curved metallic tube at the lower part of the cylinder beneath the inlet through which the reservoir is filled.

The air enters by a register on one side of the couveuse instead of at the end, as in Tarnier's apparatus. The other portions of the apparatus are the same as Tarnier's. The metallic cylinder is capable of holding ten liters

of liquid (a liter is a little over a quart). To start the apparatus, about five liters of boiling water should be poured in, after which three liters may be poured in every four hours. When ten liters are contained in the cylinder, the overflow-pipe carries off the excess. Auvard suggests having two vessels, capable of holding three

* Archives de Tocologie.

liters each, keeping one under the escape-pipe and the other over the fire, reheating the water in the vessel filled by the escape-pipe and having it in readiness for the next change. The two vessels may be thus used alternately, and but little time consumed in the heating of the apparatus as compared with that required in the use of Tarnier's invention.

To empty the cylinder, a rubber tube is attached to the escape-pipes, by which it is made to act as a siphon -a small quantity of water poured into the cylinder through the funnel being sufficient to start the liquid.

Before the couveuse was known premature babies were swaddled in cotton, in order to be kept sufficiently warm. The directions for doing this are as follows:

Take a square baby-blanket and place it diagonally on the table or bed. Turn down one corner for four inches distance, to come up over the baby's head. Spread over this blanket a lap of raw cotton. Have the baby's napkin and binder on, and a flannel undervest. Make a cap out of the cotton, fitting it over the baby's head and bringing it down well under the chin. Then roll the baby up in the cotton lap. Bring the blanket around this firmly, so as to hold it; the portion of the blanket on

FIG. 39.-Swaddled Baby.

the baby's right being brought over and tucked in on the left side, the portion on the left being correspondingly folded over toward the right. The corner of the blanket left at the feet is then folded up over the front, and the whole held in place by means of a strip of muslin bandage or ribbon. The bandage is first applied beneath the chin, crossed under the back, again crossed in front, the ends being brought forward to fasten in a bow-knot at the feet.

The great disadvantages of this method may be seen in the restriction it gives to the movements of the child's

limbs, and the difficulty of determining when the child's napkin needs changing, also the frequent exposure of the child during these changes to the ordinary atmosphere.

An ingenious method of maintaining the body-heat of a baby, and one readily accomplished in any household, is described as follows by Dr. Reynolds :

"A large basket should be thickly lined with heated blankets or other flannels. A number of bottles, filled with very hot water, should be so arranged around the sides of the receptacle that they can be removed and reinserted without disturbance of the infant. The child is wholly covered, with the exception of its face, with wellwarmed cotton batting, and is laid between the bottles; and the cradle is then covered with a thick blanket, a space at the end which corresponds to the child's head being left open to permit the entrance of air. A thermometer should be laid beside the child, and one or more of the bottles should be refilled with hot water whenever the temperature is seen to fall below 87° F. The water should not, on the other hand, be so hot as to raise the temperature of the contained air much above 90° F."

If the baby, be very weak, it may be necessary to stimulate it for two or three days by giving it a drop or two of brandy, with or without a drop of aromatic spirit of ammonia, in a teaspoonful of warm water once in two hours.

The length of time a premature baby should be kept in its close quarters is dependent upon the progress it makes, or until the gain in weight and strength brings it

up, as nearly as possible, to the standard of a baby at full term. A seven-months child, if strong enough, may be dressed when it is four weeks old, and allowed to nurse. Great care, however, must continue to be exercised until the child reaches full term.

The skin of a premature baby should be well greased after every bath, or some oil, as cotton or sweet oil, may be used, and will serve the double purpose of protecting the skin and giving nourishment by absorption.

The child should be fed every hour. As it is usually too weak to suck, it is safer to feed the baby with a spoon or with a dropper, to make sure of its obtaining a sufficient amount of food. From one to two teaspoonfuls should be given every hour. Breast milk is, of course, the best. It may be drawn from the mother's breast and fed to the child while warm. The nurse should introduce her little finger into the child's mouth and allow the milk to trickle slowly down the finger, so as to enter the mouth drop by drop, while the child sucks the finger. Should the mother have no milk, the first week's feeding recommended by Dr. Starr, or sterilized peptonized milk, diluted two-thirds with boiled and filtered water, should be used-if no wet-nurse can be had as a substitute.

Gavage. Should the baby drink badly and throw up a large proportion of the liquid given to it, "gavage may have to be resorted to. The physician must. authorize the nurse to carry this out, for she should never undertake it otherwise. The directions for prac