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103
This work has been carried on for some considerable time in
the laboratory, and shows how impossible it is to expect children to
thrive on milk of such quality. One so often finds in these cases
the amount of milk secreted is adequate and a test feed reveals
nothing as to the real nature of the trouble. The majority of these
analyses are on 24-hour specimens, either taken from alternate
breasts as alternate feeds, or else the child is put on the bottle for
24 hours and the breast pumped. One of the striking things one
finds is the frequent difference in the cream content and actual
output of the two breasts.
In the case of the very high cream content in most of these
cases the amount is small.
One of the satisfactory things is that one is able to demonstrate
to the mother the necessity of making efforts to improve matters,
and further one finds that this particular work enhances the reputation
of the clinic, in that the mothers feel that what is done for
them is done on some basis of scientific understanding; which
differs markedly from a case at the other extreme, in which a
mother who had recently come into the district, reported with regard
to the difficulty of a wasted baby, that she had been given
samples which were on the doctor's table and was told to "try
these and see which suits." Despite the enormous increases which
have been made in recent years in teaching the student to deal with
infants, there seems to be still in tihe minds of the educating
and examining bodies a want of proportion in the teaching which
is necessary to a student before he qualifies. From the point of
view of general practice it does not seem to be sufficiently realised
that the most important person in the house is a sick infant, and
that if the doctor attending exhibits a real understanding of the
child his future attendance, as far as the child and mother are
concerned, is secured. She is as a rule far more concerned about
her infant than she is about herself. Further, there is still another
point which is not dinned into students sufficiently, which is that