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hospital. She has had but one other child, now two years old, stout and healthy. The infant, now ten months old, is not at all emaciated, but of a pale and sickly appearance. Several parts of its body are covered by a copper-coloured eruption, slightly raised and smooth; this particularly affects the parts of generation and the neck; it became affected nearly at the same time with the mother."

Whitehead (On Hereditary Diseases; p. 174) relates an interesting case of secondary syphilis communicated by vaccination, the case of the mother who suckled the child proved to be one of a very distressing kind. The breasts, with the nipples and superficial absorbent vessels, became so inflamed as to necessitate the discontinuance of their use in nursing. The disturbance was most severe on the left side, extending to the axilla, in which situation an extensive abscess formed, which gave exit to an incredible quantity of offensive purulent matter. As the abscess contracted, blotches of roseola came out in various parts of the body, and these continued for a considerable period, varying with the state of functional health prevalent at the time; but she was ever afterwards an invalid.

A writer in the British and Foreign Medico-Chirurgical Review, 1852, vol. ix, p. 327, narrates the following case: A gentleman had a chancre six months before marriage, for which he took mercury and was cured; and his marriage was permitted by a surgeon of high reputation. The wife bore two children, both of whom pined away and died. She had recently been confined with a third child; but as it was supposed that her milk was not good, a healthy young woman had been engaged as a wet nurse. In a short time her left nipple became very sore, and deeply ulcerated, and resisted various efforts to cure it, so that at last she was obliged to abandon her charge. Another nurse was sent for in her place, who became affected in a similar way; and it was at this time that we first saw the case. On examining the child, who was beginning to emaciate, we found marks of syphilitic Lepra about the nates and legs, which had not been suspected; and on inquiry it was ascertained that the former children had had cutaneous eruptions. On cross-questioning the husband, we found that three months after marriage he had had sore throat and a dark red eruption, principally at the edge of the hair at the back part of the head, which had never entirely left him. The palm of the right hand had, at the time we saw him, a mottled aspect, and the skin was desquamating; and some small circular copper-coloured spots were visible on the thighs. The wife's health had been ailing, but she had not manifested any notable symptom of syphilis. The sores on the nipple of the nurse we saw had an angry look, with indurated margins. The surface of the mamma for a considerable distance around them was inflamed, and an abscess eventually formed in the gland itself. The whole of this family-husband, wife, child, and nurse-were treated for syphilis.

Acton (Practical Treatise on Diseases of the Urinary and Generative Organs, &c.; p. 632, 1851) records the following case as an instance in which the mother was probably contaminated through the placental circulation, but it is rather to be regarded as an instance of infection from the mouth of the child through the nipple, as the mother had remained healthy until some time after the birth of the child.

July, 1850. A gentleman twenty-eight years of age came to me to-day complaining of a sore tongue. On the left side of the organ a white spot as large as a threepenny piece, looking like a cicatrized ulcer, has broken out; on the lip there is a similar spot, but the surface is quite level.

"His history is the following: Two years and a half ago he contracted syphilis, secondary symptoms followed. During the time he laboured under the complaint his wife became pregnant, went her full time, and the child was born healthy. A few weeks after birth it showed symptoms of secondary syphilis, spots at the corners

of the mouth, and on the palms of the hands; the mother, who had been perfectly healthy up to this time, then (some months after her confinement) had unequivocal marks of secondary symptoms; no sore breasts, but Psoriasis palmaris.”

The observations of Calderini and Rizzi at the Milan hospital seem to put beyond all question, not only the possibility but the frequency with which children give the disease to wet nurses, and these to their husbands. Of 1050 syphilitic women, 266 gave birth to infected children. The disease most frequently communicated to the nurse was "tuberculous syphilide" of the mammæ. In 100 cases this occurred alone in 34, with angina in 19, and with other symptoms in 47 cases. Of these 100 women, 19 infected their husbands, chiefly with tuberculous syphilide of the penis, scrotum, and perinæum.-P.H.B.]

Such are the facts that can be brought forward in favour of the transmission of the syphilis of newly-born infants to their nurses. They are not certainly all of equal value, nor of the same degree of importance; they cannot all equally conduce to the solution of the question. For this they must be divided and classed according to their value.

Some of them, as those of Hunter, Cullerier, and Bouchacourt, present marks of identity which admit of no doubt regarding the origin of the contagion; these are the most important; others, on the contrary, analogues to the last case I reported, and amongst which we find those of Bertin and M. Rayer, only afford great probability in favour of contagion by the child, but perhaps do not demonstrate it in a very decided manner. Lastly, a great many are deficient in the most important details, represent only an opinion quite devoid of proof, and cannot be admitted.

It is by throwing aside this last category of cases, and only consulting the two others, where are found ranged the most certain and the most probable cases, that we are of opinion we may conclude by stating;

That syphilis may be transmitted from the nursling to the nurse.

THE END.

Formulary of Medicines

ADMINISTERED

IN

THE DISEASES OF CHILDREN.

As it is known, the dose of medicines varies according to the age, sex, and constitution of the individuals. The following, as respects the age, is the table of reduction proposed by Gaubius.

Supposing a medicine is given to an adult in a dose represented by unity, we should give to a child

Below 1 year

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At 2 years

At 3 years

At 4 years

At 7 years

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At 14 years

In this formulary it will generally only be a question of the dose of medicines suitable for infants and children at the breast.

1. EMOLLIENT BATH.

Various emollients, 3 xvii; linseed, 3 iij. Boil in 5 pints of water. To be put in the water of the bath.

2. AROMATIC BATH.

Species aromaticæ,* 3 xvii; water, 3 pints. Boil and use as a bath. In scrofulous rickety children, and in all cases of cachexia.

3. SULPHUROUS BATH.

Dry sulphuret of potassium 3j to 3 iv. To be put in the water of the bath, the quantity of which should not exceed 20 to 34 pints. In scabies, in chorea, and in certain nervous affections.

4. ANOTHER.

Liquid sulphuret of potassium, 3 iiss to 3 vii; warm water, q. s. Mix.

5. ANTISPASMODIC BATH.

Infusion of 3j of valerian root, for a bath. In certain cases of essential convulsions, and particularly in what is termed eclampsia of infants (Trousseau).

* This includes various species of the natural order Labiatæ, as sage, mint, rosemary, balm, marjoram, &c.

6. BATH OF CORROSIVE SUBLIMATE.

Corrosive sublimate, 3 to 15 grains; alcohol, 3 ij ; distilled water, 3 j. Dissolve In diseases of the skin and in syphilitic affections

and put into the bath.

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Sulphate of alumina and potash, 3 xii to xx. To be dissolved in the bath.

9. BATHS FOR THE FEET.

Soap and water, water with bay salt, fresh wood ashes, flour of mustard, hydrochloric acid, &c., are indifferently used for this purpose.

10. POWDER FOR DRESSING CHILDREN.

Powdered marshmallow, to be used as a powder.

11. ANOTHER.

Lycopodium powder, scented with essence of roses. This powder is much to be preferred to the preceding. Water glides off it without mostening it.

12. ANOTHER.

Powder of old dry wood.

Water, 3 j; tincture of benzoin, gtt. xv.

13. AROMATIC LOTION FOR THE SKIN.

14.

Mix. In cutaneous eruptions.
ASTRINGENT LOTION.
Take of the liquor of Van Swieten, 3 ij.*
with a toilet sponge. In " gourmes" of the

eruptions.

To be used with a piece of linen or head, of the eye, and in cutaneous

15. EMOLLIENT COLLUTORY.

Honey, j; decoction of marshmallow, 3 iv; dissolve. To be applied to the mouth with a brush. In simple stomatitis, in aphthæ, and in the irritation of the buccal mucous membrane which accompanies dentition. In young children, collutories are very preferable to gargles.

16. ANTISEPTIC COLLUTORY.

Decoction of bark, 3 iss; syrup of orange peel, 3 j; chloride of soda, 3 iss. Mix. In cases of ulcerous stomatitis.

17. DETERSIVE COLLUTORY.

White honey, 3 ss to 3 vj; hydrochloric acid, 3 iss. Mix and agitate. In cases of ulcerous stomatitis, aphthæ, gangrene of the mouth, thrush, &c.

18. ASTRINGENT COLLUTORY.

Honey, borax, of each equal parts. In aphthæ, thrush.

19. ANOTHER.

Honey, 3 parts; borax, 1 part. In thrush.

* The liquor of Van Swieten is thus composed: bichloride of mercury, 1; distilled water, 900; alcohol, 100. Dissolve the bichloride in the alcohol, and then add the distilled water.

20. ANOTHER.

Honey of roses, 3 j; sulphate of alumina and potash, 30 grains; distilled water, 3 ss. Dissolve. In aphthæ, thrush.

21. DRY COLLUTORY.

Dry chloride of lime. To be applied to the diseased parts with a slightly moistened brush, and some mucilaginous liquid injected soon afterwards. gangrene of the mouth.

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In

Nitrate of silver, 24 to 45 grains; distilled water, 3 j. Dissolve. In aphthæ, thrush.

23. ANOTHER.

Syrup of mulberries, 3j; honey of roses, 3 ss; borax, 30 grains. In aphthæ and thrush at the commencement of the disease.

24. POWDER FOR CHILDREN IN ACIDITY OF THE ALIMENTARY CANAL.

Calcined magnesia, 3j; rhubarb root, 3 ijss; valerian, 30 grains; oleo-saccharate of fennel, 3 ss. Mix. To form a powder; about 6 grains to be taken once or twice a day (Hufeland).

25. ABSORBENT DRAUGHT.

Powdered crabs' eyes, 30 grains; lettuce water, syrup of rhubarb, of each 3 j. Mix. Shake well and give a teaspoonful every hour. In diarrhoea.

26.

ABSORBENT POWDER FOR NURSES WHEN CHILDREN

HAVE DIARRHEA.

Carbonate of magnesia, 3 v; fennel seeds, orange peel, sugar, of each 30 grains. Mix. Make a powder; a teaspoonful morning and evening.

27. ASTRINGENT DRAUGHT.

Extract of rhatany, 7 to 15 grains; distilled water, 3 ij; mucilage, 3 j; syrup of marshmallow, 3 j. Mix; a teaspoonful every two hours. In diarrhoea.

28. ASTRINGENT DRAUGHT.

Tannin, grain; tincture of the tartrate of iron, 3 iss; syrup, 3 vj; distilled water, 3 j. In diarrhoea (Trousseau).

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Julep, 3ij; add from 2 to 15 grains of the extract of rhatany. In diarrhoea.

30. ANOTHER.

Nitrate of silver, .15 to .30 grain; syrup, 3 vj; distilled water, 3j. Dissolve. In entero-colitis (Trousseau).

31. ABSORBENT MIXTURE.

Powdered magnesia, 3 to 6 grains; syrup of gum, 3 j. Mix; a teaspoonful every two hours. In diarrhoea.

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Subnitrate of bismuth, 2 grains; powdered sugar, 7 grains. To be taken in preserve. In diarrhoea.

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