the jaundice. This gives rise to great distress to the parent when she perceives it, and she becomes very anxious for the medical man's next visit. Now, or

dinarily, it is of no consequence; commonly disappearing spontaneously, and requiring no medical treatment. If, however, it does not go off in two or three days, a tea-spoonful of castor oil should be given once, or oftener if necessary.

It is, of course, possible for an attack of real jaundice to occur at this early period, and a disease of a very serious nature will then have to be dealt with; but, except as a consequence of malformation (a very unfrequent occurrence), it is not likely to arise; and therefore, jaundice during the first and second week after delivery need not, as a rule, create alarm.

Sect. 6.-Retention of Urine and Motions.

Occasionally an infant will not pass any urine for many hours after its birth. This most frequently arises from the fact of none being secreted. In the last case of this kind that I was called to, three days had elapsed since birth, and no urine had been passed; it proved that none had been secreted. Sometimes, however, it is the effect of another cause, which the use of the warm bath will be found to remove, which should always therefore be employed four-and-twenty hours after the birth of the infant, if it has not by that time passed any water.

It now and then happens, but fortunately very rarely, that some physical obstruction exists. It is always important, therefore, for the nurse to pay attention to the above point; and it is her duty to direct the attention of the medical man to the subject, if any

The same ob

thing unusual or unnatural be present. servation applies to the bowel also; and if twelve hours pass without any motion, the parts should be examined.

Sect. 7.-Swelling of the Breasts.

At birth, or two or three days subsequently, the breasts of the infant will frequently be found swollen, hard, and painful, containing a fluid much resembling milk. Some nurses endeavour to squeeze this out, and thus do great mischief; for by this means inflammation is excited in the part, and sometimes abscess is the result.

If the breasts are simply slightly enlarged, it is unnecessary to do anything more than rub them occasionally and very gently with warm almond oil, and in a little time they will be restored to their proper size.

If, however, they are inflamed, hot, painful, with a red surface, and unusually large, a bread-and-water poultice must be applied every three or four hours, which will generally prevent either the formation of matter, or any other unpleasant consequence. In a few days, under this treatment, they will usually subside, and be quite well.

Sect. 8.-Inflammation of the Eyes.

I only desire, in mentioning this complaint, to inform the attendants of the lying-in room of its great importance that it may not be trifled with, that upon its first approach the physician may be informed of it, and that the treatment he directs for its cure may be sedulously and rigidly followed.

The inflammation commonly comes on about three

days after birth, but it may take place at a later period. It may be known by its commencing thus :—When the child wakes from sleep, the eyelids will be observed to stick together a little; their edges will be redder than natural, and especially at the corners; the child experiences pain from the access of light, and therefore shuts the eye against it. A little white matter will also be observed lying on the inside of the lower lid. After a short time, the lids swell, become red on their external surface, and a large quantity of matter is secreted, and constantly poured from the eye; the quantity of discharge increasing until it becomes very great. But enough has been said to point out the importance of the disease, and the signs by which it may be recognised at its first approach.

Keeping the eye free from discharge, by the con.stant removal of the matter secreted, is what the medical attendant will chiefly insist upon, and unless this is done, any treatment he may adopt will be useless; with it there is no doubt of a successful issue of the case, provided his attention has only been called to it at a sufficiently early period.

Sect. 9. Hare-Lip and Cleft-Palate.

This is a blemish too well known to require a formal description. The questions most interesting to a mother in relation to it are :-How does it affect the child's feeding? And when ought the operation for its relief to be undertaken?

Hare-lip most frequently affects the upper lip, though it may occur very rarely on the lower lip. It may or may not be complicated with a cleft in the roof of the mouth. When simple and in its slighter forms

it seldom interferes with the child's sucking, but when the roof of the mouth participates in the deformity, there will be greater risk of the child not being able to suck properly. In its least degree it occasions considerable. deformity, but fortunately it is one which the surgeon can easily remedy. And it is desirable, provided the child be healthy and well, to have the operation done within the first six months, so that it may be well over before the child begins with its teeth. When carefully done, the operation is neither a long one nor a dangerous one. As a rule, I would advise its performance at about the fourth month. But should the infant experience any difficulty in sucking, and should there be any appearance of mal-nutrition as a result, then I would advise the operation at a still earlier age.

In complicated cases, where the cleft exists on both sides, I would advise a consultation with the medical attendant, as the course to be adopted will vary in individual cases.

Cleft-Palate. This deformity consists in a cleft along the roof of the mouth. As in the case of the hare-lip, so here also there are varying degrees. In the slightest forms, the uvula alone is cleft-next, the cleft may involve the posterior half of the palate (i.e., the soft palate), or it may extend forward to the teeth, or, as said in the last paragraph, it may involve the lip also. This deformity is now-a-days easily remedied in a large proportion of cases, but the operation should not be undertaken before the child is two years of age. Neither should it be postponed too long, as, even if the children learn to talk at all, they acquire a 'twang' which, to say the least of it, is not agreeable, and which cannot be got rid of, if it is once really acquired.

The mode of feeding the infant.- -If the defect is but trifling, the infant will be able to suck, provided the mother's nipple be large, and the milk flows freely from it. If this is not the case, the difficulty may be obviated by using the nipple shield already spoken of.1 I have known this to answer the purpose admirably, when the mother had previously despaired of nursing her infant, the nipple being too small for it to grasp.

If, however, the defect exists in a still greater degree, feeding by means of the spoon must be resorted to; the greatest care being necessary as to the quantity, quality, and preparation of the food. For instruction upon these points, see' Artificial Feeding,' page 55.

Sect. 10.-Tongue-tied.

This arises from the bridle under the tongue being so short, or its attachment to the tongue extended so near the tips as to interfere with the motions of the organ in sucking, and, in after years, in speaking. It is a rare occurrence, although nothing is more common than for medical men to have infants brought to them supposed to be labouring under the above defect.

How its existence may be determined.-The best guide for a parent to determine whether it exist or not, is for her to watch whether the infant can protrude the tip of the tongue beyond the lips: if so, it will be able to suck a good nipple readily, and nothing need or ought to be done. No mother will unnecessarily expose her infant to an operation which, unless very carefully performed, is not altogether unattended with danger; and if she suspects any defect of this kind to exist, she has only to observe the circumstances mentioned above, to satisfy her mind upon the subject.

1 'Hints to Mothers,' p. 206.