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The Household

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The mortality report of Detroit for ,lie month justclosed furnishes a text lor a much longer sermón than we care to preach f roin it. In all 265 persons died in the city during July, and of tliis number 172- very nearly one-half - were children, and of these 172, considerably more than one-half - about 100 - were under one year of age. Seventeen were still born, 52 died of cholera infantum, 28 of suinmer complaint, and the others of a variety of complaints incident to childhood. The sanitary condition of the city is uot worse than usual and the city itself has the reputation of being healthf ui above the average, If to the above figures we could add those of other cities and towns throughout the country, the aggregate infant mortality would be alarming, and make all the thoughtf ui and humane ask in one voice, what can we do to save the children ? That many infants should succumb to the heat and poisonous exhalations of a great city in July is only to be expected, but that one-half of all death's victima should be children, and that nearly one-third of these should be swept away with cholera infantum, cannot surely be claimed as inevitable. If so, then 'modern medical skill is far more powerless to prevent diseases than is generally supposed. This infant mortality, liowever, is largely chargeable to the ignorance or carelessness of nurses, and not to any lack of skill on the part of the medical profession, and the remedy must come from a better general knowledge as to the care of children. On this point we cannot do rSclïiui'l11 quote from the circular, State Board of 'He'afÈtf: assachusetts The diseases of children whicl cause the greatest mortality occur mainly during the hot months or immediately thereaf ter, and are due largely to overcrowding the popuia tion, in cities and in thickly populatec parts of towns. They are much aggra vated, if not directly caused, by iiltl of all kinds, especially by filth putrefy ing under the influence of Summe heat. Therefore infants and childrei should be taken, so far as it is possible during the Summer, to places where the air is clear and cool ; if not to live in the country or at the seashore, thei to parks, open squares, beaches, etc for a day, or for as many hours at i time, and as often as may be. Al sources of impure air in and about the dwellings should be avoided; th drainage should be carefully looked af ter, the water-supply should be pure no sink-spouts should pour filthy wate on the soil ; there should be no un trapped sinks or drains, stinking privy or pig-sty, no ill-arranged water-closet no arsenical wall-paper, poisoi the air. Soiled clothing, diapers, etc should be promptly removed from the rooms. A baby should not sleep in the sarne bed with another person, aiu should have a plenty of fresh air, day and night. Improper f ood is directly or indirect connected with at least one-half of the deaths of younger children. Of all the deaths under one year in Massachusetts, more than one-quarter are from disease of the digestive apparatus, mainly of diarrhceal character. Errors in diet cause also a vast number of deaths which do not show their real nature in the mortuary record. The new-born child should, if possible, live altogether on the milk 3f its mother, or, failing that, of a perfectly heatthy wet-nurse, unless, indeed, when the mobher has not quite enough milk, the physician thinks best to supplement it with bottle-f ood. If neither the milk of the mother nor of a wetnurse can be had, the milk of the cow or some other animal may be used instead; and this should be gupplied fresh, night and morning - not necessarily from one cow. Milk warm from the cow can usually be taken undiluted by infants of any age; if it has time to cool, it should be thoroughly chilled immediately af ter milking, bef ore being used for feeding infants, Whether the baby is nursed or bottle-fed, the meals should be given at regular intervals during the day, every two, three, or four hours, according to the age and vigor of the child; during the night, only once or twiee, for one or two months; after that, once or not at all. The infant should not be allowed to go to sleep during its meals, but should be made to nurse continually, except for occasional rests of a few seconds, until it has taken all it wants. By this means it soon learns to take j list the quantityit needs; and being neither hungry nor over-filled, it sleeps or lies comfortably between meals. Crying should not a'lways be considered a sign of hunger, and nursing out of meal-times should never be used to quiet the child. Both breasts should be used at each nursing; and, when the milk has any tendency to be scanty, each breast should be given twice at each meal. Jt is not always easy to teil whether a child gets as much milk as it ought. ïiot infrequently when the mother or nurse is losing her milk, and the child is obviously failing, it will yet seem satisfied at each meal, probably because it has learned not to expect more, and has ceased to hope for it. Then it suffers for want of sufficient food, and should, of course, be fed from other sources. Drawing on an empty breast, too, is in itself injurious tothe child. It mav be said in general that the food which suits the mother will make goodmilk. It would be better to abandon most of the current popular theories as to what is or is not suitable for nursing women. Perhaps the most objectionable one is that milk is indefinitely increased by taking large quantities of fluid. Certainly enough extra fluid must be taken to supply the extra amount manded by the breast. Such vegetables and fruits as give the mother indigestión, or such as are found by experience, from some individual idiosyncrasy, to disturb the child without disturbing the mother, should be avoided; but, as a rule, the mother should eat what she usually fínds conductive to her health. ít should generally be lef t to a physician to decide whether or not a mother is able to nurse her child. Mothers often think their child is not thriving on breastmilk, when the real difficulty arises from faulty liabits of nursing, irregularity of meáis, etc. Cow's milk is usually, on the wliole, the best material for supplying the place of the natural food. The constituents of cow's milk, and oí' human milk, are mainly water, casein, fat and sugar, although not in the same proportions; but that is not the most important difference between the two milks, as may be seen when they are curdled. The curds of human milk are soft and ilocculent; those of cow's milk tough and leathery, with a tendency to contract and to become more and more hard. Pure cow's milk is not often well digested by infants under six montlis old, not always by older ones. The hard curds that it forms are often vomited, or pass through the bowels, and appear in the discharges. It therefore becomes necessary to dilute it with water or soroe othermaterial. Wken water is used, it is commonly found best to give from onethird to one-half milk and from twotlairds to one-half water for the first nonth or six weeks, and then gradually to diminish the amount of water un'til ftt the age of six or eight months ,lie mille is given without water.


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