such an approach considerably complicates and expands existing accounts of how political interests and agreements shaped pasteurization and milk purification policies and practice.

Chicago holds the distinction of having been the first American city to intro duce cows milk pasteurization into municipal law. In 1908 the city health department passed an ordinance requiring the pasteurization of all cows milk entering Chicago that had not come from dairies in which cattle had been certified tuberculosisfree. Yet several years later, ironically, the city lagged behind other large cities in mandating full pasteurization of the entire cows milk supply. Thus while New York passed such an ordinance in 1910 and Philadelphia, Milwaukee, Boston, and San Francisco introduced full mandatory pasteurization in 191415 (Wolf 1998), it took eight years of politi cal contestation for Chicago to mandate full pasteurization in 1916. Conflict about milk purity and pasteurization crystallized in Chicago on
Social Science History 31:3 (Fall 2007) DOI 10.1215/014555322007004 2007 by Social Science History Association

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a level unrivaled elsewhere. The obvious question is, why did this happen? This article explains this eightyear controversy by pointing to the impor tance of statemunicipal relations and institutional layering effects. It argues that Chicago public health officials accommodated pasteurization as a result of their preferred purification methodtuberculin testingbeing closed off by the greater authority of the state government. This veto point in intergovernmental affairs initiated a process of institutional layering through which pasteurization slowly became integrated with the hygienic practices of routine inspections, bacterial counts, and control over the conditions of milk production. Thus this analysis challenges conventional accounts that view the adop tion of pasteurization as an inevitable result of its efficiency or cost effec tiveness. Chicago city officials did not actively promote pasteurization until its successes in 191516, well after its first adoption into law. While cheap, massproduced pasteurized milk addressed some public health concerns in the city, it never became a motivating force behind the use of pasteurization. Furthermore, this article seeks to complicate political accounts that posit the existence of a politicized industrial bargain among large milk dealers, con sumers, and government officials. Relevant actors expressed highly variable and changing opinions on the appropriateness of milk pasteurization, and institutional constraints on city government combined with this ambivalence to produce outcomes. Thus any clear bargain among government, indus try, and consumers only existed post hoc and in retrospect. Chicagos experience with milk purification over the years 19001920 highlights the complex process of policy innovation and transition in local government. Pasteurizations incorporation into existing hygienic practices resulted more from the weaknesses of local government visvis state offi cials, however, than from conscious deliberation by Chicagos public health department. In this sense, the article stresses how important policy inno vation can result from positions of weakness and constraint as well as from positions of strength and agency, showing how veto points at the state level helped precipitate a major policy innovation at the local level.

Early Efforts to Protect the Milk Supply

Bacteriology significantly shifted sanitarians understanding of the etiology of infectious disease in the 1880s (de Kruif 1926). Though bacteriology refined the causal agent of disease, that agent nevertheless often existed in the filth

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that sanitarians focused on in their reform efforts. This commonality in the site of disease posited by both bacteriological and miasmic theories allowed public health officials and interested doctors to simply shift their frame of reference from filth to microbes. This occurred with limited interrup tion to existing inspection regimes or hygienic practices used by public health organizations or philanthropic groups (McClary 1979; Duffy 1990). Entering the twentieth century, public health officials in the United States had not chosen to use pasteurization for milk purification. American doctors and public health officials chose to rely on milk purification meth ods that had originated in the hygienic or miasmic ideas of disease transmis sion that preceded the advent of bacteriology. These methods focused on a cleansing process applied to farms, train cars, milk depots, and when pos sible, local milk sellers stores. Interestingly, this choice differed from that of doctors in France, which had started a program of pasteurizing milk for the working classes as early as 1890 and saw pasteurization as central to French neonatal policy through reducing infant mortality and morbidity (La Berge 1991; Klaus 1993). To the degree that pasteurization was used in the United States, it was connected to social reform efforts. As early as 1900 philanthropist and Democratic Party organizer Nathan Strauss donated a number of pasteur ization facilities to various cities, including Chicago. Chicagos Infant Wel fare Society accepted Strausss donation in 1902 after much debate and uti lized the plant over the next decade to provide subsidized pure milk to poor families in the tenement communities of the North Side (Infant Wel fare Society 1903, 1904).1 In other cities, similar situations pertained, and the facilities were mainly linked to philanthropic activities surrounding infant health, the reduction of summer diarrhea, and baby tents. Municipal adop tion of pasteurization did not occur, however, until Chicagos city ordinance of 1908.

Explaining the Adoption of Pasteurization

What accounts for Chicagos shift to municipally directed pasteurization during the decade 190818? The transition to municipal pasteurization was more complicated than simple diffusion from these other sites, and several ideas have been put forward to explain pasteurizations adoption by city governments. The first set of explanationscalled progress narratives by E. Melanie

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DuPuis (2002: 88)focus on the efficiencies gained by pasteurization. These suggest that the process of pasteurization allowed lowcost, massproduced purified milk to enter the market and that the large quantities of this puta tively goodquality milk convinced city officials of the importance of pas teurization. The relatively low cost of this milkespecially versus other types of purified milkworked to the advantage of city officials, as the poor and working classes would be more likely to buy an affordable alternative to raw milk. In short, these theories argue that public health officials promoted pasteurization because it was the most effective method of providing quality milk to the local population. A second version of this argument focuses on the technological capaci ties of local governments. For example, Harvey Levenstein (1983) suggests that when largescale pasteurization facilities became technologically avail able around 191415, many large cities moved to adopt the technology both on the East Coast and in the Midwest. This argument shares the progress narratives assumption that pasteurization provided an obvious solution to milk purification problems in large American cities. The only factor retard ing its use, therefore, was the lack of technological knowhow to allow its efficiencies to diffuse to larger cities. Both arguments make important points; clearly, from our current per spective, it is difficult to argue against the efficiencies of scale and standard ized quality of milk pasteurization. There remain serious flaws with these theories, however, the first being that the perspectives of current observers should not be projected onto the thought processes of public health officials in the early twentieth century.2 Just as important, however, these theories underspecify the mechanisms by which public health departments made the transition to new technologies, even assuming they saw the benefits pre sumed by efficiency explanations. In progress narratives, policy transitions remain a black box that tells us little about how public health officials and city councils introduced pasteurization into policy debates, incorporated pasteurization into existing public health procedures, or generally translated their predilection for pasteurized milk into an effective citywide purification effort. Moreover, the technology argument assumes that largescale pasteur ization facilities developed independently of public health efforts in large cities. It is not clear, though, that this technological development would have occurred without the increasing use of pasteurization by Chicago and New

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York City in the period 190812. A plausible argument could be made that municipal interest in largescale pasteurization facilities precipitated research in this area, with tangible results appearing in 191415 as many cities used this research to establish their own pasteurization plants. Thus the issue of whether technological advances enabled largescale municipal pasteurization or if municipal interest in pasteurization propelled research into largescale facilities should be considered more an empirical question than a theoretical assumption.3 A second set of theories takes more seriously the politics surrounding the adoption of pasteurization. DuPuis (2002: 8889) argues that municipal pasteurization resulted from an industrial bargain among milk producers, government officials, and consumers. She sees the transition to pasteuriza tion as helping bring the end to a period in which yeoman farmers were idealized as true Americans to become merely servants to the city. In this transition, politicians, industrialists, and even farmers pointed to the bene fit of pasteurization as an efficient process that lowered the costs per quart for purifying milk through its economies of scale. Farmers and dealers especially promoted the process, according to DuPuis, since it would pass the costs of purification on to consumers. Politicians supported pasteuriza tion for similar reasons, not wishing to alienate taxpayers by funding a more costly certification regime. Sealing the triangle, consumers thought highly of the relatively similar prices for pasteurized and raw milk, reinforcing con sensus on the issue. Daniel Ralston Block (2002: 25) notes some of the same issues as DuPuis, arguing that pasteurization became the dominant method [of milk purifica tion], primarily because certified milk was too expensive and required more of farmers than the health departments were able to demand. He suggests that public health experts were pragmatic about milk safety and concerned with cost, believing that producing the purest milk was not worth a possible decline in overall milk intake due to high prices (Block 1999: 25). Both authors also point to the difficulties of municipal and state governments in replicating the certification system of milk purification, which involved laborintensive inspection strategies (DuPuis 2002: 79) that governments would be responsible for funding. For Block and DuPuis, then, public health departments promoted pasteurization to shift the cost of the purification system away from taxpayers and governments to private companies. These companies would pay for the technology necessary for pasteurization and,

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given their eventual market strength, pass these costs on to large numbers of consumers. Thomas R. Pegram (1991) offers a contrary view, suggesting that pasteur ization instead resulted from political failures in consensus making between important actors in milk purification debates. He argues that unresolved conflicts between small farmers, large progressive dairymen, and state and municipal officials stymied all attempts to establish a community of inter ests between these groups, allowing the lax standards of small dairymen and priceconscious consumers to govern the quality of milk (ibid.: 36). In short, Pegram suggests that although large dairymen advocated milk purifi cation reforms, city officials decried the limited extent of those reforms, while small farmers and their political allies protested price fixing and perceived attempts by large dairies to eliminate them from the market. In turn large dairies resisted municipal efforts at reform for fear of varying, overlapping standards across municipalities and in their desire to control the pace and trajectory of reform through captured state officials. Finally, public support for reforms remained largely secondary to price considerations as milk con sumers. In this situation of a marketdriven, lowestcommondenominator (non)solution, Chicago city officials promoted pasteurization as an aftereffect of political stalemate and the potential public health disaster of poorquality milk and bovine tuberculosis. All three of these analyses highlight the political dynamics of milk puri fication efforts, offering compelling accounts of the various interest groups and their coalitions. While differing on the outcomes of political contention, these authors agree in situating pasteurization in the political maelstrom cre ated by bovine tuberculosis, consolidation and centralization of milk pro duction, and differing visions for reform. Moreover, they share a common position with progress narratives in discussing milk pricing as central to the political compromises around pasteurization and milk purity. While agreeing that politics are important, this study takes issue with two elements of the above analyses. First, it disagrees with the assumption that interest groups held clearly defined positions regarding pasteurization and its adoption. As it will show, state and local government officials, phi lanthropies, and dairy industry groups exhibited considerable ambivalence about the utility of pasteurization, even given its efficiencies of scale. In over looking these ambiguities, interestbased accounts assume a clear political lobby for pasteurization, with the outcome depending on the political power

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of these groups. Second, it departs from political interestbased accounts that foreground the importance of cost in driving action around pasteuriza tion. Clearly, pasteurization produced cheaper milk than alternative purifi cation processes.4 However, this situation pertained to the years leading up to and through the debate over pasteurization in Chicago. At no time did Chi cago city officials base support for pasteurization primarily on its lowcost product. In fact, considerable opposition to the processfrom state officials, doctors, and Chicagos health departmentpersisted despite the obvious benefits of scale and cost provided by pasteurization. The cost of milk alone, therefore, cannot explain the lengthy transition to full mandatory pasteuriza tion in Chicago.

Method and Sources

This analysis draws on both primary historical records and secondary sources. Primary source materials included articles appearing in the Chicago Tribune over the years 19089 on the initial introduction of pasteurization into Chicago municipal law, annual reports and handbooks from the Chi cago health department, state commission reports, and archival records of Chicagos Infant Welfare Society for the years 190220. The analysis also includes the annual meeting reports of the American Association of Medical Milk Commissions (AAMMC), an organization of physicians committed to milk purification. These last records provide important information about variations in opinion on the purification techniques available during the period under study. Publications and annual reports from the Chicago Department of Health were also used to document city health inspectors activities during this period. The Chicago Department of Health published large compilations of annual reports with extensive health and population statistics as well as case studies of illness epidemics and the policies and procedures of the depart ment over the years included. Additionally, the Illinois General Assembly published the entire transcript of committee hearings on the tuberculin testing debates following the passage of Chicagos 1908 tuberculintesting and pasteurization ordinance. The transcripts hold verbatim testimony from Chicago health commissioner William G. Evans and many of his subordi nates, providing a firsthand account of their opinions on the subject of milk pasteurization.

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Chicagos 1908 Tuberculin-Testing Ordinance

Suspect milk quality and milkborne disease became a political and regu latory firestorm in the first decade of the twentieth century. In 1907 about onequarter of Illinoiss milk cows produced little profit, and conditions on many dairy farms were so poor that they tainted the reputation of the entire dairy industry (Pegram 1991: 39). Public health officials worried about the transmission of bovine tuberculosis from cows milk to humans, especially milkfed infants, from these types of farms.5 They had good reason to worry, as Alan L. Olmstead and Paul W. Rhode (2004a) estimate that in 1900 as many as 10 percent of all cases of tuberculosis in humans could be attributed to infection from bovine tuberculosis bacilli. Moreover, an epidemic of the disease had spread throughout the Illinois countryside; state officials pre dicted in 1910 that 300,000 cattle had already contracted tuberculosis, and new infections remained rampant (Pegram 1991). City officials expressed considerable concern over this situation. Follow ing Milwaukees lead, in 1908 Evans stated that all cows whose milk was delivered to Chicago needed to be tuberculintested within five years and that the milk of those not tested, or testing positively, could be sent to the city milk depots only if it had been pasteurized (Illinois General Assembly 1912: 31314). The logic behind Evanss action was simple, as he stated that what was good for Milwaukee was good for Chicago (ibid.: 313). In this sense, Chicagos temporary adoption of tuberculin testing can be ascribed to conformist tendencies among city governments during this period, as many of the citys counterparts looked to each other for working policies to control the bovine tuberculosis situation. The introduction of pasteurization as the second component of the ordi nance is more complex. In 1908 Chicago stood alone among American cities in having a pasteurization requirement on the books.6 Other researchers gloss over this problem by placing Chicagos adoption of pasteurization in 1912 (Pegram 1991; DuPuis 2002) or by focusing on the citys move to full manda tory pasteurization in 1916 (Levenstein 1983). But it was in 1908 that Chicago officials first saw a (dubious) merit in pasteurization as a way of smoothing the transition to tuberculintested herds. Pasteurization would protect the popu lace, however temporarily, while farmers slowly brought their herds into compliance with the 1908 ordinance, or so Chicago health officials thought at the time. So how did officials come to incorporate pasteurization into the

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ordinance? Little direct evidence exists to explain this choice, but conditions in Chicago at this time suggest a possible explanation. By 1908 pasteurization was a known quantity. The pasteurization facility that Strauss donated to Chicagos Infant Welfare Society in 1902 had been used by that group to pasteurize milk for distribution to the Polish ghettos (Infant Welfare Society 1903, 1904). Moreover, two of the large milk pro ducers in the Chicago milk shed, Bordens and Bowdins dairies, also pas teurized some milk and milkbased products starting around 19045 (Wolf 1998: 190; DuPuis 2002: 85). Finally, many milk dealers and groceries sold various products under a pasteurized label, even though such products would be considered deficient based on later standards (Apple 1980). Although used, pasteurization nevertheless remained peripheral to these organizations. The Infant Welfare Society decided to use their pasteuriza tion facility only in conjunction with milk contractually produced by a local farmer under certified clean conditions. Thus the society pasteurized already certifiably pure milk.7 Largescale commercial pasteurizationas with the Borden and Bowdin dairiesoften allowed dirty milk to stay sweet until market time and could contain variable amounts of pathogenic and benign bacteria (Waserman 1972: 372). Finally, some small dealers sold adulterated products under the pasteurization label, clearly violating the false advertis ing provisions of the 1906 Pure Food Act (DuPuis 2002: 7880). All of these practices made Chicago health officials aware of the partial and sometimes dubious uses of pasteurization. Unlike its approach to tuberculin testing, the citys adoption of pasteur ization should not be seen simply as mimicry of existing local uses of the pro cess. While pasteurization had a clear presence in the city, its potential uses remained ambiguous and relatively undetermined. Yet its status as a pos sible solution put it at hand when Evans and his staff made a decision about how to protect the milk supply until tuberculin testing could be established statewide. This suggests that the initial introduction of pasteurization into law stemmed less from political interests or accommodation in an industrial triangle. Instead, city officials adopted a process easily at hand and possible to implement, given the facilities extant at the Borden and Bowdin dairies. Evanss ambivalence to the procedure confirms this interpretation. In conference speeches for the AAMMC,8 Evans promoted pasteurization as allowing the poor to afford safe milk (AAMMC 1909: 56; Halpern 1988: 60) but also suggested that city officials are up against a practical ques

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tion. . . . we would like, of course, to have a perfectly produced milk [but] . . . [p]asteurization does not put anything into milk that is not there (Chicago Tribune 1909e). Evanss support for pasteurization in the early years of the ordinance thus appears tepid, even though the city eventually succeeded in pasteurizing over 50 percent of the milk supply in 1909 (Chicago Depart ment of Health 1919). In sum, then, city officials choice to include pasteurization most closely follows a garbage can model of organizational decision making (Cohen et al. 1972), which suggests that the citys decision stemmed more from the availability of a ready solution than from any rational process of assessing the merits of pasteurization and other procedures. It also suggests that commit ment to the process remained contingentno strong interest group clearly promoted pasteurizations inclusion in city law, including government officials.

Protecting Turf: Jurisdictional Conflict in Illinois

Given the size of the Chicago milk shed, Chicagos 1908 ordinance affected farmers and cows from across northern and central Illinois as well as their counterparts in southern Wisconsin, northwestern Indiana, and southeastern Minnesota (Whitaker 1911; Chicago Department of Health 1919). Olmstead and Rhode (2004a: 749) note that tuberculintesting ordinances became com mon during this period, affecting large areas of the country when passed in many cities and smaller towns. Yet the authors suggest that these laws often only served as paper measures, since city governments lacked sufficient resources to initiate purification efforts and political opponents often initi ated significant legal challenges against the laws implementation. Chicago had more resources than many other cities, however, and by one account suc ceeded in testing 30,000 cows in 1909 while increasing the city health depart ment staff from 12 to 67 sanitary inspectors by 1911 (Chicago Department of Health 1919; Pegram 1991: 47). Thus the law should be considered more than an empty mandate in Chicagos case. Perhaps because of this, Chicago health officials faced political opposition to the ordinance not only from dairy interests (as Olmstead and Rhode suggested in other cases) but also from the Illinois state legislature and state health department. The lack of state laws on tubercular cows placed Illinois in a precarious

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position visvis other states, since, as Olmstead and Rhode (2004b) sug gest, limited regulations in Illinois made it the dumping ground for dis eased cattle in the Midwest and perhaps the United States. A cadre of large and disreputable cattle dealers, centered around Illinoisan James Dorsey, had manipulated the variations in state and local regulations for tubercular cattle to create a vibrant interstate trade in diseased animals. Olmstead and Rhode (ibid.: 93031) note that these dealers exploited Illinoiss lack of legal regu lations around cattle trading, creating a lemons problem for buyers unable to determine the health of proffered stock. As a result, Illinois gained a repu tation for being a clearinghouse for diseased cattle. Evans picked up on the buyer dilemma in promoting the ordinance, claiming that tuberculin testing provided insurance for farmers since such tests would allow them to stop the spread of tuberculosis in their herds (Illi nois General Assembly 1912: 316). At the same time, the Chicago health department produced posters decrying the lack of tuberculosis control measures for the states cattle. One set of posters illustrated this fear and frustration with an outline of the borders of Illinois being transgressed by sickly, tubercular, stumbling cows from adjacent states, including Wisconsin (Chicago Department of Health 1919).9 Such actions confirm Olmstead and Rhodes depiction of Illinois as a dumping ground for cattle and the desire of Chicago city officials to stimulate a state response to the problem. After the passage of Chicagos ordinance, the state health department studied the bovine tuberculosis issue and came up with the disturbing fact that as many as onequarter of the states cattle could possibly be tuberculosis positive. Besides the possible health effects of this figure, state officials also worried about the financial implications of slaughtering tuberculinpositive cattle. Surrounding states had passed a number of compensation acts for farmers with diseased cattle, including offering indemnities for lost livestock. As in Wisconsin, health officials assessed these indemnities at a set frac tion of the animals appraised value as healthy stock (Olmstead and Rhode 2004b: 939).10 Thus in Illinois, when members of the state legislature multi plied the onequarter figure by the average market value of a milk cow, they determined that the state would owe farmers $50 million in compensation (at full market value). This number, these politicians asserted, was higher than the annual state budget (Illinois General Assembly 1912: 6063). These economic considerations provided fuel for Illinois state legis lators already sympathetic to the states cattle industry. Small farmers and

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disreputable dealers had significant political power in the state, including support from the Illinois House speaker Edward Shurtleff (Pegram 1991; Olmstead and Holmes 2004b). Shurtleff responded to small farmers warn ings that tuberculintested milk, or model milk, would cost consumers more money (Chicago Tribune 1909a, 1909f ) and appointed members to the Illinois General Assemblys Joint Committee on the Tuberculin Test, cre ated by the state legislature in 1909. Officially, the legislature charged the committee with determining the political, economic, and scientific merits of Chicagos ordinance. For many contemporary observers, however, the com mittee served as a political tool to promote the special interests of the cattle and dairy industries. In its proceedings, the committee solicited testimony from Chicagos health commissioner and his subordinates. Evanss testimony to the com mittee focused on Chicagos confusing landscape of milk purification, in which raw, pasteurized, and certified milk commingled in Chicago stores. Evans claimed that pasteurized milk had been controlled by no standard and regulated by no one before the passage of the 1908 ordinance. As a result of the ordinance, he declared, the city had certified 25 percent of Illinois dairy cows in the Chicago milk shed tuberculosisfree, while 45 percent of the citys milk supply was currently pasteurized (Illinois General Assembly 1912: 313, 325). To these achievements he added that the city had developed a corps of milk inspectors, with six to eight special farm inspectors collecting milk samples for three bacteriologists on staff. Evanss second in command Gottfried Koehler further suggested that he considered tuberculin testing of cows justified, even if not economical, because it is wise to save human lives wherever we can (ibid.: 339). In this way, Chicago health department members played up the successes of the ordinance and its positive impact on milk safety in the city. Unfortunately for the city, the committee also drew on testimony from other Chicagoarea officials, state health department personnel, and scien tific and descriptive documents from other cities experiences with tuber culosis testing, including those of Milwaukee and Sacramento. Committee members gave considerable credence to farmers complaints that the method of measuring the tuberculin test was inaccurate, a common complaint of the industry in the years before an improved method of testing became mar keted in 1920 (Olmstead and Rhode 2004a).11 Some members of Chicagos city council testified in opposition to the ordinance, particularly Alderman

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Jacob A. Hey, who decried the false science behind tuberculin testing and charged that pasteurization was deleterious to the health, since it purport edly caused scurvy and rickets (Chicago Tribune 1909c). Illinois state health commissioner J. A. Egan reiterated this view, maintaining that bovine tuber culosis could not be spread to humans. He further suggested that cases of intestinal tuberculosis in infants could have been caused by their swallowing sputum from an infection of human tuberculosis in their lungsand not from bovine tuberculosis in cows milk (Illinois General Assembly 1912: 60). Finally, dairy interests also weighed in, castigating Chicago health inspectors as incompetent and unfit for their duties (Pegram 1991). Given this testimony and given that the committee had been stacked with enemies of the tuberculin test (ibid.: 48), it is no surprise that the com mittee opposed tuberculin testing of cattle. Instead, the committee opined that municipal contracts with large milk dealers and increased sanitation of milk depots would be the best way to clean Chicagos milk supply (Illinois General Assembly 1912: 7173). These actions clearly promoted the laissez faire instincts of the states dairy industry. Acting on the committees recom mendation, the state legislature passed a law in 1912 forbidding any munici pality to pass a mandatory tuberculosis testing ordinance, thereby rendering the major feature of Chicagos 1908 ordinance invalid. Tuberculin testing would for the time being no longer be Illinoiss or Chicagos route to control ling bovine tuberculosis in cattle or humans. The committees position on pasteurization was more ambiguous. State legislators feared that pasteurized milk may well mean cooked dirt, cooked dung and cooked bacterial products and that a false sense of security is undoubtedly conveyed by the term pasteurized milk (ibid.: 78). Abuse of the pasteurization label, they suggested, could lead the poorer classes to stop drinking milk altogether. Increased sanitary measures were the only way to prevent this possibility (ibid.: 63). Nevertheless, committee members decided not to regulate or forbid pasteurization, allowing municipalities to decide its fate. For Chicago, this meant that the committee left pasteurization as the only functioning element of the 1908 ordinance. Pasteurization effec tively transitioned from the secondary component of the law to the primary milk purification method of the Chicago health department, regardless of the ambivalence of health officials to its initial selection and use. This transition also resulted in pasteurizations presence as the only surviving remnant of the law, leading to its association with the entire ordinancehence the ordi

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nances later moniker as Evans Pasteurization Law. Unfortunately, this attribution retrospectively elided the complexity of the transition, suggesting that the ordinance evolved out of a health department campaign to promote and extend pasteurization. This was clearly not the case, and as we will see, Evans and his staff remained committed to sanitary methods outside of pas teurization even after the committee ruling. The label also obscured the working of an important institutional con straint on city governmentveto points maintained by the state govern ment (Immergut 1998). No strong interest group initially promoted pas teurization as a primary milk purification process; Chicago health officials reliance on pasteurization occurred in the aftermath of a jurisdictional and political battle between city and state officials over tuberculin testing. Thus Illinoiss legal authority under American federalism over municipal tuber culin testing drove Chicagos eventual use of pasteurizationand only after city health officials initially incorporated the process into the ordinance as a result of its easy availability. Interestbased analyses unfortunately fail to capture these institutional dynamics so vital to understanding pasteuriza tions early history in the city.

Certification and Pasteurization: Competing Purification Processes

The Chicago health department reacted to the state legislatures ban on tuberculin testing by issuing a new version of the ordinance in 1912. This new law reflected continued ambivalence toward pasteurization as a purifica tion process. Establishing two grades of milk, the law required that all farms providing milk to the city be subjected to inspections for cleanliness and appropriate milk production techniques. Those farmers wanting to sell milk in the higher grade would also have to tuberculintest their cattle voluntarily. If unwilling to do so, farmers could still sell at the lower grade if they passed basic sanitary requirements and pasteurized the milk (Chicago Department of Health 1919). In this way, city officials reincorporated tuberculin testing through the back door of voluntary action while creating a clear distinction between the higherquality, tuberculintested inspected grade of milk and the lowerquality, pasteurized grade. Chicago health department officials were not unusual in their predis position toward sanitary requirements, including tuberculin testing. These ideas had strong support among philanthropic medical doctors who had

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banded together into medical milk commissions in Chicago and other cities. In fact, Chicagos sanitary scorecardsused to rank the cleanliness of different elements of farmsmirrored the scorecards produced by the AAMMC (AAMMC 1910; Chicago Department of Health 1919). Chicago health inspectors using these scorecards searched for sources of contamina tion around the production of milk; the actual productmilkwas consid ered pure insofar as it was free from contact with humans or other sources of contamination. Thus sanitary inspections enforced various regulations for cleanliness of barns and stables, grooming and treatment of cattle, food and water sources for cattle, and handling and cooling of milk (Waserman 1972: 364). The use of sanitary scorecards purportedly made the production of clean milk . . . an exact art (AAMMC 1907: 65). Medical milk commission members followed the injunction of their founder, Henry L. Coit, who suggested the true springs of cleanliness are in the thought before we can have effective cleanliness in the surround ings (AAMMC 1910: 13). Commissions therefore took upon themselves the responsibility to establish clinical standards of purity for the milk, be responsible for the inspection of the dairy or dairies under their patronage, and provide for the examinations of dairy stock and be responsible for the chemical and bacteriological testing of [milk] (Waserman 1972: 362). By 1909 the association boasted 57 member commissions and had firmly estab lished its presence on the national milk purification scene by hosting annual conferences to discuss new methods of sanitation and the accomplishments of member organizations (AAMMC 1909: 5157). Manfred J. Waserman (1972) argues that medical professionals, espe cially pediatricians, remained strong opponents of pasteurization into the 1910s and made up the majority of medical milk commission members. As physicians, these members promoted bacteriological theories of disease and suggested that the ideal certified milk would contain very few micro organisms, and no pathogenic microorganisms (AAMMC 1907: 15). How ever, the AAMMC juxtaposed this pure certified milk to pasteurization, with one member remarking that the slogan of the AAMMC should be pure milk is better than purified milk (AAMMC 1908: 20; Waserman 1972: 376). Moreover, Coit himself echoed the Illinois committees arguments against pasteurization, suggesting that the process would be used by the smaller milk producers to cover stale milk for sale (Levenstein 1983: 86). Comments from Chicago health officials showed considerably more ambivalence over the question of certification versus pasteurization than

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found among most AAMMC members. In speeches in front of the AAMMC, Evansa member of the organizationclaimed that certification and pas teurization should not be contrasted to each other. Rather, both should be compared with the poorquality raw milk sold in poor neighborhoods (Waserman 1972: 376). Evans further claimedthis time in testimony for the Joint Committee on the Tuberculin Testthat pasteurization would be necessary in the future, since milk transportation by train extended the milk shed to more distant farms, where inspections could not be made (Illinois General Assembly 1912: 365). Further, he suggested that the increased price for pasteurized milk would be relatively small, between 0.53 to 0.85 cent per pint (ibid.: 316). Other sections of Evanss testimony, however, suggest a focus toward sanitary inspections consistent with milk certification. Thus Evans also told the committee that the handling of milk in its production and shipping was the greatest issue relating to its purity (ibid.: 319),12 while his deputy Koehler argued that pasteurization might be needed in the city since per fect sanitation in milk production was very difficult to obtain (ibid.: 341, 369). In addition, Evans suggested that even with pasteurization, the city health department would continue to need even more sanitary inspectors at farms in addition to pasteurization facilities. In combination with the citys active use of the AAMMCs sanitary scorecards, these comments suggest that Chicago health officials trod a fine line between promoting certification and promoting pasteurization as purification processes. This ambivalence clearly became institutionalized in the two grades of milk created by the 1912 ordinance. Hygienic practices underlying certifica tion remained central to Chicago health officials campaign for milk purity even as they actively started to use pasteurization. In this sense, the Chicago health department followed the logic of AAMMC member W. H. Park, who suggested that milk should be [produced] as good as conditions made pos sible, even if to be pasteurized (AAMMC 1909: 55).

Making Pasteurization Appropriate: Syncretism and Institutional Layering

The outcome of the 1912 revised ordinance was a health department divided between hygienic practices often associated with milk certification and a selectively applied pasteurization regimen. Although Chicago public health officials increasingly relied on pasteurization, their use of scorecards and

Pasteurization and Milk Purity in Chicago 427

continued inspection of farms suggests a continued orientation to exist ing hygienic practices. The coexistence of these two sets of practices in the departments activities can be understood by application of institutional theories on layering or grafting. Historical institutionalist scholars have pointed to the importance of layering effects in endogenous institutional change. For example, Kathleen Thelen (2004) follows Eric Schickler (2001: 35) in defining institutional layering as the grafting of new elements onto an otherwise stable institu tional framework. Thelen sees this form of layering as a form of bounded change that can occur, for example, when political conditions require an addition to or change in existing organizational practices to maintain the overall institution. For his part, John L. Campbell (2004: 85) describes a similar process when he discusses institutional translation. His term trans lation denotes institutional layering that involves the introduction of new ideas . . . with already existing practices. Both translation and layering capture the process of merging old and new practices and ideas with shifting organizational and institutional trajec tories. In Chicago pasteurization not only existed beside its old archnemesis milk certification in the inspected grade of milk, but health officials also extended sanitary inspections to pasteurization facilities (Chicago Depart ment of Health 1919). The staff of health inspectors hired by the Chicago health department over the period 190812 continued to carry out their duties and served as a strong obstacle to the complete elimination of the sani tation components of Chicagos milk purification scheme. As Block (1999: 25) argues: Though pasteurization was the chosen route, certification influ enced milk laws by providing the model for city inspection of dairy farms, the other end of city milk regulations. Often long lists of requirements were made, many of which resembled the requirements of the certification move ment. In short, pasteurization would not cleanly supplant existing methods of milk purification, nor was pasteurization completely relied on to protect the public from 1912 to 1914. Instead, a gradual process of institutional change took place during this period in the form of an institutional layering of pasteurization with preexist ing sanitary practices. As suggested, Chicagos dependence on pasteurization resulted from the veto power of state officials over municipal ordinances, especially those with effects outside the municipalitys jurisdiction. Legally constrained, the city health department innovated new solutions to the milk purification issue based on its weakness visvis the state. Such condi

428 Social Science History

tions correspond to a process of institutional layering that can be termed syncretism. As used by Randall Collins (1998), syncretism refers to a survival strategy used by philosophies facing defeat from a stronger competing philosophy. In this process, marginalized philosophies combine to stave off extinction from their dominant competitor. Through this merger, the philosophies incorpo rate often inchoate or contradictory elements from other weak philosophies into their doctrines. Lack of power prevents these merged philosophies from eliminating dissonant elements. Thus syncretism differs from processes of synthesis, in which a strong philosophy takes positive and consistent ele ments from its merging partner, or hybridization, in which two philosophies merge to create a new and distinct philosophical entity. In similar conditions, Chicago health officials syncretized pasteurization with existing sanitary practices after the state legislatures Joint Committee on the Tuberculin Test prohibited mandatory tuberculin testing. This state veto led to a situation in which both certification and pasteurization coexisted in Chicagos public health law and practices, even though these processes were often vehemently contrasted to each other in debates among doctors, philanthropists, and public health officials. Evans and his staff grappled with this contradictory situation, as suggested in their ambivalent stand between certification and pasteurization in public speeches and testimony. This was not a struggle that Evans chose. Rather, it was forced on him by the greater authority of state officials over tuberculin testing. The syncretization of pasteurization in hygienic practices also smoothed the way for health officials full use and acceptance of the process. When used in combination with sanitary scorecards and farm inspections, pasteurization did not fundamentally alter the routines of sanitary inspectors or diminish the importance of promoting sanitation as a public health department goal. Thus the health departments adoption of pasteurization reflects a form of institutional layering that resulted from a position of weakness. At the same time, Chicagos experience suggests that policy innovation can derive from situations of disadvantage, constraint, and compromise as well as from the forceful, proactive promotion of new agendas and policies.

Conclusion: Pasteurization Ascendant

From 1914 to 1916 Chicago experienced a wave of epidemics that swept in from the eastern United States. Health department officials used reports of these

Pasteurization and Milk Purity in Chicago 429

epidemics in eastern cities as advance notice, tracing the spread of disease westward to selectively mandate full milk pasteurization in exposed areas of the milk shed. In 1914 the health department responded to a hoofandmouth disease epidemic by requiring the pasteurization of all milk coming into the city from within a radius of five miles of an infected farm or premises (Chi cago Department of Health 1919: 916). Inspected milk temporarily became unavailable during this period, and pasteurization was largely credited with the fact that no humans contracted the disease (ibid.: 1003).13 Following this success, the new Chicago health commissioner, John D. Robertson, extended the strategy during an infantile paralysis epidemic in 1916, mandating the pasteurization of all milk entering the city (ibid.: xv). The lack of deaths from these epidemics confirmed the symbolic and practical utility of pasteuriza tion, and by March 1916 the health department reported that 99 percent of the milk entering the city was properly pasteurized (ibid.: xv; see also Wolf 1998: 56). Several years later Robertson proclaimed that pasteurization was one of the two foundation rocks on which the superstructure of disease elimination could proceed (Chicago Department of Health 1919: 5). A narrow view of these last few years would suggest that pasteuriza tion proved itself through its obvious utility in preventing epidemics. The present analysis suggests, however, that significant political contestation and institutional transformation occurred to place pasteurization in the position to prove its worth in protecting the public. The eightyear halting progres sion toward pasteurization challenges interpretations that Chicago adopted pasteurization because it simply worked or due to the clear political interests of powerful societal actors. In contrast, the lessons of Chicagos experience center on the ambiva lence of interest groups to pasteurization during this period of time. Pas teurizations adoption as a stopgap measure in the 1908 ordinance reflected its availability rather than interest group influence, while institutional con straints on Chicagos public health department propelled the process into position as a major milk purification measure. Even this, however, involved considerable institutional layering with existing hygienic practices to make the process more palatable and less organizationally disruptive. The combination of hygienic practices and pasteurization provided Chicagos population with the best of both worlds in milk purification. But such contentions can only be made in retrospect. In this case, Chicago pub lic health officials syncretized pasteurization with hygienic practices as a coping strategy, one that incidentally had positive effects on the purity of the

430 Social Science History

milk supply during epidemics. Thus we see how policy innovation can occur through institutional constraints, as with the veto points of Illinois legislators over Chicagos city government and lack of clear interests and intentions on the part of governmental actors. Finally, this account illustrates how statelevel veto points and syncre tization worked to create consensus and clear support for pasteurization. It provides a background for the industrial bargain approaches to this topic, showing historical conditions in which pasteurization, seen only in retro spect, became an efficient, highquality, and inevitable process. In this way, then, the account provides an explanation of how our own contemporary views on pasteurization were first formed.

Notes
I would like to thank Nicola Beisel, Carol Heimer, Ryon Lancaster, Ann Shola Orloff, Allan Schnaiberg, and Arthur L. Stinchcombe for intellectual guidance. The participants in the Graduate Writing Seminar at Northwestern Universitys Department of Sociology offered critical assessments and much helpful advice on several versions of this article. Many thanks to the editor and anonymous viewers at Social Science History for insightful comments on the strengths and weaknesses of earlier drafts. All mistakes remain mine. 1 As with many other milkoriented philanthropies, the Infant Welfare Society pre ferred the use of certified milk produced by contract from a local farmer over pas teurization. The acceptance of Strausss offer, therefore, can be considered a case of not looking a gift horse in the mouth. 2 Abbott (2001) and Pierson (2000) have both commented on historical analyses that project contemporary assumptions onto historical actors, calling this a version of putting the cart in front of the horse. Both argue that this strategy characterizes functionalist accounts that read the future success of a phenomenon (e.g., pasteur ization) as the initial reason for its utilization. 3 Moreover, as far as Chicago is concerned, the presence of pasteurization facilities in large local dairies and the Infant Welfare Society as early as 1902 suggests that the latter explanation has more support (i.e., that Chicagos eventual interest in emulat ing private facilities drove local research in and growth of largescale pasteurization facilities in municipal milk depots). 4 Block (1999) argues that existing evidence shows that certified milk was twice as expensive as pasteurized milk during the period under study. 5 In Chicago previous attempts to control infection from contaminated milk included regulations mandating the sale of milk in individual quart bottles versus large open canisters in 1904 and the empowerment of city health inspectors to revoke milk dealers licenses for unsanitary practices in 1906 (Wolf 1998: 3638). 6 Specifically, Chicago health officials adopted the quick or flash method of heating at

Pasteurization and Milk Purity in Chicago 431 160 degrees Fahrenheit for 30 to 45 seconds followed by rapid cooling as their pre ferred method. See the following sections for a discussion of milk certification. The AAMMC was an umbrella association for physician groups advocating city level milk purification efforts to reduce infant mortality. The particular ideas of this association will be taken up in subsequent sections. See also Waserman 1972. Conflicts between the city and state health departments were not uncommon, and the two organizations had a history of disputes over the licensing of individual milk dealers in Chicago (Chicago Tribune 1909b, 1909d). Olmstead and Rhode (2004b) argue that a considerable moral hazard attended to these payments. Health officials spent considerable energy trying to find a suitable balance between providing needed compensation for farmers while still offering stingy enough payments to discourage abuse of the program. The concern was that farmers would slaughter healthy cattle with poor market values as tubercular to take advantage of generous compensation rates from the state. Farmer representatives asserted that cows brought into the barn from the pasture, standing on cement floors and in an unusual situation, would respond to these stresses through a rise in body temperature that inspectors would then record as a positive response to the tuberculin injection (Illinois General Assembly 1912). Olm stead and Rhode (2004a) document various other criticisms of the test during these years. The poor handling of milk could be overcome either by a tighter inspection regime or by pasteurizing all handled milk. Hence the comment itself underscores consider able ambivalence about the appropriate purification technique. This is clearly ironic, given that hoofandmouth disease is not transmissible from cattle to humans. Adding to the irony, the Illinois Dairymens Association also responded to the epidemic by shifting toward advocating full mandatory pasteuriza tion (Pegram 1991).

7 8

10

11

12

13

References
Abbott, Andrew (2001) Time Matters: On Theory and Method. Chicago: University of Chicago Press. American Association of Medical Milk Commissions (AAMMC) (1907) Proceedings of the First Conference of the Medical Milk Commissions in the United States. Cin cinnati, OH: American Association of Medical Milk Commissions. (1908) Proceedings of the Second Annual Conference of the American Associa tion of Medical Milk Commissions. Cincinnati, OH: American Association of Medi cal Milk Commissions. (1909) Proceedings of the Third Annual Conference of the American Association of Medical Milk Commissions: Held at the St. Charles Hotel, Atlantic City, New Jersey, Monday, June 17, 1909. Cincinnati, OH: American Association of Medical Milk Commissions.

432 Social Science History (1910) Proceedings of the Fourth Annual Conference of the Medical Milk Com missions, with a Manual of the Working Methods and Standards. St. Louis, MO: American Association of Medical Milk Commissions. Apple, Rima D. (1980) To be used only under the direction of a physician: Commercial infant feeding and medical practice, 18701940. Bulletin of the History of Medicine 54: 40217. Block, Daniel Ralston (1999) Purity, economy, and social welfare in the Progressive Era milk movement. Journal for the Study of Food and Society 3: 2027. (2002) Protecting and connecting: Separation, connection, and the U.S. dairy economy, 18402002. Journal for the Study of Food and Society 6: 2230. Campbell, John L. (2004) Institutional Change and Globalization. Princeton, NJ: Prince ton University Press. Chicago Department of Health (1919) Report and Handbook of the Department of Health of the City of Chicago for the Years 1911 to 1918 Inclusive. Chicago: House of Severinghaus. Chicago Tribune (1909a) Chicago must pay for model milk. January 20. (1909b) City bars milk with state OK. February 19. (1909c) Differ on safety of Pasteur Milk. February 17. (1909d) Fires a new shot at state board. February 26. (1909e) Pasteurized milk lauded by Evans. February 4. (1909f ) Price of milk is advanced. February 27. Cohen, Michael D., James G. March, and Johan P. Olsen (1972) A garbage can model of institutional choice. Administrative Science Quarterly 17: 125. Collins, Randall (1998) The Sociology of Philosophies: A Global Theory of Intellectual Change. Cambridge, MA: Belknap Press of Harvard University Press. de Kruif, Paul (1926) Microbe Hunters. New York: Blue Ribbon Books. Duffy, John (1990) The Sanitarians: A History of American Public Health. Urbana: Uni versity of Illinois Press. DuPuis, E. Melanie (2002) Natures Perfect Food: How Milk Became Americas Drink. New York: New York University Press. Halpern, Sydney A. (1988) American Pediatrics: The Social Dynamics of Professional ism, 18801980. Berkeley: University of California Press. Illinois General Assembly (1912) Evidence Taken before the Joint Committee on the Tuberculin Test, 1911. Springfield: Illinois State Journal Company. Immergut, Ellen M. (1998) The theoretical core of the new institutionalism. Politics and Society 26: 534. Infant Welfare Society (1903) Minutes ( June 7, 1903). Infant Welfare Society Papers, Chicago Historical Society, box 1, folder 7. (1904) Yearly report, 19031904. Infant Welfare Society Papers, Chicago His torical Society, box 1, folder 6. Klaus, Alisa (1993) Every Child a Lion: The Origins of Maternal and Infant Health Policy in the United States and France, 18901920. Ithaca, NY: Cornell University Press. La Berge, Ann F. (1991) Mother and infants, nurses and nursing: Alfred Donn and the

Pasteurization and Milk Purity in Chicago 433 medicalization of childcare [sic] in nineteenthcentury France. Journal of the His tory of Medicine and Allied Sciences 46: 2043. Levenstein, Harvey (1983) Best for babies or preventable infanticide? The contro versy over artificial feeding of infants in America, 18801920. Journal of American History 70: 7594. McClary, Andrew (1979) Germs are everywhere: The germ threat as seen in magazine articles, 18901920. Journal of American Culture 3: 3346. Olmstead, Alan L., and Paul W. Rhode (2004a) An impossible undertaking: The eradi cation of bovine tuberculosis in the United States. Journal of Economic History 64: 73472. (2004b) The Tuberculous Cattle Trust: Disease contagion in an era of regula tory uncertainty. Journal of Economic History 64: 92963. Pegram, Thomas R. (1991) Public health and progressive dairying in Illinois. Agricul tural History 65: 3650. Pierson, Paul (2000) Not just what, but when: Timing and sequence in political pro cesses. Studies in American Political Development 14: 7292. Schickler, Eric (2001) Disjointed Pluralism: Institutional Innovation and the Develop ment of the U.S. Congress. Princeton, NJ: Princeton University Press. Thelen, Kathleen (2004) How Institutions Evolve: The Political Economy of Skills in Germany, Britain, the United States, and Japan. Cambridge, U.K.: Cambridge Uni versity Press. Waserman, Manfred J. (1972) Henry L. Coit and the certified milk movement in the development of modern pediatrics. Bulletin of the History of Medicine 46: 35990. Whitaker, George M. (1911) The Milk Supply of Chicago and Washington, DC. Washing ton, DC: U.S. Department of Agriculture, Bureau of Animal Industry. Wolf, Jacqueline (1998) Discarding natures plan: A social history of infant feeding in Chicago, 18921938. PhD diss., University of Illinois at Chicago.