[1] A notable exception is the "Boston Cook Book."

[2] Although in some hospitals it is not practicable for a nurse to do much cooking for her patients, she has the control and distribution of the food which is prepared.

[3] Carbonic acid is composed of one part of carbon and two parts of oxygen. Its symbol is CO₂. One volume of hydrogen united with one volume of chlorin forms hydrochloric acid, HCl. Common salt, or sodium chlorid, is composed of one part sodium and one part chlorin. Symbol, NaCl.

[4] Oxygen is often called the supporter of combustion, but it is no more so than the carbon and hydrogen of fuels, since they are necessary for a fire.

[5] Hydrogen is 14.44 times lighter than air.

[6] See Eliot and Storer's "Chemistry," the revised edition, edited by Nichols, and the "Elementary Text-book of Chemistry," by Mixter.

[7] Mattieu Williams, in "Chemistry of Cookery."

[8] The carbonic acid breathed in has united with the lime, thus leaving the water without excess of it.

[9] As a general thing water does not contain organisms that form spores.

[10] Atwater.

[11] The decline in the sardine trade during the last few years is accounted for by the fact that cotton-seed oil has so largely replaced olive-oil in the packing of these fish. People who once regarded them as a great delicacy no longer find them satisfying.

[12] This is not the first instance of the discovery of organisms in hail; but Dr. Abbott, if not the first, is one of the first bacteriologists to demonstrate the fact in this country.

[13] Parkes's "Practical Hygiene."

[14] For a detailed description of this method of heating and ventilation, see the report of the Johns Hopkins Hospital for the year 1891.

[15] Variations in the composition of cow's milk (300 analyses):

[16] The following is the police order for milk, published in Darmstadt, 1879: (1) All milk must have a specific gravity of 1.029–1.033. (2) When skimmed it must have a specific gravity of 1.033. (3) All milk with a specific gravity under 1.027 is to be considered as watered and immediately confiscated. (4) All milk with specific gravity over 1.027, if after twenty-four hours standing and skimming the specific gravity is under 1.033, must also be confiscated, also all skimmed milk with a specific gravity under 1.033. (5) All milk must be considered skimmed which has less than 2.8 per cent. of fat.

[17] See article on the Feeding of Children.

[18] Spores may be further described as resistant forms which some organisms assume in times of danger, or lack of nourishment for the purpose of preserving their lives. Not all organisms form spores.

[19] It is supposed, but I think not yet demonstrated, that bacteria are among the transforming agents of our food, in the alimentary canal. Organisms in the saliva have been isolated and found to produce substances which will partially digest starch.

[20] Flint's "Physiology."

[21] It is possible that albumen and fibrin are acted upon by some of the juices secreted in the mouth.

[22] The body loses each day, in the performance of its ordinary and usual functions, about nine pounds of matter (Martin); therefore, that amount of income of food, water, and air will be needed in every twenty-four hours.

[23] Prof. Atwater, in "The Century Magazine," 1887–88.

[24] Hemoglobin, the red coloring matter of the blood, contains albumen.

[25] Protein may be converted into fat; but although this will happen, it will not do to depend upon it for the supply in the nutrition of the body; for either it cannot be formed in sufficient quantity, or the excess of nitrogen acts as a poison. The body suffers unless a due amount of fat as such be taken. (Martin.)

[26] By regulating the amount of fat taken each day with food, so that a little less than is needed is consumed, one may reduce the amount of fat of the body and become thin, or reduce an excess of fat without injury to health. The process must be gradual, and continued for a number of months. Bismarck, by the advice of his physician, reduced himself in this way without loss of energy or any ill feeling.

[27] Flint's "Physiology."

[28] Parkes.

[29] Martin.

[30] Martin.

[31] Composition of oatmeal:

From Prof. Mott's Chart of the Composition, Digestibility, and Nutritive Value of Food.

[32] For a further account of micro-organisms in milk, see the chapter on Milk.

[33] George Kennan, in his accounts of his perilous journeyings through Siberia, bears ample testimony to the comforting effects of hot tea. Often when he and his companion were chilled through, and almost dead with cold and fatigue, after many hours' travel over the frozen snows, they were revived by draughts of hot tea provided at the stations.

[34] The ash of tea contains potash, soda, magnesia, phosphoric acid, chlorin, carbonic acid, iron, silica, and traces of manganese.

[35]

[36] Another analysis is that of Payen, the distinguished French chemist.

Pohl found the proportion of starch, judging by specific gravity in different varieties, to be as follows: 16.38%, 17.11%, 18.43%, 18.95%, 20.45%, 21.32%, 24.14%.

Dr. Smith's "Food."

[37] Mattieu Williams.

[38] From actual experiment.

[39] From Mrs. Lincoln's "Boston Cook Book."

[40] Pink sugar may be made by putting a few drops of carmine into a cup of powdered sugar, and sifting it several times until the carmine is entirely distributed through it.

[41] Mrs. Richards.

[42] A portion of the starch and sugar is consumed to feed the growing yeast. It has been estimated that about 1 7 of a barrel of flour is lost in raising bread—that is, that amount is consumed by the yeast used.

[43] Oven thermometers may be obtained of Joseph Davis & Co., Fitzroy Works, London, S. E., England. 400° Fahr. is a good temperature for the first fifteen minutes. Some writers give 380°, but the higher temperature is better, provided it can be gradually decreased; it should not fall below 250° until the loaf is done.

[44] There is, of course, an exception in the case of the use of milk for young children, it being a perfect food for them during the first year or year and a half of life.

[45] In England it is the custom to serve eggs in the shell, and it is considered bad form to open them, but in America the latter way is general; for an invalid there is no question but that it is the most convenient way to do.

[46] The spatters should be soaked in boiling water for a few minutes, and then in cold water, to prevent the sticking of the butter.

[47] It should not be inferred from this that mother's milk is the best under all circumstances. It not infrequently happens that a mother, disregarding all indications to the contrary, will continue to nurse her baby after it has become disastrous both to herself and the infant to do so. If a baby remains puny, and the mother is exhausted and languid without any known cause, it is the part of wisdom to call in the aid of a physician, and have the milk analyzed. Good and careful feeding is infinitely better than nursing a baby upon impoverished milk, even if the quantity seems sufficient. A mother, in nursing her child, should do so at stated regular intervals. If it is injurious for a grown person to eat at odd times all day long, it is far more injurious for an infant. It will not hurt a child to be occasionally hungry, or even to cry, whereas it will hurt it seriously and perhaps induce life-long dyspepsia if food is introduced into the stomach while there yet remains in it that previously taken in an undigested, or partly digested, condition. The cry which a young mother thinks indicates hunger, and hopes to allay by feeding, is often only a dyspeptic pain, which is increased by the very means she takes to lessen it.

[48] The milk of goats and asses is said to be more easily digested than cow's milk, but is procurable only in exceptional cases.

[49] From Uffelmann's "Hygiene of the Child."

[50] See chapter on Milk.

[51] Vessels for holding milk may be made sterile by boiling them in water for fifteen minutes. Glass is best.

[52] A low temperature retards the growth of micro-organisms.

[53] Test for reaction, fat, and specific gravity. See article on Milk.

[54] The following mineral substances occur in both cow's and woman's milk: potassa, soda, lime, magnesia, iron, phosphoric acid, sulphuric acid, and chlorin.

[55] It is worthy of notice, in this connection, that children have been known to be made ill by drinking water which has stood for a length of time—such water containing great numbers of bacteria, but none of the so-called disease-producing organisms. The same water, when boiled, produced no ill effects.

[56] Stated by Sedgwick.

[57] Welsh.

[58] Since writing the above I have learned that Prof. Vaughan has isolated a poisonous matter—the product of the growth of certain organisms which multiply readily in milk—which caused active vomiting, purging, collapse, and death when injected into the lower animals.

[59] In England and America many cases of scarlatina, typhoid fever, and diphtheria have been traced to the milk supply. But there is no satisfactory evidence that those diseases were transmitted from the cow; more probably the milk, which is an especially good nutritive medium for bacteria, became infected after leaving the cow. In October, 1891, an epidemic of diphtheria prevailed in Melrose, Mass. Thirty-three cases were reported. On investigation it was found that every case could be traced to the milk supply. The farm from which it came was situated in an adjoining town, and the family of the dealer had been afflicted with diphtheria, two of the children having died. The use of the milk was, of course, promptly stopped.

[60] A simple and inexpensive apparatus for sterilizing milk consists of a covered tin kettle ten inches in height by eight inches in diameter, a wire basket, which fits easily into the kettle, supplied with supports or legs projecting one and a half inches from the bottom, one dozen eight-ounce nursing-bottles, and a bundle of fresh cotton wadding. The whole apparatus, costing about $1.25, is kept in most drug stores.

Milk for twenty-four hours' use is properly sweetened and diluted with water in a clean pitcher, and as much of this as the child will take at one feeding is poured into each bottle, and the bottle stopped with cotton wadding, which should fit only moderately tight in the neck of the bottle. The kettle is filled to the depth of one half to one inch with water, the basket containing the bottles placed in it, the kettle covered and placed over a fire until the steam comes out from the sides of the top for half an hour, when the basket containing the bottles should be removed and put in a cool place. When the milk is to be used, it should be heated by placing a bottle in warm water for a few minutes. The cotton is then removed, and a sterilized nipple attached. After the feeding the bottle is cleansed and kept in an inverted position until used again. The above directions are those of Dr. Booker, specialist of children's diseases, Johns Hopkins Hospital.

[61] In the Walker-Gordon Milk Laboratory, in Boston, milk is sterilized at 175° to 180° Fahr. for fifteen minutes, and it is claimed that this temperature gives the best results for milk to be used within twenty-four hours. If the milk has to be kept a longer time, a higher temperature is necessary, as only the bacteria and not the spores are destroyed by 175° Fahr.

Machines are in use in France which will heat great quantities of milk to about 155° Fahr. and then rapidly cool it. Not all, but nearly all, forms of bacteria likely to be found in milk are destroyed at the temperature of 155°, and the good flavor of the milk is not injured. Such milk is known as Pasteurized milk.

[62] See the works of Drs. Louis Starr, Uffelmann, and Jacobi.

[63] The amount of condensation in preserved milk may be easily ascertained by noting the amount of water which it is necessary to add in order to make its specific gravity equal to that of ordinary milk.

[64] To prepare whey: 1 pint of milk mixed with 1 teaspoon of liquid rennet. Set in a warm place until the curd is formed; then break the curd and put it into a cloth or a wire strainer to drain.

[65] To make barley jelly: Boil two tablespoons of pearl barley in a pint of water for two hours. Strain. It will form a tender jelly.

[66] The condensed cream of the Highland Co. may be used when other cream cannot be obtained.

[67] Malted milk, NestlÉ's food, Ridge's food, Imperial Granum, or barley-flour, may be used as attenuants.

[68] Enough for the whole day may be made by multiplying the rule by eight, dividing the quantity into eight bottles, and sterilizing all at once. Keep in a cool place until needed.

[69] Milk-sugar may be obtained without difficulty, and always, at a pharmacy. It is better for infants than cane-sugar, because it is a little easier of digestion.

[70]

[71] Although Mellin's food is made from grain, the starch in it has been changed in the process of manufacture into easily assimilated dextrine and sugar.

[72] The ordinary powdered cocoa, which has been deprived of oil. Dutch brands are good.

[73] Zwieback is a slightly sweetened and dried bread, which may be bought at any grocer's. It is like dried rusk.

[74] Bacon is very easy of digestion, and is a valuable form of fat for children four or five years old. Given with bread or potatoes, it will often be eaten when butter is refused.