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The Pamphlet Collection of Sir Robert Stout: Volume 36

On Alcoholic Drinks as an Article of Diet for Nursing Mothers

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On Alcoholic Drinks as an Article of Diet for Nursing Mothers.

The nursing mother is peculiarly placed in that she has to provide a supply of nutriment for the child which is dependent upon her as well as for the ordinary requirements of her own system. The nutrition of the child is to be provided for upon the same principles and by the same food-elements as is the nutrition of the mother, the only difference being that the young child is possessed of less perfect masticatory and digestive powers, and therefore requires food to be presented to it in a state more simple, uniform and readily assimilable than the adult who is furnished with strong teeth, and possessed of a fully-grown stomach. The mastication, digestion, and primary assimilation of the sucking infant's food is thrown upon the mother's organs; but the tissues of the child are nourished precisely as are the tissues of the mother, and a nursing mother requires simply to digest a larger supply of wholesome and appropriate food. As a matter of course mothers with imperfect teeth or weak stomachs cannot perform the digestion of extra food for the infant so well as those page 4 mothers who have an abundance of reserve-power in their digestive-apparatus, and with such patients the question arises, how are they to make up for the deficiency which they soon experience in the supply of milk I Such mothers appeal to their medical advisers to prescribe some stimulant which will enable them to overcome the difficulty which they experience, and often are greatly dissatisfied if informed that there is no drug in the materia medica which will make up for structural weakness in the organs which masticate, digest, or assimilate the food. The proper course for such women to adopt is a simple and rational one. They should assist their digestive apparatus as much as possible by securing an abundance of suitable and nutritious food, prepared in the best way and as is most digestible, while they should lessen the demands of their own system by the avoidance of bodily fatigue and mental excitement. These means, aided by that philosophical hygiene which is at all times essential to the preservation of pure and perfect health, will enable them to supply a maximum quantity of pure and wholesome milk; and further calls by the child require proper artificial food. Unfortunately such advice fails to satisfy many anxious mothers who refuse to admit or believe that they are less robust or less capable than other ladies of their acquaintance, and such mothers fall easy victims to circulars vaunting the nourishing properties of "Hoare's Stout," "Tanqueray's Gin," or Gilbey's "strengthening Port," circulars which are always backed up by the example and advice of lady friends, who themselves have acquired the habit of using these liquors, and who view as a reproach to themselves the practice of any other lady who may not keep them in countenance as the perfection of all moral and physical propriety. Unfortunately the pressure of such lady friends is often so persistent as to paralyse the influence of a conscientious and thoughtful medical adviser, while the appetites and beliefs of such friends often throw them into active antagonism to any medical adviser who may not endorse the habits in which, as they believe, and no doubt conscientiously, duty to their child requires them to indulge. The only course that a medical practitioner, whose family is dependent upon his practice, can safely take with veteran mothers on this question, is to let them have their own way without reiterated admonition. When once they have acquired the habit of depending upon large quantities of beer for nursing their children, they become perfectly infatuated, and are practically incapable of passing through the probationary fortnight which takes place before the digestive apparatus can work under its natural, but to them strange, conditions, while the temporary longing for beer, and the sudden lessening of the quantity of milk afforded by their strained and impoverished systems, are at once set down as clear proofs that their medical adviser is a crochetty and dangerous person, who must be superseded at the first convenient opportunity. Facts and arguments have no more influence on such mothers than they have upon opium-eaters, drunkards, or inveterate consumers of tobacco; while the extreme page 5 propriety of conduct which these ladies manifest, and the encouragement they receive from other medical men, make the convictions based upon their own personal sensations incontrovertible, and their position practically unassailable. I think I might fairly say that among the comfortable middle classes of society the views at present held on this question are so deplorable that a large proportion of children are never sober from the first moment of their existence until they have been weaned; while often after a few years the use of alcohol is again introduced to the children as a "medical comfort," as a part of their regular diet, or as an invariable accompaniment of all their juvenile visitation and company-keeping. Under such circumstances it is not surprising that Temperance reformers appeal in vain on this question, and that their facts and arguments are viewed with plausible indifference, or insidious opposition, by persons whose appetites and instincts have been undergoing debasement and perversion from the very dawn of their lives. My own deliberate conviction is that nothing but harm comes to nursing mothers, and to the infants who are dependent upon them, by the ordinary use of alcoholic beverages of any kind, and in the following remarks I propose to give very shortly and practically the results of a somewhat extended experience in reference to this question, and the reasons which I trust will justify to the minds of common-sense readers this expression of my own very strong convictions.

I fully believe that in most cases the use of alcoholic liquor does increase the quantity of milk secreted by the nursing mother. But what is the nature of the milk thus increased in quantity, and how is that increase brought about? These questions require consideration in regard to the constitution of the mother, and in regard to the health of the child. The supply of milk may be increased in the following ways:—

Firstly. By the transformation in the mother's system of some substance into milk which requires no digestion. For instance, if by any magic water—which will soak through the stomach as it will soak through a sponge—without any tax on the masticating, digesting, or assimilating organs, could be transformed into blood or milk, it is clear that any quantity of milk could be supplied by the mother in whose system such a transformation took place. But that would be virtually equivalent to water being poured into a tube at one end and coming out as blood or milk at the other—a feat which, so far as I know, medical men have hitherto discovered no means of accomplishing.

Secondly. By such use of any stimulant to the mother's digestive organs as would temporarily cause them to digest a larger quantity of food than they would naturally do. If in this way a larger supply of food be forced into the mother's system, a larger supply of milk would be provided for the infant; and in that case the only drawback is that the mother's digestive apparatus would be strained and page 6 injured in order to produce this result. Such injury might not be felt at the time, but it certainly would be incurred, and it would manifest itself in the long run, whether or not it were ever credited to the real cause, i.e. the use of alcoholic beverages as an unnatural goad to the digestive organs.

Thirdly. A greater supply of milk might be produced at the expense of the mother's blood and constitution, although without involving either of the two foregoing suppositions, just as a horse in good condition may be worked down by an amount of labour more than equivalent to the food it can digest, or—if the amount of its food be stinted—more than equivalent to the force yielded by the food which it consumes. In short, the results would be precisely equivalent to those which are exemplified every day in the London cowhouses, where, by stimulating but comparatively in-nutritious foods, such as the refuse of breweries and distilleries, healthy cows are made for a few months to produce an inordinate quantity of milk. The cows gradually waste away, lose their health, and are only saved from dying of consumption by the knife of the butcher, after a brief reversal of the treatment.

Fourthly. The quantity of milk may be increased at the expense of its quality by mere dilution, and this will readily take place if the mother be induced to drink an inordinate quantity of watery fluid. In this way the London cows are made to produce ready-made milk-and-water which needs no further dilution.

Fifthly. There are many substances which, when taken into the human system, are treated by the system as foreign and poisonous agents, and are immediately eliminated by the excreting organs. Thus diaphoretics, which increase perspiration, do so by virtue of a poisonous element which is most readily eliminated by the skin, and no sooner do medicines of this kind get into the blood than the skin immediately sets to work to get rid of them. The skin discharges them in a large quantity of aqueous perspiration derived from the blood, and many such medicinal substances may be recognised in the perspiration which they evoke. For instance, sulphur may be recognised by its odour; alcohol, which acts as a diaphoretic under certain conditions, and is commonly used as such to cure a cold, also may be recognised by its odour in the perspiration when it is thus eliminated. A more palpable illustration may be cited in the action of snuff, which when brought into contact with the lining membrane of the nose is at once washed away by a profuse secretion. Snuff, pepper, and other irritating substances, in like manner, when put against the mucous membrane of the eye, provoke a profuse secretion of tears, which washes them away and gets rid of them. Other substances, again, called diuretics, enormously increase the action of the kidneys. Some of these substances will act either as purgatives, or as diuretics, or as diaphoretics, according to the conditions to which the patient is subjected while the medicine is in process of elimination. Thus if a patient, having taken a diapho- page 7 retic, go to bed immediately, and be placed under such circumstances as to lacilitate the action of the skin, a profuse perspiration will follow; whereas, if the patient had gone out into a cold atmosphere, the medicine might have been got rid of, not by the skin but by the kidneys, and would have acted as a diuretic. A seidlitz powder, if taken upon an empty stomach, will act as a purgative; whereas, if taken with a full meal, it will act not as a purgative, but as a diuretic. Many medicines which ordinarily act as purgatives will, when taken by a nursing mother, act as lactagogues (milk drivers); i.e. they -will be eliminated by the breasts instead of by the bowels, and will pass off by the intestines of the child instead of by the intestines of the mother; and the child, its system being a much more sensitive index than that of the mother, will often suffer greatly from drugs, or from crude or improper food, although the more callous system of the mother may not have shown that any impropriety of diet had been committed.

Alcohol, the essential principle of all intoxicating liquors, will, under different circumstances, act either as a purgative or as a diuretic or as a diaphoretic, or will be got rid of almost entirely by the lungs, or will act as a lactagogue, according to the circumstances and conditions of the alcoholised subject. The bilious diarrhoea which follows a debauch in hot weather, when the lungs are less able to eliminate the alcohol—the frequent urination required by habitual soakers—the sweating caused by a full dose of hot spirit-and-water on going to bed—the stinking odour of secondhand beer, wine, or spirit, which pervades the breath and perspiration of the drinker, and the profuse discharge of milk which comes from the breasts of a beery nurse—are all phenomena of precisely the same order, and which actually reciprocate with each other according to the exigencies and conditions of the system and circumstances by which the drinker is surrounded. It is a matter of common observation that a glass of spirit taken at bedtime by a nursing mother, not merely increases the flow of milk during the night, but causes the child to sleep heavily; in fact, the spirit under these circumstances acts, not as a purgative, nor as a diuretic, nor as a diaphoretic, nor does much of it pass off by the lungs, but it acts as a lactagogue, because the breasts are then in a state of great activity, and form the readiest channel through which the mother's system can eliminate the alcohol, and for that elimination the breasts have to discharge a profuser quantity of milk; but the increased quantity of milk is produced by a mere addition of alcohol and water, or it is produced by impoverishing and straining the system of the mother. In either case, the poisonous influence of the alcohol is manifested in narcotising the child, and it cannot need much reflection to show that children ought not to have alcohol filtered into them as receptacles for matters which the mother's system finds it necessary to eliminate, and that probably nothing could be worse than to have the very fabric of the child's tissues laid down from alcoholised blood.

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Probably few persons would be found to believe in the proposition that stout could be transformed into milk in the mother's system, if that proposition were stated in explicit terms, as by substituting the term stout for water in our first supposition. But in order to understand how it is that an increased quantity of milk is often produced by the use of alcoholic liquor, some deliberate discussion of this point is really necessary. There is a large proportion of medical opinion in England at this day which supports the hypothesis that alcohol serves as food in the body, and, as it soaks into the body without taxing the digestive apparatus, it would need no more effort for digestion or assimilation than it needs for mastication. That opinion rests not merely upon the beliefs and likings of a large mass of our population medical and non-medical—"practical experience" as it is called—but it rests also upon a shadow of scientific fact, as we have never yet succeeded in reproducing from the excretions all the alcohol which may have been taken into the body. Every one is aware that a person who has swallowed a small quantity of beer, wine, spirit, or pure alcohol, gives out a corresponding alcoholic odour for some hours afterwards, and therefore it is clear that some of the alcohol, being extruded in the same state as it was ingested, cannot have served as food, inasmuch as food never leaves the body undecomposed. I have always thought that the burden of proving the hypothesis that alcohol is decomposed in the body rests with those who propound it, as we may fairly begin by assuming that what we know to take place with a large proportion of the alcohol, also takes place with the remainder. In February, 1867, at Manchester, I delivered a lecture* to the Church of England Diocesan Temperance Reformation Society, upon the properties of alcohol as a medicine and in reference to the action of alcohol in the system. I condense the following sentences from a report of that lecture which appeared in the Alliance News of March 2nd, 1867:—

"Alcohol in the blood diminishes the osmosis or permeation of its fluids through the membranous tissues of the body, and thus the extra-vascular circulation or soakage of the fluid parts of the blood is interfered with. The alcohol also blunts the chemical affinities by virtue of which the tissues of the body and the fluids of the blood react upon each other. These two effects obstruct the onward passage of the blood through its capillaries, and the blood accumulating behind distends the arteries and stirs up the heart to force on the current. Thus we get what is called 'the stimulating action of alcohol,' i.e., a fuller pulse and a more laborious action of the heart—the real fact being that more heart-labour is required to keep the circulation going, just as when respiration is interfered with the breathing becomes more laborious."

"I can see nothing in the action of alcohol in the human body in any

* This Manchester lecture has since been reprinted by Heywood & Co., 335, Strand, W.C.

page 9 case or at any time but that of a paralyser, and I see in that view the key by which we can explain all the contradictory phenomena, and all the contradictory benefits which have been ascribed to the influence of alcohol. . . . . Life assurance tables show that the total abstainers live longer than even the moderate and respectable drinkers do, and all round, the facts come out to show that the sensations of comfort which are experienced when alcohol is taken, are but modifications of the comfort with which the man lies in the gutter when drunk. If we look to the influence of alcohol in the various kinds of sickness, the same simple key will unravel all the mysteries . . . . . By giving alcohol as a 'stimulus' in exhausting diseases, I believe we always do what we should do by giving a dose of opium, or brandy-and-water, to comfort a half-suffocated patient (i.e. increase his danger). If that be so we reduce alcohol not only from the position of a food medicine, but we reduce it from the position of a goad, and we say that the suppositious stimulating or goading influence of alcohol is a mere delusion, that in fact alcohol always lessens the power of the patients, and always damages their chances of recovery when it is a question of their getting through exhausting diseases. There are some cases in which alcohol is invaluable, e.g., as a narcotic in staving off certain kinds of convulsions, or in lessening the sensibility of the body under a painful operation. But these are cases which happen but rarely, and which do not come within the scope of that class of ailments for which we now see brandy and wine indiscriminately prescribed and relied upon. In the case of a child cutting its teeth there is a nervous irritation which throws the whole body out of gear, and the respiratory muscles become locked as it were by the violence of the spasm, and the patient may be killed by momentary suffocation through the very energy with which certain parts of the body act, just as a machine may become 'locked,' and in order to put it right you have to turn the steam down or turn it off for a moment. Under these circumstances alcohol is useful as a paralyser, a blunter of those extreme sensibilities which evoke the convulsive action by which a patient may be killed. But I think alcohol should be restricted to such cases as are usually treated by opium or chloroform . . . . I think that these arguments not only will come home to clergymen and other leaders of opinion, but also should influence even the mere rationalist who is not swayed by religious expediency, and ready to give up even that meat which might make his weaker brother to offend. We conclude by simply affirming these propositions:—That alcohol never sustains the forces of the body as a food or a food medicine; that alcohol never acts as a goad to the body; that it has no stimulating properties whatever in the sense of increased action either in rate or quantity; that alcohol always acts as a narcotic, and is always a paralyser of sensation and a lessener of action."
It will be found by those who refer to that lecture that I had been led to view alcohol, not as a food, not even as a true stimulant, but as always a narcotic and paralyser, and to aver that its true use in medicine was not that of a food or stimulant but that of a narcotic. I still hold to that view, and I am pleased to find that a view which I believe to be the only sound one as a scientific basis for the use of alcohol, has since been very fully adopted by other medical men. The Medical Times and Gazette of December 18th, 1869, contains a page 10 very interesting lecture, entitled, "Physiological Research upon Alcohols," by Dr. Benjamin Ward Richardson, whose attention I called to the views which I had arrived at, and I now quote the concluding paragraphs of that very able lecture, as being one of the most recent and authoritative expressions of professional opinion upon this point:—*

"I have dwelt on these points from their immediate relation to practice. The evidence of the physicians is not less conflicting than the evidence of the physiologists. What shall we believe? Dr. Todd and his followers cure fever with alcohol. Dr. Gairdner, of Glasgow, treats fever with and without alcohol, and finds that he cures without better by far than with it. I will contest on neither side, because I know that as yet physicians have never prescribed alcoholic fluids with any precision at all, either in regard to quality or quantity, the common alcoholic drinks being anything; but I am prepared to contest, if under scientific administration alcohol be found, to cure fever, that the medicine acts by lowering temperature and checking waste, not by sustaining as food sustains the body.

"The alcohols are strictly anæsthetics, and, indeed, the first published case of surgical operation under anæsthetic sleep was performed in 1839, by Dr. Collier, on a negro, who was rendered insensible by breathing the fumes of alcohol.

"Speaking honestly, I cannot, by the argument yet presented to me, admit the alcohols through any gate that might distinguish them as apart from other chemical bodies. I can no more accept them as foods than I can chloroform, or ether, or methylal. That they produce a temporary excitement is true, but as their general action is quickly to reduce animal heat, I cannot see how they can supply animal force. I see clearly how they reduce animal power, and can show a reason for using them in order to stop physical pain, or to stupefy mental pain; but that they give strength—i.e. that they supply material for construction of fine tissue, or throw force into tissues supplied by other material—must be an error as solemn as it is widespread.

"The true character of the alcohols is that they are agreeable temporary shrouds. The savage, with the mansions of his soul unfurnished, buries his restless energy under their shadow. The civilised man, overburdened with mental labour, or engrossing care, seeks the same shade; but it is a shade after all in which, in exact proportion as he seeks it, the seeker retires from perfect natural life. To resort for force to alcohol is, to my mind, equivalent to the act of searching for the sun in subterranean gloom until all is night.

"As yet alcohol, the most commonly summoned of accredited remedies, has never been properly tested to meet human diseases. I mean by this that it has never been tested as alcohol of a given chemical composition, of a given purity, and in given measures. Wines, beers, and spirits, are anythings —compounds of alcohols, and compounds of alcohols with ethers and other foreign substances. It is time, therefore, now for the learned to be precise

* Dr. Richardson's Lecture will be found entire in the Medical Temperance Journal for April, 1870.

page 11 respecting alcohol, and for the learned to learn the positive meaning of one of their most potent instruments for good or for evil, wheroupon I think they will place the alcohol series in the position I have placed it, even though their prejudices in regard to it are, as mine are by moderate habit, but confessed inconsistency, in its favour."

If this view be adopted, it follows that alcohol never yields up force in the body as a food on the one hand, and that it never acts as a stimulant by exciting force on the other. All the observations which I have been able to make impress me with the conviction that, at any rate, the drug-action of alcohol is that of a narcotic, and not that of a stimulant; but in case it should hereafter be proved that alcohol does undergo oxidation in the body so as to yield up force, and thereby serve to some extent as food, the total abstainers' platform would still remain unshaken. We should then inquire, firstly, Is alcohol a good food? Every medical man would reply that alcohol, if a food, is certainly at the same time the cause of most of those degenerations of blood and tissue which constitute the diseases of the present day—a charge which cannot be brought against any other substance that ranks as a food; and there is no doubt that the physical injury resulting from the use of alcohol as a food would far outweigh the benefits which its possible yielding up of force might give. We should ask, secondly, Is alcohol a cheap food? The reply would be that you could get as much food in a pennyworth of oatmeal, beef-suet, or sugar, as you would in a shilling's-worth of alcohol. "We should ask, thirdly, Is alcohol a safe food? The reply would be that, while gluttony and other abuses of true foods are practically very trifling evils, and evils moreover which seem to have a natural tendency to cure themselves, the drunkenness and other evils which arise out of the drinking usages of society are admitted on all hands to be the greatest curse with which society is at present afflicted, and to be evils, moreover, which have a tendency to perpetuate and aggravate themselves instead of curing themselves. Therefore, if alcohol were a food, it would be an injurious food, a dear food, and a dangerous food. What applies to alcohol as a food for hard-working men, applies to it quite as much for nursing mothers, whose strength may be overtaxed. But those who wish to follow this discussion out may refer to a five-column report of my lecture, already referred to, in the Alliance News, and they must not leave unstudied the recent lecture of Dr. Richardson.

As to the effects of beer-drinking upon nursing mothers I have observed the following facts. The mothers frequently make flesh, and even become corpulent; often, however, at the same time they get pale, and wherever they are not constutionally robust in fibre they become inactive, short-breathed, coarse complexioned, nervous and irritable, and sutler from the weakness of the heart and a long train of symptoms, which are more or less severe according to the constitution of the mother and the quantity of alcohol she imbibes. page 12 The young mother prematurely loses the bloom and beauty of youth. Often it is quite startling to meet some lady, who during an interval of two years has been transformed from a sprightly and charming young woman, into an uninteresting and coarse-looking matron. She has nursed her first infant for twelve months. With a pure and rational diet, she would simply have acquired a more dignified and womanly bearing, with a robuster gentleness of manner; but a liberal supply of "nourishing" stout—a glass of port at luncheon, and a little gin-and-water at bedtime—one after the other, were adopted, and imbibed regularly, in order to supply her infant with "milk." The presence of a nerveless apathy, or unintelligent irritability, afterwards proved that a liberal supply of "stimulants" was required to support her strength, and, although she ceased nursing, her own sensations convinced her of the necessity of continuing them. The outward and visible change is but an exponent of the degenerations and diseases which are taking root within. If there be a predisposition to insanity or consumption, these diseases are developed very rapidly, or they are brought on where proper management might altogether have tided over those periods of life at which the predisposition is prone to become provoked into actual disease.

Infants nursed by mothers who drink much beer also become fatter than usual, and to an untrained eye sometimes appear as "magnificent children." But the fatness of such children is not a recommendation to the more knowing observer; they are extremely prone to die of inflammation of the chest (bronchitis) after a few days' illness from an ordinary cold. They die very much more frequently than other children of convulsions and diarrhœa while cutting their teeth, and they are very liable to die of scrofulous inflammation of the membranes of the brain, commonly called "water on the brain," while their childhood often presents a painful contrast—in the way of crooked legs and stunted or ill-shapen figure—to the "magnificent" and promising appearance of their infancy.

Those ladies who adopt the general views I have thus expressed in relation to the nursing of their children, will want to know what is the "proper artificial food" with which to supplement their milk when it is deficient in quantity. With some patients the milk will fall off in quantity at the end of two or three mouths. With others, although the quantity may not fall off, the child seems unsatisfied; and there is a third class with whom a profusion of milk is supplied and the child thrives exceedingly, but the mother gets flabby, weak, nervous, pale and exhausted. In the last case, the mother is simply goaded on by susceptibility of her own nervous system, or by inordinate activity of the breasts to yield an amount of milk which her digestive powers are not equal to providing for. The treatment of such cases should be simply repressive. The mother should separate herself somewhat more from the child, and make a rule of only nursing it from five to eight times in the twenty-four hours, while the neck of the mother should be kept cool in regard to dress, and page 13 cold sponging may be practised carefully night and morning. Her attention should be diverted by outdoor exercise on foot, and additionally in a carriage if necessary. When the mother's milk, though apparently not deficient in quantity, proves unsatisfying to the child, great attention should be paid to varying the diet of the mother, while such staple foods should be taken as are most easily and thoroughly assimilated into milk. The unsatisfying quality of the milk will generally be remedied by taking a more varied diet, together with three or four half-pints of milk in the course of the day, accompanied with farinaceous matter, as in the shape of well-made milk gruel; and in case these measures fail, the only alternative is to supplement the mother's milk by obtaining a wet-nurse to suckle the child three or four times a day alternately with the mother, or by feeding the child with proper artificial food. The same measures may be resorted to where the milk, though satisfying in character, is deficient in quantity; and in preparing artificial food for the child it must always be remembered that the food requires to be adapted to the stage of development which is manifested by a young infant's digestive organs. The infant's digestive apparatus is in fact designed to digest milk, and to digest nothing else, but when the teeth are cut, farinaceous matter of a more or less solid character should be gradually mixed with the milk. Almost all the illnesses of infants under twelve months of age are caused by some gross impropriety of diet or otherwise on the part of the mother, for which the child suffers through the medium of the milk, or they are caused by feeding the child with improper artificial food. Thick sop and many other articles often given as food are as indigestible to an infant of three months old as cabbages would be to a lion or beefsteaks to a horse; and until the child has cut its teeth, it should have nothing but food resembling the mother's milk as closely as possible. Of course milk is an article which varies immensely in large towns, according to the management of the cows who yield it, and according to the manipulations of the persons who sell it; but by proper attention and careful watching there is never anything like as much difficulty in obtaining pure milk as there is in obtaining pure beer. Assume that we start with unadulterated milk of fair quality—that milk contains twice as much cheese, twice as much butter, and about as much sugar as is contained in human milk. By adding a little sugar so as to double the proportion of sugar also, and then an equal quantity of boiling water, the three main ingredients will be reduced to their proper proportions, and most infants will thrive perfectly upon nice fresh sweetened milk, diluted with boiling water. If the milk be very rich, or if the milk pass undigested through the bowels, it should be diluted still more, or until the stools cease to contain milk. If a dishonest tradesman has already supplied the water, it is obvious the milk need not be further diluted. There are many groundless fears as to the extent and character of the adulterations to which milk is subjected—chalk, horses' brains, and various other page 14 materials have been brought by sensational scribblers before the vivid imaginations of mothers. I think I may say, without hesitation, that chalk is never, under any circumstances, used to adulterate milk; and certainly if any stupid adulterator were to put chalk into milk, it would be discovered by the first person who looked for it, inasmuch as the chalk would be deposited at the bottom of the vessel in the course of a few minutes. I have witnessed the process of adulterating milk over and over again at the places in London where milk from the country is wholesaled to the retailers. The materials consist of an ordinary tap of running water, a jug of burnt sugar, a dish of salt, and a clean stick. The men hold their half-filled cans of milk under the tap for a time proportioned to the length of their consciences, and the softness of their customers, but always until the "milk" presents an ominous blueness to the eye, and acquires an insipid watery taste. They then stir burnt sugar into it, drop by drop until a rich creamy hue appears, and finally the flavour is brought up by a little salt. This is really the process by which milk is adulterated in our great towns, and shameful and disgusting though it is, yet it is not so bad as people imagine, being limited to mere cheating by dilution of the milk, and not extending to the use of deleterious or nasty ingredients.

The proper way to feed an infant of three months old, whose mother is only able to partially support it, is as follows:—When the child wakes in the morning it should not go to the mother, but should be taken away by the nurse, and immediately fed from the bottle, sucking its milk through a suitable teat. After the mother has breakfasted the child may go to the breast, and during the day it should be alternately fed from the bottle, and nursed by the mother. At six o'clock the baby should invariably be placed in its crib, by the side of the mother's bed, and fed just before going to sleep, and the habit of going to bed at six o'clock should be strictly and invariably enforced. If once the child be allowed to come down to the family circle after dark, the habit of going to sleep will be broken, and the child will continuously cry to come down. In the course of the evening the mother may nurse the child once, and at ten or eleven o'clock, when the mother goes to bed, the child should be again fed from the bottle, and the mother should have a basin of well-made milk- gruel; and by her bedside should be placed, at the last moment, as much gruel as she is likely to drink with relish during the night. Whenever the child is restless it should be taken out of its crib, gently, by the mother, and nursed, say two or three times during the night, and put back again into its crib, the child never being allowed to sleep with the mother. When the night is fairly over, and the child awakens, it should be fetched by the nurse, and have its first morning meal from the bottle. This plan of feeding should be persisted in continuously until the child has cut its teeth; and it is only when every means have been taken to ensure the sweetness, freshness, and niceness, not only of the milk and page 15 water, but of the bottle and of the teat, and the child still fails to get on, that, in rare eases, I advise the admixture of a little farinaceous matter in the way of food containing one part milk and two parts of properly sweetened barley-water. As the milk teeth come through, other farinaceous matter may be gradually blended with the milk, and there is nothing better than to begin at about eight months with a teaspoonful of baked flour, well boiled in a pint of milk and water, or in the water, to be afterwards cooled with milk. Oftentimes a little salt, as well as sugar, will materially help its digestion. The child will do well on that food—the quantity being duly increased—until it has cut almost all its milk teeth, when it may eat bread and butter, rice and egg puddings, and occasionally eat a boiled egg once a day. I believe that it is a great mistake to give red flesh meat to children in their early years, unless there be some very special reason for it, and then that it should only be temporarily used; but nice potatoes, flavoured with fresh gravy from a joint, may be given at dinner, as the child becomes able to feed itself.

The British Medical Journal of June 4th, 1870, contains an article headed "Doctors and Water-drinkers," which is probably the most important article upon this subject in relation to the medical profession which has ever appeared in the medical journals of this country. The article is of considerable length, and is written ably, dispassionately, and honestly. This journal speaks in the name of an association that numbers 4,000 members of the medical profession of this country, and the article must be regarded as an exponent, according to its editor's lights, of the position of our medical men in regard to the question of total abstinence. It contains the following remark:—"Probably almost every member of the medical profession in the three kingdoms himself uses dietetic stimulants, in bold defiance of gout and tissue degeneration, and honestly believes himself on the whole the gainer from them." I do not know how a worse compliment could have been paid to the profession, and this sentence will probably be quoted in support of the complaints made by Temperance reformers to the effect that in this country the greatest enemies to the Temperance reformation are the medical men, and that they, by their personal example and their indiscriminate prescription of "dietetic stimulants," are responsible for much of the present drunkenness, and for most of the relapses which occur to those who have been reclaimed. Certainly the proportion of medical men who are free from the influence of "dietetic stimulants," upon their own stomachs, and therefore in a position to judge for their patients upon this question without bias, is very small, but I am able to state that it is not so small as is represented by the British Medical Journal. My experience in my own person, after very careful testing of my health, working-power, and capacity for enduring mental strain, has convinced me that I am the gainer in every way by abstaining, and I have been a total abstainer for some page 16 years, and an abstainer practically for many years previously. I may also add that my partner in life has arrived at the same convictions and the same practice; and that, by adopting the principles to which I have already given expression, she has preserved her health, and satisfactorily nursed five children for twelve months each. Indeed, we have great cause to be thankful for the health of ourselves, and for the health and promise of our children; and we ascribe these largely to abstinence from alcoholic beverages. I could cite large numbers of families in my own practice who have been under my observation for years, where the mother and children have derived similar benefits from total or practical abstinence, and no language would be too strong to express my convictions on this point in a general way.

4, Fitzroy Square, London, W., June, 1870.