anointing the stomach with a composition in great part of tar and garlic, or by amulets. They are ashamed to confess to the doctors that such means have been employed. In the better classes, where every family has a doctor, the female practice is of very little consequence, but in the country the doctors are few.

We have no observations calculated for the different classes of society, because the differences of the classes are not really so great. We have nobles in all occupations of life; we have no manufacturing districts comparable with the English or those of other countries; but the difference between the town, especially the large town, and the country population, has an important effect on the mortality of children. The influence of zymotic diseases seems to afford as great variability of the rate of mortality in the towns as in the country. I give you specimens of mortality from Stockholm, where the contagious diseases have a good soil, and where the great number of illegitimate children (about 40 per cent.) must augment the mortality; also from the Isle of Gothland, and from the province of Jemtland, both the most isolated provinces. But it is to be remarked that our peninsula has in the last years been severely visited by scarlatina, measles, and diphtheria. There is also in different places a great variation in the absolute number of the classes of different ages and the influence of this difference is very great on the population of Stockholm, composed to a considerable extent of a number of immigrants above 15 years. For the mortality in the whole of Sweden see the table of mortality and the diagram in the Report for 1856-60, A. II, 3. On the diagram No. 2, the mortality is marked by asterisks; but it must be observed that the first asterisk is erroneously placed, and may be corrected to 8,565 entering in the second year.

Amongst the causes of death the suffocation of infants sleeping in the same bed as the mother or wetnurse has attracted much attention. One of the reasons for recommending the use of the so called "wattje," a kind of basket made of twigs, was to prevent the mother from laying the baby close to her side and pressing it when falling asleep. Now it is well known that spasmus glottides greatly augments the number referred to sudden deaths, which are reported still to be about 160 a-year. In the years 1861-63 together, we have lost in Sweden 4,461 from scarlatina, 10,441 from measles, and 7,607 from diphtheria and croup consisting principally of children from 2 to 9 years. About 100 children a-year are burned and scalded by faults of the mothers leaving them alone near to fire or boiling fluid, &c. About 200 children a-year are drowned, for the most part from carelessness when going in boats, or bathing, or on the ice.

FRANCE.

By M. LEGOYT, Chief of Statistical Department in the Ministry of Agriculture, Commerce and Public Works.

Traitement des Enfans en bas Ages.

Il continue à être déplorable, surtout dans les campagnes. Les femmes s'y occupant des travaux des champs, presque autant que

les hommes, et, par conséquent, étant obligées de faire de longues absences, non-seulement emmaillotent leurs enfans, mais encore les attachent à leurs berceaux, de manière à leur interdire tout mouvement.

Les sages-femmes sorties des écoles d'accouchement, combattent vainement cette pratique barbare; leur influence dans ce sens a été à peu près nulle jusqu'à ce jour, l'intérêt des parens paralysant toute tentative de réforme.

Mais ce n'est pas là la cause principale de la mortalité considérable de nos petits enfans, on peut encore l'expliquer par les faits ci-après :

Un très-grand nombre d'enfans des villes ne sont pas nourris par leurs mères, mais bien par des nourrices des campagnes qui donnent de préférence leur lait à leur propre enfant et font avaler de très-bonne heure à leur nourrisson d'affreuses bouillies que leur estomac et leurs intestins ne peuvent digérer. De là des inflammations auxquelles un grand nombre succombe. Ces enfans ne sont, d'ailleurs, l'objet d'aucun soin de propreté; ils croupissent dans leurs ordures, ne sont que très-rarement lavés et changent plus rarement encore de linge. En cas de maladie, le médecin n'est le plus souvent appelé (je parle toujours des enfans élevés dans les campagnes) qu'à la dernière extrémité, et presque toujours trop tard. Sous ce rapport, et le nourrisson et l'enfant de la nourrice sont soumis au même et déplorable régime.

Joignez à cela que les habitations de la plupart de nos paysans sont malsaines, que le jour et l'air n'y pénètrent que difficilement, que les lits, fermés par d'épais rideaux, ne sont presque jamais ventilés; que les planchers sont souvent en terre battue, et, par suite, les chambres froides et humides, condition déplorable quand les enfans sont atteints de fièvres éruptives. Enfin, les fumiers et les mares destinées à l'abreuvage des bestiaux sont le plus souvent dans l'extrême voisinage de l'habitation, où il n'est pas rare, en outre, de trouver confondus les hommes et les animaux. Cet état de choses domine surtout dans nos départemens du centre et de l'ouest, où l'aisance a encore le moins pénétré.

Non-seulement, dans nos campagnes, le médecin est rarement appelé en cas de maladie des enfans (et des adultes également), mais il est rare que le traitement (surtout s'il est coûteux) et le régime soient suivis. Quoique malades, les enfans continuent à être nourris comme par le passé un lait insuffisant et de la bouillie s'ils ne sont pas encore sevrés; une mauvaise soupe, du pain noir et dur, et des fruits verts ou gâtés. J'ai vu quelquefois des enfants atteints de la rougeole, et dans le paroxysme de l'éruption, exposés, dans la cour de l'habitation, à la pluie et aux vents, et mangeant de ces abominables fruits.

Les prétentions des nourrices augmentant sans relâche, beaucoup de mères de famille qui ne peuvent plus faire nourrir leurs enfans dans les campagnes, se décident, si elles n'ont pas de lait, ou si elles sont obligées d'aller travailler au dehors, à recourir au biberon, c'est à dire, au lait de vache; or il est d'expérience commune que les trois quarts des enfans ainsi nourris, succombent en peu de temps.

C'est parce que les administrations hospitalières, en France, ne

Années.

trouvent plus de nourrices, que leur enlève la concurrence des familles
aisées des villes, qu'elles sont obligées de faire nourrir au biberon un
grand nombre des 30,000 enfans trouvés ou abandonnés qu'elles
recueillent tous les ans ; or la mortalité de ces malheureux petits
êtres est de plus de moitié!
Elle n'est que de 29 p.c.
pour les enfans pauvres que leurs mères consentent à garder et à
nourrir elles-mêmes, moyennant un secours annuel.

Enfin, nous avons, en France, un grand nombre de naissances
illégitimes (quoique beaucoup moins cependant que dans d'autres
Etats Européens); eh bien! les enfans mis au monde dans cette
triste condition, ont une bien moindre viabilité que les légitimes, soit
parce qu'ils apportent en naissant le germe de maladies graves, fruit
ou des désordres ou des privations de la mère, ou de ses tentatives
d'avortement; soit parce qu'ils manquent des soins qu'exige leur
faiblesse, les mères appartenant, pour la plupart, aux classes les moins
aisées de la société, et étant généralement abandonnées par les
séducteurs, lâcheté qu'encourage notre législation civile en interdisant
la recherche de la paternité.

Voilà, mon cher Farr, les seuls renseignemens que je puisse vous donner, au courant de la plume, et sans y avoir suffisamment songé, sur les principales causes de la mortalité enfantile en France.

Cette mortalité qui est, d'ailleurs, en voie de diminution, est d'autant plus sensible en France, que la fécondité générale de notre population est de plus en plus faible et qu'elle ne s'accroîtra bientôt plus. Dans cinquante ans, si l'état actuel des choses continue, elle sera peut-être stationnaire.

Actes d'Adoption soumis à l'Homologation des Cours Impériales.

AUSTRIA.

By DR. HERZ, Assistant Physician to the Vienna Foundling Institution.

In general, it must be mentioned, that the wide differences in the social position of parents influence the education and the principles therein employed in no smaller degree here than in your country, so that the higher classes follow a more or less rational way in bringing up their children; whilst in the lower classes it is very badly done, partly on account of ignorance, and partly on account of the poverty of the people. Some difference also exists in the management of town children and those in the country; the former being, on the whole, better managed, on account of the higher intelligence of the town inhabitants; whilst, again, these advantages may be somewhat counterbalanced by the residence in the crowded, and therefore unhealthy, towns. I am very sorry that time does not permit me to collect some details on this subject, but I feel sure that the difference of these conditions in England and in this country would not be a very wide one.

You may be aware that the obstetrical practice in this country, as almost in all Germany, is in the hands of midwives (Hebammen), medical men are only sent for in somewhat severe and complicated cases. These females, before being permitted to practice, have to attend a theoretical-practical course of lectures, lasting half a-year, in one of the public obstetrical schools, and to undergo a strict examination. In spite of these measures the midwives prove to be a principal source of many abuses, fibs and superstitious customs regarding children. These midwives are also in the possession of the most wonderful nostrums; they cure the newborn, and like especially to purge them, even to death; and I do not exaggerate in stating that many hundreds of children die annually in this country by the perverse means of these female doctors.

The majority of our children are suckled, a small part of them by their own mothers, a greater part in Vienna by wetnurses. In the better ranks of society it is now a common practice for the mother not to suckle her own offspring, while of course the wife of the working man is prevented from fulfilling this maternal duty by the necessity of working for her livelihood out of doors. The former hire wetnurses, the latter feed their babies artificially.

With regard to wetnursing we do not send our children to the country, as they do at Paris and in other towns of France, but we take the wetnurse as a kind of servant to our house. The public foundling institutions of the metropolis and of other provincial towns procure, for private families, trustworthy wetnurses, whom the medical officer of the day, after a thorough and repeated examination has found and testified to be quite healthy and fit for that task. The family in want of such an individual pays a certain sum to the institution (for Vienna it is about 3l., in other places half of that), and may choose the wetnurse they would like best. In order not to be misunderstood, I must add, that only unmarried females are received in our public lying-in hospitals, where they are delivered and their children are cared for in the foundling institutions, quite free

of expense, until they attain their seventh year. These females have, however, if they are fit, to remain for a certain time at the foundling institution, where they suckle, besides their own children, some other, weak or sick one, whose mother has not been found fit for this task. If they do not wish to enter private houses as wetnurses, they are dismissed after about three months' time.

The babies are generally suckled for six to nine months, or even a year, and I know also cases in which foolish mothers suckle them for two or three years; in most houses the children do not get any other food during this period, in other families the children are accustomed to soup, or rather beef-tea, light milk diet, &c., besides the breast milk, and then get exclusively the above-mentioned articles of food.

With regard to artificial feeding of children, much peccatur extra muros et intra. The better classes, it is true, by the directions of their medical advisers, give to their babies an equal and nourishing food, consisting mainly of cow milk, arrowroot cooked in milk, &c.; in the lower classes, they give to them different stuff pêle-mêle, and, as I know from my experience in the children's hospitals of this town, sugar-water and the different medical teasorts play a most important part amongst these dietetics. This part of popular knowledge is dreadfully neglected amongst the lower ranks; and, from my own experience, I must certify that the majority of diarrhoeas, so frequent and so fatal during the first period of life, are chiefly caused by the neglect of the elements of hygiene. In the later periods of childhood, also, no care is taken regarding a somewhat rational selection of the food, and everything the grown up people eat, is also thought fit for the children, and even babies. So, in many country districts, where brandy and strong liquors are much in use, the children, and even the youngest ones, get spirits, of course not to the advantage of their health. I may, however, be permitted to mention that opiates for quieting restless children are very little used by the parents, or at least not nearly as frequently as it is done (according to official reports), in some parts of England; sometimes only, syr. papav. or syr. diarolii is bought here by the mothers for that purpose. One of the greatest blessings for the lower, and especially for the labouring, classes, proves to be the "Crêches," erected and supported chiefly by voluntary subscriptions, in large and industrial towns; the children are received during the day time, and kept and boarded for a trifling payment (about d-id. a-day). Our city has now eight such places, where several hundred children are daily received. Of the highest utility are our childrens' hospitals (for Vienna, we have two large ones), not only for the care and comfort the sick ones find there, but especially because the parents are instructed how best to treat and keep their healthy offspring. Of an equal importance is a third kind of institution, I would call them dispensaries for diseases of children ("Oeffentliche Kinder-Kranken Institute"). There are now six or seven in Vienna, where the sick children get medical advice and the drugs gratis (at the public expense).

The dress of our babies consists generally of a knitted light cap, a linen shirt extending down to the knees, and over that a short