Cooley's Cyclopaedia of Practical Receipts Volume I Part 285

Writing on this subject M. Hanon says that of 59,927 infants born in Paris, 20,049 are sent into the country to nurses. Of those children that remain in Paris, and that are so rarely suckled by their mothers, no less than 8250 die from 0-1 year, which gives a death-rate of 243 per 1000 births. As to the mortality of the unfortunate infants, 20,049 in number, sent off to nurse, this amounts to 500 or 700 per 1000 in the first year of life.

We extract the following from the 'Echo' of October 9th, 1878:

"ALLEGED BABY-FARMING.

"Dr Hardwicke, the coroner for Central Middles.e.x, held an inquest at the Islington Coroner's Court, Holloway Road, this morning, relative to the death of the female child of Emily Corley, a servant at 49, Gower Street, Euston Road. Mr Baby, the inspector under the Infants Life Protection Act, watched the case. The mother of the child had gone to service as a wet nurse after coming out of the workhouse, leaving it with one Ann Leach, who said it was a very delicate child. She added that she had for a time two children under one year of age with her, and had been told that this was contrary to the Act. The inspector under the Infant Life Protection Act pointed out that persons having more than one child to nurse under a year old had to obtain a licence. The coroner characterised the Act as a mere farce. It left children to take care of themselves after they were twelve months old--the most critical time of their existence. He also remarked on how prolific a source of prost.i.tution such cases as the present were, where mothers had to forsake their own illegitimate offspring, depriving them of breast milk in order that they might sell it to the rich. The jury found that the child died from exhaustion following from diarrha, accelerated by want of breast milk."

=INFANTS, Food for.= For the newly-born and very young of all mammiferous animals, no food is so expressly and admirably adapted as that drawn from the mother. In the nourishment of the babe from the maternal breast lies the soundest condition for its physical well-being and growth, subject to the qualification that the mother must be in good health, which, of course, implies that she must be well fed. This latter essential fulfilled, it is very wonderful to note how nature makes provision for the proper nourishment of the offspring by converting even a weakly and frequently ailing mother into a strong one during the period of suckling.

There may be, and doubtless are, many circ.u.mstances in which lactation cannot be practised with safety either to mother or child; but, where such circ.u.mstances do not exist, the practice of seeking the vicarious services of the wet-nurse, or of having recourse to other than the maternal milk, for many reasons, calls for remonstrance and reproof.

We may emphasise this by the following quotation from Dr West's admirable work, 'Diseases of Infancy and Childhood.' He says: "The infant whose mother refuses to perform towards it a mother's part, or who by accident, disease, or death is deprived of the food that nature destined for it, too often languishes and dies. Such children you may see with no fat to give plumpness to their limbs--no red particles in their blood to impart a healthy hue to the skin, their face wearing in infancy the lineaments of age; the voice a constant wail; their whole aspect an embodiment of woe.

But give to such children the food that nature destined for them, and if the remedy do not come too late to save them, the mournful cry will cease, the face will a.s.sume a look of content, by degrees the features will disclose themselves, the limbs will grow round, the skin pure red and white."

But although the maternal aliment (or, failing this, that supplied from the breast of a young and healthy wet-nurse, who has been recently confined) is undoubtedly the best adapted for infantile nutrition, it fortunately happens that in circ.u.mstances where the infant is unable to be fed from either of these sources, we have a very valuable subst.i.tute in the milk of the cow, the similarity of which, in composition to woman's milk, will be seen at once by studying the following table arranged by Dr Letheby:

--------------+---------------------------+-------- Woman's Milk. Cow's Milk.

--------------+--------+--------+---------+-------- Max. Min. Average. Average.

Casein 436 297 352 364 b.u.t.ter 518 445 402 355 Sugar of Milk 443 329 427 470 Various salts 026 038 028 081 +--------+--------+---------+-------- Total solids 1420 1109 1209 1270 Water 8580 8891 8791 8730 +--------+--------+---------+-------- Total 10000 10000 10000 10000 --------------+--------+--------+---------+--------

The milk of the cow being rather richer in solids than that of woman, it is considered desirable to somewhat dilute the former when it is used as food for the infant. Dr Letheby recommends the addition to it of a third of water, with a little sugar to sweeten it, and to render it more acceptable to the baby palate. It cannot be too forcibly insisted upon that immeasurably the best and safest food for an infant, next to human milk, is the milk of the cow, _and nothing else_, until it reaches the age of eight or nine months. It is perhaps needless to state that the milk must be perfectly pure and unadulterated, and that it will fail of being this if yielded by an unhealthy cow. The animal's food and habitat also exercise an important influence on the quality of the milk, that given by gra.s.s-fed cows roaming in open pastures undoubtedly being the best and richest.

Different cows yield different qualities of milk; hence, when milk from any particular cow suits an infant, it has been found desirable not to change it.

The newer and fresher the milk the better is it adapted for the child's use; that which has in the least become soured should be especially rejected.

Sometimes even fresh and good milk is found to disagree with a child. When this is the case it may be remedied by adding a little lime water to it previous to its being drunk. If it were practicable, and within the means of every family to keep their own cow, so that the infant could be fed with the milk directly it came from the animal, nature's example in giving it direct from the mother's breast might be followed. The writer remembers, some years ago, the Princess of Wales travelling with her baby on a voyage to and from Denmark, and being accompanied by her bovine purveyor in the shape of an Alderney.

In hot weather, more particularly, if milk be kept even for a short time it is liable to become acid, or "to turn," as it is called. It is, therefore, always desirable to keep it in a cool cellar till required for use, and in very hot weather it should be stood in ice.

The daily allowance of milk for a child during the first month of its life is two or three pints. M. Guillot says 2-1/2 lbs. avoirdupois is the least the babe can properly subsist on. He weighed several infants before and after they had taken the breast, and found that they had gained in weight, in quant.i.ties varying from 2 oz. to 5 oz.

Opinion is divided as to the value of condensed cows' milk as a food for infants. Its chief merit seems to be that it affords a subst.i.tute for the natural milk in cases where this latter is not obtainable, or where, in consequence of disease amongst the cows of a neighbourhood, it cannot with safety be consumed. Since the maternal fluid, without undergoing alteration or modification, forms so perfect and model a food for infants, it does not seem an unreasonable inference that the milk from the cow, which so nearly approaches it in composition and qualities, should prove most advantageous when partaken of under similar conditions. It has been a.s.serted that condensed milk is inferior in strengthening qualities to the natural cows' milk. If this be the case it is certainly not due, according to Mr w.a.n.klyn, to any removal of the const.i.tuents of the latter. In his useful little work on 'Milk a.n.a.lysis' Mr w.a.n.klyn says: "A year ago a report was spread that these preserved milks were preserved skim-milk, and not preserved new milk. I have myself examined the princ.i.p.al brands of preserved and condensed milk, which are in the London market, and find that the milk which has been condensed, or condensed and preserved, had been charged with its due proportion of fat."

The physiological facts that in an early stage of infancy the digestion is very feeble, and that until an infant has cut its first teeth there is but little, if any, secretion of saliva, which latter is essential for the conversion in the system of starch into sugar, point, therefore, to the imprudence of feeding very young infants upon so-called "infants' foods,"

where these consist of amylaceous substances. The starch of which these latter are composed not only fails to become a.s.similated, and therefore to produce no nutrient effect, but clogs up the lower parts of the bowels, and thus gives rise to a train of evils, amongst which may be included indigestion, diarrha, vomiting, and not infrequently convulsions and death.

The difference in the mortality between infants under one year of age who annually die of convulsions in England and Scotland is attributed to the fact that whereas the English mother feeds her offspring on thick spoon-food, the Scotch woman nourishes hers from the breast. In 'The Fourteenth detailed Annual Report of the Registrar-General of Scotland' it is stated that "The English practice of stuffing their babes with spoon-meat occasioned the death by convulsions of 23,198 children under one year of age during the year 1868, out of 786,858 births; in other words, caused 1 death from convulsions in every 34 of the children born during the year in England. In Scotland, during the same year, only 312 infants under one year of age fell victims to convulsions out of 115,514 children born during the year; in other words, 1 death from convulsions in every 370 born during the year."

When a child has reached the age of eight or nine months the judicious use of farinaceous foods is not only un.o.bjectionable but desirable; but even then it is most important to increase the quant.i.ty of the food very cautiously with the age, as well as to see that it has been well baked and afterwards boiled before being partaken of. In all cases it should be mixed with the milk.

When the child has reached the age of twenty months Dr Letheby advises the quant.i.ty of farinaceous food to be still further increased, and with a little egg given in the form of pudding until it attains its third year.

At this period the child's diet may also include bread and b.u.t.ter, and at the end of it well-boiled potato with a little meat gravy.

From the third to the fifth year he prescribes a small quant.i.ty of meat, and at the end of the ninth year the usual food of the family. During all these periods the use of milk as an important article of the dietary is enforced.

The following table by the late Dr Edward Smith, exhibiting the proportions between the daily quant.i.ties of carbon and nitrogen required at different periods of human existence, ill.u.s.trates the great preponderance of nitrogen demanded by the infant over those who succeed him in the scale of age:

Carbon. Nitrogen.

In infancy 69 672 At ten years of age 48 281 At sixteen years of age 30 216 At adult life 23 104 In middle life 25 113

See MILK.

=IN'FANTS' PRESER'VATIVE.= (Atkinson's.) Carbonate of magnesia, 6 dr.; white sugar, 2-1/2 oz.; oil of aniseed, 20 drops; compound spirit of ammonia and rectified spirit, of each 2-1/2 fl. dr.; laudanum, 1 fl. dr.; syrup of saffron, 1 oz.; caraway water, q. s. to make the whole measure 1 pint. Antacid, anodyne, and hypnotic.

=INFEC'TION.= _Syn._ CONTAGION. The communication of disease, either by personal contact with the sick or by means of effluvia arising from their bodies. Attempts have been made to restrict the term contagion to the former, and infection to the latter, but this distinction is now discarded by the majority of writers. The following are the princ.i.p.al diseases which are commonly regarded as contagious:--Chicken-pox, cholera, cow-pox, dysentery, erysipelas, glanders, gonorrha, hooping-cough, hydrophobia, itch, measles, mumps, ophthalmia (purulent), plague, scald-head, scarlet fever, smallpox, syphilis, yaws. See DISINFECTANT, &c.

=INFLAM'MABLE AIR.= See HYDROGEN.

=INFLAMMA'TION.= _Syn._ INFLAMMATIO, L. In _pathology_, a certain state of disease. The common symptoms of inflammation are pain, swelling, heat, and redness, attended with fever, and general const.i.tutional derangement when severe.

The treatment of inflammations, whether trifling; or serious, is essentially the same in principle, and only differs in degree. This consists in the adoption of the usual means for lowering the force of the circulation and the frequency of the pulse; of which leeching, purging, a low diet, and the use of refrigerant drinks and lotions, form the most important part. The const.i.tutional derangement or symptomatic inflammatory fever, and inflammatory condition of the blood always accompany local inflammation, and progress with its intensity. In inflammations of a more purely local character, cupping or leeching the part immediately affected, or the parts adjacent to it, is in general more appropriate and successful. In these cases the application of refrigerant or sedative lotions, baths, &c., generally proves of much advantage. In cases in which there is induration or dryness of the part, the use of warm embrocations is indicated.

Inflammation often arises from apparently very trifling causes, particularly in persons of a full or bad habit of body, or who indulge in the free use of malt liquors. In some persons a very trifling local injury, as a slight abrasion, cut, p.r.i.c.k, or sprain, produces a considerable amount of tumefaction, attended with severe const.i.tutional excitement. Punctured wounds, sprains, and dislocations commonly furnish the most serious cases of inflammation that depend on mere external injury.[359] See ABSCESS, FEVER, TUMOUR, &c.

[Footnote 359: In all inflammatory cases of a serious nature, the reader is strongly advised to commit himself to the care of a medical pract.i.tioner.]

=Inflammation of the Bowels.= The common causes are incautious exposure to cold, the use of improper food, and the presence of acrid substances or hardened faeces in the bowels. The more constant symptoms are pain over the abdomen, thirst, heat, and extensive restlessness and anxiety; sickness, obstinate constipation, and a hard, small, quick pulse. In the later stages the pain and tenderness of the abdomen, especially around the navel, become excessive, and there is difficult micturition. In some cases the pain suddenly ceases, the belly becomes tumid, the pulse scarcely perceptible, the countenance ghastly, and the patient dies in a few hours.

The treatment consists in blisters, leeches to the abdomen, hot bath and fomentations, aperient clysters, and mercurial purges; with effervescing draughts and opium to allay sickness, followed by diaph.o.r.etic salines and gentle aperients. See STOMACH AFFECTIONS, &c.

=INFLAMMATORY FE'VER.= See FEVER and INFLAMMATION.

=INFLUEN'ZA.= See CATARRH.

=INFU'SION.= _Syn._ INFUSUM, INFUSIO, L. A liquid medicine, prepared by macerating vegetable or animal substances in water, at any temperature below that of ebullition.

The mode of preparing infusions is, with most substances, precisely similar to that pursued for making the almost universal beverage--TEA. The ingredients are commonly placed in a stoneware pot or vessel (an 'infusion pot'), previously made hot; boiling water is then poured over them, and the cover being placed on, the whole is allowed to digest together, at first, for a short time, in a warm situation, as on the hob or the fender, and afterwards (the vessel being removed from the heat) until the whole becomes cold. The liquid is then poured from the ingredients, and the latter, being slightly pressed, if necessary, the infusion is strained through a piece of clean linen or a hair sieve for use. During the digestion the ingredients should be occasionally stirred, an important matter often neglected, and not even referred to by most pharmaceutical writers.

The substances employed for making infusions receive the same preliminary treatment as those intended for making DECOCTIONS. Shavings, leaves, and flowers require no previous preparation beyond being pulled asunder; but roots, woods, and other solid substances must be bruised or sliced, if in the green or recent state, or bruised or coa.r.s.ely pulverised, if dry, for the purpose of exposing as large a surface as possible to the action of the menstruum.

The substances extracted by water from vegetables by infusion are chiefly gum, mucus extractive, tannin, certain vegetable acids, the bitter and narcotic principles, gum-resin, essential oil, and alkaloids. Some of these substances are only sparingly soluble in water at ordinary temperatures; but more readily so in hot water, and freely soluble in boiling water. The temperature of the water should be therefore proportioned to the nature of the vegetable matter operated on. For mere 'demulcent infusions,' in which starch and gum are the chief substances sought to be dissolved out, and when the active principle is scarcely soluble in water, unless at nearly the boiling temperature, boiling water alone should be employed; but when the medicinal virtues of vegetables are soluble in water at lower temperatures, it is better to employ hot water (165 to 175 Fahr.), and to allow a little longer period for the digestion. In many cases temperate water (from 60 to 70 Fahr.), or tepid water (from 80 to 90 Fahr.), may be used with advantage, especially in the preparation of 'aromatic bitter infusions,' and in most cases where it is wished that the product should contain as little inert matter as possible; but when water at low temperatures is employed, the period of the maceration must be proportionately increased. By adopting the method of maceration in vacuo, or in an atmosphere of carbonic acid, the menstruum may be allowed to lay in contact with the vegetable matter for an unlimited period, without decomposition taking place.

Infusions, like decoctions, are liable to undergo spontaneous decomposition by keeping, especially in warm weather, when a few hours are often sufficient for their pa.s.sage into a state of active fermentation; they should, therefore, when possible, be prepared for use daily, as beyond twenty-four hours they cannot be depended on. The London College directs a pint only to be made at a time, thus very properly regarding them as extemporaneous preparations.

CONCENTRATED INFUSIONS, now so common in the shops, and, unfortunately, so generally used in dispensing, are either made by taking 8 times the quant.i.ty of the ingredients ordered in the pharmacopia, and then proceeding in the usual manner, or by the method of displacement; or, by carefully and rapidly concentrating the simple infusions, by evaporation in a steam or salt-water bath, until reduced to about 1-7th of the original quant.i.ty. In either case the liquid is put into a strong bottle, without being filtered, and 10 to 12% of rectified spirit added to it, whilst still hot. The cork is then put in and secured down, and the whole agitated for some minutes, after which it is set aside for a week, when the clear portion is carefully decanted from the sediment for sale.

Another method, which answers well with the aromatic bitter vegetables, is to take 8 times the usual quant.i.ty of the ingredients, and to exhaust them with a mixture of rectified spirits, 1 part, and distilled water, 3 parts; by digestion, or, better still, by percolation. Concentrated infusions made in this way keep well, and deposit scarcely any sediment. Many houses that are remarkable for the 'brilliancy' and beauty of these preparations, employ 1/3 spirit of wine and 2/3 water as the menstruum. It may, however, be taken, as a general rule, that for vegetable substances that abound in woody fibre, and contain little extractive matter soluble in water (as qua.s.sia, for instance), 1/6 to 1/5 part of spirit is sufficient for their preservation; whilst for those abounding in mucilage or fecula, or that readily soften and become pulpy and glutinous in weak spirit (as rhubarb), 1/5 to 1/3 is required.

By adopting the method originally suggested by Mr Alsop, infusions may be preserved, uninjured, for a year or longer, without the addition of spirit or any other substance. The only precaution necessary is to keep them in bottles, perfectly filled and hermetically sealed.[360] Our own plan is to put a few bruised cloves or seeds of black mustard into the bottles, which must be only 2-3rds filled, then completely fill them with a condensed atmosphere of carbonic acid gas; and, lastly, to stopper them and seal them over, so as to perfectly exclude the air. A pint of decoction of sarsaparilla and 1/2 pint of infusion of calumba, treated in this way, kept good for fully 9 years. By simply macerating in the infusion as much bruised mustard seed as can be added without flavouring the liquor, along with a little bruised cloves, we find that most vegetable infusions may be preserved in bottles which are occasionally uncorked, without either fermenting or becoming mouldy, by the use of very little spirit (1/9 or 1/10).

[Footnote 360: 'Pharm. Journ.,' i, 57.]

Before adding the spirit to infusions made with cold water, or with water which is only tepid, it is advisable to heat the liquid to about 185 Fahr., in a water bath, and after keeping it at that temperature for a few minutes, and allowing it again to become cold, to separate it from the precipitated matter, either by filtration or decantation.

It is often very difficult to render vegetable infusions and decoctions perfectly transparent, a quality always expected in the concentrated preparations. Defecation by repose is always better than filtration, owing to the more or less viscidity of the suspended matter. When this is not sufficient, they may be clarified with white of egg (2 or 3 to the gall.), previously beaten up with 5 or 6 fl. oz. of water. Most of the vegetable infusions and decoctions will readily pa.s.s the filter, after a very small quant.i.ty of acetic, nitric, or sulphuric acid has been added to them. The most obstinate may be rendered 'brilliant,' or 'candle bright,' as the 'cellarmen' call it, by shaking them up, first with about a drachm of dilute sulphuric acid, and afterwards with the whites of 3 or 4 eggs, previously mixed with a few ounces of water, for each gallon of the liquid. This plan is, however, objectionable for many medicinal preparations.

As many infusions which are occasionally employed in medicine must necessarily escape being separately noticed in this work, it may be as well to remark that the infusions of all vegetables that do not exert a very powerful action on the human frame as ordinary herbs and roots may be made by pouring 1 pint of boiling water on 1 oz. of the vegetable matter, and allowing it to macerate for 1/2 an hour to an hour. The decoctions of the same vegetables may be made by simply boiling the above ingredients, in the same proportions, for 10 or 15 minutes, instead of operating by mere infusion. With substances of somewhat greater activity, only half the above quant.i.ty should be taken; whilst, with the narcotic plants and those possessing great activity, 1 to 2 dr. to water, 1 pint, will be the proper quant.i.ty. The ordinary dose of such infusions and decoctions is 1/2 to 1 wine-gla.s.sful (1 to 2 fl. oz.), two, three, or four times a day, as the case may indicate.

Infusion is preferred for all bodies of a delicate texture, which readily yield their active principles to water; and especially when these are either volatile or liable to be injured by the heat of ebullition.