As to Dr. Green’s statement, “Modified milk” is a very general term. What is usually meant is milk with a high percentage of fat and a low percentage of sugar, while malted and condensed milk have a high percentage of carbohydrate. In my opinion, if he had used cow’s milk without the addition of cream and with large amounts of cane sugar, he would not have had this trouble. But a large number of children will not do well on this diet. We have special rules for abnormal children with exudative and nervous diathesis.
In reply to Dr. Fleming’s question regarding the mother’s diet and its effect on her milk: What the mother eats has absolutely no effect on the composition of the milk in any way whatever, except perhaps in the percentage of fat. Now-a-days we do not advise any particular foods for the mother’s diet,—anything she likes, and can digest, plus large quantities of fluid;—otherwise there is no single food we advocate—none that will make the milk richer or better, or increase the quantity.
I cannot agree with Dr. Jensen that raw milk is so far superior to boiled milk. Of course, wherever it is possible, we should use certified milk, which does not require boiling; but, if we have inferior cow’s milk contaminated with bacteria, we can boil the milk with very little harm. It is just as well digested, and the food value just as great. There is of course slight danger of scurvy; but that is very easily diagnosed, and very easily cured by a little fresh milk or small doses of orange juice. Where we have inferior milk, it should be boiled in every case.
Dr. White brought up a very interesting point in regard to nervous mothers. Their milk supply is subject to wide fluctuations; but, if the breasts are well emptied at each nursing, they will secrete sufficient milk. I will admit that these cases are difficult to handle, for the infants usually have nervous diathesis, and do not respond well to ordinary food. The one important point is to completely empty the breasts; and that is the only measure we can take to increase the supply of milk.
In reply to Dr. Aurand: I would feed a new-born infant 200 c.c. at a feeding if the milk is sufficiently diluted. The liquid part of the food passes very quickly into the duodenum, so that, before the infant has finished feeding, a part of this quantity has already left the stomach.
In conclusion: We have an opportunity in our infant-feeding to practice the really scientific prophylactic medicine of the future. We can do more in preventing infant-mortality by proper feeding than by any other single measure; and we should encourage mothers to bring their new-born infants to the physician for advice on feeding, and to continue to consult him at longer or shorter intervals during the whole of the first year of life.
THE INEBRIATE [2]
By George H. Freeman, M. D.
Superintendent of the Minnesota State Hospital for Inebriates
WILLMAR, MINNESOTA
[2] Read at the 46th annual meeting of the Minnesota State Medical Association, St. Paul, October 1 and 2, 1914.
The Minnesota Legislature of 1907 passed a bill establishing the Hospital Farm for Inebriates, placing its management under the State Board of Control, and providing for its maintenance by setting aside 2 per cent of the saloon-license money for that purpose. Later, a law was enacted providing for the issuance of certificates of indebtedness; and active construction work soon commenced. The Hospital was opened on Dec. 26, 1912, with Dr. Tomlinson, formerly Superintendent of the St. Peter State Hospital, at its head. Through his untimely death, five months later, Minnesota lost one of her most faithful officials. The principles underlying the work at Willmar, are, with but slight change, those that he so earnestly advocated.