under way. Moreover the fat does not perfectly emulsify. The defects of sterilized milk as furnished by laboratories for infant-feeding may be inferred from the above, but the sterilization itself does harm in the following ways:

1. It melts the fat and destroys the emulsion.

2. It dehydrates and partially decomposes the sugar.

3. It coagulates the albumin and globulin, and alters the composition of the caseinogen.

4. It destroys nuclein and lecithin, converting the organic into organic phosphorus which is lost in the feces.

5. Children fed exclusively upon sterilized milk become rachitic. 6. It is unnecessary, as the pasteurization temperature of 155° F. is sufficient to destroy all germs except the tubercle bacilli.

The writer has prepared for the use of mothers directions for preparing an infant's food, in which so far as possible the defects of other infant's foods have been remedied.

Siphon off from the bottom of a bottle of good fresh milk threefourths of its contents, leaving the milk and cream at top undisturbed. The skim-milk should be placed in a double boiler; add to it a teaspoon and a half of essence of pepsin, warm in a boiler slowly to blood heat, and keep at that temperature until well curdled. Heat, with constant stirring to 155° F., then remove from fire; strain, while hot, through wire strainer, and dissolve in the whey a heaping teaspoon of sugar of milk and the white of one egg. When cold, pour the sweetened whey back into the milk bottle and mix thoroughly with the milk and cream. Pasteurize the mixture in a Freeman's pas

teurizer.

If this food prove too laxative, decrease the amount of milk-sugar. It is well to add, at time of feeding, one or two teaspoons of limewater to each meal.

As the child grows older, less bottom milk may be siphoned off. This food has given uniformly good results.

Use of Opium in Infancy, seen in Adult Life.

T. D. CROTHERS (Jour. Amer. Med. As., May 19, 1900) says that the danger of opium as a remedy in infancy has only recently been recognized, even a text-book speaks of the action of even continued doses as transient. The various tinctures and infusions are household remedies, and herein lies the great danger, for the administration of the drug is continued long after the trouble which called for the initial

dose has passed. Opium and its alkaloids seem to have two distinct effects on the nerve-centers and organism of infancy. Cell functions and growths are retarded and finally changed. In some cases the symptoms of stupor and quietness go on to lessened mental vigor, mental perversion and even imbecility in later life. In other cases there are extreme irritability and tendencies to morbid impulses, almost beyond control. Two children of a noted missionary were nursed by a Hindoo woman, who was afterward found to be an opium-taker. The children, as infants, were more quiet and sleepy than children usually The daughter grew up extremely nervous, and although an accomplished woman of fine character, began suddenly, when 24 years old, to use both alcohol and opium to excess. The history of the son was similar. Two other children in the family, who did not nurse this Hindoo, are strong and healthy in mind and body. The writer cites the case of five children in one family, who became addicted to alcohol and opium by the time they were 20 years of age. The parents were total abstainers, and the home life all that it should be. It was found that from earliest infancy and throughout childhood the mother had been in the habit of giving laudanum and paregoric for all sorts of ills, sometimes continuing the use of the drug for several months at a time. The writer has investigated the history of a large number of alcohol and opium habitués, and in at least ten per cent. there was a history of more or less drugging with opium in infancy. Nor are these pronounced habits the only result. Nervous dyspepsia, profound exhaustion from slight overwork or excitement, degeneracies appearing after puberty or in early manhood, may in numerous instances be traced to the same cause.

In other cases the disturbances of nutrition, retarded growth, anæmia, and kindred disorders are more pronounced than the mental disturbances. Not only are mothers offenders in this matter, but the thoughtless physician who uses opium freely in infantile prescriptions is responsible for many wrecks in later life. Inquiry brings out this cause with great frequency.

THE

AMERICAN GYNECOLOGICAL

AND

OBSTETRICAL JOURNAL.

AUGUST, 1900.

THE UTILITY OF A CERTAIN CHART FOR THE DETERMINATION O FPELVIC ASYMMETRY FROM A SIMPLE METHOD OF EXTERNAL PELVIMETRY.*

BY PHILANDER A. HARRIS, M.D., PATERSON, N. J.

Pelvimeter.

I employ the pelvimeter shown you in Fig. 1, and which I devised several years ago. Although graduated in centimeters, the centimeter marks are so widely separated that it is possible to read fractions of a centimeter, even to two-tenths of a centimeter. The points are not spherical or conated, as is usual with pelvimeters, but they are diskshaped. The disks are held between the thumb and a finger of each hand and pressed firmly but not painfully upon the patient and the distance read during the application.

Method of Measurement.

1. Apply the disks of the pelvimeter at those points on the outer side of the iliac crests where I can effect the greatest diameter.

2. Locate the two anterior-superior iliac spines and place the disks of the pelvimeter on the outside of each, but very near the anterior termination of processes.

3. Place one disk of the pelvimeter in the median line at the lumbosacral junction and the other at the most prominent anterior point of the pubes. By the most prominent point is meant the point at which the greatest diameter is obtainable.

All measurements are made with firm but not painful pressure of the disks of the pelvimeter during the reading.

*Read before the American Gynecological Society, Washington, D.C., May 3d, 1900.