of bread may be given them to suck, and a little weak sugared wine and water given them to drink. Later still, a little cow's milk may be given, and then broths, made as has been described under the head of artificial lactation. In every case, if the child thrives well with his May be nurse, if it is plump and well developed, it is useless to have recourse to the employment of these artificial means. The child may be kept at the Fetal breast of the nurse to the eighth or tenth month. At this period it is prudent to give it other kinds of food, so that its stomach may b become habituated to it, in case a disease of the nurse should necessitate the suspension of lactation. 3 When they begin to feed the child, it should be by means of soups made with milk or butter; fat food should be forbidden until the end of the first year. These substances are more difficult to digest than those we have referred to, and are not, before this period, appropriate to the requirements of the child. They are not proper until the period of its passage from parasitical to independent existence. This transition can hardly take place without bad symptoms ensuing until towards the age of ten to twelve months. [Dr. Churchill (on Diseases of Children, p. 31) recommends the following article of diet, which is called by him, "bread jelly." "A quantity of the soft part of a loaf is broken up; and boiling water being poured upon it, it is covered and allowed to steep for some time; the water is then strained off completely and fresh water added, and the whole placed on the fire and allowed to boil slowly for some time, until it becomes smooth; the water is then pressed out, and the bread, on cooling, forms a thick jelly, a portion of which is to be mixed with milk or water and sugar for use as it is wanted. The steeping in hot water, and the subsequent boiling, removes all the noxious matters used in making the bread, and it both agrees very well with the child, and the child likes it very much." In a late number of the Journal für Kinderkrankheiten there is a paper by Dr. Gumprecht of Hamburg, calling the attention of the profession to a novel kind of food, viz., carrot pap (Karotten brei). It is true that as far back as 1819, Friedländer in his work Sur l'education physique de l'homme, remarked "on fait en Vallachie du bouillon avec des carrottes ;" and in 1830, Schmidhmann stated, that in Turkey, carrot pap was highly prized as a nourishment for young children; Øyet it is due to Dr. Gumprecht to say that all credit attaches to him for bringing it prominently before the notice of the profession, and for its present use in Germany, through the recommendations of some of the first authorities there. At the request of Gumprecht, Müller of Hamburg, Mauthner of Vienna, Münchmeyer of Lüneberg, &c., have employed it, and speak highly of its value. Wakenroder gives the following analyses of the expressed and inspissated juice of the carrot: But as the scraped root of the carrot contains other matters than the above, especi ally a large quantity of ligneous substance, which cannot be digested, and which will a remain often two or three days in the intestinal canal before being discharged, and be highly detrimental to the delicate mucous membrane of children, it becomes important to separate that which will be useful from that which will not. Gumprecht advises an ounce of finely scraped full grown carrot to be mixed with two cupfuls of cold soft water and allowed to stand for twelve hours, being frequently stirred during this period. The fluid portion is then to be strained off, what remains to be pressed to yield some more. This fluid is then to be mixed with the proper quantity of biscuit powder, or bruised crust of bread, or arrow root, &c., and the pap placed over a slow fire, until it begins to bubble. Care must be taken that the heating be not pushed so far as to cause boiling, or the albumen will coagulate. After its removal from Make a the fire it is to be sweetened with a due amount of white sugar. Dr. Gumprecht states, that by mixing the coarse juice with biscuit, crust of bread, or arrow-root and sugar, we obtain all the farinative and nutritious elements required, viz., albumen, gluten, starch, sugar, fat, and the phosphates of lime and magnesia. This food Al is more particularly adapted for children who have been suckled and are being weaned; for those who are being brought up by hand, the following preparation is deemed more advisable: an ounce of very finely scraped yellow carrots, and two drachms of biscuit powder, are to be mixed with two cupfuls of cold soft water. This must stand in a covered vessel, in a cool place, for twelve hours, and be frequently stirred during this time. It is then to be drawn off, or strained through a linen cloth. Some sugar candy and a pinch of salt are to be added to the fluid, Cold in which may then be administered by means of the sucking bottle, care being taken Riseut that the food is at the proper temperature. We may state, that Zeise of Altona (Annal. v. Wöhler u. Liebig, 1847) has given a scientific reason to support a prac-will, 8 He Sugar. tical belief common in Germany, viz., that the carrot is a good anthelmintic. THE FOLLOWING IS THE DIET TABLE OF THE HOSPITAL Children under eight years old to have a third less. Extras, as mutton chops, fish, eggs, beef tea, &c., may be ordered, as may wine, beer, or spirits, for any of the patients for whom the medical officers think fit to prescribe them. E ८ RECEIPTS FOR THE FOREGOING DIET TABLE. Cocoa Cocoa nibs, half-ounce; water, one pint; boil to half-pint; add half-pint of milk, half-ounce of sugar. Gruel.-Grits, 1 ounce; water, two-thirdspint; milk, one-third-pint; sugar, half-ounce. Milk and water.-Milk, two-thirds-pint; water, one-third-pint; sugar, quarter-ounce. Arrow-root.-Arrow-root, half-ounce; water, three-quarters-pint; milk, quarter-pint; sugar, half-ounce. Thin arrow-root for drink, made with quarter-ounce of arrow-root. Rice pudding.-Carolina rice, half-ounce ; sugar, half-ounce; milk, half-pint. Bread pudding.-Either boiled or baked.Half-breakfast cup or 2 ounces of bread crumbs, 1 egg, half-pint of milk, half-ounce of sugar. Mutton broth.-Half-pound meat, 1 ounce carrot, 1 ounce turnip, half-ounce barley, 14 pint of water, to make 14 pint of broth. Served with the meat in it. ON WEANING. Suet pudding.-Half-pound flour, half-pound suet, half-pound bread crumbs, with a little salt and a little powdered ginger, if liked, mixed with water, and boiled for two hours. Mashed potatoes.- Mashed without butter, with milk only. The meat for mutton broth, neck of mutton. For meat diet, mutton legs and shoulders only. Acidulated rice drink.-1 ounce ground rice, 2 quarts water; boil and strain; sweeten with barleysugar, 1 ounce; acidulate with 1 ounce lemon juice. Acidulated barley water.- Barley water, 3 pints; 2 lemons sliced; boil to a quart; sweeten with 2 ounces loaf sugar. White decoction.-1 ounce bread crumbs, half-ounce hartshorn shavings, 3 pints water, boil to two; flavour with lemon peel; sweeten with 1 ounce sugar. P.H.B.] The term weaning is applied to the changes introduced into the alimentation of children, when it is desired to deprive them of the breast of their nurse, so as to give them an independent existence by accustoming them to the food they should use in the course of their life. This is often a critical time for children, either because the transition has not been properly managed, and has been too violent and premature, or because it has not been made at a favourable opportunity. Except in the case of special circumstances, such as a serious disease of the mother or of the nurse, lactation should not be interrupted before the age of twelve or eighteen months. It would be inflicting a serious injury on the child to wean it too early; first, because its development experiences a momentary retardation; again, because the organs are not sufficiently accustomed to the stimulus of the food which may be given it, without more or less serious accidents resulting from it; lastly, because at the moment of the dental evolution, the breast is a great consolation to children, who ardently attach themselves to it and thence derive great alleviation to their suffering. It should be delayed until the process of dentition is much advanced, or nearly finished; consequently, the period of weaning should be fixed at the age of twelve or eighteen months. For my part, in directing the weaning of children, I always select one of those moments of repose which is observed in the eruption of their teeth, and I never put a stop to lactation until after the appearance of the canine teeth. In this manner the child is in possession of the first fifteen or sixteen caducous teeth, the evolution of which is the most difficult; and there only remain the last four molars to be cut, which usually appear with great facility. It is equally wrong to prolong lactation too much; for great difficulties are often experienced in interrupting it, and the child Allay may suffer from not having food sufficiently substantial for its age. Es metil Chap. III.] ON LACTATION. Gad te 51 Lustatu When, then, the period fixed for weaning is come, it should be ter long Should Gradual commenced by leaving off lactation in the night time, and by familiarizing the child with the food which should form a portion of its regimen for the future. In this manner it is not deprived of the breast of its nurse, that is to say, of the milk, until it is in a state to be fed differently. Then it should be accustomed to bread; to be dine sweetened weak wine and water; to thin, weak, or nourishing broths once or twice a day; to the use of meat, which is to be given it in small portions to suck; and, lastly, when it is sufficiently accustomed to these kinds of food, at the end of about a month, suckling is suddenly stopped. At first, the child cries and is obstinate; but if it is not ill, it must be resisted, and it soon gives up, making amends in the food for the breast of which it is deprived. Some, notwithstanding, continue obstinately attached to the breast of the nurse; in order to cause a distaste for it, a bitter, but harmless, solution of gentian or aloes, the flavour of which is very disagreeable and effectually repels them, should be applied round the nipple. Instances have been observed of mothers prolonging lactation much beyond the time when it should cease, but these cases are exceptional. Thus, M. Baffos used formerly to relate to his pupils at the hospital for children, the history of a lady who much dreaded the period of her son's weaning. She continued to suckle him, and towards the age of three years, when she called him one day to give him the breast, he answered-" Really, mamma, I don't wish for any more." ["The term of nursing will depend upon various circumstances, such as the health of the child or mother, the abundance of milk, &c. Some women are not able to suckle more than six or seven months; some continue for two or three years. I know a lady who nursed a child (now a tall, strong man) until he was able to draw down the blinds and bring her a footstool, previous to his taking his meal. Astruc and others advise nursing for two years, and the lower orders occasionally practice it to avoid pregnancy. But these cases are exceptions; and I believe it will generally be found, that nursing prolonged beyond twelve months is unnecessary for the child, and positively injurious to the mother in most cases. Taking this as one extreme, we may fix the other at nine months, and conclude that it is desirable that a child should not be weaned before nine months, nor suck after twelve. By this time he will be provided, generally, with a sufficient number of teeth to make use of the proper food, and he will have retained the comfort of suckling until he has passed through the first trouble of teething.”—Churchill on Diseases of Children, p. 28.-P.H.B.] 1 After weaning, the regimen should be simple, and composed of the most delicate substances of the family food. It should include no highly flavoured or strongly spiced food, which may possibly be suitable le for adults, but would assuredly be injurious to these young children. They should make several meals a day, for if they eat but little at a time, they should eat often; this is a fact well known to mothers of families, who are quite alive to this point. The diseases of weaning were formerly alluded to as diseases of a special nature, in relation with the change in the alimentation of children. These affections possess no peculiarities, and present at this period the same characteristics as in the other periods of early childhood. Most of them appear as simple phenomena of coincidence without any relation of cause to effect. There is one, however, which appears to be in special relation with weaning, this is inflammation of the alimentary canal. Its characters are not in any way modified; and its development may be prevented by the employment of the means capable of softening the transition between lactation and independent Jediges existence. CHAPTER IV. ON THE HABITS, EXERCISE, SLEEP, AND REST OF CHILDREN. Nothing is more dangerous than to allow children to acquire bad habits. Their cries then possess such a ready and absolute means of command, that those who surround them become their slaves, and submit to their most trivial wishes, in the dread of exciting their anger and of doing them injury. It was formerly the custom to send children to sleep by rocking them in the arms, or in the cradle; but proper remarks have caused these means to be abandoned, so that we rarely have occasion to forbid it now. However, the necessity is still pretty generally believed in, of sending the children to sleep, either by caresses when they are in their bed, or by holding them on the knees until sleep has weighed down their eyelids. It then happens that if other occupations should distract the nurse from this attention, the child cries until some one sends it to sleep; and when it awakes in the night, they are obliged to fly to its bed and recommence the same caresses. This is a bad habit to allow children to acquire, who would always wish to have some one near them during their sleep, or would sleep on the knees of their nurse. They can be brought up differently, and their sleep is not, on that account, the less beneficial to them. They have only to be placed quite awake in their cradle, and they quickly get into the habit of falling asleep there. It costs but little to follow this line of conduct from the very commencement of lactation; it is very advantageous in this sense-that the children become very docile, and allow the nurse all the time necessary for her rest. When this bad habit is established, and when it becomes irksome to the parents, it may be destroyed with a little courage and determination. All that is required is to resist the cries of the children, which |