will co-operate with the Census Office in this important work. The record should be kept from June 1, 1889, to May 31, 1890. Nearly 26,000 of these registration books were filled up and returned to the office in 1880, and nearly all of them used for statistical purposes. It is hoped that double this number will be obtained for the Eleventh Census.

"Physicians not receiving Registers can obtain them by sending their names and addresses to the Census Office, and, with the Register, an official envelope which requires no stamp will be provided for their return to Washington.

"If all medical and surgical practitioners throughout the country will lend their aid, the mortality and vital statistics of the Eleventh Census will be more comprehensive and complete than they have ever been. Every physician should take a personal pride in having this report as full and accurate as it is possible to make it.

"It is hereby promised that all information obtained through this source shall be held strictly confidential."

A further guarantee of the accuracy of the work is found in the fact that it will be done under the direct supervision of Dr. John S. Billings, of the United States army. We congratulate the Department on its wisdom in selecting Dr. Billings for the place.

THE AMERICAN ASSOCIATION OF OBSTETRICIANS AND GYNECOLOGISTS will hold its second annual meeting at the Burnet House, Cincinnati, September 17, 18, and 19. The membership of this association, while limited in number, is national in character. Papers will be read by a number of the most prominent men of the profession. No formal invitations will be extended but members of the profession will be welcomed at the sessions. Dr. W. H. Taylor, President, Cincinnati; Dr. W. W. Potter, Secretary, Buffalo.

THE MISSISSIPPI VALLEY MEDICAL ASSOCIATION will meet at Evansville, Ind., September 10, 11, and 12, 1889. The officers for this year are: President, Dr. Geo. J. Cook, Indianapolis; VicePresidents, Dr. J. D. Griffiths, Kansas City, and Dr. J. A. Larabee, Louisville; Secretary, Dr. R. L. Thomson, St. Louis; Treasurer, Dr. C. W. Chapman, Toledo, O.; Chairman Committee of Arrangements, Dr. A. M. Owen, Evansville, Ind.

THE PROBLEM OF INFANT FEEDING.-INTESTINAL DISEASES OF CHILDREN AND CHOLERA INFANTUM.

BY I. N. LOVE, M.D., ST. Louis, Mo.

Under proper conditions the period of growth being antagonistic to decay, man in the infantile state should rarely be the subject of disease.

It is a proposition which will not be questioned that the great majority of diseases of early life are closely related to interference with and interruptions of nutrition.

The problem of infant feeding has been before the profession prominently for many years, and I feel safe in saying that we are probably nearer its solution now than at any previous time. It goes without saying that the first month is the most important period of the babe's nuitrition, on the principle that they are most apt to go right who start right.

No one will deny that, on general principles, the proper food for the infant is that furnished in the laboratory of its own mother's breasts; the exceptions prove the rule, and they should be provided for with a substitute either from some other mother's breast or a food which will as nearly as possible approximate it. The most important thought which should be borne in mind in considering the maternal milk, is the fact of its perfect sterilization, and in this fact we have the key to the situation.

Through the efforts of Escherich, Forster, Harrington, Meigs, Jacobi, Rotch, Vaughn, Booker and other delvers in the laboratory and clinical observers, we have been given the cue furnished by Dame Nature, and should now be able to read the lines which follow readily.

If the conditions will permit, I think the next best substitute for the mother's milk, next to the healthy wet-nurse, is a healthy, well-fed, well-cared-for goat or cow; the milk of both these animals, although not identical in composition to the human milk, possesses the virtue of sterility.

Many things have to be considered in the selection of a substitute for the mother's milk. I think we should use every effort to secure the nursing of the child upon the part of the mother. Among the laboring classes the mother is usually able to suckle her young. It is among the upper ten thousand that we find the

"poor milkers."

Seventy-five per cent. of my private practice is among the better social class, and, in justice to womanhood and maternal instinct, I will say that ninety per cent. of the inability to properly nurse their offspring is due to physical weakness, and not moral turpitude upon the part of the mother. I am inclined to think, however, that the profession has not been sufficiently alive to the fact that by proper effort-moral, hygienic, and medical-the natural nourishment could more frequently be secured.

When it comes to the recommending of a wet-nurse, many things are to be considered. First of all, can our patients afford the cost? Then again, wet-nurses are subject to diseases, such as syphilis, etc., that do not affect cows and goats. In addition, the wet-nurse may be accessible, physically healthy, but so constituted mentally as to be an objectionable member of our family, or her moral character may be such as to make her more objectionable than a leper. The best way to determine this question is to bring it home to one's self. I recall an experience in my own family,a danger which my little daughter of seven would have been exposed to by contact with moral leper, recommended to us as a healthy wet-nurse for our infant boy. Better far for the latter to have been wafted to the angels than for our first-born to have breathed the same air for a day with the moral monster in the shape of a wet-nurse.

For practical purposes the suggestion furnished us by our grandmothers' empirical practice in years gone by (the boiling of the milk in digestive disturbances) is sufficient. I prefer the plan favored by Rotch in Keating's Cyclopædia, that of putting the milk in convenient-sized bottles and steaming it for twenty minutes. But whether the milk be steamed or boiled, we accomplish the destruction of all putrefactive bacteria and disease germs as well as

the tyrotoxicon and other ptomaines produced by them. A temperature of 180° F. is sufficient to accomplish this, and inasmuch as steaming at this temperature does not affect the taste or the accomplishment of the coagulation of an amount of albumen and the throwing to the surface of a certain amount of the fat in the form of a decided scum, as does boiling it, it is preferable.

After steaming it the receptacle should be hermetically sealed, and the "Mason fruit-jar" for preserving purposes is an admirable convenience for this purpose. The particular place where the milk is kept is then not so important, though the ice-chest, refrigerator, or cellar, country well, or spring-house should be scrupulously guarded from dirt, and be well ventilated.

Many conditions arise where we need the help of artificial digestion, and we lean not upon a broken reed when we call it into service. The profession is under great obligations to organized capital and the various manufacturers who have concentrated their efforts upon artificial food for infants. Many cases arise where these so-called commercial foods are of great value to us. Babies are like adults, in that each one is a law unto itself. What is meat for one is poison for another.

Among artificial foods, Mellin's has served me well often, as also has Carnrick's. Many cases come to us to whom no form of milk can be given. With such I have found Bushe's Bovinine of great value. I have no patience with the dilettanteism and the MissNancy isms which would preclude a physician's prescribing or specifying a reliable manufacturer's product, whether it be a drug or a food.

The second topic presented in this session-" the intestinal diseases of children "—would, I think, not require consideration save in a few rare instances if the feeding of the child were properly accomplished. In other words, I think the proper attention. to the first duty would prevent the intestinal disturbances. If the latter is an accomplished fact, if the riot in the alimentary canal be well under way, we must ignore the past regime, with its opiates and astringents, and administer small doses of the mild chloride (one-twentieth grain) or infinitesimal doses of the bichloride (oneone-hundredth grain) and other germicide and antifermentative remedies; but, first and foremost, correct the diet. At the same time, if we are in the midst of the heated term, we must guard our little patients against excessive heat. To this end. cooling baths at proper intervals are all-important. These have a

wonderfully beneficial effect upon the nervous system, which is greatly disturbed.

Overfeeding is frequent at all times, but especially so in hot weather (when the food-supply should in reality be somewhat diminished), owing to the ever-present thirst. Plenty of cool, pure water (sterilized by boiling, placed in the sealed "Masonjar," and kept in the ice-chest, and not polluted by the placing of ice in it) should be given freely to the babes of all ages; their thirst will be abated and less food will be taken.

Another important point which should not be overlooked is the danger of "taking cold," even in hot weather. Extreme and pronounced currents of air should be avoided, and a great protection to the digestive apparatus of the little one is a flannel bandage over the abdomen. This should be worn till the child is at least five years old; good rather than harm would result from its use throughout life.

CHOLERA INFANTUM.-This last in the trio of subjects before us follows in regular sequence, and in the majority of instances would "die a-borning" if the two subjects which precede it were properly handled. In other words, in my judgment cholera infantum, like cholera, or more properly speaking, cholera morbus in the adult, would never occur if the feeding problem were properly solved, or, in case of error there, if the resulting intestinal war were suppressed before it reached the culminating point.

tion.

Briefly, the best treatment of cholera infantum is its preven

MEDICINES WHICH MAY BE GIVEN TO NURSING MOTHERS.— Fehling (Ibid.), after a series of experiments to determine the action of drugs upon infants when administered to the nurse, found that salicylate of sodium given in doses as large as forty-five grains per diem produce dangerous symptoms in the infant. The iodide of potassium in doses as small as three grains daily would be safe, Iodoform enters the system of the baby, through the nurse, more readily than when given directly. Iodine was found in the child's urine nursed by a woman who had an iodoform dressing on a wound. Mercurial salts have but little effect upon the child, and twenty-five drops of tincture of opium (Gr. Pharmac.) and threetenths grain of morphine could be safely given to the mother. Chloral may be given in doses of twenty-three grains and as high as forty-five grains. Atropine in small doses affects the child quickly. Salads and acids have no injurious effects upon the child.