He observed in a number of children the clinical symptoms of an acute intestinal catarrh coming on suddenly during full health which led to the passage of spurting movements of a light yellow- color with a slight greenish tinge, and less often to the production of a flocculent slimy diarrhcra of small masses of mucus expelled with tenesmus. These cases always ran a favorable course. Microscopic examination show-ed in preponderance fat globules, fat crystals, fatty soaps, glairy mucus, intestinal epithelium and in two cases there were also numerous leu cocytes. Cover-glass preparations stained by Weigert's method showed, instead of the normal bacteriologic picture, only occasional bluish black bacilli, and in every field numerous (lark blue-stained clumps of staphylococci and a few somewhat larger cocci, also Gram-staining and arranged in pairs of short chains. Cultures from the stools gave the characteristic colonies of the aureus and albus, which showed no patho genicity toward animals. The same species were to be found more or less abundantly in the milk of tbe nurse. An experiment of Moro's on a child seems to me e.specially significant. When a child of previously normal digestion was put to the breast of a nurse in whose milk numer ous staphylococci were found, it promptly reacted with dyspeptic movements showing the characteristic bacteriologic finding.
Rosthorn briefly reports an epidemic of intestinal catarrh, also in purely breast-fed infants, observed in the Heidelberg lying-in hos pital, in which epidemic a staphylococcus was found in the stool,.
These observations were not so free from objection as those of Moro, because in the first place the patient showed various skin affections with the consequent possibility of infection from another source, and in the second place the microorganisms were not demonstrated in the milk.
Nevertheless, such eases suffice to point out the possibility- of the occurrence of diseases of nutrition after taking breast-milk contami nated from without by suppurating organisms derived from the nipple, and point the way toward prophylaxis. We should retain the custom of rejecting the first portions of milk and of carefully cleansing the nipple before putting the child to the breast, a custom which was form erly general, but which has lately been largely considered superfluous. The same consideration will cause us to forbid further nursing from an inflamed breast, which is also prohibited for other reasons pertaining rather to the nurse.
The treatment of such infections is relatively simple. When there are severe enteric symptoms, we put the child on a water or weak tea, diet for 12-24 hours, and in the meantime treat the breast by repeated mechanical emptying and by careful cleansing of the skin with corro sive sublimate, alcohol and ether. If this does not. bring about a marked diminution or a disappearance of the bacterial content of the milk, we seek a. better qualified nurse. For the diarrhma, Moro recommends rice jelly, to every 50 grams of which a gram of tincture of opium is added, and gives a teaspoonful of this mixture every two hours.