Sometimes this secretion is so abundant, that it escapes naturally, and

of itself, by the nipple."

M. Donné has proved that a nearly constant relation exists between

the nature of this liquid, secreted during pregnancy, and the milk as itation. is secreted after delivery. From the examination of the colostrum, and the of its principal characters, it may be predicted what will be the character

of the secretion of milk, its essential qualities, and its quantity. Colostrum

As M. Donné has remarked, there is nothing in this which should

create astonishment, for it is the same organ which produces the milk. and the colostrum, and it is easy enough to discover a relation between these two liquids.

As I have already observed, we sometimes meet with women, originally incapable of suckling, in whom the colostrum appears to possess satisfactory qualities, and who, nevertheless, should not nurse their children. Consequently, these characters, highly important as they are, do not possess an absolute value. If they are to be taken into consideration, we must, at the same time, attend to the state of the constitution of women who wish to suckle. In fact, this subject is one of those which merits the greatest attention from the practitioner.

In order to discover the future qualities of the milk, from the exami- " bussis nation of the colostrum, it is necessary, as M. Donné states, to divide

the women into three categories. "In the first are found those in e whom the secretion of colostrum is so scanty, that we can scarcely obtain a few drops of it, at the termination of pregnancy, by pressure on the mammary gland. If colostrum, in this condition, is examined t by the microscope, it is observed to contain a small number of imperfectly formed milk globules, and some granular bodies.* In these cases the milk will be almost certainly in small quantity after delivery-poor and insufficient for the nourishment of the child.

"The second category includes women whose mammary gland secretes an abundant colostrum, but fluid, watery, and flowing readily, like thin gum water, as poor as the preceding in milk globules, and in granular bodies; in these cases the woman may have an abundant supply of milk, but it will always be poor, watery, and without body.

"Lastly, when, at the termination of pregnancy, the secretion of colostrum is very abundant; when this fluid contains a more or less thick yellow matter, contrasting by its consistence and its colour with the rest of the liquid, in which it forms yellowish striæ; when it is rich in well formed milk globules, and combined with a greater or less quantity of granular bodies, it is almost certain that the woman will have a sufficient quantity of milk; and that this milk will be rich in nutritive principles, that it will possess, in a word, all materially essential qualities."

To these bodies, which constitute a part of the colostrum, we shall again refer.

As for the virus or morbid principles which it may contain, whether syphilitic, tuberculous, or otherwise, they escape microscopical analysis, and the state of the constitution must be referred to in order to discover their existence. The practitioner should then extend his inquiries beyond the results furnished by the physical or chemical examination; and besides having regard to the characteristics of the colostrum, he should especially take into consideration the health of the mother, in order to decide if she should suckle her child.

ON THE CONFORMATION OF THE BREASTS.

There is a considerable number of primiparous women, whose breasts are sufficiently large, but whose nipples are flattened, shapeless, and buried in the mammary gland. This state of parts is a very common one, and is very troublesome to those women who wish to suckle their children. It results from the compression exercised on the breast by the stays, which are a little too high, and the gussets of which are too narrow to allow the breast to develop itself freely. This condition should be remedied early, as it is one which always hinders, and sometimes prevents, lactation; for the child has no hold on which to exercise suction, and exhausts itself in useless efforts to draw out the milk which is contained in the breasts.

It is in the course of pregnancy, during the last months, that women should get the nipple into shape. This they may readily accomplish themselves by occasionally exercising suction of this part, by means of a glass tube with a curved arm, which may be readily obtained, and which is made for this purpose. This proceeding is sometimes painful, and some women cannot bear the application of it; the husband ought then to endeavour, by means of gentle and moderate suction, to give to the nipple that prominence which is proper for lactation.

CHAPTER III.

ON LACTATION.

Children are only nourished by milk during the first months following birth. It is the nourishment which suits them best, and which nature has destined for them. Some draw it by suction from the breast of their mother, of their nurse, or from the teats of an animal; others from a bottle called the feeding bottle, the orifice of which, made for this purpose, is pierced by a small opening; or they drink it from the glass which is offered them.

These methods of alimentation, are collectively comprised under the term lactation; but the lactation by the mother and the nurse, must be

distinguished from the artificial lactation which is effected by means of a glass, or of the feeding bottle.

ON LACTATION BY THE MOTHER.

If no obstacle of the nature of which we have spoken exists in the constitution or in the health of the mothers, they should be recommended to suckle their children. The delicacy of the figure should not be considered as an impediment to this duty; indeed, most of the women living in towns, frequently very delicate, but otherwise in good health, may fulfil this duty.

children.

Lactation by the mother possesses, moreover, this advantage, that it is De best by far the most advantageous to the children. We see women of delicate appearance, whose milk is of a medium quality, rear their own children Steled very healthily, and only make puny specimens of the strange children who are confided to their care in consequence of the healthy appearance of their nurslings.

When, then, no general vice which may hinder lactation exists in the constitution or in the health of women, they should, having the interest of their progeny at heart, sacrifice the world and its pleasures, and give the breast to their child.

As Désormeaux has remarked, the child should be presented to the n breast of its mother as soon as she has recovered from the fatigues of the confinement, which last a greater or less time, according as the Chal delivery has been more or less difficult. The movements of suction inst which it vigorously executes, the cries which it utters, sufficiently indicate the want it experiences; and what more suitable aliment can be offered than that which nature has prepared for it? At first it only derives from the breast a yellowish, slightly abundant liquid, known under the name of colostrum, and which, by its nature, is very fit to run u lubricate the internal surface of the intestinal canal, to induce, gently, 2.4 02 its contractions, to dilute the meconium, and by this means to facilitate the expulsion of that matter. This liquid gradually acquires thes appearance and the qualities of milk, and becomes more and more abundant. If the placing the child at the breast is deferred, besides the advantages it would lose derivable from the colostrum, the great distension of the breasts which takes place at the period of the milk fever would be an impediment to suction; it would be then necessary to wait until this tension had diminished. A weak and vigorous child could not endure these delays, and would become the victim of the ignorance or of the prejudices of those under whose care it is placed. There are, as we see, very good reasons why the child should be put to the breast at an early period-two, four, six, or eight hours after

delivery; there are none why we should wait until after the milk fever, to the

as some persons would recommend.

In the first days following birth, the children may be frequently put to the breast, for it is a difficult matter to satisfy them; but after the first few weeks, a greater interval should be allowed to elapse between the hours of lactation. Women should not be inconsiderately zealous to discharge their duty of nurse, and always endeavour to Euring calm the cries of the child by giving it the breast; they should, day having the interest of the nursling at heart, take care of themselves, and not exhaust their strength by too frequent lactation.

During the day, mothers should suckle their children every hour, or every two hours, at least; during the night they should train their - child not to wake them to take the breast. This is very easily accomplished; they soon acquire the habit, and experience no injury from it. The mother then, finds in sleep a salutary repose after the fatigues of the day. She may enjoy from six to eight hours uninterrupted sleep, by giving the breast, for the last time, towards eleven or twelve o'clock at night; and by recommencing the next day at six or seven o'clock in the morning.

If, during this interval, the child awakes and begins to cry, in order to make it lose the habit of taking the breast during the night, a little good cow's milk, diluted with water gruel, should be given it. It is still better to endeavour by caresses to quiet and get it to sleep, so as to avoid its taking anything. This may appear rather hard to it the first night; but soon, accustomed to this method, it awakes and goes to sleep again without crying, for experience has taught it that tears would be useless. Mothers should, then, have the courage to hear their child crying a little; for without this, far from being their master, one is their slave, and is uselessly disturbed by them, and lactation is interrupted in consequence of the exhaustion of the nurse.

The mammary glands-which by their seat and form constitute the ornaments of the sex, become, by their functions, the source of a new existence, and are placed, by their structure, under the influence of the moral activity. We cannot, then, too strongly recommend to mothers who suckle their children, to endeavour to acquire the calmness and tranquillity necessary to the direction of a good education. But what words can one use to a woman whose heart thrills at the cries of her child, and whose mind is so deeply disturbed at them? Are we not fearful of seeing the heart get the better of the intelligence, and maternal passion triumph over reason? Nevertheless, the practitioner should deliver his firm and respectful dictum in the midst of these blind and exalted sentiments, which exercise the most disastrous influence on the health of the children.

Dental The mother should be given to understand that the qualities of her milk are rapidly changed by violent mental emotions; and Eel that tranquillity is absolutely necessary to her, in order that she may

become a good nurse. What matter the cries of a child which has had the breast to a sufficient extent at the proper hour; which does not suffer, and which experiences no want? If it cries, it is by caprice; we must h learn to resist it; then it ceases, and learns for the future not to cry without a motive. In this manner it becomes docile, and its cries assume much value from the time when it is known that they are always a manifestation of suffering.

METHOD OF CAUSING THE MILK TO FLOW INTO THE BREASTS. When a woman has but little milk, and absolutely wishes to suckle her child; or when an accident, a moral impression, or any other cause, has diminished or suspended the lacteal secretion to such an extent as to render lactation impossible, there are several means to which we may have recourse in order to quicken the secretion of milk; and one of these has been several times successful in my hands. These expedients, known under the name of galactagogues, have fallen into the greatest discredit; but, rather than allow the lacteal secretion entirely to dry up, is it not better, at the risk of want of success, to make use of remedies which are uncertain, but sometimes useful?

The mercurialis, the ricinus, the jatropha curcas, were formerly employed, and Tabernæmontanus made use of the pimpernel exclusively. All these plants should be used as cataplasms on the breasts. I have only had recourse to the ricinus communis of botanists, the leaves of which, to the extent of a handful, boiled in two or three pints of water until half dried, form a cataplasm, which should be retained in position for twenty-four hours. On one occasion, on the eighth day after the delivery of a lady whose supply of milk had become arrested under the influence of a very acute moral impression, this (4. cataplasm reëxcited it. Another instance presented itself in a person of rather delicate constitution, who had a poor supply of milk; the same plan of treatment was successful, and under its influence a considerable increase in the lacteal secretion was observed.

ON LACTATION BY NURSES.

When, in consequence of the conditions of health which have been before noticed, or from any other cause, the mother refuses to suckle the child herself, it should be intrusted to a nurse.

The choice of a nurse is a very difficult matter. Many women of Paris, or of the provinces, will undertake this office, but there are a great number of them who possess none of the necessary qualities to discharge this duty in a proper manner. Nurses should be selected from their external appearance, from their state of health, and from the examination of their milk.

A primiparous woman seldom possesses that experience which is