“CAUSES OF MORTALITY IN HAND-FED CHILDREN.--Much of the mortality following hand-feeding may be traced to unsuitable food. Among the poorer classes especially there is a prevalent notion that milk alone is insufficient, and hence the almost universal custom of administering various farinaceous foods, such as corn-flour or arrowroot, even from the earliest period. Many of these consist of starch alone, and are therefore absolutely unsuited for forming the staple of diet, on account of the total absence of nitrogenous elements. Independently of this, it has been shown that the saliva of infants has not at first the digestive action on starch that it subsequently acquires, and this affords a further explanation of its so constantly producing intestinal derangement. Reason, as well as experience, abundantly proves that the object to be aimed at in hand-feeding is to imitate as nearly as possible the food which nature supplies for the newborn child, and therefore the obvious course is to use milk from some animal, so treated as to make it resemble human milk as nearly as may be. “ARTIFICIAL HUMAN MILK.--An admirable plan of treating cow’s milk, so as to reduce it to almost absolute chemical identity with human milk has been devised by Professor Frankland, to whom I am indebted for permission to insert the receipt. I have followed this method in many cases, and find it far superior to the usual one, as it produces an exact and uniform compound. With a little practice nurses can employ it with no more trouble than the ordinary mixing of cow’s milk with water and sugar. The following extracts from Dr. Frankland’s work will explain the principles on which the preparation of the artificial human milk is founded: ‘The rearing of infants, who can not be supplied with their natural food, is notoriously difficult and uncertain, owing chiefly to the great difference in the chemical composition of human milk and cow’s milk. The latter is much richer in casein, and poorer in milk-sugar than the former, whilst asses’ milk, which is sometimes used for feeding infants, is too poor in casein and butter, although the proportion of sugar is nearly the same as in human milk. The relation of the three kinds of milk to each other are clearly seen from the following analytical numbers, which express the percentage amounts of the different constituents: Woman. Ass. Cow. Casein 2.7 1.7 4.2 Butter 3.5 1.3 3.8 Milk-sugar 5.0 4.5 3.8 Salts .2 .5 .7 These numbers show that by the removal of one-third of the casein from cow’s milk, and the addition of about one-third more milk-sugar, a liquid is obtained which closely approaches human milk in composition, the percentage amounts of the four chief constituents being as follows: Casein 2.8 Butter 3.8 Milk-sugar 5.0 Salts .7