divided into fifty portions, will give the means of dividing by 1.50 the space engendered at each turn of the screw of one-half millimeter of separation.

"It is in the space comprised between the two glasses, and which may be altered at will, that the milk which it is desired to investigate is poured. A sufficient quantity must be introduced to prevent the light of a candle placed at a distance of three feet from being seen. The instrument, thus charged, is to be interposed between the eye of the observer and the light. Then by progressively diminishing the layer of milk, by gently screwing one tube on the other, and thus separating the glasses, a certain thickness is obtained, through which the image of the flame begins to dawn; this is the time to stop. The reading of the position of the division in relation with the indicatory arrow will give the thickness of the layer at this moment. By separating, by means

of the screw, these tubes several times in succession, so as to restore the opacity to the layer of milk, and bringing them again to the point at which the image begins to appear; if every time the same relation is observed between the division and the indicatory arrow, one may be assured of the correctness of these means of observation."*

This instrument is, in reality, a very ingenious one, and enables us to determine with facility the richness of the cream in the milk of a nurse. It is the best means to employ for this purpose, for it is impossible to arrive at any positive result by boiling the milk in a spoon, and observing the transparency through a drop of this liquid placed on the nail, &c., as was formerly done.

A small quantity of the milk to be examined is sufficient when introduced into the instrument. A thin layer of this liquid is sufficient to eclipse the light of the candle when the quantity of cream is considerable. On the contrary, a thicker layer is necessary when the milk is watery, impoverished, and only contains a small quantity of cream.

If the instrument be well graduated, as the degree of the separation of the glasses for a good ordinary milk is under the eye, this figure serves as a comparison for the different kinds of milk concerning which we may have to give an opinion.

If, on the contrary, chemical analysis is to be employed to determine the exact proportions of the various elements of milk, the method of proceeding adopted by MM. Becquerel and Vernois should be used, and this will be concisely related.

From one ounce and a half to two ounces of milk is to be taken, and this is to be divided into three portions, one of two to three drachms, the two others of from five to six drachms.

The first portion, that of two to three drachms, is placed in a flask

* Extract from the Report of the Academy of Sciences on the Memoir of M. Donné. Cours de Microscopie; Paris, 1844; pp. 534 et suiv.

for the determination of the specific gravity, and by means of the well known methods of proceeding, the specific gravity of the milk as compared with that of distilled water at a given temperature is readily ascertained. When only a small quantity of milk is at our disposal, the determination of the specific gravity, being of less importance than the other results, may be neglected.

The second portion of the milk, from five to six drachms, is destined it the to furnish the quantity of the sugar, the weight of the extractive Thethon matters, and salts. In order to obtain the weight of sugar, these five or chruis six drachms of milk are treated by five or six drops of rennet and four

or five drops of acetic acid. It is beaten up with a spatula, and the Qualysis. whole is exposed in a platinum capsule to a temperature of 120° to 140° Fah., and then placed upon a filter. In this operation, which must be rapidly accomplished, the caseum becomes coagulated, taking with it the fatty matter, and filtering allows the serum to pass perfectly clear and limpid. Sometimes a second filtration is necessary, or two or three hours rest, so as this clearness may be perfect. This serum is placed in a polarizing apparatus. The deviation to the right is determined, and, by means of a table drawn up for this purpose, the quantity of sugar of milk contained in 1000 parts of milk, for example, is exactly obtained. To determine the weight of the extractive matters and soluble salts, the serum is evaporated, the dry residue weighed, and the difference between the weight of the sugar and the total weight of the dried serum gives the quantity of extractive matters sought for. This latter valuation is not, however, so exact as that of the sugar, but it is sufficient.

the

The third portion of the milk which has been put aside, and which amounts to five or six drachms, is weighed in its liquid state, then dried at a temperature of 158° to 177° Fah. for a very considerable time; weight of the dried product is then ascertained, this product is treated by ether, which removes all the greasy matter; it is filtered, and then again dried and weighed. The product is the amount of caseum, of sugar, and of extractive matters. The difference with the first weight expresses the quantity of butter. The whole is reduced to 1000 parts. We have then separately, 1, the quantity of sugar; 2, of extractive matters; 3, of caseum. If these three weights are added together, and from this sum the weight furnished by the product of the dried milk is subtracted, the difference gives the quantity of caseum. The analysis of the milk is then complete, and, as we have observed, by reducing all the results to 1000 grains, we have, 1, the specific gravity of the milk; 2, the water; 3, the butter; 4, the sugar; 5, the soluble extractive matters; 6, the caseum. Incineration will furnish the absolute weight of the salts.

In a word, then, as we have just seen, the choice of the nurse rests upon the determination of a great number of very variable circumstances;

1, on the actual or former state of the health of the woman; 2, on their appearance; 3, on their character; 4, on the age and composition of their milk-a composition which is readily determined by the microscope, and by the two instruments referred to; and, 5, by means of an exact analysis of its various constituent elements.

OF NURSES IN GENERAL.

There are two kinds of nurses: those who take the children from Paris to rear them in the country, and those who are admitted into a family, there to suckle the child confided to them. These last are called home wet nurses.

The first cannot be watched; they attend to the child as they please, and at their leisure, either well or indifferently, according to their disposition. It sometimes happens that a nurse may be engaged in a district where a friend may visit her, to give her advice on the subject of the child, but it is not always thus. The nurses carry off the infant after having promised to wean their own child, but they do nothing of the sort, they suckle both of them. Doubtless their own is best taken care of, and what encourages them in this line of conduct, is, the want of surveillance.

When a child is to be brought up in the country, a place at a little distance from Paris should be chosen readily accessible, so as to surprise the nurse in case she should be inattentive. Preference should be given to women who live in a dry district and free from marshes. Thus the nurses of Normandy and Burgundy are the best; the nurses of Orléanais, of Berry, of Sologne are to be avoided, on account of the localities to which the children are brought. These countries are infected by intermittent fever; the children there are in general, pale, etiolated, and feverish; their belly swollen, their spleen enlarged, their legs oedematous; they often suffer from a fever which it is difficult to detect, and which ends by destroying them. These are the countries in which the mortality of children is the greatest.

Amongst the nurses from the country who come to Paris to seek children, some are unmarried, others are married to artizans, and others to agricultural labourers; selection should be made as much as possible from those last mentioned. They have their home, and frequently a cow, and if perchance they do not possess one, there is always one to be found not far off. Then we are sure that in case of the indisposition of the nurse, or of diminution in the quantity of her milk, the child need not suffer, since cow's milk which is readily obtained can be given it.

On the contrary, the nursing wives of artizans have no farm and no cow, and they sometimes live in places where it is a difficult matter to procure milk. When employment fails, misery enters the house; the woman suffers, her milk becomes changed, and the child experiences the

consequences of it, for they give it broths, soups, dry bread, and other kinds of food not suitable to its organs which are not yet sufficiently developed.

In the first case, nurses may without trouble give the children good milk; it costs them nothing; in the second, they must go farther to obtain it; idleness, the inclemency of the weather, want of money, and a multitude of other circumstances, make the nurses stay at home and take other means to feed the children, to the detriment of their health.

Home wet nurses, are those who enter a house to suckle the child, in the midst of the family. It is especially to these that the recommendations about to be given must apply, and which may be equally useful to mothers who are suckling their children and to nurses in the country.

NURSES CONSIDERED WITH RESPECT TO THEIR HEALTH, THEIR
REGIMEN, AND ΤΟ THE HABITS THEY SHOULD ADOPT
WITH REGARD TO THE CHILDREN.

No change should be made in the habits and regimen of the nurses who come up from the country to live in the midst of society. It is impossible to make a peasant a gentlewoman, consequently they should not be harassed in this attempt. However, if their mode of living is not consistent with that which we have a right to require from them, for the advantage of the child, the practitioner should progressively modify what does not appear proper to him.

Partie

The regimen of these women should not be different from the ordinary regimen of the family in which they are engaged. It is only necessaryulai w to be careful to deprive them of highly-flavoured food, rendered too exciting by the spices contained therein. With this exception, nurses should eat all kinds of food, such as vegetables, salads, and fruits; drink wine in small quantity, or cider, if such is their habit; in a word, they may take all they can digest without doing themselves harm.

A special regimen is of no importance, for it is decided by all practitioners that, as regards the human race, that which has succeeded in the females of large domestic animals cannot be accomplished. In woman the qualities of the milk cannot be modified by the use of this or that variety of food. It is probable that some day this may be attained; A but in the mean time it is useless to restrict the nurses to one kind of food rather than to another. They should be allowed to follow the regimen of the persons with whom they live, and to eat whatever they h can readily digest.

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Nurses should daily take moderate exercise, at all times, and cially in the sunshine. This is as necessary for them as for the child which they rear. When out of doors, the nurse should be accompanied as often as possible. Great inconveniences might arise

र

Lone Tun from allowing them to go out alone, especially when we cannot depend of the

on their conduct, and when they are not very reserved in their manners. This observation leads to the consideration of the restraint in which nurses should be kept. Although it is not established that the 44 union of the sexes may change the qualities of the milk, it should be forbidden. Conception may result from it, and then the milk diminishes,

teateid is altered, resumes the qualities of colostrum, and becomes unwholesome

to the child.

During lactation, the modifications in the health of the nurses should be carefully watched. Some are subject to constipation, and will not own it for fear of being injured in the estimation of the parents. When their artifice is discovered, it is best to reprove them gently, and to prevail on them to have more frankness for the future; for it is a very important thing to acquire the confidence of nurses. This indisposition can never be attended with very serious consequences, and to effect its disappearance it will be sufficient to give one or two doses of the remedies customary in such cases.

Others, and these are numerous,

before the termination of lactation.

observe the catamenia reappear This was formerly considered

a very serious affair, one that occasioned much alarm in the family, and
necessitated the change of the nurse. It was thought that from this
moment the milk assumed qualities deleterious to the child. But such
is not the case, and this circumstance alone should not decide us to
send
away a nurse with whom we are satisfied in every other respect.
In fact, I have made inquiries from a great number of women whose
catamenia appeared during lactation, concerning the phenomena which the
nursling presented. The greater number of them did not appear to
suffer at all from it. Some were a little dull at this period, they had
colic, and in some few cases a slight diarrhoea; others were more
seriously affected, they had severe colic and an abundant diarrhoea.
Consequently, when the catamenia reappear in a nurse, future events
should not be too hastily judged of. We should wait-for all that can
be decided must evidently be subordinate to the attentive observation of
these phenomena. The nurse should continue the lactation, and she
should only be made to suspend it if, at the menstrual periods, the
nursling should be in a state of indifferent health.

As to the other diseases of the nurse, and the influence which they exercise on the milk and on the health of children, we shall treat of them in a special chapter.

The habits of nurses should be attentively watched, as much on their account as on account of their child. They should not be allowed to give it the breast continually, although they do it with a good motive, because they say a child cannot suck too much, or because they wish to quiet cries which harass them. The hours of lactation should be