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It scarcely comes within our province to the milk's being derived from a healthy anigive advice on the selection of a wet nurse. mal, and one that is surrounded by wholeIndeed, the directions usually offered on this some conditions; but another point of great point are of the most obvious and apparent importance-viz., the desirability of always description-viz., that she should be young, obtaining the supply from the same cow, recently confined, and in perfect health. It instead of indiscriminately from any animal is said that a brunette makes a better purse -is not so apparent, and more likely to be than a blonde, and L'Héritier even affirms overlooked. It cannot, therefore, be too frethat the milk of the former is richer in solid quently enforced. constituents than that of the latter.
M. Guillot, by weighing the child immeShould, however, a wet nurse be impracti- diately before and after suckling, found that cable, recourse must be had to the milk of the the increase in weight varied from 2 to 5 oz. cow, which approaches in composition nearer in infants under a month old, and that 2} lbs. to the milk of woman than any other. Ass's avoirdupois has been concluded to form the milk has been recommended as a food for smallest quantity that will suffice for the daily infants, but it is deficient in nitrogenous nourishment of a healthy infant during the matter and fat, although rich in sugar and first month of its existence. soluble salts. It will be seen from the follow- Much discussion has taken place with regard ing tables that cow's milk is richer in solid to the value of condensed milk as a food for constituent principles than woman's, but by infants (for composition of the different varieslight dilution with water and the addition of ties, see MILK), and the question is scarcely sugar it may be made to approximate more yet satisfactorily settled, though it would closely to the composition of the infant's appear that while condensed milk may prove natural food. In the following tabulated of value if occasionally given, its habitual form, Payen gives the constituents of different use is not calculated to add to the strength milks :
of the child.
Many attempts have been made to produce Goat. Sheep
Mare. by artificial means a milk which would prove
valuable as a food for infants. Nitrogen
Dr. C. A. Condereau recommends a mixture
of eight eggs with 2 oz. of sugar, and enough 3.35 4.55 4.50 8.00 1.70 (insoluble
water to make a pint and a half of liquid, to salts......
which he adds a little lime-water and a small 3:34 3.70 4.10
6-50 140 0.20 Lactine
quantity of sulphate of potash and chloride of and solu- 3.77 5.35 5.80 4.50 6:40
8.75 sodium. ble salts.
Dufrunfant states that a good substitute Water.... 89-54 86:40 86-60 82.09 30-50 89-33 for milk may be made by emulsifying about
900 grains of olive oil or other comestible Letheby gives the following table as illus- fatty matter with from 600 to 870 grains of trating the composition of woman's and cow's sugar (milk-sugar, cane-sugar, or glucose), milk :
from 300 to 460 grains of dried albumen (the dried white of egg, as met with in Paris), and from 15 to 30 grains of crystals of carbonate
of soda dissolved in a pint of water. This
Average. Average, Caseine.........
liquid has the appearance of cream, and reButter.....
quires to be mixed with twice its volume of Sugar of milk.... 4.43
4.70 Various salts ....
0-38 0.28 0.81
water before it produces a liquid resembling
milk. These substances, though occasionally Total solids
useful for adults, must be given to children 87-91
with extreme caution, if at all.
upon chemical principles to form an approIt is stated by Sourdat that the milk of the priate substitute for woman's milk. The folright breast is generally much richer in butter | lowing is the method of its preparation : and caseine than that of the left. With “Take oz. of wheat-flour, oz. of maltreference to the caseine of woman's milk, four, and 74 grains of crystallised bicarbonato Lehmann states that in general it is some- of potash, and after well mixing them, add what gelatinous, and not so dense or solid as 1 oz. of water, and lastly 5 oz. of cow's milk. that of cow's, and therefore more easily Warm the mixture, continually stirring over a digested by the child's stomach.
slow fire until it becomes thick. Then remove It will hardly be necessary to insist upon the vessel from the fire, stir again for fire
ous matter and
000 Liebig's food for infants is a food devised
Carbon Nitrogen. :
69 6.78 48 281 30 2.16 23 1.04 25 1:13
OZ. 1.00 0.74 0.58
minutes, put it back on the fire, take it off as , deadly influence we have most frequently to soon as it gets thick, and finally let it boil combat is corn-flour, since this is in some parts well
. It is necessary that the food should of the country universally used. form a thin and sweet liquid previous to its Until the teeth are formed an infant's diet final boiling. Before use it should be strained cannot be too simple, and up to seven or eight through a muslin or fine hair sieve, to sepa- months should consist exclusively of milk. rate fragments of husk that may be present. After this age other solid substances may be The bicarbonate of potash is added to neu- administered, much depending on the constitralise the acid reaction of the two kinds of tution of the child itself. Without recomflour, and also to raise the amount of alkali in mending their use at too early an age, it is the food to the equivalent of that in woman's well to remember that a child can digest albumilk. The ferment contained in the malt men and meat far more easily than it can leads, during the exposure to the warmth starch. employed in the process of preparation, to the The daily proportion of carbon and nitrogen conversion of the starch of both the flours required in the food at different ages is calinto dextrine and sugar, the latter of which culated by Dr. Edward Smith to be about as gives the required sweet taste. The newly follows:formed products also being soluble accounts
In infancy for the mixture becoming thin, and it is a At ten years of age point contended for by Liebig that principles At sixteen years of age in this state tax the digestive and assimilative
At adult life
In middle age powers of the infant much less than starch.”
The composition of the food, according to See Food, DIETARIES, FLOUR, &c.
Infant Mortality-A very large number
of young children die in infancy. 800,000 10 oz. milk
are born yearly, and of these 119,594 die in 1 oz wheat flour
the first year. 1 oz. malt-flour.
The causes of mortality may be stated approximatively thus :
The causes of death in 10,000 infants would This food has been extensively used in Ger- be as follows :many, and is widely known in England, but it 5000, or about , are returned from is probable that it owes its reputation more to atrophy, debility, convulsions, diarrhoea, &c., the name of its popular introducer than to most of which are certainly caused by the use any intrinsic merits it may possess.
of a too exclusively farinaceous diet, such as All articles of a farinaceous nature—such as bread soaked in water, arrowroot, sago, cornbread, biscuit-powder, baked flour, rusks, and flour, and other imperfect substitutes for milk. more particularly the so-termed food for in- About 150, or d, would die from diseases of fants-must be looked upon as foreign to the various kinds, especially pneumonia and brondiet of infants of tender age. They should chitis ; 80, or about 1, are born prematurely. be firmly and energetically excluded, and About it die violent deaths, mostly accidental. habitually discountenanced. All these arti. Of all the violent deaths, "overlaying" is the cles contain a large percentage of starch, a most common. The frequency of this accisubstance which is entirely wanting in the dent on Saturday nights raises the question mother's milk, a substance which has to as to whether a large proportion of such deaths undergo a special and elaborate digestive pro- are not due to the drunkenness of the mothers, cess before it can be assimilated, and a sub- who retire to rest in a state of alcoholic stupor. stance for the transformation of which at an A smaller proportion is directly ascribed to early stage of infantile life there is no pro- infanticide, want of breast-milk, and other vision. No greater fallacy is possible than to imagine that because many articles contain- Among other influences unfavourable to ing it form a light and useful diet for older infant life is the attendance of unskilled midchildren, they are also valuable as a diet for wives on women in their confinements. It infants. A great portion of such food passes would appear that both in rural districts and unacted upon into the lower part of the bowel, in towns an immense number of confinements, there to decompose, giving rise to fætid eva- varying from 30 to 90 per cent., are attended cuations, diarrhea, vomiting, spasms, emacia- by midwives, many of whom are not alone tion, loss of appetite, and if this diet be per- unskilled, but grossly ignorant; and it is to sisted in, death may supervene. No class of be feared that some few may be criminal. aliments causes so much infantile disease as In London, Glasgow, and Sheffield there are, farinaceous foods, and the one food whose however, a few midwives of a superior class. In the manufacturing districts the adminis. | mains to a great extent a dead letter. See tration of cordials, spirits, and narcotics pre- INFANTS, DIET OF, &c. vails to an alarming extent. It is probable
Infection-This term is now used as syno. that many deaths returned as convulsions are
nymous with contagion. Some would, hos. really cases of poisoning. Indeed, the causes
ever, restrict the latter term to the communiof convulsions amongst children are often so
cation of disease by actual contact, and use the obscure that mistakes in diagnosis must occa
word “infection” when disease is generated sionally occur. Baby-farming, although prevalent in Lon by contagium acting at a distance or wafted
through the air. The distinction is, however, don, does not appear to be common else- merely one of words. In each case there is where.* According to Mr. Curquiver, 80 per contact of the poison ; but in the one it is cent. of the illegitimate children put out to either volatile, or capable of being wafted in a nurse in London die. Neglect, ill-usage, and dry state, in another it is fixed. For example
, deficient food, either from poverty or from a criminal design, is without doubt
syphilis would be a strictly contagious disease,
common, and in all probability infanticide is more fre while typhus would be both contagious and
infectious. See CONTAGION. quent than is generally supposed. Looking at other countries, the infant mortality in
Infectious Diseases—There are in force Norway is lowest, in Italy highest, and Eng. various regulations with regard to the prerenland occupies an intermediate station. tion of infectious diseases, some of which are
On the authority of Dr. Willard Parker, enumerated under CONVEYANCES, CHOLERA, speaking in 1871, among the 35,000 annual EPIDEMIC DISEASES, HOSPITALS, LODGING. births in New York, 2500 are illegitimate, and HOUSE. about 3000 children are annually got rid of in
It is noticeable that no definition of the any way whereby the individual can be secure term "infectious disease” is attempted in the from the penalty of the law. In 1869, 27.4 Sanitary Acts, and as, unfortunately, it willfor per cent., and in 1870, 31 per cent., of all the some time to come be a matter of opinion whedeaths were of infants under one year. In the ther certain diseases are or are not infectious, foundling asylum at Montreal out of 4059 some difficulty may arise upon this point. infants received, 3769 died, or only 7 per cent. The Local Government Board may from time lived one year. On Randall's Island 10 per totime make such regulations as they may think cent. of infants only are saved when reared by fit with regard to epidemic and infectious dishand, but 27, when suckled by nurses. When eases. Penalty for obstruction or neglect of nursed by the mother 70 per cent. are reared, such orders, &c., £50 or less. — (P. H., s. 130.) while in rural towns 88 per cent. survive. Local authorities have power to provide
In this country the Infant Life Protection carriages for the conveyance of persons sufferAct is now in force. Its leading clause enacts ing from infectious disorders.(P. H., 8. 123.) that “ from and after the commencement of Sce CONVEYANCES. this Act it shall not be lawful for any person In certain cases persons so suffering may be to retain or receive for hire or reward in that compulsorily removed to a hospital. --(P. H., behalf more than one infant, and in case of s. 124, 125.) See HOSPITALS. twins more than two infants, under the age of Ships or vessels having on board any person one year, for the purpose of nursing or main-affected with a dangerous or infectious distaining such infants apart from their parents order are to be deemed within the provisions for a longer period than twenty-four hours, of 6 Geo. IV. c. 78.—(29 & 30 Vict. c. 90, s except in a house which has been registered 52, and Sched. V. Part III., P. H.) as hereinafter provided.” This regulation is Any person whoput in the hands of the petty justices of each 1. While suffering from any dangerous indivision of the county, and in the town coun- fectious disorder wilfully exposes kriacils of boroughs, each of which bodies is to self without proper precautions against keep a proper register. In the absence of any spreading the said disorder in any street, regular system of inspection, such an Act re- public place, or public conveyance, or
enters any public conveyance without * It is to be feared that it may secretly exist in
previously notifying to the owner, cokmany places, owing to the apathy of the authorities ductor, or driver thereof that he is so and the cunning concealment of the baby-farming suffering; or householder. Witness the case of Betsy Binmore, sentenced at the Devon Lent Assizes (1875) to twelve
2. Being in charge of any person so sufferyears' penal servitude. She had taken a house in ing, so exposes such sufferer; or Newton Abbott, and regularly nursed and received children for a year, during the whole of which period
3. Gives, lends, sells, transmits, or exposes the authorities were ignorant of her occupation, and
without previous disinfection, any bedthe house was not registered.
ding, clothing, rags, or other things which have been exposed to infection which is in such a state as to endanger the from any such disorder,
health of the inmates of the same house or shall be liable to a penalty not exceeding five room, any justice may, on the certificate of a pounds; and a person who, while suffering qualified medical man, order the body to be from any such disorder, enters any public removed, at the cost of the local authority, conveyance without previously notifying to to any mortuary provided by such authority, the owner or driver that he is so suffering, and direct the same to be buried within a time shall in addition be ordered by the court to to be limited in such order ; and unless the pay such owner and driver the amount of any friends or relations of the deceased undertake loss and expense they may incur in carrying to bury the body within the time so limited, into effect the provisions of this Act with re- and do bury the same, it shall be the duty of spect to disinfection of the conveyance.
the relieving officer to bury such body at the Provided that no proceedings under this expense of the poor-rate, but the expense so section shall be taken against persons trans- incurred may be recovered by the relieving mitting with proper precautions any bedding, officer in a summary manner from any person clothing, rags, or other things for the purpose legally liable to pay the expense of such of having the same disinfected.
burial. Penalty for obstruction of order, £5 The words in the Act " while suffering” do
or less.--(P. H., s. 142.) not appear to include “
convalescents," and the convalescent period in many diseases is, as
Influenza – The disease was first given is well known, the most infectious period. It this name by the Italians,
“ thus recognising may, however, he perhaps argued legally that an inscrutable influence which affects numberthe convalescent period is part and portion of less persons at the same time.”——(HECKER.) the illness.-(P. H., s. 126.)
It is essentially an infectious specific disease, The owner or driver must disinfect and dependent upon the absorption of a morbid cleanse the conveyance after conveying a per- poison into the blood; its chief symptoms son suffering from an infectious disorder. are those of an intense catarrh, with cough, Penalty for neglect, £5 or less.
running at the eyes and nose, frontal headThe following sections are very stringent ache, fever, disorders of the digestive organs, and important:
and often rheumatic pains. Its average duraAny person who knowingly lets for hire tion is five days. any house, room, or part of a house, in which In various epidemics there are different any person has been suffering from any dan- complications, the most common and most gerous infectious disorder, without having fatal of which are bronchitis and pneusuch house, room, or part of a house, and all monia. articles therein liable to retain infection, dis- One of the noteworthy and distinctive infected to the satisfaction of a legally-quali- features of influenza is the short sojourn it fied medical practitioner, as testified by a cer.
makes in places attacked by it, as well as its tificate signed by him, shall be liable to a almost simultaneous appearance over a large penalty not exceeding twenty pounds.
For the purposes of this section, the keeper Its great interest to the hygienist consists of an inn shall be deemed to let for hire part not only in its fatality during certain years, of a house to any person admitted as a guest but also in the fact that it has several times into such inn.
preceded cholera, and has been the forerunner Any person letting for hire, or showing for as well as the follower of extensive epidemics. the purpose of letting for hire, any house or It appears to attack animals as well as men; part of a house, who, on being questioned by at all events, extensive epizootics accomany person negotiating for the hire of such panied by similar symptoms have prevailed house or part of a house as to the fact of there during various epidemics. In the present being, or within six weeks previously having obscurity as to the mode of propagation of heen therein, any person suffering from any the disease, no means of prevention can be dangerous infectious disorder, knowingly pointed out; the discharges from the nostril makes a false answer to such question, shall and sputa are probably the vehicle of the be liable, at the discretion of the court, to a poison, but this is not conclusively proved. penalty not exceeding twenty pounds, or to It only remains, therefore, to give a short imprisonment, with or without hard labour, historical account of the disease. for a period pot exceeding one month.—(P. H. No very distinct notices of influenza are to s. 129.)
be found before 1411. “In the year 1411," Where the body of one who has died of any says Pasquier, “there was another kind of infectious disease is retained in a room in disease which affected an infinity of people, which persons live or sleep, or any dead body by which they lost the desire to drink, eat, or
sleep; it was accompanied with fever. What in the winter, being somewhat rare in warm the sick ate became bitter and putrid; there weather. was shivering, and the limbs were so weak
Inhumation-See DEAD, DISPOSAL OF. and tender that they could not bear them to be touched. The disease was accompanied Inspector of Nuisances, Sanitary with a violent cough, which tormented them Inspector—The name of inspector of nuisday and night, and lasted three whole weeks, ances should be discarded, and the wider term yet without proving fatal; although it is true of sanitary inspector substituted; this not that, by reason of the vehemence of the cough, alone on account of the somewhat unsavoury many men were ruptured and women aborted. appellation, but because under the new régime When they were about recovering, there was the sanitary inspector has various duties be. an effusion of blood from the nose, mouth, sides that of detecting nuisances. The apand bowels. No physician could imagine from pointment of a sanitary inspector is obligatory whence the disease came, unless from a general both for urban and rural authorities. (See infection of the air, the cause of which was OFFICERS, APPOINTMENT OF.) An inspector obscure. This disease was called the Tac.”- thus appointed, if the authority pay him the (PASQUIER, livre iv. chap. xxviii. pp. 375, whole of his salary without aid from Govern. 376.)
ment, may be under the entire control of the The tac of 1411, which appeared in France, sanitary authority, and be removable at their was followed by the coqueluche of 1414. This pleasure. This mode of holding office is word signifies “a monk's hood,” and this neither to the interest of the authority nor nickname was given to the disease on account
to that of the officer. The authority, by acof the sufferers necessarily covering and wrap- cepting Government assistance, merely lose ping up their heads. The coqueluche was
the right of dismissing their officer without succeeded by the ladendo of 1427. All these the sanction of the Local Government Board, are probably one and the same disease-viz., which is more than counterbalanced by the influenza. The coqueluche of 1414 more solid pecuniary gain of half the salary. especially attacked the larynx, so that many
If, on the other hand, any portion of his colleges in Paris were shut up on account of salary be paid by Government, the appointthe hoarseness of the professors; the ladendo ment cannot be made without the consent of of 1427 more especially seized the loins. In the Local Government Board, nor can the the sixteenth century there were five epi- officer whose appointment is thus sanctioned demics of influenza; the dates of the out- be dismissed within the period for which he breaks are 1510, 1551, 1557, 1564, and 1580. is appointed without the consent of the Local Indeed, from 1510 to 1837 there are recorded, Government Board. The sanitary authorities in Dr. T. Thompson's “Annals of Influenza, 's in either case control the duties and salaries no less than twenty epidemics ; of these, that of their officers. which occurred in the winter of 1732-33 was
The duties and conduct of the inspector of the most noteworthy. Dr. Short characterises nuisances are to be regulated in the case of it as “the most sudden and universally epi- urban sanitary authorities by bylaws. demic catarrh that has been in this age,
It may be laid down as a general and insparing neither ranks, sexes, ages, old or portant principle, that an inspector of nuisyoung, weak or strong," and killing off ances should not have any private calling “ many hectic and phthisical people."
whatever; but as under the present system it From 1838 to 1847 the average deaths from appears impossible, or at least not usual, to influenza were a little over 1000 yearly; but give good salaries, any public office, not inin 1847 and 1848 there was a very widespread compatible, might be held by inspectors epidemic, and the returns showed the large certain cases. In large towns and populous numbers (considering the general non-fatal districts a sufficient salary should be given, character of the disease) of respectively 4881 and the officer's whole time devoted to the and 7963. From 1849 to 1860 about 1600 died work. In some cases it will be advisable for annually; since then not more, according to adjoining sanitary authorities to have a comithe returns, than a yearly average of 600; so mon inspector-power is given under P. H., that, practically speaking, we are at the present time comparatively free from in- The Local Government Board does not think fluenza. The history of all these epidemics it desirable that the offices of relieving officer shows that it is most fatal in the lowest, and inspector of nuisances should be held by dirtiest, and overcrowded portions of towns. one and the same person ; nor may the superSeason, weather, and latitude influence it intendents of police be inspectors of nuisances. greatly. It is hardly known out of northern Such public posts as surveyor (P. H., s. 1921, latitudes, and generally occurs in a severe form ( vaccination officer, inspector of weights and