through a quill. The mother after a premature confinement is almost sure
to have no milk with which to nourish her child, at any rate for two or
three days. It is, therefore, wise to obtain the help of a woman with a
healthy baby. She must be allowed to bring her baby with her, since
otherwise her supply of milk would fail, especially if she had no other
means of getting rid of it than by the breast-pump or by drawing her
breast. Even though she may have her own baby, there are few women who
can submit, for more than a very few days, to the artificial emptying
their breast without the secretion being either greatly lessened or
altogether arrested. This, therefore, must be regarded as a resource
available only for a few days, and as the child gains strength every
effort must be made to get it to take its mother's breast, if she has
any supply, or that of the wet-nurse. If this is found impossible, it
will be wisest to give up, at any rate for the present, the attempt to
nourish the child from the breast, and to obtain for it asses' milk,
which is the best substitute. By no means whatever can more than from a
sixth to a fourth part of a pint of milk be obtained either by the
breast-pump or by drawing the breast; and since a healthy infant of a
few weeks old sucks about two pints of milk in twenty-four hours, it is
evident that the supply artificially obtained must after the first few
days be utterly inadequate.

I have in cases of extreme weakness in premature children succeeded in
preserving them by giving them every two hours for two or three days ten
measured drops of raw beef juice, five of brandy, and two teaspoonfuls
of breast milk. Medicine has no place in the management of these cases;
the question is one entirely of warmth, food, and for a time the
judicious use of stimulants.

=Imperfect Expansion of the Lungs.=--Children not premature and
perfectly well nourished are yet sometimes feeble, breathe imperfectly,
cry weakly, suck difficultly or not at all, and die at the end of a few
days. Their lamp of life flickered and went out. Such cases are met with
for the most part in conditions similar to those in which children are
actually still-born; or now and then they take place when labour has
been of unusually short duration, the child hurried into the world too
rapidly; while in other instances it is not possible to account for
their occurrence.

For a long time the nature of these cases was not understood; but