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MILK, Human. This liquid has a specific gravity of 1028.34, and contains water, 87.4; total solids, 12.6; fat, 3.4; albuminoids, 1.2; sugar, 7.0; ash, 0.2. It is slightly alkaline, is sterile and differs mainly from cow's milk in being sweeter and having less fat and casein. Its fat is more fluid and the casein is more readily dissolved. Cow's milk is frequently acid and its casein is often digested with difficulty. Experience shows that an infant should, if possible, be nursed during the earlier months of its life, for human milk is usually adapted to the digestive powers of infants. Its alkalin ity, its temperature (98°-100° F.), its chem ical constituents aid the development of the child. But poor health of the nurse, mental emotions, improper food or deranged diges tion of the infant may prevent natural feeding or require its cessation. It is an interesting fact that the demands of the nursing infant have a great influence upon the quantity of mother's milk. Thus a wet nurse feeding two infants produced 720 grams, but this quantity increased to 1,750 grams when it becomes neces sary for her to nurse five. In human milk there is a great variability in the fat contained, while the globules are more numerous in hu man than in cow's milk. The effect of varia tion of food upon the composition of human milk is doubtful, with the exception that when the mother is undernurtured, her consumption of fat will increase the fat in her milk. but when fat is fed to well-nurtured mothers the fat in their milk increases only temporarily. It is therefore concluded that only a dimi nution of food can permanently affect the fat in human milk. The effect of some drugs is seen in the mother's milk. Traces of alcohol have been found in the milk of mothers after they have drunk to excess. In cases where the mother is syphiletic, the injection of salvarsan has produced an excretion of it in her milk and in these cases the child which has also the disease is sometimes improved but has in other cases died. Immunity to certain diseases is thought to be secured through the mother's milk, from the fact that typhoid fever, mumps, scarlet fever and measles are not usually con tracted by nursing infants.

If it is impossible for any reason for the mother to nurse her own child, and a suitable wet nurse cannot be obtained it is quite easy for the physician to direct the making of a modified milk from cow's milk which shall have almost the same properties as human milk, this is secured by the removal of the cream or a part of it and mixing it with the proper proportion of the skimmed milk and with milk-sugar. Often a small amount of

lime water is added to offset the greater acid ity of cow's milk. For this modified milk it is imperative that the cleanest possible raw milk be had, as pasteurization of the milk re moves some of the requisite qualities and that the cream be "gravity cream," i.e., 'be not re moved by a separator which produces so-called "Centrifugal cream." With modified milk pre pared in this way under the direction of a physician experienced in infant's diet the child may be brought up to he quite as healthy as those fed at the breast. The formula of milk, cream, sugar of milk and lime water will he changed from week to week as the child in creases in weight and the sugar of milk and lime water gradually diminished until the in fant's digestion is trained to take unmodified cow's milk.

The living on milk alone, or mainly, for weeks is a recognized form of treatment in obstinate hysteria, hepatic conges tion, dropsy and various disorders of nutrition. The amount of • milk taken is gradually in creased, beginning at about four ounces every three hours. When used exclusively, two or more quarts are ordinarily consumed daily. When the taste of milk becomes disagreeable, salt, coffee, bread, arrowroot, cocoa, rice, etc., may be added as the attending physician decides. The sole use of milk for a length of time may increase the frequency of the pulse, stimulate the kidneys to undue action, coat the tongue and produce obstinate constipation. It is not a cure to be undertaken without the supervision of a physician.

(called ephemeral fever when the symptoms disappear very quickly) is a febrile state, the temperature reaching 102° F. or over, occurring in the mother usually two or three days after delivery, considered to be connected with the beginning of the milk sun ply. It chiefly affects those in a feeble condi tion or under- or over-fed, or in whom the milk-ducts have not been freed by early lacta tion. A chill may induce it. It occurs in the lower animals as well as in the human being. It begins with rigors, which are followed by headache, pains in the limbs, fever, swelling and tenderness of the breasts (going on, it may be, to abscesses), and sweating, when the symp toms abate. Pain is to be relieved by hot-water bottles, breasts to be emptied, bowels moved by salines and fever reduced by diaphoretics; other medicines may be necessary. Owing to antiseptic obstetrics and great care as to hy gienic measures, milk-fever is nowadays com paratively rare. If not relieved promptly by medical skill, it may prove a dangerous disease.