In connection with the exercises of practical life, it may be fitting to consider the matter of refection.

In order to protect the child's development, especially in neighbourhoods where standards of child hygiene are not yet prevalent in the home, it would be well if a large part at least of the child's diet could be entrusted to the school. It is well known to-day that the diet must be adapted to the physical nature of the child; and as the medicine of children is not the medicine of adults in reduced doses, so the diet must not be that of the adult in lesser quantitative proportions. For this reason I should prefer that even in the "Children's Houses" which are situated in tenements and from which little ones, being at home, can go up to eat with the family, school refection should be instituted. Moreover, even in the case of rich children, school refection would always be advisable until a scientific course in cooking shall have introduced into the wealthier families the habit of specialising in children's food.

The diet of little children must be rich in fats and sugar: the first for reserve matter and the second for plastic tissue. In fact, sugar is a stimulant to tissues in the process of formation.

As for the form of preparation, it is well that the alimentary substances should always be minced, because the child has not yet the capacity for completely masticating the food, and his stomach is still incapable of fulfilling the function of mincing food matter.

Consequently, soups, purÉes, and meat balls, should constitute the ordinary form of dish for the child's table.

The nitrogenous diet for a child from two or three years of age ought to be constituted chiefly of milk and eggs, but after the second year broths are also to be recommended. After three years and a half meat can be given; or, in the case of poor children, vegetables. Fruits are also to be recommended for children.

Perhaps a detailed summary on child diet may be useful, especially for mothers.

Method of Preparing Broth for Little Children. (Age three to six; after that the child may use the common broth of the family.) The quantity of meat should correspond to 1 gramme for every cubic centimetre of broth and should be put in cold water. No aromatic herbs should be used, the only wholesome condiment being salt. The meat should be left to boil for two hours. Instead of removing the grease from the broth it is well to add butter to it, or, in the case of the poor, a spoonful of olive oil; but substitutes for butter, such as margerine, etc., should never be used. The broth must be prepared fresh; it would be well, therefore, to put the meat on the fire two hours before the meal, because as soon as broth is cool there begins to take place a separation of chemical substances, which are injurious to the child and may easily cause diarrhea.

Soups. A very simple soup, and one to be highly recommended for children, is bread boiled in salt water or in broth and abundantly seasoned with oil. This is the classic soup of poor children and an excellent means of nutrition. Very like this, is the soup which consists of little cubes of bread toasted in butter and allowed to soak in the broth which is itself fat with butter. Soups of grated bread also belong in this class.

Pastine,[10] especially the glutinous pastine, which are of the same nature, are undoubtedly superior to the others for digestibility, but are accessible only to the privileged social classes.

The poor should know how much more wholesome is a broth made from remnants of stale bread, than soups of coarse spaghetti—often dry and seasoned with meat juice. Such soups are most indigestible for little children.

Excellent soups are those consisting of purÉes of vegetables (beans, peas, lentils). To-day one may find in the shops dried vegetables especially adapted for this sort of soups. Boiled in salt water, the vegetables are peeled, put to cool and passed through a sieve (or simply compressed, if they are already peeled). Butter is then added, and the paste is stirred slowly into the boiling water, care being taken that it dissolves and leaves no lumps.

Vegetable soups can also be seasoned with pork. Instead of broth, sugared milk may be the base of vegetable purÉes.

I strongly recommend for children a soup of rice boiled in broth or milk; also cornmeal broth, provided it be seasoned with abundant butter, but not with cheese. (The porridge form—polenta, really cornmeal mush, is to be highly recommended on account of the long cooking.)

The poorer classes who have no meat-broth can feed their children equally well with soups of boiled bread and porridge seasoned with oil.

Milk and Eggs. These are foods which not only contain nitrogenous substances in an eminently digestible form, but they have the so-called enzymes which facilitate assimilation into the tissues, and, hence, in a particular way, favour the growth of the child. And they answer so much the better this last most important condition if they are fresh and intact, keeping in themselves, one may say, the life of the animals which produced them.

Milk fresh from the cow, and the egg while it is still warm, are assimilable to the highest degree. Cooking, on the other hand, makes the milk and eggs lose their special conditions of assimilability and reduces the nutritive power in them to the simple power of any nitrogenous substance.

To-day, consequently, there are being founded special dairies for children where the milk produced is sterile; the rigorous cleanliness of the surroundings in which the milk-producing animals live, the sterilisation of the udder before milking, of the hands of the milker, and of the vessels which are to contain the milk, the hermetic sealing of these last, and the refrigerating bath immediately after the milking, if the milk is to be carried far,—otherwise it is well to drink it warm, procure a milk free from bacteria which, therefore, has no need of being sterilised by boiling, and which preserves intact its natural nutritive powers.

As much may be said of eggs; the best way of feeding them to a child is to take them still warm from the hen and have him eat them just as they are, and then digest them in the open air. But where this is not practicable, eggs must be chosen fresh, and barely heated in water, that is to say, prepared À la coque.

All other forms of preparation, milk-soup, omelettes, and so forth, do, to be sure, make of milk and eggs an excellent food, more to be recommended than others; but they take away the specific properties of assimilation which characterise them.

Meat. All meats are not adapted to children, and even their preparation must differ according to the age of the child. Thus, for example, children from three to five years of age ought to eat only more or less finely-ground meats, whereas at the age of five children are capable of grinding meat completely by mastication; at that time it is well to teach the child accurately how to masticate because he has a tendency to swallow food quickly, which may produce indigestion and diarrhea.

This is another reason why school-refection in the "Children's Houses" would be a very serviceable as well as convenient institution, as the whole diet of the child could then be rationally cared for in connection with the educative system of the Houses.

The meats most adapted to children are so-called white meats, that is, in the first place, chicken, then veal; also the light flesh of fish, (sole, pike, cod).

After the age of four, filet of beef may also be introduced into the diet, but never heavy and fat meats like that of the pig, the capon, the eel, the tunny, etc., which are to be absolutely excluded along with mollusks and crustaceans, (oysters, lobsters), from the child's diet.

Croquettes made of finely ground meat, grated bread, milk, and beaten eggs, and fried in butter, are the most wholesome preparation. Another excellent preparation is to mould into balls the grated meat, with sweet fruit-preserve, and eggs beaten up with sugar.

At the age of five, the child may be given breast of roast fowl, and occasionally veal cutlet or filet of beef.

Boiled meat must never be given to the child, because meat is deprived of many stimulating and even nutritive properties by boiling and rendered less digestible.

Nerve Feeding Substances. Besides meat a child who has reached the age of four may be given fried brains and sweetbreads, to be combined, for example, with chicken croquettes.

Milk Foods. All cheeses are to be excluded from the child's diet.

The only milk product suitable to children from three to six years of age is fresh butter.

Custard. Custard is also to be recommended provided it be freshly prepared, that is immediately before being eaten, and with very fresh milk and eggs: if such conditions cannot be rigorously fulfilled, it is preferable to do without custard, which is not a necessity.

Bread. From what we have said about soups, it may be inferred that bread is an excellent food for the child. It should be well selected; the crumb is not very digestible, but it can be utilised, when it is dry, to make a bread broth; but if one is to give the child simply a piece of bread to eat, it is well to offer him the crust, the end of the loaf. Bread sticks are excellent for those who can afford them.

Bread contains many nitrogenous substances and is very rich in starches, but is lacking in fats; and as the fundamental substances of diet are, as is well known, three in number, namely, proteids, (nitrogenous substances), starches, and fats, bread is not a complete food; it is necessary therefore to offer the child buttered bread, which constitutes a complete food and may be considered as a sufficient and complete breakfast.

Green Vegetables. Children must never eat raw vegetables, such as salads and greens, but only cooked ones; indeed they are not to be highly recommended either cooked or raw, with the exception of spinach which may enter with moderation into the diet of children.

Potatoes prepared in a purÉe with much butter form, however, an excellent complement of nutrition for children.

Fruits. Among fruits there are excellent foods for children. They too, like milk and eggs, if freshly gathered, retain a living quality which aids assimilation.

As this condition, however, is not easily attainable in cities, it is necessary to consider also the diet of fruits which are not perfectly fresh and which, therefore, should be prepared and cooked in various ways. All fruits are not to be advised for children; the chief properties to be considered are the degree of ripeness, the tenderness and sweetness of the pulp, and its acidity. Peaches, apricots, grapes, currants, oranges, and mandarins, in their natural state, can be given to little children with great advantage. Other fruits, such as pears, apples, plums, should be cooked or prepared in syrup.

Figs, pineapples, dates, melons, cherries, walnuts, almonds, hazelnuts, and chestnuts, are excluded for various reasons from the diet of early childhood.

The preparation of fruit must consist in removing from it all indigestible parts, such as the peel, and also such parts as the child inadvertently may absorb to his detriment, as, for example, the seed.

Children of four or five should be taught early how carefully the seeds must be thrown away and how the fruits are peeled. Afterwards, the child so educated may be promoted to the honour of receiving a fine fruit intact, and he will know how to eat it properly.

The culinary preparation of fruits consists essentially in two processes: cooking, and seasoning with sugar.

Besides simple cooking, fruits may be prepared as marmalades and jellies, which are excellent but are naturally within the reach of the wealthier classes only. While jellies and marmalades may be allowed, candied fruits,—on the other hand,—marrons glacÉs, and the like, are absolutely excluded from the child's diet.

Seasonings. An important phase of the hygiene of child diet concerns seasonings—with a view to their rigorous limitation. As I have already indicated, sugar and some fat substances along with kitchen salt (sodium chloride) should constitute the principal part of the seasonings.

To these may be added organic acids (acetic acid, citric acid) that is, vinegar and lemon juice; this latter can be advantageously used on fish, on croquettes, on spinach, etc.

Other condiments suitable to little children are some aromatic vegetables like garlic and rue which disinfect the intestines and the lungs, and also have a direct anthelminthic action.

Spices, on the other hand, such as pepper, nutmeg, cinnamon, clove, and especially mustard, are to be absolutely abolished.

Drinks. The growing organism of the child is very rich in water, and, hence, needs a constant supply of moisture. Among the beverages, the best, and indeed the only one, to be unreservedly advised is pure fresh spring water. To rich children might be allowed the so-called table waters which are slightly alkaline, such as those of San Gemini, Acqua Claudia, etc., mixed with syrups, as, for example, syrup of black cherry.

It is now a matter of general knowledge that all fermented beverages, and those exciting to the nervous system, are injurious to children; hence, all alcoholic and caffeic beverages are absolutely eliminated from child diet. Not only liquors, but wine and beer, ought to be unknown to the child's taste, and coffee and tea should be inaccessible to childhood.

The deleterious action of alcohol on the child organism needs no illustration, but in a matter of such vital importance insistent repetition is never superfluous. Alcohol is a poison especially fatal to organisms in the process of formation. Not only does it arrest their total development (whence infantilism, idiocy), but also predisposes the child to nervous maladies (epilepsy, meningitis), and to maladies of the digestive organs, and metabolism (cirrhosis of the liver, dyspepsia, anÆmia).

If the "Children's Houses" were to succeed in enlightening the people on such truths, they would be accomplishing a very lofty hygienic work for the new generations.

Instead of coffee, children may be given roasted and boiled barley, malt, and especially chocolate which is an excellent child food, particularly when mixed with milk.

DISTRIBUTION OF THE MEALS

Another chapter of child diet concerns the distribution of the meals. Here, one principle must dominate, and must be diffused, among mothers, namely, that the children shall be kept to rigorous meal hours in order that they may enjoy good health and have excellent digestion. It is true that there prevails among the people (and it is one of the forms of maternal ignorance most fatal to children) the prejudice that children in order to grow well must be eating almost continuously, without regularity, nibbling almost habitually a crust of bread. On the contrary, the child, in view of the special delicacy of his digestive system, has more need of regular meals than the adult has. It seems to me that the "Children's Houses" with very prolonged programmes are, for this reason, suitable places for child culture, as they can direct the child's diet. Outside of their regular meal hours, children should not eat.

In a "Children's House" with a long programme there ought to be two meals, a hearty one about noon, and a light one about four in the afternoon.

At the hearty meal, there should be soup, a meat dish, and bread, and, in the case of rich children, also fruits or custard, and butter on the bread.

At the four o'clock meal there should be prepared a light lunch, which from a simple piece of bread can range to buttered bread, and to bread accompanied by a fruit marmalade, chocolate, honey, custard, etc. Crisp crackers, biscuits, and cooked fruits, etc., might also be usefully employed. Very suitably the lunch might consist of bread soaked in milk or an egg À la coque with bread sticks, or else of a simple cup of milk in which is dissolved a spoonful of Mellin's Food. I recommend Mellin's Food very highly, not only in infancy, but also much later on account of its properties of digestibility and nutrition, and on account of its flavour, which is so pleasing to children.

Mellin's Food is a powder prepared from barley and wheat, and containing in a concentrated and pure state the nutritive substances proper to those cereals; the powder is slowly dissolved in hot water in the bottom of the same cup which is to be used for drinking the mixture, and very fresh milk is then poured on top.

The child would take the other two meals in his own home, that is, the morning breakfast and the supper, which latter must be very light for children so that shortly after they may be ready to go to bed. On these meals it would be well to give advice to mothers, urging them to help complete the hygienic work of the "Children's Houses," to the profit of their children.

The morning breakfast for the rich might be milk and chocolate, or milk and extract of malt, with crackers, or, better, with toasted bread spread with butter or honey; for the poor, a cup of fresh milk, with bread.

For the evening meal, a soup is to be advised (children should eat soups twice a day), and an egg À la coque or a cup of milk; or rice soup with a base of milk, and buttered bread, with cooked fruits, etc.

As for the alimentary rations to be calculated, I refer the reader to the special treatises on hygiene: although practically such calculations are of no great utility.

In the "Children's Houses," especially in the case of the poor, I should make extensive use of the vegetable soups and I should have cultivated in the garden plots vegetables which can be used in the diet, in order to have them plucked in their freshness, cooked, and enjoyed. I should try, possibly, to do the same for the fruits, and, by the raising of animals, to have fresh eggs and pure milk. The milking of the goats could be done directly by the larger children, after they had scrupulously washed their hands. Another important educative application which school-refection in the "Children's Houses" has to offer, and which concerns "practical life," consists in the preparing of the table, arranging the table linen, learning its nomenclature, etc. Later, I shall show how this exercise can gradually increase in difficulty and constitute a most important didactic instrument.

It is sufficient to intimate here that it is very important to teach the children to eat with cleanliness, both with respect to themselves and with respect to their surroundings (not to soil the napkins, etc.), and to use the table implements (which, at least, for the little ones, are limited to the spoon, and for the larger children extended to the fork and knife).

[10] Those very fine forms of vermicelli used in soups.