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HEALTHY NURSES.

TABLE 1.-ON THE INFLUENCE OF THE AGE OF THE MILK ON THE PROPORTION OF ITS ELEMENTS; FROM 1 TO 15 DAYS.

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TABLE 2.-ON THE INFLUENCE OF THE AGE OF THE MILK ON THE PROPORTION OF ITS ELEMENTS; FROM 1 TO 24 MONTHS.

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1.50

1031.69 1033.11 1032.70 1032.90 1032.10 1034.35 1034.97 1031.37 1032.88 1031.44 1031.61 1030.68 1032.50 1030.81
872.84 872.99 886.16 889.67 888.25 901.51 891.35 889.49 891.65 889.28 900.63 889.04 891.34 876.55
127.16 127.01 113.84 110.33 111.75 98.49 108.65 110.51 108.35 110.72 99.37 110.96 108.66
40.40 43.13 43.37 44.47 44.66 42.00 44.18 41.52 45.31 45.84 47.62 43.91
39.55 34.05 31.22 27.79 27.31 16.57 24.35 22.79 23.06 25.03
45.38 48.26 37.92 36.96 38.28 38.63 38.86 45.02 38.79 38.57
1.83 1.57 1.33 1.11
1.29 1.26 1.18

123.45

43.92 41.33

19.47

24.61

24.44

43.47

31.06

41.06

36.98

37.32

1.19

1.28

1.22

1.38

1.32

1.33

[Simon (on Animal Chemistry, Sydenham Society's translation, vol. 2, p. 56) analysed the milk of a woman during a period of nearly six months, commencing with the second day after delivery, and repeating the observations at intervals of eight or ten days.

The fourteen analyses gave the following results:

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A glance at the three columns of casein, sugar, and butter, will show with few exceptions, 1stly, that the quantity of casein is at its minimum at the commencement, it then rises considerably, and ultimately attains a nearly fixed proportion; 2ndly, that the quantity of sugar is at its maximum at the commencement, and subsequently diminishes; and 3rdly, that the butter is a very variable constituent of the milk.

The variations observed in the column of the sugar and of the casein, arise, in all probability, from those disturbances of the mode of living, and of the tranquillity of the mind, which produce a decided influence on the composition of the milk, and over which the experimentalist can exert no control.—P.H.B.]

Modifications from sojourn in the breasts. Observation on this point teaches us as follows: explanations will be given afterwards : 1. That in the same experiment, the milk is the richer in proportion as it has been drawn later; the poorest is that which comes first. 2. That the milk is the more serous in proportion as more time

elapses between two consecutive experiments.

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Thus, contrary to all that is known of the other fluid secretions, the milk becomes more and more aqueous in proportion as its retention in the breasts is prolonged; the more solid ingredients are sla absorbed first.

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Numerous analyses were, at least, necessary to confirm this doxical result, announced by M. Péligot in his memoir on asses milk; l

a result, moreover, which partly contradicted the experiments of Deyeux to comed and Parmentier, who have informed us that the milk of a cow is less abundant, and more rich in butter, when it is only drawn once in twenty-four hours.

Nevertheless, we should in some measure cease to be surprised when we reflect on the nature and uses of milk, which are very different from those of the other secretions.

In fact, the uses of milk are only casual, and the secretion only

takes place when it happens that the organ destined to accomplish it continually receives a fresh stimulus; it forms part of the plan of nature to dry up the lacteal secretion as soon as it becomes useless.

For when the young animal no longer exercises the usual suction, or rather, when no artificial stimulus is made use of, the milk becomes useless; not only is this henceforth the case, but even that which distended the breast at the time of the last flow quickly disappears.

Such is not the case with the other secretions, such as the urine and the bile, for while their uses commence with life, they can only terminate with existence itself.

Moreover, it would not be a matter of indifference if the principles of the urine or of the bile were taken back into the blood as rapidly as those of the milk; the nature of the latter approaches so closely to that of the blood itself, that its reabsorption could not occasion any disturbance in the economy; on the contrary, its caseum might be converted into fibrine; and its fatty matter, as well as its sugar of milk, into combustible material, as happens with the analogous principles of blood.

[L'Heretier has investigated the changes produced in the milk by a prolonged sojourn in the breast. The two following analyses illustrate the effect thus produced. The milk in each analysis was afforded by the same woman. In the first case, it had remained in the breast for forty hours; in the second, it was obtained after the infant had been sucking for some little time:

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4.-Modifications from alimentary regimen. The milk of woman is slightly modified as to the quantity of its solid materials by an insufficient nourishment. This diminution almost exclusively affects the specific gravity, and the quantity of butter and caseum. Thus MM. Vernois and Becquerel, who have looked upon this question in the most varied points of view, and who have made special analyses with reference to it, have arrived at the following means:

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[Simon (Op. Cit., p. 55) analysed the milk of a very poor woman fifteen times, at regular intervals, during the course of half a year, commencing with the second day after delivery. It so happened that she was suddenly deprived of the means of

obtaining the most ordinary necessaries of life. The milk secreted at this period Good altur (Nov. 11) was sufficiently abundant in quantity, but was very poor in solid constituents,` containing only 8.6. Some days afterwards (Nov. 18) she was placed upon a full and undis nutritious meat diet. The milk, in consequence, was secreted so copiously as to run spontaneously from the breasts: it left 11.9 of solid constituents. Her fik

circumstances again became very bad, and she was frequently in a state of the utmost destitution. On the 1st of December, while in this condition, the milk again became very thin, and left only 9.8 of solid constituents. He concluded his researches on the milk of this woman, by an examination on January 4th, after she had been supplied for two days with a nutritous meat diet: the milk was then very rich in solid constituents, and left a residue of 12.6.

The following are the results of the examinations on these four occasions; below them is the average of the fourteen analyses already referred to:

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buttery Constitius

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880.6

119.4

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34.0

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37.5

45.4

3. Ditto Dec. 1.

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4. Ditto Jan. 4.

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It is evident from these analyses, that however much the nutriment of the mother may vary, no great influence is thereby exerted on the relative quantities of casein and sugar. The changes consist in a greater or less degree of saturation, in the rich yellowish white or the bluish colour, in the quantity of the milk, and in its amount of solid constituents. With the exception of the variation in quantity, all the other changes are dependent on an increase or diminution of the butter; the former occurs under the use of a copious and nutritious diet, the latter when the food is poor and scanty.-P.H.B.]

M. Péligot, in his memoir previously mentioned, observes that nourishment possesses an influence over the solid constituents of the principles of the milk; he was led to the conclusion, that as regards asses at least, beetroot give the richest milk; then come lucerne and wheat, mixed; and, lastly, carrots.

MM. Boussingault and Lebel, in the work which they have published relating to the influence of the nourishment of cows on the af quantity and the chemical constitution of the milk, thus express

themselves:

"Finally, this investigation enables us to state that the nature (44

of the aliments consumed does not exercise a very marked influence Car:4.

on the quantity and chemical composition of the milk (we do not say on its quality), if the cows receive nourishment equivalent to these various kinds of food."

We may, however, remark, that certain matters pass into the milk, and that others are developed therein, under the influence of a determinate nourishment. These facts will be more properly referred to in another chapter.

5.-Modifications from the genital functions. After the return alai of the catamenia in a mother who suckles her infant, and during her menstruation, the lacteal secretion is less abundant, and the milk

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P is slightly altered in its composition. Up to the present time it was believed that this liquid became more serous under this influence. This error has been corrected by the researches of MM. Vernois and Becquerel. The milk, on the contrary, becomes more dense and richer in solid constituents, which may render it injurious to children, as attentive observation will prove.

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[So great is the difficulty of obtaining true statements upon this point, that among the great number of hired nurses in Paris, M.M. Becquerel and Vernois have only been able to examine the condition of the milk in three women while actually menstruating. In these, as the above analyses will show, the density of the fluid was found slightly diminished, as was the proportion of sugar, and the proportion of water was sensibly So. The solid parts were notably increased, especially the caseum. The authors cannot believe that such changes in composition can induce any mischief beyond some temporary derangement in the digestive organs, and even this might be prevented, by causing the child to suck less, and letting it drink a little sugar and water, to replace the sugar and water lost during menstruation.

M. Roger, while attached to the office for nurses, paid considerable attention to this point, and arrived at the following conclusions: If the menses reappear easily, without pain or derangement of the nurse's health, while her milk is under twelve or fifteen months old, and the quantity of blood lost is normal and moderate, the quantity of milk does not become diminished, or its qualities altered, and the child does not suffer from its use. If, however, the menses are too abundant, or too frequent, the milk may diminish in quantity, or disappear. The same effect is also produced, though more slowly, in some days or weeks, when the menses are prolonged for a week, so that the loss is considerable. The milk will much more certainly dry up if the menses reappear at an advanced period of lactation; this being then the signal of the imperfection and approaching termination of the secretion.

When the milk becomes thus diminished, it rarely exhibits the physical characters of poor milk; but by its density, whiteness, and the access in number and size of its globules, it more approaches in character and richness cow's milk. When the menstrual epochs reappear with difficulty, and are attended with pain, indigestion, and diarrhoea, &c., or are preceded or followed by leucorrhoea, the child may suffer symptoms due to indigestion, induced by the altered characters of the milk. The alteration of the milk chiefly consisting in increase in the number and size of the globules. These influences are, however, only temporary, and the milk soon recovers its normal character. The ailments which the child hence suffers are only temporary, and have been greatly exaggerated.-L'Union Medicale, 70.—P.H.B.]

Pregnancy generally dries up or alters the secretion of milk, which shows a tendency to pass again into the state of colostrum.

Nothing positive is known concerning the influence exercised by coitus.

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